Bill Text: IA HF2673 | 2023-2024 | 90th General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: A bill for an act related to state behavioral health, disability, and addictive disorder services and related programs, including the transition of behavioral health services from a mental health and disability services system to a behavioral health service system, the transfer of disability services to the division of aging and disability services of the department of health and human services, the elimination of the commission on aging, the elimination of special intellectual disability units at state mental health institutes, making appropriations, and including effective date provisions. (Formerly HF 2509, HSB 653.) Effective date: 05/15/2024, 07/01/2024, 07/01/2025.
Spectrum: Committee Bill
Status: (Passed) 2024-05-24 - NOBA: Final [HF2673 Detail]
Download: Iowa-2023-HF2673-Introduced.html
Bill Title: A bill for an act related to state behavioral health, disability, and addictive disorder services and related programs, including the transition of behavioral health services from a mental health and disability services system to a behavioral health service system, the transfer of disability services to the division of aging and disability services of the department of health and human services, the elimination of the commission on aging, the elimination of special intellectual disability units at state mental health institutes, making appropriations, and including effective date provisions. (Formerly HF 2509, HSB 653.) Effective date: 05/15/2024, 07/01/2024, 07/01/2025.
Spectrum: Committee Bill
Status: (Passed) 2024-05-24 - NOBA: Final [HF2673 Detail]
Download: Iowa-2023-HF2673-Introduced.html
House
File
2673
-
Introduced
HOUSE
FILE
2673
BY
COMMITTEE
ON
APPROPRIATIONS
(SUCCESSOR
TO
HF
2509)
(SUCCESSOR
TO
HSB
653)
A
BILL
FOR
An
Act
related
to
state
behavioral
health,
disability,
and
1
addictive
disorder
services
and
related
programs,
including
2
the
transition
of
behavioral
health
services
from
a
mental
3
health
and
disability
services
system
to
a
behavioral
health
4
service
system,
the
transfer
of
disability
services
to
the
5
division
of
aging
and
disability
services
of
the
department
6
of
health
and
human
services,
the
elimination
of
the
7
commission
on
aging,
the
elimination
of
special
intellectual
8
disability
units
at
state
mental
health
institutes,
making
9
appropriations,
and
including
effective
date
provisions.
10
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
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DIVISION
I
1
BEHAVIORAL
HEALTH
SERVICE
SYSTEM
2
Section
1.
NEW
SECTION
.
225A.1
Definitions.
3
As
used
in
this
chapter
unless
the
context
otherwise
4
requires:
5
1.
“Administrative
services
organization”
means
an
entity
6
designated
by
the
department
pursuant
to
section
225A.4,
to
7
develop
and
perform
planning
and
administrative
services
in
8
accordance
with
a
district
behavioral
health
service
system
9
plan.
10
2.
“Behavioral
health
condition”
means
a
substantial
11
limitation
in
major
life
activities
due
to
a
mental,
12
behavioral,
or
addictive
disorder
or
condition
diagnosed
in
13
accordance
with
the
criteria
provided
in
the
most
current
14
edition
of
the
diagnostic
and
statistical
manual
of
mental
15
disorders,
published
by
the
American
psychiatric
association.
16
3.
“Behavioral
health
district”
or
“district”
means
a
17
geographic,
multicounty,
sub-state
area
as
designated
by
the
18
department
under
section
225A.4.
19
4.
“Behavioral
health
provider”
or
“provider”
means
an
20
individual,
firm,
corporation,
association,
or
institution
21
that,
pursuant
to
this
chapter,
is
providing
or
has
been
22
approved
by
the
department
to
provide
services
to
an
individual
23
with
a
behavioral
health
condition.
24
5.
“Behavioral
health
service
system”
means
the
behavioral
25
health
service
system
established
in
section
225A.3.
26
6.
“Caregiver”
means
an
adult
family
member,
or
other
27
individual,
who
is
providing
care
to
a
person
outside
of
a
28
formal
program.
29
7.
“Community
mental
health
center”
means
an
entity
30
designated
by
the
department
to
address
the
mental
health
needs
31
of
one
or
more
counties.
32
8.
“Department”
means
the
department
of
health
and
human
33
services.
34
9.
“Director”
means
the
director
of
the
department
of
health
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and
human
services.
1
10.
“District
behavioral
health
advisory
council”
2
or
“advisory
council”
means
a
council
established
by
an
3
administrative
services
organization
under
section
225A.5,
to
4
identify
opportunities,
address
challenges,
and
advise
the
5
administrative
services
organization
in
accordance
with
section
6
225A.5.
7
11.
“District
behavioral
health
service
system
plan”
or
8
“district
behavioral
health
plan”
means
a
plan
developed
by
9
an
administrative
services
organization
and
approved
by
the
10
department
to
outline
the
services
intended
to
be
provided
11
within
the
administrative
services
organization’s
behavioral
12
health
district.
13
12.
“Indicated
prevention”
means
prevention
activities
14
designed
to
prevent
the
onset
of
substance
use
disorders
in
15
individuals
who
do
not
meet
the
medical
criteria
for
addiction,
16
but
who
show
early
signs
of
developing
a
substance
use
disorder
17
in
the
future.
18
13.
“Selective
prevention”
means
prevention
activities
19
designed
to
target
subsets
of
the
total
population
who
are
20
considered
at-risk
for
a
substance
use
disorder
by
virtue
of
21
their
membership
in
a
particular
segment
of
the
population.
22
Selective
prevention
targets
the
entire
subgroup,
regardless
of
23
the
degree
of
risk
of
any
individual
within
the
group.
24
14.
“State
behavioral
health
service
system
plan”
or
25
“state
behavioral
health
plan”
means
the
plan
developed
by
the
26
department
that
describes
the
key
components
of
the
state’s
27
behavioral
health
service
system.
28
15.
“Universal
prevention”
means
prevention
activities
29
designed
to
address
an
entire
population
class
for
the
purpose
30
of
preventing
or
delaying
the
use
of
alcohol,
tobacco,
and
31
other
drugs.
Population
classes
include
but
are
not
limited
32
to
the
national
population,
local
populations,
community
33
populations,
school
populations,
and
neighborhood
populations.
34
Sec.
2.
NEW
SECTION
.
225A.2
State
mental
health
authority
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——
state
agency
for
substance
abuse.
1
1.
The
department
is
designated
as
the
state
mental
health
2
authority
as
defined
in
42
U.S.C.
§201(m)
for
the
purpose
of
3
directing
benefits
from
the
federal
community
mental
health
4
services
block
grant,
42
U.S.C.
§300x
et
seq.,
and
the
state
5
authority
designated
for
the
purpose
of
directing
benefits
6
from
the
federal
substance
abuse
prevention
and
treatment
7
block
grant,
42
U.S.C.
§300x-21
et
seq.
This
designation
8
does
not
preclude
the
state
board
of
regents
from
authorizing
9
or
directing
any
institution
under
the
board
of
regents’
10
jurisdiction
to
carry
out
educational,
prevention,
and
research
11
activities
in
the
areas
of
mental
health
and
intellectual
12
disability.
13
2.
The
department
is
designated
as
the
single
state
agency
14
for
substance
abuse
for
the
purposes
of
42
U.S.C.
§1396a
et
15
seq.
16
3.
For
the
purposes
of
effectuating
the
department’s
roles
17
designated
in
this
section,
the
department
shall
have
the
18
following
powers
and
the
authority
to
take
all
of
the
following
19
actions:
20
a.
Plan,
establish,
and
maintain
prevention,
education,
21
early
intervention,
treatment,
recovery
support,
and
crisis
22
services
programs
as
necessary
or
desirable
for
the
behavioral
23
health
service
system
established
in
section
225A.3.
24
b.
Develop
and
submit
a
state
plan
as
required
by,
and
in
25
accordance
with,
42
U.S.C.
§300x-1.
26
c.
Review
and
approve
district
behavioral
health
service
27
system
plans
developed
in
accordance
with
the
state
behavioral
28
health
service
system
plan.
29
d.
Perform
all
necessary
acts
to
cooperate
with
any
state
30
agency,
political
subdivision,
or
federal
government
agency
to
31
apply
for
grants.
32
e.
Solicit
and
accept
for
use
any
gift
of
money
by
will
or
33
otherwise,
and
any
grant
of
money
or
services
from
the
federal
34
government,
the
state,
or
any
political
subdivision
thereof,
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or
any
private
source.
1
f.
Collect
and
maintain
records,
engage
in
studies
and
2
analyses,
and
gather
relevant
statistics.
3
g.
Take
any
other
actions
as
necessary
to
execute
the
4
duties
granted
to
the
department
in
this
chapter,
or
that
5
are
otherwise
required
to
maintain
compliance
with
federal
6
requirements
related
to
the
department’s
roles
as
designated
in
7
this
section.
8
Sec.
3.
NEW
SECTION
.
225A.3
Behavioral
health
service
9
system
——
department
powers
and
duties.
10
1.
a.
A
behavioral
health
service
system
is
established
11
under
the
control
of
the
department
for
the
purposes
of
12
implementing
a
statewide
system
of
prevention,
education,
early
13
intervention,
treatment,
recovery
support,
and
crisis
services
14
related
to
mental
health
and
addictive
disorders,
including
but
15
not
limited
to
alcohol
use,
substance
use,
tobacco
use,
and
16
problem
gambling.
17
b.
The
behavioral
health
service
system
shall
support
18
equitable
statewide
access
to
all
services
offered
through
19
the
behavioral
health
service
system
and
offer
specialized
20
services
with
a
focus
on
at-risk
populations
including
but
not
21
limited
to
children,
youth,
young
adults,
individuals
with
22
disabilities,
pregnant
and
parenting
women,
older
adults,
and
23
people
with
limited
access
to
financial
resources.
24
c.
Services
offered
through
the
behavioral
health
service
25
system
shall,
at
a
minimum,
include
all
of
the
following:
26
(1)
Prevention
intervention
services
and
education
27
programs
designed
to
reduce
and
mitigate
behavioral
health
28
conditions
and
future
behavioral
health
conditions.
Prevention
29
intervention
programs
shall
incorporate
indicated
prevention,
30
selective
prevention,
and
universal
prevention
activities.
31
(2)
Evidence-based
and
evidence-informed
early
intervention
32
and
treatment
services.
33
(3)
Comprehensive
recovery
support
services
with
a
focus
on
34
community-based
services
that
avoid,
divert,
or
offset
the
need
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for
long-term
inpatient
services,
law
enforcement
involvement,
1
or
incarceration.
2
(4)
Crisis
services
with
a
focus
on
reducing
the
escalation
3
of
crisis
situations,
relieving
the
immediate
distress
of
4
individuals
experiencing
a
crisis
situation,
and
reducing
the
5
risk
that
individuals
in
a
crisis
situation
harm
themselves.
6
2.
To
the
extent
funding
is
available,
the
department
shall
7
perform
all
of
the
following
duties
to
develop
and
administer
8
the
behavioral
health
service
system:
9
a.
(1)
Develop
a
state
behavioral
health
service
system
10
plan
that
accomplishes
all
of
the
following:
11
(a)
Identifies
the
goals,
objectives,
and
targeted
outcomes
12
for
the
behavioral
health
service
system.
13
(b)
Identifies
the
strategies
to
meet
system
objectives
and
14
ensure
equitable
access
statewide
to
prevention,
education,
15
early
intervention,
treatment,
recovery
support,
and
crisis
16
services.
17
(c)
Is
consistent
with
the
state
health
improvement
plan
18
developed
under
section
217.17.
19
(d)
Is
consistent
with
the
department’s
agency
strategic
20
plan
adopted
pursuant
to
section
8E.206.
21
(2)
The
department
shall
do
all
of
the
following
when
22
developing
the
state
behavioral
health
service
system
plan:
23
(a)
Collaborate
with
stakeholders
including
but
not
limited
24
to
county
supervisors
and
other
local
elected
officials,
25
experienced
behavioral
health
providers,
and
organizations
that
26
represent
populations,
including
but
not
limited
to
children,
27
served
by
the
behavioral
health
service
system.
28
(b)
Publish
the
proposed
state
behavioral
health
service
29
system
plan
on
the
department’s
internet
site
and
allow
the
30
public
to
review
and
comment
on
the
proposed
state
behavioral
31
health
system
plan
prior
to
the
adoption
of
the
proposed
state
32
behavioral
health
plan.
33
b.
Administer
and
distribute
state
appropriations,
federal
34
aid,
and
grants
that
have
been
deposited
into
the
behavioral
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health
fund
established
in
section
225A.7.
1
c.
Oversee,
provide
technical
assistance
to,
and
2
monitor
administrative
services
organizations
to
ensure
the
3
administrative
services
organizations’
compliance
with
district
4
behavioral
health
plans.
5
d.
Collaborate
with
the
department
of
inspections,
appeals,
6
and
licensing
on
the
accreditation,
certification,
and
7
licensure
of
behavioral
health
providers
including
but
not
8
limited
to
the
approval,
denial,
revocation,
or
suspension
of
9
a
behavioral
health
provider’s
accreditation,
certification,
10
or
licensure.
11
e.
Develop
and
adopt
minimum
accreditation
standards
for
12
the
maintenance
and
operation
of
community
mental
health
13
centers
to
ensure
that
each
community
mental
health
center,
14
and
each
entity
that
provides
services
under
contract
with
a
15
community
mental
health
center,
furnishes
high-quality
mental
16
health
services
to
the
community
that
the
community
mental
17
health
center
serves
in
accordance
with
rules
adopted
by
the
18
department.
19
f.
Designate
community
mental
health
centers.
20
g.
Conduct
formal
accreditation
reviews
of
community
mental
21
health
centers
based
on
minimum
accreditation
standards
adopted
22
by
the
department
pursuant
to
paragraph
“e”
.
23
h.
Establish
and
maintain
a
data
collection
and
management
24
information
system
to
identify,
collect,
and
analyze
service
25
outcome
and
performance
data
to
address
the
needs
of
patients,
26
providers,
the
department,
and
programs
operating
within
the
27
behavioral
health
service
system.
28
i.
Collect,
monitor,
and
utilize
information
including
but
29
not
limited
to
behavioral
health
service
system
patient
records
30
and
syndromic
surveillance
data
to
understand
emerging
needs,
31
and
to
deploy
information,
resources,
and
technical
assistance
32
in
response.
33
j.
Adopt
rules
pursuant
to
chapter
17A
to
administer
this
34
chapter.
Such
rules
shall
include
but
not
be
limited
to
rules
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that
provide
for
all
of
the
following:
1
(1)
Minimum
access
standards
to
ensure
equitable
access
to
2
services
provided
through
the
behavioral
health
service
system
3
including
but
not
limited
to
when
services
are
available,
who
4
is
eligible
for
services,
and
where
services
are
available.
5
(2)
Methods
to
ensure
each
individual
who
is
eligible
6
for
services
receives
an
uninterrupted
continuum
of
care
for
7
prevention,
education,
early
intervention,
treatment,
recovery
8
support,
and
crisis
services.
9
(3)
Standards
for
the
implementation
and
maintenance
10
of
behavioral
health
programs
and
services
offered
by
the
11
behavioral
health
service
system,
and
by
each
administrative
12
services
organization.
13
(4)
Procedures
for
the
management
and
oversight
of
14
behavioral
health
providers
to
ensure
compliance
with
the
terms
15
of
the
behavioral
health
providers’
contracts
relating
to
the
16
behavioral
health
service
system,
and
with
state
and
federal
17
law
and
rules.
18
(5)
Procedures
for
the
suspension
of
an
administrative
19
services
organization’s
services
due
to
the
administrative
20
services
organization’s
failure
to
comply
with
the
terms
and
21
conditions
of
its
contract
with
the
department.
22
(6)
Procedures
for
the
reallocation
of
funds
from
23
an
administrative
services
organization
that
is
not
in
24
compliance
with
the
terms
of
its
contract
with
the
department
25
to
an
alternative
administrative
services
organization
or
26
a
behavioral
health
provider
to
provide
for
services
the
27
noncompliant
administrative
services
organization
failed
to
28
provide.
29
(7)
Procedures
for
the
termination
of
an
administrative
30
services
organization’s
designation
as
an
administrative
31
services
organization.
32
(8)
Procedures
for
the
collection,
utilization,
and
33
maintenance
of
the
data
necessary
to
establish
a
central
data
34
repository
in
accordance
with
section
225A.6.
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(9)
Any
other
requirements
the
department
deems
necessary
1
to
ensure
that
an
administrative
services
organization
2
fulfills
the
administrative
services
organization’s
duties
3
as
established
in
this
chapter,
and
as
established
in
the
4
administrative
services
organization’s
district
behavioral
5
health
plan.
6
Sec.
4.
NEW
SECTION
.
225A.4
Behavioral
health
service
7
system
——
districts
and
administrative
services
organizations.
8
1.
a.
The
department
shall
divide
the
entirety
of
the
9
state
into
designated
behavioral
health
districts.
Behavioral
10
health
prevention,
education,
early
intervention,
treatment,
11
recovery
support,
and
crisis
services
related
to
mental
health
12
and
addictive
disorders,
including
but
not
limited
to
alcohol
13
use,
substance
use,
tobacco
use,
and
problem
gambling,
shall
14
be
made
available
through
each
behavioral
health
district
in
a
15
manner
consistent
with
directives
each
district
receives
from
16
the
department.
17
b.
For
the
purpose
of
providing
equitable
access
to
all
18
services
provided
through
the
behavioral
health
service
19
system,
the
department
shall
consider
all
of
the
following
when
20
designating
behavioral
health
districts:
21
(1)
City
and
county
lines.
22
(2)
The
maximum
population
size
that
behavioral
health
23
services
available
in
an
area
are
able
to
effectively
serve.
24
(3)
Areas
of
high
need
for
behavioral
health
services.
25
(4)
Patterns
various
populations
exhibit
when
accessing
or
26
receiving
behavioral
health
services.
27
c.
Notwithstanding
chapter
17A,
the
manner
in
which
the
28
department
designates
behavioral
health
districts
including
but
29
not
limited
to
the
determination
of
the
boundaries
for
each
30
district
shall
not
be
subject
to
judicial
review.
31
2.
a.
The
department
shall
designate
an
administrative
32
services
organization
for
each
behavioral
health
district
to
33
oversee
and
organize
each
district
and
the
behavioral
health
34
services
associated
with
the
district.
The
department
shall
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issue
requests
for
proposals
for
administrative
services
1
organization
candidates.
2
b.
At
the
department’s
discretion,
the
department
may
3
designate
any
of
the
following
entities
as
an
administrative
4
services
organization:
5
(1)
An
organization
that
coordinated
administrative
6
services
or
mental
health
and
disability
services
for
a
mental
7
health
and
disability
services
region
formed
on
or
before
June
8
30,
2024.
9
(2)
A
public
or
private
nonprofit
agency
located
in
a
10
behavioral
health
district,
or
any
separate
organizational
11
unit
within
the
public
or
private
nonprofit
agency,
that
has
12
the
capabilities
to
engage
in
the
planning
or
provision
of
a
13
broad
range
of
behavioral
health
prevention,
education,
early
14
intervention,
treatment,
recovery
support,
and
crisis
services
15
related
to
mental
health
and
addictive
disorders,
including
but
16
not
limited
to
alcohol
use,
substance
use,
tobacco
use,
and
17
problem
gambling,
only
as
directed
by
the
department.
18
c.
The
department
shall
consider
all
of
the
following
19
factors
in
determining
whether
to
designate
an
entity
as
an
20
administrative
services
organization:
21
(1)
Whether
the
entity
has
demonstrated
the
capacity
to
22
manage
and
utilize
available
resources
in
a
manner
required
of
23
an
administrative
services
organization.
24
(2)
Whether
the
entity
has
demonstrated
the
ability
to
25
ensure
the
delivery
of
behavioral
health
services
within
the
26
district
as
required
by
the
department
by
rule.
27
(3)
Whether
the
entity
has
demonstrated
the
ability
to
28
fulfill
the
monitoring,
oversight,
and
provider
compliance
29
responsibilities
as
required
by
the
department
by
rule.
30
(4)
Whether
the
entity
has
demonstrated
the
capacity
to
31
function
as
a
subrecipient
for
the
purposes
of
the
federal
32
community
mental
health
services
block
grant,
42
U.S.C.
33
§300x
et
seq.,
and
the
federal
substance
abuse
prevention
and
34
treatment
block
grant,
42
U.S.C.
§300x-21
et
seq.,
and
the
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ability
to
comply
with
all
federal
requirements
applicable
to
1
subrecipients
under
the
block
grants.
2
3.
a.
Upon
designation
by
the
department,
an
administrative
3
services
organization
shall
be
considered
an
instrumentality
of
4
the
state
and
shall
adhere
to
all
state
and
federal
mandates
5
and
prohibitions
applicable
to
an
instrumentality
of
the
state.
6
b.
An
entity’s
designation
as
an
administrative
services
7
organization
shall
continue
until
the
designation
is
removed
8
by
the
department,
the
administrative
services
organization
9
withdraws,
or
a
change
in
state
or
federal
law
necessitates
the
10
removal
of
the
designation.
11
4.
Each
administrative
services
organization
shall
function
12
as
a
subrecipient
for
the
purposes
of
the
federal
community
13
mental
health
services
block
grant,
42
U.S.C.
§300x
et
seq.,
14
and
the
federal
substance
abuse
prevention
and
treatment
block
15
grant,
42
U.S.C.
§300x-21
et
seq.,
and
shall
comply
with
all
16
federal
requirements
applicable
to
subrecipients
under
the
17
block
grants.
18
5.
Each
administrative
services
organization
shall
perform
19
all
of
the
following
duties:
20
a.
Develop
and
administer
a
district
behavioral
health
plan
21
in
accordance
with
the
standards
adopted
by
the
department
by
22
rule.
23
b.
Coordinate
the
administration
of
the
district
behavioral
24
health
plan
with
federal,
state,
and
local
resources
in
order
25
to
develop
a
comprehensive
and
coordinated
local
behavioral
26
health
service
system.
27
c.
Enter
into
contracts
necessary
to
provide
services
under
28
the
district
behavioral
health
plan.
29
d.
Oversee,
provide
technical
assistance
to,
and
monitor
30
the
compliance
of
providers
contracted
by
the
administrative
31
services
organization
to
provide
behavioral
health
services
in
32
accordance
with
the
district
behavioral
health
plan.
33
e.
Establish
a
district
behavioral
health
advisory
council
34
pursuant
to
section
225A.5.
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Sec.
5.
NEW
SECTION
.
225A.5
District
behavioral
health
1
advisory
councils.
2
1.
Each
administrative
services
organization
shall
3
establish
a
district
behavioral
health
advisory
council
that
4
shall
do
all
of
the
following:
5
a.
Identify
opportunities
and
address
challenges
based
on
6
updates
received
from
the
administrative
services
organization
7
regarding
the
implementation
of
the
district
behavioral
health
8
plan.
9
b.
Advise
the
administrative
services
organization
while
the
10
administrative
services
organization
is
developing
behavioral
11
health
policies.
12
c.
Advise
the
administrative
services
organization
on
13
how
to
best
provide
access
to
behavioral
health
prevention,
14
education,
early
intervention,
treatment,
recovery
support,
15
and
crisis
services
related
to
mental
health
and
addictive
16
disorders,
including
but
not
limited
to
alcohol
use,
substance
17
use,
tobacco
use,
and
problem
gambling,
throughout
the
district
18
as
directed
by
the
department.
19
2.
An
advisory
council
shall
consist
of
ten
members.
20
Members
shall
be
appointed
by
the
administrative
services
21
organization
subject
to
the
following
requirements:
22
a.
Three
members
shall
be
local
elected
public
officials
23
currently
holding
office
within
the
behavioral
health
district,
24
or
the
public
official’s
designated
representative.
25
b.
Three
members
shall
be
chosen
in
accordance
with
26
procedures
established
by
the
administrative
services
27
organization
to
ensure
representation
of
the
populations
28
served
within
the
behavioral
health
district.
At
least
one
29
member
chosen
under
this
paragraph
shall
represent
child
and
30
adolescent
persons.
31
c.
Three
members
shall
be
chosen
who
have
experience
32
or
education
related
to
core
behavioral
health
functions,
33
essential
behavioral
health
services,
behavioral
health
34
prevention,
behavioral
health
treatment,
population-based
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behavioral
health
services,
or
community-based
behavioral
1
health
initiatives.
2
d.
One
member
shall
be
a
law
enforcement
representative
from
3
within
the
behavioral
health
district.
4
3.
An
advisory
council
shall
perform
the
duties
required
5
under
this
section
regardless
of
whether
any
seat
on
the
6
advisory
council
is
vacant.
7
Sec.
6.
NEW
SECTION
.
225A.6
Behavioral
health
service
8
system
——
data
collection
and
use.
9
1.
The
department
shall
take
all
of
the
following
actions
10
for
data
related
to
the
behavioral
health
service
system:
11
a.
Collect
and
analyze
the
data,
including
but
not
12
limited
to
Medicaid
and
community
services
network
data,
as
13
necessary
to
issue
cost
estimates
for
serving
populations,
14
providing
treatment,
making
and
receiving
payments,
conducting
15
operations,
and
performing
prevention
and
health
promotion
16
activities.
In
doing
so,
the
department
shall
maintain
17
compliance
with
applicable
federal
and
state
privacy
laws
18
to
ensure
the
confidentiality
and
integrity
of
individually
19
identifiable
data.
The
department
shall
periodically
assess
20
the
status
of
the
department’s
compliance
to
ensure
that
data
21
collected
by
and
stored
with
the
department
is
protected.
22
b.
Establish
and
administer
a
central
data
repository
for
23
collecting
and
analyzing
state,
behavioral
health
district,
and
24
contracted
behavioral
health
provider
data.
25
c.
Establish
a
record
for
each
individual
receiving
publicly
26
funded
services
from
an
administrative
services
organization.
27
Each
record
shall
include
a
unique
client
identifier
for
the
28
purposes
of
identifying
and
tracking
the
individual’s
record.
29
d.
Consult
with
administrative
services
organizations,
30
behavioral
health
service
providers,
and
other
behavioral
31
health
service
system
stakeholders
on
an
ongoing
basis
to
32
implement
and
maintain
the
central
data
repository.
33
e.
Engage
with
all
entities
that
maintain
information
the
34
department
is
required
to
collect
pursuant
to
this
section
in
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order
to
integrate
all
data
concerning
individuals
receiving
1
services
within
the
behavioral
health
service
system.
2
f.
Engage
with
all
entities
that
maintain
general
population
3
data
relating
to
behavioral
health
in
order
to
develop
action
4
plans,
create
projections
relating
to
a
population’s
behavioral
5
health
needs,
develop
policies
concerning
behavioral
health,
6
and
otherwise
perform
acts
as
necessary
to
enhance
the
state’s
7
overall
behavioral
health.
8
2.
Administrative
services
organizations
shall
report
all
9
data
required
to
be
maintained
in
the
central
data
repository
10
to
the
department
in
a
manner
as
established
by
the
department
11
by
rule.
For
the
purpose
of
making
such
data
reports,
an
12
administrative
services
organization
shall
do
one
of
the
13
following:
14
a.
Utilize
a
data
system
that
integrates
with
the
data
15
systems
used
by
the
department.
16
b.
Utilize
a
data
system
that
has
the
capacity
to
securely
17
exchange
information
with
the
department,
other
behavioral
18
health
districts,
contractors,
and
other
entities
involved
with
19
the
behavioral
health
service
system
who
are
authorized
to
20
access
the
central
data
repository.
21
3.
Data
and
information
maintained
by
and
exchanged
between
22
an
administrative
services
organization
and
the
department
23
shall
be
labeled
consistently,
share
the
same
definitions,
24
utilize
the
same
common
coding
and
nomenclature,
and
be
in
a
25
form
and
format
as
required
by
the
department
by
rule.
26
4.
