Senate File 463 - Enrolled
SENATE FILE
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO SSB
1181)
\5
A BILL FOR
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Senate File 463
AN ACT
RELATING TO THE REDESIGN OF MENTAL HEALTH AND DISABILITIES
SERVICES ADMINISTERED BY REGIONS COMPRISED OF COUNTIES.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. Section 135.180, subsection 3, Code 2015, is
amended to read as follows:
3. The program shall provide stipends to support
psychiatrist positions with an emphasis on securing and
retaining medical directors at community mental health
centers, providers of mental health services to county
residents pursuant to a waiver approved under section 225C.7,
subsection 3, Code 2011, designated under chapter 230A and
hospital psychiatric units that are located in mental health
professional shortage areas.
Sec. 2. Section 222.1, Code 2015, is amended to read as
follows:
222.1 Purpose of chapter ==== state resource centers ==== special
unit at state mental health institute.
1. This chapter addresses the public and private services
available in this state to meet the needs of persons with an
intellectual disability. The responsibility of the mental
health and disability services regions formed by counties and
of the state for the costs and administration of publicly
funded services shall be as set out in section 222.60 and other
pertinent sections of this chapter.
1. 2. The Glenwood state resource center and the Woodward
state resource center are established and shall be maintained
as the state's regional resource centers for the purpose of
providing treatment, training, instruction, care, habilitation,
and support of persons with an intellectual disability or other
disabilities in this state, and providing facilities, services,
and other support to the communities located in the region
being served by a state resource center. In addition, the
state resource centers are encouraged to serve as a training
resource for community=based program staff, medical students,
and other participants in professional education programs. A
resource center may request the approval of the council on
human services to change the name of the resource center for
use in communication with the public, in signage, and in other
forms of communication.
2. 3. A special intellectual disability unit may be
maintained at one of the state mental health institutes for the
purposes set forth in sections 222.88 to 222.91.
Sec. 3. Section 222.2, subsection 3, Code 2015, is amended
by striking the subsection.
Sec. 4. Section 222.2, Code 2015, is amended by adding the
following new subsections:
NEW SUBSECTION. 5A. "Mental health and disability services
region" means a mental health and disability services region
formed in accordance with section 331.389.
NEW SUBSECTION. 5B. "Regional administrator" means the
regional administrator of a mental health and disability
services region, as defined in section 331.388.
Sec. 5. Section 222.6, Code 2015, is amended to read as
follows:
222.6 State districts.
The administrator shall divide the state into two districts
in such manner that one of the resource centers shall be
located within each of the districts. Such districts may
from time to time be changed. After such districts have been
established, the administrator shall notify all boards of
supervisors, county auditors, regional administrators of the
mental health and disability services regions, and clerks of
the district courts of the action. Thereafter, unless the
administrator otherwise orders, all admissions of persons with
an intellectual disability from a district shall be to the
resource center located within such district.
Sec. 6. Section 222.12, subsection 2, Code 2015, is amended
to read as follows:
2. Notice of the death of the patient, and the cause
of death, shall be sent to the county board of supervisors
regional administrator of the mental health and disability
services region of the patient's county of residence. The
fact of death with the time, place, and alleged cause shall be
entered upon the docket of the court.
Sec. 7. Section 222.13, Code 2015, is amended to read as
follows:
222.13 Voluntary admissions.
1. If an adult person is believed to be a person with
an intellectual disability, the adult person or the adult
person's guardian may submit a request in writing through the
central point of coordination process for the county board
of supervisors of the adult person's county of residence to
apply to the department and the superintendent of any state
resource center for the voluntary admission of the adult person
either as an inpatient or an outpatient of the resource center.
The board of supervisors shall, on forms prescribed by the
department's administrator, apply to the superintendent of
the resource center in the district for the admission of the
adult person to the resource center. If the expenses of the
person's admission or placement are payable in whole or in
part by the person's county of residence, application for the
admission shall be made through the regional administrator. An
application for admission to a special unit of any adult person
believed to be in need of any of the services provided by the
special unit under section 222.88 may be made in the same
manner, upon request of the adult person or the adult person's
guardian. The superintendent shall accept the application if
a preadmission diagnostic evaluation, performed through the
central point of coordination process, confirms or establishes
the need for admission, except that an application shall not be
accepted if the institution does not have adequate facilities
available or if the acceptance will result in an overcrowded
condition.
2. If the resource center has no does not have an
appropriate program for the treatment of an adult or minor
person with an intellectual disability applying under this
section or section 222.13A, the board of supervisors regional
administrator for the person's county of residence or the
department, as applicable, shall arrange for the placement of
the person in any public or private facility within or without
the state, approved by the director of the department of human
services, which offers appropriate services for the person, as
determined through the central point of coordination process.
If the expenses of the placement are payable in whole or in
part by a county, the placement shall be made by the regional
administrator for the county.
3. Upon applying for admission If the expenses of an
admission of an adult or minor person to a resource center, or
a special unit, or upon arranging for of the placement of the
person in a public or private facility are payable in whole
or in part by a mental health and disability services region,
the board of supervisors regional administrator shall make a
full investigation into the financial circumstances of that the
person and those liable for that the person's support under
section 222.78 to determine whether or not any of them are able
to pay the expenses arising out of the admission of the person
to a resource center, special treatment unit, or public or
private facility. If the board regional administrator finds
that the person or those legally responsible for the person are
presently unable to pay the expenses, the board shall direct
that regional administrator shall pay the expenses be paid by
the county. The board regional administrator may review its
such a finding at any subsequent time while the person remains
at the resource center, or is otherwise receiving care or
treatment for which this chapter obligates the county region
to pay. If the board regional administrator finds upon review
that the person or those legally responsible for the person
are presently able to pay the expenses, the finding shall
apply only to the charges incurred during the period beginning
on the date of the review and continuing thereafter, unless
and until the board regional administrator again changes its
such a finding. If the board regional administrator finds
that the person or those legally responsible for the person
are able to pay the expenses, the board shall direct that
regional administrator shall collect the charges be so paid to
the extent required by section 222.78, and the county auditor
regional administrator shall be responsible for the collection
payment of the remaining charges.
Sec. 8. Section 222.13A, Code 2015, is amended to read as
follows:
222.13A Voluntary admissions ==== minors.
1. If a minor is believed to be a person with an
intellectual disability, the minor's parent, guardian, or
custodian may request the county board of supervisors to
apply to the department for admission of the minor as a
voluntary patient in a state resource center. If the resource
center does not have appropriate services for the minor's
treatment, the board of supervisors department may arrange for
the admission of the minor in a public or private facility
within or without the state, approved by the director of human
services, which offers appropriate services for the minor's
treatment.
2. Upon receipt of an application for voluntary admission of
a minor, the board of supervisors department shall provide for
a preadmission diagnostic evaluation of the minor to confirm
or establish the need for the admission. The preadmission
diagnostic evaluation shall be performed by a person who meets
the qualifications of a qualified intellectual disability
professional who is designated through the central point of
coordination process by the department.
3. During the preadmission diagnostic evaluation, the
minor shall be informed both orally and in writing that the
minor has the right to object to the voluntary admission. If
the preadmission diagnostic evaluation determines that the
voluntary admission is appropriate but the minor objects to
the admission, the minor shall not be admitted to the state
resource center unless the court approves of the admission. A
petition for approval of the minor's admission may be submitted
to the juvenile court by the minor's parent, guardian, or
custodian.
