House
File
2417
-
Reprinted
HOUSE
FILE
2417
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HSB
637)
(As
Amended
and
Passed
by
the
House
March
5,
2014
)
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
2014,
is
1
amended
to
read
as
follows:
2
3.
The
program
shall
provide
stipends
to
support
3
psychiatrist
positions
with
an
emphasis
on
securing
and
4
retaining
medical
directors
at
community
mental
health
centers
,
5
providers
of
mental
health
services
to
county
residents
6
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
7
3
,
designated
under
chapter
230A
and
hospital
psychiatric
units
8
that
are
located
in
mental
health
professional
shortage
areas.
9
Sec.
2.
Section
222.1,
Code
2014,
is
amended
to
read
as
10
follows:
11
222.1
Purpose
of
chapter
——
state
resource
centers
——
special
12
unit
at
state
mental
health
institute
.
13
1.
This
chapter
addresses
the
public
and
private
services
14
available
in
this
state
to
meet
the
needs
of
persons
with
an
15
intellectual
disability.
The
responsibility
of
counties,
of
16
the
mental
health
and
disability
service
regions
formed
by
17
counties,
and
of
the
state
for
the
costs
and
administration
of
18
publicly
funded
services
shall
be
as
set
out
in
section
222.60
19
and
other
pertinent
sections
of
this
chapter.
20
1.
2.
The
Glenwood
state
resource
center
and
the
Woodward
21
state
resource
center
are
established
and
shall
be
maintained
22
as
the
state’s
regional
resource
centers
for
the
purpose
of
23
providing
treatment,
training,
instruction,
care,
habilitation,
24
and
support
of
persons
with
an
intellectual
disability
or
other
25
disabilities
in
this
state,
and
providing
facilities,
services,
26
and
other
support
to
the
communities
located
in
the
region
27
being
served
by
a
state
resource
center.
In
addition,
the
28
state
resource
centers
are
encouraged
to
serve
as
a
training
29
resource
for
community-based
program
staff,
medical
students,
30
and
other
participants
in
professional
education
programs.
A
31
resource
center
may
request
the
approval
of
the
council
on
32
human
services
to
change
the
name
of
the
resource
center
for
33
use
in
communication
with
the
public,
in
signage,
and
in
other
34
forms
of
communication.
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2.
3.
A
special
intellectual
disability
unit
may
be
1
maintained
at
one
of
the
state
mental
health
institutes
for
the
2
purposes
set
forth
in
sections
222.88
to
222.91
.
3
Sec.
3.
Section
222.2,
subsection
3,
Code
2014,
is
amended
4
by
striking
the
subsection.
5
Sec.
4.
Section
222.2,
Code
2014,
is
amended
by
adding
the
6
following
new
subsections:
7
NEW
SUBSECTION
.
5A.
“Mental
health
and
disability
services
8
region”
means
a
mental
health
and
disability
services
region
9
formed
in
accordance
with
section
331.389.
10
NEW
SUBSECTION
.
5B.
“Regional
administrator”
means
the
11
regional
administrator
of
a
mental
health
and
disabilities
12
services
region,
as
defined
in
section
331.388.
13
Sec.
5.
Section
222.6,
Code
2014,
is
amended
to
read
as
14
follows:
15
222.6
State
districts.
16
The
administrator
shall
divide
the
state
into
two
districts
17
in
such
manner
that
one
of
the
resource
centers
shall
be
18
located
within
each
of
the
districts.
Such
districts
may
19
from
time
to
time
be
changed.
After
such
districts
have
been
20
established,
the
administrator
shall
notify
all
boards
of
21
supervisors,
regional
administrators
of
the
mental
health
and
22
disability
services
regions,
county
auditors,
and
clerks
of
23
the
district
courts
of
the
action.
Thereafter,
unless
the
24
administrator
otherwise
orders,
all
admissions
or
commitments
25
of
persons
with
an
intellectual
disability
from
a
district
26
shall
be
to
the
resource
center
located
within
such
district.
27
Sec.
6.
Section
222.12,
subsection
2,
Code
2014,
is
amended
28
to
read
as
follows:
29
2.
Notice
of
the
death
of
the
patient,
and
the
cause
30
of
death,
shall
be
sent
to
the
county
board
of
supervisors
31
regional
administrator
of
the
mental
health
and
disability
32
services
region
of
the
patient’s
county
of
residence
and
to
33
the
judge
of
the
court
that
had
jurisdiction
over
a
committed
34
patient.
The
fact
of
death
with
the
time,
place,
and
alleged
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cause
shall
be
entered
upon
the
docket
of
the
court.
1
Sec.
7.
Section
222.13,
Code
2014,
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
of
8
supervisors
of
regional
administrator
of
the
mental
health
and
9
disability
services
region
for
the
adult
person’s
county
of
10
residence
to
apply
to
the
superintendent
of
any
state
resource
11
center
for
the
voluntary
admission
of
the
adult
person
either
12
as
an
inpatient
or
an
outpatient
of
the
resource
center.
The
13
board
of
supervisors
regional
administrator
shall,
on
forms
14
prescribed
by
the
department’s
administrator,
apply
to
the
15
superintendent
of
the
resource
center
in
the
district
for
16
the
admission
of
the
adult
person
to
the
resource
center.
17
An
application
for
admission
to
a
special
unit
of
any
adult
18
person
believed
to
be
in
need
of
any
of
the
services
provided
19
by
the
special
unit
under
section
222.88
may
be
made
in
the
20
same
manner,
upon
request
of
the
adult
person
or
the
adult
21
person’s
guardian.
The
superintendent
shall
accept
the
22
application
if
a
preadmission
diagnostic
evaluation,
performed
23
authorized
through
the
central
point
of
coordination
process
24
regional
administrator
,
confirms
or
establishes
the
need
for
25
admission,
except
that
an
application
shall
not
be
accepted
if
26
the
institution
does
not
have
adequate
facilities
available
or
27
if
the
acceptance
will
result
in
an
overcrowded
condition.
28
2.
If
the
resource
center
has
no
does
not
have
an
29
appropriate
program
for
the
treatment
of
an
adult
or
minor
30
person
with
an
intellectual
disability
applying
under
this
31
section
or
section
222.13A
,
the
board
of
supervisors
regional
32
administrator
shall
arrange
for
the
placement
of
the
person
in
33
any
public
or
private
facility
within
or
without
the
state,
34
approved
by
the
director
of
the
department
of
human
services,
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which
offers
appropriate
services
for
the
person,
as
determined
1
through
the
central
point
of
coordination
process
by
the
2
regional
administrator
.
3
3.
Upon
applying
for
admission
of
an
adult
or
minor
person
4
to
a
resource
center,
or
a
special
unit,
or
upon
arranging
for
5
the
placement
of
the
person
in
a
public
or
private
facility,
6
the
board
of
supervisors
regional
administrator
shall
make
a
7
full
investigation
into
the
financial
circumstances
of
that
8
person
and
those
liable
for
that
person’s
support
under
section
9
222.78
to
determine
whether
or
not
any
of
them
are
able
to
10
pay
the
expenses
arising
out
of
the
admission
of
the
person
11
to
a
resource
center,
special
treatment
unit,
or
public
or
12
private
facility.
If
the
board
regional
administrator
finds
13
that
the
person
or
those
legally
responsible
for
the
person
14
are
presently
unable
to
pay
the
expenses,
the
board
regional
15
administrator
shall
direct
that
authorize
the
expenses
to
be
16
paid
by
the
county
region
.
The
board
regional
administrator
17
may
review
its
finding
at
any
subsequent
time
while
the
person
18
remains
at
the
resource
center,
or
is
otherwise
receiving
care
19
or
treatment
for
which
this
chapter
obligates
the
county
region
20
to
pay.
If
the
board
regional
administrator
finds
upon
review
21
that
the
person
or
those
legally
responsible
for
the
person
22
are
presently
able
to
pay
the
expenses,
the
finding
shall
23
apply
only
to
the
charges
incurred
during
the
period
beginning
24
on
the
date
of
the
review
and
continuing
thereafter,
unless
25
and
until
the
board
regional
administrator
again
changes
its
26
finding.
If
the
board
regional
administrator
finds
that
the
27
person
or
those
legally
responsible
for
the
person
are
able
28
to
pay
the
expenses,
the
board
regional
administrator
shall
29
direct
that
the
charges
be
so
paid
to
the
extent
required
by
30
section
222.78
,
and
the
county
auditor
of
the
person’s
county
31
of
residence
shall
be
responsible
for
the
collection
of
the
32
charges.
33
Sec.
8.
Section
222.13A,
Code
2014,
is
amended
to
read
as
34
follows:
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222.13A
Voluntary
admissions
——
minors.
1
1.
If
a
minor
is
believed
to
be
a
person
with
an
2
intellectual
disability,
the
minor’s
parent,
guardian,
or
3
custodian
may
request
the
county
board
of
supervisors
to
4
apply
to
the
department
for
admission
of
the
minor
as
a
5
voluntary
patient
in
a
state
resource
center.
If
the
resource
6
center
does
not
have
appropriate
services
for
the
minor’s
7
treatment,
the
board
of
supervisors
department
may
arrange
for
8
the
admission
of
the
minor
in
a
public
or
private
facility
9
within
or
without
the
state,
approved
by
the
director
of
human
10
services,
which
offers
appropriate
services
for
the
minor’s
11
treatment.
12
2.
Upon
receipt
of
an
application
for
voluntary
admission
of
13
a
minor,
the
board
of
supervisors
department
shall
provide
for
14
a
preadmission
diagnostic
evaluation
of
the
minor
to
confirm
15
or
establish
the
need
for
the
admission.
The
preadmission
16
diagnostic
evaluation
shall
be
performed
by
a
person
who
meets
17
the
qualifications
of
a
qualified
intellectual
disability
18
professional
who
is
designated
through
the
central
point
of
19
coordination
process
by
the
department
.
20
3.
During
the
preadmission
diagnostic
evaluation,
the
21
minor
shall
be
informed
both
orally
and
in
writing
that
the
22
minor
has
the
right
to
object
to
the
voluntary
admission.
If
23
the
preadmission
diagnostic
evaluation
determines
that
the
24
voluntary
admission
is
appropriate
but
the
minor
objects
to
25
the
admission,
the
minor
shall
not
be
admitted
to
the
state
26
resource
center
unless
the
court
approves
of
the
admission.
A
27
petition
for
approval
of
the
minor’s
admission
may
be
submitted
28
to
the
juvenile
court
by
the
minor’s
parent,
guardian,
or
29
custodian.
30
4.
As
soon
as
practicable
after
the
filing
of
a
petition
for
31
approval
of
the
voluntary
admission,
the
court
shall
determine
32
whether
the
minor
has
an
attorney
to
represent
the
minor
in
the
33
proceeding.
If
the
minor
does
not
have
an
attorney,
the
court
34
shall
assign
to
the
minor
an
attorney.
If
the
minor
is
unable
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to
pay
for
an
attorney,
the
attorney
shall
be
compensated
by
1
the
county
at
an
hourly
rate
to
be
established
by
the
county
2
board
of
supervisors
regional
administrator
in
substantially
3
the
same
manner
as
provided
in
section
815.7
.
4
5.
The
court
shall
order
the
admission
of
a
minor
who
5
objects
to
the
admission,
only
after
a
hearing
in
which
it
6
is
shown
by
clear
and
convincing
evidence
that
both
of
the
7
following
circumstances
exist:
8
a.
The
minor
needs
and
will
substantially
benefit
from
9
treatment
or
habilitation.
10
b.
A
placement
which
involves
less
restriction
of
the
11
minor’s
liberties
for
the
purposes
of
treatment
or
habilitation
12
is
not
feasible.
13
Sec.
9.
Section
222.14,
Code
2014,
is
amended
to
read
as
14
follows:
15
222.14
Care
by
county
region
pending
admission.
16
If
the
institution
is
unable
to
receive
a
patient,
the
17
superintendent
shall
notify
the
county
board
of
supervisors
18
of
regional
administrator
for
the
county
from
which
the
19
application
in
behalf
of
the
prospective
patient
was
made
of
20
the
time
when
such
person
may
be
received.