Administrative
services
organizations
shall
report
27
to
the
department,
in
a
manner
specified
by
the
department,
28
information
including
but
not
limited
to
demographic
29
information,
expenditure
data,
and
data
concerning
the
30
behavioral
health
services
and
other
support
provided
to
31
individuals
in
the
administrative
service
organization’s
32
district.
33
5.
The
department
shall
ensure
that
public
and
private
34
agencies,
organizations,
and
individuals
that
operate
within
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the
behavioral
health
service
system,
or
that
make
formal
1
requests
for
the
release
of
data
collected
by
the
department,
2
maintain
uniform
methods
for
keeping
statistical
information
3
relating
to
behavioral
health
service
system
outcomes
and
4
performance.
5
6.
The
department
shall
develop
and
implement
a
6
communication
plan
that
details
how
outcome
and
performance
7
data
will
be
shared
with
stakeholders
including
but
not
limited
8
to
the
public,
persons
involved
with
the
behavioral
health
9
service
system,
and
the
general
assembly.
10
Sec.
7.
NEW
SECTION
.
225A.7
Behavioral
health
fund.
11
1.
For
purposes
of
this
section:
12
a.
“Population”
means,
as
of
July
1
of
the
fiscal
year
13
preceding
the
fiscal
year
in
which
the
population
figure
is
14
applied,
the
population
shown
by
the
latest
preceding
certified
15
federal
census
or
the
latest
applicable
population
estimate
16
issued
by
the
United
States
census
bureau,
whichever
is
most
17
recent.
18
b.
“State
growth
factor”
for
a
fiscal
year
means
an
amount
19
equal
to
the
dollar
amount
used
to
calculate
the
appropriation
20
under
this
section
for
the
immediately
preceding
fiscal
year
21
multiplied
by
the
percent
increase,
if
any,
in
the
amount
of
22
sales
tax
revenue
deposited
into
the
general
fund
of
the
state
23
under
section
423.2A,
subsection
1,
paragraph
“a”
,
less
the
24
transfers
required
under
section
423.2A,
subsection
2,
between
25
the
fiscal
year
beginning
three
years
prior
to
the
applicable
26
fiscal
year
and
the
fiscal
year
beginning
two
years
prior
27
to
the
applicable
year,
but
not
to
exceed
one
and
one-half
28
percent.
29
2.
A
behavioral
health
fund
is
established
in
the
state
30
treasury
under
the
control
of
the
department.
The
fund
shall
31
consist
of
moneys
deposited
into
the
fund
pursuant
to
this
32
section
and
section
426B.1,
gifts
of
money
or
property
accepted
33
by
the
state
or
the
department
to
support
any
services
under
34
this
chapter
or
chapter
231,
and
moneys
otherwise
appropriated
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by
the
general
assembly.
Moneys
in
the
fund
are
appropriated
1
to
the
department
to
implement
and
administer
the
behavioral
2
health
service
system
and
related
programs
including
but
not
3
limited
to
all
of
the
following:
4
a.
Distributions
to
administrative
services
organizations
5
to
provide
services
as
outlined
in
the
organizations’
district
6
behavioral
health
plan.
7
b.
Distributions
to
providers
of
mental
health
services
8
and
addictive
disorder
services,
including
but
not
limited
to
9
tobacco
use
services,
substance
use
disorder
services,
and
10
problem
gambling
services.
11
c.
Funding
of
disability
services
pursuant
to
chapter
231.
12
This
paragraph
is
repealed
July
1,
2028.
13
d.
Administrative
costs
associated
with
services
described
14
under
this
subsection.
The
department
shall
not
use
more
than
15
five
percent
of
the
moneys
in
the
behavioral
health
fund
at
the
16
beginning
of
each
fiscal
year
for
purposes
of
administrative
17
costs.
18
3.
For
the
fiscal
year
beginning
July
1,
2025,
there
19
is
transferred
from
the
general
fund
of
the
state
to
the
20
behavioral
health
fund
an
amount
equal
to
forty-two
dollars
21
multiplied
by
the
state’s
population
for
the
fiscal
year.
22
4.
For
the
fiscal
year
beginning
July
1,
2026,
and
each
23
succeeding
fiscal
year,
there
is
transferred
from
the
general
24
fund
of
the
state
to
the
behavioral
health
fund
an
amount
equal
25
to
the
state’s
population
for
the
fiscal
year
multiplied
by
26
the
sum
of
the
dollar
amount
used
to
calculate
the
transfer
27
from
the
general
fund
to
the
behavioral
health
fund
for
the
28
immediately
preceding
fiscal
year,
plus
the
state
growth
factor
29
for
the
fiscal
year
for
which
the
transfer
is
being
made.
30
5.
For
each
fiscal
year,
an
administrative
services
31
organization
shall
not
spend
on
administrative
costs
an
amount
32
more
than
seven
percent
of
the
total
amount
distributed
to
the
33
administrative
services
organization
through
this
section
and
34
all
other
appropriations
for
the
same
fiscal
year.
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6.
Moneys
in
the
behavioral
health
fund
may
be
used
by
the
1
department
for
cash
flow
purposes,
provided
that
any
moneys
so
2
allocated
are
returned
to
the
behavioral
health
fund
by
the
end
3
of
each
fiscal
year.
4
7.
Notwithstanding
section
12C.7,
subsection
2,
interest
5
or
earnings
on
moneys
deposited
in
the
behavioral
health
fund
6
shall
be
credited
to
the
behavioral
health
fund.
7
8.
Notwithstanding
section
8.33,
moneys
appropriated
in
8
this
section
that
remain
unencumbered
or
unobligated
at
the
9
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
10
available
for
expenditure
for
the
purposes
designated.
11
Sec.
8.
NEW
SECTION
.
225A.8
Addictive
disorders
prevention
12
——
prohibitions.
13
1.
For
purposes
of
this
section,
“entity”
means
a
14
manufacturer,
distributor,
wholesaler,
retailer,
or
15
distributing
agent,
or
an
agent
of
a
manufacturer,
distributor,
16
wholesaler,
retailer,
or
distributing
agent
as
those
terms
are
17
defined
in
section
453A.1.
18
2.
To
promote
comprehensive
tobacco
use
prevention
and
19
control
initiatives
outlined
in
the
state
behavioral
health
20
service
system
plan,
an
entity
shall
not
perform
any
of
the
21
following
acts:
22
a.
Give
away
cigarettes
or
tobacco
products.
23
b.
Provide
free
articles,
products,
commodities,
gifts,
or
24
concessions
in
any
exchange
for
the
purchase
of
cigarettes
or
25
tobacco
products.
26
3.
The
prohibitions
in
this
section
shall
not
apply
to
27
transactions
between
manufacturers,
distributors,
wholesalers,
28
or
retailers
as
those
terms
are
defined
in
section
453A.1.
29
Sec.
9.
NEW
SECTION
.
225A.9
Application
for
services
——
30
minors.
31
A
minor
who
is
twelve
years
of
age
or
older
shall
have
32
the
legal
capacity
to
act
and
give
consent
to
the
provision
33
of
tobacco
cessation
coaching
services
pursuant
to
a
tobacco
34
cessation
telephone
and
internet-based
program
approved
by
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the
department
through
the
behavioral
health
service
system
1
established
in
section
225A.3.
Consent
shall
not
be
subject
to
2
later
disaffirmance
by
reason
of
such
minority.
The
consent
of
3
another
person,
including
but
not
limited
to
the
consent
of
a
4
spouse,
parent,
custodian,
or
guardian,
shall
not
be
necessary.
5
Sec.
10.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
is
directed
6
to
do
all
of
the
following:
7
1.
Designate
sections
225A.1
through
225A.9,
as
enacted
8
in
this
division
of
this
Act,
as
Code
chapter
225A
entitled
9
“Department
of
Health
and
Human
Services
——
Behavioral
Health
10
Service
System”.
11
2.
Correct
internal
references
in
the
Code
and
in
any
12
enacted
legislation
as
necessary
due
to
the
enactment
of
this
13
division
of
this
Act.
14
Sec.
11.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
15
effect
July
1,
2025.
16
DIVISION
II
17
BEHAVIORAL
HEALTH
SERVICE
SYSTEM
——
CONFORMING
CHANGES
18
Sec.
12.
Section
11.6,
subsection
1,
paragraph
b,
Code
2024,
19
is
amended
to
read
as
follows:
20
b.
The
financial
condition
and
transactions
of
community
21
mental
health
centers
organized
under
chapter
230A
,
substance
22
use
disorder
programs
organized
licensed
under
chapter
125
,
and
23
community
action
agencies
organized
under
chapter
216A
,
shall
24
be
audited
at
least
once
each
year.
25
Sec.
13.
Section
97B.1A,
subsection
8,
paragraph
a,
26
subparagraph
(13),
Code
2024,
is
amended
by
striking
the
27
subparagraph.
28
Sec.
14.
Section
123.17,
subsection
5,
Code
2024,
is
amended
29
to
read
as
follows:
30
5.
After
any
transfer
provided
for
in
subsection
3
is
made,
31
the
department
shall
transfer
into
a
special
revenue
account
32
in
the
general
fund
of
the
state,
a
sum
of
money
at
least
equal
33
to
seven
percent
of
the
gross
amount
of
sales
made
by
the
34
department
from
the
beer
and
liquor
control
fund
on
a
monthly
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basis
but
not
less
than
nine
million
dollars
annually.
Of
1
the
amounts
transferred,
two
three
million
dollars,
plus
an
2
additional
amount
determined
by
the
general
assembly,
shall
be
3
appropriated
to
the
department
of
health
and
human
services
for
4
use
by
the
staff
who
administer
the
comprehensive
substance
use
5
disorder
program
under
chapter
125
for
substance
use
disorder
6
treatment
and
prevention
programs
shall
be
transferred
to
the
7
behavioral
health
fund
established
under
section
225A.7
.
Any
8
amounts
received
in
excess
of
the
amounts
appropriated
to
the
9
department
of
health
and
human
services
for
use
by
the
staff
10
who
administer
the
comprehensive
substance
use
disorder
program
11
under
chapter
125
transferred
to
the
behavioral
health
fund
12
shall
be
considered
part
of
the
general
fund
balance.
13
Sec.
15.
Section
123.17,
subsection
8,
Code
2024,
is
amended
14
by
striking
the
subsection.
15
Sec.
16.
Section
123.17,
subsection
9,
Code
2024,
is
amended
16
to
read
as
follows:
17
9.
After
any
transfers
provided
for
in
subsections
3,
5,
18
6,
and
7
,
and
8
are
made,
and
before
any
other
transfer
to
the
19
general
fund,
the
department
shall
transfer
to
the
economic
20
development
authority
from
the
beer
and
liquor
control
fund
the
21
lesser
of
two
hundred
fifty
thousand
dollars
or
one
percent
of
22
the
gross
sales
of
native
distilled
spirits
by
all
class
“A”
23
native
distilled
spirits
license
holders
made
by
the
department
24
for
the
purposes
of
promoting
Iowa
wine,
beer,
and
spirits.
25
Sec.
17.
Section
124.409,
subsection
2,
Code
2024,
is
26
amended
by
striking
the
subsection.
27
Sec.
18.
Section
125.2,
subsections
4,
5,
and
10,
Code
2024,
28
are
amended
by
striking
the
subsections.
29
Sec.
19.
Section
125.91,
subsection
1,
Code
2024,
is
amended
30
to
read
as
follows:
31
1.
The
procedure
prescribed
by
this
section
shall
only
32
be
used
for
a
person
with
a
substance
use
disorder
due
to
33
intoxication
or
substance-induced
incapacitation
who
has
34
threatened,
attempted,
or
inflicted
physical
self-harm
or
harm
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on
another,
and
is
likely
to
inflict
physical
self-harm
or
harm
1
on
another
unless
immediately
detained,
or
who
is
incapacitated
2
by
a
chemical
substance,
if
an
application
has
not
been
filed
3
naming
the
person
as
the
respondent
pursuant
to
section
125.75
4
and
the
person
cannot
be
ordered
into
immediate
custody
and
5
detained
pursuant
to
section
125.81
.
6
Sec.
20.
Section
125.93,
Code
2024,
is
amended
to
read
as
7
follows:
8
125.93
Commitment
records
——
confidentiality.
9
Records
of
the
identity,
diagnosis,
prognosis,
or
treatment
10
of
a
person
which
are
maintained
in
connection
with
the
11
provision
of
substance
use
disorder
treatment
services
are
12
confidential,
consistent
with
the
requirements
of
section
13
125.37
,
and
with
the
federal
confidentiality
regulations
14
authorized
by
the
federal
Drug
Abuse
Office
and
Treatment
Act
,
15
42
U.S.C.
§290ee
and
the
federal
Comprehensive
Alcohol
Abuse
16
and
Alcoholism
Prevention,
Treatment
and
Rehabilitation
Act,
42
17
U.S.C.
§290dd-2.
However,
such
records
may
be
disclosed
to
an
18
employee
of
the
department
of
corrections,
if
authorized
by
the
19
director
of
the
department
of
corrections,
or
to
an
employee
20
of
a
judicial
district
department
of
correctional
services,
if
21
authorized
by
the
director
of
the
judicial
district
department
22
of
correctional
services.
23
Sec.
21.
Section
135.11,
subsection
11,
Code
2024,
is
24
amended
to
read
as
follows:
25
11.
Administer
chapters
125,
136A
,
136C
,
139A
,
142
,
142A
,
26
144
,
and
147A
.
27
Sec.
22.
Section
135C.2,
subsection
5,
unnumbered
paragraph
28
1,
Code
2024,
is
amended
to
read
as
follows:
29
The
department
shall
establish
a
special
classification
30
within
the
residential
care
facility
category
in
order
to
31
foster
the
development
of
residential
care
facilities
which
32
serve
persons
with
an
intellectual
disability,
chronic
mental
33
illness,
a
developmental
disability,
or
brain
injury,
as
34
described
under
section
225C.26
,
and
which
contain
five
or
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fewer
residents.
A
facility
within
the
special
classification
1
established
pursuant
to
this
subsection
is
exempt
from
the
2
requirements
of
section
10A.713
.
The
department
shall
adopt
3
rules
which
are
consistent
with
rules
previously
developed
for
4
the
waiver
demonstration
waiver
project
pursuant
to
1986
Iowa
5
Acts,
ch.
1246,
§206
,
and
which
include
all
of
the
following
6
provisions:
7
Sec.
23.
Section
135C.6,
subsection
1,
Code
2024,
is
amended
8
to
read
as
follows:
9
1.
A
person
or
governmental
unit
acting
severally
or
10
jointly
with
any
other
person
or
governmental
unit
shall
not
11
establish
or
operate
a
health
care
facility
in
this
state
12
without
a
license
for
the
facility.
A
supported
community
13
living
service,
as
defined
in
section
225C.21
249A.38A
,
is
not
14
required
to
be
licensed
under
this
chapter
,
but
is
subject
to
15
approval
under
section
225C.21
249A.38A
in
order
to
receive
16
public
funding.
17
Sec.
24.
Section
135C.23,
subsection
1,
unnumbered
18
paragraph
1,
Code
2024,
is
amended
to
read
as
follows:
19
Each
resident
shall
be
covered
by
a
contract
executed
20
by
the
resident,
or
the
resident’s
legal
representative,
21
and
the
health
care
facility
at
or
prior
to
the
time
of
the
22
resident’s
admission
or
prior
thereto
by
the
resident,
or
the
23
legal
representative,
and
the
health
care
facility,
except
as
24
otherwise
provided
by
subsection
5
with
respect
to
residents
25
admitted
at
public
expense
to
a
county
care
facility
operated
26
under
chapter
347B
.
Each
party
to
the
contract
shall
be
27
entitled
to
a
duplicate
of
the
original
thereof
contract
,
and
28
the
health
care
facility
shall
keep
on
file
all
contracts
29
which
it
has
with
residents
and
shall
not
destroy
or
otherwise
30
dispose
of
any
such
contract
for
at
least
one
year
after
its
31
expiration.
Each
such
contract
shall
expressly
set
forth:
32
Sec.
25.
Section
135C.23,
subsection
2,
paragraph
b,
Code
33
2024,
is
amended
to
read
as
follows:
34
b.
This
section
does
not
prohibit
the
admission
of
a
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patient
with
a
history
of
dangerous
or
disturbing
behavior
to
1
an
intermediate
care
facility
for
persons
with
mental
illness,
2
intermediate
care
facility
for
persons
with
an
intellectual
3
disability,
or
nursing
facility
,
or
county
care
facility
when
4
the
intermediate
care
facility
for
persons
with
mental
illness,
5
intermediate
care
facility
for
persons
with
an
intellectual
6
disability,
or
nursing
facility
,
or
county
care
facility
has
a
7
program
which
has
received
prior
approval
from
the
department
8
to
properly
care
for
and
manage
the
patient.
An
intermediate
9
care
facility
for
persons
with
mental
illness,
intermediate
10
care
facility
for
persons
with
an
intellectual
disability,
11
or
nursing
facility
,
or
county
care
facility
is
required
to
12
transfer
or
discharge
a
resident
with
dangerous
or
disturbing
13
behavior
when
the
intermediate
care
facility
for
persons
with
14
mental
illness,
intermediate
care
facility
for
persons
with
an
15
intellectual
disability,
or
nursing
facility
,
or
county
care
16
facility
cannot
control
the
resident’s
dangerous
or
disturbing
17
behavior.
The
department
,
in
coordination
with
the
state
18
mental
health
and
disability
services
commission
created
in
19
section
225C.5
,
shall
adopt
rules
pursuant
to
chapter
17A
for
20
programs
to
be
required
in
intermediate
care
facilities
for
21
persons
with
mental
illness,
intermediate
care
facilities
22
for
persons
with
an
intellectual
disability,
and
nursing
23
facilities
,
and
county
care
facilities
that
admit
patients
24
or
have
residents
with
histories
of
dangerous
or
disturbing
25
behavior.
26
Sec.
26.
Section
135C.23,
subsection
5,
Code
2024,
is
27
amended
by
striking
the
subsection.
28
Sec.
27.
Section
135C.24,
subsection
5,
Code
2024,
is
29
amended
by
striking
the
subsection.
30
Sec.
28.
Section
135G.1,
subsection
12,
Code
2024,
is
31
amended
to
read
as
follows:
32
12.
a.
“Subacute
mental
health
services”
means
the
same
33
as
defined
in
section
225C.6
services
that
provide
all
of
the
34
following:
35
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(1)
A
comprehensive
set
of
wraparound
services
for
a
1
person
who
has
had,
or
is
at
imminent
risk
of
having,
acute
or
2
crisis
mental
health
symptoms
that
do
not
permit
the
person
to
3
remain
in
or
threatens
removal
of
the
person
from
the
person’s
4
home
and
community,
but
who
has
been
determined
by
a
mental
5
health
professional
and
a
licensed
health
care
professional,
6
subject
to
the
professional’s
scope
of
practice,
not
to
need
7
inpatient
acute
hospital
services.
For
the
purposes
of
this
8
subparagraph,
“licensed
health
care
professional”
means
a
person
9
licensed
under
chapter
148,
an
advanced
registered
nurse
10
practitioner,
or
a
physician
assistant.
11
(2)
Intensive,
recovery-oriented
treatment
and
monitoring
12
of
a
person.
Treatment
may
be
provided
directly
or
remotely
13
by
a
licensed
psychiatrist
or
an
advanced
registered
nurse
14
practitioner.
15
(3)
An
outcome-focused,
interdisciplinary
approach
designed
16
to
return
a
person
to
living
successfully
in
the
community.
17
b.
Subacute
mental
health
services
may
include
services
18
provided
in
a
wide
array
of
settings
ranging
from
a
person’s
19
home
to
a
specialized
facility
with
restricted
means
of
egress.
20
c.
Subacute
mental
health
services
shall
be
limited
to
a
21
period
not
to
exceed
ten
calendar
days
or
another
time
period
22
determined
in
accordance
with
rules
adopted
by
the
department
23
for
this
purpose,
whichever
is
longer
.
24
Sec.
29.
Section
142.1,
Code
2024,
is
amended
to
read
as
25
follows:
26
142.1
Delivery
of
bodies.
27
The
body
of
every
person
dying
who
died
in
a
public
asylum,
28
hospital,
county
care
facility,
penitentiary,
or
reformatory
29
in
this
state,
or
found
dead
within
the
state,
or
which
who
30
is
to
be
buried
at
public
expense
in
this
state,
except
those
31
buried
under
the
provisions
of
chapter
144C
or
249
,
and
which
32
is
suitable
for
scientific
purposes,
shall
be
delivered
to
the
33
medical
college
of
the
state
university,
or
some
osteopathic
34
or
chiropractic
college
or
school
located
in
this
state,
which
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has
been
approved
under
the
law
regulating
the
practice
of
1
osteopathic
medicine
or
chiropractic;
but
no
such
body
shall
2
be
delivered
to
any
such
college
or
school
if
the
deceased
3
person
expressed
a
desire
during
the
person’s
last
illness
4
that
the
person’s
body
should
be
buried
or
cremated,
nor
if
5
such
is
the
desire
of
the
person’s
relatives.
Such
bodies
6
shall
be
equitably
distributed
among
said
colleges
and
schools
7
according
to
their
needs
for
teaching
anatomy
in
accordance
8
with
such
rules
as
may
be
adopted
by
the
department
of
health
9
and
human
services.
The
expense
of
transporting
said
bodies
to
10
such
college
or
school
shall
be
paid
by
the
college
or
school
11
receiving
the
same.
If
the
deceased
person
has
not
expressed
12
a
desire
during
the
person’s
last
illness
that
the
person’s
13
body
should
be
buried
or
cremated
and
no
person
authorized
to
14
control
the
deceased
person’s
remains
under
section
144C.5
15
requests
the
person’s
body
for
burial
or
cremation,
and
if
a
16
friend
objects
to
the
use
of
the
deceased
person’s
body
for
17
scientific
purposes,
said
deceased
person’s
body
shall
be
18
forthwith
delivered
to
such
friend
for
burial
or
cremation
at
19
no
expense
to
the
state
or
county.
Unless
such
friend
provides
20
for
burial
and
burial
expenses
within
five
days,
the
body
shall
21
be
used
for
scientific
purposes
under
this
chapter
.
22
Sec.
30.
Section
142.3,
Code
2024,
is
amended
to
read
as
23
follows:
24
142.3
Notification
of
department.
25
Every
county
medical
examiner,
funeral
director
or
embalmer,
26
and
the
managing
officer
of
every
public
asylum,
hospital,
27
county
care
facility,
penitentiary,
or
reformatory,
as
soon
as
28
any
dead
body
shall
come
into
the
person’s
custody
which
may
be
29
used
for
scientific
purposes
as
provided
in
sections
142.1
and
30
142.2
,
shall
at
once
notify
the
nearest
relative
or
friend
of
31
the
deceased,
if
known,
and
the
department
of
health
and
human
32
services,
and
hold
such
body
unburied
for
forty-eight
hours.
33
Upon
receipt
of
notification,
the
department
shall
issue
verbal
34
or
written
instructions
relative
to
the
disposition
to
be
made
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of
said
body.
Complete
jurisdiction
over
said
bodies
is
vested
1
exclusively
in
the
department
of
health
and
human
services.
No
2
autopsy
or
post
mortem,
except
as
are
legally
ordered
by
county
3
medical
examiners,
shall
be
performed
on
any
of
said
bodies
4
prior
to
their
delivery
to
the
medical
schools.
5
Sec.
31.
NEW
SECTION
.
217.17
State
health
improvement
plan.
6
1.
The
department
shall
develop,
implement,
and
administer
7
a
state
health
improvement
plan
to
identify
health
priorities,
8
goals,
and
measurable
objectives,
and
outline
strategies
to
9
improve
health
statewide.
10
2.
The
state
health
improvement
plan
shall
be
developed
11
and
updated
in
collaboration
and
in
coordination
with
other
12
state
departments,
stakeholders,
and
statewide
organizations
13
the
department
determines
to
be
relevant.
14
3.
The
state
health
improvement
plan
may
be
updated
by
the
15
department
at
the
department’s
discretion.
16
Sec.
32.
NEW
SECTION
.
217.37
Recovery
of
payment
——
17
assignment
of
liens
——
county
attorney
to
enforce.
18
1.
For
purposes
of
this
section,
“assistance”
means
all
of
19
the
following:
20
a.
A
payment
by
the
state
for
services
rendered
through
21
the
behavioral
health
service
system
established
under
section
22
225A.3.
23
b.
A
payment
by
the
state
for
aging
and
disability
services
24
rendered
in
accordance
with
chapter
231.
25
2.
The
department
shall
have
the
authority
to
investigate
if
26
a
person
is
eligible
to
have
assistance
paid
on
the
person’s
27
behalf
and
whether
payment
of
assistance
was
proper.
28
3.
Notwithstanding
any
provision
of
law
to
the
contrary,
29
assistance
shall
not
be
recoverable
unless
the
department
30
finds
that
the
assistance
was
paid
for
the
benefit
of
a
person
31
who
was
not
entitled
to
have
assistance
paid
on
the
person’s
32
behalf.
33
4.
Assistance
paid
for
the
benefit
of
a
person
who
was
34
not
entitled
to
have
assistance
paid
on
the
person’s
behalf
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shall
be
recoverable
from
the
entity
to
which
the
assistance
1
was
paid,
from
the
person
on
whose
behalf
assistance
was
paid,
2
or
from
a
third
party
who
is
liable
for
the
person’s
debts
or
3
support.
4
5.
Upon
the
death
of
a
person
who
was
not
entitled
to
5
have
assistance
paid
on
the
person’s
behalf,
the
department
6
shall
have
a
lien
equivalent
in
priority
to
liens
described
7
in
section
633.425,
subsection
6,
against
the
person’s
estate
8
for
the
portion
of
the
assistance
improperly
paid
which
the
9
department
had
not
recovered
at
the
time
of
the
person’s
death.
10
6.
The
department
may
waive
all
or
a
portion
of
improperly
11
paid
assistance,
or
a
lien
created
under
subsection
5,
if
12
the
department
finds
that
collection
would
result
in
undue
13
hardship.
14
7.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
15
to
implement
and
administer
this
section.
16
Sec.
33.
Section
218.30,
Code
2024,
is
amended
to
read
as
17
follows:
18
218.30
Investigation
of
other
facilities.
19
The
director
may
investigate
or
cause
the
investigation
of
20
charges
of
abuse,
neglect,
or
mismanagement
on
the
part
of
an
21
officer
or
employee
of
a
private
facility
which
is
subject
to
22
the
director’s
supervision
or
control.
The
director
shall
also
23
investigate
or
cause
the
investigation
of
charges
concerning
24
county
care
facilities
in
which
persons
with
mental
illness
are
25
served.
26
Sec.
34.
Section
218.78,
subsection
1,
Code
2024,
is
amended
27
to
read
as
follows:
28
1.
All
institutional
receipts
of
the
department,
including
29
funds
received
from
client
participation
at
the
state
resource
30
centers
under
section
222.78
and
at
the
state
mental
health
31
institutes
under
section
230.20
,
shall
be
deposited
in
the
32
general
fund
except
for
reimbursements
for
services
provided
33
to
another
institution
or
state
agency,
for
receipts
deposited
34
in
the
revolving
farm
fund
under
section
904.706
,
for
deposits
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into
the
medical
assistance
fund
under
section
249A.11
,
and
for
1
rentals
charged
to
employees
or
others
for
room,
apartment,
or
2
house
and
meals,
which
shall
be
available
to
the
institutions.
3
Sec.
35.
Section
222.1,
subsection
1,
Code
2024,
is
amended
4
to
read
as
follows:
5
1.
This
chapter
addresses
the
public
and
private
services
6
available
in
this
state
to
meet
the
needs
of
persons
with
an
7
intellectual
disability.