4. As soon as practicable after the filing of a petition for
approval of the voluntary admission, the court shall determine
whether the minor has an attorney to represent the minor in the
proceeding. If the minor does not have an attorney, the court
shall assign to the minor an attorney. If the minor is unable
to pay for an attorney, the attorney shall be compensated
by the county mental health and disability services region
at an hourly rate to be established by the county board of
supervisors regional administrator in substantially the same
manner as provided in section 815.7.
5. The court shall order the admission of a minor who
objects to the admission, only after a hearing in which it
is shown by clear and convincing evidence that both of the
following circumstances exist:
a. The minor needs and will substantially benefit from
treatment or habilitation.
b. A placement which involves less restriction of the
minor's liberties for the purposes of treatment or habilitation
is not feasible.
Sec. 9. Section 222.14, Code 2015, is amended to read as
follows:
222.14 Care by county region pending admission.
If the institution is unable to receive a patient, the
superintendent shall notify the county board of supervisors
of regional administrator for the county from which the
application in behalf of residence of the prospective patient
was made of the time when such person may be received.
Until such time as the patient is able to be received by the
institution, or when application has been made for admission
to a public or private facility as provided in section 222.13
and the application is pending, the care of said person the
patient shall be provided as arranged by the county board of
supervisors regional administrator.
Sec. 10. Section 222.59, subsection 1, unnumbered paragraph
1, Code 2015, is amended to read as follows:
Upon receiving a request from an authorized requester, the
superintendent of a state resource center shall coordinate
with the central point of coordination process regional
administrator for the person's county of residence or
the department, as applicable, in assisting the requester
in identifying available community=based services as an
alternative to continued placement of a patient in the state
resource center. For the purposes of this section, "authorized
requester" means the parent, guardian, or custodian of a minor
patient, the guardian of an adult patient, or an adult patient
who does not have a guardian. The assistance shall identify
alternatives to continued placement which are appropriate to
the patient's needs and shall include but are not limited to
any of the following:
Sec. 11. Section 222.60, subsections 1 and 2, Code 2015, are
amended to read as follows:
1. All necessary and legal expenses for the cost of
admission or for the treatment, training, instruction, care,
habilitation, support, and transportation of persons with
an intellectual disability, as provided for in the county
applicable regional service system management plan provisions
implemented pursuant to section 331.439, subsection 1, 331.393
in a state resource center, or in a special unit, or any public
or private facility within or without the state, approved by
the director of human services, shall be paid by either:
a. The regional administrator for the person's county of
residence.
b. The state when the person is a resident in another state
or in a foreign country, or when the person's residence is
unknown. The payment responsibility shall be deemed to be a
state case.
2. a. Prior to the regional administrator for a county of
residence approving the payment of expenses for a person under
this section, the county regional administrator may require
that the person be diagnosed to determine if the person has
an intellectual disability or that the person be evaluated to
determine the appropriate level of services required to meet
the person's needs relating to an intellectual disability. The
diagnosis and the evaluation may be performed concurrently and
shall be performed by an individual or individuals approved
by the regional administrator for the person's county who
are qualified to perform the diagnosis or the evaluation.
Following the initial approval for payment of expenses, the
county regional administrator may require that an evaluation be
performed at reasonable time periods.
b. The cost of a county=required regional
administrator=required diagnosis and an evaluation is
at the county's mental health and disability services region's
expense. For a state case, the state may apply the diagnosis
and evaluation provisions of this subsection at the state's
expense.
c. A diagnosis or an evaluation under this section may be
part of a county's central point of coordination process under
section 331.440, diagnosis and assessment process implemented
by the applicable regional administrator, provided that a
diagnosis is performed only by an individual qualified as
provided in this section.
Sec. 12. Section 222.61, Code 2015, is amended to read as
follows:
222.61 Residency determined.
When a county receives an application on behalf of any person
for admission to a resource center or a special unit, the board
of supervisors application shall refer the determination of
residency be forwarded to the central point of coordination
process regional administrator for the county to determine
and certify that the residence of the person is in one of the
following:
1. In the county in which the application is received.
2. In some other county of the state.
3. In another state or in a foreign country.
4. Unknown.
Sec. 13. Section 222.62, Code 2015, is amended to read as
follows:
222.62 Residency in another county.
When the board of supervisors determines through the central
point of coordination process regional administrator for the
county determines that the residency of the person is other
than in the county in which the application is received, the
determination shall be certified to the superintendent of
the resource center or the special unit where the person is
a patient. The certification shall be accompanied by a copy
of the evidence supporting the determination. The If the
person is not eligible for the medical assistance program, the
superintendent shall charge the expenses already incurred and
unadjusted, and all future expenses of the patient, to the
county certified to be mental health and disability services
region for the county of the person's residency.
Sec. 14. Section 222.63, Code 2015, is amended to read as
follows:
222.63 Finding of residency ==== objection.
A board of supervisors' certification utilizing the
central point of coordination process through the regional
administrator for a county that a person's residency is
in another county shall be sent to the auditor of regional
administrator for the county of residence. The certification
shall be accompanied by a copy of the evidence supporting the
determination. The auditor of regional administrator for the
county of residence shall submit the certification to the board
of supervisors of the auditor's regional administrator for the
county and it shall be conclusively presumed that the patient
has residency in that county unless the regional administrator
for that county disputes the determination of residency as
provided in section 331.394.
Sec. 15. Section 222.64, Code 2015, is amended to read as
follows:
222.64 Foreign state or country or unknown residency.
If the residency of the person is determined by a regional
administrator on behalf of a county or by the state to be in
a foreign state or country or is determined to be unknown,
the county regional administrator or the state shall certify
the determination to the administrator. The certification
shall be accompanied by a copy of the evidence supporting the
determination. The care of the person shall be as arranged by
the county regional administrator or the state. Application
for admission may be made pending investigation by the
administrator.
Sec. 16. Section 222.73, subsection 2, paragraph a,
subparagraph (6), Code 2015, is amended to read as follows:
(6) A county mental health and disability services region
shall not be billed for the cost of a patient unless the
patient's admission is authorized through the applicable
central point of coordination process regional administrator.
The state resource center and the county regional administrator
shall work together to locate appropriate alternative
placements and services, and to educate patients and the family
members of patients regarding such alternatives.
Sec. 17. Section 222.73, subsection 2, paragraph b, Code
2015, is amended to read as follows:
b. The per diem costs billed to each county mental health
and disability services region shall not exceed the per diem
costs billed to the county in the fiscal year beginning July
1, 1996. However, the per diem costs billed to a county may
be adjusted in for a fiscal year to reflect increased costs to
the extent of the percentage increase in the total of county
fixed budgets pursuant to the allowed growth factor adjustment
authorized statewide per capita expenditure target amount,
if any per capita growth amount is authorized by the general
assembly for that fiscal year in accordance with section
331.439 331.424A.
Sec. 18. Section 222.92, subsection 3, paragraph a, Code
2015, is amended to read as follows:
a. Moneys received by the state from billings to counties
and regional administrators for the counties.