Until
such
time
as
21
the
patient
is
able
to
be
received
by
the
institution,
or
when
22
application
has
been
made
for
admission
to
a
public
or
private
23
facility
as
provided
in
section
222.13
and
the
application
is
24
pending,
the
care
of
said
person
the
patient
shall
be
provided
25
as
arranged
by
the
county
board
of
supervisors
regional
26
administrator
.
27
Sec.
10.
Section
222.22,
Code
2014,
is
amended
to
read
as
28
follows:
29
222.22
Time
of
appearance.
30
The
time
of
appearance
shall
not
be
less
than
five
days
31
after
completed
service
unless
the
court
orders
otherwise.
32
Appearance
on
behalf
of
the
person
who
is
alleged
to
have
33
an
intellectual
disability
may
be
made
by
any
citizen
of
the
34
county
or
by
any
relative.
The
district
court
shall
assign
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counsel
for
the
person
who
is
alleged
to
have
an
intellectual
1
disability.
Counsel
shall
prior
to
proceedings
personally
2
consult
with
the
person
who
is
alleged
to
have
an
intellectual
3
disability
unless
the
judge
appointing
counsel
certifies
that
4
in
the
judge’s
opinion,
consultation
shall
serve
no
useful
5
purpose.
The
certification
shall
be
made
a
part
of
the
record.
6
An
attorney
assigned
by
the
court
shall
be
compensated
by
the
7
county
at
an
hourly
rate
to
be
established
by
the
county
board
8
of
supervisors
regional
administrator
for
the
person’s
county
9
of
residence
in
substantially
the
same
manner
as
provided
in
10
section
815.7
.
11
Sec.
11.
Section
222.28,
Code
2014,
is
amended
to
read
as
12
follows:
13
222.28
Commission
to
examine.
14
The
court
may,
at
or
prior
to
the
final
hearing,
appoint
15
a
commission
of
one
qualified
physician
and
one
qualified
16
psychologist,
designated
through
the
central
point
of
17
coordination
process
by
the
regional
administrator
for
the
18
person’s
county
of
residence
,
who
shall
make
a
personal
19
examination
of
the
person
alleged
to
have
an
intellectual
20
disability
for
the
purpose
of
determining
the
mental
condition
21
of
the
person.
22
Sec.
12.
Section
222.31,
subsection
1,
paragraph
b,
Code
23
2014,
is
amended
to
read
as
follows:
24
b.
(1)
Commit
the
person
to
the
state
resource
center
25
designated
by
the
administrator
to
serve
the
county
mental
26
health
and
disability
services
region
in
which
the
hearing
27
is
being
held,
or
to
a
special
unit.
The
court
shall,
prior
28
to
issuing
an
order
of
commitment,
request
that
a
diagnostic
29
evaluation
of
the
person
be
made
by
a
person
qualified
to
30
perform
the
diagnostic
evaluation.
The
cost
of
the
evaluation
31
shall
be
defrayed
by
the
committed
person’s
county
of
32
residence
unless
otherwise
ordered
by
the
court.
The
cost
33
of
the
evaluation
to
be
charged
may
be
equal
to
but
shall
34
not
exceed
the
actual
cost
of
the
evaluation.
An
order
of
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commitment
shall
not
be
issued
unless
the
superintendent
of
the
1
institution
recommends
that
the
order
be
issued
and
advises
the
2
court
that
adequate
facilities
for
the
care
of
the
person
are
3
available.
4
(2)
The
court
shall
examine
the
report
of
the
county
5
attorney
filed
pursuant
to
section
222.13
,
and
if
the
report
6
shows
that
neither
the
person
nor
those
liable
for
the
person’s
7
support
under
section
222.78
are
presently
able
to
pay
the
8
charges
rising
out
of
the
person’s
care
in
a
resource
center,
9
or
special
treatment
unit,
shall
enter
an
order
stating
that
10
finding
and
directing
that
the
charges
be
paid
by
the
regional
11
administrator
for
the
person’s
county
of
residence.
The
12
court
may,
upon
request
of
the
board
of
supervisors
regional
13
administrator
,
review
its
finding
at
any
subsequent
time
while
14
the
person
remains
at
the
resource
center,
or
is
otherwise
15
receiving
care
or
treatment
for
which
this
chapter
obligates
16
the
county
to
pay.
If
the
court
finds
upon
review
that
17
the
person
or
those
legally
responsible
for
the
person
are
18
presently
able
to
pay
the
expenses,
that
finding
shall
apply
19
only
to
the
charges
incurred
during
the
period
beginning
on
the
20
date
of
the
board’s
regional
administrator’s
request
for
the
21
review
and
continuing
thereafter,
unless
and
until
the
court
22
again
changes
its
finding.
If
the
court
finds
that
the
person,
23
or
those
liable
for
the
person’s
support,
are
able
to
pay
the
24
charges,
the
court
shall
enter
an
order
directing
that
the
25
charges
be
so
paid
to
the
extent
required
by
section
222.78
.
26
Sec.
13.
Section
222.59,
subsection
1,
unnumbered
paragraph
27
1,
Code
2014,
is
amended
to
read
as
follows:
28
Upon
receiving
a
request
from
an
authorized
requester,
the
29
superintendent
of
a
state
resource
center
shall
coordinate
30
with
the
central
point
of
coordination
process
regional
31
administrator
for
the
person’s
county
of
residence
or
32
the
department,
as
applicable,
in
assisting
the
requester
33
in
identifying
available
community-based
services
as
an
34
alternative
to
continued
placement
of
a
patient
in
the
state
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resource
center.
For
the
purposes
of
this
section
,
“authorized
1
requester”
means
the
parent,
guardian,
or
custodian
of
a
minor
2
patient,
the
guardian
of
an
adult
patient,
or
an
adult
patient
3
who
does
not
have
a
guardian.
The
assistance
shall
identify
4
alternatives
to
continued
placement
which
are
appropriate
to
5
the
patient’s
needs
and
shall
include
but
are
not
limited
to
6
any
of
the
following:
7
Sec.
14.
Section
222.60,
subsection
1,
Code
2014,
is
amended
8
to
read
as
follows:
9
1.
All
necessary
and
legal
expenses
for
the
cost
of
10
admission
or
commitment
or
for
the
treatment,
training,
11
instruction,
care,
habilitation,
support
and
transportation
of
12
persons
with
an
intellectual
disability,
as
provided
for
in
13
the
county
applicable
regional
service
system
management
plan
14
provisions
implemented
pursuant
to
section
331.439,
subsection
15
1
331.393
,
in
a
state
resource
center,
or
in
a
special
unit,
16
or
any
public
or
private
facility
within
or
without
the
state,
17
approved
by
the
director
of
human
services,
shall
be
paid
by
18
either:
19
a.
The
If
the
person
is
not
eligible
for
the
medical
20
assistance
program
and
the
service
is
covered
by
the
regional
21
service
system
management
plan
of
the
person’s
county
of
22
residence
,
the
county
of
residence
.
23
b.
The
state
when
the
person
is
eligible
for
the
medical
24
assistance
program,
or
when
the
person
is
a
resident
in
another
25
state
,
or
in
a
foreign
country
,
or
the
residence
is
unknown.
26
The
For
persons
addressed
by
this
paragraph
other
than
those
27
eligible
for
the
medical
assistance
program,
the
payment
28
responsibility
shall
be
deemed
to
be
a
state
case.
29
Sec.
15.
Section
222.60,
subsection
2,
Code
2014,
is
amended
30
to
read
as
follows:
31
2.
a.
Prior
to
the
regional
administrator
for
a
county
of
32
residence
approving
the
payment
of
expenses
for
a
person
under
33
this
section
,
the
county
regional
administrator
may
require
34
that
the
person
be
diagnosed
to
determine
if
the
person
has
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an
intellectual
disability
or
that
the
person
be
evaluated
to
1
determine
the
appropriate
level
of
services
required
to
meet
2
the
person’s
needs
relating
to
an
intellectual
disability.
The
3
diagnosis
and
the
evaluation
may
be
performed
concurrently
and
4
shall
be
performed
by
an
individual
or
individuals
approved
5
by
the
regional
administrator
for
the
person’s
county
who
6
are
qualified
to
perform
the
diagnosis
or
the
evaluation.
7
Following
the
initial
approval
for
payment
of
expenses,
the
8
county
regional
administrator
may
require
that
an
evaluation
be
9
performed
at
reasonable
time
periods.
10
b.
The
cost
of
a
county-required
regional
11
administrator-required
diagnosis
and
an
evaluation
is
12
at
the
county’s
expense.
For
a
state
case,
the
state
may
apply
13
the
diagnosis
and
evaluation
provisions
of
this
subsection
at
14
the
state’s
expense.
15
c.
A
diagnosis
or
an
evaluation
under
this
section
may
be
16
part
of
a
county’s
central
point
of
coordination
process
under
17
section
331.440
diagnosis
and
assessment
process
implemented
18
by
the
applicable
regional
administrator
,
provided
that
a
19
diagnosis
is
performed
only
by
an
individual
qualified
as
20
provided
in
this
section
.
21
Sec.
16.
Section
222.61,
Code
2014,
is
amended
to
read
as
22
follows:
23
222.61
Residency
determined.
24
When
a
county
receives
an
application
on
behalf
of
any
25
person
for
admission
to
a
resource
center
or
a
special
unit
26
or
when
a
court
issues
an
order
committing
any
person
to
a
27
resource
center
or
a
special
unit,
the
board
of
supervisors
28
shall
refer
the
determination
of
residency
to
the
central
point
29
of
coordination
process
regional
administrator
for
the
county
30
to
determine
and
certify
that
the
residence
of
the
person
is
31
in
one
of
the
following:
32
1.
In
the
county
in
which
the
application
is
received
or
in
33
which
the
court
is
located.
34
2.
In
some
other
county
of
the
state.
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3.
In
another
state
or
in
a
foreign
country.
1
4.
Unknown.
2
Sec.
17.
Section
222.62,
Code
2014,
is
amended
to
read
as
3
follows:
4
222.62
Residency
in
another
county.
5
When
the
board
of
supervisors
determines
through
the
central
6
point
of
coordination
process
regional
administrator
for
the
7
county
that
the
residency
of
the
person
is
other
than
in
the
8
county
in
which
the
application
is
received,
the
determination
9
shall
be
certified
to
the
superintendent
of
the
resource
10
center
or
the
special
unit
where
the
person
is
a
patient.
The
11
certification
shall
be
accompanied
by
a
copy
of
the
evidence
12
supporting
the
determination.
The
If
the
person
is
not
13
eligible
for
the
medical
assistance
program,
the
superintendent
14
shall
charge
the
expenses
already
incurred
and
unadjusted
,
and
15
all
future
expenses
of
the
patient,
to
the
county
certified
to
16
be
the
county
of
residency.
17
Sec.
18.
Section
222.63,
Code
2014,
is
amended
to
read
as
18
follows:
19
222.63
Finding
of
residency
——
objection.
20
A
board
of
supervisors’
certification
utilizing
the
21
central
point
of
coordination
process
through
the
regional
22
administrator
for
a
county
that
a
person’s
residency
is
23
in
another
county
shall
be
sent
to
the
auditor
of
regional
24
administrator
for
the
county
of
residence.
The
certification
25
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
26
determination.
The
auditor
of
regional
administrator
for
27
the
county
of
residence
shall
submit
the
certification
to
28
the
regional
governing
board
of
supervisors
of
the
auditor’s
29
for
the
county
and
it
shall
be
conclusively
presumed
that
30
the
patient
has
residency
in
that
county
unless
the
regional
31
administrator
for
that
county
disputes
the
determination
of
32
residency
as
provided
in
section
331.394
.
33
Sec.
19.
Section
222.64,
Code
2014,
is
amended
to
read
as
34
follows:
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222.64
Foreign
state
or
country
or
unknown
residency.
1
If
the
residency
of
the
person
is
determined
by
a
regional
2
administrator
on
behalf
of
a
county
or
by
the
state
to
be
in
3
a
foreign
state
or
country
or
is
determined
to
be
unknown,
4
the
county
regional
administrator
or
the
state
shall
certify
5
the
determination
to
the
administrator
.