The
responsibility
of
the
mental
8
health
and
disability
services
regions
formed
by
counties
and
9
of
the
state
for
the
costs
and
administration
of
publicly
10
funded
services
shall
be
as
set
out
in
section
222.60
and
other
11
pertinent
sections
of
this
chapter
.
12
Sec.
36.
Section
222.2,
Code
2024,
is
amended
by
adding
the
13
following
new
subsection:
14
NEW
SUBSECTION
.
01.
“Administrative
services
organization”
15
means
the
same
as
defined
in
section
225A.1.
16
Sec.
37.
Section
222.2,
subsections
6
and
7,
Code
2024,
are
17
amended
by
striking
the
subsections.
18
Sec.
38.
Section
222.12,
subsection
2,
Code
2024,
is
amended
19
by
striking
the
subsection.
20
Sec.
39.
Section
222.13,
Code
2024,
is
amended
to
read
as
21
follows:
22
222.13
Voluntary
admissions.
23
1.
If
an
adult
person
is
believed
to
be
a
person
with
an
24
intellectual
disability,
the
adult
person
or
the
adult
person’s
25
guardian
may
apply
to
the
department
and
the
superintendent
of
26
any
state
resource
center
for
the
voluntary
admission
of
the
27
adult
person
either
as
an
inpatient
or
an
outpatient
of
the
28
resource
center.
If
the
expenses
of
the
person’s
admission
29
or
placement
are
payable
in
whole
or
in
part
by
the
person’s
30
county
of
residence,
application
for
the
admission
shall
be
31
made
through
the
regional
administrator.
An
application
for
32
admission
to
a
special
unit
of
any
adult
person
believed
to
be
33
in
need
of
any
of
the
services
provided
by
the
special
unit
34
under
section
222.88
may
be
made
in
the
same
manner.
The
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superintendent
shall
accept
the
application
if
a
preadmission
1
diagnostic
evaluation
confirms
or
establishes
the
need
for
2
admission,
except
that
an
application
shall
not
be
accepted
if
3
the
institution
does
not
have
adequate
facilities
available
or
4
if
the
acceptance
will
result
in
an
overcrowded
condition.
5
2.
If
the
resource
center
does
not
have
an
appropriate
6
program
for
the
treatment
of
an
adult
or
minor
person
with
an
7
intellectual
disability
applying
under
this
section
or
section
8
222.13A
,
the
regional
administrator
for
the
person’s
county
9
of
residence
or
the
department
,
as
applicable,
shall
arrange
10
for
the
placement
of
the
person
in
any
public
or
private
11
facility
within
or
without
outside
of
the
state,
approved
by
12
the
director,
which
offers
appropriate
services
for
the
person.
13
If
the
expenses
of
the
placement
are
payable
in
whole
or
in
14
part
by
a
county,
the
placement
shall
be
made
by
the
regional
15
administrator
for
the
county.
16
3.
If
the
expenses
of
an
admission
of
an
adult
to
a
resource
17
center
or
a
special
unit,
or
of
the
placement
of
the
person
18
in
a
public
or
private
facility
are
payable
in
whole
or
in
19
part
by
a
mental
health
and
disability
services
region,
the
20
regional
administrator
shall
make
a
full
investigation
into
21
the
financial
circumstances
of
the
person
and
those
liable
for
22
the
person’s
support
under
section
222.78
to
determine
whether
23
or
not
any
of
them
are
able
to
pay
the
expenses
arising
out
of
24
the
admission
of
the
person
to
a
resource
center,
special
unit,
25
or
public
or
private
facility.
If
the
regional
administrator
26
finds
that
the
person
or
those
legally
responsible
for
27
the
person
are
presently
unable
to
pay
the
expenses,
the
28
regional
administrator
shall
pay
the
expenses.
The
regional
29
administrator
may
review
such
a
finding
at
any
subsequent
30
time
while
the
person
remains
at
the
resource
center,
or
is
31
otherwise
receiving
care
or
treatment
for
which
this
chapter
32
obligates
the
region
to
pay.
If
the
regional
administrator
33
finds
upon
review
that
the
person
or
those
legally
responsible
34
for
the
person
are
presently
able
to
pay
the
expenses,
the
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finding
shall
apply
only
to
the
charges
incurred
during
the
1
period
beginning
on
the
date
of
the
review
and
continuing
2
thereafter,
unless
and
until
the
regional
administrator
again
3
changes
such
a
finding.
If
the
regional
administrator
finds
4
that
the
person
or
those
legally
responsible
for
the
person
5
are
able
to
pay
the
expenses,
the
regional
administrator
shall
6
collect
the
charges
to
the
extent
required
by
section
222.78
,
7
and
the
regional
administrator
shall
be
responsible
for
the
8
payment
of
the
remaining
charges.
9
Sec.
40.
Section
222.13A,
subsections
3
and
4,
Code
2024,
10
are
amended
to
read
as
follows:
11
3.
During
the
preadmission
diagnostic
evaluation,
the
12
minor
shall
be
informed
both
orally
and
in
writing
that
the
13
minor
has
the
right
to
object
to
the
voluntary
admission.
If
14
Notwithstanding
section
222.33,
if
the
preadmission
diagnostic
15
evaluation
determines
that
the
voluntary
admission
is
16
appropriate
but
the
minor
objects
to
the
admission,
the
minor
17
shall
not
be
admitted
to
the
state
resource
center
unless
the
18
court
approves
of
the
admission.
A
petition
for
approval
of
19
the
minor’s
admission
may
be
submitted
to
the
juvenile
court
by
20
the
minor’s
parent,
guardian,
or
custodian.
21
4.
As
soon
as
practicable
after
the
filing
of
a
petition
for
22
approval
of
the
voluntary
admission,
the
court
shall
determine
23
whether
the
minor
has
an
attorney
to
represent
the
minor
in
the
24
proceeding.
If
the
minor
does
not
have
an
attorney,
the
court
25
shall
assign
an
attorney
to
the
minor
an
attorney
.
If
the
26
minor
is
unable
to
pay
for
an
attorney,
the
attorney
shall
be
27
compensated
by
the
mental
health
and
disability
services
region
28
an
administrative
services
organization
at
an
hourly
rate
to
be
29
established
by
the
regional
administrator
in
substantially
the
30
same
manner
as
provided
in
section
815.7
.
31
Sec.
41.
Section
222.14,
Code
2024,
is
amended
to
read
as
32
follows:
33
222.14
Care
by
region
pending
admission.
34
If
the
institution
is
unable
to
receive
a
patient,
the
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superintendent
shall
notify
the
regional
administrator
1
for
the
county
of
residence
of
the
prospective
patient
an
2
administrative
services
organization
.
Until
such
time
as
the
3
patient
is
able
to
be
received
by
the
institution,
or
when
4
application
has
been
made
for
admission
to
a
public
or
private
5
facility
as
provided
in
section
222.13
and
the
application
6
is
pending,
the
care
of
the
patient
shall
be
provided
as
7
arranged
by
the
regional
administrator
administrative
services
8
organization
.
9
Sec.
42.
NEW
SECTION
.
222.33
State
resource
center
——
10
admissions
and
discharge.
11
1.
The
department
shall
make
all
final
determinations
12
concerning
whether
a
person
may
be
admitted
to
a
state
resource
13
center.
14
2.
If
a
patient
is
admitted
to
a
state
resource
center
15
pursuant
to
section
222.13
or
222.13A,
and
the
patient
16
wishes
to
be
placed
outside
of
the
state
resource
center,
the
17
discharge
of
the
patient
shall
be
made
in
accordance
with
18
section
222.15.
19
Sec.
43.
NEW
SECTION
.
222.35
State
——
payor
of
last
resort.
20
The
department
shall
implement
services
and
adopt
rules
21
pursuant
to
chapter
17A
in
a
manner
that
ensures
that
the
state
22
is
the
payor
of
last
resort,
and
that
the
department
shall
not
23
make
any
payments
for
services
that
have
been
provided
until
24
the
department
has
determined
that
the
services
provided
are
25
not
payable
by
a
third-party
source.
26
Sec.
44.
Section
222.73,
subsections
2
and
4,
Code
2024,
are
27
amended
by
striking
the
subsections.
28
Sec.
45.
Section
222.77,
Code
2024,
is
amended
to
read
as
29
follows:
30
222.77
Patients
on
leave.
31
The
cost
of
support
of
patients
placed
on
convalescent
leave
32
or
removed
as
a
habilitation
measure
from
a
resource
center,
33
or
a
special
unit,
except
when
living
in
the
home
of
a
person
34
legally
bound
for
the
support
of
the
patient,
shall
be
paid
by
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the
county
of
residence
or
the
state
as
provided
in
section
1
222.60
.
2
Sec.
46.
Section
222.78,
subsection
1,
Code
2024,
is
amended
3
to
read
as
follows:
4
1.
The
father
and
mother
of
any
patient
admitted
to
a
5
resource
center
or
to
a
special
unit
,
as
either
an
inpatient
6
or
an
outpatient,
and
any
person,
firm,
or
corporation
bound
7
by
contract
made
for
support
of
the
patient
,
are
liable
for
8
the
support
of
the
patient.
The
patient
and
those
legally
9
bound
for
the
support
of
the
patient
shall
be
liable
to
the
10
county
or
state
,
as
applicable,
for
all
sums
advanced
in
11
accordance
with
the
provisions
of
sections
222.60
and
222.77
12
relating
to
reasonable
attorney
fees
and
court
costs
for
13
the
patient’s
admission
to
the
resource
center,
and
for
the
14
treatment,
training,
instruction,
care,
habilitation,
support,
15
transportation,
or
other
expenditures
made
on
behalf
of
the
16
patient
pursuant
to
this
chapter
.
17
Sec.
47.
Section
222.79,
Code
2024,
is
amended
to
read
as
18
follows:
19
222.79
Certification
statement
presumed
correct.
20
In
actions
to
enforce
the
liability
imposed
by
section
21
222.78
,
the
superintendent
or
the
county
of
residence,
as
22
applicable,
shall
submit
a
certification
statement
stating
23
the
sums
charged,
and
the
certification
statement
shall
be
24
considered
presumptively
correct.
25
Sec.
48.
Section
222.80,
Code
2024,
is
amended
to
read
as
26
follows:
27
222.80
Liability
to
county
or
state.
28
A
person
admitted
to
a
county
institution
or
home
or
admitted
29
at
county
or
state
expense
to
a
private
hospital,
sanitarium,
30
or
other
facility
for
treatment,
training,
instruction,
care,
31
habilitation,
and
support
as
a
patient
with
an
intellectual
32
disability
shall
be
liable
to
the
county
or
state
,
as
33
applicable,
for
the
reasonable
cost
of
the
support
as
provided
34
in
section
222.78
.
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Sec.
49.
Section
222.82,
Code
2024,
is
amended
to
read
as
1
follows:
2
222.82
Collection
of
liabilities
and
claims.
3
If
liabilities
and
claims
exist
as
provided
in
section
4
222.78
or
any
other
provision
of
this
chapter
,
the
county
of
5
residence
or
the
state
,
as
applicable,
may
proceed
as
provided
6
in
this
section
.
If
the
liabilities
and
claims
are
owed
to
7
a
county
of
residence,
the
county’s
board
of
supervisors
may
8
direct
the
county
attorney
to
proceed
with
the
collection
of
9
the
liabilities
and
claims
as
a
part
of
the
duties
of
the
10
county
attorney’s
office
when
the
board
of
supervisors
deems
11
such
action
advisable.
If
the
liabilities
and
claims
are
owed
12
to
the
state,
the
state
shall
proceed
with
the
collection.
13
The
board
of
supervisors
or
the
state
,
as
applicable,
may
14
compromise
any
and
all
liabilities
to
the
county
or
state
15
arising
under
this
chapter
when
such
compromise
is
deemed
to
be
16
in
the
best
interests
of
the
county
or
state.
Any
collections
17
and
liens
shall
be
limited
in
conformance
to
section
614.1,
18
subsection
4
.
19
Sec.
50.
Section
222.85,
subsection
2,
Code
2024,
is
amended
20
to
read
as
follows:
21
2.
Moneys
paid
to
a
resource
center
from
any
source
other
22
than
state
appropriated
funds
and
intended
to
pay
all
or
a
23
portion
of
the
cost
of
care
of
a
patient,
which
cost
would
24
otherwise
be
paid
from
state
or
county
funds
or
from
the
25
patient’s
own
funds,
shall
not
be
deemed
“funds
belonging
to
a
26
patient”
for
the
purposes
of
this
section
.
27
Sec.
51.
Section
222.86,
Code
2024,
is
amended
to
read
as
28
follows:
29
222.86
Payment
for
care
from
fund.
30
If
a
patient
is
not
receiving
medical
assistance
under
31
chapter
249A
and
the
amount
in
the
account
of
any
patient
32
in
the
patients’
personal
deposit
fund
exceeds
two
hundred
33
dollars,
the
department
may
apply
any
amount
of
the
excess
to
34
reimburse
the
county
of
residence
or
the
state
for
liability
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incurred
by
the
county
or
the
state
for
the
payment
of
care,
1
support,
and
maintenance
of
the
patient
,
when
billed
by
the
2
county
or
state
,
as
applicable
.
3
Sec.
52.
Section
222.92,
subsection
1,
Code
2024,
is
amended
4
to
read
as
follows:
5
1.
The
department
shall
operate
the
state
resource
centers
6
on
the
basis
of
net
appropriations
from
the
general
fund
of
7
the
state.
The
appropriation
amounts
shall
be
the
net
amounts
8
of
state
moneys
projected
to
be
needed
for
the
state
resource
9
centers
for
the
fiscal
year
of
the
appropriations.
The
purpose
10
of
utilizing
net
appropriations
is
to
encourage
the
state
11
resource
centers
to
operate
with
increased
self-sufficiency,
to
12
improve
quality
and
efficiency,
and
to
support
collaborative
13
efforts
between
the
state
resource
centers
and
counties
and
14
other
providers
of
funding
for
the
services
available
from
15
the
state
resource
centers.
The
state
resource
centers
shall
16
not
be
operated
under
the
net
appropriations
in
a
manner
that
17
results
in
a
cost
increase
to
the
state
or
in
cost
shifting
18
between
the
state,
the
medical
assistance
program,
counties,
or
19
other
sources
of
funding
for
the
state
resource
centers.
20
Sec.
53.
Section
222.92,
subsection
3,
paragraph
a,
Code
21
2024,
is
amended
by
striking
the
paragraph.
22
Sec.
54.
Section
225.1,
subsection
2,
Code
2024,
is
amended
23
to
read
as
follows:
24
2.
For
the
purposes
of
this
chapter
,
unless
the
context
25
otherwise
requires:
26
a.
“Mental
health
and
disability
services
region”
means
27
a
mental
health
and
disability
services
region
approved
in
28
accordance
with
section
225C.56
.
“Administrative
services
29
organization”
means
the
same
as
defined
in
section
225A.1.
30
b.
“Regional
administrator”
means
the
administrator
of
a
31
mental
health
and
disability
services
region,
as
defined
in
32
section
225C.55
.
“Department”
means
the
department
of
health
33
and
human
services.
34
c.
“Respondent”
means
the
same
as
defined
in
section
229.1
.
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Sec.
55.
NEW
SECTION
.
225.4
State
psychiatric
hospital
——
1
admissions.
2
The
department
shall
make
all
final
determinations
3
concerning
whether
a
person
may
be
admitted
to
the
state
4
psychiatric
hospital.
5
Sec.
56.
Section
225.11,
Code
2024,
is
amended
to
read
as
6
follows:
7
225.11
Initiating
commitment
procedures.
8
When
a
court
finds
upon
completion
of
a
hearing
held
pursuant
9
to
section
229.12
that
the
contention
that
a
respondent
is
10
seriously
mentally
impaired
has
been
sustained
by
clear
and
11
convincing
evidence,
and
the
application
filed
under
section
12
229.6
also
contends
or
the
court
otherwise
concludes
that
it
13
would
be
appropriate
to
refer
the
respondent
to
the
state
14
psychiatric
hospital
for
a
complete
psychiatric
evaluation
and
15
appropriate
treatment
pursuant
to
section
229.13
,
the
judge
16
may
order
that
a
financial
investigation
be
made
in
the
manner
17
prescribed
by
section
225.13
.
If
the
costs
of
a
respondent’s
18
evaluation
or
treatment
are
payable
in
whole
or
in
part
by
a
19
county
an
administrative
services
organization
,
an
order
under
20
this
section
shall
be
for
referral
of
the
respondent
through
21
the
regional
administrator
for
the
respondent’s
county
of
22
residence
by
an
administrative
services
organization
for
an
23
evaluation
and
referral
of
the
respondent
to
an
appropriate
24
placement
or
service,
which
may
include
the
state
psychiatric
25
hospital
for
additional
evaluation
or
treatment.
26
Sec.
57.
Section
225.12,
Code
2024,
is
amended
to
read
as
27
follows:
28
225.12
Voluntary
public
patient
——
physician’s
or
physician
29
assistant’s
report.
30
A
physician
or
a
physician
assistant
who
meets
the
31
qualifications
set
forth
in
the
definition
of
a
mental
health
32
professional
in
section
228.1
filing
information
under
33
section
225.10
shall
include
a
written
report
to
the
regional
34
administrator
for
the
county
of
residence
of
the
person
named
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in
the
information,
giving
shall
submit
a
detailed
history
of
1
the
case
to
an
administrative
services
organization
as
will
be
2
likely
to
aid
in
the
observation,
treatment,
and
hospital
care
3
of
the
person
and
describing
the
history
in
detail
.
4
Sec.
58.
Section
225.13,
Code
2024,
is
amended
to
read
as
5
follows:
6
225.13
Financial
condition.
7
The
regional
administrator
for
the
county
of
residence
of
8
a
person
being
admitted
to
the
state
psychiatric
hospital
is
9
Administrative
services
organizations
shall
be
responsible
for
10
investigating
the
financial
condition
of
the
a
person
and
of
11
those
legally
responsible
for
the
person’s
support.
12
Sec.
59.
Section
225.15,
Code
2024,
is
amended
to
read
as
13
follows:
14
225.15
Examination
and
treatment.
15
1.
When
a
respondent
arrives
at
the
state
psychiatric
16
hospital,
the
admitting
physician,
or
a
physician
assistant
17
who
meets
the
qualifications
set
forth
in
the
definition
of
a
18
mental
health
professional
in
section
228.1
,
shall
examine
the
19
respondent
and
determine
whether
or
not,
in
the
physician’s
20
or
physician
assistant’s
judgment,
the
respondent
is
a
fit
21
subject
for
observation,
treatment,
and
hospital
care.
If,
22
upon
examination,
the
physician
or
physician
assistant
who
23
meets
the
qualifications
set
forth
in
the
definition
of
a
24
mental
health
professional
in
section
228.1
decides
that
the
25
respondent
should
be
admitted
to
the
hospital,
the
respondent
26
shall
be
provided
a
proper
bed
in
the
hospital.
The
physician
27
or
physician
assistant
who
meets
the
qualifications
set
forth
28
in
the
definition
of
a
mental
health
professional
in
section
29
228.1
who
has
charge
of
the
respondent
shall
proceed
with
30
observation,
medical
treatment,
and
hospital
care
as
in
the
31
physician’s
or
physician
assistant’s
judgment
are
proper
and
32
necessary,
in
compliance
with
sections
229.13
,
229.14
,
this
33
section
,
and
section
229.16
.
After
the
respondent’s
admission,
34
the
observation,
medical
treatment,
and
hospital
care
of
the
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respondent
may
be
provided
by
a
mental
health
professional,
1
as
defined
in
section
228.1
,
who
is
licensed
as
a
physician,
2
advanced
registered
nurse
practitioner,
or
physician
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
6
care
under
this
section
which
are
payable
in
whole
or
in
part
7
by
a
county
shall
only
be
provided
as
determined
through
8
the
regional
administrator
for
the
respondent’s
county
of
9
residence.
10
Sec.
60.
Section
225.16,
subsection
1,
Code
2024,
is
amended
11
to
read
as
follows:
12
1.
If
the
regional
administrator
for
a
person’s
county
of
13
residence
department
finds
from
the
physician’s
information
14
or
from
the
information
of
a
physician
assistant
who
15
meets
the
qualifications
set
forth
in
the
definition
of
16
a
mental
health
professional
in
section
228.1
which
was
17
filed
under
the
provisions
of
section
225.10
225.12
that
it
18
would
be
appropriate
for
the
person
to
be
admitted
to
the
19
state
psychiatric
hospital,
and
the
report
of
the
regional
20
administrator
made
pursuant
to
section
225.13
shows
the
21
department
finds
that
the
person
and
those
who
are
legally
22
responsible
for
the
person
are
not
able
to
pay
the
expenses
23
incurred
at
the
hospital,
or
are
able
to
pay
only
a
part
of
24
the
expenses,
the
person
shall
be
considered
to
be
a
voluntary
25
public
patient
and
the
regional
administrator
shall
direct
that
26
the
person
shall
be
sent
to
the
state
psychiatric
hospital
at
27
the
state
university
of
Iowa
for
observation,
treatment,
and
28
hospital
care.
29
Sec.
61.
Section
225.17,
subsection
2,
Code
2024,
is
amended
30
to
read
as
follows:
31
2.
When
the
respondent
arrives
at
the
hospital,
the
32
respondent
shall
receive
the
same
treatment
as
is
provided
for
33
committed
public
patients
in
section
225.15
,
in
compliance
34
with
sections
229.13
through
229.16
.
However,
observation,
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treatment,
and
hospital
care
under
this
section
of
a
respondent
1
whose
expenses
are
payable
in
whole
or
in
part
by
a
county
2
shall
only
be
provided
as
determined
through
the
regional
3
administrator
for
the
respondent’s
county
of
residence.
4
Sec.
62.
Section
225.18,
Code
2024,
is
amended
to
read
as
5
follows:
6
225.18
Attendants.
7
The
regional
administrator
An
administrative
services
8
organization
may
appoint
an
attendant
to
accompany
the
9
committed
public
patient
or
the
voluntary
public
patient
10
or
the
committed
private
patient
from
the
place
where
the
11
patient
may
be
to
the
state
psychiatric
hospital,
or
to
12
accompany
the
patient
from
the
hospital
to
a
place
as
may
13
be
designated
by
the
regional
administrator
administrative
14
services
organization
.
If
a
patient
is
moved
pursuant
to
this
15
section
,
at
least
one
attendant
shall
be
of
the
same
gender
as
16
the
patient.
17
Sec.
63.
Section
225.22,
Code
2024,
is
amended
to
read
as
18
follows:
19
225.22
Liability
of
private
patients
——
payment.
20
Every
committed
private
patient,
if
the
patient
has
an
21
estate
sufficient
for
that
purpose,
or
if
those
legally
22
responsible
for
the
patient’s
support
are
financially
able,
23
shall
be
liable
to
the
county
and
state
for
all
expenses
paid
24
by
them
in
the
state
on
behalf
of
such
patient.
All
bills
25
for
the
care,
nursing,
observation,
treatment,
medicine,
and
26
maintenance
of
such
patients
shall
be
paid
by
the
director
of
27
the
department
of
administrative
services
in
the
same
manner
as
28
those
of
committed
and
voluntary
public
patients
as
provided
in
29
this
chapter
,
unless
the
patient
or
those
legally
responsible
30
for
the
patient
make
such
settlement
with
the
state
psychiatric
31
hospital.
32
Sec.
64.
Section
225.24,
Code
2024,
is
amended
to
read
as
33
follows:
34
225.24
Collection
of
preliminary
expense.
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Unless
a
committed
private
patient
or
those
legally
1
responsible
for
the
patient’s
support
offer
to
settle
the
2
amount
of
the
claims,
the
regional
administrator
for
the
3
person’s
county
of
residence
department
shall
collect,
by
4
action
if
necessary,
the
amount
of
all
claims
for
per
diem
and
5
expenses
that
have
been
approved
by
the
regional
administrator
6
for
the
county
an
administrative
services
organization
and
7
paid
by
the
regional
administrator
as
provided
under
section
8
225.21
administrative
services
organization
.
Any
amount
9
collected
shall
be
credited
to
the
mental
health
and
disability
10
services
region
combined
account
created
behavioral
health
fund
11
established
in
accordance
with
section
225C.58
225A.7
.
12
Sec.
65.
Section
225.27,
Code
2024,
is
amended
to
read
as
13
follows:
14
225.27
Discharge
——
transfer.
15
The
state
psychiatric
hospital
may,
at
any
time,
discharge
16
any
patient
as
recovered,
as
improved,
or
as
not
likely
to
17
be
benefited
by
further
treatment.
If
the
patient
being
so
18
discharged
was
involuntarily
hospitalized,
the
hospital
shall
19
notify
the
committing
judge
or
court
of
the
discharge
as
20
required
by
section
229.14
or
section
229.16
,
whichever
is
as
21
applicable
,
and
the
applicable
regional
administrator
.
Upon
22
receiving
the
notification,
the
court
shall
issue
an
order
23
confirming
the
patient’s
discharge
from
the
hospital
or
from
24
care
and
custody,
as
the
case
may
be,
and
shall
terminate
the
25
proceedings
pursuant
to
which
the
order
was
issued.
The
court
26
or
judge
shall,
if
necessary,
appoint
a
person
to
accompany
the
27
discharged
patient
from
the
state
psychiatric
hospital
to
such
28
place
as
the
hospital
or
the
court
may
designate,
or
authorize
29
the
hospital
to
appoint
such
attendant.
30
Sec.
66.
Section
226.1,
subsection
4,
Code
2024,
is
amended
31
by
adding
the
following
new
paragraph:
32
NEW
PARAGRAPH
.
0a.
“Administrative
services
organization”
33
means
the
same
as
defined
in
section
225A.1.
34
Sec.
67.
Section
226.1,
subsection
4,
paragraphs
d
and
f,
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Code
2024,
are
amended
by
striking
the
paragraphs.
1
Sec.
68.
Section
226.8,
subsection
2,
Code
2024,
is
amended
2
to
read
as
follows:
3
2.
Charges
for
the
care
of
any
person
with
a
diagnosis
of
4
an
intellectual
disability
admitted
to
a
state
mental
health
5
institute
shall
be
made
by
the
institute
in
the
manner
provided
6
by
chapter
230
,
but
the
liability
of
any
other
person
to
any
7
mental
health
and
disability
services
region
the
state
for
the
8
cost
of
care
of
such
person
with
a
diagnosis
of
an
intellectual
9
disability
shall
be
as
prescribed
by
section
222.78
.
10
Sec.
69.
Section
226.32,
Code
2024,
is
amended
to
read
as
11
follows:
12
226.32
Overcrowded
conditions.
13
The
director
shall
order
the
discharge
or
removal
from
the
14
mental
health
institute
of
incurable
and
harmless
patients
15
whenever
it
is
necessary
to
make
room
for
recent
cases.
If
16
a
patient
who
is
to
be
discharged
entered
the
mental
health
17
institute
voluntarily,
the
director
shall
notify
the
regional
18
administrator
for
the
county
interested
at
least
ten
days
in
19
advance
of
the
day
of
actual
discharge.
20
Sec.
70.
Section
226.34,
subsection
2,
paragraph
d,
Code
21
2024,
is
amended
by
striking
the
paragraph.
22
Sec.
71.
Section
228.6,
subsection
1,
Code
2024,
is
amended
23
to
read
as
follows:
24
1.
A
mental
health
professional
or
an
employee
of
or
25
agent
for
a
mental
health
facility
may
disclose
mental
health
26
information
if
and
to
the
extent
necessary,
to
meet
the
27
requirements
of
section
229.24
,
229.25
,
230.20
,
230.21
,
230.25
,
28
230.26
,
230A.108
,
232.74
,
or
232.147
,
or
to
meet
the
compulsory
29
reporting
or
disclosure
requirements
of
other
state
or
federal
30
law
relating
to
the
protection
of
human
health
and
safety.