Sec. 19. Section 225.1, Code 2015, is amended to read as
follows:
225.1 Establishment ==== definitions.
1. There shall be established a The state psychiatric
hospital, is established. The hospital shall be especially
designed, kept, and administered for the care, observation,
and treatment of those persons who are afflicted with abnormal
mental conditions.
2. For the purposes of this chapter, unless the context
otherwise requires:
a. "Mental health and disability services region" means
a mental health and disability services region approved in
accordance with section 331.389.
b. "Regional administrator" means the administrator of a
mental health and disability services region, as defined in
section 331.388.
Sec. 20. Section 225.10, unnumbered paragraph 1, Code 2015,
is amended to read as follows:
Persons suffering from mental diseases may be admitted to
the state psychiatric hospital as voluntary public patients
if a physician authorized to practice medicine or osteopathic
medicine in the state of Iowa files information with the board
of supervisors regional administrator of the person's county
of residence or the board's designee, stating all of the
following:
Sec. 21. Section 225.11, Code 2015, is amended to read as
follows:
225.11 Initiating commitment procedures.
When a court finds upon completion of a hearing held pursuant
to section 229.12 that the contention that a respondent is
seriously mentally impaired has been sustained by clear and
convincing evidence, and the application filed under section
229.6 also contends or the court otherwise concludes that it
would be appropriate to refer the respondent to the state
psychiatric hospital for a complete psychiatric evaluation and
appropriate treatment pursuant to section 229.13, the judge
may order that a financial investigation be made in the manner
prescribed by section 225.13. If the costs of a respondent's
evaluation or treatment are payable in whole or in part by
a county, an order under this section shall be for referral
of the respondent through the central point of coordination
process regional administrator for the respondent's county of
residence for an evaluation and referral of the respondent
to an appropriate placement or service, which may include
the state psychiatric hospital for additional evaluation or
treatment. For purposes of this chapter, "central point of
coordination process" means the same as defined in section
331.440.
Sec. 22. Section 225.12, Code 2015, is amended to read as
follows:
225.12 Voluntary public patient ==== physician's report.
A physician filing information under section 225.10 shall
include a written report to the county board of supervisors
or the board's designee regional administrator for the
county of residence of the person named in the information,
giving a history of the case as will be likely to aid in the
observation, treatment, and hospital care of the person named
in the information and describing the history in detail.
Sec. 23. Section 225.13, Code 2015, is amended to read as
follows:
225.13 Financial condition.
The county board of supervisors or the board's designee
regional administrator of the county of residence of a person
being admitted to the state psychiatric hospital is responsible
for investigating the financial condition of a person being
admitted to the state psychiatric hospital the person and of
those legally responsible for the person's support.
Sec. 24. Section 225.15, Code 2015, is amended to read as
follows:
225.15 Examination and treatment.
1. When a respondent arrives at the state psychiatric
hospital, the admitting physician shall examine the respondent
and determine whether or not, in the physician's judgment, the
respondent is a fit subject for observation, treatment, and
hospital care. If, upon examination, the physician decides
that the respondent should be admitted to the hospital, the
respondent shall be provided a proper bed in the hospital. The
physician who has charge of the respondent shall proceed with
observation, medical treatment, and hospital care as in the
physician's judgment are proper and necessary, in compliance
with sections 229.13 to 229.16. After the respondent's
admission, the observation, medical treatment, and hospital
care of the respondent may be provided by a mental health
professional, as defined in section 228.1, who is licensed as a
physician, advanced registered nurse practitioner, or physician
assistant.
2. A proper and competent nurse shall also be assigned to
look after and care for the respondent during observation,
treatment, and care. Observation, treatment, and hospital care
under this section which are payable in whole or in part by a
county shall only be provided as determined through the central
point of coordination process regional administrator of the
respondent's county of residence.
Sec. 25. Section 225.16, subsection 1, Code 2015, is amended
to read as follows:
1. If the county board of supervisors or the board's
designee regional administrator for a person's county of
residence finds from the physician's information which was
filed under the provisions of section 225.10 that it would
be appropriate for the person to be admitted to the state
psychiatric hospital, and the report of the county board of
supervisors or the board's designee regional administrator made
pursuant to section 225.13 shows that the person and those who
are legally responsible for the person are not able to pay the
expenses incurred at the hospital, or are able to pay only a
part of the expenses, the person shall be considered to be a
voluntary public patient and the board of supervisors regional
administrator shall direct that the person shall be sent to the
state psychiatric hospital at the state university of Iowa for
observation, treatment, and hospital care.
Sec. 26. Section 225.17, subsection 2, Code 2015, is amended
to read as follows:
2. When the respondent arrives at the hospital, the
respondent shall receive the same treatment as is provided for
committed public patients in section 225.15, in compliance with
sections 229.13 to 229.16. However, observation, treatment,
and hospital care under this section of a respondent whose
expenses are payable in whole or in part by a county shall
only be provided as determined through the central point of
coordination process regional administrator of the respondent's
county of residence.
Sec. 27. Section 225.18, Code 2015, is amended to read as
follows:
225.18 Attendants.
The county board of supervisors or the board's designee
regional administrator may appoint a person an attendant to
accompany the committed public patient or the voluntary public
patient or the committed private patient from the place where
the patient may be to the state psychiatric hospital, or to
accompany the patient from the hospital to a place as may be
designated by the county regional administrator. If a patient
is moved pursuant to this section, at least one attendant shall
be of the same gender as the patient.
Sec. 28. Section 225.19, Code 2015, is amended to read as
follows:
225.19 Compensation for attendant.
An individual appointed by the county board of supervisors
or the board's designee regional administrator in accordance
with section 225.18 to accompany a person to or from the
hospital or to make an investigation and report on any question
involved in the matter shall receive three dollars per day for
the time actually spent in making the investigation and actual
necessary expenses incurred in making the investigation or
trip. This section does not apply to an appointee who receives
fixed compensation or a salary.
Sec. 29. Section 225.21, Code 2015, is amended to read as
follows:
225.21 Compensation claims ==== filing ==== approval.
The person making claim to compensation under section 225.19
shall file the claim in the office of the county auditor
regional administrator for the person's county of residence.
The claim is subject to review and approval by the board of
supervisors or the board's designee regional administrator for
the county.
Sec. 30. Section 225.24, Code 2015, is amended to read as
follows:
225.24 Collection of preliminary expense.
Unless a committed private patient or those legally
responsible for the patient's support offer to settle
the amount of the claims, the county auditor of regional
administrator for the person's county of residence shall
collect, by action if necessary, the amount of all claims
for per diem and expenses that have been approved by the
county board of supervisors or the board's designee regional
administrator for the county and paid by the county regional
administrator as provided under section 225.21. Any amount
collected shall be credited to the county treasury mental
health and disabilities services fund created in accordance
with section 331.424A.
Sec. 31. Section 225.27, Code 2015, is amended to read as
follows:
225.27 Discharge ==== transfer.
The state psychiatric hospital may, at any time, discharge
any patient as recovered, as improved, or as not likely to
be benefited by further treatment. If the patient being so
discharged was involuntarily hospitalized, the hospital shall
notify the committing judge or court of the discharge as
required by section 229.14 or section 229.16, whichever is
applicable, and the applicable regional administrator. Upon
receiving the notification, the court shall issue an order
confirming the patient's discharge from the hospital or from
care and custody, as the case may be, and shall terminate the
proceedings pursuant to which the order was issued. The court
or judge shall, if necessary, appoint a person to accompany the
discharged patient from the state psychiatric hospital to such
place as the hospital or the court may designate, or authorize
the hospital to appoint such attendant.
