Bill Text: IA SF525 | 2011-2012 | 84th General Assembly | Enrolled
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: A bill for an act relating to reforming state and county responsibilities for adult disability services, making appropriations, and including effective date provisions. (Formerly SSB 1077 and SF 481.) Various effective dates; see sections 5, 23, and 62 of bill (see also SF 533, section 151).
Spectrum: Committee Bill
Status: (Passed) 2011-12-31 - END OF 2011 ACTIONS [SF525 Detail]
Download: Iowa-2011-SF525-Enrolled.html
Bill Title: A bill for an act relating to reforming state and county responsibilities for adult disability services, making appropriations, and including effective date provisions. (Formerly SSB 1077 and SF 481.) Various effective dates; see sections 5, 23, and 62 of bill (see also SF 533, section 151).
Spectrum: Committee Bill
Status: (Passed) 2011-12-31 - END OF 2011 ACTIONS [SF525 Detail]
Download: Iowa-2011-SF525-Enrolled.html
Senate
File
525
AN
ACT
RELATING
TO
REFORMING
STATE
AND
COUNTY
RESPONSIBILITIES
FOR
ADULT
DISABILITY
SERVICES,
MAKING
APPROPRIATIONS,
AND
INCLUDING
EFFECTIVE
DATE
PROVISIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
DIVISION
I
SERVICE
SYSTEM
REDESIGN
Section
1.
ADULT
DISABILITY
SERVICES
SYSTEM
REDESIGN.
1.
For
the
purposes
of
this
section,
“disability
services”
means
services
and
other
support
available
to
a
person
with
mental
illness
or
an
intellectual
disability
or
other
developmental
disability.
2.
It
is
the
intent
of
the
general
assembly
to
redesign
the
system
for
adult
disability
services
to
implement
all
of
the
following:
a.
Shifting
the
funding
responsibility
for
the
nonfederal
share
of
adult
disability
services
paid
for
by
the
Medicaid
program,
including
but
not
limited
to
all
costs
for
the
state
resource
centers,
from
the
counties
to
the
state.
b.
Reorganizing
adult
disability
services
not
paid
for
by
the
Medicaid
program
into
a
system
administered
on
a
regional
basis
in
a
manner
that
provides
multiple
local
points
of
access
to
adult
disability
services
both
paid
for
by
the
Medicaid
Senate
File
525,
p.
2
program
and
not
paid
for
by
the
Medicaid
program.
c.
Replacing
legal
settlement
as
the
basis
for
determining
financial
responsibility
for
publicly
funded
disability
services
by
determining
such
responsibility
based
upon
residency.
d.
Meeting
the
needs
of
consumers
for
disability
services
in
a
responsive
and
cost-effective
manner.
3.
a.
The
legislative
council
is
requested
to
authorize
an
interim
committee
on
mental
health
and
disability
services
for
the
2011
legislative
interim
to
commence
as
soon
as
practicable.
The
purpose
of
the
interim
committee
is
to
closely
engage
with,
monitor,
and
propose
legislation
concerning
the
recommendations
and
proposals
developed
by
the
workgroups
and
other
bodies
addressed
by
this
Act,
particularly
with
regard
to
the
identification
of
core
services.
b.
(1)
It
is
intended
that
the
interim
committee
members
consist
of
equal
numbers
of
legislators
from
both
chambers
and
from
both
political
parties.
It
is
also
requested
that
legislators
serving
on
the
interim
committee
and
other
interested
legislators
be
authorized
to
participate
in
the
meetings
of
the
workgroups
and
subcommittees
addressed
in
this
Act.
(2)
In
addition
to
addressing
workgroup
recommendations,
it
is
intended
that
the
interim
committee
address
property
tax
issues,
devise
a
means
of
ensuring
the
state
maintains
its
funding
commitments
for
the
redesigned
services
system,
recommend
revisions
in
the
requirements
for
mental
health
professionals
who
are
engaged
in
the
involuntary
commitment
and
examination
processes
under
chapter
229,
recommend
revisions
to
the
chapter
230A
amendments
contained
in
this
Act
as
necessary
to
conform
with
the
system
redesign
proposed
by
the
interim
committee,
develop
proposed
legislation
for
amending
Code
references
to
mental
retardation
to
instead
refer
to
intellectual
disabilities,
and
consider
issues
posed
by
the
July
1,
2013,
repeals
of
county
disability
services
administration
and
funding
provisions
in
2011
Iowa
Acts,
Senate
File
209.
In
addressing
the
repeal
provisions,
the
interim
committee
shall
consider
all
funding
sources
for
replacing
the
county
authority
to
levy
for
adult
disability
services.
(3)
It
is
intended
that
the
interim
committee
shall
receive
and
make
recommendations
concerning
the
detailed
and
final
proposals
submitted
by
workgroups
during
the
2011
legislative
interim
for
consideration
by
the
general
assembly
in
the
2012
Senate
File
525,
p.
3
legislative
session.
c.
(1)
The
department
of
human
services
shall
design
the
workgroup
process
to
facilitate
effective
decision
making
while
allowing
for
a
broad
array
of
input.
The
workgroup
process
shall
begin
as
soon
after
the
effective
date
of
this
Act
as
is
practicable.
The
membership
of
workgroups
and
subcommittees
involved
with
the
process
shall
include
consumers,
service
providers,
county
representatives,
and
advocates
and
provide
for
adequate
representation
by
both
rural
and
urban
interests.
