Senate
Study
Bill
1181
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
MATHIS)
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
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Section
1.
Section
135.180,
subsection
3,
Code
2015,
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
5
centers
,
providers
of
mental
health
services
to
county
6
residents
pursuant
to
a
waiver
approved
under
section
225C.7,
7
subsection
3,
Code
2011,
designated
under
chapter
230A
and
8
hospital
psychiatric
units
that
are
located
in
mental
health
9
professional
shortage
areas.
10
Sec.
2.
Section
222.1,
Code
2015,
is
amended
to
read
as
11
follows:
12
222.1
Purpose
of
chapter
——
state
resource
centers
——
special
13
unit
at
state
mental
health
institute
.
14
1.
This
chapter
addresses
the
public
and
private
services
15
available
in
this
state
to
meet
the
needs
of
persons
with
an
16
intellectual
disability.
The
responsibility
of
counties,
of
17
the
mental
health
and
disability
service
regions
formed
by
18
counties,
and
of
the
state
for
the
costs
and
administration
of
19
publicly
funded
services
shall
be
as
set
out
in
section
222.60
20
and
other
pertinent
sections
of
this
chapter.
21
1.
2.
The
Glenwood
state
resource
center
and
the
Woodward
22
state
resource
center
are
established
and
shall
be
maintained
23
as
the
state’s
regional
resource
centers
for
the
purpose
of
24
providing
treatment,
training,
instruction,
care,
habilitation,
25
and
support
of
persons
with
an
intellectual
disability
or
other
26
disabilities
in
this
state,
and
providing
facilities,
services,
27
and
other
support
to
the
communities
located
in
the
region
28
being
served
by
a
state
resource
center.
In
addition,
the
29
state
resource
centers
are
encouraged
to
serve
as
a
training
30
resource
for
community-based
program
staff,
medical
students,
31
and
other
participants
in
professional
education
programs.
A
32
resource
center
may
request
the
approval
of
the
council
on
33
human
services
to
change
the
name
of
the
resource
center
for
34
use
in
communication
with
the
public,
in
signage,
and
in
other
35
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forms
of
communication.
1
2.
3.
A
special
intellectual
disability
unit
may
be
2
maintained
at
one
of
the
state
mental
health
institutes
for
the
3
purposes
set
forth
in
sections
222.88
to
222.91
.
4
Sec.
3.
Section
222.2,
subsection
3,
Code
2015,
is
amended
5
by
striking
the
subsection.
6
Sec.
4.
Section
222.2,
Code
2015,
is
amended
by
adding
the
7
following
new
subsections:
8
NEW
SUBSECTION
.
5A.
“Mental
health
and
disability
services
9
region”
means
a
mental
health
and
disability
services
region
10
formed
in
accordance
with
section
331.389.
11
NEW
SUBSECTION
.
5B.
“Regional
administrator”
means
the
12
regional
administrator
of
a
mental
health
and
disability
13
services
region,
as
defined
in
section
331.388.
14
Sec.
5.
Section
222.6,
Code
2015,
is
amended
to
read
as
15
follows:
16
222.6
State
districts.
17
The
administrator
shall
divide
the
state
into
two
districts
18
in
such
manner
that
one
of
the
resource
centers
shall
be
19
located
within
each
of
the
districts.
Such
districts
may
20
from
time
to
time
be
changed.
After
such
districts
have
been
21
established,
the
administrator
shall
notify
all
boards
of
22
supervisors,
regional
administrators
of
the
mental
health
and
23
disability
services
regions,
county
auditors,
and
clerks
of
24
the
district
courts
of
the
action.
Thereafter,
unless
the
25
administrator
otherwise
orders,
all
admissions
of
persons
with
26
an
intellectual
disability
from
a
district
shall
be
to
the
27
resource
center
located
within
such
district.
28
Sec.
6.
Section
222.12,
subsection
2,
Code
2015,
is
amended
29
to
read
as
follows:
30
2.
Notice
of
the
death
of
the
patient,
and
the
cause
31
of
death,
shall
be
sent
to
the
county
board
of
supervisors
32
regional
administrator
of
the
mental
health
and
disability
33
services
region
of
the
patient’s
county
of
residence
.
The
34
fact
of
death
with
the
time,
place,
and
alleged
cause
shall
be
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entered
upon
the
docket
of
the
court.
1
Sec.
7.
Section
222.13,
Code
2015,
is
amended
to
read
as
2
follows:
3
222.13
Voluntary
admissions.
4
1.
If
an
adult
person
is
believed
to
be
a
person
with
5
an
intellectual
disability,
the
adult
person
or
the
adult
6
person’s
guardian
may
submit
a
request
in
writing
through
the
7
central
point
of
coordination
process
for
the
county
board
8
of
supervisors
of
the
adult
person’s
county
of
residence
to
9
apply
to
the
department
and
the
superintendent
of
any
state
10
resource
center
for
the
voluntary
admission
of
the
adult
person
11
either
as
an
inpatient
or
an
outpatient
of
the
resource
center.
12
The
board
of
supervisors
shall,
on
forms
prescribed
by
the
13
department’s
administrator,
apply
to
the
superintendent
of
14
the
resource
center
in
the
district
for
the
admission
of
the
15
adult
person
to
the
resource
center.
If
the
expenses
of
the
16
person’s
admission
or
placement
are
payable
in
whole
or
in
17
part
by
the
person’s
county
of
residence,
application
for
the
18
admission
shall
be
made
through
the
regional
administrator
for
19
the
county.
An
application
for
admission
to
a
special
unit
of
20
any
adult
person
believed
to
be
in
need
of
any
of
the
services
21
provided
by
the
special
unit
under
section
222.88
may
be
made
22
in
the
same
manner
,
upon
request
of
the
adult
person
or
the
23
adult
person’s
guardian
.
The
superintendent
shall
accept
the
24
application
if
a
preadmission
diagnostic
evaluation
,
performed
25
through
the
central
point
of
coordination
process,
confirms
or
26
establishes
the
need
for
admission,
except
that
an
application
27
shall
not
be
accepted
if
the
institution
does
not
have
adequate
28
facilities
available
or
if
the
acceptance
will
result
in
an
29
overcrowded
condition.
30
2.
If
the
resource
center
has
no
does
not
have
an
31
appropriate
program
for
the
treatment
of
an
adult
or
minor
32
person
with
an
intellectual
disability
applying
under
this
33
section
or
section
222.13A
,
the
board
of
supervisors
regional
34
administrator
for
the
person’s
county
of
residence
or
the
35
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department,
as
applicable,
shall
arrange
for
the
placement
of
1
the
person
in
any
public
or
private
facility
within
or
without
2
the
state,
approved
by
the
director
of
the
department
of
human
3
services,
which
offers
appropriate
services
for
the
person
,
as
4
determined
through
the
central
point
of
coordination
process
.
5
If
the
expenses
of
the
placement
are
payable
in
whole
or
in
6
part
by
a
county,
the
placement
shall
be
made
by
the
regional
7
administrator
for
the
county.
8
3.
Upon
applying
for
admission
If
the
expenses
of
an
9
admission
of
an
adult
or
minor
person
to
a
resource
center
,
or
10
a
special
unit,
or
upon
arranging
for
of
the
placement
of
the
11
person
in
a
public
or
private
facility
are
payable
in
whole
12
or
in
part
by
a
county
,
the
board
of
supervisors
regional
13
administrator
for
the
county
shall
make
a
full
investigation
14
into
the
financial
circumstances
of
that
the
person
and
those
15
liable
for
that
the
person’s
support
under
section
222.78
16
to
determine
whether
or
not
any
of
them
are
able
to
pay
the
17
expenses
arising
out
of
the
admission
of
the
person
to
a
18
resource
center,
special
treatment
unit,
or
public
or
private
19
facility.
If
the
board
regional
administrator
finds
that
20
the
person
or
those
legally
responsible
for
the
person
are
21
presently
unable
to
pay
the
expenses,
the
board
shall
direct
22
that
regional
administrator
shall
pay
the
expenses
be
paid
23
by
payable
by
a
county
on
behalf
of
the
county.
The
board
24
regional
administrator
may
review
its
such
a
finding
at
any
25
subsequent
time
while
the
person
remains
at
the
resource
26
center,
or
is
otherwise
receiving
care
or
treatment
for
27
which
this
chapter
obligates
the
county
to
pay.
If
the
board
28
regional
administrator
finds
upon
review
that
the
person
or
29
those
legally
responsible
for
the
person
are
presently
able
to
30
pay
the
expenses,
the
finding
shall
apply
only
to
the
charges
31
incurred
during
the
period
beginning
on
the
date
of
the
review
32
and
continuing
thereafter,
unless
and
until
the
board
regional
33
administrator
again
changes
its
such
a
finding.
If
the
board
34
regional
administrator
finds
that
the
person
or
those
legally
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responsible
for
the
person
are
able
to
pay
the
expenses,
the
1
board
shall
direct
that
regional
administrator
shall
collect
2
the
charges
be
so
paid
to
the
extent
required
by
section
3
222.78
,
and
the
county
auditor
regional
administrator
shall
4
be
responsible
for
the
collection
payment
of
the
remaining
5
charges.
6
Sec.
8.
Section
222.13A,
Code
2015,
is
amended
to
read
as
7
follows:
8
222.13A
Voluntary
admissions
——
minors.
9
1.
If
a
minor
is
believed
to
be
a
person
with
an
10
intellectual
disability,
the
minor’s
parent,
guardian,
or
11
custodian
may
request
the
county
board
of
supervisors
to
12
apply
to
the
department
for
admission
of
the
minor
as
a
13
voluntary
patient
in
a
state
resource
center.
If
the
resource
14
center
does
not
have
appropriate
services
for
the
minor’s
15
treatment,
the
board
of
supervisors
department
may
arrange
for
16
the
admission
of
the
minor
in
a
public
or
private
facility
17
within
or
without
the
state,
approved
by
the
director
of
human
18
services,
which
offers
appropriate
services
for
the
minor’s
19
treatment.
20
2.
Upon
receipt
of
an
application
for
voluntary
admission
of
21
a
minor,
the
board
of
supervisors
department
shall
provide
for
22
a
preadmission
diagnostic
evaluation
of
the
minor
to
confirm
23
or
establish
the
need
for
the
admission.
The
preadmission
24
diagnostic
evaluation
shall
be
performed
by
a
person
who
meets
25
the
qualifications
of
a
qualified
intellectual
disability
26
professional
who
is
designated
through
the
central
point
of
27
coordination
process
by
the
department
.
28
3.
During
the
preadmission
diagnostic
evaluation,
the
29
minor
shall
be
informed
both
orally
and
in
writing
that
the
30
minor
has
the
right
to
object
to
the
voluntary
admission.
If
31
the
preadmission
diagnostic
evaluation
determines
that
the
32
voluntary
admission
is
appropriate
but
the
minor
objects
to
33
the
admission,
the
minor
shall
not
be
admitted
to
the
state
34
resource
center
unless
the
court
approves
of
the
admission.
A
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petition
for
approval
of
the
minor’s
admission
may
be
submitted
1
to
the
juvenile
court
by
the
minor’s
parent,
guardian,
or
2
custodian.
3
4.
As
soon
as
practicable
after
the
filing
of
a
petition
for
4
approval
of
the
voluntary
admission,
the
court
shall
determine
5
whether
the
minor
has
an
attorney
to
represent
the
minor
in
the
6
proceeding.
If
the
minor
does
not
have
an
attorney,
the
court
7
shall
assign
to
the
minor
an
attorney.
If
the
minor
is
unable
8
to
pay
for
an
attorney,
the
attorney
shall
be
compensated
by
9
the
county
at
an
hourly
rate
to
be
established
by
the
county
10
board
of
supervisors
regional
administrator
in
substantially
11
the
same
manner
as
provided
in
section
815.7
.
12
5.
The
court
shall
order
the
admission
of
a
minor
who
13
objects
to
the
admission,
only
after
a
hearing
in
which
it
14
is
shown
by
clear
and
convincing
evidence
that
both
of
the
15
following
circumstances
exist:
16
a.
The
minor
needs
and
will
substantially
benefit
from
17
treatment
or
habilitation.
18
b.
A
placement
which
involves
less
restriction
of
the
19
minor’s
liberties
for
the
purposes
of
treatment
or
habilitation
20
is
not
feasible.
21
Sec.
9.
Section
222.14,
Code
2015,
is
amended
to
read
as
22
follows:
23
222.14
Care
by
county
region
pending
admission.
24
If
the
institution
is
unable
to
receive
a
patient,
the
25
superintendent
shall
notify
the
county
board
of
supervisors
26
of
regional
administrator
for
the
county
from
which
the
27
application
in
behalf
of
the
prospective
patient
was
made
of
28
the
time
when
such
person
may
be
received.
Until
such
time
as
29
the
patient
is
able
to
be
received
by
the
institution,
or
when
30
application
has
been
made
for
admission
to
a
public
or
private
31
facility
as
provided
in
section
222.13
and
the
application
is
32
pending,
the
care
of
said
person
the
patient
shall
be
provided
33
as
arranged
by
the
county
board
of
supervisors
regional
34
administrator
.
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Sec.
10.