Sec. 32. Section 225C.2, subsection 2, Code 2015, is amended
by striking the subsection.
Sec. 33. Section 225C.5, subsection 1, paragraph f, Code
2015, is amended to read as follows:
f. Two members shall be staff members of regional
administrators of the central point of coordination process
established in accordance with section 331.440 selected from
nominees submitted by the community services affiliate of the
Iowa state association of counties.
Sec. 34. Section 225C.6, subsection 1, paragraph i,
subparagraph (1), Code 2015, is amended to read as follows:
(1) The extent to which services to persons with
disabilities are actually available to persons in each county
and mental health and disability services region in the state
and the quality of those services.
Sec. 35. Section 225C.6, subsection 1, paragraph m, Code
2015, is amended to read as follows:
m. Identify disability services outcomes and indicators to
support the ability of eligible persons with a disability to
live, learn, work, and recreate in communities of the persons'
choice. The identification duty includes but is not limited to
responsibility for identifying, collecting, and analyzing data
as necessary to issue reports on outcomes and indicators at the
county, region, and state levels.
Sec. 36. Section 225C.13, subsection 1, Code 2015, is
amended to read as follows:
1. The administrator assigned, in accordance with section
218.1, to control the state mental health institutes and
the state resource centers may enter into agreements under
which a facility or portion of a facility administered by the
administrator is leased to a department or division of state
government, a county or group of counties, a mental health and
disability services region, or a private nonprofit corporation
organized under chapter 504. A lease executed under this
section shall require that the lessee use the leased premises
to deliver either disability services or other services
normally delivered by the lessee.
Sec. 37. Section 225C.14, Code 2015, is amended to read as
follows:
225C.14 Preliminary diagnostic evaluation.
1. Except in cases of medical emergency, a person shall be
admitted to a state mental health institute as an inpatient
only after a preliminary diagnostic evaluation performed
through the central point of coordination process regional
administrator of the person's county of residence has confirmed
that the admission is appropriate to the person's mental health
needs, and that no suitable alternative method of providing the
needed services in a less restrictive setting or in or nearer
to the person's home community is currently available. If
provided for through the central point of coordination process
regional administrator, the evaluation may be performed by a
community mental health center or by an alternative diagnostic
facility. The policy established by this section shall be
implemented in the manner and to the extent prescribed by
sections 225C.15, 225C.16 and 225C.17.
2. As used in this section and sections 225C.15, 225C.16
and 225C.17, the term "medical emergency" means a situation
in which a prospective patient is received at a state mental
health institute in a condition which, in the opinion of the
chief medical officer, or that officer's physician designee,
requires the immediate admission of the person notwithstanding
the policy stated in subsection 1.
Sec. 38. Section 225C.15, Code 2015, is amended to read as
follows:
225C.15 County implementation of evaluations.
The board of supervisors of regional administrator for a
county shall, no later than July 1, 1982, require that the
policy stated in section 225C.14 be followed with respect
to admission of persons from that county to a state mental
health institute. A community mental health center which is
supported, directly or in affiliation with other counties, by
that county may perform the preliminary diagnostic evaluations
for that county, unless the performance of the evaluations
is not covered by the agreement entered into by the county
regional administrator and the center, and the center's
director certifies to the board of supervisors regional
administrator that the center does not have the capacity to
perform the evaluations, in which case the board of supervisors
regional administrator shall proceed under section 225C.17.
Sec. 39. Section 225C.16, Code 2015, is amended to read as
follows:
225C.16 Referrals for evaluation.
1. The chief medical officer of a state mental health
institute, or that officer's physician designee, shall advise
a person residing in that county who applies for voluntary
admission, or a person applying for the voluntary admission
of another person who resides in that county, in accordance
with section 229.41, that the board of supervisors regional
administrator for the county has implemented the policy
stated in section 225C.14, and shall advise that a preliminary
diagnostic evaluation of the prospective patient be sought,
if that has not already been done. This subsection does not
apply when voluntary admission is sought in accordance with
section 229.41 under circumstances which, in the opinion of the
chief medical officer or that officer's physician designee,
constitute a medical emergency.
2. The clerk of the district court in that county shall
refer a person applying for authorization for voluntary
admission, or for authorization for voluntary admission of
another person, in accordance with section 229.42, to the
appropriate entity designated through the central point of
coordination process regional administrator of the person's
county of residence under section 225C.14 for the preliminary
diagnostic evaluation unless the applicant furnishes a written
statement from the appropriate entity which indicates that the
evaluation has been performed and that the person's admission
to a state mental health institute is appropriate. This
subsection does not apply when authorization for voluntary
admission is sought under circumstances which, in the opinion
of the chief medical officer or that officer's physician
designee, constitute a medical emergency.
3. Judges of the district court in that county or the
judicial hospitalization referee appointed for that county
shall so far as possible arrange for the entity designated
through the central point of coordination process regional
administrator under section 225C.14 to perform a prehearing
examination of a respondent required under section 229.8,
subsection 3, paragraph "b".
4. The chief medical officer of a state mental health
institute shall promptly submit to the appropriate entity
designated through the central point of coordination process
regional administrator under section 225C.14 a report of the
voluntary admission of a patient under the medical emergency
clauses provisions of subsections 1 and 2. The report shall
explain the nature of the emergency which necessitated the
admission of the patient without a preliminary diagnostic
evaluation by the designated entity.
Sec. 40. Section 225C.17, Code 2015, is amended to read as
follows:
225C.17 Alternative diagnostic facility.
If a county is not served by a community mental health
center having the capacity to perform the required preliminary
diagnostic evaluations, the board of supervisors regional
administrator for the county shall arrange for the evaluations
to be performed by an alternative diagnostic facility for
the period until the county is served by a community mental
health center with the capacity to provide that service. An
alternative diagnostic facility may be the outpatient service
of a state mental health institute or any other mental health
facility or service able to furnish the requisite professional
skills to properly perform a preliminary diagnostic evaluation
of a person whose admission to a state mental health institute
is being sought or considered on either a voluntary or an
involuntary basis.
Sec. 41. Section 225C.19, subsection 3, paragraphs a, b, and
c, Code 2015, are amended to read as follows:
a. Standards for accrediting or approving emergency mental
health crisis services providers. Such providers may include
but are not limited to a community mental health center
designated under chapter 230A, a provider approved in a waiver
adopted by the commission to provide services to a county
in lieu of a community mental health center, a unit of the
department or other state agency, a county, a mental health
and disability services region, or any other public or private
provider who meets the accreditation or approval standards for
an emergency mental health crisis services provider.
b. Identification by the division of geographic regions,
groupings of mental health and disability services regions,
service areas, or other means of distributing and organizing
the emergency mental health crisis services system to ensure
statewide availability of the services.
c. Coordination of emergency mental health crisis services
with all of the following:
(1) The district and juvenile courts.
(2) Law enforcement.
(3) Judicial district departments of correctional services.
(4) County central point of coordination processes Mental
health and disability services regions.