The
certification
6
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
the
7
determination.
The
care
of
the
person
shall
be
as
arranged
8
by
the
county
regional
administrator
or
the
state
or
by
an
9
order
as
the
court
may
enter.
Application
for
admission
or
10
order
of
commitment
may
be
made
pending
investigation
by
the
11
administrator.
12
Sec.
20.
Section
222.73,
subsection
2,
paragraph
a,
13
subparagraph
(6),
Code
2014,
is
amended
to
read
as
follows:
14
(6)
A
county
shall
not
be
billed
for
the
cost
of
a
patient
15
unless
the
patient’s
admission
is
authorized
through
the
16
applicable
central
point
of
coordination
process
regional
17
administrator
.
The
state
resource
center
and
the
county
18
regional
administrator
shall
work
together
to
locate
19
appropriate
alternative
placements
and
services,
and
to
educate
20
patients
and
the
family
members
of
patients
regarding
such
21
alternatives.
22
Sec.
21.
Section
222.73,
subsection
2,
paragraph
b,
Code
23
2014,
is
amended
to
read
as
follows:
24
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
25
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
26
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
27
to
a
county
may
be
adjusted
in
for
a
fiscal
year
to
reflect
28
increased
costs
to
the
extent
of
the
percentage
increase
in
the
29
total
of
county
fixed
budgets
pursuant
to
the
allowed
growth
30
factor
adjustment
authorized
statewide
per
capita
expenditure
31
target
amount,
if
any
per
capita
growth
amount
is
authorized
by
32
the
general
assembly
for
that
fiscal
year
in
accordance
with
33
section
331.439
331.424A
.
34
Sec.
22.
Section
222.74,
Code
2014,
is
amended
to
read
as
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follows:
1
222.74
Duplicate
to
county.
2
When
certifying
to
the
department
amounts
to
be
charged
3
against
each
county
as
provided
in
section
222.73
,
the
4
superintendent
shall
send
to
the
county
auditor
of
and
the
5
regional
administrator
for
each
county
against
which
the
6
superintendent
has
so
certified
any
amount,
a
duplicate
of
7
the
certification
statement.
The
county
auditor
upon
receipt
8
of
the
duplicate
certification
statement
and
approval
by
the
9
regional
administrator
for
payment
of
the
certified
amount
10
shall
enter
it
to
the
credit
of
the
state
in
the
ledger
of
11
state
accounts,
and
shall
immediately
issue
a
notice
to
the
12
county
treasurer
authorizing
the
treasurer
to
transfer
the
13
amount
from
the
county
fund
to
the
general
state
revenue.
The
14
county
treasurer
shall
file
the
notice
as
authority
for
making
15
the
transfer
and
shall
include
the
amount
transferred
in
the
16
next
remittance
of
state
taxes
to
the
treasurer
of
state,
17
designating
the
fund
to
which
the
amount
belongs.
18
Sec.
23.
Section
222.92,
subsection
3,
paragraph
a,
Code
19
2014,
is
amended
to
read
as
follows:
20
a.
Moneys
received
by
the
state
from
billings
to
counties
21
and
regional
administrators
for
the
counties
.
22
Sec.
24.
Section
225.1,
Code
2014,
is
amended
to
read
as
23
follows:
24
225.1
Establishment
——
definitions
.
25
1.
There
shall
be
established
a
The
state
psychiatric
26
hospital
,
is
established.
The
hospital
shall
be
especially
27
designed,
kept,
and
administered
for
the
care,
observation,
28
and
treatment
of
those
persons
who
are
afflicted
with
abnormal
29
mental
conditions.
30
2.
For
the
purposes
of
this
chapter,
unless
the
context
31
otherwise
requires:
32
a.
“Mental
health
and
disability
services
region”
means
33
a
mental
health
and
disability
services
region
approved
in
34
accordance
with
section
331.389.
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b.
“Regional
administrator”
means
the
administrator
of
a
1
mental
health
and
disability
services
region,
as
defined
in
2
section
331.388.
3
Sec.
25.
Section
225.10,
unnumbered
paragraph
1,
Code
2014,
4
is
amended
to
read
as
follows:
5
Persons
suffering
from
mental
diseases
may
be
admitted
to
6
the
state
psychiatric
hospital
as
voluntary
public
patients
7
if
a
physician
authorized
to
practice
medicine
or
osteopathic
8
medicine
in
the
state
of
Iowa
files
information
with
the
board
9
of
supervisors
regional
administrator
of
the
person’s
county
10
of
residence
or
the
board’s
designee
,
stating
all
of
the
11
following:
12
Sec.
26.
Section
225.11,
Code
2014,
is
amended
to
read
as
13
follows:
14
225.11
Initiating
commitment
procedures.
15
When
a
court
finds
upon
completion
of
a
hearing
held
pursuant
16
to
section
229.12
that
the
contention
that
a
respondent
is
17
seriously
mentally
impaired
has
been
sustained
by
clear
and
18
convincing
evidence,
and
the
application
filed
under
section
19
229.6
also
contends
or
the
court
otherwise
concludes
that
it
20
would
be
appropriate
to
refer
the
respondent
to
the
state
21
psychiatric
hospital
for
a
complete
psychiatric
evaluation
and
22
appropriate
treatment
pursuant
to
section
229.13
,
the
judge
23
may
order
that
a
financial
investigation
be
made
in
the
manner
24
prescribed
by
section
225.13
.
If
the
costs
of
a
respondent’s
25
evaluation
or
treatment
are
payable
in
whole
or
in
part
by
26
a
county,
an
order
under
this
section
shall
be
for
referral
27
of
the
respondent
through
the
central
point
of
coordination
28
process
regional
administrator
for
the
respondent’s
county
of
29
residence
for
an
evaluation
and
referral
of
the
respondent
30
to
an
appropriate
placement
or
service,
which
may
include
31
the
state
psychiatric
hospital
for
additional
evaluation
or
32
treatment.
For
purposes
of
this
chapter
,
“central
point
of
33
coordination
process”
means
the
same
as
defined
in
section
34
331.440
.
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Sec.
27.
Section
225.12,
Code
2014,
is
amended
to
read
as
1
follows:
2
225.12
Voluntary
public
patient
——
physician’s
report.
3
A
physician
filing
information
under
section
225.10
shall
4
include
a
written
report
to
the
county
board
of
supervisors
5
or
the
board’s
designee
regional
administrator
for
the
6
county
of
residence
of
the
person
named
in
the
information
,
7
giving
a
history
of
the
case
as
will
be
likely
to
aid
in
the
8
observation,
treatment,
and
hospital
care
of
the
person
named
9
in
the
information
and
describing
the
history
in
detail.
10
Sec.
28.
Section
225.13,
Code
2014,
is
amended
to
read
as
11
follows:
12
225.13
Financial
condition.
13
The
county
board
of
supervisors
or
the
board’s
designee
14
regional
administrator
of
the
county
of
residence
of
a
person
15
being
admitted
to
the
state
psychiatric
hospital
is
responsible
16
for
investigating
the
financial
condition
of
a
person
being
17
admitted
to
the
state
psychiatric
hospital
the
person
and
of
18
those
legally
responsible
for
the
person’s
support.
19
Sec.
29.
Section
225.15,
Code
2014,
is
amended
to
read
as
20
follows:
21
225.15
Examination
and
treatment.
22
1.
When
a
respondent
arrives
at
the
state
psychiatric
23
hospital,
the
admitting
physician
shall
examine
the
respondent
24
and
determine
whether
or
not,
in
the
physician’s
judgment,
the
25
respondent
is
a
fit
subject
for
observation,
treatment,
and
26
hospital
care.
If,
upon
examination,
the
physician
decides
27
that
the
respondent
should
be
admitted
to
the
hospital,
the
28
respondent
shall
be
provided
a
proper
bed
in
the
hospital.
The
29
physician
who
has
charge
of
the
respondent
shall
proceed
with
30
observation,
medical
treatment,
and
hospital
care
as
in
the
31
physician’s
judgment
are
proper
and
necessary,
in
compliance
32
with
sections
229.13
to
229.16
.
After
the
respondent’s
33
admission,
the
observation,
medical
treatment,
and
hospital
34
care
of
the
respondent
may
be
provided
by
a
mental
health
35
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professional,
as
defined
in
section
228.1
,
who
is
licensed
as
a
1
physician,
advanced
registered
nurse
practitioner,
or
physician
2
assistant.
3
2.
A
proper
and
competent
nurse
shall
also
be
assigned
to
4
look
after
and
care
for
the
respondent
during
observation,
5
treatment,
and
care.
Observation,
treatment,
and
hospital
care
6
under
this
section
which
are
payable
in
whole
or
in
part
by
a
7
county
shall
only
be
provided
as
determined
through
the
central
8
point
of
coordination
process
regional
administrator
of
the
9
respondent’s
county
of
residence
.
10
Sec.
30.
Section
225.16,
subsection
1,
Code
2014,
is
amended
11
to
read
as
follows:
12
1.
If
the
county
board
of
supervisors
or
the
board’s
13
designee
regional
administrator
for
a
person’s
county
of
14
residence
finds
from
the
physician’s
information
which
was
15
filed
under
the
provisions
of
section
225.10
that
it
would
16
be
appropriate
for
the
person
to
be
admitted
to
the
state
17
psychiatric
hospital,
and
the
report
of
the
county
board
of
18
supervisors
or
the
board’s
designee
regional
administrator
made
19
pursuant
to
section
225.13
shows
that
the
person
and
those
who
20
are
legally
responsible
for
the
person
are
not
able
to
pay
the
21
expenses
incurred
at
the
hospital,
or
are
able
to
pay
only
a
22
part
of
the
expenses,
the
person
shall
be
considered
to
be
a
23
voluntary
public
patient
and
the
board
of
supervisors
regional
24
administrator
shall
direct
that
the
person
shall
be
sent
to
the
25
state
psychiatric
hospital
at
the
state
university
of
Iowa
for
26
observation,
treatment,
and
hospital
care.
27
Sec.
31.
Section
225.17,
subsection
2,
Code
2014,
is
amended
28
to
read
as
follows:
29
2.
When
the
respondent
arrives
at
the
hospital,
the
30
respondent
shall
receive
the
same
treatment
as
is
provided
for
31
committed
public
patients
in
section
225.15
,
in
compliance
with
32
sections
229.13
to
229.16
.
However,
observation,
treatment,
33
and
hospital
care
under
this
section
of
a
respondent
whose
34
expenses
are
payable
in
whole
or
in
part
by
a
county
shall
35
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only
be
provided
as
determined
through
the
central
point
of
1
coordination
process
regional
administrator
of
the
respondent’s
2
county
of
residence
.
3
Sec.
32.
Section
225.18,
Code
2014,
is
amended
to
read
as
4
follows:
5
225.18
Attendants.
6
The
county
board
of
supervisors
or
the
board’s
designee
7
regional
administrator
may
appoint
a
person
an
attendant
to
8
accompany
the
committed
public
patient
or
the
voluntary
public
9
patient
or
the
committed
private
patient
from
the
place
where
10
the
patient
may
be
to
the
state
psychiatric
hospital,
or
to
11
accompany
the
patient
from
the
hospital
to
a
place
as
may
be
12
designated
by
the
county
regional
administrator
.
If
a
patient
13
is
moved
pursuant
to
this
section
,
at
least
one
attendant
shall
14
be
of
the
same
gender
as
the
patient.
15
Sec.
33.
Section
225.19,
Code
2014,
is
amended
to
read
as
16
follows:
17
225.19
Compensation
for
attendant.
18
An
individual
appointed
by
the
county
board
of
supervisors
19
or
the
board’s
designee
regional
administrator
in
accordance
20
with
section
225.18
to
accompany
a
person
to
or
from
the
21
hospital
or
to
make
an
investigation
and
report
on
any
question
22
involved
in
the
matter
shall
receive
three
dollars
per
day
for
23
the
time
actually
spent
in
making
the
investigation
and
actual
24
necessary
expenses
incurred
in
making
the
investigation
or
25
trip.