Section
222.59,
subsection
1,
unnumbered
paragraph
1
1,
Code
2015,
is
amended
to
read
as
follows:
2
Upon
receiving
a
request
from
an
authorized
requester,
the
3
superintendent
of
a
state
resource
center
shall
coordinate
4
with
the
central
point
of
coordination
process
regional
5
administrator
for
the
person’s
county
of
residence
or
6
the
department,
as
applicable,
in
assisting
the
requester
7
in
identifying
available
community-based
services
as
an
8
alternative
to
continued
placement
of
a
patient
in
the
state
9
resource
center.
For
the
purposes
of
this
section
,
“authorized
10
requester”
means
the
parent,
guardian,
or
custodian
of
a
minor
11
patient,
the
guardian
of
an
adult
patient,
or
an
adult
patient
12
who
does
not
have
a
guardian.
The
assistance
shall
identify
13
alternatives
to
continued
placement
which
are
appropriate
to
14
the
patient’s
needs
and
shall
include
but
are
not
limited
to
15
any
of
the
following:
16
Sec.
11.
Section
222.60,
subsections
1
and
2,
Code
2015,
are
17
amended
to
read
as
follows:
18
1.
All
necessary
and
legal
expenses
for
the
cost
of
19
admission
or
for
the
treatment,
training,
instruction,
care,
20
habilitation,
support,
and
transportation
of
persons
with
21
an
intellectual
disability,
as
provided
for
in
the
county
22
applicable
regional
service
system
management
plan
provisions
23
implemented
pursuant
to
section
331.439,
subsection
1
,
331.393
24
in
a
state
resource
center,
or
in
a
special
unit,
or
any
public
25
or
private
facility
within
or
without
the
state,
approved
by
26
the
director
of
human
services,
shall
be
paid
by
either:
27
a.
The
county
of
residence,
if
the
person
is
not
eligible
28
for
the
medical
assistance
program
and
the
service
is
covered
29
by
the
regional
service
system
management
plan
of
the
person’s
30
county
of
residence.
31
b.
The
state
when
if
the
person
is
eligible
for
the
medical
32
assistance
program,
or
if
the
person
is
a
resident
in
another
33
state
,
or
in
a
foreign
country
,
or
the
residence
is
unknown.
34
The
For
persons
addressed
by
this
paragraph
other
than
those
35
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eligible
for
the
medical
assistance
program,
the
payment
1
responsibility
shall
be
deemed
to
be
a
state
case.
2
2.
a.
Prior
to
the
regional
administrator
for
a
county
of
3
residence
approving
the
payment
of
expenses
for
a
person
under
4
this
section
,
the
county
regional
administrator
may
require
5
that
the
person
be
diagnosed
to
determine
if
the
person
has
6
an
intellectual
disability
or
that
the
person
be
evaluated
to
7
determine
the
appropriate
level
of
services
required
to
meet
8
the
person’s
needs
relating
to
an
intellectual
disability.
The
9
diagnosis
and
the
evaluation
may
be
performed
concurrently
and
10
shall
be
performed
by
an
individual
or
individuals
approved
11
by
the
regional
administrator
for
the
person’s
county
who
12
are
qualified
to
perform
the
diagnosis
or
the
evaluation.
13
Following
the
initial
approval
for
payment
of
expenses,
the
14
county
regional
administrator
may
require
that
an
evaluation
be
15
performed
at
reasonable
time
periods.
16
b.
The
cost
of
a
county-required
regional
17
administrator-required
diagnosis
and
an
evaluation
is
18
at
the
county’s
expense.
For
a
state
case,
the
state
may
apply
19
the
diagnosis
and
evaluation
provisions
of
this
subsection
at
20
the
state’s
expense.
21
c.
A
diagnosis
or
an
evaluation
under
this
section
may
be
22
part
of
a
county’s
central
point
of
coordination
process
under
23
section
331.440
,
diagnosis
and
assessment
process
implemented
24
by
the
applicable
regional
administrator,
provided
that
a
25
diagnosis
is
performed
only
by
an
individual
qualified
as
26
provided
in
this
section
.
27
Sec.
12.
Section
222.61,
Code
2015,
is
amended
to
read
as
28
follows:
29
222.61
Residency
determined.
30
When
a
county
receives
an
application
on
behalf
of
any
31
person
for
admission
to
a
resource
center
or
a
special
unit,
32
the
board
of
supervisors
shall
refer
the
determination
of
33
residency
to
the
central
point
of
coordination
process
regional
34
administrator
for
the
county
to
determine
and
certify
that
the
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residence
of
the
person
is
in
one
of
the
following:
1
1.
In
the
county
in
which
the
application
is
received.
2
2.
In
some
other
county
of
the
state.
3
3.
In
another
state
or
in
a
foreign
country.
4
4.
Unknown.
5
Sec.
13.
Section
222.62,
Code
2015,
is
amended
to
read
as
6
follows:
7
222.62
Residency
in
another
county.
8
When
the
board
of
supervisors
determines
through
the
central
9
point
of
coordination
process
regional
administrator
for
the
10
county
that
the
residency
of
the
person
is
other
than
in
the
11
county
in
which
the
application
is
received,
the
determination
12
shall
be
certified
to
the
superintendent
of
the
resource
13
center
or
the
special
unit
where
the
person
is
a
patient.
The
14
certification
shall
be
accompanied
by
a
copy
of
the
evidence
15
supporting
the
determination.
The
If
the
person
is
not
16
eligible
for
the
medical
assistance
program,
the
superintendent
17
shall
charge
the
expenses
already
incurred
and
unadjusted
,
and
18
all
future
expenses
of
the
patient,
to
the
county
certified
to
19
be
the
county
of
residency.
20
Sec.
14.
Section
222.63,
Code
2015,
is
amended
to
read
as
21
follows:
22
222.63
Finding
of
residency
——
objection.
23
A
board
of
supervisors’
certification
utilizing
the
24
central
point
of
coordination
process
through
the
regional
25
administrator
for
a
county
that
a
person’s
residency
is
26
in
another
county
shall
be
sent
to
the
auditor
of
regional
27
administrator
for
the
county
of
residence.
The
certification
28
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
29
determination.
The
auditor
of
regional
administrator
for
30
the
county
of
residence
shall
submit
the
certification
to
31
the
regional
governing
board
of
supervisors
of
the
auditor’s
32
for
the
county
and
it
shall
be
conclusively
presumed
that
33
the
patient
has
residency
in
that
county
unless
the
regional
34
administrator
for
that
county
disputes
the
determination
of
35
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_____
residency
as
provided
in
section
331.394
.
1
Sec.
15.
Section
222.64,
Code
2015,
is
amended
to
read
as
2
follows:
3
222.64
Foreign
state
or
country
or
unknown
residency.
4
If
the
residency
of
the
person
is
determined
by
a
regional
5
administrator
on
behalf
of
a
county
or
by
the
state
to
be
in
6
a
foreign
state
or
country
or
is
determined
to
be
unknown,
7
the
county
regional
administrator
or
the
state
shall
certify
8
the
determination
to
the
administrator
.
The
certification
9
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
10
determination.
The
care
of
the
person
shall
be
as
arranged
by
11
the
county
regional
administrator
or
the
state.
Application
12
for
admission
may
be
made
pending
investigation
by
the
13
administrator.
14
Sec.
16.
Section
222.73,
subsection
2,
paragraph
a,
15
subparagraph
(6),
Code
2015,
is
amended
to
read
as
follows:
16
(6)
A
county
shall
not
be
billed
for
the
cost
of
a
patient
17
unless
the
patient’s
admission
is
authorized
through
the
18
applicable
central
point
of
coordination
process
regional
19
administrator
.
The
state
resource
center
and
the
county
20
regional
administrator
shall
work
together
to
locate
21
appropriate
alternative
placements
and
services,
and
to
educate
22
patients
and
the
family
members
of
patients
regarding
such
23
alternatives.
24
Sec.
17.
Section
222.73,
subsection
2,
paragraph
b,
Code
25
2015,
is
amended
to
read
as
follows:
26
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
27
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
28
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
29
to
a
county
may
be
adjusted
in
for
a
fiscal
year
to
reflect
30
increased
costs
to
the
extent
of
the
percentage
increase
in
the
31
total
of
county
fixed
budgets
pursuant
to
the
allowed
growth
32
factor
adjustment
authorized
statewide
per
capita
expenditure
33
target
amount,
if
any
per
capita
growth
amount
is
authorized
by
34
the
general
assembly
for
that
fiscal
year
in
accordance
with
35
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section
331.439
331.424A
.
1
Sec.
18.
Section
222.74,
Code
2015,
is
amended
to
read
as
2
follows:
3
222.74
Duplicate
to
county.
4
When
certifying
to
the
department
amounts
to
be
charged
5
against
each
county
as
provided
in
section
222.73
,
the
6
superintendent
shall
send
to
the
county
auditor
and
the
7
regional
administrator
for
of
each
county
against
which
the
8
superintendent
has
so
certified
any
amount,
a
duplicate
of
9
the
certification
statement.
The
county
auditor
upon
receipt
10
of
the
duplicate
certification
statement
and
approval
by
the
11
regional
administrator
for
payment
of
the
certified
amount
12
shall
enter
it
to
the
credit
of
the
state
in
the
ledger
of
13
state
accounts,
and
shall
immediately
issue
a
notice
to
the
14
county
treasurer
authorizing
the
treasurer
to
transfer
the
15
amount
from
the
county
fund
to
the
general
state
revenue.
The
16
county
treasurer
shall
file
the
notice
as
authority
for
making
17
the
transfer
and
shall
include
the
amount
transferred
in
the
18
next
remittance
of
state
taxes
to
the
treasurer
of
state,
19
designating
the
fund
to
which
the
amount
belongs.
20
Sec.
19.
Section
222.92,
subsection
3,
paragraph
a,
Code
21
2015,
is
amended
to
read
as
follows:
22
a.
Moneys
received
by
the
state
from
billings
to
counties
23
and
regional
administrators
for
the
counties
.
24
Sec.
20.
Section
225.1,
Code
2015,
is
amended
to
read
as
25
follows:
26
225.1
Establishment
——
definitions
.
27
1.
There
shall
be
established
a
The
state
psychiatric
28
hospital
,
is
established.
The
hospital
shall
be
especially
29
designed,
kept,
and
administered
for
the
care,
observation,
30
and
treatment
of
those
persons
who
are
afflicted
with
abnormal
31
mental
conditions.
32
2.
For
the
purposes
of
this
chapter,
unless
the
context
33
otherwise
requires:
34
a.
“Mental
health
and
disability
services
region”
means
35
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a
mental
health
and
disability
services
region
approved
in
1
accordance
with
section
331.389.
2
b.
“Regional
administrator”
means
the
administrator
of
a
3
mental
health
and
disability
services
region,
as
defined
in
4
section
331.388.
5
Sec.
21.
Section
225.10,
unnumbered
paragraph
1,
Code
2015,
6
is
amended
to
read
as
follows:
7
Persons
suffering
from
mental
diseases
may
be
admitted
to
8
the
state
psychiatric
hospital
as
voluntary
public
patients
9
if
a
physician
authorized
to
practice
medicine
or
osteopathic
10
medicine
in
the
state
of
Iowa
files
information
with
the
board
11
of
supervisors
regional
administrator
of
the
person’s
county
12
of
residence
or
the
board’s
designee
,
stating
all
of
the
13
following:
14
Sec.
22.
Section
225.11,
Code
2015,
is
amended
to
read
as
15
follows:
16
225.11
Initiating
commitment
procedures.
17
When
a
court
finds
upon
completion
of
a
hearing
held
pursuant
18
to
section
229.12
that
the
contention
that
a
respondent
is
19
seriously
mentally
impaired
has
been
sustained
by
clear
and
20
convincing
evidence,
and
the
application
filed
under
section
21
229.6
also
contends
or
the
court
otherwise
concludes
that
it
22
would
be
appropriate
to
refer
the
respondent
to
the
state
23
psychiatric
hospital
for
a
complete
psychiatric
evaluation
and
24
appropriate
treatment
pursuant
to
section
229.13
,
the
judge
25
may
order
that
a
financial
investigation
be
made
in
the
manner
26
prescribed
by
section
225.13
.
If
the
costs
of
a
respondent’s
27
evaluation
or
treatment
are
payable
in
whole
or
in
part
by
28
a
county,
an
order
under
this
section
shall
be
for
referral
29
of
the
respondent
through
the
central
point
of
coordination
30
process
regional
administrator
for
the
respondent’s
county
of
31
residence
for
an
evaluation
and
referral
of
the
respondent
32
to
an
appropriate
placement
or
service,
which
may
include
33
the
state
psychiatric
hospital
for
additional
evaluation
or
34
treatment.
For
purposes
of
this
chapter
,
“central
point
of
35
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coordination
process”
means
the
same
as
defined
in
section
1
331.440
.
2
Sec.
23.
Section
225.12,
Code
2015,
is
amended
to
read
as
3
follows:
4
225.12
Voluntary
public
patient
——
physician’s
report.
5
A
physician
filing
information
under
section
225.10
shall
6
include
a
written
report
to
the
county
board
of
supervisors
7
or
the
board’s
designee
regional
administrator
for
the
8
county
of
residence
of
the
person
named
in
the
information
,
9
giving
a
history
of
the
case
as
will
be
likely
to
aid
in
the
10
observation,
treatment,
and
hospital
care
of
the
person
named
11
in
the
information
and
describing
the
history
in
detail.
12
Sec.
24.