31
Sec.
72.
Section
229.1,
Code
2024,
is
amended
by
adding
the
32
following
new
subsection:
33
NEW
SUBSECTION
.
01.
“Administrative
services
organization”
34
means
the
same
as
defined
in
section
225A.1.
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Sec.
73.
Section
229.1,
subsections
11,
18,
and
19,
Code
1
2024,
are
amended
by
striking
the
subsections.
2
Sec.
74.
Section
229.1B,
Code
2024,
is
amended
to
read
as
3
follows:
4
229.1B
Regional
administrator
Administrative
services
5
organization
.
6
Notwithstanding
any
provision
of
this
chapter
to
the
7
contrary,
any
person
whose
hospitalization
expenses
are
8
payable
in
whole
or
in
part
by
a
mental
health
and
disability
9
services
region
an
administrative
services
organization
10
shall
be
subject
to
all
administrative
requirements
of
the
11
regional
administrator
for
the
county
administrative
services
12
organization
.
13
Sec.
75.
Section
229.2,
subsection
1,
paragraph
b,
14
subparagraph
(3),
Code
2024,
is
amended
to
read
as
follows:
15
(3)
As
soon
as
is
practicable
after
the
filing
of
a
16
petition
for
juvenile
court
approval
of
the
admission
of
the
17
minor,
the
juvenile
court
shall
determine
whether
the
minor
18
has
an
attorney
to
represent
the
minor
in
the
hospitalization
19
proceeding,
and
if
not,
the
court
shall
assign
to
the
minor
20
an
attorney.
If
the
minor
is
financially
unable
to
pay
for
21
an
attorney,
the
attorney
shall
be
compensated
by
the
mental
22
health
and
disability
services
region
an
administrative
23
services
organization
at
an
hourly
rate
to
be
established
24
by
the
regional
administrator
for
the
county
in
which
the
25
proceeding
is
held
administrative
services
organization
in
26
substantially
the
same
manner
as
provided
in
section
815.7
.
27
Sec.
76.
Section
229.2,
subsection
2,
paragraph
a,
Code
28
2024,
is
amended
to
read
as
follows:
29
a.
The
chief
medical
officer
of
a
public
hospital
shall
30
receive
and
may
admit
the
person
whose
admission
is
sought,
31
subject
in
cases
other
than
medical
emergencies
to
availability
32
of
suitable
accommodations
and
to
the
provisions
of
sections
33
section
229.41
and
229.42
.
34
Sec.
77.
Section
229.8,
subsection
1,
Code
2024,
is
amended
35
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to
read
as
follows:
1
1.
Determine
whether
the
respondent
has
an
attorney
2
who
is
able
and
willing
to
represent
the
respondent
in
the
3
hospitalization
proceeding,
and
if
not,
whether
the
respondent
4
is
financially
able
to
employ
an
attorney
and
capable
of
5
meaningfully
assisting
in
selecting
one.
In
accordance
with
6
those
determinations,
the
court
shall
if
necessary
allow
the
7
respondent
to
select,
or
shall
assign
to
the
respondent,
an
8
attorney.
If
the
respondent
is
financially
unable
to
pay
an
9
attorney,
the
attorney
shall
be
compensated
by
the
mental
10
health
and
disability
services
region
an
administrative
11
services
organization
at
an
hourly
rate
to
be
established
12
by
the
regional
administrator
for
the
county
in
which
the
13
proceeding
is
held
administrative
services
organization
in
14
substantially
the
same
manner
as
provided
in
section
815.7
.
15
Sec.
78.
Section
229.10,
subsection
1,
paragraph
a,
Code
16
2024,
is
amended
to
read
as
follows:
17
a.
An
examination
of
the
respondent
shall
be
conducted
by
18
one
or
more
licensed
physicians
or
mental
health
professionals,
19
as
required
by
the
court’s
order,
within
a
reasonable
time.
20
If
the
respondent
is
detained
pursuant
to
section
229.11,
21
subsection
1
,
paragraph
“b”
,
the
examination
shall
be
conducted
22
within
twenty-four
hours.
If
the
respondent
is
detained
23
pursuant
to
section
229.11,
subsection
1
,
paragraph
“a”
or
24
“c”
,
the
examination
shall
be
conducted
within
forty-eight
25
hours.
If
the
respondent
so
desires,
the
respondent
shall
be
26
entitled
to
a
separate
examination
by
a
licensed
physician
or
27
mental
health
professional
of
the
respondent’s
own
choice.
The
28
reasonable
cost
of
the
examinations
shall,
if
the
respondent
29
lacks
sufficient
funds
to
pay
the
cost,
be
paid
by
the
regional
30
administrator
from
mental
health
and
disability
services
region
31
funds
an
administrative
services
organization
upon
order
of
the
32
court.
33
Sec.
79.
Section
229.11,
subsection
1,
unnumbered
paragraph
34
1,
Code
2024,
is
amended
to
read
as
follows:
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If
the
applicant
requests
that
the
respondent
be
taken
into
1
immediate
custody
and
the
judge,
upon
reviewing
the
application
2
and
accompanying
documentation,
finds
probable
cause
to
believe
3
that
the
respondent
has
a
serious
mental
impairment
and
is
4
likely
to
injure
the
respondent
or
other
persons
if
allowed
5
to
remain
at
liberty,
the
judge
may
enter
a
written
order
6
directing
that
the
respondent
be
taken
into
immediate
custody
7
by
the
sheriff
or
the
sheriff’s
deputy
and
be
detained
until
8
the
hospitalization
hearing.
The
hospitalization
hearing
shall
9
be
held
no
more
than
five
days
after
the
date
of
the
order,
10
except
that
if
the
fifth
day
after
the
date
of
the
order
is
11
a
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
12
on
the
next
succeeding
business
day.
If
the
expenses
of
a
13
respondent
are
payable
in
whole
or
in
part
by
a
mental
health
14
and
disability
services
region
an
administrative
services
15
organization
,
for
a
placement
in
accordance
with
paragraph
“a”
,
16
the
judge
shall
give
notice
of
the
placement
to
the
regional
17
administrator
for
the
county
in
which
the
court
is
located
an
18
administrative
services
organization
,
and
for
a
placement
in
19
accordance
with
paragraph
“b”
or
“c”
,
the
judge
shall
order
20
the
placement
in
a
hospital
or
facility
designated
through
21
the
regional
administrator
by
an
administrative
services
22
organization
.
The
judge
may
order
the
respondent
detained
for
23
the
period
of
time
until
the
hearing
is
held,
and
no
longer,
24
in
accordance
with
paragraph
“a”
,
if
possible,
and
if
not
then
25
in
accordance
with
paragraph
“b”
,
or,
only
if
neither
of
these
26
alternatives
is
available,
in
accordance
with
paragraph
“c”
.
27
Detention
may
be
in
any
of
the
following:
28
Sec.
80.
Section
229.13,
subsection
1,
paragraph
a,
Code
29
2024,
is
amended
to
read
as
follows:
30
a.
The
court
shall
order
a
respondent
whose
expenses
are
31
payable
in
whole
or
in
part
by
a
mental
health
and
disability
32
services
region
an
administrative
services
organization
33
placed
under
the
care
of
an
appropriate
hospital
or
facility
34
designated
through
the
regional
administrator
for
the
county
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by
an
administrative
services
organization
on
an
inpatient
or
1
outpatient
basis.
2
Sec.
81.
Section
229.13,
subsection
7,
paragraph
b,
Code
3
2024,
is
amended
to
read
as
follows:
4
b.
A
region
An
administrative
services
organization
shall
5
contract
with
mental
health
professionals
to
provide
the
6
appropriate
treatment
including
treatment
by
the
use
of
oral
7
medicine
or
injectable
antipsychotic
medicine
pursuant
to
this
8
section
.
9
Sec.
82.
Section
229.14,
subsection
2,
paragraph
a,
Code
10
2024,
is
amended
to
read
as
follows:
11
a.
For
a
respondent
whose
expenses
are
payable
in
whole
12
or
in
part
by
a
mental
health
and
disability
services
region
13
an
administrative
services
organization
,
placement
as
14
designated
through
the
regional
administrator
for
the
county
15
by
an
administrative
services
organization
in
the
care
of
an
16
appropriate
hospital
or
facility
on
an
inpatient
or
outpatient
17
basis,
or
other
appropriate
treatment,
or
in
an
appropriate
18
alternative
placement.
19
Sec.
83.
Section
229.14A,
subsections
7
and
9,
Code
2024,
20
are
amended
to
read
as
follows:
21
7.
If
a
respondent’s
expenses
are
payable
in
whole
or
in
22
part
by
a
mental
health
and
disability
services
region
through
23
the
regional
administrator
for
the
county
an
administrative
24
services
organization
,
notice
of
a
placement
hearing
shall
be
25
provided
to
the
county
attorney
and
the
regional
administrator
26
an
administrative
services
organization
.
At
the
hearing,
the
27
county
may
present
evidence
regarding
appropriate
placement.
28
9.
A
placement
made
pursuant
to
an
order
entered
under
29
section
229.13
or
229.14
or
this
section
shall
be
considered
to
30
be
authorized
through
the
regional
administrator
for
the
county
31
by
an
administrative
services
organization
.
32
Sec.
84.
Section
229.15,
subsection
4,
Code
2024,
is
amended
33
to
read
as
follows:
34
4.
When
a
patient
has
been
placed
in
an
alternative
facility
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other
than
a
hospital
pursuant
to
a
report
issued
under
section
1
229.14,
subsection
1
,
paragraph
“d”
,
a
report
on
the
patient’s
2
condition
and
prognosis
shall
be
made
to
the
court
which
placed
3
the
patient,
at
least
once
every
six
months,
unless
the
court
4
authorizes
annual
reports.
If
an
evaluation
of
the
patient
is
5
performed
pursuant
to
section
227.2,
subsection
4
,
a
copy
of
6
the
evaluation
report
shall
be
submitted
to
the
court
within
7
fifteen
days
of
the
evaluation’s
completion.
The
court
may
in
8
its
discretion
waive
the
requirement
of
an
additional
report
9
between
the
annual
evaluations.
If
the
department
exercises
10
the
authority
to
remove
residents
or
patients
from
a
county
11
care
facility
or
other
county
or
private
facility
under
section
12
227.6
,
the
department
shall
promptly
notify
each
court
which
13
placed
in
that
facility
any
resident
or
patient
removed.
14
Sec.
85.
Section
229.19,
subsection
1,
paragraphs
a
and
b,
15
Code
2024,
are
amended
to
read
as
follows:
16
a.
In
each
county
the
board
of
supervisors
shall
appoint
17
an
individual
who
has
demonstrated
by
prior
activities
an
18
informed
concern
for
the
welfare
and
rehabilitation
of
persons
19
with
mental
illness,
and
who
is
not
an
officer
or
employee
of
20
the
department
,
an
officer
or
employee
of
a
region,
an
officer
21
or
employee
of
a
county
performing
duties
for
a
region,
or
22
an
officer
or
employee
of
any
agency
or
facility
providing
23
care
or
treatment
to
persons
with
mental
illness,
to
act
as
an
24
advocate
representing
the
interests
of
patients
involuntarily
25
hospitalized
by
the
court,
in
any
matter
relating
to
the
26
patients’
hospitalization
or
treatment
under
section
229.14
or
27
229.15
.
28
b.
The
committing
court
shall
assign
the
advocate
for
the
29
county
where
the
patient
is
located.
A
county
or
region
may
30
seek
reimbursement
from
the
patient’s
county
of
residence
or
31
from
the
region
in
which
the
patient’s
county
of
residence
is
32
located
an
administrative
services
organization
.
33
Sec.
86.
Section
229.19,
subsection
4,
unnumbered
paragraph
34
1,
Code
2024,
is
amended
to
read
as
follows:
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The
state
mental
health
and
disability
services
commission
1
created
in
section
225C.5
department
,
in
consultation
with
2
advocates
and
county
and
judicial
branch
representatives,
shall
3
adopt
rules
pursuant
to
chapter
17A
relating
to
advocates
that
4
include
but
are
not
limited
to
all
of
the
following
topics:
5
Sec.
87.
Section
229.22,
subsection
2,
paragraph
b,
Code
6
2024,
is
amended
to
read
as
follows:
7
b.
If
the
magistrate
orders
that
the
person
be
detained,
8
the
magistrate
shall,
by
the
close
of
business
on
the
next
9
working
day,
file
a
written
order
with
the
clerk
in
the
county
10
where
it
is
anticipated
that
an
application
may
be
filed
11
under
section
229.6
.
The
order
may
be
filed
by
facsimile
if
12
necessary.
A
peace
officer
from
the
law
enforcement
agency
13
that
took
the
person
into
custody,
if
no
request
was
made
14
under
paragraph
“a”
,
may
inform
the
magistrate
that
an
arrest
15
warrant
has
been
issued
for
or
charges
are
pending
against
the
16
person
and
request
that
any
written
order
issued
under
this
17
paragraph
require
the
facility
or
hospital
to
notify
the
law
18
enforcement
agency
about
the
discharge
of
the
person
prior
to
19
discharge.
The
order
shall
state
the
circumstances
under
which
20
the
person
was
taken
into
custody
or
otherwise
brought
to
a
21
facility
or
hospital,
and
the
grounds
supporting
the
finding
22
of
probable
cause
to
believe
that
the
person
is
seriously
23
mentally
impaired
and
likely
to
injure
the
person’s
self
or
24
others
if
not
immediately
detained.
The
order
shall
also
25
include
any
law
enforcement
agency
notification
requirements
if
26
applicable.
The
order
shall
confirm
the
oral
order
authorizing
27
the
person’s
detention
including
any
order
given
to
transport
28
the
person
to
an
appropriate
facility
or
hospital.
A
peace
29
officer
from
the
law
enforcement
agency
that
took
the
person
30
into
custody
may
also
request
an
order,
separate
from
the
31
written
order,
requiring
the
facility
or
hospital
to
notify
the
32
law
enforcement
agency
about
the
discharge
of
the
person
prior
33
to
discharge.
The
clerk
shall
provide
a
copy
of
the
written
34
order
or
any
separate
order
to
the
chief
medical
officer
of
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the
facility
or
hospital
to
which
the
person
was
originally
1
taken,
to
any
subsequent
facility
to
which
the
person
was
2
transported,
and
to
any
law
enforcement
department,
ambulance
3
service,
or
transportation
service
under
contract
with
a
4
mental
health
and
disability
services
region
an
administrative
5
services
organization
that
transported
the
person
pursuant
6
to
the
magistrate’s
order.
A
transportation
service
that
7
contracts
with
a
mental
health
and
disability
services
region
8
an
administrative
services
organization
for
purposes
of
this
9
paragraph
shall
provide
a
secure
transportation
vehicle
and
10
shall
employ
staff
that
has
received
or
is
receiving
mental
11
health
training.
12
Sec.
88.
Section
229.24,
subsection
3,
unnumbered
paragraph
13
1,
Code
2024,
is
amended
to
read
as
follows:
14
If
all
or
part
of
the
costs
associated
with
hospitalization
15
of
an
individual
under
this
chapter
are
chargeable
to
a
county
16
of
residence
an
administrative
services
organization
,
the
17
clerk
of
the
district
court
shall
provide
to
the
regional
18
administrator
for
the
county
of
residence
and
to
the
regional
19
administrator
for
the
county
in
which
the
hospitalization
20
order
is
entered
an
administrative
services
organization
the
21
following
information
pertaining
to
the
individual
which
would
22
be
confidential
under
subsection
1
:
23
Sec.
89.
Section
229.38,
Code
2024,
is
amended
to
read
as
24
follows:
25
229.38
Cruelty
or
official
misconduct.
26
If
any
person
having
the
care
of
a
person
with
mental
illness
27
who
has
voluntarily
entered
a
hospital
or
other
facility
for
28
treatment
or
care,
or
who
is
responsible
for
psychiatric
29
examination
care,
treatment,
and
maintenance
of
any
person
30
involuntarily
hospitalized
under
sections
229.6
through
229.15
,
31
whether
in
a
hospital
or
elsewhere,
with
or
without
proper
32
authority,
shall
treat
such
patient
with
unnecessary
severity,
33
harshness,
or
cruelty,
or
in
any
way
abuse
the
patient
or
if
34
any
person
unlawfully
detains
or
deprives
of
liberty
any
person
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with
mental
illness
or
any
person
who
is
alleged
to
have
mental
1
illness,
or
if
any
officer
required
by
the
provisions
of
this
2
chapter
and
chapters
chapter
226
and
227
,
to
perform
any
act
3
shall
willfully
refuse
or
neglect
to
perform
the
same,
the
4
offending
person
shall,
unless
otherwise
provided,
be
guilty
of
5
a
serious
misdemeanor.
6
Sec.
90.
Section
230.1,
Code
2024,
is
amended
by
adding
the
7
following
new
subsection:
8
NEW
SUBSECTION
.
01.
“Administrative
service
organization”
9
means
the
same
as
defined
in
section
225A.1.
10
Sec.
91.
Section
230.1,
subsections
4
and
5,
Code
2024,
are
11
amended
by
striking
the
subsections.
12
Sec.
92.
Section
230.10,
Code
2024,
is
amended
to
read
as
13
follows:
14
230.10
Payment
of
costs.
15
All
legal
costs
and
expenses
for
the
taking
into
custody,
16
care,
investigation,
and
admission
or
commitment
of
a
person
to
17
a
state
mental
health
institute
under
a
finding
that
the
person
18
has
residency
in
another
county
of
this
state
shall
be
charged
19
against
the
regional
administrator
of
the
person’s
county
of
20
residence
to
an
administrative
services
organization
.
21
Sec.
93.
Section
230.11,
Code
2024,
is
amended
to
read
as
22
follows:
23
230.11
Recovery
of
costs
from
state.
24
Costs
and
expenses
for
the
taking
into
custody,
care,
and
25
investigation
of
a
person
who
has
been
admitted
or
committed
26
to
a
state
mental
health
institute,
United
States
department
27
of
veterans
affairs
hospital,
or
other
agency
of
the
United
28
States
government,
for
persons
with
mental
illness
and
29
who
has
no
residence
in
this
state
or
whose
residence
is
30
unknown,
including
cost
of
commitment,
if
any,
shall
be
paid
31
as
approved
by
the
department.
The
amount
of
the
costs
and
32
expenses
approved
by
the
department
is
appropriated
to
the
33
department
from
any
moneys
in
the
state
treasury
not
otherwise
34
appropriated.
Payment
shall
be
made
by
the
department
on
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itemized
vouchers
executed
by
the
regional
administrator
of
1
the
person’s
county
which
has
paid
them,
and
approved
by
the
2
department.
3
Sec.
94.
Section
230.15,
subsections
1
and
2,
Code
2024,
are
4
amended
to
read
as
follows:
5
1.
A
person
with
mental
illness
and
a
person
legally
liable
6
for
the
person’s
support
remain
liable
for
the
support
of
7
the
person
with
mental
illness
as
provided
in
this
section
.
8
Persons
legally
liable
for
the
support
of
a
person
with
mental
9
illness
include
the
spouse
of
the
person,
and
any
person
10
bound
by
contract
for
support
of
the
person.
The
regional
11
administrator
of
the
person’s
county
of
residence,
subject
to
12
the
direction
of
the
region’s
governing
board,
shall
enforce
13
the
obligation
created
in
this
section
as
to
all
sums
advanced
14
by
the
regional
administrator.
The
liability
to
the
regional
15
administrator
incurred
by
a
person
with
mental
illness
or
a
16
person
legally
liable
for
the
person’s
support
under
this
17
section
is
limited
to
an
amount
equal
to
one
hundred
percent
18
of
the
cost
of
care
and
treatment
of
the
person
with
mental
19
illness
at
a
state
mental
health
institute
for
one
hundred
20
twenty
days
of
hospitalization.
This
limit
of
liability
may
21
be
reached
by
payment
of
the
cost
of
care
and
treatment
of
the
22
person
with
mental
illness
subsequent
to
a
single
admission
23
or
multiple
admissions
to
a
state
mental
health
institute
or,
24
if
the
person
is
not
discharged
as
cured,
subsequent
to
a
25
single
transfer
or
multiple
transfers
to
a
county
care
facility
26
pursuant
to
section
227.11
.
After
reaching
this
limit
of
27
liability,
a
person
with
mental
illness
or
a
person
legally
28
liable
for
the
person’s
support
is
liable
to
the
regional
29
administrator
state
for
the
care
and
treatment
of
the
person
30
with
mental
illness
at
a
state
mental
health
institute
or,
31
if
transferred
but
not
discharged
as
cured,
at
a
county
care
32
facility
in
an
amount
not
in
excess
of
to
exceed
the
average
33
minimum
cost
of
the
maintenance
of
an
individual
who
is
34
physically
and
mentally
healthy
residing
in
the
individual’s
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own
home
,
which
standard
shall
be
as
established
and
may
be
1
revised
by
the
department
by
rule
.
A
lien
imposed
by
section
2
230.25
shall
not
exceed
the
amount
of
the
liability
which
may
3
be
incurred
under
this
section
on
account
of
a
person
with
4
mental
illness.
5
2.
A
person
with
a
substance
use
disorder
is
legally
6
liable
for
the
total
amount
of
the
cost
of
providing
care,
7
maintenance,
and
treatment
for
the
person
with
a
substance
8
use
disorder
while
a
voluntary
or
committed
patient.
When
9
a
portion
of
the
cost
is
paid
by
a
county
an
administrative
10
services
organization
,
the
person
with
a
substance
use
disorder
11
is
legally
liable
to
the
county
administrative
services
12
organization
for
the
amount
paid.
The
person
with
a
substance
13
use
disorder
shall
assign
any
claim
for
reimbursement
under
any
14
contract
of
indemnity,
by
insurance
or
otherwise,
providing
15
for
the
person’s
care,
maintenance,
and
treatment
in
a
state
16
mental
health
institute
to
the
state.
Any
payments
received
17
by
the
state
from
or
on
behalf
of
a
person
with
a
substance
use
18
disorder
shall
be
in
part
credited
to
the
county
in
proportion
19
to
the
share
of
the
costs
paid
by
the
county.
20
Sec.
95.
NEW
SECTION
.
230.23
State
——
payor
of
last
resort.
21
The
department
shall
implement
services
and
adopt
rules
22
pursuant
to
chapter
17A
in
a
manner
that
ensures
that
the
state
23
is
the
payor
of
last
resort,
and
that
the
department
does
not
24
make
any
payments
for
services
that
have
been
provided
until
25
the
department
has
determined
that
the
services
provided
are
26
not
payable
by
a
third-party
source.
27
Sec.
96.
Section
230.30,
Code
2024,
is
amended
to
read
as
28
follows:
29
230.30
Claim
against
estate.
30
On
the
death
of
a
person
receiving
or
who
has
received
31
assistance
under
the
provisions
of
this
chapter
,
and
whom
the
32
board
department
has
previously
found
,
under
section
230.25
,
33
is
able
to
pay
,
there
shall
be
allowed
against
the
estate
of
34
such
decedent
a
claim
of
the
sixth
class
for
that
portion
of
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the
total
amount
paid
for
that
person’s
care
which
exceeds
1
the
total
amount
of
all
claims
of
the
first
through
the
fifth
2
classes,
inclusive,
as
defined
in
section
633.425
,
which
are
3
allowed
against
that
estate.
4
Sec.
97.
Section
232.78,
subsection
5,
unnumbered
paragraph
5
1,
Code
2024,
is
amended
to
read
as
follows:
6
The
juvenile
court,
before
or
after
the
filing
of
a
petition
7
under
this
chapter
,
may
enter
an
ex
parte
order
authorizing
8
a
physician
or
physician
assistant
or
hospital
to
conduct
an
9
outpatient
physical
examination
or
authorizing
a
physician
or
10
physician
assistant,
a
psychologist
certified
under
section
11
154B.7,
or
a
community
mental
health
center
accredited
pursuant
12
to
chapter
230A
section
225A.3
to
conduct
an
outpatient
mental
13
examination
of
a
child
if
necessary
to
identify
the
nature,
14
extent,
and
cause
of
injuries
to
the
child
as
required
by
15
section
232.71B
,
provided
all
of
the
following
apply:
16
Sec.
98.
Section
232.83,
subsection
2,
unnumbered
paragraph
17
1,
Code
2024,
is
amended
to
read
as
follows:
18
Anyone
authorized
to
conduct
a
preliminary
investigation
in
19
response
to
a
complaint
may
apply
for,
or
the
court
on
its
own
20
motion
may
enter,
an
ex
parte
order
authorizing
a
physician
21
or
physician
assistant
or
hospital
to
conduct
an
outpatient
22
physical
examination
or
authorizing
a
physician
or
physician
23
assistant,
a
psychologist
certified
under
section
154B.7,
or
a
24
community
mental
health
center
accredited
pursuant
to
chapter
25
230A
section
225A.3
to
conduct
an
outpatient
mental
examination
26
of
a
child
if
necessary
to
identify
the
nature,
extent,
and
27
causes
of
any
injuries,
emotional
damage,
or
other
such
needs
28
of
a
child
as
specified
in
section
232.96A,
subsection
3,
5,
or
29
6
,
provided
that
all
of
the
following
apply:
30
Sec.
99.
Section
235.7,
subsection
2,
Code
2024,
is
amended
31
to
read
as
follows:
32
2.
Membership.
The
department
may
authorize
the
governance
33
boards
of
decategorization
of
child
welfare
and
juvenile
34
justice
funding
projects
established
under
section
232.188
to
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appoint
the
transition
committee
membership
and
may
utilize
1
the
boundaries
of
decategorization
projects
to
establish
2
the
service
areas
for
transition
committees.
The
committee
3
membership
may
include
but
is
not
limited
to
department
staff
4
involved
with
foster
care,
child
welfare,
and
adult
services,
5
juvenile
court
services
staff,
staff
involved
with
county
6
general
assistance
or
emergency
relief
under
chapter
251
or
7
252,
or
a
regional
administrator
of
the
county
mental
health
8
and
disability
services
region,
as
defined
in
section
225C.55,
9
in
the
area,
school
district
and
area
education
agency
staff
10
involved
with
special
education,
and
a
child’s
court
appointed
11
special
advocate,
guardian
ad
litem,
service
providers,
and
12
other
persons
knowledgeable
about
the
child.
13
Sec.
100.
Section
235A.15,
subsection
2,
paragraph
c,
14
subparagraphs
(5)
and
(8),
Code
2024,
are
amended
by
striking
15
the
subparagraphs.
16
Sec.
101.
Section
249A.4,
subsection
15,
Code
2024,
is
17
amended
by
striking
the
subsection.
18
Sec.
102.
Section
249A.12,
subsection
4,
Code
2024,
is
19
amended
by
striking
the
subsection.
20
Sec.
103.
NEW
SECTION
.
249A.38A
Supported
community
living
21
services.
22
1.
As
used
in
this
section,
“supported
community
living
23
service”
means
a
service
provided
in
a
noninstitutional
24
setting
to
adult
persons
with
mental
illness,
an
intellectual
25
disability,
or
developmental
disabilities
to
meet
the
persons’
26
daily
living
needs.
27
2.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
28
establishing
minimum
standards
for
supported
community
living
29
services.
30
3.
The
department
shall
determine
whether
to
grant,
deny,
or
31
revoke
approval
for
any
supported
community
living
service.
32
4.
Approved
supported
community
living
services
may
receive
33
funding
from
the
state,
federal
and
state
social
services
block
34
grant
funds,
and
other
appropriate
funding
sources,
consistent
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with
state
legislation
and
federal
regulations.
The
funding
1
may
be
provided
on
a
per
diem,
per
hour,
or
grant
basis,
as
2
appropriate.
3
Sec.
104.