The
department
of
public
health
shall
be
represented
on
those
workgroups
and
subcommittees
with
a
focus
relevant
to
the
department.
(2)
The
detailed
and
final
proposals
developed
by
the
workgroups
during
the
2011
interim
shall
be
submitted
to
the
interim
committee
on
or
before
December
9,
2011.
d.
At
least
one
workgroup
shall
address
redesign
of
the
adult
mental
health
system
and
at
least
one
workgroup
shall
address
redesign
of
the
adult
intellectual
and
other
developmental
disability
system.
The
workgroup
process
shall
engage
separate
workgroups
and
subcommittees
enumerated
in
this
Act
and
may
involve
additional
bodies
in
the
process
as
determined
by
the
department.
e.
It
is
intended
that
interim
committee
members
be
engaged,
to
the
extent
possible,
in
workgroup
deliberations
and
begin
formal
discussions
of
preliminary
proposals
developed
by
the
workgroups
beginning
in
October.
4.
The
workgroup
process
implemented
by
the
department
of
human
services
pursuant
to
subsection
3
shall
result
in
the
submission
of
proposals
for
redesign
of
adult
disability
services
that
include
but
are
not
limited
to
all
of
the
following:
a.
Identifying
clear
definitions
and
requirements
for
the
following:
(1)
Eligibility
criteria
for
the
individuals
to
be
served.
(2)
The
array
of
core
services
and
other
support
to
be
included
in
regional
adult
disability
services
plans
and
to
be
delivered
by
providers
based
on
individual
needs
and
medical
necessity
and
in
a
manner
that
promotes
cost-effectiveness,
uniformity,
accessibility,
and
best
practice
approaches.
The
array
shall
encompass
and
integrate
services
and
other
support
paid
for
by
both
the
Medicaid
program
and
other
sources.
(3)
Outcome
measures
that
focus
on
consumer
needs,
including
but
not
limited
to
measures
addressing
individual
Senate
File
525,
p.
4
choice,
empowerment,
and
community.
(4)
Quality
assurance
measures.
(5)
Provider
accreditation,
certification,
or
licensure
requirements
to
ensure
high
quality
services
while
avoiding
unreasonable
expectations
and
duplicative
surveys.
(6)
Input
in
regional
service
plans
and
delivery
provisions
by
consumer
and
provider
representatives.
The
input
process
shall
engage
local
consumers,
providers,
and
counties
in
developing
the
regional
provisions.
(7)
Provisions
for
representatives
of
the
regional
system
and
the
department
to
regularly
engage
in
discussions
to
resolve
Medicaid
and
non-Medicaid
issues
involving
documentation
requirements,
electronic
records,
reimbursement
methodologies,
cost
projections,
and
other
measures
to
improve
the
services
and
other
support
available
to
consumers.
b.
Incorporating
strategies
to
allow
individuals
to
receive
services
in
accordance
with
the
principles
established
in
Olmstead
v.
L.C.,
527
U.S.
581
(1999),
in
order
for
services
to
be
provided
in
the
most
community-based,
least
restrictive,
and
integrated
setting
appropriate
to
an
individual’s
needs.
c.
Continuing
the
department’s
leadership
role
in
the
Medicaid
program
in
defining
services
covered,
establishing
reimbursement
methodologies,
providing
other
administrative
functions,
and
engaging
in
federal
options
for
program
enhancements
that
are
beneficial
to
consumers
and
the
state
such
as
medical
or
behavioral
health
homes.
d.
Implementing
mental
health
crisis
response
services
statewide
in
a
manner
determined
to
be
most
appropriate
by
each
region.
e.
Implementing
a
subacute
level
of
care
to
provide
short-term
mental
health
services
in
a
structured
residential
setting
that
supplies
a
less
intensive
level
of
care
than
is
supplied
by
acute
psychiatric
services.
f.
Reviewing
best
practices
and
programs
utilized
by
other
states
in
identifying
new
approaches
for
addressing
the
needs
for
publicly
funded
services
for
persons
with
brain
injury.
The
proposals
regarding
these
approaches
may
be
submitted
after
the
workgroup
submission
date
set
out
in
subsection
3.
g.
Developing
a
proposal
for
addressing
service
provider
and
other
workforce
shortages.
The
development
of
the
proposal
shall
incorporate
an
examination
of
scope
of
practice
limitations
and
barriers
to
recruiting
providers
and
maintaining
the
workforce,
including
recruitment
of
minorities
Senate
File
525,
p.
5
and
addressing
cultural
competency
considerations
for
the
workforce
in
general
and
for
accrediting
professional
level
providers,
evaluating
the
impact
of
inadequate
reimbursement,
identifying
the
appropriate
state
role
in
providing
the
resources
to
ensure
an
appropriately
trained
workforce
is
available,
and
an
examination
of
the
variation
in
health
insurance
payment
provisions
for
the
services
provided
by
different
types
of
providers.
h.
Developing
a
proposal
for
service
providers
addressing
co-occurring
mental
health,
intellectual
disability,
brain
injury,
and
substance
abuse
disorders.
Each
workgroup
or
subcommittee
shall
address
co-occurring
disorders
as
appropriate
to
the
focus
of
the
workgroup
or
subcommittee.
The
overall
proposal
may
be
developed
by
a
body
consisting
of
members
from
other
workgroups
or
subcommittees.