Section
225.13,
Code
2015,
is
amended
to
read
as
13
follows:
14
225.13
Financial
condition.
15
The
county
board
of
supervisors
or
the
board’s
designee
16
regional
administrator
of
the
county
of
residence
of
a
person
17
being
admitted
to
the
state
psychiatric
hospital
is
responsible
18
for
investigating
the
financial
condition
of
a
person
being
19
admitted
to
the
state
psychiatric
hospital
the
person
and
of
20
those
legally
responsible
for
the
person’s
support.
21
Sec.
25.
Section
225.15,
Code
2015,
is
amended
to
read
as
22
follows:
23
225.15
Examination
and
treatment.
24
1.
When
a
respondent
arrives
at
the
state
psychiatric
25
hospital,
the
admitting
physician
shall
examine
the
respondent
26
and
determine
whether
or
not,
in
the
physician’s
judgment,
the
27
respondent
is
a
fit
subject
for
observation,
treatment,
and
28
hospital
care.
If,
upon
examination,
the
physician
decides
29
that
the
respondent
should
be
admitted
to
the
hospital,
the
30
respondent
shall
be
provided
a
proper
bed
in
the
hospital.
The
31
physician
who
has
charge
of
the
respondent
shall
proceed
with
32
observation,
medical
treatment,
and
hospital
care
as
in
the
33
physician’s
judgment
are
proper
and
necessary,
in
compliance
34
with
sections
229.13
to
229.16
.
After
the
respondent’s
35
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admission,
the
observation,
medical
treatment,
and
hospital
1
care
of
the
respondent
may
be
provided
by
a
mental
health
2
professional,
as
defined
in
section
228.1
,
who
is
licensed
as
a
3
physician,
advanced
registered
nurse
practitioner,
or
physician
4
assistant.
5
2.
A
proper
and
competent
nurse
shall
also
be
assigned
to
6
look
after
and
care
for
the
respondent
during
observation,
7
treatment,
and
care.
Observation,
treatment,
and
hospital
care
8
under
this
section
which
are
payable
in
whole
or
in
part
by
a
9
county
shall
only
be
provided
as
determined
through
the
central
10
point
of
coordination
process
regional
administrator
of
the
11
respondent’s
county
of
residence
.
12
Sec.
26.
Section
225.16,
subsection
1,
Code
2015,
is
amended
13
to
read
as
follows:
14
1.
If
the
county
board
of
supervisors
or
the
board’s
15
designee
regional
administrator
for
a
person’s
county
of
16
residence
finds
from
the
physician’s
information
which
was
17
filed
under
the
provisions
of
section
225.10
that
it
would
18
be
appropriate
for
the
person
to
be
admitted
to
the
state
19
psychiatric
hospital,
and
the
report
of
the
county
board
of
20
supervisors
or
the
board’s
designee
regional
administrator
made
21
pursuant
to
section
225.13
shows
that
the
person
and
those
who
22
are
legally
responsible
for
the
person
are
not
able
to
pay
the
23
expenses
incurred
at
the
hospital,
or
are
able
to
pay
only
a
24
part
of
the
expenses,
the
person
shall
be
considered
to
be
a
25
voluntary
public
patient
and
the
board
of
supervisors
regional
26
administrator
shall
direct
that
the
person
shall
be
sent
to
the
27
state
psychiatric
hospital
at
the
state
university
of
Iowa
for
28
observation,
treatment,
and
hospital
care.
29
Sec.
27.
Section
225.17,
subsection
2,
Code
2015,
is
amended
30
to
read
as
follows:
31
2.
When
the
respondent
arrives
at
the
hospital,
the
32
respondent
shall
receive
the
same
treatment
as
is
provided
for
33
committed
public
patients
in
section
225.15
,
in
compliance
with
34
sections
229.13
to
229.16
.
However,
observation,
treatment,
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and
hospital
care
under
this
section
of
a
respondent
whose
1
expenses
are
payable
in
whole
or
in
part
by
a
county
shall
2
only
be
provided
as
determined
through
the
central
point
of
3
coordination
process
regional
administrator
of
the
respondent’s
4
county
of
residence
.
5
Sec.
28.
Section
225.18,
Code
2015,
is
amended
to
read
as
6
follows:
7
225.18
Attendants.
8
The
county
board
of
supervisors
or
the
board’s
designee
9
regional
administrator
may
appoint
a
person
an
attendant
to
10
accompany
the
committed
public
patient
or
the
voluntary
public
11
patient
or
the
committed
private
patient
from
the
place
where
12
the
patient
may
be
to
the
state
psychiatric
hospital,
or
to
13
accompany
the
patient
from
the
hospital
to
a
place
as
may
be
14
designated
by
the
county
regional
administrator
.
If
a
patient
15
is
moved
pursuant
to
this
section
,
at
least
one
attendant
shall
16
be
of
the
same
gender
as
the
patient.
17
Sec.
29.
Section
225.19,
Code
2015,
is
amended
to
read
as
18
follows:
19
225.19
Compensation
for
attendant.
20
An
individual
appointed
by
the
county
board
of
supervisors
21
or
the
board’s
designee
regional
administrator
in
accordance
22
with
section
225.18
to
accompany
a
person
to
or
from
the
23
hospital
or
to
make
an
investigation
and
report
on
any
question
24
involved
in
the
matter
shall
receive
three
dollars
per
day
for
25
the
time
actually
spent
in
making
the
investigation
and
actual
26
necessary
expenses
incurred
in
making
the
investigation
or
27
trip.
This
section
does
not
apply
to
an
appointee
who
receives
28
fixed
compensation
or
a
salary.
29
Sec.
30.
Section
225.21,
Code
2015,
is
amended
to
read
as
30
follows:
31
225.21
Compensation
claims
——
filing
——
approval.
32
The
person
making
claim
to
compensation
under
section
225.19
33
shall
file
the
claim
in
the
office
of
the
county
auditor.
34
The
claim
is
subject
to
review
and
approval
by
the
board
of
35
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supervisors
or
the
board’s
designee
regional
administrator
for
1
the
county
.
2
Sec.
31.
Section
225.24,
Code
2015,
is
amended
to
read
as
3
follows:
4
225.24
Collection
of
preliminary
expense.
5
Unless
a
committed
private
patient
or
those
legally
6
responsible
for
the
patient’s
support
offer
to
settle
the
7
amount
of
the
claims,
the
county
auditor
of
the
person’s
county
8
of
residence
shall
collect,
by
action
if
necessary,
the
amount
9
of
all
claims
for
per
diem
and
expenses
that
have
been
approved
10
by
the
county
board
of
supervisors
or
the
board’s
designee
11
regional
administrator
for
the
county
and
paid
by
the
county
12
as
provided
under
section
225.21
.
Any
amount
collected
shall
13
be
credited
to
the
county
treasury
county’s
mental
health
and
14
disabilities
services
fund
created
in
accordance
with
section
15
331.424A
.
16
Sec.
32.
Section
225.27,
Code
2015,
is
amended
to
read
as
17
follows:
18
225.27
Discharge
——
transfer.
19
The
state
psychiatric
hospital
may,
at
any
time,
discharge
20
any
patient
as
recovered,
as
improved,
or
as
not
likely
to
21
be
benefited
by
further
treatment.
If
the
patient
being
so
22
discharged
was
involuntarily
hospitalized,
the
hospital
shall
23
notify
the
committing
judge
or
court
of
the
discharge
as
24
required
by
section
229.14
or
section
229.16
,
whichever
is
25
applicable
,
and
the
applicable
regional
administrator
.
Upon
26
receiving
the
notification,
the
court
shall
issue
an
order
27
confirming
the
patient’s
discharge
from
the
hospital
or
from
28
care
and
custody,
as
the
case
may
be,
and
shall
terminate
the
29
proceedings
pursuant
to
which
the
order
was
issued.
The
court
30
or
judge
shall,
if
necessary,
appoint
a
person
to
accompany
the
31
discharged
patient
from
the
state
psychiatric
hospital
to
such
32
place
as
the
hospital
or
the
court
may
designate,
or
authorize
33
the
hospital
to
appoint
such
attendant.
34
Sec.
33.
Section
225C.2,
subsection
2,
Code
2015,
is
amended
35
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by
striking
the
subsection.
1
Sec.
34.
Section
225C.5,
subsection
1,
paragraph
f,
Code
2
2015,
is
amended
to
read
as
follows:
3
f.
Two
members
shall
be
staff
members
of
regional
4
administrators
of
the
central
point
of
coordination
process
5
established
in
accordance
with
section
331.440
selected
from
6
nominees
submitted
by
the
community
services
affiliate
of
the
7
Iowa
state
association
of
counties.
8
Sec.
35.
Section
225C.6,
subsection
1,
paragraph
i,
9
subparagraph
(1),
Code
2015,
is
amended
to
read
as
follows:
10
(1)
The
extent
to
which
services
to
persons
with
11
disabilities
are
actually
available
to
persons
in
each
county
12
and
mental
health
and
disability
services
region
in
the
state
13
and
the
quality
of
those
services.
14
Sec.
36.
Section
225C.6,
subsection
1,
paragraph
m,
Code
15
2015,
is
amended
to
read
as
follows:
16
m.
Identify
disability
services
outcomes
and
indicators
to
17
support
the
ability
of
eligible
persons
with
a
disability
to
18
live,
learn,
work,
and
recreate
in
communities
of
the
persons’
19
choice.
The
identification
duty
includes
but
is
not
limited
to
20
responsibility
for
identifying,
collecting,
and
analyzing
data
21
as
necessary
to
issue
reports
on
outcomes
and
indicators
at
the
22
county
,
region,
and
state
levels.
23
Sec.
37.
Section
225C.13,
subsection
1,
Code
2015,
is
24
amended
to
read
as
follows:
25
1.
The
administrator
assigned,
in
accordance
with
section
26
218.1
,
to
control
the
state
mental
health
institutes
and
27
the
state
resource
centers
may
enter
into
agreements
under
28
which
a
facility
or
portion
of
a
facility
administered
by
the
29
administrator
is
leased
to
a
department
or
division
of
state
30
government,
a
county
or
group
of
counties,
a
mental
health
and
31
disability
services
region,
or
a
private
nonprofit
corporation
32
organized
under
chapter
504
.
A
lease
executed
under
this
33
section
shall
require
that
the
lessee
use
the
leased
premises
34
to
deliver
either
disability
services
or
other
services
35
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normally
delivered
by
the
lessee.
1
Sec.
38.
Section
225C.14,
Code
2015,
is
amended
to
read
as
2
follows:
3
225C.14
Preliminary
diagnostic
evaluation.
4
1.
Except
in
cases
of
medical
emergency,
a
person
shall
be
5
admitted
to
a
state
mental
health
institute
as
an
inpatient
6
only
after
a
preliminary
diagnostic
evaluation
performed
7
through
the
central
point
of
coordination
process
regional
8
administrator
of
the
person’s
county
of
residence
has
confirmed
9
that
the
admission
is
appropriate
to
the
person’s
mental
health
10
needs,
and
that
no
suitable
alternative
method
of
providing
the
11
needed
services
in
a
less
restrictive
setting
or
in
or
nearer
12
to
the
person’s
home
community
is
currently
available.
If
13
provided
for
through
the
central
point
of
coordination
process
14
regional
administrator
,
the
evaluation
may
be
performed
by
a
15
community
mental
health
center
or
by
an
alternative
diagnostic
16
facility.
The
policy
established
by
this
section
shall
be
17
implemented
in
the
manner
and
to
the
extent
prescribed
by
18
sections
225C.15
,
225C.16
and
225C.17
.
19
2.
As
used
in
this
section
and
sections
225C.15
,
225C.16
20
and
225C.17
,
the
term
“medical
emergency”
means
a
situation
21
in
which
a
prospective
patient
is
received
at
a
state
mental
22
health
institute
in
a
condition
which,
in
the
opinion
of
the
23
chief
medical
officer,
or
that
officer’s
physician
designee,
24
requires
the
immediate
admission
of
the
person
notwithstanding
25
the
policy
stated
in
subsection
1
.
26
Sec.
39.
Section
225C.15,
Code
2015,
is
amended
to
read
as
27
follows:
28
225C.15
County
implementation
of
evaluations.
29
The
board
of
supervisors
of
regional
administrator
for
a
30
county
shall
,
no
later
than
July
1,
1982,
require
that
the
31
policy
stated
in
section
225C.14
be
followed
with
respect
32
to
admission
of
persons
from
that
county
to
a
state
mental
33
health
institute.
A
community
mental
health
center
which
is
34
supported,
directly
or
in
affiliation
with
other
counties,
by
35
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that
county
may
perform
the
preliminary
diagnostic
evaluations
1
for
that
county,
unless
the
performance
of
the
evaluations
2
is
not
covered
by
the
agreement
entered
into
by
the
county
3
regional
administrator
and
the
center,
and
the
center’s
4
director
certifies
to
the
board
of
supervisors
regional
5
administrator
that
the
center
does
not
have
the
capacity
to
6
perform
the
evaluations,
in
which
case
the
board
of
supervisors
7
regional
administrator
shall
proceed
under
section
225C.17
.
8
Sec.
40.
Section
225C.16,
Code
2015,
is
amended
to
read
as
9
follows:
10
225C.16
Referrals
for
evaluation.
11
1.