Section
249N.8,
Code
2024,
is
amended
by
striking
4
the
section
and
inserting
in
lieu
thereof
the
following:
5
249N.8
Behavioral
health
services
reports.
6
The
department
shall
annually
submit
a
report
to
the
7
governor
and
the
general
assembly
with
details
related
to
the
8
department’s
review
of
the
funds
administered
by,
and
the
9
outcomes
and
effectiveness
of,
the
behavioral
health
services
10
provided
by,
the
behavioral
health
service
system
established
11
in
section
225A.3.
12
Sec.
105.
Section
252.24,
subsections
1
and
3,
Code
2024,
13
are
amended
to
read
as
follows:
14
1.
The
county
of
residence,
as
defined
in
section
225C.61
15
331.190
,
shall
be
liable
to
the
county
granting
assistance
for
16
all
reasonable
charges
and
expenses
incurred
in
the
assistance
17
and
care
of
a
poor
person.
18
3.
This
section
shall
apply
to
assistance
or
maintenance
19
provided
by
a
county
through
the
county’s
mental
health
20
and
disability
services
behavioral
health
service
system
21
implemented
under
chapter
225C
established
in
section
225A.3
.
22
Sec.
106.
Section
256.25,
subsections
2
and
3,
Code
2024,
23
are
amended
to
read
as
follows:
24
2.
A
school
district,
which
may
collaborate
and
partner
25
with
one
or
more
school
districts,
area
education
agencies,
26
accredited
nonpublic
schools,
nonprofit
agencies,
and
27
institutions
that
provide
children’s
mental
health
services,
28
located
in
mental
health
and
disability
services
regions
29
providing
children’s
behavioral
health
services
in
accordance
30
with
chapter
225C,
subchapter
VII
operating
within
the
state’s
31
behavioral
health
service
system
under
chapter
225A
,
may
apply
32
for
a
grant
under
this
program
to
establish
a
therapeutic
33
classroom
in
the
school
district
in
accordance
with
this
34
section
.
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3.
The
department
shall
develop
a
grant
application
1
and
selection
and
evaluation
criteria.
Selection
criteria
2
shall
include
a
method
for
prioritizing
grant
applications
3
submitted
by
school
districts.
First
priority
shall
be
4
given
to
applications
submitted
by
school
districts
that
5
submitted
an
application
pursuant
to
this
section
for
the
6
previous
immediately
preceding
fiscal
year.
Second
priority
7
shall
be
given
to
applications
submitted
by
school
districts
8
that,
pursuant
to
subsection
2
,
are
collaborating
and
9
partnering
with
one
or
more
school
districts,
area
education
10
agencies,
accredited
nonpublic
schools,
nonprofit
agencies,
11
or
institutions
that
provide
mental
health
services
for
12
children.
Third
priority
shall
be
given
to
applications
13
submitted
by
school
districts
located
in
mental
health
and
14
disability
services
regions
behavioral
health
districts
as
15
defined
in
section
225A.1,
and
that
are
providing
behavioral
16
health
services
for
children
in
accordance
with
chapter
225C,
17
subchapter
VII
225A
.
Grant
awards
shall
be
distributed
as
18
equitably
as
possible
among
small,
medium,
and
large
school
19
districts.
For
purposes
of
this
subsection
,
a
small
school
20
district
is
a
district
with
an
actual
enrollment
of
fewer
than
21
six
hundred
pupils;
a
medium
school
district
is
a
district
22
with
an
actual
enrollment
that
is
at
least
six
hundred
pupils,
23
but
less
than
two
thousand
five
hundred
pupils;
and
a
large
24
school
district
is
a
district
with
an
actual
enrollment
of
two
25
thousand
five
hundred
or
more
pupils.
26
Sec.
107.
Section
321.189,
subsection
10,
Code
2024,
is
27
amended
to
read
as
follows:
28
10.
Autism
spectrum
disorder
status.
A
licensee
who
has
29
autism
spectrum
disorder,
as
defined
in
section
514C.28
,
may
30
request
that
the
license
be
marked
to
reflect
the
licensee’s
31
autism
spectrum
disorder
status
on
the
face
of
the
license
32
when
the
licensee
applies
for
the
issuance
or
renewal
of
a
33
license.
The
department
may
adopt
rules
pursuant
to
chapter
34
17A
establishing
criteria
under
which
a
license
may
be
marked,
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including
requiring
the
licensee
to
submit
medical
proof
of
the
1
licensee’s
autism
spectrum
disorder
status.
When
a
driver’s
2
license
is
so
marked,
the
licensee’s
autism
spectrum
disorder
3
status
shall
be
noted
in
the
electronic
database
used
by
4
the
department
and
law
enforcement
to
access
registration,
5
titling,
and
driver’s
license
information.
The
department,
in
6
consultation
with
the
mental
health
and
disability
services
7
commission
department
of
health
and
human
services
,
shall
8
develop
educational
media
to
raise
awareness
of
a
licensee’s
9
ability
to
request
the
license
be
marked
to
reflect
the
10
licensee’s
autism
spectrum
disorder
status.
11
Sec.
108.
Section
321.190,
subsection
1,
paragraph
b,
12
subparagraph
(6),
Code
2024,
is
amended
to
read
as
follows:
13
(6)
An
applicant
for
a
nonoperator’s
identification
14
card
who
has
autism
spectrum
disorder,
as
defined
in
section
15
514C.28
,
may
request
that
the
card
be
marked
to
reflect
16
the
applicant’s
autism
spectrum
disorder
status
on
the
face
17
of
the
card
when
the
applicant
applies
for
the
issuance
or
18
renewal
of
a
card.
The
department
may
adopt
rules
pursuant
to
19
chapter
17A
establishing
criteria
under
which
a
card
may
be
20
marked,
including
requiring
the
applicant
to
submit
medical
21
proof
of
the
applicant’s
autism
spectrum
disorder
status.
22
The
department,
in
consultation
with
the
mental
health
and
23
disability
services
commission
department
of
health
and
human
24
services
,
shall
develop
educational
media
to
raise
awareness
of
25
an
applicant’s
ability
to
request
the
card
be
marked
to
reflect
26
the
applicant’s
autism
spectrum
disorder
status.
27
Sec.
109.
Section
321J.25,
subsection
1,
paragraph
b,
Code
28
2024,
is
amended
to
read
as
follows:
29
b.
“Program”
means
a
substance
use
disorder
awareness
30
program
,
licensed
under
chapter
125,
and
provided
under
a
31
contract
entered
into
between
the
provider
and
the
department
32
of
health
and
human
services
under
chapter
125
or
an
33
administrative
services
organization
as
defined
in
section
34
225A.1
.
35
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2673
Sec.
110.
Section
321J.25,
subsection
2,
unnumbered
1
paragraph
1,
Code
2024,
is
amended
to
read
as
follows:
2
A
substance
use
disorder
awareness
program
is
established
3
in
each
of
the
regions
established
by
the
director
of
health
4
and
human
services
pursuant
to
section
125.12
behavioral
5
health
district
designated
pursuant
to
section
225A.4
.
The
6
program
shall
consist
of
an
insight
class
and
a
substance
7
use
disorder
evaluation,
which
shall
be
attended
by
the
8
participant,
to
discuss
issues
related
to
the
potential
9
consequences
of
substance
use
disorder.
The
parent
or
parents
10
of
the
participant
shall
also
be
encouraged
to
participate
11
in
the
program.
The
program
provider
shall
consult
with
the
12
participant
or
the
parents
of
the
participant
in
the
program
13
to
determine
the
timing
and
appropriate
level
of
participation
14
for
the
participant
and
any
participation
by
the
participant’s
15
parents.
The
program
may
also
include
a
supervised
educational
16
tour
by
the
participant
to
any
or
all
of
the
following:
17
Sec.
111.
Section
331.321,
subsection
1,
paragraph
e,
Code
18
2024,
is
amended
by
striking
the
paragraph.
19
Sec.
112.
Section
331.323,
subsection
1,
paragraph
a,
20
subparagraph
(7),
Code
2024,
is
amended
by
striking
the
21
subparagraph.
22
Sec.
113.
Section
331.381,
subsections
4
and
5,
Code
2024,
23
are
amended
to
read
as
follows:
24
4.
Comply
with
chapter
222
,
including
but
not
limited
to
25
sections
222.13
,
222.14
,
222.59
through
222.70
,
222.73
through
26
222.75
,
and
222.77
through
222.82
,
in
regard
to
the
care
of
27
persons
with
an
intellectual
disability.
28
5.
Comply
with
chapters
227,
229
and
230
,
including
but
not
29
limited
to
sections
227.11
,
227.14
,
229.42
,
230.25
,
230.27
,
and
30
230.35
,
in
regard
to
the
care
of
persons
with
mental
illness.
31
Sec.
114.
Section
331.382,
subsection
1,
paragraphs
e,
f,
32
and
g,
Code
2024,
are
amended
by
striking
the
paragraphs.
33
Sec.
115.
Section
331.382,
subsection
3,
Code
2024,
is
34
amended
by
striking
the
subsection.
35
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2673
Sec.
116.
Section
331.432,
subsection
3,
Code
2024,
is
1
amended
by
striking
the
subsection.
2
Sec.
117.
Section
331.502,
subsection
10,
Code
2024,
is
3
amended
by
striking
the
subsection.
4
Sec.
118.
Section
331.502,
subsection
12,
Code
2024,
is
5
amended
to
read
as
follows:
6
12.
Carry
out
duties
relating
to
the
hospitalization
and
7
support
of
persons
with
mental
illness
as
provided
in
sections
8
229.42,
230.3
,
230.11
,
and
230.15
,
230.21
,
230.22
,
230.25
,
and
9
230.26
.
10
Sec.
119.
Section
331.552,
subsection
13,
Code
2024,
is
11
amended
by
striking
the
subsection.
12
Sec.
120.
Section
331.756,
subsections
25,
38,
and
41,
Code
13
2024,
are
amended
by
striking
the
subsections.
14
Sec.
121.
Section
331.910,
subsection
2,
Code
2024,
is
15
amended
by
adding
the
following
new
paragraph:
16
NEW
PARAGRAPH
.
0a.
“Administrative
services
organization”
17
means
the
same
as
defined
in
section
225A.1.
18
Sec.
122.
Section
331.910,
subsection
2,
paragraph
d,
Code
19
2024,
is
amended
by
striking
the
paragraph.
20
Sec.
123.
Section
331.910,
subsection
3,
paragraphs
a
and
c,
21
Code
2024,
are
amended
to
read
as
follows:
22
a.
A
region
An
administrative
services
organization
may
23
contract
with
a
receiving
agency
in
a
bordering
state
to
secure
24
substance
use
disorder
or
mental
health
care
and
treatment
25
under
this
subsection
for
persons
who
receive
substance
use
26
disorder
or
mental
health
care
and
treatment
pursuant
to
27
section
125.33,
125.91
,
229.2
,
or
229.22
through
a
region
.
28
c.
A
region
An
administrative
services
organization
may
29
contract
with
a
sending
agency
in
a
bordering
state
to
provide
30
care
and
treatment
under
this
subsection
for
residents
of
31
the
bordering
state
in
approved
substance
use
disorder
and
32
mental
health
care
and
treatment
hospitals,
centers,
and
33
facilities
in
this
state,
except
that
care
and
treatment
shall
34
not
be
provided
for
residents
of
the
bordering
state
who
are
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involved
in
criminal
proceedings
substantially
similar
to
the
1
involvement
described
in
paragraph
“b”
.
2
Sec.
124.
Section
347.16,
subsection
3,
Code
2024,
is
3
amended
to
read
as
follows:
4
3.
Care
and
treatment
may
be
furnished
in
a
county
public
5
hospital
to
any
sick
or
injured
person
who
has
residence
6
outside
the
county
which
maintains
the
hospital,
subject
to
7
such
policies
and
rules
as
the
board
of
hospital
trustees
8
may
adopt.
If
care
and
treatment
is
provided
under
this
9
subsection
to
a
person
who
is
indigent,
the
person’s
county
of
10
residence,
as
defined
in
section
225C.61
331.190
,
shall
pay
to
11
the
board
of
hospital
trustees
the
fair
and
reasonable
cost
of
12
the
care
and
treatment
provided
by
the
county
public
hospital
13
unless
the
cost
of
the
indigent
person’s
care
and
treatment
is
14
otherwise
provided
for.
If
care
and
treatment
is
provided
to
15
an
indigent
person
under
this
subsection
,
the
county
public
16
hospital
furnishing
the
care
and
treatment
shall
immediately
17
notify,
by
regular
mail,
the
auditor
of
the
county
of
residence
18
of
the
indigent
person
of
the
provision
of
care
and
treatment
19
to
the
indigent
person
including
care
and
treatment
provided
20
by
a
county
through
the
county’s
mental
health
and
disability
21
services
system
implemented
under
chapter
225C
behavioral
22
health
service
system
established
in
section
225A.3
.
23
Sec.
125.
Section
423.3,
subsection
18,
paragraph
d,
Code
24
2024,
is
amended
to
read
as
follows:
25
d.
Community
mental
health
centers
accredited
by
the
26
department
of
health
and
human
services
pursuant
to
chapter
27
225C
section
225A.3
.
28
Sec.
126.
Section
426B.1,
subsection
2,
Code
2024,
is
29
amended
to
read
as
follows:
30
2.
Moneys
shall
be
distributed
from
the
property
tax
relief
31
fund
to
the
mental
health
and
disability
services
regional
32
service
system
for
mental
health
and
disability
services,
33
behavioral
health
fund
established
in
section
225A.7
in
34
accordance
with
the
appropriations
made
to
the
fund
and
other
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statutory
requirements.
1
Sec.
127.
Section
437A.8,
subsection
4,
paragraph
d,
Code
2
2024,
is
amended
to
read
as
follows:
3
d.
(1)
Notwithstanding
paragraph
“a”
,
a
taxpayer
who
owns
4
or
leases
a
new
electric
power
generating
plant
and
who
has
5
no
other
operating
property
in
the
state
of
Iowa
except
for
6
operating
property
directly
serving
the
new
electric
power
7
generating
plant
as
described
in
section
437A.16
shall
pay
8
the
replacement
generation
tax
associated
with
the
allocation
9
of
the
local
amount
to
the
county
treasurer
of
the
county
in
10
which
the
local
amount
is
located
and
shall
remit
the
remaining
11
replacement
generation
tax,
if
any,
to
the
director
according
12
to
paragraph
“a”
for
remittance
of
the
tax
to
county
treasurers.
13
The
director
shall
notify
each
taxpayer
on
or
before
August
31
14
following
a
tax
year
of
its
remaining
replacement
generation
15
tax
to
be
remitted
to
the
director.
All
remaining
replacement
16
generation
tax
revenues
received
by
the
director
shall
be
17
deposited
in
the
property
tax
relief
fund
created
in
section
18
426B.1
,
and
shall
be
distributed
as
provided
in
section
426B.2
.
19
(2)
If
a
taxpayer
has
paid
an
amount
of
replacement
tax,
20
penalty,
or
interest
which
was
deposited
into
the
property
tax
21
relief
fund
and
which
was
not
due,
all
of
the
provisions
of
22
section
437A.14,
subsection
1
,
paragraph
“b”
,
shall
apply
with
23
regard
to
any
claim
for
refund
or
credit
filed
by
the
taxpayer.
24
The
director
shall
have
sole
discretion
as
to
whether
the
25
erroneous
payment
will
be
refunded
to
the
taxpayer
or
credited
26
against
any
replacement
tax
due,
or
to
become
due,
from
the
27
taxpayer
that
would
be
subject
to
deposit
in
the
property
tax
28
relief
fund.
29
Sec.
128.
Section
437A.15,
subsection
3,
paragraph
f,
Code
30
2024,
is
amended
to
read
as
follows:
31
f.
Notwithstanding
the
provisions
of
this
section
,
if
32
a
taxpayer
is
a
municipal
utility
or
a
municipal
owner
of
33
an
electric
power
facility
financed
under
the
provisions
34
of
chapter
28F
or
476A
,
the
assessed
value,
other
than
the
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local
amount,
of
a
new
electric
power
generating
plant
shall
1
be
allocated
to
each
taxing
district
in
which
the
municipal
2
utility
or
municipal
owner
is
serving
customers
and
has
3
electric
meters
in
operation
in
the
ratio
that
the
number
of
4
operating
electric
meters
of
the
municipal
utility
or
municipal
5
owner
located
in
the
taxing
district
bears
to
the
total
number
6
of
operating
electric
meters
of
the
municipal
utility
or
7
municipal
owner
in
the
state
as
of
January
1
of
the
tax
year.
8
If
the
municipal
utility
or
municipal
owner
of
an
electric
9
power
facility
financed
under
the
provisions
of
chapter
28F
10
or
476A
has
a
new
electric
power
generating
plant
but
the
11
municipal
utility
or
municipal
owner
has
no
operating
electric
12
meters
in
this
state,
the
municipal
utility
or
municipal
owner
13
shall
pay
the
replacement
generation
tax
associated
with
the
14
new
electric
power
generating
plant
allocation
of
the
local
15
amount
to
the
county
treasurer
of
the
county
in
which
the
local
16
amount
is
located
and
shall
remit
the
remaining
replacement
17
generation
tax,
if
any,
to
the
director
at
the
times
contained
18
in
section
437A.8,
subsection
4
,
for
remittance
of
the
tax
to
19
the
county
treasurers.
All
remaining
replacement
generation
20
tax
revenues
received
by
the
director
shall
be
deposited
in
the
21
property
tax
relief
behavioral
health
fund
created
established
22
in
section
426B.1,
and
shall
be
distributed
as
provided
in
23
section
426B.2
225A.7
.
24
Sec.
129.
Section
483A.24,
subsection
7,
Code
2024,
is
25
amended
to
read
as
follows:
26
7.
A
license
shall
not
be
required
of
minor
pupils
of
the
27
Iowa
school
for
the
deaf
or
of
minor
residents
of
other
state
28
institutions
under
the
control
of
the
department
of
health
29
and
human
services.
In
addition,
a
person
who
is
on
active
30
duty
with
the
armed
forces
of
the
United
States,
on
authorized
31
leave
from
a
duty
station
located
outside
of
this
state,
and
32
a
resident
of
the
state
of
Iowa
shall
not
be
required
to
33
have
a
license
to
hunt
or
fish
in
this
state.
The
military
34
person
shall
carry
the
person’s
leave
papers
and
a
copy
of
35
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the
person’s
current
earnings
statement
showing
a
deduction
1
for
Iowa
income
taxes
while
hunting
or
fishing.
In
lieu
of
2
carrying
the
person’s
earnings
statement,
the
military
person
3
may
also
claim
residency
if
the
person
is
registered
to
vote
4
in
this
state.
If
a
deer
or
wild
turkey
is
taken,
the
military
5
person
shall
immediately
contact
a
state
conservation
officer
6
to
obtain
an
appropriate
tag
to
transport
the
animal.
A
7
license
shall
not
be
required
of
residents
of
county
care
8
facilities
or
any
person
who
is
receiving
supplementary
9
assistance
under
chapter
249
.
10
Sec.
130.
Section
602.8102,
subsection
39,
Code
2024,
is
11
amended
to
read
as
follows:
12
39.
Refer
persons
applying
for
voluntary
admission
to
a
13
community
mental
health
center
accredited
by
the
department
14
of
health
and
human
services
under
section
225A.3,
for
a
15
preliminary
diagnostic
evaluation
as
provided
in
section
16
225C.16,
subsection
2
.
17
Sec.
131.
Section
714.8,
subsection
12,
Code
2024,
is
18
amended
to
read
as
follows:
19
12.
Knowingly
transfers
or
assigns
a
legal
or
equitable
20
interest
in
property,
as
defined
in
section
702.14
,
for
less
21
than
fair
consideration,
with
the
intent
to
obtain
public
22
assistance
under
chapters
16
,
35B
,
and
35D
,
and
347B
,
or
Title
23
VI,
subtitles
2
through
6
,
or
accepts
a
transfer
of
or
an
24
assignment
of
a
legal
or
equitable
interest
in
property,
as
25
defined
in
section
702.14
,
for
less
than
fair
consideration,
26
with
the
intent
of
enabling
the
party
transferring
the
property
27
to
obtain
public
assistance
under
chapters
16
,
35B
,
and
35D
,
28
and
347B
,
or
Title
VI,
subtitles
2
through
6
.
A
transfer
or
29
assignment
of
property
for
less
than
fair
consideration
within
30
one
year
prior
to
an
application
for
public
assistance
benefits
31
shall
be
evidence
of
intent
to
transfer
or
assign
the
property
32
in
order
to
obtain
public
assistance
for
which
a
person
is
33
not
eligible
by
reason
of
the
amount
of
the
person’s
assets.
34
If
a
person
is
found
guilty
of
a
fraudulent
practice
in
the
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transfer
or
assignment
of
property
under
this
subsection
the
1
maximum
sentence
shall
be
the
penalty
established
for
a
serious
2
misdemeanor
and
sections
714.9
,
714.10
,
and
714.11
shall
not
3
apply.
4
Sec.
132.
Section
812.6,
subsection
1,
Code
2024,
is
amended
5
to
read
as
follows:
6
1.
If
the
court
finds
the
defendant
does
not
pose
a
danger
7
to
the
public
peace
and
safety,
is
otherwise
qualified
for
8
pretrial
release,
and
is
willing
to
cooperate
with
treatment,
9
the
court
shall
order,
as
a
condition
of
pretrial
release,
10
that
the
defendant
obtain
mental
health
treatment
designed
to
11
restore
the
defendant
to
competency.
The
costs
of
treatment
12
pursuant
to
this
subsection
shall
be
paid
by
the
mental
13
health
and
disability
services
region
for
the
county
of
the
14
defendant’s
residency
pursuant
to
chapter
225C
regardless
of
15
whether
the
defendant
meets
financial
eligibility
requirements
16
under
section
225C.62
or
225C.66
an
administrative
services
17
organization
designated
pursuant
to
section
225A.4
.
18
Sec.
133.
Section
904.201,
subsection
8,
Code
2024,
is
19
amended
to
read
as
follows:
20
8.
Chapter
230
governs
the
determination
of
costs
and
21
charges
for
the
care
and
treatment
of
persons
with
mental
22
illness
admitted
to
the
forensic
psychiatric
hospital
,
23
except
that
charges
for
the
care
and
treatment
of
any
person
24
transferred
to
the
forensic
psychiatric
hospital
from
an
adult
25
correctional
institution
or
from
a
state
training
school
shall
26
be
paid
entirely
from
state
funds
.
Charges
for
all
other
27
persons
at
the
forensic
psychiatric
hospital
shall
be
billed
to
28
the
respective
counties
at
the
same
ratio
as
for
patients
at
29
state
mental
health
institutes
under
section
230.20.
30
Sec.
134.
REPEAL.
Chapters
142A,
225C,
227,
230A,
and
347B,
31
Code
2024,
are
repealed.
32
Sec.
135.
REPEAL.
Sections
125.1,
125.3,
125.7,
125.9,
33
125.10,
125.12,
125.25,
125.32A,
125.34,
125.37,
125.38,
34
125.39,
125.40,
125.41,
125.42,
125.43,
125.43A,
125.46,
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125.48,
125.54,
125.55,
125.58,
125.59,
125.60,
135B.18,
1
218.99,
222.59,
222.60,
222.61,
222.62,
222.63,
222.64,
222.65,
2
222.66,
222.67,
222.68,
222.69,
222.70,
222.74,
222.75,
225.10,
3
225.19,
225.21,
226.45,
229.42,
230.1A,
230.2,
230.3,
230.4,
4
230.5,
230.6,
230.9,
230.12,
230.16,
230.17,
230.18,
230.19,
5
230.20,
230.21,
230.22,
230.25,
230.26,
230.27,
426B.2,
426B.4,
6
and
426B.5,
Code
2024,
are
repealed.
7
Sec.
136.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
is
8
directed
to
correct
internal
references
in
the
Code
and
in
any
9
enacted
legislation
as
necessary
due
to
the
enactment
of
this
10
division
of
this
Act.
11
Sec.
137.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
12
effect
July
1,
2025.
13
DIVISION
III
14
AGING
AND
DISABILITY
15
Sec.
138.
Section
231.3,
Code
2024,
is
amended
to
read
as
16
follows:
17
231.3
State
policy
and
objectives.
18
1.
The
general
assembly
declares
that
it
is
the
policy
of
19
the
state
to
work
toward
attainment
of
the
following
objectives
20
for
Iowa’s
older
individuals
and
individuals
with
disabilities
:
21
1.
a.
An
adequate
income.
22
2.
b.
Access
to
physical
and
mental
health
care
and
23
long-term
living
and
community
support
services
without
regard
24
to
economic
status.
25
3.
c.
Suitable
and
affordable
housing
that
reflects
the
26
needs
of
older
individuals.
27
4.
d.
Access
to
comprehensive
information
and
a
community
28
navigation
system
providing
all
available
options
related
to
29
long-term
living
and
community
support
services
that
assist
30
older
individuals
in
the
preservation
of
personal
assets
and
31
the
ability
to
entirely
avoid
or
significantly
delay
reliance
32
on
entitlement
programs.
33
5.
e.
Full
restorative
services
for
those
who
require
34
institutional
care,
and
a
comprehensive
array
of
long-term
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living
and
community
support
services
adequate
to
sustain
older
1
people
in
their
communities
and,
whenever
possible,
in
their
2
homes,
including
support
for
caregivers.
3
6.
f.
Pursuit
of
meaningful
activity
within
the
widest
4
range
of
civic,
cultural,
educational,
recreational,
and
5
employment
opportunities.
6
7.
g.
Suitable
community
transportation
systems
to
assist
7
in
the
attainment
of
independent
movement.
8
8.
h.
Freedom,
independence,
and
the
free
exercise
of
9
individual
initiative
in
planning
and
managing
their
own
lives.
10
9.
i.
Freedom
from
abuse,
neglect,
and
exploitation.
11
2.
The
general
assembly
declares
that
the
state
of
Iowa
12
recognizes
a
brain
injury
as
a
disability,
and
each
agency
and
13
subdivision
of
this
state
shall
recognize
a
brain
injury
as
a
14
distinct
disability.
15
3.
It
is
the
policy
of
this
state
that
each
state
agency
16
shall
make
reasonable
efforts
to
identify
those
persons
with
17
brain
injuries
among
the
persons
served
by
the
state
agency.
18
Sec.
139.
Section
231.4,
subsection
1,
Code
2024,
is
amended
19
by
adding
the
following
new
paragraph:
20
NEW
PARAGRAPH
.
0c.
“Brain
injury”
means
the
same
as
defined
21
in
section
135.22.
22
Sec.
140.
Section
231.4,
subsection
1,
paragraph
d,
Code
23
2024,
is
amended
to
read
as
follows:
24
d.
“Commission”
means
the
commission
on
aging.
“Council”
25
means
the
council
on
health
and
human
services
created
in
26
section
217.2.
27
Sec.
141.
Section
231.14,
Code
2024,
is
amended
to
read
as
28
follows:
29
231.14
Commission
Council
duties
and
authority.
30
1.
The
commission
is
the
policymaking
body
of
the
sole
state
31
agency
responsible
for
administration
of
the
federal
Act.
The
32
commission
council
shall
do
all
of
the
following
:
33
a.
1.
Approve
Make
recommendations
to
the
department
34
regarding
approval
of
the
state
plan
on
aging
developed
under
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section
231.31
and
area
plans
on
aging
,
developed
under
section
1
231.33
.
2
b.
2.
Adopt
Recommend
policies
to
coordinate
state
3
activities
related
to
the
purposes
of
this
chapter
.
4
c.
3.
Serve
as
an
effective
and
visible
advocate
for
older
5
individuals
and
individuals
with
disabilities
by
establishing
6
recommending
policies
for
reviewing
and
commenting
upon
7
all
state
plans,
budgets,
and
policies
which
affect
older
8
individuals
and
for
providing
technical
assistance
to
any
9
agency,
organization,
association,
or
individual
representing
10
the
needs
of
older
individuals
with
disabilities
.