The
proposal
shall
also
provide
options,
developed
in
coordination
with
the
judicial
branch
and
department
of
human
services
workgroup,
for
implementation
of
the
provision
of
advocates
to
patients
with
substance-related
disorders.
i.
Developing
a
proposal
for
redesign
of
publicly
funded
children’s
disability
services,
including
but
not
limited
to
the
needs
of
children
who
are
placed
out-of-state
due
to
the
lack
of
treatment
services
in
this
state.
The
proposal
shall
be
developed
by
a
separate
workgroup
or
subcommittee
led
by
the
department
of
human
services,
in
consultation
with
the
department
of
public
health,
and
in
addition
to
the
other
interests
and
representation
required
by
this
section,
the
membership
shall
include
the
department
of
human
services
staff
involved
with
child
welfare,
children’s
mental
health,
and
Medicaid
services,
and
education
system
and
juvenile
court
representatives.
The
preliminary
findings
and
recommendations,
and
the
initial
proposal
shall
be
submitted
by
the
October
and
December
2011
dates
required
for
other
workgroups
and
subcommittees.
The
initial
proposal
developed
during
the
2011
legislative
interim
shall
include
an
analysis
of
gaps
in
the
children’s
system
and
other
planning
provisions
necessary
to
complete
the
final
proposal
for
submission
on
or
before
December
10,
2012.
j.
Developing
a
proposal
for
adult
disability
services
not
paid
for
by
the
Medicaid
program
to
be
administered
on
a
regional
basis
in
a
manner
that
provides
multiple
local
points
of
access
for
consumers
needing
adult
disability
services,
regardless
of
the
funding
sources
for
the
services.
Senate
File
525,
p.
6
The
proposal
shall
be
integrated
with
the
other
proposals
under
this
subsection
and
shall
be
developed
by
a
separate
workgroup
or
subcommittee
engaging
both
urban
and
rural
county
supervisors
and
central-point-of-coordination
administrators
and
other
experts.
The
considerations
for
inclusion
in
the
proposal
for
forming
regional
entities
shall
include
but
are
not
limited
to
all
of
the
following:
(1)
Modifying
the
relevant
provisions
of
chapter
28E
for
use
by
counties
in
forming
regional
entities
and
addressing
other
necessary
contracting
measures.
(2)
Providing
for
performance-based
contracting
between
the
department
of
human
services
and
regional
entities
to
ensure
the
existence
of
multiple,
local
points
of
access
for
adult
disability
services
eligibility,
intake,
and
authorization,
service
navigation
support,
and
case
coordination
or
case
management,
regardless
of
the
funding
sources
for
the
services.
(3)
Developing
a
three-year
service
plan
and
annual
update
to
meet
the
needs
of
consumers.
(4)
Providing
for
the
regional
entities
to
implement
performance-based
contracts,
uniform
cost
reports,
and
consistent
reimbursement
practices
and
payment
methodologies
with
local
providers
of
services
not
paid
for
by
the
Medicaid
program.
(5)
Providing
for
the
regional
entities
to
determine
the
Medicaid
program
targeted
case
managers
to
serve
the
regions.
(6)
Providing
for
the
regional
entities
and
the
department
of
human
services
to
regularly
coordinate
and
communicate
with
one
another
concerning
the
adult
disability
services
paid
for
by
the
Medicaid
program
so
that
services
paid
for
by
the
program
and
the
regional
entities
are
integrated
and
coordinated.
(7)
Identifying
sufficient
population
size
to
attain
economy
of
scale,
adequate
financial
resources,
and
appropriate
service
delivery.
(8)
Addressing
full
participation
in
regional
entities
by
counties.
(9)
Including
dispute
resolution
provisions
for
county-to-county
relationships,
county-to-region
relationships,
and
region-to-state
relationships.
(10)
Providing
for
a
consumer
appeal
process
that
is
clear,
impartial,
and
consistent,
with
consideration
of
an
option
that
appeals
beyond
the
regional
level
should
be
to
a
state
administrative
law
judge.
Senate
File
525,
p.
7
(11)
Addressing
financial
management
provisions,
including
appropriate
financial
reserve
levels.
(12)
Proposing
other
criteria
for
forming
regional
entities.
The
other
criteria
considered
shall
include
but
are
not
limited
to
all
of
the
following:
(a)
Requiring
a
region
to
consist
of
contiguous
counties.
(b)
Evaluating
a
proposed
region’s
capacity
for
providing
core
services
and
performing
required
functions.
(c)
Requiring
a
region
to
encompass
at
least
one
community
mental
health
center
or
federally
qualified
health
center
with
providers
qualified
to
provide
psychiatric
services,
either
directly
or
with
assistance
from
psychiatric
consultants,
that
has
the
capacity
to
provide
outpatient
services
for
the
region
and
has
provided
evidence
of
a
commitment
to
provide
outpatient
services
for
the
region.
(d)
Requiring
a
region
to
encompass
or
have
reasonably
close
proximity
to
a
hospital
with
an
inpatient
psychiatric
unit
or
to
a
state
mental
health
institute,
that
has
the
capacity
to
provide
inpatient
services
for
the
region
and
has
provided
evidence
of
a
commitment
to
provide
inpatient
services
for
the
region.
(e)
Requiring
an
administrative
structure
utilized
by
a
region
to
have
clear
lines
of
accountability
and
to
serve
as
a
lead
agency
with
shared
county
staff
or
other
means
of
limiting
administrative
costs
to
not
more
than
five
percent
of
expenditures.
k.