The
chief
medical
officer
of
a
state
mental
health
12
institute,
or
that
officer’s
physician
designee,
shall
advise
13
a
person
residing
in
that
county
who
applies
for
voluntary
14
admission,
or
a
person
applying
for
the
voluntary
admission
15
of
another
person
who
resides
in
that
county,
in
accordance
16
with
section
229.41
,
that
the
board
of
supervisors
regional
17
administrator
for
the
county
has
implemented
the
policy
18
stated
in
section
225C.14
,
and
shall
advise
that
a
preliminary
19
diagnostic
evaluation
of
the
prospective
patient
be
sought,
20
if
that
has
not
already
been
done.
This
subsection
does
not
21
apply
when
voluntary
admission
is
sought
in
accordance
with
22
section
229.41
under
circumstances
which,
in
the
opinion
of
the
23
chief
medical
officer
or
that
officer’s
physician
designee,
24
constitute
a
medical
emergency.
25
2.
The
clerk
of
the
district
court
in
that
county
shall
26
refer
a
person
applying
for
authorization
for
voluntary
27
admission,
or
for
authorization
for
voluntary
admission
of
28
another
person,
in
accordance
with
section
229.42
,
to
the
29
appropriate
entity
designated
through
the
central
point
of
30
coordination
process
regional
administrator
of
the
person’s
31
county
of
residence
under
section
225C.14
for
the
preliminary
32
diagnostic
evaluation
unless
the
applicant
furnishes
a
written
33
statement
from
the
appropriate
entity
which
indicates
that
the
34
evaluation
has
been
performed
and
that
the
person’s
admission
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to
a
state
mental
health
institute
is
appropriate.
This
1
subsection
does
not
apply
when
authorization
for
voluntary
2
admission
is
sought
under
circumstances
which,
in
the
opinion
3
of
the
chief
medical
officer
or
that
officer’s
physician
4
designee,
constitute
a
medical
emergency.
5
3.
Judges
of
the
district
court
in
that
county
or
the
6
judicial
hospitalization
referee
appointed
for
that
county
7
shall
so
far
as
possible
arrange
for
the
entity
designated
8
through
the
central
point
of
coordination
process
regional
9
administrator
under
section
225C.14
to
perform
a
prehearing
10
examination
of
a
respondent
required
under
section
229.8,
11
subsection
3
,
paragraph
“b”
.
12
4.
The
chief
medical
officer
of
a
state
mental
health
13
institute
shall
promptly
submit
to
the
appropriate
entity
14
designated
through
the
central
point
of
coordination
process
15
regional
administrator
under
section
225C.14
a
report
of
the
16
voluntary
admission
of
a
patient
under
the
medical
emergency
17
clauses
provisions
of
subsections
1
and
2
.
The
report
shall
18
explain
the
nature
of
the
emergency
which
necessitated
the
19
admission
of
the
patient
without
a
preliminary
diagnostic
20
evaluation
by
the
designated
entity.
21
Sec.
41.
Section
225C.17,
Code
2015,
is
amended
to
read
as
22
follows:
23
225C.17
Alternative
diagnostic
facility.
24
If
a
county
is
not
served
by
a
community
mental
health
25
center
having
the
capacity
to
perform
the
required
preliminary
26
diagnostic
evaluations,
the
board
of
supervisors
regional
27
administrator
for
the
county
shall
arrange
for
the
evaluations
28
to
be
performed
by
an
alternative
diagnostic
facility
for
29
the
period
until
the
county
is
served
by
a
community
mental
30
health
center
with
the
capacity
to
provide
that
service.
An
31
alternative
diagnostic
facility
may
be
the
outpatient
service
32
of
a
state
mental
health
institute
or
any
other
mental
health
33
facility
or
service
able
to
furnish
the
requisite
professional
34
skills
to
properly
perform
a
preliminary
diagnostic
evaluation
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of
a
person
whose
admission
to
a
state
mental
health
institute
1
is
being
sought
or
considered
on
either
a
voluntary
or
an
2
involuntary
basis.
3
Sec.
42.
Section
225C.19,
subsection
3,
paragraphs
a,
b,
and
4
c,
Code
2015,
are
amended
to
read
as
follows:
5
a.
Standards
for
accrediting
or
approving
emergency
mental
6
health
crisis
services
providers.
Such
providers
may
include
7
but
are
not
limited
to
a
community
mental
health
center
8
designated
under
chapter
230A
,
a
provider
approved
in
a
waiver
9
adopted
by
the
commission
to
provide
services
to
a
county
10
in
lieu
of
a
community
mental
health
center,
a
unit
of
the
11
department
or
other
state
agency,
a
county,
a
mental
health
12
and
disability
services
region,
or
any
other
public
or
private
13
provider
who
meets
the
accreditation
or
approval
standards
for
14
an
emergency
mental
health
crisis
services
provider.
15
b.
Identification
by
the
division
of
geographic
regions,
16
groupings
of
mental
health
and
disability
services
regions,
17
service
areas,
or
other
means
of
distributing
and
organizing
18
the
emergency
mental
health
crisis
services
system
to
ensure
19
statewide
availability
of
the
services.
20
c.
Coordination
of
emergency
mental
health
crisis
services
21
with
all
of
the
following:
22
(1)
The
district
and
juvenile
courts.
23
(2)
Law
enforcement.
24
(3)
Judicial
district
departments
of
correctional
services.
25
(4)
County
central
point
of
coordination
processes
Mental
26
health
and
disability
services
regions
.
27
(5)
Other
mental
health,
substance
abuse,
and
co-occurring
28
mental
illness
and
substance
abuse
services
available
through
29
the
state
and
counties
to
serve
both
children
and
adults.
30
Sec.
43.
Section
225C.20,
Code
2015,
is
amended
to
read
as
31
follows:
32
225C.20
Responsibilities
of
counties
for
individual
case
33
management
services.
34
Individual
case
management
services
funded
under
medical
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assistance
shall
be
provided
by
the
department
except
when
a
1
county
or
a
consortium
of
counties
regional
administrator
for
a
2
county
contracts
with
the
department
to
provide
the
services.
3
A
county
or
consortium
of
counties
regional
administrator
4
may
contract
for
one
or
more
counties
of
the
region
to
be
5
the
provider
at
any
time
and
the
department
shall
agree
to
6
the
contract
so
long
as
the
contract
meets
the
standards
for
7
case
management
adopted
by
the
department.
The
county
or
8
consortium
of
counties
regional
administrator
may
subcontract
9
for
the
provision
of
case
management
services
so
long
as
the
10
subcontract
meets
the
same
standards.
A
county
board
of
11
supervisors
regional
administrator
may
change
the
provider
12
of
individual
case
management
services
at
any
time.
If
the
13
current
or
proposed
contract
is
with
the
department,
the
county
14
board
of
supervisors
regional
administrator
shall
provide
15
written
notification
of
a
change
at
least
ninety
days
before
16
the
date
the
change
will
take
effect.
17
Sec.
44.
Section
225C.54,
subsection
1,
Code
2015,
is
18
amended
to
read
as
follows:
19
1.
The
mental
health
services
system
for
children
and
youth
20
shall
be
initially
implemented
by
the
division
commencing
21
with
the
fiscal
year
beginning
July
1,
2008.
The
division
22
shall
begin
implementation
by
utilizing
a
competitive
bidding
23
process
to
allocate
state
block
grants
to
develop
services
24
through
existing
community
mental
health
centers
,
providers
25
approved
in
a
waiver
adopted
by
the
commission
to
provide
26
services
to
a
county
in
lieu
of
a
community
mental
health
27
center,
designated
under
chapter
230A
and
other
local
service
28
partners.
The
implementation
shall
be
limited
to
the
extent
of
29
the
appropriations
provided
for
the
children’s
system.
30
Sec.
45.
Section
226.1,
Code
2015,
is
amended
by
adding
the
31
following
new
subsection:
32
NEW
SUBSECTION
.
4.
For
the
purposes
of
this
chapter,
unless
33
the
context
otherwise
requires:
34
a.
“Administrator”
means
the
person
assigned
by
the
35
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director
of
human
services
to
control
the
state
mental
health
1
institutes.
2
b.
“Department”
means
the
department
of
human
services.
3
c.
“Mental
health
and
disability
services
region”
means
4
a
mental
health
and
disability
services
region
formed
in
5
accordance
with
section
331.389.
6
d.
“Regional
administrator”
means
the
regional
administrator
7
of
a
mental
health
and
disability
services
region,
as
defined
8
in
section
331.388.
9
Sec.
46.
Section
226.9C,
subsection
2,
paragraphs
a
and
c,
10
Code
2015,
are
amended
to
read
as
follows:
11
a.
A
county
may
split
the
The
charges
payable
by
a
12
county
may
be
split
between
the
county’s
mental
health
and
13
disabilities
services
fund
created
pursuant
to
section
331.424A
14
and
the
county’s
budget
for
substance
abuse
substance-related
15
disorder
expenditures.
16
c.
(1)
Prior
to
an
individual’s
admission
for
dual
17
diagnosis
treatment,
the
individual
shall
have
been
18
prescreened.
The
person
performing
the
prescreening
shall
19
be
either
the
mental
health
professional,
as
defined
in
20
section
228.1
,
who
is
contracting
with
the
county
central
21
point
of
coordination
process
regional
administrator
for
the
22
county’s
mental
health
and
disability
services
region
to
23
provide
the
prescreening
or
a
mental
health
professional
with
24
the
requisite
qualifications.
A
mental
health
professional
25
with
the
requisite
qualifications
shall
meet
all
of
the
26
following
qualifications:
is
a
mental
health
professional
as
27
defined
in
section
228.1
,
is
an
alcohol
and
drug
counselor
28
certified
by
the
nongovernmental
Iowa
board
of
substance
abuse
29
certification,
and
is
employed
by
or
providing
services
for
a
30
facility,
as
defined
in
section
125.2
.
31
(2)
Prior
to
an
individual’s
admission
for
dual
diagnosis
32
treatment,
the
individual
shall
have
been
screened
through
a
33
county’s
central
point
of
coordination
process
implemented
34
pursuant
to
section
331.440
regional
administrator
to
determine
35
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the
appropriateness
of
the
treatment.
1
Sec.
47.
Section
226.32,
Code
2015,
is
amended
to
read
as
2
follows:
3
226.32
Overcrowded
conditions.
4
The
administrator
shall
order
the
discharge
or
removal
5
from
the
hospital
of
incurable
and
harmless
patients
whenever
6
it
is
necessary
to
make
room
for
recent
cases.
If
a
patient
7
who
is
to
be
so
discharged
entered
the
hospital
voluntarily,
8
the
administrator
shall
notify
the
auditor
of
regional
9
administrator
for
the
county
interested
at
least
ten
days
in
10
advance
of
the
day
of
actual
discharge.
11
Sec.
48.
Section
226.34,
subsection
2,
Code
2015,
is
amended
12
to
read
as
follows:
13
2.
If
a
patient
in
a
mental
health
institute
dies
from
any
14
cause,
the
superintendent
of
the
institute
shall
within
three
15
days
of
the
date
of
death,
send
by
certified
mail
a
written
16
notice
of
death
to
all
of
the
following:
17
a.
The
decedent’s
nearest
relative.
18
b.
The
clerk
of
the
district
court
of
the
county
from
which
19
the
patient
was
committed.
20
c.
The
sheriff
of
the
county
from
which
the
patient
was
21
committed.
22
d.
The
regional
administrator
for
the
county
from
which
the
23
patient
was
committed.
24
Sec.
49.
Section
227.1,
Code
2015,
is
amended
to
read
as
25
follows:
26
227.1
Supervision
Definitions
——
supervision
.
27
1.
For
the
purposes
of
this
chapter,
unless
the
context
28
otherwise
requires:
29
a.
“Administrator”
means
the
person
assigned
by
the
director
30
of
human
services
in
the
appropriate
division
of
the
department
31
to
administer
mental
health
and
disability
services.
32
b.
“Department”
means
the
department
of
human
services.
33
c.
“Mental
health
and
disability
services
region”
means
34
a
mental
health
and
disability
services
region
formed
in
35
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accordance
with
section
331.389.
1
d.
“Regional
administrator”
means
the
regional
administrator
2
of
a
mental
health
and
disability
services
region,
as
defined
3
in
section
331.388.
4
2.
All
The
regulatory
requirements
for
county
and
private
5
institutions
wherein
where
persons
with
mental
illness
or
an
6
intellectual
disability
are
kept
admitted,
committed,
or
placed
7
shall
be
under
the
supervision
of
the
administrator.
8
Sec.
50.
Section
227.2,
subsection
1,
unnumbered
paragraph
9
1,
Code
2015,
is
amended
to
read
as
follows:
10
The
director
of
inspections
and
appeals
shall
make,
or
cause
11
to
be
made,
at
least
one
licensure
inspection
each
year
of
12
every
county
care
facility.
Either
the
administrator
of
the
13
division
or
the
director
of
the
department
of
inspections
and
14
appeals,
in
cooperation
with
each
other,
upon
receipt
of
a
15
complaint
or
for
good
cause,
may
make,
or
cause
to
be
made,
16
a
review
of
a
county
care
facility
or
of
any
other
private
17
or
county
institution
where
persons
with
mental
illness
or
18
an
intellectual
disability
reside.
A
licensure
inspection
19
or
a
review
shall
be
made
by
a
competent
and
disinterested
20
person
who
is
acquainted
with
and
interested
in
the
care
of
21
persons
with
mental
illness
and
persons
with
an
intellectual
22
disability.