This
section
does
not
apply
to
an
appointee
who
receives
26
fixed
compensation
or
a
salary.
27
Sec.
34.
Section
225.21,
Code
2014,
is
amended
to
read
as
28
follows:
29
225.21
Compensation
claims
——
filing
——
approval.
30
The
person
making
claim
to
compensation
under
section
225.19
31
shall
file
the
claim
in
the
office
of
the
county
auditor.
32
The
claim
is
subject
to
review
and
approval
by
the
board
of
33
supervisors
or
the
board’s
designee
regional
administrator
for
34
the
county
.
35
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2417
Sec.
35.
Section
225.24,
Code
2014,
is
amended
to
read
as
1
follows:
2
225.24
Collection
of
preliminary
expense.
3
Unless
a
committed
private
patient
or
those
legally
4
responsible
for
the
patient’s
support
offer
to
settle
the
5
amount
of
the
claims,
the
county
auditor
of
the
person’s
county
6
of
residence
shall
collect,
by
action
if
necessary,
the
amount
7
of
all
claims
for
per
diem
and
expenses
that
have
been
approved
8
by
the
county
board
of
supervisors
or
the
board’s
designee
9
regional
administrator
for
the
county
and
paid
by
the
county
10
as
provided
under
section
225.21
.
Any
amount
collected
shall
11
be
credited
to
the
county
treasury
county’s
mental
health
and
12
disabilities
services
fund
created
in
accordance
with
section
13
331.424A
.
14
Sec.
36.
Section
225.27,
Code
2014,
is
amended
to
read
as
15
follows:
16
225.27
Discharge
——
transfer.
17
The
state
psychiatric
hospital
may,
at
any
time,
discharge
18
any
patient
as
recovered,
as
improved,
or
as
not
likely
to
19
be
benefited
by
further
treatment.
If
the
patient
being
so
20
discharged
was
involuntarily
hospitalized,
the
hospital
shall
21
notify
the
committing
judge
or
court
of
the
discharge
as
22
required
by
section
229.14
or
section
229.16
,
whichever
is
23
applicable
,
and
the
applicable
regional
administrator
.
Upon
24
receiving
the
notification,
the
court
shall
issue
an
order
25
confirming
the
patient’s
discharge
from
the
hospital
or
from
26
care
and
custody,
as
the
case
may
be,
and
shall
terminate
the
27
proceedings
pursuant
to
which
the
order
was
issued.
The
court
28
or
judge
shall,
if
necessary,
appoint
a
person
to
accompany
the
29
discharged
patient
from
the
state
psychiatric
hospital
to
such
30
place
as
the
hospital
or
the
court
may
designate,
or
authorize
31
the
hospital
to
appoint
such
attendant.
32
Sec.
37.
Section
225C.2,
subsection
2,
Code
2014,
is
amended
33
by
striking
the
subsection.
34
Sec.
38.
Section
225C.5,
subsection
1,
paragraph
f,
Code
35
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2417
2014,
is
amended
to
read
as
follows:
1
f.
Two
members
shall
be
staff
members
of
regional
2
administrators
of
the
central
point
of
coordination
process
3
established
in
accordance
with
section
331.440
selected
from
4
nominees
submitted
by
the
community
services
affiliate
of
the
5
Iowa
state
association
of
counties.
6
Sec.
39.
Section
225C.6,
subsection
1,
paragraph
i,
7
subparagraph
(1),
Code
2014,
is
amended
to
read
as
follows:
8
(1)
The
extent
to
which
services
to
persons
with
9
disabilities
are
actually
available
to
persons
in
each
county
10
and
mental
health
and
disability
services
region
in
the
state
11
and
the
quality
of
those
services.
12
Sec.
40.
Section
225C.6,
subsection
1,
paragraph
m,
Code
13
2014,
is
amended
to
read
as
follows:
14
m.
Identify
disability
services
outcomes
and
indicators
to
15
support
the
ability
of
eligible
persons
with
a
disability
to
16
live,
learn,
work,
and
recreate
in
communities
of
the
persons’
17
choice.
The
identification
duty
includes
but
is
not
limited
to
18
responsibility
for
identifying,
collecting,
and
analyzing
data
19
as
necessary
to
issue
reports
on
outcomes
and
indicators
at
the
20
county
,
region,
and
state
levels.
21
Sec.
41.
Section
225C.13,
subsection
1,
Code
2014,
is
22
amended
to
read
as
follows:
23
1.
The
administrator
assigned,
in
accordance
with
section
24
218.1
,
to
control
the
state
mental
health
institutes
and
25
the
state
resource
centers
may
enter
into
agreements
under
26
which
a
facility
or
portion
of
a
facility
administered
by
the
27
administrator
is
leased
to
a
department
or
division
of
state
28
government,
a
county
or
group
of
counties,
a
mental
health
and
29
disability
services
region,
or
a
private
nonprofit
corporation
30
organized
under
chapter
504
.
A
lease
executed
under
this
31
section
shall
require
that
the
lessee
use
the
leased
premises
32
to
deliver
either
disability
services
or
other
services
33
normally
delivered
by
the
lessee.
34
Sec.
42.
Section
225C.14,
Code
2014,
is
amended
to
read
as
35
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follows:
1
225C.14
Preliminary
diagnostic
evaluation.
2
1.
Except
in
cases
of
medical
emergency,
a
person
shall
be
3
admitted
to
a
state
mental
health
institute
as
an
inpatient
4
only
after
a
preliminary
diagnostic
evaluation
performed
5
through
the
central
point
of
coordination
process
regional
6
administrator
of
the
person’s
county
of
residence
has
confirmed
7
that
the
admission
is
appropriate
to
the
person’s
mental
health
8
needs,
and
that
no
suitable
alternative
method
of
providing
the
9
needed
services
in
a
less
restrictive
setting
or
in
or
nearer
10
to
the
person’s
home
community
is
currently
available.
If
11
provided
for
through
the
central
point
of
coordination
process
12
regional
administrator
,
the
evaluation
may
be
performed
by
a
13
community
mental
health
center
or
by
an
alternative
diagnostic
14
facility.
The
policy
established
by
this
section
shall
be
15
implemented
in
the
manner
and
to
the
extent
prescribed
by
16
sections
225C.15
,
225C.16
and
225C.17
.
17
2.
As
used
in
this
section
and
sections
225C.15
,
225C.16
18
and
225C.17
,
the
term
“medical
emergency”
means
a
situation
19
in
which
a
prospective
patient
is
received
at
a
state
mental
20
health
institute
in
a
condition
which,
in
the
opinion
of
the
21
chief
medical
officer,
or
that
officer’s
physician
designee,
22
requires
the
immediate
admission
of
the
person
notwithstanding
23
the
policy
stated
in
subsection
1
.
24
Sec.
43.
Section
225C.15,
Code
2014,
is
amended
to
read
as
25
follows:
26
225C.15
County
implementation
of
evaluations.
27
The
board
of
supervisors
of
regional
administrator
for
a
28
county
shall
,
no
later
than
July
1,
1982,
require
that
the
29
policy
stated
in
section
225C.14
be
followed
with
respect
30
to
admission
of
persons
from
that
county
to
a
state
mental
31
health
institute.
A
community
mental
health
center
which
is
32
supported,
directly
or
in
affiliation
with
other
counties,
by
33
that
county
may
perform
the
preliminary
diagnostic
evaluations
34
for
that
county,
unless
the
performance
of
the
evaluations
35
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44
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2417
is
not
covered
by
the
agreement
entered
into
by
the
county
1
regional
administrator
and
the
center,
and
the
center’s
2
director
certifies
to
the
board
of
supervisors
regional
3
administrator
that
the
center
does
not
have
the
capacity
to
4
perform
the
evaluations,
in
which
case
the
board
of
supervisors
5
regional
administrator
shall
proceed
under
section
225C.17
.
6
Sec.
44.
Section
225C.16,
Code
2014,
is
amended
to
read
as
7
follows:
8
225C.16
Referrals
for
evaluation.
9
1.
The
chief
medical
officer
of
a
state
mental
health
10
institute,
or
that
officer’s
physician
designee,
shall
advise
11
a
person
residing
in
that
county
who
applies
for
voluntary
12
admission,
or
a
person
applying
for
the
voluntary
admission
13
of
another
person
who
resides
in
that
county,
in
accordance
14
with
section
229.41
,
that
the
board
of
supervisors
regional
15
administrator
for
the
county
has
implemented
the
policy
16
stated
in
section
225C.14
,
and
shall
advise
that
a
preliminary
17
diagnostic
evaluation
of
the
prospective
patient
be
sought,
18
if
that
has
not
already
been
done.
This
subsection
does
not
19
apply
when
voluntary
admission
is
sought
in
accordance
with
20
section
229.41
under
circumstances
which,
in
the
opinion
of
the
21
chief
medical
officer
or
that
officer’s
physician
designee,
22
constitute
a
medical
emergency.
23
2.
The
clerk
of
the
district
court
in
that
county
shall
24
refer
a
person
applying
for
authorization
for
voluntary
25
admission,
or
for
authorization
for
voluntary
admission
of
26
another
person,
in
accordance
with
section
229.42
,
to
the
27
appropriate
entity
designated
through
the
central
point
of
28
coordination
process
regional
administrator
of
the
person’s
29
county
of
residence
under
section
225C.14
for
the
preliminary
30
diagnostic
evaluation
unless
the
applicant
furnishes
a
written
31
statement
from
the
appropriate
entity
which
indicates
that
the
32
evaluation
has
been
performed
and
that
the
person’s
admission
33
to
a
state
mental
health
institute
is
appropriate.
This
34
subsection
does
not
apply
when
authorization
for
voluntary
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admission
is
sought
under
circumstances
which,
in
the
opinion
1
of
the
chief
medical
officer
or
that
officer’s
physician
2
designee,
constitute
a
medical
emergency.
3
3.
Judges
of
the
district
court
in
that
county
or
the
4
judicial
hospitalization
referee
appointed
for
that
county
5
shall
so
far
as
possible
arrange
for
the
entity
designated
6
through
the
central
point
of
coordination
process
regional
7
administrator
under
section
225C.14
to
perform
a
prehearing
8
examination
of
a
respondent
required
under
section
229.8,
9
subsection
3
,
paragraph
“b”
.
10
4.
The
chief
medical
officer
of
a
state
mental
health
11
institute
shall
promptly
submit
to
the
appropriate
entity
12
designated
through
the
central
point
of
coordination
process
13
regional
administrator
under
section
225C.14
a
report
of
the
14
voluntary
admission
of
a
patient
under
the
medical
emergency
15
clauses
provisions
of
subsections
1
and
2
.
The
report
shall
16
explain
the
nature
of
the
emergency
which
necessitated
the
17
admission
of
the
patient
without
a
preliminary
diagnostic
18
evaluation
by
the
designated
entity.
19
Sec.
45.
Section
225C.17,
Code
2014,
is
amended
to
read
as
20
follows:
21
225C.17
Alternative
diagnostic
facility.
22
If
a
county
is
not
served
by
a
community
mental
health
23
center
having
the
capacity
to
perform
the
required
preliminary
24
diagnostic
evaluations,
the
board
of
supervisors
regional
25
administrator
for
the
county
shall
arrange
for
the
evaluations
26
to
be
performed
by
an
alternative
diagnostic
facility
for
27
the
period
until
the
county
is
served
by
a
community
mental
28
health
center
with
the
capacity
to
provide
that
service.
An
29
alternative
diagnostic
facility
may
be
the
outpatient
service
30
of
a
state
mental
health
institute
or
any
other
mental
health
31
facility
or
service
able
to
furnish
the
requisite
professional
32
skills
to
properly
perform
a
preliminary
diagnostic
evaluation
33
of
a
person
whose
admission
to
a
state
mental
health
institute
34
is
being
sought
or
considered
on
either
a
voluntary
or
an
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involuntary
basis.
1
Sec.
46.
Section
225C.19,
subsection
3,
paragraphs
a,
b,
and
2
c,
Code
2014,
are
amended
to
read
as
follows:
3
a.
Standards
for
accrediting
or
approving
emergency
mental
4
health
crisis
services
providers.