Incorporating
into
proposals
any
necessary
changes
to
the
chapter
230A
amendments
contained
in
this
Act.
l.
Providing
cost
estimates
for
the
proposals.
5.
The
target
date
for
full
implementation
of
the
plan
and
implementation
provisions
described
in
subsections
3
and
4
shall
be
July
1,
2013,
provided,
however,
that
any
expansion
of
services
is
subject
to
available
funding.
Sec.
2.
CONTINUATION
OF
WORKGROUP
BY
JUDICIAL
BRANCH
AND
DEPARTMENT
OF
HUMAN
SERVICES.
The
judicial
branch
and
department
of
human
services
shall
continue
the
workgroup
implemented
pursuant
to
2010
Iowa
Acts,
chapter
1192,
section
24,
subsection
2,
to
improve
the
processes
for
involuntary
commitment
for
chronic
substance
abuse
under
chapter
125
and
for
serious
mental
illness
under
chapter
229,
and
shall
coordinate
its
efforts
with
the
legislative
interim
committee
and
other
workgroups
initiated
pursuant
to
this
Act.
The
recommendations
issued
by
the
workgroup
shall
address
options
Senate
File
525,
p.
8
to
the
current
provision
of
transportation
by
the
county
sheriff;
to
the
role,
supervision,
and
funding
of
mental
health
patient
advocates
and
substance-related
disorder
patient
advocates,
along
with
options
for
implementation
of
the
provision
of
advocates
to
patients
with
such
disorders;
for
revising
requirements
for
mental
health
professionals
who
are
engaged
in
the
involuntary
commitment
and
examination
processes
under
chapter
229;
for
authorizing
the
court
to
order
an
involuntary
hold
of
a
patient
under
section
229.10
for
not
more
than
twenty-three
hours
who
was
not
initially
taken
into
custody
but
declined
to
be
examined
pursuant
to
a
previous
court
order;
for
implementing
jail
diversion
programs,
comprehensive
training
of
law
enforcement
in
dealing
with
individuals
who
are
experiencing
a
mental
health
crisis,
mental
health
courts,
and
other
promising
reforms
involving
mental
health
and
the
criminal
justice
system;
and
for
civil
commitment
prescreening.
Preliminary
recommendations
shall
be
submitted
to
the
legislative
interim
committee
in
October
2011,
as
specified
by
the
interim
committee.
Additional
stakeholders
shall
be
added
as
necessary
to
facilitate
the
workgroup
efforts.
The
workgroup
shall
complete
deliberations
and
submit
a
final
report
to
the
legislative
interim
committee
providing
findings
and
recommendations
on
or
before
December
9,
2011.
Sec.
3.
SERVICE
SYSTEM
DATA
AND
STATISTICAL
INFORMATION
INTEGRATION.
In
coordination
with
the
legislative
interim
committee
and
workgroups
initiated
pursuant
to
this
Act,
representatives
of
the
department
of
human
services,
department
of
public
health,
and
the
community
services
network
hosted
by
the
Iowa
state
association
of
counties
shall
develop
implementation
provisions
for
an
integrated
data
and
statistical
information
system
for
mental
health,
disability
services,
and
substance
abuse
services.
The
implementation
provisions
shall
incorporate
federal
data
and
statistical
information
requirements.
When
completed,
the
departments
and
affiliate
shall
report
on
the
integrated
system
to
the
governor,
the
joint
appropriations
subcommittee
on
health
and
human
services,
and
the
legislative
services
agency,
providing
their
findings
and
recommendations.
Sec.
4.
DEPARTMENT
OF
HUMAN
SERVICES.
There
is
appropriated
from
the
general
fund
of
the
state
to
the
department
of
human
services
for
the
fiscal
year
beginning
July
1,
2010,
and
ending
June
30,
2011,
the
following
amount,
or
so
much
thereof
as
is
necessary,
to
be
used
for
the
purposes
designated:
Senate
File
525,
p.
9
For
the
costs
of
planning
and
other
processes
associated
with
implementation
of
this
Act:
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
$
250,000
Notwithstanding
section
8.47
or
any
other
provision
of
law
to
the
contrary,
the
department
may
utilize
a
sole
source
approach
to
contract
to
support
planning
and
other
processes
associated
with
implementation
of
this
Act.
Notwithstanding
section
8.33,
moneys
appropriated
in
this
section
that
remain
unencumbered
or
unobligated
at
the
close
of
the
fiscal
year
shall
not
revert
but
shall
remain
available
for
expenditure
for
the
purposes
designated
until
the
close
of
the
succeeding
fiscal
year.
Sec.
5.
EFFECTIVE
UPON
ENACTMENT.
This
division
of
this
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
DIVISION
II
CONFORMING
PROVISIONS
Sec.
6.
CONFORMING
PROVISIONS.
The
legislative
services
agency
shall
prepare
a
study
bill
for
consideration
by
the
committees
on
human
resources
of
the
senate
and
house
of
representatives
for
the
2012
legislative
session,
providing
any
necessary
conforming
Code
changes
for
implementation
of
the
system
redesign
provisions
contained
in
this
Act.
DIVISION
III
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
Sec.
7.
Section
135H.3,
subsection
1,
Code
2011,
is
amended
to
read
as
follows:
1.