The
objective
of
a
licensure
inspection
or
a
23
review
shall
be
an
evaluation
of
the
programming
and
treatment
24
provided
by
the
facility.
After
each
licensure
inspection
of
a
25
county
care
facility,
the
person
who
made
the
inspection
shall
26
consult
with
the
county
authorities
regional
administrator
27
for
the
county
in
which
the
facility
is
located
on
plans
and
28
practices
that
will
improve
the
care
given
patients
and
.
The
29
person
shall
also
make
recommendations
to
the
administrator
of
30
the
division
and
the
director
of
public
health
for
coordinating
31
and
improving
the
relationships
between
the
administrators
of
32
county
care
facilities,
the
administrator
of
the
division,
33
the
director
of
public
health,
the
superintendents
of
state
34
mental
health
institutes
and
resource
centers,
community
35
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mental
health
centers,
mental
health
and
disability
services
1
regions,
and
other
cooperating
agencies,
to
cause
improved
2
and
more
satisfactory
care
of
patients.
A
written
report
of
3
each
licensure
inspection
of
a
county
care
facility
under
this
4
section
shall
be
filed
by
the
person
with
the
administrator
5
of
the
division
and
the
director
of
public
health
and
shall
6
include:
7
Sec.
51.
Section
227.2,
subsection
1,
paragraph
f,
Code
8
2015,
is
amended
to
read
as
follows:
9
f.
The
recommendations
given
to
and
received
from
county
10
authorities
the
regional
administrator
on
methods
and
practices
11
that
will
improve
the
conditions
under
which
the
county
care
12
facility
is
operated.
13
Sec.
52.
Section
227.2,
subsection
2,
Code
2015,
is
amended
14
to
read
as
follows:
15
2.
A
copy
of
the
written
report
prescribed
by
subsection
16
1
shall
be
furnished
to
the
county
board
of
supervisors,
17
to
the
county
mental
health
and
intellectual
disability
18
coordinating
board
or
to
its
advisory
board
if
the
county
board
19
of
supervisors
constitutes
ex
officio
the
coordinating
board
20
regional
administrator
for
the
county
,
to
the
administrator
21
of
the
county
care
facility
inspected
and
to
its
certified
22
volunteer
long-term
care
ombudsman,
and
to
the
department
on
23
aging.
24
Sec.
53.
Section
227.4,
Code
2015,
is
amended
to
read
as
25
follows:
26
227.4
Standards
for
care
of
persons
with
mental
illness
or
an
27
intellectual
disability
in
county
care
facilities.
28
The
administrator,
in
cooperation
with
the
department
of
29
inspections
and
appeals,
shall
recommend
and
the
mental
health
30
and
disability
services
commission
created
in
section
225C.5
31
shall
adopt
,
or
amend
and
adopt,
standards
for
the
care
of
and
32
services
to
persons
with
mental
illness
or
an
intellectual
33
disability
residing
in
county
care
facilities.
The
standards
34
shall
be
enforced
by
the
department
of
inspections
and
appeals
35
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as
a
part
of
the
licensure
inspection
conducted
pursuant
to
1
chapter
135C
.
The
objective
of
the
standards
is
to
ensure
2
that
persons
with
mental
illness
or
an
intellectual
disability
3
who
are
residents
of
county
care
facilities
are
not
only
4
adequately
fed,
clothed,
and
housed,
but
are
also
offered
5
reasonable
opportunities
for
productive
work
and
recreational
6
activities
suited
to
their
physical
and
mental
abilities
and
7
offering
both
a
constructive
outlet
for
their
energies
and,
if
8
possible,
therapeutic
benefit.
When
recommending
standards
9
under
this
section
,
the
administrator
shall
designate
an
10
advisory
committee
representing
administrators
of
county
care
11
facilities,
county
mental
health
and
developmental
disabilities
12
regional
planning
councils
regional
administrators
,
mental
13
health
and
disability
services
region
governing
boards,
14
and
county
care
facility
certified
volunteer
long-term
care
15
ombudsmen
to
assist
in
the
establishment
of
standards.
16
Sec.
54.
Section
227.10,
Code
2015,
is
amended
to
read
as
17
follows:
18
227.10
Transfers
from
county
or
private
institutions.
19
Patients
who
have
been
admitted
at
public
expense
to
20
any
institution
to
which
this
chapter
is
applicable
may
be
21
involuntarily
transferred
to
the
proper
state
hospital
for
22
persons
with
mental
illness
in
the
manner
prescribed
by
23
sections
229.6
to
229.13
.
The
application
required
by
section
24
229.6
may
be
filed
by
the
administrator
of
the
division
or
25
the
administrator’s
designee,
or
by
the
administrator
of
the
26
institution
where
the
patient
is
then
being
maintained
or
27
treated.
If
the
patient
was
admitted
to
that
institution
28
involuntarily,
the
administrator
of
the
division
may
arrange
29
and
complete
the
transfer,
and
shall
report
it
as
required
of
30
a
chief
medical
officer
under
section
229.15,
subsection
5
.
31
The
transfer
shall
be
made
at
county
expense,
and
the
expense
32
recovered,
as
provided
in
section
227.7
.
However,
transfer
33
under
this
section
of
a
patient
whose
expenses
are
payable
in
34
whole
or
in
part
by
a
county
is
subject
to
an
authorization
for
35
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the
transfer
through
the
central
point
of
coordination
process
1
regional
administrator
for
the
patient’s
county
of
residence
.
2
Sec.
55.
Section
227.11,
Code
2015,
is
amended
to
read
as
3
follows:
4
227.11
Transfers
from
state
hospitals.
5
A
regional
administrator
for
the
county
chargeable
with
6
the
expense
of
a
patient
in
a
state
hospital
for
persons
with
7
mental
illness
shall
transfer
the
patient
to
a
county
or
8
private
institution
for
persons
with
mental
illness
that
is
in
9
compliance
with
the
applicable
rules
when
the
administrator
10
of
the
division
or
the
administrator’s
designee
orders
the
11
transfer
on
a
finding
that
the
patient
is
suffering
from
12
chronic
mental
illness
or
from
senility
and
will
receive
equal
13
benefit
by
being
so
transferred.
A
county
shall
transfer
to
14
its
county
care
facility
any
patient
in
a
state
hospital
for
15
persons
with
mental
illness
upon
request
of
the
superintendent
16
of
the
state
hospital
in
which
the
patient
is
confined
17
pursuant
to
the
superintendent’s
authority
under
section
18
229.15,
subsection
5
,
and
approval
by
the
board
of
supervisors
19
of
regional
administrator
for
the
county
of
the
patient’s
20
residence.
In
no
case
shall
a
patient
be
thus
transferred
21
except
upon
compliance
with
section
229.14A
or
without
the
22
written
consent
of
a
relative,
friend,
or
guardian
if
such
23
relative,
friend,
or
guardian
pays
the
expense
of
the
care
of
24
such
patient
in
a
state
hospital.
Patients
transferred
to
a
25
public
or
private
facility
under
this
section
may
subsequently
26
be
placed
on
convalescent
or
limited
leave
or
transferred
to
27
a
different
facility
for
continued
full-time
custody,
care,
28
and
treatment
when,
in
the
opinion
of
the
attending
physician
29
or
the
chief
medical
officer
of
the
hospital
from
which
the
30
patient
was
so
transferred,
the
best
interest
of
the
patient
31
would
be
served
by
such
leave
or
transfer.
For
any
patient
32
who
is
involuntarily
committed,
any
transfer
made
under
this
33
section
is
subject
to
the
placement
hearing
requirements
of
34
section
229.14A
.
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Sec.
56.
Section
227.12,
Code
2015,
is
amended
to
read
as
1
follows:
2
227.12
Difference
of
opinion.
3
When
a
difference
of
opinion
exists
between
the
4
administrator
of
the
division
and
the
authorities
in
charge
5
of
any
private
or
county
hospital
in
regard
to
the
removal
6
transfer
of
a
patient
or
patients
as
herein
provided
in
7
sections
227.10
and
227.11
,
the
matter
shall
be
submitted
to
8
the
district
court
of
the
county
in
which
such
hospital
is
9
situated
and
shall
be
summarily
tried
as
an
equitable
action,
10
and
the
judgment
of
the
district
court
shall
be
final.
11
Sec.
57.
Section
227.14,
Code
2015,
is
amended
to
read
as
12
follows:
13
227.14
Caring
for
persons
with
mental
illness
from
other
14
counties.
15
Boards
of
supervisors
of
counties
having
no
The
regional
16
administrator
for
a
county
that
does
not
have
proper
facilities
17
for
caring
for
persons
with
mental
illness
may,
with
the
18
consent
of
the
administrator
of
the
division,
provide
for
such
19
care
at
the
expense
of
the
county
in
any
convenient
and
proper
20
county
or
private
institution
for
persons
with
mental
illness
21
which
is
willing
to
receive
them
the
persons
.
22
Sec.
58.
Section
229.1,
subsection
3,
Code
2015,
is
amended
23
by
striking
the
subsection.
24
Sec.
59.
Section
229.1,
Code
2015,
is
amended
by
adding
the
25
following
new
subsections:
26
NEW
SUBSECTION
.
8A.
“Mental
health
and
disability
services
27
region”
means
a
mental
health
and
disability
services
region
28
formed
in
accordance
with
section
331.389.
29
NEW
SUBSECTION
.
14A.
“Regional
administrator”
means
the
30
regional
administrator
of
a
mental
health
and
disability
31
services
region,
as
defined
in
section
331.388.
32
Sec.
60.
Section
229.1B,
Code
2015,
is
amended
to
read
as
33
follows:
34
229.1B
Central
point
of
coordination
process
Regional
35
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administrator
.
1
Notwithstanding
any
provision
of
this
chapter
to
the
2
contrary,
any
person
whose
hospitalization
expenses
are
3
payable
in
whole
or
in
part
by
a
county
shall
be
subject
4
to
all
administrative
requirements
of
the
central
point
of
5
coordination
process
regional
administrator
for
the
county
.
6
Sec.
61.
Section
229.2,
subsection
1,
paragraph
b,
7
subparagraph
(3),
Code
2015,
is
amended
to
read
as
follows:
8
(3)
As
soon
as
is
practicable
after
the
filing
of
a
9
petition
for
juvenile
court
approval
of
the
admission
of
the
10
minor,
the
juvenile
court
shall
determine
whether
the
minor
11
has
an
attorney
to
represent
the
minor
in
the
hospitalization
12
proceeding,
and
if
not,
the
court
shall
assign
to
the
minor
13
an
attorney.
If
the
minor
is
financially
unable
to
pay
for
14
an
attorney,
the
attorney
shall
be
compensated
by
the
county
15
at
an
hourly
rate
to
be
established
by
the
county
board
of
16
supervisors
regional
administrator
for
the
county
in
which
the
17
proceeding
is
held
in
substantially
the
same
manner
as
provided
18
in
section
815.7
.
19
Sec.
62.
Section
229.8,
subsection
1,
Code
2015,
is
amended
20
to
read
as
follows:
21
1.
Determine
whether
the
respondent
has
an
attorney
22
who
is
able
and
willing
to
represent
the
respondent
in
the
23
hospitalization
proceeding,
and
if
not,
whether
the
respondent
24
is
financially
able
to
employ
an
attorney
and
capable
of
25
meaningfully
assisting
in
selecting
one.
In
accordance
with
26
those
determinations,
the
court
shall
if
necessary
allow
the
27
respondent
to
select,
or
shall
assign
to
the
respondent,
an
28
attorney.
If
the
respondent
is
financially
unable
to
pay
an
29
attorney,
the
attorney
shall
be
compensated
by
the
county
30
at
an
hourly
rate
to
be
established
by
the
county
board
of
31
supervisors
regional
administrator
for
the
county
in
which
the
32
proceeding
is
held
in
substantially
the
same
manner
as
provided
33
in
section
815.7
.
34
Sec.
63.
Section
229.10,
subsection
1,
paragraph
a,
Code
35
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_____
2015,
is
amended
to
read
as
follows:
1
a.
An
examination
of
the
respondent
shall
be
conducted
by
2
one
or
more
licensed
physicians,
as
required
by
the
court’s
3
order,
within
a
reasonable
time.
If
the
respondent
is
detained
4
pursuant
to
section
229.11,
subsection
1
,
paragraph
“b”
,
5
the
examination
shall
be
conducted
within
twenty-four
hours.
6
If
the
respondent
is
detained
pursuant
to
section
229.11,
7
subsection
1
,
paragraph
“a”
or
“c”
,
the
examination
shall
8
be
conducted
within
forty-eight
hours.
If
the
respondent
9
so
desires,
the
respondent
shall
be
entitled
to
a
separate
10
examination
by
a
licensed
physician
of
the
respondent’s
own
11
choice.
The
reasonable
cost
of
the
examinations
shall,
if
the
12
respondent
lacks
sufficient
funds
to
pay
the
cost,
be
paid
by
13
the
regional
administrator
from
county
funds
upon
order
of
the
14
court.
15
Sec.
64.