Such
providers
may
include
5
but
are
not
limited
to
a
community
mental
health
center
6
designated
under
chapter
230A
,
a
provider
approved
in
a
waiver
7
adopted
by
the
commission
to
provide
services
to
a
county
8
in
lieu
of
a
community
mental
health
center,
a
unit
of
the
9
department
or
other
state
agency,
a
county,
a
mental
health
10
and
disability
services
region,
or
any
other
public
or
private
11
provider
who
meets
the
accreditation
or
approval
standards
for
12
an
emergency
mental
health
crisis
services
provider.
13
b.
Identification
by
the
division
of
geographic
regions,
14
groupings
of
mental
health
and
disability
services
regions,
15
service
areas,
or
other
means
of
distributing
and
organizing
16
the
emergency
mental
health
crisis
services
system
to
ensure
17
statewide
availability
of
the
services.
18
c.
Coordination
of
emergency
mental
health
crisis
services
19
with
all
of
the
following:
20
(1)
The
district
and
juvenile
courts.
21
(2)
Law
enforcement.
22
(3)
Judicial
district
departments
of
correctional
services.
23
(4)
County
central
point
of
coordination
processes
Mental
24
health
and
disability
services
regions
.
25
(5)
Other
mental
health,
substance
abuse,
and
co-occurring
26
mental
illness
and
substance
abuse
services
available
through
27
the
state
and
counties
to
serve
both
children
and
adults.
28
Sec.
47.
Section
225C.20,
Code
2014,
is
amended
to
read
as
29
follows:
30
225C.20
Responsibilities
of
counties
for
individual
case
31
management
services.
32
Individual
case
management
services
funded
under
medical
33
assistance
shall
be
provided
by
the
department
except
when
a
34
county
or
a
consortium
of
counties
regional
administrator
for
a
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44
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2417
county
contracts
with
the
department
to
provide
the
services.
1
A
county
or
consortium
of
counties
regional
administrator
2
may
contract
for
one
or
more
counties
of
the
region
to
be
3
the
provider
at
any
time
and
the
department
shall
agree
to
4
the
contract
so
long
as
the
contract
meets
the
standards
for
5
case
management
adopted
by
the
department.
The
county
or
6
consortium
of
counties
regional
administrator
may
subcontract
7
for
the
provision
of
case
management
services
so
long
as
the
8
subcontract
meets
the
same
standards.
A
county
board
of
9
supervisors
regional
administrator
may
change
the
provider
10
of
individual
case
management
services
at
any
time.
If
the
11
current
or
proposed
contract
is
with
the
department,
the
county
12
board
of
supervisors
regional
administrator
shall
provide
13
written
notification
of
a
change
at
least
ninety
days
before
14
the
date
the
change
will
take
effect.
15
Sec.
48.
Section
225C.54,
subsection
1,
Code
2014,
is
16
amended
to
read
as
follows:
17
1.
The
mental
health
services
system
for
children
and
youth
18
shall
be
initially
implemented
by
the
division
commencing
19
with
the
fiscal
year
beginning
July
1,
2008.
The
division
20
shall
begin
implementation
by
utilizing
a
competitive
bidding
21
process
to
allocate
state
block
grants
to
develop
services
22
through
existing
community
mental
health
centers
,
providers
23
approved
in
a
waiver
adopted
by
the
commission
to
provide
24
services
to
a
county
in
lieu
of
a
community
mental
health
25
center,
designated
under
chapter
230A
and
other
local
service
26
partners.
The
implementation
shall
be
limited
to
the
extent
of
27
the
appropriations
provided
for
the
children’s
system.
28
Sec.
49.
Section
226.1,
Code
2014,
is
amended
by
adding
the
29
following
new
subsection:
30
NEW
SUBSECTION
.
4.
For
the
purposes
of
this
chapter
unless
31
the
context
otherwise
requires:
32
a.
“Administrator”
means
the
person
assigned
by
the
33
director
of
human
services
to
control
the
state
mental
health
34
institutes.
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2417
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2417
b.
“Department”
means
the
department
of
human
services.
1
c.
“Mental
health
and
disability
services
region”
means
2
a
mental
health
and
disability
services
region
formed
in
3
accordance
with
section
331.389.
4
d.
“Regional
administrator”
means
the
regional
administrator
5
of
a
mental
health
and
disabilities
services
region,
as
defined
6
in
section
331.388.
7
Sec.
50.
Section
226.9C,
subsection
2,
paragraphs
a
and
c,
8
Code
2014,
are
amended
to
read
as
follows:
9
a.
A
county
may
split
the
charges
between
the
county’s
10
county
mental
health
,
intellectual
disability,
and
11
developmental
and
disabilities
services
fund
created
pursuant
12
to
section
331.424A
and
the
county’s
budget
for
substance
abuse
13
expenditures.
14
c.
(1)
Prior
to
an
individual’s
admission
for
dual
15
diagnosis
treatment,
the
individual
shall
have
been
16
prescreened.
The
person
performing
the
prescreening
shall
17
be
either
the
mental
health
professional,
as
defined
in
18
section
228.1
,
who
is
contracting
with
the
county
central
19
point
of
coordination
process
regional
administrator
for
the
20
county’s
mental
health
and
disability
services
region
to
21
provide
the
prescreening
or
a
mental
health
professional
with
22
the
requisite
qualifications.
A
mental
health
professional
23
with
the
requisite
qualifications
shall
meet
all
of
the
24
following
qualifications:
is
a
mental
health
professional
as
25
defined
in
section
228.1
,
is
an
alcohol
and
drug
counselor
26
certified
by
the
nongovernmental
Iowa
board
of
substance
abuse
27
certification,
and
is
employed
by
or
providing
services
for
a
28
facility,
as
defined
in
section
125.2
.
29
(2)
Prior
to
an
individual’s
admission
for
dual
diagnosis
30
treatment,
the
individual
shall
have
been
screened
through
a
31
county’s
central
point
of
coordination
process
implemented
32
pursuant
to
section
331.440
regional
administrator
to
determine
33
the
appropriateness
of
the
treatment.
34
Sec.
51.
Section
226.32,
Code
2014,
is
amended
to
read
as
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follows:
1
226.32
Overcrowded
conditions.
2
The
administrator
shall
order
the
discharge
or
removal
3
from
the
hospital
of
incurable
and
harmless
patients
whenever
4
it
is
necessary
to
make
room
for
recent
cases.
If
a
patient
5
who
is
to
be
so
discharged
entered
the
hospital
voluntarily,
6
the
administrator
shall
notify
the
auditor
of
regional
7
administrator
for
the
county
interested
at
least
ten
days
in
8
advance
of
the
day
of
actual
discharge.
9
Sec.
52.
Section
226.34,
subsection
2,
Code
2014,
is
amended
10
to
read
as
follows:
11
2.
If
a
patient
in
a
mental
health
institute
dies
from
any
12
cause,
the
superintendent
of
the
institute
shall
within
three
13
days
of
the
date
of
death,
send
by
certified
mail
a
written
14
notice
of
death
to
all
of
the
following:
15
a.
The
decedent’s
nearest
relative.
16
b.
The
clerk
of
the
district
court
of
the
county
from
which
17
the
patient
was
committed.
18
c.
The
sheriff
of
the
county
from
which
the
patient
was
19
committed.
20
d.
The
regional
administrator
for
the
county
from
which
the
21
patient
was
committed.
22
Sec.
53.
Section
227.1,
Code
2014,
is
amended
to
read
as
23
follows:
24
227.1
Supervision
Definitions
——
supervision
.
25
1.
For
the
purposes
of
this
chapter,
unless
the
context
26
otherwise
requires:
27
a.
“Administrator”
means
the
person
assigned
by
the
director
28
of
human
services
in
the
appropriate
division
of
the
department
29
to
administer
mental
health
and
disability
services.
30
b.
“Department”
means
the
department
of
human
services.
31
c.
“Mental
health
and
disability
services
region”
means
32
a
mental
health
and
disability
services
region
formed
in
33
accordance
with
section
331.389.
34
d.
“Regional
administrator”
means
the
regional
administrator
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of
a
mental
health
and
disabilities
services
region,
as
defined
1
in
section
331.388.
2
2.
All
The
regulatory
requirements
for
county
and
private
3
institutions
wherein
where
persons
with
mental
illness
or
an
4
intellectual
disability
are
kept
admitted,
committed,
or
placed
5
shall
be
under
the
supervision
of
the
administrator.
6
Sec.
54.
Section
227.2,
subsection
1,
unnumbered
paragraph
7
1,
Code
2014,
is
amended
to
read
as
follows:
8
The
director
of
inspections
and
appeals
shall
make,
or
cause
9
to
be
made,
at
least
one
licensure
inspection
each
year
of
10
every
county
care
facility.
Either
the
administrator
of
the
11
division
or
the
director
of
the
department
of
inspections
and
12
appeals,
in
cooperation
with
each
other,
upon
receipt
of
a
13
complaint
or
for
good
cause,
may
make,
or
cause
to
be
made,
14
a
review
of
a
county
care
facility
or
of
any
other
private
15
or
county
institution
where
persons
with
mental
illness
or
16
an
intellectual
disability
reside.
A
licensure
inspection
17
or
a
review
shall
be
made
by
a
competent
and
disinterested
18
person
who
is
acquainted
with
and
interested
in
the
care
of
19
persons
with
mental
illness
and
persons
with
an
intellectual
20
disability.
The
objective
of
a
licensure
inspection
or
a
21
review
shall
be
an
evaluation
of
the
programming
and
treatment
22
provided
by
the
facility.
After
each
licensure
inspection
of
a
23
county
care
facility,
the
person
who
made
the
inspection
shall
24
consult
with
the
county
authorities
regional
administrator
25
for
the
county
in
which
the
facility
is
located
on
plans
and
26
practices
that
will
improve
the
care
given
patients
and
.
The
27
person
shall
also
make
recommendations
to
the
administrator
of
28
the
division
and
the
director
of
public
health
for
coordinating
29
and
improving
the
relationships
between
the
administrators
of
30
county
care
facilities,
the
administrator
of
the
division,
31
the
director
of
public
health,
the
superintendents
of
state
32
mental
health
institutes
and
resource
centers,
community
33
mental
health
centers,
mental
health
and
disability
services
34
regions,
and
other
cooperating
agencies,
to
cause
improved
35
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2417
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44
H.F.
2417
and
more
satisfactory
care
of
patients.
A
written
report
of
1
each
licensure
inspection
of
a
county
care
facility
under
this
2
section
shall
be
filed
by
the
person
with
the
administrator
3
of
the
division
and
the
director
of
public
health
and
shall
4
include:
5
Sec.
55.
Section
227.2,
subsection
1,
paragraph
f,
Code
6
2014,
is
amended
to
read
as
follows:
7
f.
The
recommendations
given
to
and
received
from
county
8
authorities
the
regional
administrator
on
methods
and
practices
9
that
will
improve
the
conditions
under
which
the
county
care
10
facility
is
operated.
11
Sec.
56.
Section
227.2,
subsection
2,
Code
2014,
is
amended
12
to
read
as
follows:
13
2.
A
copy
of
the
written
report
prescribed
by
subsection
14
1
shall
be
furnished
to
the
county
board
of
supervisors,
15
to
the
county
mental
health
and
intellectual
disability
16
coordinating
board
or
to
its
advisory
board
if
the
county
board
17
of
supervisors
constitutes
ex
officio
the
coordinating
board
18
regional
administrator
for
the
county
,
to
the
administrator
19
of
the
county
care
facility
inspected
and
to
its
certified
20
volunteer
long-term
care
ombudsman,
and
to
the
department
on
21
aging.
22
Sec.
57.
Section
227.4,
Code
2014,
is
amended
to
read
as
23
follows:
24
227.4
Standards
for
care
of
persons
with
mental
illness
or
an
25
intellectual
disability
in
county
care
facilities.
26
The
administrator,
in
cooperation
with
the
department
of
27
inspections
and
appeals,
shall
recommend
and
the
mental
health
28
and
disability
services
commission
created
in
section
225C.5
29
shall
adopt
,
or
amend
and
adopt,
standards
for
the
care
of
and
30
services
to
persons
with
mental
illness
or
an
intellectual
31
disability
residing
in
county
care
facilities.