11
d.
Divide
the
state
into
distinct
planning
and
service
12
areas
after
considering
the
geographical
distribution
of
13
older
individuals
in
the
state,
the
incidence
of
the
need
14
for
supportive
services,
nutrition
services,
multipurpose
15
senior
centers,
and
legal
services,
the
distribution
of
older
16
individuals
who
have
low
incomes
residing
in
such
areas,
the
17
distribution
of
resources
available
to
provide
such
services
18
or
centers,
the
boundaries
of
existing
areas
within
the
19
state
which
are
drawn
for
the
planning
or
administration
of
20
supportive
services
programs,
the
location
of
units
of
general
21
purpose,
local
government
within
the
state,
and
any
other
22
relevant
factors.
23
e.
Designate
for
each
planning
and
service
area
a
public
or
24
private
nonprofit
agency
or
organization
as
the
area
agency
on
25
aging
for
that
area.
The
commission
may
revoke
the
designation
26
of
an
area
agency
on
aging
pursuant
to
section
231.32
.
27
f.
4.
Adopt
policies
to
assure
Make
recommendations
to
28
ensure
that
the
department
will
take
into
account
the
views
29
of
older
individuals
and
individuals
with
disabilities
in
the
30
development
of
policy.
31
g.
Adopt
a
method
for
the
distribution
of
federal
32
Act
and
state
funds
taking
into
account,
to
the
maximum
33
extent
feasible,
the
best
available
data
on
the
geographic
34
distribution
of
older
individuals
in
the
state,
and
publish
the
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method
for
review
and
comment.
1
h.
5.
Adopt
Recommend
policies
and
measures
to
assure
2
ensure
that
preference
will
be
given
to
providing
services
to
3
older
individuals
and
individuals
with
disabilities
with
the
4
greatest
economic
or
social
needs,
with
particular
attention
to
5
low-income
minority
older
individuals,
older
individuals
with
6
limited
English
proficiency,
and
older
individuals
residing
in
7
rural
areas.
8
i.
6.
Adopt
Recommend
policies
to
administer
state
programs
9
authorized
by
this
chapter
.
10
j.
7.
Adopt
Recommend
policies
and
administrative
rules
11
pursuant
to
chapter
17A
that
support
the
capabilities
of
the
12
area
agencies
on
aging
and
the
aging
and
disabilities
resource
13
centers
to
serve
older
individuals
and
persons
individuals
14
with
disabilities
experiencing
Alzheimer’s
disease
or
related
15
dementias.
16
2.
The
commission
shall
adopt
administrative
rules
pursuant
17
to
chapter
17A
to
administer
the
duties
specified
in
this
18
chapter
and
in
all
other
chapters
under
the
department’s
19
jurisdiction.
20
Sec.
142.
Section
231.21,
Code
2024,
is
amended
to
read
as
21
follows:
22
231.21
Administration
of
chapter
——
department
of
health
and
23
human
services.
24
The
department
of
health
and
human
services
shall
administer
25
this
chapter
under
the
policy
direction
of
the
commission
26
on
aging
consider
the
recommendations
of
the
council
when
27
administering
this
chapter
.
28
Sec.
143.
Section
231.23,
Code
2024,
is
amended
to
read
as
29
follows:
30
231.23
Department
——
duties
and
authority.
31
The
department
shall:
32
1.
Develop
and
administer
a
Administer
the
state
plan
on
33
aging
developed
pursuant
to
section
231.31
.
34
2.
Assist
the
commission
in
the
review
and
approval
of
35
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Review
and
approve
area
plans
developed
under
section
231.33
.
1
3.
Pursuant
to
commission
policy,
coordinate
Coordinate
2
state
activities
related
to
the
purposes
of
this
chapter
3
and
all
other
chapters
under
the
department’s
jurisdiction
.
4
State
activities
shall
include,
at
a
minimum,
home
and
5
community-based
services
such
as
employment
support,
community
6
living,
and
service
coordination.
7
4.
Advocate
for
older
individuals
and
individuals
with
8
disabilities
by
reviewing
and
commenting
upon
all
state
plans,
9
budgets,
laws,
rules,
regulations,
and
policies
which
affect
10
older
individuals
or
individuals
with
disabilities
and
by
11
providing
technical
assistance
to
any
agency,
organization,
12
association,
or
individual
representing
the
needs
of
older
13
individuals
or
individuals
with
disabilities
.
14
5.
Assist
the
commission
in
dividing
Divide
the
state
into
15
distinct
planning
and
service
areas
after
considering
the
16
geographical
distribution
of
older
individuals
and
individuals
17
with
disabilities
in
the
state,
the
incidence
of
the
need
18
for
supportive
services,
nutrition
services,
multipurpose
19
senior
centers,
and
legal
services,
the
distribution
of
older
20
individuals
and
individuals
with
disabilities
with
low
income
21
residing
in
such
areas,
the
distribution
of
resources
available
22
to
provide
such
services
or
centers,
the
boundaries
of
existing
23
areas
within
the
state
which
are
drawn
for
the
planning
or
24
administration
of
supportive
services
programs,
the
location
of
25
units
of
general
purpose,
local
government
within
the
state,
26
and
any
other
relevant
factors
.
27
6.
Assist
the
commission
in
designating
Designate
for
each
28
area
a
public
or
private
nonprofit
agency
or
organization
as
29
the
area
agency
on
aging
for
that
area.
The
department
may
30
revoke
the
designation
of
an
area
agency
on
aging
pursuant
to
31
section
231.32.
32
7.
Pursuant
to
commission
policy,
take
Take
into
account
the
33
views
of
older
Iowans
and
Iowans
with
disabilities
.
34
8.
Assist
the
commission
in
adopting
Adopt
a
method
for
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the
distribution
of
funds
available
from
the
federal
Act
1
and
state
appropriations
and
allocations
that
takes
into
2
account,
to
the
extent
feasible,
the
best
available
data
on
the
3
geographic
distribution
of
older
individuals
and
individuals
4
with
disabilities
in
the
state
.
5
9.
Assist
the
commission
in
assuring
Adopt
policies
and
6
measures
to
ensure
that
preference
will
be
given
to
providing
7
services
to
older
individuals
and
individuals
with
disabilities
8
with
the
greatest
economic
or
social
needs,
with
particular
9
attention
to
low-income
minority
older
individuals,
older
10
individuals
with
limited
English
proficiency,
and
older
11
individuals
residing
in
rural
areas.
12
10.
Assist
the
commission
in
developing,
adopting,
and
13
enforcing
Develop,
adopt,
and
enforce
administrative
rules,
14
including
by
issuing
necessary
forms
and
procedures
,
to
15
administer
the
duties
specified
in
this
chapter
.
16
11.
Apply
for,
receive,
and
administer
grants,
devises,
17
donations,
and
gifts
,
or
bequests
of
real
or
personal
property
18
from
any
source
to
conduct
projects
consistent
with
the
19
purposes
of
the
department.
Notwithstanding
section
8.33
,
20
moneys
received
by
the
department
pursuant
to
this
section
are
21
not
subject
to
reversion
to
the
general
fund
of
the
state.
22
12.
Administer
state
authorized
programs.
23
13.
Establish
a
procedure
for
an
area
agency
on
aging
to
24
use
in
selection
of
members
of
the
agency’s
board
of
directors.
25
The
selection
procedure
shall
be
incorporated
into
the
bylaws
26
of
the
board
of
directors.
27
14.
Adopt
rules
pursuant
to
chapter
17A
that
support
the
28
capabilities
of
the
area
agencies
on
aging,
and
aging
and
29
disabilities
resource
centers,
to
serve
older
individuals
and
30
individuals
with
disabilities.
31
Sec.
144.
Section
231.23A,
subsections
1
and
3,
Code
2024,
32
are
amended
to
read
as
follows:
33
1.
Services
for
older
individuals,
persons
with
34
disabilities
eighteen
years
of
age
and
older,
family
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caregivers,
and
veterans
as
defined
by
the
department
in
the
1
most
current
version
of
the
department’s
reporting
manual
and
2
pursuant
to
the
federal
Act
and
regulations.
3
3.
The
aging
Aging
and
disability
resource
center
centers
.
4
Sec.
145.
Section
231.23A,
Code
2024,
is
amended
by
adding
5
the
following
new
subsection:
6
NEW
SUBSECTION
.
7A.
Services
and
supports
available
to
7
individuals
with
disabilities
including
but
not
limited
to
8
individuals
with
mental
illness,
an
intellectual
disability
or
9
other
developmental
disability,
or
a
brain
injury.
10
Sec.
146.
Section
231.31,
Code
2024,
is
amended
to
read
as
11
follows:
12
231.31
State
plan
on
aging.
13
The
department
shall
develop
,
and
submit
to
the
commission
14
on
aging
for
approval,
a
multiyear
state
plan
on
aging.
15
The
state
plan
on
aging
shall
meet
all
applicable
federal
16
requirements.
17
Sec.
147.
Section
231.32,
Code
2024,
is
amended
to
read
as
18
follows:
19
231.32
Criteria
for
designation
of
area
agencies
on
aging.
20
1.
The
commission
department
shall
designate
an
area
21
agency
on
aging
for
each
planning
and
service
area.
The
22
commission
shall
continue
the
designation
shall
continue
until
23
an
area
agency
on
aging’s
designation
is
removed
for
cause
as
24
determined
by
the
commission
department
,
until
the
time
of
25
renewal
or
the
annual
update
of
an
area
plan,
until
the
agency
26
voluntarily
withdraws
as
an
area
agency
on
aging,
or
until
a
27
change
in
the
designation
of
planning
and
service
areas
or
area
28
agencies
on
aging
is
required
by
state
or
federal
law.
In
that
29
event,
the
commission
department
shall
proceed
in
accordance
30
with
subsections
2,
3,
and
4
.
Designated
area
agencies
on
31
aging
shall
comply
with
the
requirements
of
the
federal
Act.
32
2.
The
commission
department
shall
designate
an
area
33
agency
on
aging
to
serve
each
planning
and
service
area,
after
34
consideration
of
the
views
offered
by
units
of
general
purpose
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local
government.
An
area
agency
on
aging
may
be:
1
a.
An
established
office
of
aging
which
is
operating
within
2
a
planning
and
service
area
designated
by
the
commission
3
department
.
4
b.
Any
office
or
agency
of
a
unit
of
general
purpose
local
5
government,
which
is
designated
to
function
only
for
the
6
purpose
of
serving
as
an
area
agency
on
aging
by
the
chief
7
elected
official
of
such
unit.
8
c.
Any
office
or
agency
designated
by
the
appropriate
9
chief
elected
officials
of
any
combination
of
units
of
10
general
purpose
local
government
to
act
only
on
behalf
of
such
11
combination
for
such
purpose.
12
d.
Any
public
or
nonprofit
private
agency
in
a
planning
and
13
service
area
or
any
separate
organizational
unit
within
such
14
agency
which
is
under
the
supervision
or
direction
for
this
15
purpose
of
the
department
and
which
can
and
will
engage
only
in
16
the
planning
or
provision
of
a
broad
range
of
long-term
living
17
and
community
support
services
or
nutrition
services
within
the
18
planning
and
service
area.
19
3.
When
the
commission
department
designates
a
new
area
20
agency
on
aging
,
the
commission
department
shall
give
the
right
21
of
first
refusal
to
a
unit
of
general
purpose
local
government
22
if:
23
a.
Such
unit
can
meet
the
requirements
of
subsection
1
.
24
b.
The
boundaries
of
such
a
unit
and
the
boundaries
of
the
25
area
are
reasonably
contiguous.
26
4.
Each
area
agency
on
aging
shall
provide
assurance,
27
determined
adequate
by
the
commission
department
,
that
the
28
area
agency
on
aging
has
the
ability
to
develop
an
area
plan
29
and
to
carry
out,
directly
or
through
contractual
or
other
30
arrangements,
a
program
in
accordance
with
the
plan
within
the
31
planning
and
service
area.
In
designating
an
area
agency
on
32
aging
within
the
planning
and
service
area,
the
commission
33
department
shall
give
preference
to
an
established
office
of
34
aging,
unless
the
commission
department
finds
that
no
such
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office
within
the
planning
and
service
area
has
the
capacity
to
1
carry
out
the
area
plan.
2
5.
Upon
designation,
an
area
agency
on
aging
shall
be
3
considered
an
instrumentality
of
the
state
and
shall
adhere
to
4
all
state
and
federal
mandates
applicable
to
an
instrumentality
5
of
the
state.
6
Sec.
148.
Section
231.33,
subsections
1
and
13,
Code
2024,
7
are
amended
to
read
as
follows:
8
1.
Develop
and
administer
an
area
plan
on
aging
approved
by
9
the
commission
department
.
10
13.
Submit
all
fiscal
and
performance
reports
in
accordance
11
with
the
policies
of
the
commission
department
.
12
Sec.
149.
Section
231.56,
Code
2024,
is
amended
to
read
as
13
follows:
14
231.56
Services
and
programs.
15
The
department
shall
administer
long-term
living
and
16
community
support
services
and
programs
that
allow
older
17
individuals
and
individuals
with
disabilities
to
secure
and
18
maintain
maximum
independence
and
dignity
in
a
home
environment
19
that
provides
for
self-care
with
appropriate
supportive
20
services,
assist
in
removing
individual
and
social
barriers
21
to
economic
and
personal
independence
for
older
individuals
22
and
individuals
with
disabilities
,
and
provide
a
continuum
of
23
care
for
older
individuals
and
individuals
with
disabilities.
24
Funds
appropriated
for
this
purpose
shall
be
allocated
based
25
on
administrative
rules
adopted
by
the
commission
department
26
pursuant
to
chapter
17A
.
The
department
shall
require
such
27
records
as
needed
adopt
rules
pursuant
to
chapter
17A
that
28
allow
the
department
to
collect
information
as
necessary
from
29
long-term
living
and
community
support
services,
program
30
providers,
and
patients
to
administer
this
section
.
31
Sec.
150.
Section
231.57,
Code
2024,
is
amended
to
read
as
32
follows:
33
231.57
Coordination
of
advocacy.
34
The
department
shall
administer
a
program
for
the
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coordination
of
information
and
assistance
provided
within
1
the
state
to
assist
older
individuals
and
individuals
with
2
disabilities,
and
their
caregivers
,
in
obtaining
and
protecting
3
their
rights
and
benefits.
State
and
local
agencies
providing
4
information
and
assistance
to
older
individuals
and
individuals
5
with
disabilities,
and
their
caregivers
,
in
seeking
their
6
rights
and
benefits
shall
cooperate
with
the
department
in
7
administering
this
program.
8
Sec.
151.
Section
231.58,
Code
2024,
is
amended
to
read
as
9
follows:
10
231.58
Long-term
living
coordination.
11
The
director
may
convene
meetings,
as
necessary,
of
the
12
director
and
the
director
of
inspections,
appeals,
and
13
licensing,
to
assist
in
the
coordination
of
policy,
service
14
delivery,
and
long-range
planning
relating
to
the
long-term
15
living
system
and
older
Iowans
and
Iowans
with
disabilities
16
in
the
state.
The
group
may
consult
with
individuals,
17
institutions,
and
entities
with
expertise
in
the
area
of
the
18
long-term
living
system
and
older
Iowans
and
Iowans
with
19
disabilities
,
as
necessary,
to
facilitate
the
group’s
efforts.
20
Sec.
152.
Section
231.64,
Code
2024,
is
amended
to
read
as
21
follows:
22
231.64
Aging
and
disability
resource
center
centers
.
23
1.
The
aging
and
disability
resource
center
shall
be
24
administered
by
the
department
consistent
with
the
federal
25
Act
.
The
department
shall
designate
area
agencies
on
aging
and
26
disability
resource
centers
to
establish,
in
consultation
with
27
other
stakeholders
including
organizations
representing
the
28
disability
community,
a
coordinated
local
aging
and
disability
29
service
system
for
providing
.
In
addition
to
services
required
30
by
the
department
by
rules
adopted
pursuant
to
chapter
17A,
31
aging
and
disability
resource
centers
shall
provide
for
all
of
32
the
following:
33
a.
Comprehensive
information,
referral,
and
assistance
34
regarding
the
full
range
of
available
public
and
private
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long-term
living
and
community
support
services,
options,
1
service
providers,
and
resources
within
a
community,
including
2
information
on
the
availability
of
integrated
long-term
care.
3
b.
Options
counseling
to
assist
individuals
in
assessing
4
their
existing
or
anticipated
long-term
care
needs
and
5
developing
and
implementing
a
plan
for
long-term
living
and
6
community
support
services
designed
to
meet
their
specific
7
needs
and
circumstances.
The
plan
for
long-term
living
8
and
community
support
services
may
include
support
with
9
person-centered
care
transitions
to
assist
consumers
and
family
10
caregivers
with
transitions
between
home
and
care
settings.
11
c.
Consumer
access
to
the
range
of
publicly-supported
12
long-term
living
and
community
support
services
for
which
13
consumers
may
be
eligible,
by
serving
as
a
convenient
point
14
of
entry
for
such
services.
The
aging
Aging
and
disability
15
resource
center
centers
shall
offer
information
online
and
16
be
available
via
a
toll-free
telephone
number,
electronic
17
communications,
and
in
person.
18
2.
The
following
entities
shall
be
eligible
to
be
designated
19
as
an
aging
and
disability
resource
center
by
the
department:
20
a.
An
area
agency
on
aging
established
on
or
before
June
30,
21
2024.
22
b.
A
public
or
private
nonprofit
agency,
or
any
separate
23
organizational
unit
within
the
public
or
private
nonprofit
24
agency,
that
has
the
capabilities
to
engage
in
the
planning
or
25
provision
of
aging
and
disability
services
only
as
directed
by
26
the
department.
27
2.
3.
The
aging
Aging
and
disability
resource
center
28
centers
shall
assist
older
individuals,
persons
individuals
29
with
disabilities
age
eighteen
or
older
,
family
caregivers,
30
and
people
who
inquire
about
or
request
assistance
on
behalf
31
of
members
of
these
groups,
as
they
seek
long-term
living
and
32
community
support
services.
33
4.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
34
to
implement
this
section.
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Sec.
153.
NEW
SECTION
.
231.75
Scope.
1
The
service
quality
standards
and
rights
in
this
subchapter
2
VII
shall
apply
to
any
person
with
an
intellectual
disability,
3
a
developmental
disability,
brain
injury,
or
chronic
mental
4
illness
who
receives
services
which
are
funded
in
whole
or
in
5
part
by
public
funds,
or
services
which
are
permitted
under
6
Iowa
law.
7
Sec.
154.
NEW
SECTION
.
231.76
Service
quality
standards.
8
As
the
state
participates
more
fully
in
funding
services
9
and
other
support
for
persons
with
an
intellectual
disability,
10
developmental
disability,
brain
injury,
or
chronic
mental
11
illness,
it
is
the
intent
of
the
general
assembly
that
the
12
state
shall
seek
to
attain
the
following
quality
standards
in
13
the
provision
of
services
and
other
supports:
14
1.
Provide
comprehensive
evaluation
and
diagnosis
adapted
15
to
the
cultural
background,
primary
language,
and
ethnic
origin
16
of
a
person.
17
2.
Provide
an
individual
treatment,
habilitation,
and
18
program
services
plan.
19
3.
Provide
treatment,
habilitation,
and
program
services
20
that
are
individualized,
flexible,
cost-effective,
and
produce
21
results.
22
4.
Provide
periodic
review
of
an
individual’s
treatment,
23
habilitation,
and
program
services
plan.
24
5.
Provide
for
the
least
restrictive
environment,
and
25
age-appropriate
services.
26
6.
Provide
appropriate
training
and
employment
27
opportunities
so
that
a
person’s
ability
to
contribute
to,
and
28
participate
in,
the
community
is
maximized.
29
7.
Provide
an
ongoing
process
to
determine
the
degree
of
30
access
to,
and
the
effectiveness
of,
the
services
and
other
31
supports
in
achieving
the
disability
service
outcomes
and
32
indicators
identified
by
the
department.
33
Sec.
155.
NEW
SECTION
.
231.77
Rights.
34
All
of
the
following
rights
shall
apply
to
a
person
with
an
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intellectual
disability,
a
developmental
disability,
a
brain
1
injury,
or
a
chronic
mental
illness:
2
1.
Wage
protection.
A
person
engaged
in
a
work
program
3
shall
be
paid
wages
commensurate
with
the
going
rate
for
4
comparable
work
and
productivity.
5
2.
Insurance
protection.
Pursuant
to
section
507B.4,
6
subsection
3,
paragraph
“g”
,
a
person
or
designated
group
7
of
persons
shall
not
be
unfairly
discriminated
against
for
8
purposes
of
insurance
coverage.
9
3.
Citizenship.
A
person
retains
the
right
to
citizenship
10
in
accordance
with
the
laws
of
the
state.
11
4.
Participation
in
planning
activities.
A
person
has
12
the
right
to
participate
in
the
formulation
of
an
individual
13
treatment,
habilitation,
and
program
plan
developed
for
the
14
person.
15
Sec.
156.
NEW
SECTION
.
231.78
Compliance.
16
1.
A
person’s
sole
remedy
for
a
violation
of
a
rule
adopted
17
by
the
department
to
implement
sections
231.75
through
231.77
18
shall
be
to
initiate
a
proceeding
with
the
department
by
19
request
pursuant
to
chapter
17A.
20
a.
Any
decision
of
the
department
shall
be
in
accordance
21
with
due
process
of
law.
A
person
or
party
who
is
aggrieved
or
22
adversely
affected
by
the
department’s
action
may
seek
judicial
23
review
pursuant
to
section
17A.19.
A
person
or
party
who
is
24
aggrieved
or
adversely
affected
by
a
final
judgment
of
the
25
district
court
may
appeal
under
section
17A.20.
26
b.
Either
the
department
or
a
party
in
interest
may
apply
27
to
the
Iowa
district
court
for
an
order
to
enforce
a
final
28
decision
of
the
department.
29
2.
Any
rules
adopted
by
the
department
to
implement
sections
30
231.76
and
231.77
shall
not
create
any
right,
entitlement,
31
property
or
liberty
right
or
interest,
or
private
cause
of
32
action
for
damages
against
the
state
or
a
political
subdivision
33
of
the
state,
or
for
which
the
state
or
a
political
subdivision
34
of
the
state
would
be
responsible.
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3.
Notwithstanding
subsection
1,
any
violation
of
section
1
231.77,
subsection
2,
shall
be
subject
to
enforcement
by
the
2
commissioner
of
insurance
pursuant
to
chapter
507B.
3
Sec.
157.
NEW
SECTION
.
231.79
Appeals
process.
4
The
department
shall
establish
an
appeals
process
by
which
a
5
person
or
the
person’s
representative
may
appeal
a
decision
of
6
the
department
concerning
the
provision
or
denial
of
aging
or
7
disability
services
to
the
person.
8
Sec.
158.
Section
231E.3,
Code
2024,
is
amended
to
read
as
9
follows:
10
231E.3
Definitions.
11
As
used
in
this
chapter
,
unless
the
context
otherwise
12
requires:
13
1.
“Client”
means
an
individual
for
whom
a
representative
14
payee
is
appointed.
15
2.
“Commission”
means
the
commission
on
aging.
16
3.
2.
“Conservator”
means
conservator
as
defined
in
section
17
633.3
.
18
4.
3.
“Court”
means
court
as
defined
in
section
633.3
.
19
5.
4.
“Department”
means
the
department
of
health
and
human
20
services.
21
6.
5.
“Director”
means
the
director
of
health
and
human
22
services.
23
7.
6.
“Guardian”
means
guardian
as
defined
in
section
24
633.3
.
25
8.
7.
“Incompetent”
means
incompetent
as
defined
in
section
26
633.3
.
27
9.
8.
“Local
office”
means
a
local
office
of
public
28
guardian.
29
10.
9.
“Local
public
guardian”
means
an
individual
under
30
contract
with
the
department
to
act
as
a
guardian,
conservator,
31
or
representative
payee.
32
11.
10.
“Public
guardian”
means
the
state
public
guardian
33
or
a
local
public
guardian.
34
12.
11.
“Public
guardianship
services”
means
guardianship,
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conservatorship,
or
representative
payee
services
provided
by
1
the
state
public
guardian
or
a
local
public
guardian.
2
13.
12.
“Representative
payee”
means
an
individual
3
appointed
by
a
government
entity
to
receive
funds
on
behalf
of
4
a
client
pursuant
to
federal
regulation.
5
14.
13.
“State
agency”
means
any
executive
department,
6
commission,
board,
institution,
division,
bureau,
office,
7
agency,
or
other
executive
entity
of
state
government.
8
15.
14.
“State
office”
means
the
state
office
of
public
9
guardian.
10
16.
15.
“State
public
guardian”
means
the
administrator
of
11
the
state
office
of
public
guardian.
12
17.
16.
“Ward”
means
the
individual
for
whom
a
guardianship
13
or
conservatorship
is
established.
14
Sec.
159.
REPEAL.
Sections
231.11,
231.12,
and
231.13,
Code
15
2024,
are
repealed.
16
Sec.
160.
CODE
EDITOR
DIRECTIVE.
The
Code
editor
is
17
directed
to
do
all
of
the
following:
18
1.
Entitle
Code
chapter
231
“Department
of
Health
and
Human
19
Services
——
Aging
and
Disability
Services”.
20
2.
Designate
sections
231.75
through
231.79,
as
enacted
in
21
this
division
of
this
Act,
as
subchapter
VII
entitled
“Bill
22
of
Rights
and
Service
Quality
Standards
for
Persons
with
an
23
Intellectual
Disability,
Developmental
Disability,
Brain
24
Injury,
or
Chronic
Mental
Illness”.
25
3.
Correct
internal
references
in
the
Code
and
in
any
26
enacted
legislation
as
necessary
due
to
the
enactment
of
this
27
division
of
this
Act.
28
Sec.
161.
EFFECTIVE
DATE.
The
following
take
effect
July
29
1,
2025:
30
1.
The
parts
of
the
sections
of
this
division
of
this
Act
31
amending
the
following:
32
a.
Section
231.3.
33
b.
Section
231.4,
subsection
1.
34
c.
Section
231.23,
subsections
4
and
7.
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d.
Section
231.23A,
subsection
1.
1
e.
Sections
231.56,
231.57,
and
231.58.
2
f.
Section
231.64,
subsection
2.
3
2.
The
parts
of
the
sections
of
this
division
of
this
Act
4
enacting
the
following:
sections
231.23A,
subsection
7A,
5
231.75,
231.76,
231.77,
231.78,
and
231.79.
6
DIVISION
IV
7
TRANSITION
PROVISIONS
8
Sec.
162.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
9
TRANSITION
OF
MENTAL
HEALTH
SERVICES,
ADDICTIVE
DISORDER
10
SERVICES,
AND
DISABILITY
SERVICES.
11
1.
For
purposes
of
this
division:
12
a.
“Administrative
services
organization”
means
the
same
13
as
defined
in
section
225A.1,
as
enacted
in
division
I
of
this
14
Act.
15
b.
“Behavioral
health
district”
means
the
same
as
defined
in
16
section
225A.1,
as
enacted
in
division
I
of
this
Act.
17
c.
“Department”
means
the
department
of
health
and
human
18
services.
19
d.
“District
behavioral
health
service
system
plan”
means
20
the
same
as
defined
in
section
225A.1,
as
enacted
in
division
21
I
of
this
Act.
22
e.
“Mental
health
and
disability
services
region”
means
the
23
same
as
defined
in
section
225C.2,
subsection
9.
24
f.
“State
behavioral
health
service
system”
means
the
state
25
behavioral
health
service
system
as
established
in
section
26
225A.3,
as
enacted
in
division
I
of
this
Act.