Section
229.11,
subsection
1,
unnumbered
paragraph
16
1,
Code
2015,
is
amended
to
read
as
follows:
17
If
the
applicant
requests
that
the
respondent
be
taken
into
18
immediate
custody
and
the
judge,
upon
reviewing
the
application
19
and
accompanying
documentation,
finds
probable
cause
to
believe
20
that
the
respondent
has
a
serious
mental
impairment
and
is
21
likely
to
injure
the
respondent
or
other
persons
if
allowed
22
to
remain
at
liberty,
the
judge
may
enter
a
written
order
23
directing
that
the
respondent
be
taken
into
immediate
custody
24
by
the
sheriff
or
the
sheriff’s
deputy
and
be
detained
until
25
the
hospitalization
hearing.
The
hospitalization
hearing
shall
26
be
held
no
more
than
five
days
after
the
date
of
the
order,
27
except
that
if
the
fifth
day
after
the
date
of
the
order
is
a
28
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
on
the
29
next
succeeding
business
day.
If
the
expenses
of
a
respondent
30
are
payable
in
whole
or
in
part
by
a
county,
for
a
placement
31
in
accordance
with
paragraph
“a”
,
the
judge
shall
give
notice
32
of
the
placement
to
the
central
point
of
coordination
process
33
regional
administrator
for
the
county
in
which
the
court
is
34
located
,
and
for
a
placement
in
accordance
with
paragraph
“b”
35
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_____
or
“c”
,
the
judge
shall
order
the
placement
in
a
hospital
or
1
facility
designated
through
the
central
point
of
coordination
2
process
regional
administrator
.
The
judge
may
order
the
3
respondent
detained
for
the
period
of
time
until
the
hearing
4
is
held,
and
no
longer,
in
accordance
with
paragraph
“a”
,
if
5
possible,
and
if
not
then
in
accordance
with
paragraph
“b”
,
6
or,
only
if
neither
of
these
alternatives
is
available,
in
7
accordance
with
paragraph
“c”
.
Detention
may
be:
8
Sec.
65.
Section
229.13,
subsection
1,
paragraph
a,
Code
9
2015,
is
amended
to
read
as
follows:
10
a.
The
court
shall
order
a
respondent
whose
expenses
are
11
payable
in
whole
or
in
part
by
a
county
placed
under
the
care
12
of
an
appropriate
hospital
or
facility
designated
through
13
the
central
point
of
coordination
process
county’s
regional
14
administrator
on
an
inpatient
or
outpatient
basis.
15
Sec.
66.
Section
229.14,
subsection
2,
paragraph
a,
Code
16
2015,
is
amended
to
read
as
follows:
17
a.
For
a
respondent
whose
expenses
are
payable
in
whole
18
or
in
part
by
a
county,
placement
as
designated
through
19
the
central
point
of
coordination
process
county’s
regional
20
administrator
in
the
care
of
an
appropriate
hospital
or
21
facility
on
an
inpatient
or
outpatient
basis,
or
other
22
appropriate
treatment,
or
in
an
appropriate
alternative
23
placement.
24
Sec.
67.
Section
229.14A,
subsections
7
and
9,
Code
2015,
25
are
amended
to
read
as
follows:
26
7.
If
a
respondent’s
expenses
are
payable
in
whole
or
in
27
part
by
a
county
through
the
central
point
of
coordination
28
process
county’s
regional
administrator
,
notice
of
a
placement
29
hearing
shall
be
provided
to
the
county
attorney
and
the
30
county’s
central
point
of
coordination
process
regional
31
administrator.
At
the
hearing,
the
county
may
present
evidence
32
regarding
appropriate
placement.
33
9.
A
placement
made
pursuant
to
an
order
entered
under
34
section
229.13
or
229.14
or
this
section
shall
be
considered
to
35
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_____
be
authorized
through
the
central
point
of
coordination
process
1
county’s
regional
administrator
.
2
Sec.
68.
Section
229.19,
subsection
1,
paragraphs
a
and
b,
3
Code
2015,
are
amended
to
read
as
follows:
4
a.
In
each
county
with
a
population
of
three
hundred
5
thousand
or
more
inhabitants
the
board
of
supervisors
county’s
6
regional
administrator
shall
appoint
an
individual
who
has
7
demonstrated
by
prior
activities
an
informed
concern
for
the
8
welfare
and
rehabilitation
of
persons
with
mental
illness,
9
and
who
is
not
an
officer
or
employee
of
the
department
of
10
human
services
nor
of
any
agency
or
facility
providing
care
11
or
treatment
to
persons
with
mental
illness,
to
act
as
an
12
advocate
representing
the
interests
of
patients
involuntarily
13
hospitalized
by
the
court,
in
any
matter
relating
to
the
14
patients’
hospitalization
or
treatment
under
section
229.14
15
or
229.15
.
In
each
county
with
a
population
of
under
three
16
hundred
thousand
inhabitants,
the
chief
judge
of
the
judicial
17
district
encompassing
the
county
shall
appoint
the
advocate.
18
b.
The
court
or,
if
the
advocate
is
appointed
by
the
19
county
board
of
supervisors
regional
administrator
,
the
board
20
regional
administrator
shall
assign
the
advocate
appointed
from
21
a
patient’s
county
of
residence
to
represent
the
interests
22
of
the
patient.
If
a
patient
has
no
county
of
residence
or
23
the
patient
is
a
state
case,
the
court
or,
if
the
advocate
24
is
appointed
by
the
county
board
of
supervisors
regional
25
administrator
,
the
board
regional
administrator
shall
assign
26
the
advocate
appointed
from
for
the
county
where
the
hospital
27
or
facility
is
located
to
represent
the
interests
of
the
28
patient.
29
Sec.
69.
Section
229.19,
subsection
3,
Code
2015,
is
amended
30
to
read
as
follows:
31
3.
The
court
or,
if
the
advocate
is
appointed
by
the
county
32
board
of
supervisors
regional
administrator
,
the
board
regional
33
administrator
shall
prescribe
reasonable
compensation
for
the
34
services
of
the
advocate.
The
compensation
shall
be
based
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upon
the
reports
filed
by
the
advocate
with
the
court.
The
1
advocate’s
compensation
shall
be
paid
by
the
county
in
which
2
the
court
is
located,
either
on
order
of
the
court
or,
if
3
the
advocate
is
appointed
by
the
county
board
of
supervisors
4
regional
administrator
,
on
the
direction
of
the
board
regional
5
administrator
.
If
the
advocate
is
appointed
by
the
court,
the
6
advocate
is
an
employee
of
the
state
for
purposes
of
chapter
7
669
.
If
the
advocate
is
appointed
by
the
county
board
of
8
supervisors
regional
administrator
,
the
advocate
is
an
employee
9
of
the
county
for
purposes
of
chapter
670
.
If
the
patient
or
10
the
person
who
is
legally
liable
for
the
patient’s
support
is
11
not
indigent,
the
board
regional
administrator
shall
recover
12
the
costs
of
compensating
the
advocate
from
that
person.
If
13
that
person
has
an
income
level
as
determined
pursuant
to
14
section
815.9
greater
than
one
hundred
percent
but
not
more
15
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
16
least
one
hundred
dollars
of
the
advocate’s
compensation
shall
17
be
recovered
in
the
manner
prescribed
by
the
county
board
of
18
supervisors
regional
administrator
.
If
that
person
has
an
19
income
level
as
determined
pursuant
to
section
815.9
greater
20
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
21
least
two
hundred
dollars
of
the
advocate’s
compensation
shall
22
be
recovered
in
substantially
the
same
manner
prescribed
by
the
23
county
board
of
supervisors
as
provided
in
section
815.9
.
24
Sec.
70.
Section
229.24,
subsection
3,
unnumbered
paragraph
25
1,
Code
2015,
is
amended
to
read
as
follows:
26
If
all
or
part
of
the
costs
associated
with
hospitalization
27
of
an
individual
under
this
chapter
are
chargeable
to
a
county
28
of
residence,
the
clerk
of
the
district
court
shall
provide
29
to
the
regional
administrator
for
the
county
of
residence
and
30
to
the
regional
administrator
for
the
county
in
which
the
31
hospitalization
order
is
entered
the
following
information
32
pertaining
to
the
individual
which
would
be
confidential
under
33
subsection
1
:
34
Sec.
71.
Section
229.42,
subsection
1,
Code
2015,
is
amended
35
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49
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_____
to
read
as
follows:
1
1.
If
a
person
wishing
to
make
application
for
voluntary
2
admission
to
a
mental
hospital
established
by
chapter
226
is
3
unable
to
pay
the
costs
of
hospitalization
or
those
responsible
4
for
the
person
are
unable
to
pay
the
costs,
application
for
5
authorization
of
voluntary
admission
must
be
made
through
a
6
central
point
of
coordination
process
regional
administrator
7
before
application
for
admission
is
made
to
the
hospital.
The
8
person’s
county
of
residence
shall
be
determined
through
the
9
central
point
of
coordination
process
regional
administrator
10
and
if
the
admission
is
approved
through
the
central
point
11
of
coordination
process
regional
administrator
,
the
person’s
12
admission
to
a
mental
health
hospital
shall
be
authorized
as
13
a
voluntary
case.
The
authorization
shall
be
issued
on
forms
14
provided
by
the
department
of
human
services’
administrator.
15
The
costs
of
the
hospitalization
shall
be
paid
by
the
16
county
of
residence
to
the
department
of
human
services
and
17
credited
to
the
general
fund
of
the
state,
provided
that
the
18
mental
health
hospital
rendering
the
services
has
certified
19
to
the
county
auditor
of
the
county
of
residence
and
the
20
regional
administrator
the
amount
chargeable
to
the
county
21
and
has
sent
a
duplicate
statement
of
the
charges
to
the
22
department
of
human
services.
A
county
shall
not
be
billed
23
for
the
cost
of
a
patient
unless
the
patient’s
admission
is
24
authorized
through
the
central
point
of
coordination
process
25
regional
administrator
.
The
mental
health
institute
and
the
26
county
regional
administrator
shall
work
together
to
locate
27
appropriate
alternative
placements
and
services,
and
to
28
educate
patients
and
family
members
of
patients
regarding
such
29
alternatives.
30
Sec.
72.
Section
230.1,
subsection
3,
Code
2015,
is
amended
31
to
read
as
follows:
32
3.
A
county
of
residence
is
not
liable
for
costs
and
33
expenses
associated
with
a
person
with
mental
illness
unless
34
the
costs
and
expenses
are
for
services
and
other
support
35
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authorized
for
the
person
through
the
central
point
of
1
coordination
process
county’s
regional
administrator
.
For
2
the
purposes
of
this
chapter
,
“central
point
of
coordination
3
process”
“regional
administrator”
means
the
same
as
defined
in
4
section
331.440
331.388
.
5
Sec.
73.
Section
230.3,
Code
2015,
is
amended
to
read
as
6
follows:
7
230.3
Certification
of
residence.
8
If
a
person’s
county
of
residence
is
determined
by
the
9
county’s
central
point
of
coordination
process
regional
10
administrator
to
be
in
another
county
of
this
state,
the
county
11
regional
administrator
making
the
determination
shall
certify
12
the
determination
to
the
superintendent
of
the
hospital
to
13
which
the
person
is
admitted
or
committed.
The
certification
14
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
15
the
determination.
Upon
receiving
the
certification,
the
16
superintendent
shall
charge
the
expenses
already
incurred
and
17
unadjusted,
and
all
future
expenses
of
the
person,
to
the
18
county
determined
to
be
the
county
of
residence.
19
Sec.
74.
Section
230.20,
subsection
2,
paragraph
b,
Code
20
2015,
is
amended
to
read
as
follows:
21
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
22
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
23
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
to
24
a
county
may
be
adjusted
annually
to
reflect
increased
costs
,
25
to
the
extent
of
the
percentage
increase
in
the
total
of
county
26
fixed
budgets
pursuant
to
the
allowed
growth
factor
adjustment
27
statewide
per
capita
expenditure
target
amount,
if
any
per
28
capita
growth
amount
is
authorized
by
the
general
assembly
for
29
the
fiscal
year
in
accordance
with
section
331.439
426B.3
.
30
Sec.
75.
Section
232.2,
subsection
4,
paragraph
f,
31
subparagraph
(3),
Code
2015,
is
amended
to
read
as
follows:
32
(3)
The
transition
plan
shall
be
developed
and
reviewed
33
by
the
department
in
collaboration
with
a
child-centered
34
transition
team.
The
transition
team
shall
be
comprised
of
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the
child’s
caseworker
and
persons
selected
by
the
child,
1
persons
who
have
knowledge
of
services
available
to
the
child,
2
and
any
person
who
may
reasonably
be
expected
to
be
a
service
3
provider
for
the
child
when
the
child
becomes
an
adult
or
to
4
become
responsible
for
the
costs
of
services
at
that
time.
5
If
the
child
is
reasonably
likely
to
need
or
be
eligible
for
6
adult
services,
the
transition
team
membership
shall
include
7
representatives
from
the
adult
services
system.
The
adult
8
services
system
representatives
may
include
but
are
not
limited
9
to
the
administrator
of
county
general
relief
under
chapter
10
251
or
252
or
of
the
central
point
of
coordination
process
11
implemented
under
section
331.440
regional
administrator
of
12
the
county
mental
health
and
disability
services
region,
as
13
defined
in
section
331.388
.
The
membership
of
the
transition
14
team
and
the
meeting
dates
for
the
team
shall
be
documented
in
15
the
transition
plan.
16
Sec.
76.