The
standards
32
shall
be
enforced
by
the
department
of
inspections
and
appeals
33
as
a
part
of
the
licensure
inspection
conducted
pursuant
to
34
chapter
135C
.
The
objective
of
the
standards
is
to
ensure
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that
persons
with
mental
illness
or
an
intellectual
disability
1
who
are
residents
of
county
care
facilities
are
not
only
2
adequately
fed,
clothed,
and
housed,
but
are
also
offered
3
reasonable
opportunities
for
productive
work
and
recreational
4
activities
suited
to
their
physical
and
mental
abilities
and
5
offering
both
a
constructive
outlet
for
their
energies
and,
if
6
possible,
therapeutic
benefit.
When
recommending
standards
7
under
this
section
,
the
administrator
shall
designate
an
8
advisory
committee
representing
administrators
of
county
care
9
facilities,
county
mental
health
and
developmental
disabilities
10
regional
planning
councils
regional
administrators
,
mental
11
health
and
disabilities
services
region
governing
boards,
12
and
county
care
facility
certified
volunteer
long-term
care
13
ombudsmen
to
assist
in
the
establishment
of
standards.
14
Sec.
58.
Section
227.10,
Code
2014,
is
amended
to
read
as
15
follows:
16
227.10
Transfers
from
county
or
private
institutions.
17
Patients
who
have
been
admitted
at
public
expense
to
18
any
institution
to
which
this
chapter
is
applicable
may
be
19
involuntarily
transferred
to
the
proper
state
hospital
for
20
persons
with
mental
illness
in
the
manner
prescribed
by
21
sections
229.6
to
229.13
.
The
application
required
by
section
22
229.6
may
be
filed
by
the
administrator
of
the
division
or
23
the
administrator’s
designee,
or
by
the
administrator
of
the
24
institution
where
the
patient
is
then
being
maintained
or
25
treated.
If
the
patient
was
admitted
to
that
institution
26
involuntarily,
the
administrator
of
the
division
may
arrange
27
and
complete
the
transfer,
and
shall
report
it
as
required
of
28
a
chief
medical
officer
under
section
229.15,
subsection
5
.
29
The
transfer
shall
be
made
at
county
expense,
and
the
expense
30
recovered,
as
provided
in
section
227.7
.
However,
transfer
31
under
this
section
of
a
patient
whose
expenses
are
payable
in
32
whole
or
in
part
by
a
county
is
subject
to
an
authorization
for
33
the
transfer
through
the
central
point
of
coordination
process
34
regional
administrator
for
the
patient’s
county
of
residence
.
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Sec.
59.
Section
227.11,
Code
2014,
is
amended
to
read
as
1
follows:
2
227.11
Transfers
from
state
hospitals.
3
A
regional
administrator
for
the
county
chargeable
with
4
the
expense
of
a
patient
in
a
state
hospital
for
persons
with
5
mental
illness
shall
transfer
the
patient
to
a
county
or
6
private
institution
for
persons
with
mental
illness
that
is
in
7
compliance
with
the
applicable
rules
when
the
administrator
8
of
the
division
or
the
administrator’s
designee
orders
the
9
transfer
on
a
finding
that
the
patient
is
suffering
from
10
chronic
mental
illness
or
from
senility
and
will
receive
equal
11
benefit
by
being
so
transferred.
A
county
shall
transfer
to
12
its
county
care
facility
any
patient
in
a
state
hospital
for
13
persons
with
mental
illness
upon
request
of
the
superintendent
14
of
the
state
hospital
in
which
the
patient
is
confined
15
pursuant
to
the
superintendent’s
authority
under
section
16
229.15,
subsection
5
,
and
approval
by
the
board
of
supervisors
17
of
regional
administrator
for
the
county
of
the
patient’s
18
residence.
In
no
case
shall
a
patient
be
thus
transferred
19
except
upon
compliance
with
section
229.14A
or
without
the
20
written
consent
of
a
relative,
friend,
or
guardian
if
such
21
relative,
friend,
or
guardian
pays
the
expense
of
the
care
of
22
such
patient
in
a
state
hospital.
Patients
transferred
to
a
23
public
or
private
facility
under
this
section
may
subsequently
24
be
placed
on
convalescent
or
limited
leave
or
transferred
to
25
a
different
facility
for
continued
full-time
custody,
care,
26
and
treatment
when,
in
the
opinion
of
the
attending
physician
27
or
the
chief
medical
officer
of
the
hospital
from
which
the
28
patient
was
so
transferred,
the
best
interest
of
the
patient
29
would
be
served
by
such
leave
or
transfer.
For
any
patient
30
who
is
involuntarily
committed,
any
transfer
made
under
this
31
section
is
subject
to
the
placement
hearing
requirements
of
32
section
229.14A
.
33
Sec.
60.
Section
227.12,
Code
2014,
is
amended
to
read
as
34
follows:
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227.12
Difference
of
opinion.
1
When
a
difference
of
opinion
exists
between
the
2
administrator
of
the
division
and
the
authorities
in
charge
3
of
any
private
or
county
hospital
in
regard
to
the
removal
4
transfer
of
a
patient
or
patients
as
herein
provided
in
5
sections
227.10
and
227.11
,
the
matter
shall
be
submitted
to
6
the
district
court
of
the
county
in
which
such
hospital
is
7
situated
and
shall
be
summarily
tried
as
an
equitable
action,
8
and
the
judgment
of
the
district
court
shall
be
final.
9
Sec.
61.
Section
227.14,
Code
2014,
is
amended
to
read
as
10
follows:
11
227.14
Caring
for
persons
with
mental
illness
from
other
12
counties.
13
Boards
of
supervisors
of
counties
having
no
The
regional
14
administrator
for
a
county
that
does
not
have
proper
facilities
15
for
caring
for
persons
with
mental
illness
may,
with
the
16
consent
of
the
administrator
of
the
division,
provide
for
such
17
care
at
the
expense
of
the
county
in
any
convenient
and
proper
18
county
or
private
institution
for
persons
with
mental
illness
19
which
is
willing
to
receive
them
the
persons
.
20
Sec.
62.
Section
229.1,
subsection
3,
Code
2014,
is
amended
21
by
striking
the
subsection.
22
Sec.
63.
Section
229.1,
Code
2014,
is
amended
by
adding
the
23
following
new
subsections:
24
NEW
SUBSECTION
.
8A.
“Mental
health
and
disability
services
25
region”
means
a
mental
health
and
disability
services
region
26
formed
in
accordance
with
section
331.389.
27
NEW
SUBSECTION
.
14A.
“Regional
administrator”
means
the
28
regional
administrator
of
a
mental
health
and
disabilities
29
services
region,
as
defined
in
section
331.388.
30
Sec.
64.
Section
229.1B,
Code
2014,
is
amended
to
read
as
31
follows:
32
229.1B
Central
point
of
coordination
process
Regional
33
administrator
.
34
Notwithstanding
any
provision
of
this
chapter
to
the
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contrary,
any
person
whose
hospitalization
expenses
are
1
payable
in
whole
or
in
part
by
a
county
shall
be
subject
2
to
all
administrative
requirements
of
the
central
point
of
3
coordination
process
regional
administrator
for
the
county
.
4
Sec.
65.
Section
229.2,
subsection
1,
paragraph
b,
5
subparagraph
(3),
Code
2014,
is
amended
to
read
as
follows:
6
(3)
As
soon
as
is
practicable
after
the
filing
of
a
7
petition
for
juvenile
court
approval
of
the
admission
of
the
8
minor,
the
juvenile
court
shall
determine
whether
the
minor
9
has
an
attorney
to
represent
the
minor
in
the
hospitalization
10
proceeding,
and
if
not,
the
court
shall
assign
to
the
minor
11
an
attorney.
If
the
minor
is
financially
unable
to
pay
for
12
an
attorney,
the
attorney
shall
be
compensated
by
the
county
13
at
an
hourly
rate
to
be
established
by
the
county
board
of
14
supervisors
regional
administrator
for
the
county
in
which
the
15
proceeding
is
held
in
substantially
the
same
manner
as
provided
16
in
section
815.7
.
17
Sec.
66.
Section
229.8,
subsection
1,
Code
2014,
is
amended
18
to
read
as
follows:
19
1.
Determine
whether
the
respondent
has
an
attorney
20
who
is
able
and
willing
to
represent
the
respondent
in
the
21
hospitalization
proceeding,
and
if
not,
whether
the
respondent
22
is
financially
able
to
employ
an
attorney
and
capable
of
23
meaningfully
assisting
in
selecting
one.
In
accordance
with
24
those
determinations,
the
court
shall
if
necessary
allow
the
25
respondent
to
select,
or
shall
assign
to
the
respondent,
an
26
attorney.
If
the
respondent
is
financially
unable
to
pay
an
27
attorney,
the
attorney
shall
be
compensated
by
the
county
28
at
an
hourly
rate
to
be
established
by
the
county
board
of
29
supervisors
regional
administrator
for
the
county
in
which
the
30
proceeding
is
held
in
substantially
the
same
manner
as
provided
31
in
section
815.7
.
32
Sec.
67.
Section
229.10,
subsection
1,
paragraph
a,
Code
33
2014,
is
amended
to
read
as
follows:
34
a.
An
examination
of
the
respondent
shall
be
conducted
by
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one
or
more
licensed
physicians,
as
required
by
the
court’s
1
order,
within
a
reasonable
time.
If
the
respondent
is
detained
2
pursuant
to
section
229.11,
subsection
1
,
paragraph
“b”
,
3
the
examination
shall
be
conducted
within
twenty-four
hours.
4
If
the
respondent
is
detained
pursuant
to
section
229.11,
5
subsection
1
,
paragraph
“a”
or
“c”
,
the
examination
shall
6
be
conducted
within
forty-eight
hours.
If
the
respondent
7
so
desires,
the
respondent
shall
be
entitled
to
a
separate
8
examination
by
a
licensed
physician
of
the
respondent’s
own
9
choice.
The
reasonable
cost
of
the
examinations
shall,
if
the
10
respondent
lacks
sufficient
funds
to
pay
the
cost,
be
paid
by
11
the
regional
administrator
from
county
funds
upon
order
of
the
12
court.
13
Sec.
68.
Section
229.11,
subsection
1,
unnumbered
paragraph
14
1,
Code
2014,
is
amended
to
read
as
follows:
15
If
the
applicant
requests
that
the
respondent
be
taken
into
16
immediate
custody
and
the
judge,
upon
reviewing
the
application
17
and
accompanying
documentation,
finds
probable
cause
to
believe
18
that
the
respondent
has
a
serious
mental
impairment
and
is
19
likely
to
injure
the
respondent
or
other
persons
if
allowed
20
to
remain
at
liberty,
the
judge
may
enter
a
written
order
21
directing
that
the
respondent
be
taken
into
immediate
custody
22
by
the
sheriff
or
the
sheriff’s
deputy
and
be
detained
until
23
the
hospitalization
hearing.
The
hospitalization
hearing
shall
24
be
held
no
more
than
five
days
after
the
date
of
the
order,
25
except
that
if
the
fifth
day
after
the
date
of
the
order
is
a
26
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
on
the
27
next
succeeding
business
day.
If
the
expenses
of
a
respondent
28
are
payable
in
whole
or
in
part
by
a
county,
for
a
placement
29
in
accordance
with
paragraph
“a”
,
the
judge
shall
give
notice
30
of
the
placement
to
the
central
point
of
coordination
process
31
regional
administrator
for
the
county
in
which
the
court
is
32
located
,
and
for
a
placement
in
accordance
with
paragraph
“b”
33
or
“c”
,
the
judge
shall
order
the
placement
in
a
hospital
or
34
facility
designated
through
the
central
point
of
coordination
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process
regional
administrator
.
The
judge
may
order
the
1
respondent
detained
for
the
period
of
time
until
the
hearing
2
is
held,
and
no
longer,
in
accordance
with
paragraph
“a”
,
if
3
possible,
and
if
not
then
in
accordance
with
paragraph
“b”
,
4
or,
only
if
neither
of
these
alternatives
is
available,
in
5
accordance
with
paragraph
“c”
.