A
psychiatric
medical
institution
for
children
shall
utilize
a
team
of
professionals
to
direct
an
organized
program
of
diagnostic
services,
psychiatric
services,
nursing
care,
and
rehabilitative
services
to
meet
the
needs
of
residents
in
accordance
with
a
medical
care
plan
developed
for
each
resident.
The
membership
of
the
team
of
professionals
may
include
but
is
not
limited
to
an
advanced
registered
nurse
practitioner
or
a
physician
assistant.
Social
and
rehabilitative
services
shall
be
provided
under
the
direction
of
a
qualified
mental
health
professional.
Sec.
8.
Section
135H.6,
subsection
8,
Code
2011,
is
amended
to
read
as
follows:
8.
The
department
of
human
services
may
give
approval
to
conversion
of
beds
approved
under
subsection
6
,
to
beds
which
are
specialized
to
provide
substance
abuse
treatment.
However,
the
total
number
of
beds
approved
under
subsection
6
and
this
Senate
File
525,
p.
10
subsection
shall
not
exceed
four
hundred
thirty.
Conversion
of
beds
under
this
subsection
shall
not
require
a
revision
of
the
certificate
of
need
issued
for
the
psychiatric
institution
making
the
conversion.
Beds
for
children
who
do
not
reside
in
this
state
and
whose
service
costs
are
not
paid
by
public
funds
in
this
state
are
not
subject
to
the
limitations
on
the
number
of
beds
and
certificate
of
need
requirements
otherwise
applicable
under
this
section.
Sec.
9.
PSYCHIATRIC
MEDICAL
INSTITUTIONS
FOR
CHILDREN
AND
RELATED
SERVICES
——
TRANSITION
COMMITTEE.
1.
For
the
purposes
of
this
section,
unless
the
context
otherwise
requires:
a.
“Iowa
plan”
means
the
contract
to
administer
the
behavioral
health
managed
care
plan
under
the
state’s
Medicaid
program.
b.
“PMIC”
means
a
psychiatric
medical
institution
for
children.
2.
It
is
the
intent
of
the
general
assembly
to
do
the
following
under
this
section:
a.
Improve
the
reimbursement,
expected
outcomes,
and
integration
of
PMIC
services
to
serve
the
best
interests
of
children
within
the
context
of
a
redesign
of
the
delivery
of
publicly
funded
children’s
mental
health
services
in
this
state.
b.
Support
the
development
of
specialized
programs
for
children
with
high
acuity
requirements
whose
needs
are
not
met
by
Iowa’s
current
system
and
must
be
served
in
out-of-state
placements.
c.
Transition
PMIC
services
while
providing
services
in
a
manner
that
applies
best
practices
and
is
cost-effective.
3.
The
department
of
human
services,
in
collaboration
with
PMIC
providers,
shall
develop
a
plan
for
transitioning
the
administration
of
PMIC
services
to
the
Iowa
plan.
The
transition
plan
shall
address
specific
strategies
for
appropriately
addressing
PMIC
lengths
of
stay
by
increasing
the
availability
of
less
intensive
levels
of
care,
establishing
vendor
performance
standards,
identifying
levels
of
PMIC
care,
providing
for
performance
and
quality
improvement
technical
assistance
to
providers,
identifying
methods
and
standards
for
credentialing
providers
of
specialized
programs,
using
innovative
reimbursement
incentives
to
improve
access
while
building
the
capacity
of
less
intensive
levels
of
care,
and
providing
implementation
guidelines.
Senate
File
525,
p.
11
4.
a.
The
transition
plan
shall
address
the
development
of
specialized
programs
to
address
the
needs
of
children
in
need
of
more
intensive
treatment
who
are
currently
underserved.
All
of
the
following
criteria
shall
be
used
for
such
programs:
(1)
Geographic
accessibility.
(2)
Expertise
needed
to
assure
appropriate
and
effective
treatment.
(3)
Capability
to
define
and
provide
the
appropriate
array
of
services
and
report
on
standardized
outcome
measures.
(4)
Best
interests
of
the
child.
b.
The
transition
plan
shall
also
address
all
of
the
following:
(1)
Providing
navigation,
access,
and
care
coordination
for
children
and
families
in
need
of
services
from
the
children’s
mental
health
system.
(2)
Integrating
the
children’s
mental
health
waiver
services
under
the
Medicaid
program
with
other
services
addressed
by
the
transition
plan
as
a
means
for
supporting
the
transition
plan
and
ensuring
availability
of
choices
for
community
placements.
(3)
Identifying
admission
and
continued
stay
criteria
for
PMIC
providers.
(4)
Evaluating
changes
in
licensing
standards
for
PMICs
as
necessary
to
ensure
that
the
standards
are
aligned
with
overall
system
goals.
(5)
Evaluating
alternative
reimbursement
and
service
models
that
are
innovative
and
could
support
overall
system
goals.
The
models
may
include
but
are
not
limited
to
accountable
care
organizations,
medical
or
other
health
homes,
and
performance-based
payment
methods.
(6)
Evaluating
the
adequacy
of
reimbursement
at
all
levels
of
the
children’s
mental
health
system.
(7)
Developing
profiles
of
the
conditions
and
behaviors
that
result
in
a
child’s
involuntary
discharge
or
out-of-state
placement.
The
plan
shall
incorporate
provisions
for
developing
specialized
programs
that
are
designed
to
appropriately
meet
the
needs
identified
in
the
profiles.