Section
235.7,
subsection
2,
Code
2015,
is
amended
17
to
read
as
follows:
18
2.
Membership.
The
department
may
authorize
the
governance
19
boards
of
decategorization
of
child
welfare
and
juvenile
20
justice
funding
projects
established
under
section
232.188
to
21
appoint
the
transition
committee
membership
and
may
utilize
22
the
boundaries
of
decategorization
projects
to
establish
23
the
service
areas
for
transition
committees.
The
committee
24
membership
may
include
but
is
not
limited
to
department
of
25
human
services
staff
involved
with
foster
care,
child
welfare,
26
and
adult
services,
juvenile
court
services
staff,
staff
27
involved
with
county
general
relief
under
chapter
251
or
252
,
28
or
of
the
central
point
of
coordination
process
implemented
29
under
section
331.440
a
regional
administrator
of
the
county
30
mental
health
and
disability
services
region,
as
defined
31
in
section
331.388,
in
the
area
,
school
district
and
area
32
education
agency
staff
involved
with
special
education,
and
a
33
child’s
court
appointed
special
advocate,
guardian
ad
litem,
34
service
providers,
and
other
persons
knowledgeable
about
the
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child.
1
Sec.
77.
Section
235A.15,
subsection
2,
paragraph
c,
2
subparagraph
(9),
Code
2015,
is
amended
to
read
as
follows:
3
(9)
To
the
administrator
of
an
agency
providing
mental
4
health,
intellectual
disability,
or
developmental
disability
5
services
under
a
county
management
plan
developed
pursuant
6
to
section
331.439
regional
service
system
management
plan
7
implemented
in
accordance
with
section
331.393
,
if
the
data
8
concerns
a
person
employed
by
or
being
considered
by
the
agency
9
for
employment.
10
Sec.
78.
Section
235B.6,
subsection
2,
paragraph
c,
11
subparagraph
(6),
Code
2015,
is
amended
to
read
as
follows:
12
(6)
To
the
administrator
of
an
agency
providing
mental
13
health,
intellectual
disability,
or
developmental
disability
14
services
under
a
county
management
plan
developed
pursuant
15
to
section
331.439
regional
service
system
management
plan
16
implemented
in
accordance
with
section
331.393
,
if
the
17
information
concerns
a
person
employed
by
or
being
considered
18
by
the
agency
for
employment.
19
Sec.
79.
Section
426B.2,
subsection
2,
Code
2015,
is
amended
20
to
read
as
follows:
21
2.
As
used
in
this
chapter
,
and
in
sections
331.438
and
22
331.439
section
331.424A
,
for
purposes
of
population-based
23
funding
calculations,
“population”
means
the
population
shown
24
by
the
latest
preceding
certified
federal
census
or
the
25
latest
applicable
population
estimate
issued
by
the
federal
26
government
,
whichever
is
most
recent
and
available
as
of
July
27
1
of
the
fiscal
year
preceding
the
fiscal
year
to
which
the
28
funding
calculations
apply
.
29
Sec.
80.
Section
426B.5,
subsection
1,
Code
2015,
is
amended
30
by
striking
the
subsection.
31
Sec.
81.
Section
426B.5,
subsections
2
and
3,
Code
2015,
are
32
amended
to
read
as
follows:
33
2.
Risk
pool.
34
a.
For
the
purposes
of
this
subsection
section
,
unless
the
35
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context
otherwise
requires
,
“services
fund”
:
1
(1)
“Mental
health
and
disability
services
region”
means
2
a
mental
health
and
disability
services
region
formed
in
3
accordance
with
section
331.389.
4
(2)
“Regional
administrator”
means
the
regional
5
administrator
of
a
mental
health
and
disability
services
6
region,
as
defined
in
section
331.388.
7
(3)
“Services
fund”
means
a
county’s
mental
health
and
8
disabilities
services
fund
created
in
section
331.424A
.
9
b.
A
risk
pool
is
created
in
the
property
tax
relief
fund.
10
The
pool
shall
consist
of
the
moneys
credited
to
the
pool
by
11
law.
12
c.
A
risk
pool
board
is
created.
The
board
shall
consist
13
of
two
county
supervisors,
two
county
auditors,
a
member
of
14
the
mental
health
and
disability
services
commission
who
is
15
not
a
member
of
a
county
board
of
supervisors,
a
member
of
16
the
county
finance
committee
created
in
chapter
333A
who
is
17
not
an
elected
official,
a
representative
of
a
provider
of
18
mental
health
or
developmental
disabilities
services
selected
19
from
nominees
submitted
by
the
Iowa
association
of
community
20
providers,
and
two
central
point
of
coordination
process
21
staff
members
of
regional
administrators
of
county
mental
22
health
and
disability
services
,
all
appointed
by
the
governor,
23
and
one
member
appointed
by
the
director
of
human
services.
24
All
members
appointed
by
the
governor
shall
be
subject
to
25
confirmation
by
the
senate.
Members
shall
serve
for
three-year
26
terms.
A
vacancy
shall
be
filled
in
the
same
manner
as
the
27
original
appointment.
Expenses
and
other
costs
of
the
risk
28
pool
board
members
representing
counties
shall
be
paid
by
the
29
county
of
origin.
Expenses
and
other
costs
of
risk
pool
board
30
members
who
do
not
represent
counties
shall
be
paid
from
a
31
source
determined
by
the
governor.
Staff
assistance
to
the
32
board
shall
be
provided
by
the
department
of
human
services
and
33
counties.
Actuarial
expenses
and
other
direct
administrative
34
costs
shall
be
charged
to
the
pool.
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d.
A
county
regional
administrator
must
apply
to
the
risk
1
pool
board
for
assistance
from
the
risk
pool
on
or
before
2
October
31.
The
purpose
of
the
assistance
shall
be
to
provide
3
financial
support
for
services
provided
by
one
or
more
of
the
4
counties
comprising
the
regional
administrator’s
mental
health
5
and
disability
services
region.
The
risk
pool
board
shall
6
make
its
final
decisions
on
or
before
December
15
regarding
7
acceptance
or
rejection
of
the
applications
for
assistance
and
8
the
total
amount
accepted
shall
be
considered
obligated.
9
e.
Basic
eligibility
for
risk
pool
assistance
requires
that
10
a
county
meet
all
of
the
following
conditions:
11
(1)
The
county
is
in
compliance
with
the
regional
service
12
system
management
plan
requirements
of
section
331.439
331.393
.
13
(2)
The
county
levied
the
maximum
amount
allowed
for
the
14
county’s
services
fund
under
section
331.424A
for
the
fiscal
15
year
of
application
for
risk
pool
assistance.
16
(3)
In
the
fiscal
year
that
commenced
two
years
prior
to
17
the
fiscal
year
of
application,
the
county’s
services
fund
18
ending
balance
under
generally
accepted
accounting
principles
19
was
equal
to
or
less
than
twenty
percent
of
the
county’s
actual
20
gross
expenditures
for
that
fiscal
year.
21
f.
The
board
shall
review
the
fiscal
year-end
financial
22
records
for
all
counties
that
are
granted
risk
pool
assistance.
23
If
the
board
determines
a
county’s
actual
need
for
risk
pool
24
assistance
was
less
than
the
amount
of
risk
pool
assistance
25
granted
to
the
county,
the
county
shall
refund
the
difference
26
between
the
amount
of
assistance
granted
and
the
actual
need.
27
The
county
shall
submit
the
refund
within
thirty
days
of
28
receiving
notice
from
the
board.
Refunds
shall
be
credited
29
to
the
risk
pool.
The
mental
health
and
disability
services
30
commission
shall
adopt
rules
pursuant
to
chapter
17A
providing
31
criteria
for
the
purposes
of
this
lettered
paragraph
and
as
32
necessary
to
implement
the
other
provisions
of
this
subsection
.
33
g.
The
board
shall
determine
application
requirements
to
34
ensure
prudent
use
of
risk
pool
assistance.
The
board
may
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accept
or
reject
an
application
for
assistance
in
whole
or
in
1
part.
The
decision
of
the
board
is
final.
2
h.
The
total
amount
of
risk
pool
assistance
shall
be
limited
3
to
the
amount
available
in
the
risk
pool
for
a
fiscal
year.
Any
4
unobligated
balance
in
the
risk
pool
at
the
close
of
a
fiscal
5
year
shall
remain
in
the
risk
pool
for
distribution
in
the
6
succeeding
fiscal
year.
7
i.
Risk
pool
assistance
shall
only
be
made
available
to
8
address
one
or
more
of
the
following
circumstances:
9
(1)
Continuing
support
for
mandated
services.
10
(2)
Avoiding
the
need
for
reduction
or
elimination
of
11
critical
services
when
the
reduction
or
elimination
places
12
consumers’
health
or
safety
at
risk.
13
(3)
Avoiding
the
need
for
reduction
or
elimination
of
a
14
mobile
crisis
team
or
other
critical
emergency
services
when
15
the
reduction
or
elimination
places
the
public’s
health
or
16
safety
at
risk.
17
(4)
Avoiding
the
need
for
reduction
or
elimination
of
18
the
services
or
other
support
provided
to
entire
disability
19
populations.
20
(5)
Avoiding
the
need
for
reduction
or
elimination
of
21
services
or
other
support
that
maintain
consumers
in
a
22
community
setting,
creating
a
risk
that
the
consumers
would
be
23
placed
in
more
restrictive,
higher
cost
settings.
24
j.
Subject
to
the
amount
available
and
obligated
from
the
25
risk
pool
for
a
fiscal
year,
the
department
of
human
services
26
shall
annually
calculate
the
amount
of
moneys
due
to
eligible
27
counties
in
accordance
with
the
board’s
decisions
and
that
28
amount
is
appropriated
from
the
risk
pool
to
the
department
29
for
payment
of
the
moneys
due.
The
department
shall
authorize
30
the
issuance
of
warrants
payable
to
the
county
treasurer
for
31
the
amounts
due
and
the
warrants
shall
be
issued
on
or
before
32
January
1.
33
k.
On
or
before
March
1
and
September
1
of
each
fiscal
year,
34
the
department
of
human
services
shall
provide
the
risk
pool
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board
with
a
report
of
the
financial
condition
of
each
funding
1
source
administered
by
the
board.
The
report
shall
include
2
but
is
not
limited
to
an
itemization
of
the
funding
source’s
3
balances,
types
and
amount
of
revenues
credited,
and
payees
4
and
payment
amounts
for
the
expenditures
made
from
the
funding
5
source
during
the
reporting
period.
6
l.
If
the
board
has
made
its
decisions
but
has
determined
7
that
there
are
otherwise
qualifying
requests
for
risk
pool
8
assistance
that
are
beyond
the
amount
available
in
the
risk
9
pool
fund
for
a
fiscal
year,
the
board
shall
compile
a
list
of
10
such
requests
and
the
supporting
information
for
the
requests.
11
The
list
and
information
shall
be
submitted
to
the
mental
12
health
and
disability
services
commission,
the
department
of
13
human
services,
and
the
general
assembly.
14
3.
Incentive
pool.
15
a.
An
incentive
pool
is
created
in
the
property
tax
relief
16
fund.
The
incentive
pool
shall
consist
of
the
moneys
credited
17
to
the
incentive
pool
by
law.
18
b.
Moneys
available
in
the
incentive
pool
for
a
fiscal
19
year
shall
be
distributed
to
those
counties
mental
health
and
20
disability
services
regions
that
either
meet
or
show
progress
21
toward
meeting
the
purposes
and
intent
described
in
section
22
331.439,
subsection
1
,
paragraph
“c”
225C.1
.
The
moneys
23
received
by
a
county
region
from
the
incentive
pool
shall
be
24
used
to
build
community
capacity
to
support
individuals
covered
25
by
the
county’s
region’s
regional
service
system
management
26
plan
approved
under
section
331.439
,
331.393
in
meeting
such
27
purposes.
28
Sec.
82.
REPEAL.
Section
226.47,
Code
2015,
is
repealed.
29
EXPLANATION
30
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
31
the
explanation’s
substance
by
the
members
of
the
general
assembly.
32
This
bill
relates
to
the
redesign
of
mental
health
and
33
disabilities
services
(MH/DS)
administered
by
regions
comprised
34
of
counties.
Under
the
redesign
provisions
initially
enacted
35
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in
2012,
each
organization
of
counties
as
a
region
is
governed
1
by
a
Code
chapter
28E
agreement
and
the
region
is
to
have
2
an
administrative
office,
organization,
or
entity
formed
by
3
agreement
of
the
counties
participating
in
the
region
to
4
function
on
behalf
of
those
counties,
known
as
the
regional
5
administrator
and
defined
in
Code
section
331.388.
The
6
redesign
legislation
maintained
the
financial
responsibility
7
for
MH/DS
with
each
county
but
provided
for
the
regional
8
administrator
and
the
regional
governance
board
to
assume
the
9
administrative
functions
on
behalf
of
the
county.
The
bill
10
makes
conforming
Code
amendments
relating
to
the
redesign
11
legislation.
12
In
general,
references
throughout
the
Code
to
the
central
13
point
of
coordination
(CPC)
process
(codified
in
Code
section
14
331.440,
which
was
repealed
effective
July
1,
2013,
by
2011
15
Iowa
Acts,
ch.