(5) Other mental health, substance abuse, and co=occurring
mental illness and substance abuse services available through
the state and counties to serve both children and adults.
Sec. 42. Section 225C.20, Code 2015, is amended to read as
follows:
225C.20 Responsibilities of counties mental health and
disabilities services regions for individual case management
services.
Individual case management services funded under medical
assistance shall be provided by the department except when
a county or a consortium of counties contracts with the
department to provide the services. A county or consortium
of counties regional administrator may contract for one or
more counties of the region to be the provider at any time
and the department shall agree to the contract so long as
the contract meets the standards for case management adopted
by the department. The county or consortium of counties
regional administrator may subcontract for the provision
of case management services so long as the subcontract
meets the same standards. A county board of supervisors
regional administrator may change the provider of individual
case management services at any time. If the current or
proposed contract is with the department, the county board
of supervisors regional administrator shall provide written
notification of a change at least ninety days before the date
the change will take effect.
Sec. 43. Section 225C.54, subsection 1, Code 2015, is
amended to read as follows:
1. The mental health services system for children and youth
shall be initially implemented by the division commencing
with the fiscal year beginning July 1, 2008. The division
shall begin implementation by utilizing a competitive bidding
process to allocate state block grants to develop services
through existing community mental health centers, providers
approved in a waiver adopted by the commission to provide
services to a county in lieu of a community mental health
center, designated under chapter 230A and other local service
partners. The implementation shall be limited to the extent of
the appropriations provided for the children's system.
Sec. 44. Section 226.1, Code 2015, is amended by adding the
following new subsection:
NEW SUBSECTION. 4. For the purposes of this chapter, unless
the context otherwise requires:
a. "Administrator" means the person assigned by the
director of human services to control the state mental health
institutes.
b. "Department" means the department of human services.
c. "Mental health and disability services region" means
a mental health and disability services region formed in
accordance with section 331.389.
d. "Regional administrator" means the regional administrator
of a mental health and disability services region, as defined
in section 331.388.
Sec. 45. Section 226.9C, subsection 2, paragraphs a and c,
Code 2015, are amended to read as follows:
a. A county may split the The charges payable by a
county may be split between the county's mental health and
disabilities services fund created pursuant to section 331.424A
and the county's budget for substance abuse substance=related
disorder expenditures.
c. (1) Prior to an individual's admission for dual
diagnosis treatment, the individual shall have been
prescreened. The person performing the prescreening shall
be either the mental health professional, as defined in
section 228.1, who is contracting with the county central
point of coordination process regional administrator for the
county's mental health and disability services region to
provide the prescreening or a mental health professional with
the requisite qualifications. A mental health professional
with the requisite qualifications shall meet all of the
following qualifications: is a mental health professional as
defined in section 228.1, is an alcohol and drug counselor
certified by the nongovernmental Iowa board of substance abuse
certification, and is employed by or providing services for a
facility, as defined in section 125.2.
(2) Prior to an individual's admission for dual diagnosis
treatment, the individual shall have been screened through a
county's central point of coordination process implemented
pursuant to section 331.440 regional administrator to determine
the appropriateness of the treatment.
Sec. 46. Section 226.32, Code 2015, is amended to read as
follows:
226.32 Overcrowded conditions.
The administrator shall order the discharge or removal
from the hospital of incurable and harmless patients whenever
it is necessary to make room for recent cases. If a patient
who is to be so discharged entered the hospital voluntarily,
the administrator shall notify the auditor of regional
administrator for the county interested at least ten days in
advance of the day of actual discharge.
Sec. 47. Section 226.34, subsection 2, Code 2015, is amended
to read as follows:
2. If a patient in a mental health institute dies from any
cause, the superintendent of the institute shall within three
days of the date of death, send by certified mail a written
notice of death to all of the following:
a. The decedent's nearest relative.
b. The clerk of the district court of the county from which
the patient was committed.
c. The sheriff of the county from which the patient was
committed.
d. The regional administrator for the county from which the
patient was committed.
Sec. 48. Section 227.1, Code 2015, is amended to read as
follows:
227.1 Supervision Definitions ==== supervision.
1. For the purposes of this chapter, unless the context
otherwise requires:
a. "Administrator" means the person assigned by the director
of human services in the appropriate division of the department
to administer mental health and disability services.
b. "Department" means the department of human services.
c. "Mental health and disability services region" means
a mental health and disability services region formed in
accordance with section 331.389.
d. "Regional administrator" means the regional administrator
of a mental health and disability services region, as defined
in section 331.388.
2. All The regulatory requirements for county and private
institutions wherein where persons with mental illness or an
intellectual disability are kept admitted, committed, or placed
shall be under the supervision of the administrator.
Sec. 49. Section 227.2, subsection 1, unnumbered paragraph
1, Code 2015, is amended to read as follows:
The director of inspections and appeals shall make, or cause
to be made, at least one licensure inspection each year of
every county care facility. Either the administrator of the
division or the director of the department of inspections and
appeals, in cooperation with each other, upon receipt of a
complaint or for good cause, may make, or cause to be made,
a review of a county care facility or of any other private
or county institution where persons with mental illness or
an intellectual disability reside. A licensure inspection
or a review shall be made by a competent and disinterested
person who is acquainted with and interested in the care of
persons with mental illness and persons with an intellectual
disability. The objective of a licensure inspection or a
review shall be an evaluation of the programming and treatment
provided by the facility. After each licensure inspection of a
county care facility, the person who made the inspection shall
consult with the county authorities regional administrator
for the county in which the facility is located on plans and
practices that will improve the care given patients and. The
person shall also make recommendations to the administrator of
the division and the director of public health for coordinating
and improving the relationships between the administrators of
county care facilities, the administrator of the division,
the director of public health, the superintendents of state
mental health institutes and resource centers, community
mental health centers, mental health and disability services
regions, and other cooperating agencies, to cause improved
and more satisfactory care of patients. A written report of
each licensure inspection of a county care facility under this
section shall be filed by the person with the administrator
of the division and the director of public health and shall
include:
Sec. 50. Section 227.2, subsection 1, paragraph f, Code
2015, is amended to read as follows:
f. The recommendations given to and received from county
authorities the regional administrator on methods and practices
that will improve the conditions under which the county care
facility is operated.
Sec. 51. Section 227.2, subsection 2, Code 2015, is amended
to read as follows:
2. A copy of the written report prescribed by subsection
1 shall be furnished to the county board of supervisors,
to the county mental health and intellectual disability
coordinating board or to its advisory board if the county board
of supervisors constitutes ex officio the coordinating board
regional administrator for the county, to the administrator
of the county care facility inspected and to its certified
volunteer long=term care ombudsman, and to the department on
aging.
Sec. 52. Section 227.4, Code 2015, is amended to read as
follows:
227.4 Standards for care of persons with mental illness or an
intellectual disability in county care facilities.