(8)
Evaluating
and
defining
the
appropriate
array
of
less
intensive
services
for
a
child
leaving
a
hospital
or
PMIC
placement.
(9)
Evaluating
and
defining
the
standards
for
existing
and
new
PMIC
and
other
treatment
levels.
5.
a.
The
department
shall
establish
a
transition
committee
Senate
File
525,
p.
12
that
includes
departmental
staff
representatives
for
Medicaid,
child
welfare,
field,
and
mental
health
services,
the
director
of
the
Iowa
plan,
the
department
of
inspections
and
appeals,
a
representative
of
each
licensed
PMIC,
the
executive
director
of
the
coalition
of
family
and
children’s
services
in
Iowa,
a
person
with
knowledge
and
expertise
in
care
coordination
and
integration
of
PMIC
and
community-based
services,
two
persons
representing
families
affected
by
the
children’s
mental
health
system,
and
a
representative
of
juvenile
court
officers.
b.
The
transition
committee
shall
develop
the
plan
and
manage
the
transition
if
the
plan
is
implemented.
A
preliminary
plan
shall
be
provided
to
the
legislative
interim
committee
authorized
pursuant
to
division
I
of
this
Act
for
consideration
by
the
committee
in
October
2011.
The
completed
plan
shall
be
provided
to
the
interim
committee
by
December
9,
2011,
and
any
revisions
to
address
concerns
identified
by
the
interim
committee
shall
be
incorporated
into
a
final
plan
developed
by
December
31,
2011,
which
shall
be
submitted
to
the
general
assembly
by
January
16,
2012.
The
submitted
plan
shall
include
an
independent
finding
by
the
director
of
human
services,
in
consultation
with
the
office
of
the
governor
and
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services,
that
the
plan
meets
the
intent
of
the
general
assembly
under
this
section.
Unless
otherwise
directed
by
enactment
of
the
general
assembly
the
department
and
the
transition
committee
may
proceed
with
implementation
of
the
submitted
plan
on
or
before
July
1,
2012.
c.
The
transition
committee
shall
continue
to
meet
through
December
31,
2013,
to
oversee
transition
of
PMIC
services
to
the
Iowa
plan.
6.
The
director
of
the
Medicaid
enterprise
of
the
department
of
human
services
shall
annually
report
on
or
before
December
15
to
the
chairpersons
and
ranking
members
of
the
joint
appropriations
subcommittee
on
health
and
human
services
through
December
15,
2016,
regarding
the
implementation
of
this
section.
The
content
of
the
report
shall
include
but
is
not
limited
to
information
on
children
served
by
PMIC
providers,
the
types
of
locations
to
which
children
are
discharged
following
a
hospital
or
PMIC
placement
and
the
community-based
services
available
to
such
children,
and
the
incidence
of
readmission
to
a
PMIC
within
12
months
of
discharge.
The
report
shall
also
recommend
whether
or
not
to
continue
Senate
File
525,
p.
13
administration
of
PMIC
services
under
the
Iowa
plan
based
upon
the
quality
of
service
delivery,
the
value
of
utilizing
the
Iowa
plan
administration
rather
than
the
previous
approach
through
the
Medicaid
enterprise,
and
analysis
of
the
cost
and
benefits
of
utilizing
the
Iowa
plan
approach.
DIVISION
IV
COMMUNITY
MENTAL
HEALTH
CENTERS
COMMUNITY
MENTAL
HEALTH
CENTERS
——
CATCHMENT
AREAS
Sec.
10.
IMPLEMENTATION
OF
DIVISION
——
LEGISLATIVE
INTENT.
It
is
the
intent
of
the
general
assembly
that
the
statutory
amendments
contained
in
this
division
shall
receive
further
consideration
in
the
disability
services
system
redesign
process
implemented
pursuant
to
division
I
of
this
Act
and
by
the
general
assembly
during
the
2012
legislative
session.
The
purpose
of
the
further
consideration
is
to
ensure
that
the
statutory
amendments
are
integrated
with
the
system
redesign
provisions,
including
but
not
limited
to
the
provisions
involving
meeting
the
needs
of
consumers,
connecting
the
regional
administration
of
the
overall
system
with
the
catchment
areas
for
community
mental
health
services,
involvement
of
counties,
terminology
utilized,
matching
core
services
for
centers
with
the
core
services
for
the
overall
system
redesign,
and
matching
accreditation
standards,
financing
provisions,
and
accountability
measures.
Sec.
11.
NEW
SECTION
.
230A.101
Services
system
roles.
1.
The
role
of
the
department
of
human
services,
through
the
division
of
the
department
designated
as
the
state
mental
health
authority
with
responsibility
for
state
policy
concerning
mental
health
and
disability
services,
is
to
develop
and
maintain
policies
for
the
mental
health
and
disability
services
system.
The
policies
shall
address
the
service
needs
of
individuals
of
all
ages
with
disabilities
in
this
state,
regardless
of
the
individuals’
places
of
residence
or
economic
circumstances,
and
shall
be
consistent
with
the
requirements
of
chapter
225C
and
other
applicable
law.
2.
The
role
of
community
mental
health
centers
in
the
mental
health
and
disability
services
system
is
to
provide
an
organized
set
of
services
in
order
to
adequately
meet
the
mental
health
needs
of
this
state’s
citizens
based
on
organized
catchment
areas.