27
g.
“State
behavioral
health
service
system
plan”
means
the
28
same
as
defined
in
section
225A.1,
as
enacted
in
division
I
of
29
this
Act.
30
h.
“Transition
period”
means
the
period
beginning
on
the
31
date
of
enactment
of
this
division
of
this
Act
and
concluding
32
on
June
30,
2025.
33
2.
There
is
created
a
behavioral
health
service
system
under
34
the
control
of
the
department.
For
the
fiscal
year
beginning
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July
1,
2025,
and
each
succeeding
fiscal
year,
the
behavioral
1
health
service
system
shall
be
responsible
for
implementing
and
2
maintaining
a
statewide
system
of
prevention,
education,
early
3
intervention,
treatment,
recovery
support,
and
crisis
services
4
related
to
mental
health
and
addictive
disorders,
including
5
but
not
limited
to
substance
use,
tobacco
use,
and
problem
6
gambling.
For
the
fiscal
year
beginning
July
1,
2025,
and
each
7
succeeding
fiscal
year,
the
department’s
division
of
aging
8
and
disability
services
shall
be
responsible
for
disability
9
services.
10
3.
During
the
transition
period,
the
department
may
11
exercise
all
policymaking
functions
and
regulatory
powers
12
established
in
division
I
of
this
Act,
as
necessary
to
13
establish
the
state
behavioral
health
service
system.
14
4.
To
ensure
the
state
behavioral
health
service
system
15
and
the
division
of
aging
and
disability
services
are
able
to
16
operate
as
intended
at
the
conclusion
of
the
transition
period,
17
the
department
shall
perform
all
the
following
duties:
18
a.
Make
contracts
as
necessary
to
set
up
services
and
19
administrative
functions.
20
b.
Adopt
rules
as
necessary
to
establish
and
administer
the
21
state’s
behavioral
health
service
system.
22
c.
Establish
policies
as
necessary
to
ensure
efficient
23
implementation
and
operation
of
the
behavioral
health
service
24
system.
25
d.
Prepare
forms
necessary
for
the
implementation
and
26
administration
of
behavioral
health
services.
27
e.
Prepare
a
state
behavioral
health
service
system
plan
for
28
the
state
behavioral
health
service
system.
29
f.
Designate
behavioral
health
districts
on
or
before
30
August
1,
2024.
The
behavioral
health
district
designation
31
process
shall
include
an
opportunity
for
the
public
to
32
review
and
to
comment
on
proposed
behavioral
health
district
33
boundaries.
34
g.
Designate
an
administrative
services
organization
for
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each
behavioral
health
district
on
or
before
December
31,
2024.
1
h.
Review
and
approve
district
behavioral
health
service
2
system
plans
for
services
related
to
the
behavioral
health
3
service
system.
4
i.
Issue
all
necessary
licenses
and
certifications.
5
j.
Establish
contractual
rights,
privileges,
and
6
responsibilities
as
necessary
to
establish
and
implement
the
7
state
behavioral
health
service
system.
8
k.
Develop
and
implement
a
plan
to
ensure
that
persons
9
currently
receiving
disability
services
or
early
intervention,
10
treatment,
recovery
support,
or
crisis
services
related
11
to
mental
health
or
addictive
disorders,
including
but
not
12
limited
to
alcohol
use,
substance
use,
tobacco
use,
and
problem
13
gambling,
have
an
uninterrupted
continuum
of
care.
14
l.
Establish
a
central
data
repository
as
described
in
15
section
225A.6,
as
enacted
in
division
I
of
this
Act.
16
5.
If
the
department
determines
that
a
federal
waiver
or
17
authorization
is
necessary
to
administer
any
provision
of
this
18
division
of
this
Act
or
to
effectuate
the
state
behavioral
19
health
service
system
by
the
conclusion
of
the
transition
20
period,
the
department
shall
timely
request
the
federal
waiver
21
or
authorization.
Notwithstanding
any
other
effective
date
to
22
the
contrary,
a
provision
the
department
determines
requires
a
23
federal
waiver
or
authorization
shall
be
effective
only
upon
24
receipt
of
federal
approval
for
the
waiver
or
authorization.
25
6.
a.
On
or
before
July
1,
2024,
the
department
shall
26
publish
on
the
department’s
internet
site
an
initial
transition
27
plan
for
establishing
the
state
behavioral
health
service
28
system.
The
transition
plan
shall
describe,
at
a
minimum,
all
29
of
the
following:
30
(1)
All
tasks
that
require
completion
before
July
1,
2025.
31
The
description
of
tasks
shall
include
a
description
of
how
the
32
department
will
solicit
comments
from
stakeholders,
including
33
employees
of
the
department,
persons
served
by
the
department,
34
partners
of
the
department,
members
of
the
public,
and
members
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of
the
general
assembly,
and
a
detailed
timeline
for
the
1
completion
of
the
tasks
described.
2
(2)
The
proposed
organizational
structure
of
the
state
3
behavioral
health
service
system.
4
(3)
The
transition
of
service
delivery
sites
from
locations
5
where
people
currently
receive
behavioral
health
services
to
6
where
the
people
will
receive
behavioral
health
services
under
7
the
state
behavioral
health
service
system.
8
(4)
Procedures
for
the
transfer
and
reconciliation
of
9
budgeting
and
funding
between
the
mental
health
and
disability
10
services
regions
and
the
department.
11
(5)
A
description
of
how
responsibilities
for
disability
12
services
programs
will
be
transferred
from
current
program
13
administrators
to
the
department’s
division
of
aging
and
14
disability
services
by
the
end
of
the
transition
period.
15
(6)
Any
additional
known
tasks
that
may
require
completion
16
after
the
transition
on
July
1,
2025.
17
b.
The
transition
plan
published
under
paragraph
“a”
shall:
18
(1)
Be
updated
no
less
than
quarterly
during
the
transition
19
period
with
the
current
status
of
completing
the
tasks
20
identified
in
paragraph
“a”,
subparagraph
(1).
21
(2)
Describe
how
information
regarding
any
changes
in
22
service
delivery
will
be
provided
to
persons
receiving
services
23
from
the
mental
health
and
disability
services
regions
or
24
current
behavioral
health
care
providers
contracted
with
the
25
department.
26
(3)
Describe
how
the
transition
is
being
funded,
including
27
how
expenses
associated
with
the
transition
will
be
managed.
28
7.
a.
Before
the
end
of
the
transition
period,
the
29
governing
board
of
each
mental
health
and
disability
services
30
region
that
maintains
a
combined
account
pursuant
to
section
31
225C.58,
subsection
1,
shall
transfer
all
unencumbered
and
32
unobligated
moneys
remaining
in
the
combined
account
to
the
33
treasurer
of
state
for
deposit
into
the
behavioral
health
fund
34
as
established
in
section
225A.7
as
enacted
in
division
I
of
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this
Act.
1
b.
Before
the
end
of
the
transition
period,
each
county
2
which
maintains
a
county
mental
health
and
disability
services
3
fund
pursuant
to
section
225C.58,
subsection
1,
shall
transfer
4
all
unencumbered
and
unobligated
moneys
remaining
in
the
mental
5
health
and
disability
services
fund
to
the
treasurer
of
state
6
for
deposit
into
the
behavioral
health
fund
as
established
in
7
section
225A.7
as
enacted
in
division
I
of
this
Act.
8
c.
Moneys
in
the
behavioral
health
fund
as
established
9
in
section
225A.7
as
enacted
in
division
I
of
this
Act
are
10
appropriated
to
the
department
for
the
purposes
established
in
11
section
225A.7
as
enacted
in
division
I
of
this
Act,
and
as
12
otherwise
necessary
to
effectuate
this
division
of
this
Act.
13
8.
a.
All
debts,
claims,
or
other
liabilities
owed
to
a
14
county,
a
mental
health
and
disability
services
region,
or
15
the
state
due
to
services
rendered
pursuant
to
chapter
125,
16
222,
225,
225C,
226,
227,
229,
230,
or
230A,
Code
2024,
at
the
17
conclusion
of
the
transition
period
shall
remain
due
and
owing
18
after
the
transition
period
concludes.
19
b.
After
the
transition
period
concludes,
each
county
20
auditor
shall
collect
outstanding
debts,
claims,
or
other
21
liabilities
owed
to
the
county
for
services
rendered
pursuant
22
to
chapter
125,
222,
225,
225C,
226,
227,
229,
230,
or
230A,
23
Code
2024,
before
the
transition
period
concluded.
The
county
24
attorney
may
bring
a
judicial
action
as
necessary
to
collect
25
the
outstanding
debts,
claims,
or
other
liabilities.
26
9.
With
input
from
appropriate
stakeholders,
the
department
27
shall
identify
each
contract
that
will
be
impacted
by
mental
28
health
and
disability
services
being
transferred
to
the
state
29
behavioral
health
service
system,
or
by
responsibilities
30
being
transferred
to
the
department’s
division
of
aging
and
31
disabilities,
pursuant
to
this
Act.
On
or
before
June
30,
32
2025,
a
party
to
a
contract
identified
by
the
department
33
under
this
subsection
shall
exercise
the
option,
if
available
34
pursuant
to
the
terms
of
the
contract,
to
terminate
the
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contract
in
accordance
with
the
terms
of
the
contract
which
1
provide
for
termination.
Contracts
that
do
not
provide
for
2
termination
shall
not
be
renewed
or
extended
at
the
end
of
the
3
current
contract
term.
4
10.
A
mental
health
and
disability
services
region,
a
5
regional
administrator
as
defined
in
section
225C.55,
and
6
any
subdivision
of
the
state
shall
not
enter
into,
renew,
or
7
extend
any
contract
for
services
related
to
mental
health
and
8
disability
services
or
addictive
disorder
services
beyond
June
9
30,
2025.
10
Sec.
163.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
11
TRANSITION
FUNDING.
Notwithstanding
any
provision
of
law
to
12
the
contrary,
there
is
appropriated
from
the
region
incentive
13
fund
of
the
mental
health
and
disability
services
regional
14
service
fund
created
in
section
225C.7A,
subsection
8,
to
the
15
department
of
health
and
human
services
for
the
fiscal
year
16
beginning
July
1,
2024,
and
ending
June
30,
2025,
the
following
17
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
18
purposes
designated:
19
For
the
establishment
of
a
central
data
repository
as
20
described
in
section
225A.6,
subsection
1,
as
enacted
in
21
division
I
of
this
Act:
22
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
645,179
23
Notwithstanding
section
8.33,
moneys
appropriated
in
this
24
section
that
remain
unencumbered
or
unobligated
at
the
close
25
of
the
fiscal
year
shall
not
revert
to
the
credit
of
the
region
26
incentive
fund
of
the
mental
health
and
disability
services
27
regional
service
fund,
but
shall
be
credited
to
the
behavioral
28
health
fund
created
in
section
225A.7,
as
enacted
in
division
I
29
of
this
Act,
and
are
appropriated
to
the
department
of
health
30
and
human
services
for
expenditure
for
the
purposes
of
the
31
behavioral
health
fund.
32
Sec.
164.
EMERGENCY
RULES.
The
department
of
health
and
33
human
services
may
adopt
emergency
rules
under
section
17A.4,
34
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
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to
implement
the
provisions
of
this
division
of
this
Act
and
1
the
rules
shall
be
effective
immediately
upon
filing
unless
2
a
later
date
is
specified
in
the
rules.
Any
rules
adopted
3
in
accordance
with
this
section
shall
also
be
published
as
a
4
notice
of
intended
action
as
provided
in
section
17A.4.
5
Sec.
165.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
6
deemed
of
immediate
importance,
takes
effect
upon
enactment.
7
DIVISION
V
8
ELIMINATION
OF
SPECIAL
INTELLECTUAL
DISABILITY
UNITS
9
Sec.
166.
Section
222.1,
subsection
3,
Code
2024,
is
amended
10
by
striking
the
subsection.
11
Sec.
167.
Section
222.2,
subsection
8,
Code
2024,
is
amended
12
by
striking
the
subsection.
13
Sec.
168.
Section
222.5,
Code
2024,
is
amended
to
read
as
14
follows:
15
222.5
Preadmission
diagnostic
evaluation.
16
A
person
shall
not
be
eligible
for
admission
to
a
resource
17
center
or
a
special
unit
until
a
preadmission
diagnostic
18
evaluation
has
been
made
by
a
resource
center
or
a
special
unit
19
which
confirms
or
establishes
the
need
for
admission.
20
Sec.
169.
Section
222.7,
unnumbered
paragraph
1,
Code
2024,
21
is
amended
to
read
as
follows:
22
The
department
may
transfer
patients
from
one
state
resource
23
center
to
the
other
and
may
at
any
time
transfer
patients
from
24
the
resource
centers
to
the
hospitals
for
persons
with
mental
25
illness
,
or
transfer
patients
in
the
resource
centers
to
a
26
special
unit
or
vice
versa
.
The
department
may
also
transfer
27
patients
from
a
hospital
for
persons
with
mental
illness
to
a
28
resource
center
if
consent
is
given
or
obtained
as
follows:
29
Sec.
170.
Section
222.8,
Code
2024,
is
amended
to
read
as
30
follows:
31
222.8
Communications
by
patients.
32
Persons
admitted
to
the
resource
centers
or
a
special
33
unit
shall
have
all
reasonable
opportunity
and
facility
for
34
communication
with
their
friends.
Such
persons
shall
be
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permitted
to
write
and
send
letters,
provided
the
letters
1
contain
nothing
of
an
offensive
character.
Letters
written
by
2
any
patient
to
the
director
or
to
any
state
or
county
official
3
shall
be
forwarded
unopened.
4
Sec.
171.
Section
222.9,
Code
2024,
is
amended
to
read
as
5
follows:
6
222.9
Unauthorized
departures.
7
If
any
person
with
an
intellectual
disability
shall
depart
8
without
proper
authorization
from
a
resource
center
or
a
9
special
unit
,
it
shall
be
the
duty
of
the
superintendent
10
and
the
superintendent’s
assistants
and
all
peace
officers
11
of
any
county
in
which
such
patient
may
be
found
to
take
12
and
detain
the
patient
without
a
warrant
or
order
and
to
13
immediately
report
such
detention
to
the
superintendent
who
14
shall
immediately
provide
for
the
return
of
such
patient
to
the
15
resource
center
or
special
unit
.
16
Sec.
172.
Section
222.12,
subsection
1,
Code
2024,
is
17
amended
to
read
as
follows:
18
1.
Upon
the
death
of
a
patient
of
a
resource
center
or
19
special
unit
,
a
preliminary
investigation
of
the
death
shall
be
20
conducted
as
required
by
section
218.64
by
the
county
medical
21
examiner
as
provided
in
section
331.802
.
Such
a
preliminary
22
investigation
shall
also
be
conducted
in
the
event
of
a
sudden
23
or
mysterious
death
of
a
patient
in
a
private
institution
24
for
persons
with
an
intellectual
disability.
The
chief
25
administrative
officer
of
any
private
institution
may
request
26
an
investigation
of
the
death
of
any
patient
by
the
county
27
medical
examiner.
28
Sec.
173.
Section
222.73,
subsections
1,
3,
and
5,
Code
29
2024,
are
amended
to
read
as
follows:
30
1.
The
superintendent
of
each
resource
center
and
special
31
unit
shall
compute
by
February
1
the
average
daily
patient
32
charge
and
outpatient
treatment
charges
for
which
each
county
33
will
be
billed
for
services
provided
to
patients
chargeable
to
34
the
county
during
the
fiscal
year
beginning
the
following
July
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1.
The
department
shall
certify
the
amount
of
the
charges
and
1
notify
the
counties
of
the
billing
charges.
2
a.
The
superintendent
shall
compute
the
average
daily
3
patient
charge
for
a
resource
center
or
special
unit
for
4
services
provided
in
the
following
fiscal
year,
in
accordance
5
with
generally
accepted
accounting
procedures,
by
totaling
6
the
expenditures
of
the
resource
center
or
special
unit
for
7
the
immediately
preceding
calendar
year,
by
adjusting
the
8
expenditures
by
a
percentage
not
to
exceed
the
percentage
9
increase
in
the
consumer
price
index
for
all
urban
consumers
10
for
the
immediately
preceding
calendar
year,
and
by
dividing
11
the
adjusted
expenditures
by
the
total
inpatient
days
of
12
service
provided
during
the
immediately
preceding
calendar
13
year.
14
b.
The
department
shall
compute
the
outpatient
treatment
15
charges,
in
accordance
with
generally
accepted
accounting
16
procedures,
on
the
basis
of
the
actual
cost
of
the
outpatient
17
treatment
provided
during
the
immediately
preceding
calendar
18
year.
19
3.
2.
The
superintendent
shall
compute
in
January
the
20
actual
per-patient-per-day
cost
for
each
resource
center
or
21
special
unit
for
the
immediately
preceding
calendar
year,
in
22
accordance
with
generally
accepted
accounting
procedures,
by
23
totaling
the
actual
expenditures
of
the
resource
center
or
24
special
unit
for
the
calendar
year
and
by
dividing
the
total
25
actual
expenditures
by
the
total
inpatient
days
of
service
26
provided
during
the
calendar
year.
27
5.
3.
A
superintendent
of
a
resource
center
or
special
28
unit
may
request
that
the
director
enter
into
a
contract
with
29
a
person
for
the
resource
center
or
special
unit
to
provide
30
consultation
or
treatment
services
or
for
fulfilling
other
31
purposes
which
are
consistent
with
the
purposes
stated
in
32
section
222.1
.
The
contract
provisions
shall
include
charges
33
which
reflect
the
actual
cost
of
providing
the
services.
Any
34
income
from
a
contract
authorized
under
this
subsection
may
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be
retained
by
the
resource
center
or
special
unit
to
defray
1
the
costs
of
providing
the
services
or
fulfilling
the
other
2
purposes.
Except
for
a
contract
voluntarily
entered
into
by
a
3
county
under
this
subsection
,
the
costs
or
income
associated
4
with
a
contract
authorized
under
this
subsection
shall
not
5
be
considered
in
computing
charges
and
per
diem
costs
in
6
accordance
with
the
provisions
of
subsections
1
through
4
and
7
2
.
8
Sec.
174.
Section
222.83,
Code
2024,
is
amended
to
read
as
9
follows:
10
222.83
Nonresident
patients.
11
The
estates
of
all
nonresident
patients
who
are
provided
12
treatment,
training,
instruction,
care,
habilitation,
and
13
support
in
or
by
a
resource
center
or
a
special
unit
,
and
all
14
persons
legally
bound
for
the
support
of
such
persons,
shall
be
15
liable
to
the
state
for
the
reasonable
value
of
such
services.
16
The
certificate
of
the
superintendent
of
the
resource
center
17
or
special
unit
in
which
any
nonresident
is
or
has
been
a
18
patient,
showing
the
amounts
drawn
from
the
state
treasury
or
19
due
therefrom
as
provided
by
law
on
account
of
such
nonresident
20
patient,
shall
be
presumptive
evidence
of
the
reasonable
value
21
of
such
services
furnished
such
patient
by
the
resource
center
22
or
special
unit
.
23
Sec.
175.
Section
222.84,
Code
2024,
is
amended
to
read
as
24
follows:
25
222.84
Patients’
personal
deposit
fund.
26
There
is
established
at
each
resource
center
and
special
27
unit
a
patients’
personal
deposit
fund.
In
the
case
of
a
28
special
unit,
the
director
may
direct
that
the
patients’
29
personal
deposit
fund
be
maintained
and
administered
as
a
part
30
of
the
fund
established,
pursuant
to
sections
226.43
through
31
226.46
,
by
the
state
mental
health
institute
where
the
special
32
unit
is
located.
33
Sec.
176.
Section
222.85,
subsection
1,
Code
2024,
is
34
amended
to
read
as
follows:
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1.
Any
funds
coming
into
the
possession
of
the
1
superintendent
or
any
employee
of
a
resource
center
or
special
2
unit
belonging
to
any
patient
in
that
institution
shall
be
3
deposited
in
the
name
of
the
patient
in
the
patients’
personal
4
deposit
fund,
except
that
if
a
guardian
of
the
property
has
5
been
appointed
for
the
person,
the
guardian
shall
have
the
6
right
to
demand
and
receive
such
funds.
Funds
belonging
to
a
7
patient
deposited
in
the
patients’
personal
deposit
fund
may
8
be
used
for
the
purchase
of
personal
incidentals,
desires,
and
9
comforts
for
the
patient.
10
Sec.
177.
Section
222.87,
Code
2024,
is
amended
to
read
as
11
follows:
12
222.87
Deposit
in
bank.
13
The
department
shall
deposit
the
patients’
personal
deposit
14
fund
in
a
commercial
account
of
a
bank
of
reputable
standing.
15
When
deposits
in
the
commercial
account
exceed
average
monthly
16
withdrawals,
the
department
may
deposit
the
excess
at
interest.
17
The
savings
account
shall
be
in
the
name
of
the
patients’
18
personal
deposit
fund
and
interest
paid
on
the
account
may
be
19
used
for
recreational
purposes
for
the
patients
at
the
resource
20
center
or
special
unit
.
21
Sec.
178.
REPEAL.
Sections
222.88,
222.89,
222.90,
and
22
222.91,
Code
2024,
are
repealed.
23
Sec.
179.
EFFECTIVE
DATE.
This
division
of
this
Act,
being
24
deemed
of
immediate
importance,
takes
effect
upon
enactment.
25
DIVISION
VI
26
COUNTY
OF
RESIDENCE
DETERMINATIONS
27
Sec.
180.
NEW
SECTION
.
331.190
County
of
residence
——
28
dispute
resolution.
29
1.
“County
of
residence”
means
the
county
in
this
state
30
in
which,
at
the
time
a
person
applies
for
or
receives
31
services,
the
person
is
living
and
has
established
an
ongoing
32
presence
with
the
declared,
good
faith
intention
of
living
33
for
a
permanent
or
indefinite
period
of
time.
The
county
34
of
residence
of
a
homeless
person
is
the
county
in
which
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the
homeless
person
usually
sleeps.
A
person
maintains
1
residency
in
the
county
or
state
in
which
the
person
last
2
resided
during
the
time
period
that
the
person
is
present
in
3
a
different
county
or
state
receiving
services
in
a
hospital,
4
a
correctional
facility,
a
halfway
house
for
community-based
5
corrections
or
substance
use
disorder
treatment,
a
nursing
6
facility,
an
intermediate
care
facility
for
persons
with
an
7
intellectual
disability,
a
residential
care
facility,
or
for
8
the
purpose
of
attending
a
college
or
university.
9
2.
a.
The
dispute
resolution
process
in
this
subsection
10
shall
apply
to
county
of
residence
disputes.
The
dispute
11
resolution
process
shall
not
be
applicable
to
any
of
the
12
following:
13
(1)
Disputes
involving
persons
committed
to
a
state
14
facility
pursuant
to
chapter
812.
15
(2)
Disputes
involving
Iowa
rule
of
criminal
procedure
16
2.22(8)(b),
commitment
for
evaluation.
17
(3)
Disputes
involving
chapter
12
of
Iowa
court
rules,
rules
18
for
involuntary
hospitalization
of
mentally
ill
persons.
19
b.
If
a
county
objects
to
a
billing
for
services
or
a
20
residency
determination
and
asserts
that
either
the
person
21
has
residency
in
a
different
county
or
the
person
is
not
a
22
resident
of
this
state,
the
person’s
county
of
residence
23
shall
be
determined
as
provided
in
this
subsection.
If
the
24
county
asserts
that
the
person
has
residency
in
a
different
25
county
in
this
state,
the
county
shall
notify
that
county
in
26
writing
within
one
hundred
twenty
calendar
days
of
receiving
27
the
billing
for
services
or
of
the
county
of
residence
28
determination.
29
c.
The
county
that
receives
the
notification
under
paragraph
30
“b”
shall
respond
in
writing
to
the
county
that
provided
the
31
notification
within
forty-five
calendar
days
of
receiving
the
32
notification.
If
the
parties
cannot
agree
as
to
the
person’s
33
county
of
residence
within
ninety
calendar
days
of
the
date
of
34
notification,
on
motion
of
either
of
the
parties,
the
matter
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shall
be
referred
to
the
administrative
hearings
division
of
1
the
department
of
inspections,
appeals,
and
licensing
for
2
a
contested
case
proceeding
under
chapter
17A,
before
an
3
administrative
law
judge
assigned
in
accordance
with
section
4
10A.801,
to
determine
the
person’s
county
of
residence.
5
d.
(1)
Notwithstanding
section
17A.15,
the
administrative
6
law
judge’s
determination
of
a
person’s
county
of
residence
7
shall
be
considered
final
agency
action.
Judicial
review
of
8
the
determination
may
be
sought
in
accordance
with
section
9
17A.19.
10
(2)
If
following
the
determination
of
a
person’s
county
of
11
residence
under
this
subsection
additional
evidence
becomes
12
available
that
merits
a
change
in
the
determination
of
the
13
person’s
county
of
residence,
the
affected
parties
may
change
14
the
determination
of
county
of
residence
by
mutual
agreement.
15
Otherwise,
a
party
may
move
that
the
matter
be
reconsidered
16
by
the
county,
or
by
an
administrative
law
judge
assigned
in
17
accordance
with
section
10A.801.
18
e.
Unless
a
petition
is
filed
for
judicial
review,
the
19
administrative
law
judge’s
determination
of
the
person’s
county
20
of
residence
shall
result
in
one
of
the
following:
21
(1)
If
a
county
is
determined
to
be
the
person’s
county
22
of
residence,
that
county
shall
pay
any
amounts
due
and
shall
23
reimburse
the
other
county
for
any
amounts
paid
for
services
24
provided
to
the
person
by
the
other
county
prior
to
the
county
25
of
residence
determination.
26
(2)
If
it
is
determined
that
the
person
is
not
a
resident
of
27
this
state,
neither
the
state
nor
either
county
shall
be
liable
28
for
payment
of
amounts
due
for
services
provided
to
the
person
29
prior
to
the
determination
of
the
person’s
county
of
residence.
30
f.
(1)
The
party
that
does
not
prevail
in
a
contested
31
case
proceeding
or
a
subsequent
judicial
review
pursuant
to
32
this
subsection
shall
be
liable
for
costs
associated
with
33
the
proceeding
or
judicial
review,
including
reimbursement
34
of
the
administrative
hearings
division
of
the
department
of
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inspections,
appeals,
and
licensing’s
actual
costs
associated
1
with
the
administrative
proceeding,
court
costs,
and
reasonable
2
attorney
fees.
3
(2)
A
payment
or
reimbursement
pursuant
to
this
subsection
4
shall
be
remitted
within
forty-five
calendar
days
of
the
5
date
the
county
of
residence
determination
is
issued
by
the
6
administrative
law
judge
or
the
date
the
court
files
an
order
7
determining
the
person’s
county
of
residence,
whichever
is
8
later.
After
forty-five
calendar
days,
the
prevailing
party
9
may
add
a
penalty
of
up
to
one
percent
per
month
to
any
amounts
10
due.
11
Sec.
181.
Section
35D.9,
Code
2024,
is
amended
to
read
as
12
follows:
13
35D.9
County
of
residence
upon
discharge.
14
A
member
of
the
home
does
not
acquire
residency
in
the
county
15
in
which
the
home
is
located
unless
the
member
is
voluntarily
16
or
involuntarily
discharged
from
the
home
and
the
member
17
meets
county
of
residence
requirements.
For
purposes
of
this
18
section
,
“county
of
residence”
means
the
same
as
defined
in
19
section
225C.61
331.190
.
20
Sec.
182.
Section
232.141,
subsections
7
and
8,
Code
2024,
21
are
amended
to
read
as
follows:
22
7.