Detention
may
be:
6
Sec.
69.
Section
229.13,
subsection
1,
paragraph
a,
Code
7
2014,
is
amended
to
read
as
follows:
8
a.
The
court
shall
order
a
respondent
whose
expenses
are
9
payable
in
whole
or
in
part
by
a
county
placed
under
the
care
10
of
an
appropriate
hospital
or
facility
designated
through
11
the
central
point
of
coordination
process
county’s
regional
12
administrator
on
an
inpatient
or
outpatient
basis.
13
Sec.
70.
Section
229.14,
subsection
2,
paragraph
a,
Code
14
2014,
is
amended
to
read
as
follows:
15
a.
For
a
respondent
whose
expenses
are
payable
in
whole
16
or
in
part
by
a
county,
placement
as
designated
through
17
the
central
point
of
coordination
process
county’s
regional
18
administrator
in
the
care
of
an
appropriate
hospital
or
19
facility
on
an
inpatient
or
outpatient
basis,
or
other
20
appropriate
treatment,
or
in
an
appropriate
alternative
21
placement.
22
Sec.
71.
Section
229.14A,
subsections
7
and
9,
Code
2014,
23
are
amended
to
read
as
follows:
24
7.
If
a
respondent’s
expenses
are
payable
in
whole
or
in
25
part
by
a
county
through
the
central
point
of
coordination
26
process
county’s
regional
administrator
,
notice
of
a
placement
27
hearing
shall
be
provided
to
the
county
attorney
and
the
28
county’s
central
point
of
coordination
process
regional
29
administrator.
At
the
hearing,
the
county
may
present
evidence
30
regarding
appropriate
placement.
31
9.
A
placement
made
pursuant
to
an
order
entered
under
32
section
229.13
or
229.14
or
this
section
shall
be
considered
to
33
be
authorized
through
the
central
point
of
coordination
process
34
county’s
regional
administrator
.
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Sec.
72.
Section
229.19,
subsection
1,
paragraphs
a
and
b,
1
Code
2014,
are
amended
to
read
as
follows:
2
a.
In
each
county
with
a
population
of
three
hundred
3
thousand
or
more
inhabitants
the
board
of
supervisors
county’s
4
regional
administrator
shall
appoint
an
individual
who
has
5
demonstrated
by
prior
activities
an
informed
concern
for
the
6
welfare
and
rehabilitation
of
persons
with
mental
illness,
7
and
who
is
not
an
officer
or
employee
of
the
department
of
8
human
services
nor
of
any
agency
or
facility
providing
care
9
or
treatment
to
persons
with
mental
illness,
to
act
as
an
10
advocate
representing
the
interests
of
patients
involuntarily
11
hospitalized
by
the
court,
in
any
matter
relating
to
the
12
patients’
hospitalization
or
treatment
under
section
229.14
13
or
229.15
.
In
each
county
with
a
population
of
under
three
14
hundred
thousand
inhabitants,
the
chief
judge
of
the
judicial
15
district
encompassing
the
county
shall
appoint
the
advocate.
16
b.
The
court
or,
if
the
advocate
is
appointed
by
the
17
county
board
of
supervisors
regional
administrator
,
the
board
18
regional
administrator
shall
assign
the
advocate
appointed
from
19
a
patient’s
county
of
residence
to
represent
the
interests
20
of
the
patient.
If
a
patient
has
no
county
of
residence
or
21
the
patient
is
a
state
case,
the
court
or,
if
the
advocate
22
is
appointed
by
the
county
board
of
supervisors
regional
23
administrator
,
the
board
regional
administrator
shall
assign
24
the
advocate
appointed
from
for
the
county
where
the
hospital
25
or
facility
is
located
to
represent
the
interests
of
the
26
patient.
27
Sec.
73.
Section
229.19,
subsection
3,
Code
2014,
is
amended
28
to
read
as
follows:
29
3.
The
court
or,
if
the
advocate
is
appointed
by
the
county
30
board
of
supervisors
regional
administrator
,
the
board
regional
31
administrator
shall
prescribe
reasonable
compensation
for
the
32
services
of
the
advocate.
The
compensation
shall
be
based
33
upon
the
reports
filed
by
the
advocate
with
the
court.
The
34
advocate’s
compensation
shall
be
paid
by
the
county
in
which
35
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the
court
is
located,
either
on
order
of
the
court
or,
if
1
the
advocate
is
appointed
by
the
county
board
of
supervisors
2
regional
administrator
,
on
the
direction
of
the
board
regional
3
administrator
.
If
the
advocate
is
appointed
by
the
court,
the
4
advocate
is
an
employee
of
the
state
for
purposes
of
chapter
5
669
.
If
the
advocate
is
appointed
by
the
county
board
of
6
supervisors
regional
administrator
,
the
advocate
is
an
employee
7
of
the
county
for
purposes
of
chapter
670
.
If
the
patient
or
8
the
person
who
is
legally
liable
for
the
patient’s
support
is
9
not
indigent,
the
board
regional
administrator
shall
recover
10
the
costs
of
compensating
the
advocate
from
that
person.
If
11
that
person
has
an
income
level
as
determined
pursuant
to
12
section
815.9
greater
than
one
hundred
percent
but
not
more
13
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
14
least
one
hundred
dollars
of
the
advocate’s
compensation
shall
15
be
recovered
in
the
manner
prescribed
by
the
county
board
of
16
supervisors
regional
administrator
.
If
that
person
has
an
17
income
level
as
determined
pursuant
to
section
815.9
greater
18
than
one
hundred
fifty
percent
of
the
poverty
guidelines,
at
19
least
two
hundred
dollars
of
the
advocate’s
compensation
shall
20
be
recovered
in
substantially
the
same
manner
prescribed
by
the
21
county
board
of
supervisors
as
provided
in
section
815.9
.
22
Sec.
74.
Section
229.24,
subsection
3,
unnumbered
paragraph
23
1,
Code
2014,
is
amended
to
read
as
follows:
24
If
all
or
part
of
the
costs
associated
with
hospitalization
25
of
an
individual
under
this
chapter
are
chargeable
to
a
county
26
of
residence,
the
clerk
of
the
district
court
shall
provide
27
to
the
regional
administrator
for
the
county
of
residence
and
28
to
the
regional
administrator
for
the
county
in
which
the
29
hospitalization
order
is
entered
the
following
information
30
pertaining
to
the
individual
which
would
be
confidential
under
31
subsection
1
:
32
Sec.
75.
Section
229.42,
subsection
1,
Code
2014,
is
amended
33
to
read
as
follows:
34
1.
If
a
person
wishing
to
make
application
for
voluntary
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admission
to
a
mental
hospital
established
by
chapter
226
is
1
unable
to
pay
the
costs
of
hospitalization
or
those
responsible
2
for
the
person
are
unable
to
pay
the
costs,
application
for
3
authorization
of
voluntary
admission
must
be
made
through
a
4
central
point
of
coordination
process
regional
administrator
5
before
application
for
admission
is
made
to
the
hospital.
The
6
person’s
county
of
residence
shall
be
determined
through
the
7
central
point
of
coordination
process
regional
administrator
8
and
if
the
admission
is
approved
through
the
central
point
9
of
coordination
process
regional
administrator
,
the
person’s
10
admission
to
a
mental
health
hospital
shall
be
authorized
as
11
a
voluntary
case.
The
authorization
shall
be
issued
on
forms
12
provided
by
the
department
of
human
services’
administrator.
13
The
costs
of
the
hospitalization
shall
be
paid
by
the
14
county
of
residence
to
the
department
of
human
services
and
15
credited
to
the
general
fund
of
the
state,
provided
that
the
16
mental
health
hospital
rendering
the
services
has
certified
17
to
the
county
auditor
of
the
county
of
residence
and
the
18
regional
administrator
the
amount
chargeable
to
the
county
19
and
has
sent
a
duplicate
statement
of
the
charges
to
the
20
department
of
human
services.
A
county
shall
not
be
billed
21
for
the
cost
of
a
patient
unless
the
patient’s
admission
is
22
authorized
through
the
central
point
of
coordination
process
23
regional
administrator
.
The
mental
health
institute
and
the
24
county
regional
administrator
shall
work
together
to
locate
25
appropriate
alternative
placements
and
services,
and
to
26
educate
patients
and
family
members
of
patients
regarding
such
27
alternatives.
28
Sec.
76.
Section
230.1,
subsection
3,
Code
2014,
is
amended
29
to
read
as
follows:
30
3.
A
county
of
residence
is
not
liable
for
costs
and
31
expenses
associated
with
a
person
with
mental
illness
unless
32
the
costs
and
expenses
are
for
services
and
other
support
33
authorized
for
the
person
through
the
central
point
of
34
coordination
process
county’s
regional
administrator
.
For
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2417
the
purposes
of
this
chapter
,
“central
point
of
coordination
1
process”
“regional
administrator”
means
the
same
as
defined
in
2
section
331.440
331.388
.
3
Sec.
77.
Section
230.3,
Code
2014,
is
amended
to
read
as
4
follows:
5
230.3
Certification
of
residence.
6
If
a
person’s
county
of
residence
is
determined
by
the
7
county’s
central
point
of
coordination
process
regional
8
administrator
to
be
in
another
county
of
this
state,
the
county
9
regional
administrator
making
the
determination
shall
certify
10
the
determination
to
the
superintendent
of
the
hospital
to
11
which
the
person
is
admitted
or
committed.
The
certification
12
shall
be
accompanied
by
a
copy
of
the
evidence
supporting
13
the
determination.
Upon
receiving
the
certification,
the
14
superintendent
shall
charge
the
expenses
already
incurred
and
15
unadjusted,
and
all
future
expenses
of
the
person,
to
the
16
county
determined
to
be
the
county
of
residence.
17
Sec.
78.
Section
230.20,
subsection
2,
paragraph
b,
Code
18
2014,
is
amended
to
read
as
follows:
19
b.
The
per
diem
costs
billed
to
each
county
shall
not
exceed
20
the
per
diem
costs
billed
to
the
county
in
the
fiscal
year
21
beginning
July
1,
1996.
However,
the
per
diem
costs
billed
to
22
a
county
may
be
adjusted
annually
to
reflect
increased
costs
,
23
to
the
extent
of
the
percentage
increase
in
the
total
of
county
24
fixed
budgets
pursuant
to
the
allowed
growth
factor
adjustment
25
statewide
per
capita
expenditure
target
amount,
if
any
per
26
capita
growth
amount
is
authorized
by
the
general
assembly
for
27
the
fiscal
year
in
accordance
with
section
331.439
426B.3
.
28
Sec.
79.
Section
232.2,
subsection
4,
paragraph
f,
29
subparagraph
(3),
Code
2014,
is
amended
to
read
as
follows:
30
(3)
The
transition
plan
shall
be
developed
and
reviewed
31
by
the
department
in
collaboration
with
a
child-centered
32
transition
team.
The
transition
team
shall
be
comprised
of
33
the
child’s
caseworker
and
persons
selected
by
the
child,
34
persons
who
have
knowledge
of
services
available
to
the
child,
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and
any
person
who
may
reasonably
be
expected
to
be
a
service
1
provider
for
the
child
when
the
child
becomes
an
adult
or
to
2
become
responsible
for
the
costs
of
services
at
that
time.
3
If
the
child
is
reasonably
likely
to
need
or
be
eligible
for
4
adult
services,
the
transition
team
membership
shall
include
5
representatives
from
the
adult
services
system.
The
adult
6
services
system
representatives
may
include
but
are
not
limited
7
to
the
administrator
of
county
general
relief
under
chapter
8
251
or
252
or
of
the
central
point
of
coordination
process
9
implemented
under
section
331.440
regional
administrator
of
10
the
county
mental
health
and
disabilities
services
region,
as
11
defined
in
section
331.388
.
The
membership
of
the
transition
12
team
and
the
meeting
dates
for
the
team
shall
be
documented
in
13
the
transition
plan.
14
Sec.
80.