The administrator, in cooperation with the department of
inspections and appeals, shall recommend and the mental health
and disability services commission created in section 225C.5
shall adopt, or amend and adopt, standards for the care of and
services to persons with mental illness or an intellectual
disability residing in county care facilities. The standards
shall be enforced by the department of inspections and appeals
as a part of the licensure inspection conducted pursuant to
chapter 135C. The objective of the standards is to ensure
that persons with mental illness or an intellectual disability
who are residents of county care facilities are not only
adequately fed, clothed, and housed, but are also offered
reasonable opportunities for productive work and recreational
activities suited to their physical and mental abilities and
offering both a constructive outlet for their energies and, if
possible, therapeutic benefit. When recommending standards
under this section, the administrator shall designate an
advisory committee representing administrators of county care
facilities, county mental health and developmental disabilities
regional planning councils regional administrators, mental
health and disability services region governing boards,
and county care facility certified volunteer long=term care
ombudsmen to assist in the establishment of standards.
Sec. 53. Section 227.10, Code 2015, is amended to read as
follows:
227.10 Transfers from county or private institutions.
Patients who have been admitted at public expense to
any institution to which this chapter is applicable may be
involuntarily transferred to the proper state hospital for
persons with mental illness in the manner prescribed by
sections 229.6 to 229.13. The application required by section
229.6 may be filed by the administrator of the division or
the administrator's designee, or by the administrator of the
institution where the patient is then being maintained or
treated. If the patient was admitted to that institution
involuntarily, the administrator of the division may arrange
and complete the transfer, and shall report it as required
of a chief medical officer under section 229.15, subsection
5. The transfer shall be made at county the mental health
and disabilities services region's expense, and the expense
recovered, as provided in section 227.7. However, transfer
under this section of a patient whose expenses are payable in
whole or in part by a county the mental health and disabilities
services region is subject to an authorization for the transfer
through the central point of coordination process regional
administrator for the patient's county of residence.
Sec. 54. Section 227.11, Code 2015, is amended to read as
follows:
227.11 Transfers from state hospitals.
A regional administrator for the county chargeable with
the expense of a patient in a state hospital for persons with
mental illness shall transfer the patient to a county or
private institution for persons with mental illness that is in
compliance with the applicable rules when the administrator
of the division or the administrator's designee orders the
transfer on a finding that the patient is suffering from
chronic mental illness or from senility a serious mental
illness and will receive equal benefit by being so transferred.
A county mental health and disability services region shall
transfer to its a county care facility any patient in a state
hospital for persons with mental illness upon request of the
superintendent of the state hospital in which the patient is
confined pursuant to the superintendent's authority under
section 229.15, subsection 5, and approval by the board of
supervisors of regional administrator for the county of the
patient's residence. In no case shall a patient be thus
transferred except upon compliance with section 229.14A or
without the written consent of a relative, friend, or guardian
if such relative, friend, or guardian pays the expense of
the care of such patient in a state hospital. Patients
transferred to a public or private facility under this
section may subsequently be placed on convalescent or limited
leave or transferred to a different facility for continued
full=time custody, care, and treatment when, in the opinion
of the attending physician or the chief medical officer of
the hospital from which the patient was so transferred, the
best interest of the patient would be served by such leave or
transfer. For any patient who is involuntarily committed, any
transfer made under this section is subject to the placement
hearing requirements of section 229.14A.
Sec. 55. Section 227.12, Code 2015, is amended to read as
follows:
227.12 Difference of opinion.
When a difference of opinion exists between the
administrator of the division and the authorities in charge
of any private or county hospital in regard to the removal
transfer of a patient or patients as herein provided in
sections 227.10 and 227.11, the matter shall be submitted to
the district court of the county in which such hospital is
situated and shall be summarily tried as an equitable action,
and the judgment of the district court shall be final.
Sec. 56. Section 227.14, Code 2015, is amended to read as
follows:
227.14 Caring for persons with mental illness from other
counties.
Boards of supervisors of counties having no The regional
administrator for a county that does not have proper facilities
for caring for persons with mental illness may, with the
consent of the administrator of the division, provide for
such care at the expense of the county mental health and
disabilities services region in any convenient and proper
county or private institution for persons with mental illness
which is willing to receive them the persons.
Sec. 57. Section 229.1, subsection 3, Code 2015, is amended
by striking the subsection.
Sec. 58. Section 229.1, Code 2015, is amended by adding the
following new subsections:
NEW SUBSECTION. 8A. "Mental health and disability services
region" means a mental health and disability services region
formed in accordance with section 331.389.
NEW SUBSECTION. 14A. "Regional administrator" means the
regional administrator of a mental health and disability
services region, as defined in section 331.388.
Sec. 59. Section 229.1B, Code 2015, is amended to read as
follows:
229.1B Central point of coordination process Regional
administrator.
Notwithstanding any provision of this chapter to the
contrary, any person whose hospitalization expenses are payable
in whole or in part by a county mental health and disabilities
services region shall be subject to all administrative
requirements of the central point of coordination process
regional administrator for the county.
Sec. 60. Section 229.2, subsection 1, paragraph b,
subparagraph (3), Code 2015, is amended to read as follows:
(3) As soon as is practicable after the filing of a
petition for juvenile court approval of the admission of the
minor, the juvenile court shall determine whether the minor
has an attorney to represent the minor in the hospitalization
proceeding, and if not, the court shall assign to the minor
an attorney. If the minor is financially unable to pay for
an attorney, the attorney shall be compensated by the county
mental health and disabilities services region at an hourly
rate to be established by the county board of supervisors
regional administrator for the county in which the proceeding
is held in substantially the same manner as provided in section
815.7.
Sec. 61. Section 229.8, subsection 1, Code 2015, is amended
to read as follows:
1. Determine whether the respondent has an attorney
who is able and willing to represent the respondent in the
hospitalization proceeding, and if not, whether the respondent
is financially able to employ an attorney and capable of
meaningfully assisting in selecting one. In accordance with
those determinations, the court shall if necessary allow the
respondent to select, or shall assign to the respondent, an
attorney. If the respondent is financially unable to pay an
attorney, the attorney shall be compensated by the county
mental health and disabilities services region at an hourly
rate to be established by the county board of supervisors
regional administrator for the county in which the proceeding
is held in substantially the same manner as provided in section
815.7.
Sec. 62. Section 229.10, subsection 1, paragraph a, Code
2015, is amended to read as follows:
a. An examination of the respondent shall be conducted by
one or more licensed physicians, as required by the court's
order, within a reasonable time. If the respondent is detained
pursuant to section 229.11, subsection 1, paragraph "b",
the examination shall be conducted within twenty=four hours.
If the respondent is detained pursuant to section 229.11,
subsection 1, paragraph "a" or "c", the examination shall
be conducted within forty=eight hours. If the respondent
so desires, the respondent shall be entitled to a separate
examination by a licensed physician of the respondent's own
choice. The reasonable cost of the examinations shall, if the
respondent lacks sufficient funds to pay the cost, be paid
by the regional administrator from county mental health and
disabilities services region funds upon order of the court.