123)
are
changed
to
instead
refer
to
regional
16
administrators;
references
to
the
county
mental
health,
17
intellectual
disability,
and
developmental
disabilities
18
services
fund
are
changed
to
mental
health
and
disabilities
19
services
fund
(codified
in
Code
section
331.424A,
amended
by
20
2012
Iowa
Acts,
ch.
1120,
§132);
and
references
to
county
21
service
management
plans
(codified
in
Code
section
331.439,
22
repealed
effective
July
1,
2013,
by
2011
Iowa
Acts,
ch.
23
123)
are
changed
to
instead
refer
to
regional
service
system
24
management
plans
approved
in
accordance
with
Code
section
25
331.393.
References
throughout
the
Code
to
responsibilities
26
for
a
county
to
provide
or
have
administrative
responsibility
27
for
services
or
other
responsibilities
in
connection
with
a
28
person
in
need
of
mental
health
or
disability
services
are
29
changed
to
instead
refer
to
the
regional
administrator.
Prior
30
to
the
redesign,
MH/DS
services
in
each
county
were
delineated
31
in
a
service
management
plan
adopted
by
that
county,
subject
32
to
approval
by
the
department
of
human
services
(DHS).
These
33
individual
county
plans
were
replaced
by
a
regional
service
34
system
management
plan
effective
beginning
on
July
1,
2014.
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County
MH/DS
levy
authority
and
spending
authority
remains
1
in
Code
section
331.424A.
However,
the
name
of
the
fund
2
was
changed
in
the
redesign
legislation
but
references
to
3
the
old
fund
in
other
Code
sections
are
corrected
in
the
4
bill.
In
addition,
related
Code
changes
are
reflected
in
this
5
explanation.
6
References
to
waivers
for
providers
of
mental
health
7
services
approved
under
Code
section
225C.7
to
operate
in
lieu
8
of
a
community
mental
health
center
are
stricken
because
the
9
Code
section
was
repealed
by
2014
Iowa
Acts,
ch.
1092,
§152.
10
Code
chapter
230A,
relating
to
community
mental
health
centers,
11
was
substantially
rewritten
by
2011
Iowa
Acts,
ch.
121,
and
12
the
revisions
took
effect
July
1,
2012.
In
the
rewrite,
13
Code
section
230A.107,
codified
the
waiver
authorization
for
14
a
for-profit
corporation,
nonprofit
corporation,
or
county
15
hospital
providing
mental
health
services
to
county
residents
16
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
17
3,
Code
2011,
as
of
October
1,
2010,
to
be
designated
as
a
18
community
mental
health
center
under
Code
chapter
230A.
The
19
reference
change
is
applied
by
the
bill
in
the
following
Code
20
sections:
135.180,
relating
to
mental
health
professional
21
shortage
area
program;
225C.19,
relating
to
emergency
mental
22
health
crisis
services
system;
and
225C.54,
relating
to
the
23
mental
health
services
system
for
children
and
youth.
24
References
to
the
central
point
of
coordination
process
25
are
changed
to
instead
refer
to
the
regional
administrator
in
26
the
following
Code
sections:
222.2,
providing
definitions
27
for
Code
chapter
222,
relating
to
the
state
resource
centers;
28
222.13,
relating
to
voluntary
admissions
of
persons
to
a
state
29
resource
center;
222.59,
relating
to
coordination
between
a
30
state
resource
center
and
county
in
identifying
community-based
31
services
for
an
individual;
222.60,
relating
to
payment
32
of
costs
by
county
or
state
and
diagnosis
and
evaluation
33
requirements;
222.61,
relating
to
determination
of
a
person’s
34
residency
status;
222.62,
relating
to
the
procedure
when
a
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person’s
residency
is
determined
to
be
another
county;
222.63,
1
providing
a
procedure
for
a
county
to
object
to
a
residency
2
determination;
222.64,
providing
a
procedure
for
when
a
3
person’s
residency
is
determined
to
be
outside
of
this
state
or
4
is
unknown;
222.73,
relating
to
billing
of
charges
to
counties
5
for
the
state
resource
centers;
225.11,
providing
a
procedure
6
for
commitment
of
a
person
to
the
state
psychiatric
hospital
7
at
the
university
of
Iowa;
225.15,
relating
to
examination
and
8
treatment
at
the
state
psychiatric
hospital;
225.17,
relating
9
to
examination
and
treatment
of
private
patients
at
the
state
10
psychiatric
hospital
when
costs
are
paid
by
a
county;
section
11
225C.2,
providing
definitions
for
Code
chapter
225C;
225C.5,
12
relating
to
membership
of
the
mental
health
and
disability
13
services
commission;
section
225C.6,
relating
to
the
duties
14
of
the
MH/DS
commission;
225C.14,
relating
to
requirements
15
for
a
preliminary
diagnostic
evaluation
before
a
person
is
16
admitted
to
a
state
mental
health
institute
(MHI);
225C.16,
17
requiring
referrals
for
a
preliminary
diagnostic
or
prehearing
18
evaluation
for
persons
desiring
voluntary
admission
to
a
state
19
MHI;
225C.19,
providing
requirements
for
implementation
of
20
an
emergency
mental
health
crisis
services
system;
226.9C,
21
relating
to
the
dual
diagnosis
program
at
the
state
mental
22
health
institute
at
Mount
Pleasant;
227.10,
relating
to
23
transfers
of
patients
from
county
or
private
facilities
24
for
mental
health
treatment
to
a
state
institution;
229.1,
25
providing
definitions
for
the
involuntary
commitment
Code
26
chapter;
229.1B,
providing
that
the
CPC
process
applies
to
27
persons
who
are
involuntarily
committed;
229.11,
relating
to
28
immediate
custody
of
a
person
who
is
involuntarily
committed;
29
229.13,
relating
to
evaluation
orders
for
persons
who
are
30
involuntarily
committed;
229.14,
relating
to
chief
medical
31
officer
reports;
229.14A,
relating
to
placement
orders;
229.42,
32
relating
to
county
payment
for
a
person
voluntarily
admitted
to
33
an
MHI;
230.1,
relating
to
the
costs
and
expenses
associated
34
with
the
commitment
of
a
person
with
mental
illness
to
a
state
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hospital;
230.3,
relating
to
a
certification
of
residence
for
1
purposes
of
charging
expenses
incurred
for
a
commitment
of
2
a
person
with
a
mental
illness
to
a
state
hospital;
232.2,
3
relating
to
the
membership
of
a
transition
team
for
a
child
4
adjudicated
as
a
child
in
need
of
assistance;
235.7,
relating
5
to
transition
committees
to
address
transition
needs
of
6
children
receiving
child
welfare
services
who
are
age
16
or
7
older;
and
426B.5,
relating
to
the
membership
of
the
risk
pool
8
board.
9
References
to
county
board
of
supervisors
or
to
a
county
10
responsibility
are
changed
to
instead
refer
to
the
regional
11
administrator
or
MH/DS
region,
or
to
add
such
a
reference
in
12
the
following
Code
sections:
222.6,
relating
to
the
catchment
13
areas
for
the
two
state
resource
centers;
222.12,
relating
to
14
investigations
of
deaths
at
a
state
resource
center;
222.13,
15
relating
to
referrals
for
voluntary
admissions
of
adults
to
16
a
state
resource
center;
222.14,
relating
to
care
provided
17
pending
admission
of
a
person
to
a
state
resource
center;
18
222.63,
relating
to
determination
of
residency
findings;
19
222.74,
relating
to
approval
of
state
resource
center
charges;
20
222.92,
relating
to
the
use
of
net
budgeting
by
the
state
21
resource
centers;
225.1,
providing
definitions
for
the
22
state
psychiatric
hospital
Code
chapter;
225.10,
relating
23
to
voluntary
patients
at
the
state
psychiatric
hospital;
24
225.12,
relating
to
reports
concerning
voluntary
public
25
patients
at
the
state
psychiatric
hospital;
225.13,
relating
26
to
investigations
of
the
financial
condition
of
persons
being
27
admitted
to
the
state
psychiatric
hospital;
225.16,
relating
to
28
admission
of
voluntary
public
patients
to
the
state
psychiatric
29
hospital;
225.18,
relating
to
appointment
of
attendants
to
30
accompany
committed
persons
to
or
from
the
hospital;
225.19,
31
relating
to
compensation
of
attendants;
225.21,
relating
to
32
claims
for
compensation
of
attendants;
225.24,
relating
to
33
county
collection
of
the
costs
of
care
provided
at
the
state
34
psychiatric
hospital;
225.27,
requiring
notice
of
the
discharge
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or
transfer
of
a
patient
from
the
state
psychiatric
hospital;
1
225C.13,
authorizing
DHS
to
lease
portions
of
MHIs
to
certain
2
public
and
private
organizations;
225C.14,
225C.15,
225C.16,
3
and
225C.17,
relating
to
preliminary
diagnostic
evaluations
4
of
persons
with
respect
to
admission
to
an
MHI,
county
policy
5
regarding
the
evaluations,
referral
of
voluntary
patients
6
for
the
evaluations,
and
the
use
of
alternative
diagnostic
7
facilities
for
the
evaluations;
225C.20,
relating
to
provision
8
of
individual
case
management
services
under
the
medical
9
assistance
(Medicaid)
program
by
counties;
226.32,
requiring
10
notice
to
a
county
when
a
voluntary
patient
is
discharged
to
11
relieve
overcrowding;
226.34,
requiring
notice
when
a
patient
12
at
an
MHI
dies;
227.1,
relating
to
supervision
of
county
and
13
private
institutions
for
persons
with
mental
illness
or
an
14
intellectual
disability
(often
referred
to
as
“county
care
15
facilities”)
is
amended
to
provide
definitions
for
the
Code
16
chapter
including
DHS
and
the
MH/DS
regions;
227.2,
relating
17
to
state
inspection
of
county
facilities;
227.4,
relating
18
to
standards
adoption
pertaining
to
county
care
facilities;
19
227.11,
relating
to
transfers
of
patients
from
state
hospitals;
20
227.12,
relating
to
civil
trials
when
there
is
a
disagreement
21
between
DHS
and
the
authorities
in
charge
of
a
county
care
22
facility
as
to
transfer
of
patients;
227.14,
relating
to
care
23
provided
at
a
county
care
facility
to
patients
from
another
24
county;
229.2
and
229.8,
relating
to
compensation
of
attorneys
25
for
minors
applying
for
voluntary
admission
to
an
MHI
and
26
respondents
in
involuntary
commitment
proceedings;
229.10,
27
relating
to
the
payment
of
examinations
with
county
funds;
28
229.19,
relating
to
mental
health
advocates;
229.24,
relating
29
to
confidential
records
in
involuntary
commitment
proceedings;
30
426B.2,
relating
to
property
tax
relief
fund
payments;
and
31
426B.5,
relating
to
the
risk
pool
and
the
incentive
pool
within
32
the
property
tax
relief
fund.
33
References
to
county
management
plans
developed
pursuant
to
34
repealed
Code
section
331.439
are
changed
to
regional
service
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system
management
plans
implemented
in
accordance
with
Code
1
section
331.393
in
the
following
Code
sections:
222.60,
2
relating
to
payment
of
costs
at
a
state
resource
center
by
3
county
or
state
and
diagnosis
and
evaluation
requirements;
4
222.73,
relating
to
billing
of
per
diem
costs
at
a
state
5
resource
center;
235A.15
and
235B.6,
relating
to
access
to
6
child
and
dependent
adult
abuse
registry
record
checks
for
7
employment
by
an
agency
providing
services
under
a
plan;
8
426B.2,
relating
to
property
tax
relief
fund
payments;
and
9
426B.5,
relating
to
the
risk
and
incentive
pools
of
the
10
property
tax
relief
fund.
11
Current
law
in
Code
sections
222.73
and
230.20,
limits
an
12
increase
in
the
per
diem
changed
to
a
county
for
services
13
provided
at
a
state
resource
center
or
a
state
mental
health
14
institute
to
the
percentage
increase
in
the
allowed
growth
15
factor
adjustment,
a
funding
formula
provision
repealed
by
the
16
redesign.
The
bill
instead
references
the
per
capita
growth
17
amount,
which
replaced
the
repealed
allowed
growth
factor
in
18
the
redesign
legislation.
19
Code
sections
222.13
and
222.13A,
relating
to
voluntary
20
admissions
to
the
state
resource
centers
in
general
and
21
for
minors
in
particular,
are
amended
by
providing
for
the
22
department
of
human
services
to
assume
responsibilities
for
23
voluntary
admissions
of
minors
instead
of
counties.
Code
24
section
222.60,
relating
to
financial
responsibilities
of
the
25
state
and
counties
for
the
cost
of
admission
or
commitment
or
26
for
the
treatment,
training,
instruction,
care,
habilitation,
27
support,
and
transportation
of
persons
with
an
intellectual
28
disability,
is
amended.
The
amendment
specifies
the
county
29
responsibility
is
present
if
the
person
is
not
eligible
for
30
the
medical
assistance
(Medicaid)
program
and
the
service
is
31
covered
by
the
regional
service
system
management
plan
and
32
the
state
is
responsible
when
the
person
is
eligible
for
the
33
Medicaid
program
or
is
a
state
case.
34
Code
section
226.47,
a
single
definition
Code
section
which
35
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49
S.F.
_____
is
replaced
in
the
bill
by
amending
Code
section
226.1
to
1
provide
a
multiple
definition
Code
section,
is
repealed.
2
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86
rh/rj
49/
49