Sec.
12.
NEW
SECTION
.
230A.102
Definitions.
As
used
in
this
chapter,
unless
the
context
otherwise
requires:
Senate
File
525,
p.
14
1.
“Administrator”
,
“commission”
,
“department”
,
“disability
services”
,
and
“division”
mean
the
same
as
defined
in
section
225C.2.
2.
“Catchment
area”
means
a
community
mental
health
center
catchment
area
identified
in
accordance
with
this
chapter.
3.
“Community
mental
health
center”
or
“center”
means
a
community
mental
health
center
designated
in
accordance
with
this
chapter.
Sec.
13.
NEW
SECTION
.
230A.103
Designation
of
community
mental
health
centers.
1.
The
division,
subject
to
agreement
by
any
community
mental
health
center
that
would
provide
services
for
the
catchment
area
and
approval
by
the
commission,
shall
designate
at
least
one
community
mental
health
center
under
this
chapter
for
addressing
the
mental
health
needs
of
the
county
or
counties
comprising
the
catchment
area.
The
designation
process
shall
provide
for
the
input
of
potential
service
providers
regarding
designation
of
the
initial
catchment
area
or
a
change
in
the
designation.
2.
The
division
shall
utilize
objective
criteria
for
designating
a
community
mental
health
center
to
serve
a
catchment
area
and
for
withdrawing
such
designation.
The
commission
shall
adopt
rules
outlining
the
criteria.
The
criteria
shall
include
but
are
not
limited
to
provisions
for
meeting
all
of
the
following
requirements:
a.
An
appropriate
means
shall
be
used
for
determining
which
prospective
designee
is
best
able
to
serve
all
ages
of
the
targeted
population
within
the
catchment
area
with
minimal
or
no
service
denials.
b.
An
effective
means
shall
be
used
for
determining
the
relative
ability
of
a
prospective
designee
to
appropriately
provide
mental
health
services
and
other
support
to
consumers
residing
within
a
catchment
area
as
well
as
consumers
residing
outside
the
catchment
area.
The
criteria
shall
address
the
duty
for
a
prospective
designee
to
arrange
placements
outside
the
catchment
area
when
such
placements
best
meet
consumer
needs
and
to
provide
services
within
the
catchment
area
to
consumers
who
reside
outside
the
catchment
area
when
the
services
are
necessary
and
appropriate.
3.
The
board
of
directors
for
a
designated
community
mental
health
center
shall
enter
into
an
agreement
with
the
division.
The
terms
of
the
agreement
shall
include
but
are
not
limited
to
all
of
the
following:
Senate
File
525,
p.
15
a.
The
period
of
time
the
agreement
will
be
in
force.
b.
The
services
and
other
support
the
center
will
offer
or
provide
for
the
residents
of
the
catchment
area.
c.
The
standards
to
be
followed
by
the
center
in
determining
whether
and
to
what
extent
the
persons
seeking
services
from
the
center
shall
be
considered
to
be
able
to
pay
the
costs
of
the
services.
d.
The
policies
regarding
availability
of
the
services
offered
by
the
center
to
the
residents
of
the
catchment
area
as
well
as
consumers
residing
outside
the
catchment
area.
e.
The
requirements
for
preparation
and
submission
to
the
division
of
annual
audits,
cost
reports,
program
reports,
performance
measures,
and
other
financial
and
service
accountability
information.
4.
This
section
does
not
limit
the
authority
of
the
board
or
the
boards
of
supervisors
of
any
county
or
group
of
counties
to
continue
to
expend
money
to
support
operation
of
a
center.
Sec.
14.
NEW
SECTION
.
230A.104
Catchment
areas.
1.
The
division
shall
collaborate
with
affected
counties
in
identifying
community
mental
health
center
catchment
areas
in
accordance
with
this
section.
2.
a.
Unless
the
division
has
determined
that
exceptional
circumstances
exist,
a
catchment
area
shall
be
served
by
one
community
mental
health
center.
The
purpose
of
this
general
limitation
is
to
clearly
designate
the
center
responsible
and
accountable
for
providing
core
mental
health
services
to
the
target
population
in
the
catchment
area
and
to
protect
the
financial
viability
of
the
centers
comprising
the
mental
health
services
system
in
the
state.
b.
A
formal
review
process
shall
be
used
in
determining
whether
exceptional
circumstances
exist
that
justify
designating
more
than
one
center
to
serve
a
catchment
area.
The
criteria
for
the
review
process
shall
include
but
are
not
limited
to
a
means
of
determining
whether
the
catchment
area
can
support
more
than
one
center.
c.
Criteria
shall
be
provided
that
would
allow
the
designation
of
more
than
one
center
for
all
or
a
portion
of
a
catchment
area
if
designation
or
approval
for
more
than
one
center
was
provided
by
the
division
as
of
October
1,
2010.
The
criteria
shall
require
a
determination
that
all
such
centers
would
be
financially
viable
if
designation
is
provided
for
all.
Sec.
15.
NEW
SECTION
.
230A.105
Target
population
——
eligibility.
Senate
File
525,
p.
16
1.
The
target
population
residing
in
a
catchment
area
to
be
served
by
a
community
mental
health
center
shall
include
but
is
not
limited
to
all
of
the
following:
a.
Individuals
of
any
age
who
are
experiencing
a
mental
health
crisis.
b.