Sec. 63. Section 229.11, subsection 1, unnumbered paragraph
1, Code 2015, is amended to read as follows:
If the applicant requests that the respondent be taken into
immediate custody and the judge, upon reviewing the application
and accompanying documentation, finds probable cause to believe
that the respondent has a serious mental impairment and is
likely to injure the respondent or other persons if allowed
to remain at liberty, the judge may enter a written order
directing that the respondent be taken into immediate custody
by the sheriff or the sheriff's deputy and be detained until
the hospitalization hearing. The hospitalization hearing shall
be held no more than five days after the date of the order,
except that if the fifth day after the date of the order is a
Saturday, Sunday, or a holiday, the hearing may be held on the
next succeeding business day. If the expenses of a respondent
are payable in whole or in part by a county mental health and
disabilities services region, for a placement in accordance
with paragraph "a", the judge shall give notice of the
placement to the central point of coordination process regional
administrator for the county in which the court is located,
and for a placement in accordance with paragraph "b" or "c",
the judge shall order the placement in a hospital or facility
designated through the central point of coordination process
regional administrator. The judge may order the respondent
detained for the period of time until the hearing is held,
and no longer, in accordance with paragraph "a", if possible,
and if not then in accordance with paragraph "b", or, only if
neither of these alternatives is available, in accordance with
paragraph "c". Detention may be:
Sec. 64. Section 229.13, subsection 1, paragraph a, Code
2015, is amended to read as follows:
a. The court shall order a respondent whose expenses are
payable in whole or in part by a county mental health and
disabilities services region placed under the care of an
appropriate hospital or facility designated through the central
point of coordination process county's regional administrator
on an inpatient or outpatient basis.
Sec. 65. Section 229.14, subsection 2, paragraph a, Code
2015, is amended to read as follows:
a. For a respondent whose expenses are payable in whole or
in part by a county mental health and disabilities services
region, placement as designated through the central point of
coordination process county's regional administrator in the
care of an appropriate hospital or facility on an inpatient
or outpatient basis, or other appropriate treatment, or in an
appropriate alternative placement.
Sec. 66. Section 229.14A, subsections 7 and 9, Code 2015,
are amended to read as follows:
7. If a respondent's expenses are payable in whole or in
part by a county mental health and disabilities services region
through the central point of coordination process county's
regional administrator, notice of a placement hearing shall
be provided to the county attorney and the county's central
point of coordination process regional administrator. At the
hearing, the county may present evidence regarding appropriate
placement.
9. A placement made pursuant to an order entered under
section 229.13 or 229.14 or this section shall be considered to
be authorized through the central point of coordination process
county's regional administrator.
Sec. 67. Section 229.24, subsection 3, unnumbered paragraph
1, Code 2015, is amended to read as follows:
If all or part of the costs associated with hospitalization
of an individual under this chapter are chargeable to a county
of residence, the clerk of the district court shall provide
to the regional administrator for the county of residence and
to the regional administrator for the county in which the
hospitalization order is entered the following information
pertaining to the individual which would be confidential under
subsection 1:
Sec. 68. Section 229.42, subsection 1, Code 2015, is amended
to read as follows:
1. If a person wishing to make application for voluntary
admission to a mental hospital established by chapter 226 is
unable to pay the costs of hospitalization or those responsible
for the person are unable to pay the costs, application for
authorization of voluntary admission must be made through a
central point of coordination process regional administrator
before application for admission is made to the hospital. The
person's county of residence shall be determined through the
central point of coordination process regional administrator
and if the admission is approved through the central point
of coordination process regional administrator, the person's
admission to a mental health hospital shall be authorized as
a voluntary case. The authorization shall be issued on forms
provided by the department of human services' administrator.
The costs of the hospitalization shall be paid by the county
of residence through the regional administrator to the
department of human services and credited to the general
fund of the state, provided that the mental health hospital
rendering the services has certified to the county auditor of
the county of residence and the regional administrator the
amount chargeable to the county mental health and disabilities
services region and has sent a duplicate statement of the
charges to the department of human services. A county mental
health and disabilities services region shall not be billed
for the cost of a patient unless the patient's admission is
authorized through the central point of coordination process
regional administrator. The mental health institute and the
county regional administrator shall work together to locate
appropriate alternative placements and services, and to
educate patients and family members of patients regarding such
alternatives.
Sec. 69. Section 230.1, subsection 3, Code 2015, is amended
to read as follows:
3. A mental health and disabilities services region or
county of residence is not liable for costs and expenses
associated with a person with mental illness unless the costs
and expenses are for services and other support authorized for
the person through the central point of coordination process
county's regional administrator. For the purposes of this
chapter, "central point of coordination process" "regional
administrator" means the same as defined in section 331.440
331.388.
Sec. 70. Section 230.3, Code 2015, is amended to read as
follows:
230.3 Certification of residence.
If a person's county of residence is determined by the
county's central point of coordination process regional
administrator to be in another county of this state, the county
regional administrator making the determination shall certify
the determination to the superintendent of the hospital to
which the person is admitted or committed. The certification
shall be accompanied by a copy of the evidence supporting
the determination. Upon receiving the certification, the
superintendent shall charge the expenses already incurred and
unadjusted, and all future expenses of the person, to the
regional administrator of the county determined to be the
county of residence.
Sec. 71. Section 230.20, subsection 2, paragraph b, Code
2015, is amended to read as follows:
b. The per diem costs billed to each county mental health
and disabilities services region shall not exceed the per
diem costs billed to the county in the fiscal year beginning
July 1, 1996. However, the per diem costs billed to a county
mental health and disabilities services region may be adjusted
annually to reflect increased costs, to the extent of the
percentage increase in the total of county fixed budgets
pursuant to the allowed growth factor adjustment statewide per
capita expenditure target amount, if any per capita growth
amount is authorized by the general assembly for the fiscal
year in accordance with section 331.439 426B.3.
Sec. 72. Section 232.2, subsection 4, paragraph f,
subparagraph (3), Code 2015, is amended to read as follows:
(3) The transition plan shall be developed and reviewed
by the department in collaboration with a child=centered
transition team. The transition team shall be comprised of
the child's caseworker and persons selected by the child,
persons who have knowledge of services available to the child,
and any person who may reasonably be expected to be a service
provider for the child when the child becomes an adult or to
become responsible for the costs of services at that time.
If the child is reasonably likely to need or be eligible for
adult services, the transition team membership shall include
representatives from the adult services system. The adult
services system representatives may include but are not limited
to the administrator of county general relief under chapter
251 or 252 or of the central point of coordination process
implemented under section 331.440 regional administrator of
the county mental health and disability services region, as
defined in section 331.388. The membership of the transition
team and the meeting dates for the team shall be documented in
the transition plan.
Sec. 73. Section 235.7, subsection 2, Code 2015, is amended
to read as follows:
2. Membership. The department may authorize the governance
boards of decategorization of child welfare and juvenile
justice funding projects established under section 232.188 to
appoint the transition committee membership and may utilize
the boundaries of decategorization projects to establish
the service areas for transition committees. The committee
membership may include but is not limited to department of
human services staff involved with foster care, child welfare,
and adult services, juvenile court services staff, staff
involved with county general relief under chapter 251 or 252,
or of the central point of coordination process implemented
under section 331.440 a regional administrator of the county
mental health and disability services region, as defined
in section 331.388, in the area, school district and area
education agency staff involved with special education, and a
child's court appointed special advocate, guardian ad litem,
service providers, and other persons knowledgeable about the
child.
Sec. 74. Section 235A.15, subsection 2, paragraph c,
subparagraph (9), Code 2015, is amended to read as follows:
(9) To the administrator of an agency providing mental
health, intellectual disability, or developmental disability
services under a county management plan developed pursuant
to section 331.439 regional service system management plan
implemented in accordance with section 331.393, if the data
concerns a person employed by or being considered by the agency
for employment.