Section
235.7,
subsection
2,
Code
2014,
is
amended
15
to
read
as
follows:
16
2.
Membership.
The
department
may
authorize
the
governance
17
boards
of
decategorization
of
child
welfare
and
juvenile
18
justice
funding
projects
established
under
section
232.188
to
19
appoint
the
transition
committee
membership
and
may
utilize
20
the
boundaries
of
decategorization
projects
to
establish
21
the
service
areas
for
transition
committees.
The
committee
22
membership
may
include
but
is
not
limited
to
department
of
23
human
services
staff
involved
with
foster
care,
child
welfare,
24
and
adult
services,
juvenile
court
services
staff,
staff
25
involved
with
county
general
relief
under
chapter
251
or
252
,
26
or
of
the
central
point
of
coordination
process
implemented
27
under
section
331.440
a
regional
administrator
of
the
county
28
mental
health
and
disabilities
services
region,
as
defined
29
in
section
331.388,
in
the
area
,
school
district
and
area
30
education
agency
staff
involved
with
special
education,
and
a
31
child’s
court
appointed
special
advocate,
guardian
ad
litem,
32
service
providers,
and
other
persons
knowledgeable
about
the
33
child.
34
Sec.
81.
Section
235A.15,
subsection
2,
paragraph
c,
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subparagraph
(9),
Code
2014,
is
amended
to
read
as
follows:
1
(9)
To
the
administrator
of
an
agency
providing
mental
2
health,
intellectual
disability,
or
developmental
disability
3
services
under
a
county
management
plan
developed
pursuant
4
to
section
331.439
regional
service
system
management
plan
5
implemented
in
accordance
with
section
331.393
,
if
the
data
6
concerns
a
person
employed
by
or
being
considered
by
the
agency
7
for
employment.
8
Sec.
82.
Section
235B.6,
subsection
2,
paragraph
c,
9
subparagraph
(6),
Code
2014,
is
amended
to
read
as
follows:
10
(6)
To
the
administrator
of
an
agency
providing
mental
11
health,
intellectual
disability,
or
developmental
disability
12
services
under
a
county
management
plan
developed
pursuant
13
to
section
331.439
regional
service
system
management
plan
14
implemented
in
accordance
with
section
331.393
,
if
the
15
information
concerns
a
person
employed
by
or
being
considered
16
by
the
agency
for
employment.
17
Sec.
83.
Section
426B.2,
subsection
2,
Code
2014,
is
amended
18
to
read
as
follows:
19
2.
As
used
in
this
chapter
,
and
in
sections
331.438
and
20
331.439
section
331.424A
,
for
purposes
of
population-based
21
funding
calculations,
“population”
means
the
population
shown
22
by
the
latest
preceding
certified
federal
census
or
the
23
latest
applicable
population
estimate
issued
by
the
federal
24
government
,
whichever
is
most
recent
and
available
as
of
July
25
1
of
the
fiscal
year
preceding
the
fiscal
year
to
which
the
26
funding
calculations
apply
.
27
Sec.
84.
Section
426B.5,
subsection
1,
Code
2014,
is
amended
28
by
striking
the
subsection.
29
Sec.
85.
Section
426B.5,
subsections
2
and
3,
Code
2014,
are
30
amended
to
read
as
follows:
31
2.
Risk
pool.
32
a.
For
the
purposes
of
this
subsection
section
,
unless
the
33
context
otherwise
requires
,
:
34
(1)
“Mental
health
and
disability
services
region”
means
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a
mental
health
and
disability
services
region
formed
in
1
accordance
with
section
331.389.
2
(2)
“Regional
administrator”
means
the
regional
3
administrator
of
a
mental
health
and
disabilities
services
4
region,
as
defined
in
section
331.388.
5
(3)
“services
“Services
fund”
means
a
county’s
mental
6
health
,
intellectual
disability,
and
developmental
disabilities
7
services
fund
created
in
pursuant
to
section
331.424A
.
8
b.
A
risk
pool
is
created
in
the
property
tax
relief
fund.
9
The
pool
shall
consist
of
the
moneys
credited
to
the
pool
by
10
law.
11
c.
A
risk
pool
board
is
created.
The
board
shall
consist
12
of
two
county
supervisors,
two
county
auditors,
a
member
of
13
the
mental
health
and
disability
services
commission
who
is
14
not
a
member
of
a
county
board
of
supervisors,
a
member
of
15
the
county
finance
committee
created
in
chapter
333A
who
is
16
not
an
elected
official,
a
representative
of
a
provider
of
17
mental
health
or
developmental
disabilities
services
selected
18
from
nominees
submitted
by
the
Iowa
association
of
community
19
providers,
and
two
central
point
of
coordination
process
staff
20
members
of
regional
administrators
of
county
mental
health
and
21
disabilities
services
regions
,
all
appointed
by
the
governor,
22
and
one
member
appointed
by
the
director
of
human
services.
23
All
members
appointed
by
the
governor
shall
be
subject
to
24
confirmation
by
the
senate.
Members
shall
serve
for
three-year
25
terms.
A
vacancy
shall
be
filled
in
the
same
manner
as
the
26
original
appointment.
Expenses
and
other
costs
of
the
risk
27
pool
board
members
representing
counties
shall
be
paid
by
the
28
county
of
origin.
Expenses
and
other
costs
of
risk
pool
board
29
members
who
do
not
represent
counties
shall
be
paid
from
a
30
source
determined
by
the
governor.
Staff
assistance
to
the
31
board
shall
be
provided
by
the
department
of
human
services
and
32
counties.
Actuarial
expenses
and
other
direct
administrative
33
costs
shall
be
charged
to
the
pool.
34
d.
A
county
regional
administrator
must
apply
to
the
risk
35
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44
H.F.
2417
pool
board
for
assistance
from
the
risk
pool
on
or
before
1
October
31.
The
purpose
of
the
assistance
shall
be
to
provide
2
financial
support
for
services
provided
by
one
or
more
of
the
3
counties
comprising
the
regional
administrator’s
mental
health
4
and
disability
services
region.
The
risk
pool
board
shall
5
make
its
final
decisions
on
or
before
December
15
regarding
6
acceptance
or
rejection
of
the
applications
for
assistance
and
7
the
total
amount
accepted
shall
be
considered
obligated.
8
e.
Basic
eligibility
for
risk
pool
assistance
requires
that
9
a
county
meet
all
of
the
following
conditions:
10
(1)
The
county
is
in
compliance
with
the
regional
service
11
system
management
plan
requirements
of
section
331.439
331.393
.
12
(2)
The
county
levied
the
maximum
amount
allowed
for
the
13
county’s
services
fund
under
section
331.424A
for
the
fiscal
14
year
of
application
for
risk
pool
assistance.
15
(3)
In
the
fiscal
year
that
commenced
two
years
prior
to
16
the
fiscal
year
of
application,
the
county’s
services
fund
17
ending
balance
under
generally
accepted
accounting
principles
18
was
equal
to
or
less
than
twenty
percent
of
the
county’s
actual
19
gross
expenditures
for
that
fiscal
year.
20
f.
The
board
shall
review
the
fiscal
year-end
financial
21
records
for
all
counties
that
are
granted
risk
pool
assistance.
22
If
the
board
determines
a
county’s
actual
need
for
risk
pool
23
assistance
was
less
than
the
amount
of
risk
pool
assistance
24
granted
to
the
county,
the
county
shall
refund
the
difference
25
between
the
amount
of
assistance
granted
and
the
actual
need.
26
The
county
shall
submit
the
refund
within
thirty
days
of
27
receiving
notice
from
the
board.
Refunds
shall
be
credited
28
to
the
risk
pool.
The
mental
health
and
disability
services
29
commission
shall
adopt
rules
pursuant
to
chapter
17A
providing
30
criteria
for
the
purposes
of
this
lettered
paragraph
and
as
31
necessary
to
implement
the
other
provisions
of
this
subsection
.
32
g.
The
board
shall
determine
application
requirements
to
33
ensure
prudent
use
of
risk
pool
assistance.
The
board
may
34
accept
or
reject
an
application
for
assistance
in
whole
or
in
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part.
The
decision
of
the
board
is
final.
1
h.
The
total
amount
of
risk
pool
assistance
shall
be
limited
2
to
the
amount
available
in
the
risk
pool
for
a
fiscal
year.
Any
3
unobligated
balance
in
the
risk
pool
at
the
close
of
a
fiscal
4
year
shall
remain
in
the
risk
pool
for
distribution
in
the
5
succeeding
fiscal
year.
6
i.
Risk
pool
assistance
shall
only
be
made
available
to
7
address
one
or
more
of
the
following
circumstances:
8
(1)
Continuing
support
for
mandated
services.
9
(2)
Avoiding
the
need
for
reduction
or
elimination
of
10
critical
services
when
the
reduction
or
elimination
places
11
consumers’
health
or
safety
at
risk.
12
(3)
Avoiding
the
need
for
reduction
or
elimination
of
a
13
mobile
crisis
team
or
other
critical
emergency
services
when
14
the
reduction
or
elimination
places
the
public’s
health
or
15
safety
at
risk.
16
(4)
Avoiding
the
need
for
reduction
or
elimination
of
17
the
services
or
other
support
provided
to
entire
disability
18
populations.
19
(5)
Avoiding
the
need
for
reduction
or
elimination
of
20
services
or
other
support
that
maintain
consumers
in
a
21
community
setting,
creating
a
risk
that
the
consumers
would
be
22
placed
in
more
restrictive,
higher
cost
settings.
23
j.
Subject
to
the
amount
available
and
obligated
from
the
24
risk
pool
for
a
fiscal
year,
the
department
of
human
services
25
shall
annually
calculate
the
amount
of
moneys
due
to
eligible
26
counties
in
accordance
with
the
board’s
decisions
and
that
27
amount
is
appropriated
from
the
risk
pool
to
the
department
28
for
payment
of
the
moneys
due.
The
department
shall
authorize
29
the
issuance
of
warrants
payable
to
the
county
treasurer
for
30
the
amounts
due
and
the
warrants
shall
be
issued
on
or
before
31
January
1.
32
k.
On
or
before
March
1
and
September
1
of
each
fiscal
year,
33
the
department
of
human
services
shall
provide
the
risk
pool
34
board
with
a
report
of
the
financial
condition
of
each
funding
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source
administered
by
the
board.
The
report
shall
include
1
but
is
not
limited
to
an
itemization
of
the
funding
source’s
2
balances,
types
and
amount
of
revenues
credited,
and
payees
3
and
payment
amounts
for
the
expenditures
made
from
the
funding
4
source
during
the
reporting
period.
5
l.
If
the
board
has
made
its
decisions
but
has
determined
6
that
there
are
otherwise
qualifying
requests
for
risk
pool
7
assistance
that
are
beyond
the
amount
available
in
the
risk
8
pool
fund
for
a
fiscal
year,
the
board
shall
compile
a
list
of
9
such
requests
and
the
supporting
information
for
the
requests.
10
The
list
and
information
shall
be
submitted
to
the
mental
11
health
and
disability
services
commission,
the
department
of
12
human
services,
and
the
general
assembly.
13
3.
Incentive
pool.
14
a.
An
incentive
pool
is
created
in
the
property
tax
relief
15
fund.
The
incentive
pool
shall
consist
of
the
moneys
credited
16
to
the
incentive
pool
by
law.
17
b.
Moneys
available
in
the
incentive
pool
for
a
fiscal
18
year
shall
be
distributed
to
those
counties
mental
health
and
19
disability
services
regions
that
either
meet
or
show
progress
20
toward
meeting
the
purposes
and
intent
described
in
section
21
331.439,
subsection
1
,
paragraph
”c“
225C.1
.
The
moneys
22
received
by
a
county
region
from
the
incentive
pool
shall
be
23
used
to
build
community
capacity
to
support
individuals
covered
24
by
the
county’s
region’s
regional
service
system
management
25
plan
approved
under
section
331.439
331.393
,
in
meeting
such
26
purposes.
27
Sec.
86.
REPEAL.
Sections
225C.7,
225C.12,
225C.18,
and
28
226.47,
Code
2014,
are
repealed.
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