A
county
charged
with
the
costs
and
expenses
under
23
subsections
2
and
3
may
recover
the
costs
and
expenses
from
the
24
child’s
custodial
parent’s
county
of
residence,
as
defined
in
25
section
225C.61
331.190
,
by
filing
verified
claims
which
are
26
payable
as
are
other
claims
against
the
county.
A
detailed
27
statement
of
the
facts
upon
which
a
claim
is
based
shall
28
accompany
the
claim.
29
8.
This
subsection
applies
only
to
placements
in
a
juvenile
30
shelter
care
home
which
is
publicly
owned,
operated
as
a
county
31
or
multicounty
shelter
care
home,
organized
under
a
chapter
32
28E
agreement,
or
operated
by
a
private
juvenile
shelter
care
33
home.
If
the
actual
and
allowable
costs
of
a
child’s
shelter
34
care
placement
exceed
the
amount
the
department
is
authorized
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to
pay,
the
unpaid
costs
may
be
recovered
from
the
child’s
1
custodial
parent’s
county
of
residence.
However,
the
maximum
2
amount
of
the
unpaid
costs
which
may
be
recovered
under
this
3
subsection
is
limited
to
the
difference
between
the
amount
4
the
department
is
authorized
to
pay
and
the
statewide
average
5
of
the
actual
and
allowable
rates
as
reasonably
determined
6
by
the
department
annually.
A
home
may
only
be
reimbursed
7
for
the
lesser
of
the
home’s
actual
and
allowable
costs
or
8
the
statewide
average
of
the
actual
and
allowable
rates
as
9
determined
by
the
department
in
effect
on
the
date
the
costs
10
were
paid.
The
unpaid
costs
are
payable
pursuant
to
filing
of
11
verified
claims
against
the
child’s
custodial
parent’s
county
12
of
residence.
A
detailed
statement
of
the
facts
upon
which
a
13
claim
is
based
shall
accompany
the
claim.
Any
dispute
between
14
counties
arising
from
filings
of
claims
filed
pursuant
to
this
15
subsection
shall
be
settled
in
the
manner
provided
to
determine
16
residency
county
of
residence
in
section
225C.61
331.190
.
17
Sec.
183.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
18
effect
July
1,
2025.
19
DIVISION
VII
20
CHILDREN’S
BEHAVIORAL
HEALTH
——
PSYCHIATRIC
MEDICAL
21
INSTITUTIONS
FOR
CHILDREN
——
HAWKI
PROGRAM
BENEFITS
22
Sec.
184.
REDUCTION
OF
REGULATORY
BARRIERS
AND
RESTRICTIONS
23
——
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN.
The
24
department
of
health
and
human
services
shall
review
the
25
department’s
administrative
rules
regarding
psychiatric
medical
26
institutions
for
children
(PMICs)
and
shall
update
the
rules,
27
informed
by
the
findings
of
the
association
of
children’s
28
residential
centers’
most
recent
nationwide
survey
and
scan
29
of
psychiatric
residential
treatment
facilities,
and
the
30
recommendations
of
the
coalition
for
family
and
children’s
31
services
in
Iowa,
to
do
all
of
the
following:
32
1.
Allow
a
physician
assistant
or
advanced
registered
nurse
33
practitioner
to
serve
as
a
member
of
the
plan
of
care
team
34
as
a
member
who
is
experienced
in
child
psychiatry
or
child
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psychology
pursuant
to
481
IAC
41.13(2).
1
2.
Allow
a
physician
assistant
or
advanced
registered
2
nurse
practitioner
to
be
a
member
of
the
team
to
complete
3
the
certification
of
need
for
services
for
a
PMIC
placement
4
pursuant
to
481
IAC
41.9.
5
3.
Remove
the
reserve
bed
day
limitations
for
6
hospitalizations
and
expand
the
number
of
other
therapeutic
7
absences
beyond
thirty
days
to
allow
for
skill
acquisition,
8
stabilization,
and
continuity
of
care
as
deemed
necessary
by
9
the
child’s
medical
providers
and
in
accordance
with
a
child’s
10
discharge
plan.
11
4.
Allow
licensed
professionals,
based
on
competencies
12
rather
than
license
type,
to
order
the
use
of
restraints
13
or
seclusions
and
to
conduct
post-restraint
or
seclusion
14
assessments,
including
via
telehealth,
to
increase
response
15
times
and
expand
access
to
care.
16
5.
a.
Allow
therapy
and
behavioral
health
intervention
17
services
to
be
included
as
billable
services
provided
during
18
a
placement
at
a
PMIC
to
provide
continuity
of
care,
maintain
19
established
clinical
relationships,
and
avoid
disruption
in
20
services
or
delays
in
reestablishing
care
post
discharge.
21
b.
Allow
family
therapy
and
family
behavioral
health
22
intervention
services
to
be
included
in
billable
services
23
during
the
placement
of
a
child
in
a
PMIC
without
requiring
24
the
child’s
presence
for
the
family
to
work
on
targeted
skills
25
essential
for
the
child’s
success
and
to
prepare
the
family
for
26
the
child’s
return
home.
27
c.
Provide
reimbursement
codes
to
cover
services
beyond
28
those
provided
outside
the
PMIC
care
team
as
necessary
to
29
adequately
treat
substance
use
disorder,
sexualized
behaviors,
30
autism,
and
other
services
needed
to
support
the
child.
31
6.
Standardize
all
of
the
following
across
all
managed
care
32
organizations
as
follows:
33
a.
Require
that
authorization
for
a
PMIC
placement
shall
34
be
retroactive
to
the
date
the
request
for
authorization
is
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submitted
to
the
managed
care
organization
not
the
date
the
1
managed
care
organization
responds;
or
require
a
managed
care
2
organization
to
respond
within
five
business
days
from
receipt
3
of
a
request
for
authorization
for
a
PMIC
placement,
if
the
4
certification
of
need
and
independent
assessment
have
been
5
received
in
a
timely
manner.
6
b.
Prohibit
a
managed
care
organization
from
denying
7
authorization
for
a
PMIC
placement
based
on
lack
of
parental
8
involvement,
based
on
lack
of
participation
in
behavioral
9
health
intervention
services
on
an
outpatient
basis,
or
based
10
on
other
perceived
behavioral
issues.
11
c.
Allow
a
managed
care
organization
to
authorize
an
initial
12
PMIC
placement
of
sixty
days
upon
admission
with
concurrent
13
stay
reviews
every
thirty
days
thereafter.
A
PMIC
shall
submit
14
a
care
plan
to
the
managed
care
organization
within
thirty
days
15
of
the
admission.
16
d.
Require
concurrent
stay
reviews
to
be
standardized
17
and
limited
to
a
brief
description
of
progress,
or
lack
of
18
progress,
toward
the
child’s
goals
and
objectives.
19
e.
Require
a
managed
care
organization
to
offer
support
to
20
families,
including
assistance
with
transportation
to
and
from
21
a
PMIC
to
visit
a
child.
22
7.
Notwithstanding
any
provision
of
law
to
the
contrary,
23
including
certificate
of
need
requirements,
allow
a
previously
24
licensed
PMIC
that
has
the
capacity
to
provide
up
to
an
25
additional
four
intermediate
care
facility
for
persons
with
an
26
intellectual
disability
beds,
and
which
additional
beds
meet
27
all
other
licensing
and
state
fire
marshal
requirements,
to
28
increase
their
licensed
capacity
to
include
the
additional
29
beds
without
further
review
including
by
the
health
facilities
30
council.
31
8.
Allow
for
step-down
PMIC
placements
or
supervised
32
apartment
living
for
a
child
to
utilize
programming
provided
33
in
a
PMIC
while
living
independently
in
a
smaller
residential
34
setting
without
twenty-four-hour
supervision.
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Sec.
185.
HAWKI
PROGRAM
——
BENEFITS
INCLUDED
IN
QUALIFIED
1
CHILD
HEALTH
PLAN
——
REVIEW.
The
department
of
health
2
and
human
services
shall
review
the
benefits
included
in
a
3
qualified
child
health
plan
under
the
Hawki
program
and
shall
4
specifically
address
the
inclusion
of
applied
behavior
analysis
5
services
as
a
covered
benefit.
The
department
shall
report
the
6
findings
of
the
review
to
the
general
assembly
by
December
1,
7
2024.
8
DIVISION
VIII
9
STATE-FUNDED
PSYCHIATRY
RESIDENCY
AND
FELLOWSHIP
PROGRAM
AND
10
PSYCHIATRY
RESIDENCY
PROGRAM
11
Sec.
186.
Section
135.180,
Code
2024,
is
amended
to
read
as
12
follows:
13
135.180
State-funded
psychiatry
residency
and
fellowship
14
program
and
psychiatry
residency
program
——
fund
——
15
appropriations.
16
1.
a.
The
university
of
Iowa
hospitals
and
clinics
shall
17
administer
a
state-funded
psychiatry
residency
and
fellowship
18
program
for
up
to
nine
seven
residents
and
up
to
two
fellows,
19
annually.
In
addition,
a
county
medical
center,
and
a
medical
20
center
operating
for
more
than
one
hundred
forty
years,
that
21
are
members
of
separate
health
systems,
administer
psychiatry
22
residency
programs,
and
are
located
in
a
county
with
a
23
population
of
over
five
hundred
thousand
shall
each
annually
24
administer
a
state-funded
psychiatry
residency
program
for
one
25
resident.
The
university
of
Iowa
hospitals
and
clinics
and
the
26
specified
medical
centers
shall
expand
the
their
psychiatry
27
residency
program
programs
to
provide
additional
residency
28
positions
by
providing
financial
support
for
residency
29
positions
which
are
in
excess
of
the
federal
residency
cap
30
established
by
the
federal
Balanced
Budget
Act
of
1997,
Pub.
31
L.
No.
105-33.
32
b.
The
university
of
Iowa
hospitals
and
clinics
and
the
33
specified
medical
centers
shall
cooperate
with
the
state
34
mental
health
institutes
at
Independence
and
Cherokee,
the
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state
resource
center
at
Woodward,
the
state
training
school
1
at
Eldora,
and
the
Iowa
medical
and
classification
center
2
at
Oakdale
in
administering
the
program
their
programs
.
3
Participating
residents
and
fellows
shall
complete
a
portion
4
of
their
psychiatry
training
at
one
of
the
state
mental
health
5
institutes,
the
state
resource
center,
the
state
training
6
school,
or
the
Iowa
medical
and
classification
center
at
7
Oakdale.
For
accreditation-required
clinical
experiences
not
8
available
at
the
state
mental
health
institutes,
the
state
9
resource
center,
the
state
training
school,
or
the
Iowa
medical
10
and
classification
center
at
Oakdale,
the
residents
of
the
11
psychiatry
residency
and
fellowship
program
administered
by
the
12
university
of
Iowa
hospitals
and
clinics
may
utilize
clinical
13
rotations
at
the
university
of
Iowa
hospitals
and
clinics
14
and
its
affiliates
across
the
state.
The
residents
of
the
15
psychiatry
residency
program
administered
by
the
specified
16
medical
centers
may
utilize
clinical
rotations
at
affiliates
of
17
such
medical
centers
across
the
state.
18
2.
The
university
of
Iowa
hospitals
and
clinics
shall
apply
19
to
the
accreditation
council
for
graduate
medical
education
20
for
approval
of
nine
seven
additional
residency
positions
21
for
each
class
of
residents
and
the
psychiatry
residency
and
22
fellowship
program
shall
award
the
total
number
of
residency
23
positions
approved
for
each
class
of
residents.
The
university
24
of
Iowa
hospitals
and
clinics
shall
approve
and
award
up
to
25
two
fellowship
positions
annually.
The
specified
medical
26
centers
shall
apply
to
the
accreditation
council
for
graduate
27
medical
education
for
approval
of
one
additional
residency
28
position
each
for
each
class
of
residents
and
shall
award
the
29
total
number
of
residency
positions
approved
for
each
class
30
of
residents.
Preference
in
the
awarding
of
residency
and
31
fellowship
positions
shall
be
given
to
candidates
who
are
32
residents
of
Iowa,
attended
and
earned
an
undergraduate
degree
33
from
an
Iowa
college
or
university,
or
attended
and
earned
a
34
medical
degree
from
a
medical
school
in
Iowa.
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3.
A
psychiatry
residency
and
fellowship
program
fund
1
is
created
in
the
state
treasury
consisting
of
the
moneys
2
appropriated
or
credited
to
the
fund
by
law.
Notwithstanding
3
section
8.33
,
moneys
in
the
fund
at
the
end
of
each
fiscal
year
4
shall
not
revert
to
any
other
fund
but
shall
remain
in
the
5
psychiatry
residency
and
fellowship
program
fund
for
use
in
6
subsequent
fiscal
years.
Moneys
in
the
fund
are
appropriated
7
to
the
university
of
Iowa
hospitals
and
clinics
to
be
used
8
for
the
purposes
of
the
program.
Of
the
amount
appropriated
9
annually
to
the
university
of
Iowa
hospitals
and
clinics,
the
10
university
of
Iowa
hospitals
and
clinics
shall
distribute
one
11
hundred
thousand
dollars
to
each
of
the
specified
medical
12
centers
for
each
residency
position
approved
and
awarded.
For
13
the
fiscal
years
beginning
on
or
after
July
1,
2023,
there
14
is
appropriated
from
the
general
fund
of
the
state
to
the
15
psychiatry
residency
and
fellowship
program
fund
one
hundred
16
thousand
dollars
for
each
residency
position
approved
and
17
awarded
under
the
program
and
one
hundred
fifty
thousand
18
dollars
for
each
fellowship
position
approved
and
awarded
under
19
the
program.
20
EXPLANATION
21
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
22
the
explanation’s
substance
by
the
members
of
the
general
assembly.
23
This
bill
relates
to
state
behavioral
health,
disability,
24
and
addictive
disorder
services
and
related
programs,
25
including
the
transition
of
behavioral
health
services
from
a
26
mental
health
and
disability
services
system
to
a
behavioral
27
health
service
system
(BHSS),
the
transfer
of
disability
28
services
to
the
division
of
aging
and
disability
services
29
of
the
department
of
health
and
human
services
(HHS),
the
30
elimination
of
the
commission
on
aging,
and
the
elimination
of
31
special
intellectual
disability
units
at
state
mental
health
32
institutes.
33
DIVISION
I
——
BEHAVIORAL
HEALTH
SERVICE
SYSTEM.
This
34
division
relates
to
the
establishment
of
the
BHSS
under
the
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control
of
HHS.
The
division
defines
terms
related
to
the
1
BHSS.
2
The
division
designates
HHS
as
the
state
authority
for
3
purposes
of
directing
benefits
and
providing
services
relating
4
to
certain
federal
block
grants
and
statutes.
5
The
division
establishes
a
BHSS
for
the
purposes
of
6
implementing
a
statewide
system
of
prevention,
education,
early
7
intervention,
treatment,
recovery
support,
and
crisis
services
8
related
to
mental
health
and
addictive
disorders,
including
but
9
not
limited
to
alcohol
use,
substance
use,
tobacco
use,
and
10
problem
gambling.
11
The
division
requires
HHS
to
support
equitable
statewide
12
access
to
all
services
offered
through
the
BHSS
and
offer
13
specialized
behavioral
health
services
with
a
focus
on
certain
14
at-risk
populations.
The
division
sets
minimum
services
that
15
must
be
offered
through
the
BHSS
and
outlines
HHS’s
powers
and
16
duties
in
relation
to
the
BHSS.
17
The
division
requires
HHS
to
divide
the
entirety
of
the
18
state
into
designated
behavioral
health
districts
(district).
19
The
division
requires
each
district
to
provide
behavioral
20
health
prevention,
education,
early
intervention,
treatment,
21
recovery
support,
and
crisis
services
related
to
mental
health
22
and
addictive
disorders
throughout
each
district
in
a
manner
23
consistent
with
directives
the
district
receives
from
HHS.
HHS
24
must
consider
several
factors,
as
detailed
in
the
division,
25
when
designating
districts.
The
manner
in
which
HHS
designates
26
districts
is
not
subject
to
judicial
review.
27
The
division
requires
HHS
to
designate
an
administrative
28
services
organization
(ASO)
to
oversee
and
organize
each
29
district
and
the
BHSS
services
associated
with
the
district.
30
HHS
must
issue
requests
for
proposals
for
ASO
candidates.
31
The
division
details
which
entities
may
qualify
as
an
ASO.
32
HHS
is
required
to
consider
several
factors
outlined
in
the
33
division
when
determining
whether
to
designate
an
entity
as
an
34
ASO.
Upon
an
entity’s
designation
as
an
ASO,
the
entity
is
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considered
an
instrumentality
of
the
state
and
must
adhere
to
1
all
state
and
federal
mandates
and
prohibitions
applicable
to
2
an
instrumentality
of
the
state.
3
Each
ASO
must
function
as
a
subrecipient
for
the
purposes
4
of
the
federal
community
mental
health
services
block
grant
5
and
the
federal
substance
abuse
prevention
and
treatment
6
block
grant.
Duties
an
ASO
must
perform
are
detailed
in
the
7
division,
including
the
establishment
of
a
district
behavioral
8
health
advisory
council
(advisory
council).
An
advisory
9
council
must
perform
duties
detailed
in
the
division
to
assist
10
the
ASO
in
carrying
out
the
ASO’s
duties.
An
advisory
council
11
must
consist
of
10
members.
Advisory
council
membership
12
requirements
are
established
in
the
division.
13
The
division
requires
HHS
to
take
certain
actions
for
data
14
related
to
the
BHSS,
and
to
create
a
central
data
repository
15
for
collecting
and
analyzing
state,
behavioral
health
district,
16
and
contracted
behavioral
health
provider
data.
The
division
17
establishes
requirements
for
HHS
and
ASOs
relating
to
the
18
collection,
maintenance,
and
distribution
of
data,
and
the
19
maintenance
and
administration
of
the
central
data
repository.
20
The
division
establishes
a
behavioral
health
fund
(fund).
21
For
purposes
of
the
fund,
the
division
defines
the
terms
22
“population”
and
“state
growth
factor”.
Moneys
deposited
into
23
the
fund
are
appropriated
to
HHS
to
implement
and
administer
24
the
BHSS
and
related
programs,
including
distributions
25
to
ASOs
for
services;
distributions
to
behavioral
health
26
providers;
funding
of
disability
services
pursuant
to
Code
27
chapter
231
(department
of
health
and
human
services
——
28
aging
——
older
Iowans)
until
June
30,
2028;
and
payment
of
29
administrative
costs
for
services
associated
with
the
BHSS.
30
The
division
prohibits
HHS
from
using
more
than
5
percent
of
31
the
moneys
in
the
fund
at
the
beginning
of
each
fiscal
year
for
32
administrative
costs.
33
For
FY
2025-2026,
the
division
transfers
an
amount
equal
to
34
$42
multiplied
by
the
state’s
population
for
the
fiscal
year
35
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from
the
general
fund
of
the
state
to
the
fund.
1
For
fiscal
years
beginning
on
or
after
July
1,
2026,
the
2
division
transfers
an
amount
from
the
general
fund
to
the
fund
3
equal
to
the
state’s
population
for
the
fiscal
year
multiplied
4
by
the
sum
of
the
dollar
amount
used
to
calculate
the
transfer
5
from
the
general
fund
to
the
fund
for
the
immediately
preceding
6
fiscal
year,
plus
the
state
growth
factor
for
the
fiscal
year
7
for
which
the
transfer
is
being
made.
8
For
each
fiscal
year,
the
division
prohibits
an
ASO
from
9
spending
more
than
7
percent
of
the
total
amount
distributed
to
10
the
ASO
from
HHS
and
all
other
appropriations
on
administrative
11
costs
for
the
same
fiscal
year.
12
The
division
allows
moneys
in
the
fund
to
be
used
for
cash
13
flow
purposes,
provided
that
any
moneys
so
allocated
are
14
returned
to
the
fund
by
the
end
of
each
fiscal
year.
Interest
15
and
earnings
on
moneys
deposited
into
the
fund
are
credited
to
16
the
fund
and
moneys
in
the
fund
that
remain
unencumbered
or
17
unobligated
at
the
close
of
the
fiscal
year
are
to
remain
in
18
the
fund
to
be
used
for
the
purposes
designated.
19
The
division
amends
and
moves
Code
sections
142A.6(6)
20
(tobacco
use
prevention
and
control)
and
142A.11
(application
21
for
services
——
minors)
to
new
Code
chapter
225A,
as
enacted
22
in
this
division.
23
This
division
of
the
bill
is
effective
July
1,
2025.
24
DIVISION
II
——
BEHAVIORAL
HEALTH
SERVICE
SYSTEM
——
25
CONFORMING
CHANGES.
This
division
of
the
bill
makes
conforming
26
changes
related
to
the
establishment
and
implementation
of
the
27
BHSS.
28
The
bill
repeals
Code
chapters
142A
(tobacco
use
prevention
29
and
control),
225C
(mental
health
and
disability
services),
227
30
(facilities
for
persons
with
mental
illness
or
an
intellectual
31
disability),
230A
(community
mental
health
centers),
and
347B
32
(county
care
facilities).
33
The
bill
repeals
Code
sections
125.1,
125.3,
125.7,
125.9,
34
125.10,
125.12,
125.25,
125.32A,
125.34,
125.37
through
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125.43A,
125.46,
125.48,
125.54,
125.55,
125.58,
125.59,
1
125.60,
135B.18,
218.99,
222.59
through
222.70,
222.74,
222.75,
2
225.10,
225.19,
225.21,
226.45,
229.42,
230.1A,
230.2
through
3
230.6,
230.9,
230.12,
230.16
through
230.22,
230.25,
230.26,
4
230.27,
426B.2,
426B.4,
and
426B.5.
5
This
division
of
the
bill
takes
effect
July
1,
2025.
6
DIVISION
III
——
AGING
AND
DISABILITY.
This
division
of
the
7
bill
relates
to
aging
and
disability
services.
8
The
division
transfers
services
related
to
individuals
with
9
disabilities
to
Code
chapter
231,
as
amended
in
this
division,
10
eliminates
the
commission
on
aging,
and
transfers
commission
11
on
aging
duties
to
HHS
and
the
council
on
health
and
human
12
services.
13
The
division
requires
HHS
to
designate
aging
and
disability
14
resource
centers
(ADRC)
to
establish
a
coordinated
local
aging
15
and
disability
service
system,
and
details
which
entities
may
16
be
ADRCs.
17
Current
Code
sections
225C.25,
225C.26,
225C.28A,
and
18
225C.28B
(the
bill
of
rights
and
service
quality
standards
19
of
persons
with
an
intellectual
disability,
developmental
20
disabilities,
brain
injury,
or
chronic
mental
illness),
are
21
amended
and
moved
to
Code
sections
231.75
through
231.79.
22
The
division
repeals
Code
sections
231.11,
231.12,
and
23
231.13.
24
The
parts
of
the
sections
of
the
division
amending
the
25
following
Code
sections
take
effect
July
1,
2025:
231.3,
26
231.4(1),
231.23(4),
231.23(7),
231.23A(1),
231.56,
231.57,
27
231.58,
and
231.64(2).
28
The
parts
of
the
sections
of
the
division
enacting
Code
29
sections
231.23A(7A)
and
231.75
through
231.79
take
effect
July
30
1,
2025.
31
DIVISION
IV
——
TRANSITION
PROVISIONS.
This
division
32
provides
a
process,
grants
HHS
certain
powers,
and
assigns
33
HHS
certain
duties
during
the
period
beginning
on
the
date
of
34
enactment
of
this
division
and
concluding
June
30,
2025,
to
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transition
the
state’s
behavioral
health
services
to
the
BHSS,
1
and
the
state’s
disability
services
to
HHS’s
division
of
aging
2
and
disability
services,
effective
July
1,
2025.
3
The
division
appropriates
$645,179
from
the
region
incentive
4
fund
of
the
mental
health
and
disability
services
regional
5
service
fund
to
HHS
for
FY
2024-2025
for
the
establishment
6
of
a
central
data
repository
as
described
in
Code
section
7
225A.6(1)(b)
as
enacted
in
division
I.
8
The
division
allows
HHS
to
adopt
emergency
rules
to
9
implement
the
division.
10
The
division
is
effective
upon
enactment.
11
DIVISION
V
——
ELIMINATION
OF
SPECIAL
INTELLECTUAL
DISABILITY
12
UNITS.
This
division
eliminates
special
intellectual
13
disability
units
at
state
mental
health
institutes
in
Code
14
chapter
222
(persons
with
an
intellectual
disability),
and
is
15
effective
upon
enactment.
16
DIVISION
VI
——
COUNTY
OF
RESIDENCE
DETERMINATIONS.
This
17
division
amends
and
moves
language
from
Code
section
225C.61
18
(county
of
residence
——
services
to
residents
——
service
19
authorization
appeals
——
disputes
between
counties
or
regions)
20
to
new
Code
section
331.190,
as
enacted
in
this
division,
which
21
establishes
a
process
for
determining
a
person’s
county
of
22
residence
and
for
resolving
disputes
related
to
a
person’s
23
county
of
residence.
The
division
makes
conforming
changes
and
24
takes
effect
July
1,
2025.
25
DIVISION
VII
——
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
26
CHILDREN
AND
HAWKI
PROGRAM
BENEFITS.
This
division
relates
27
to
children’s
behavioral
health.
The
division
requires
HHS
28
to
review
and
update
rules
regarding
psychiatric
medical
29
institutions
for
children
(PMICs)
to
permit
physician
30
assistants
and
advanced
registered
nurse
practitioners
to
serve
31
as
plan
of
care
team
members
and
to
complete
the
certification
32
of
need
for
services
for
a
PMIC
placement;
to
remove
the
33
reserve
bed
day
limitations
for
hospitalizations
and
expand
34
the
number
of
other
therapeutic
absences
allowed;
to
allow
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licensed
professionals,
based
on
competencies
rather
than
1
license
type,
to
order
the
use
of
restraints
or
seclusions
and
2
to
conduct
post-restraint
or
seclusion
assessments,
to
increase
3
response
times
and
expand
access
to
care;
to
require
therapy
4
and
behavioral
health
intervention
services
and
family
therapy
5
and
family
behavioral
health
intervention
services
as
required
6
services
during
a
PMIC
placement,
and
to
provide
reimbursement
7
codes
to
cover
certain
services
beyond
those
provided
outside
8
the
PMIC
care
team
to
support
the
child;
to
standardize
9
certain
activities
across
all
managed
care
organizations;
to
10
allow
for
certain
exceptions
for
PMICs
to
increase
capacity
11
without
further
certification
of
need
review;
and
to
allow
for
12
step-down
PMIC
placements
or
supervised
apartment
living
for
a
13
child.
14
The
division
also
directs
HHS
to
review
the
benefits
under
15
the
Hawki
program,
specifically
the
inclusion
of
applied
16
behavioral
analysis
services
as
a
covered
benefit,
and
to
17
report
findings
to
the
general
assembly
by
December
1,
2024.
18
DIVISION
VIII
——
STATE-FUNDED
PSYCHIATRY
RESIDENCY
AND
19
FELLOWSHIP
PROGRAM
AND
PSYCHIATRY
RESIDENCY
PROGRAM.
This
20
division
amends
the
state-funded
psychiatry
residency
and
21
fellowship
program.
The
division
reduces
the
number
of
22
residents
in
the
program
administered
by
the
university
of
Iowa
23
hospitals
and
clinics
by
two
residents
annually
and
provides
24
that
a
county
medical
center,
and
a
medical
center
operating
25
for
more
than
140
years,
that
are
members
of
separate
health
26
systems,
administer
psychiatry
residency
programs,
and
are
27
located
in
a
county
with
a
population
of
over
500,000
to
each
28
annually
administer
a
state-funded
psychiatry
residency
program
29
for
one
resident.
The
division
makes
conforming
changes
to
the
30
existing
program
to
provide
for
the
distribution
of
funding
to
31
the
specified
medical
centers
for
the
two
residency
positions.
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