Sec. 75. Section 235B.6, subsection 2, paragraph c,
subparagraph (6), Code 2015, is amended to read as follows:
(6) To the administrator of an agency providing mental
health, intellectual disability, or developmental disability
services under a county management plan developed pursuant
to section 331.439 regional service system management plan
implemented in accordance with section 331.393, if the
information concerns a person employed by or being considered
by the agency for employment.
Sec. 76. Section 426B.2, subsection 2, Code 2015, is amended
to read as follows:
2. As used in this chapter, and in sections 331.438 and
331.439 section 331.424A, for purposes of population=based
funding calculations, "population" means the population shown
by the latest preceding certified federal census or the
latest applicable population estimate issued by the federal
government, whichever is most recent and available as of July
1 of the fiscal year preceding the fiscal year to which the
funding calculations apply.
Sec. 77. Section 426B.5, subsection 1, Code 2015, is amended
by striking the subsection.
Sec. 78. Section 426B.5, subsections 2 and 3, Code 2015, are
amended to read as follows:
2. Risk pool.
a. For the purposes of this subsection section, unless the
context otherwise requires, "services fund":
(1) "Mental health and disability services region" means
a mental health and disability services region formed in
accordance with section 331.389.
(2) "Regional administrator" means the regional
administrator of a mental health and disability services
region, as defined in section 331.388.
(3) "Services fund" means a county's mental health and
disabilities services fund created in section 331.424A.
b. A risk pool is created in the property tax relief fund.
The pool shall consist of the moneys credited to the pool by
law.
c. A risk pool board is created. The board shall consist
of two county supervisors, two county auditors, a member of
the mental health and disability services commission who is
not a member of a county board of supervisors, a member of
the county finance committee created in chapter 333A who is
not an elected official, a representative of a provider of
mental health or developmental disabilities services selected
from nominees submitted by the Iowa association of community
providers, and two central point of coordination process
staff members of regional administrators of county mental
health and disability services, all appointed by the governor,
and one member appointed by the director of human services.
All members appointed by the governor shall be subject to
confirmation by the senate. Members shall serve for three=year
terms. A vacancy shall be filled in the same manner as the
original appointment. Expenses and other costs of the risk
pool board members representing counties shall be paid by the
county of origin. Expenses and other costs of risk pool board
members who do not represent counties shall be paid from a
source determined by the governor. Staff assistance to the
board shall be provided by the department of human services and
counties. Actuarial expenses and other direct administrative
costs shall be charged to the pool.
d. A county regional administrator must apply to the risk
pool board for assistance from the risk pool on or before
October 31. The purpose of the assistance shall be to provide
financial support for services provided by one or more of the
counties comprising the regional administrator's mental health
and disability services region. The risk pool board shall
make its final decisions on or before December 15 regarding
acceptance or rejection of the applications for assistance and
the total amount accepted shall be considered obligated.
e. Basic eligibility for risk pool assistance requires that
a county mental health and disability services region meet all
of the following conditions:
(1) The county mental health and disability services region
is in compliance with the regional service system management
plan requirements of section 331.439 331.393.
(2) The county counties comprising the mental health and
disability services region each levied the maximum amount
allowed for the county's services fund under section 331.424A
for the fiscal year of application for risk pool assistance.
(3) In the fiscal year that commenced two years prior to the
fiscal year of application, the county's ending balance, under
generally accepted accounting principles, of the mental health
and disability services region's combined services fund ending
balance under generally accepted accounting principles funds
was equal to or less than twenty percent of the county's actual
gross expenditures of the counties comprising the mental health
and disability services region for that fiscal year.
f. The board shall review the fiscal year=end financial
records for all counties mental health and disability services
regions that are granted risk pool assistance. If the board
determines a county's mental health and disability services
region's actual need for risk pool assistance was less than
the amount of risk pool assistance granted to the county
mental health and disability services region, the county
mental health and disability services region shall refund the
difference between the amount of assistance granted and the
actual need. The county mental health and disability services
region shall submit the refund within thirty days of receiving
notice from the board. Refunds shall be credited to the risk
pool. The mental health and disability services commission
shall adopt rules pursuant to chapter 17A providing criteria
for the purposes of this lettered paragraph and as necessary to
implement the other provisions of this subsection.
g. The board shall determine application requirements to
ensure prudent use of risk pool assistance. The board may
accept or reject an application for assistance in whole or in
part. The decision of the board is final.
h. The total amount of risk pool assistance shall be limited
to the amount available in the risk pool for a fiscal year. Any
unobligated balance in the risk pool at the close of a fiscal
year shall remain in the risk pool for distribution in the
succeeding fiscal year.
i. Risk pool assistance shall only be made available to
address one or more of the following circumstances:
(1) Continuing support for mandated services.
(2) Avoiding the need for reduction or elimination of
critical services when the reduction or elimination places
consumers' health or safety at risk.
(3) Avoiding the need for reduction or elimination of a
mobile crisis team or other critical emergency services when
the reduction or elimination places the public's health or
safety at risk.
(4) Avoiding the need for reduction or elimination of
the services or other support provided to entire disability
populations.
(5) Avoiding the need for reduction or elimination of
services or other support that maintain consumers in a
community setting, creating a risk that the consumers would be
placed in more restrictive, higher cost settings.
j. Subject to the amount available and obligated from the
risk pool for a fiscal year, the department of human services
shall annually calculate the amount of moneys due to eligible
counties mental health and disability services regions in
accordance with the board's decisions and that amount is
appropriated from the risk pool to the department for payment
of the moneys due. The department shall authorize the issuance
of warrants payable to the county treasurer mental health
and disability services regions for the amounts due and the
warrants shall be issued on or before January 1.
k. On or before March 1 and September 1 of each fiscal year,
the department of human services shall provide the risk pool
board with a report of the financial condition of each funding
source administered by the board. The report shall include
but is not limited to an itemization of the funding source's
balances, types and amount of revenues credited, and payees
and payment amounts for the expenditures made from the funding
source during the reporting period.
l. If the board has made its decisions but has determined
that there are otherwise qualifying requests for risk pool
assistance that are beyond the amount available in the risk
pool fund for a fiscal year, the board shall compile a list of
such requests and the supporting information for the requests.
The list and information shall be submitted to the mental
health and disability services commission, the department of
human services, and the general assembly.
3. Incentive pool.
a. An incentive pool is created in the property tax relief
fund. The incentive pool shall consist of the moneys credited
to the incentive pool by law.
b. Moneys available in the incentive pool for a fiscal
year shall be distributed to those counties mental health and
disability services regions that either meet or show progress
toward meeting the purposes and intent described in section
331.439, subsection 1, paragraph "c" 225C.1. The moneys
received by a county region from the incentive pool shall be
used to build community capacity to support individuals covered
by the county's region's regional service system management
plan approved under section 331.439, 331.393 in meeting such
purposes.
Sec. 79. REPEAL. Section 226.47, Code 2015, is repealed.
PAM JOCHUM
President of the Senate
KRAIG PAULSEN
Speaker of the House
I hereby certify that this bill originated in the Senate and
is known as Senate File 463, Eighty=sixth General Assembly.
MICHAEL E. MARSHALL
Secretary of the Senate
Approved , 2015
TERRY E. BRANSTAD
Governor
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