Individuals
of
any
age
who
have
a
mental
health
disorder.
c.
Adults
who
have
a
serious
mental
illness
or
chronic
mental
illness.
d.
Children
and
youth
who
are
experiencing
a
serious
emotional
disturbance.
e.
Individuals
described
in
paragraph
“a”
,
“b”
,
“c”
,
or
“d”
who
have
a
co-occurring
disorder,
including
but
not
limited
to
substance
abuse,
mental
retardation,
a
developmental
disability,
brain
injury,
autism
spectrum
disorder,
or
another
disability
or
special
health
care
need.
2.
Specific
eligibility
criteria
for
members
of
the
target
population
shall
be
identified
in
administrative
rules
adopted
by
the
commission.
The
eligibility
criteria
shall
address
both
clinical
and
financial
eligibility.
Sec.
16.
NEW
SECTION
.
230A.106
Services
offered.
1.
A
community
mental
health
center
designated
in
accordance
with
this
chapter
shall
offer
core
services
and
support
addressing
the
basic
mental
health
and
safety
needs
of
the
target
population
and
other
residents
of
the
catchment
area
served
by
the
center
and
may
offer
other
services
and
support.
The
core
services
shall
be
identified
in
administrative
rules
adopted
by
the
commission
for
this
purpose.
2.
The
initial
core
services
identified
shall
include
all
of
the
following:
a.
Outpatient
services.
Outpatient
services
shall
consist
of
evaluation
and
treatment
services
provided
on
an
ambulatory
basis
for
the
target
population.
Outpatient
services
include
psychiatric
evaluations,
medication
management,
and
individual,
family,
and
group
therapy.
In
addition,
outpatient
services
shall
include
specialized
outpatient
services
directed
to
the
following
segments
of
the
target
population:
children,
elderly,
individuals
who
have
serious
and
persistent
mental
illness,
and
residents
of
the
service
area
who
have
been
discharged
from
inpatient
treatment
at
a
mental
health
facility.
Outpatient
services
shall
provide
elements
of
diagnosis,
treatment,
and
appropriate
follow-up.
The
provision
of
only
screening
and
referral
services
does
not
constitute
outpatient
services.
Senate
File
525,
p.
17
b.
Twenty-four-hour
emergency
services.
Twenty-four-hour
emergency
services
shall
be
provided
through
a
system
that
provides
access
to
a
clinician
and
appropriate
disposition
with
follow-up
documentation
of
the
emergency
service
provided.
A
patient
shall
have
access
to
evaluation
and
stabilization
services
after
normal
business
hours.
The
range
of
emergency
services
that
shall
be
available
to
a
patient
may
include
but
are
not
limited
to
direct
contact
with
a
clinician,
medication
evaluation,
and
hospitalization.
The
emergency
services
may
be
provided
directly
by
the
center
or
in
collaboration
or
affiliation
with
other
appropriately
accredited
providers.
c.
Day
treatment,
partial
hospitalization,
or
psychosocial
rehabilitation
services.
Such
services
shall
be
provided
as
structured
day
programs
in
segments
of
less
than
twenty-four
hours
using
a
multidisciplinary
team
approach
to
develop
treatment
plans
that
vary
in
intensity
of
services
and
the
frequency
and
duration
of
services
based
on
the
needs
of
the
patient.
These
services
may
be
provided
directly
by
the
center
or
in
collaboration
or
affiliation
with
other
appropriately
accredited
providers.
d.
Admission
screening
for
voluntary
patients.
Admission
screening
services
shall
be
available
for
patients
considered
for
voluntary
admission
to
a
state
mental
health
institute
to
determine
the
patient’s
appropriateness
for
admission.
e.
Community
support
services.
Community
support
services
shall
consist
of
support
and
treatment
services
focused
on
enhancing
independent
functioning
and
assisting
persons
in
the
target
population
who
have
a
serious
and
persistent
mental
illness
to
live
and
work
in
their
community
setting,
by
reducing
or
managing
mental
illness
symptoms
and
the
associated
functional
disabilities
that
negatively
impact
such
persons’
community
integration
and
stability.
f.
Consultation
services.
Consultation
services
may
include
provision
of
professional
assistance
and
information
about
mental
health
and
mental
illness
to
individuals,
service
providers,
or
groups
to
increase
such
persons’
effectiveness
in
carrying
out
their
responsibilities
for
providing
services.
Consultations
may
be
case-specific
or
program-specific.
g.
Education
services.
Education
services
may
include
information
and
referral
services
regarding
available
resources
and
information
and
training
concerning
mental
Senate
File
525,
p.
18
health,
mental
illness,
availability
of
services
and
other
support,
the
promotion
of
mental
health,
and
the
prevention
of
mental
illness.
Education
services
may
be
made
available
to
individuals,
groups,
organizations,
and
the
community
in
general.
3.
A
community
mental
health
center
shall
be
responsible
for
coordinating
with
associated
services
provided
by
other
unaffiliated
agencies
to
members
of
the
target
population
in
the
catchment
area
and
to
integrate
services
in
the
community
with
services
provided
to
the
target
population
in
residential
or
inpatient
settings.
Sec.
17.
NEW
SECTION
.
230A.107
Form
of
organization.
1.
Except
as
authorized
in
subsection
2,
a
community
mental
health
center
designated
in
accordance
with
this
chapter
shall
be
organized
and
administered
as
a
nonprofit
corporation.
2.
A
for-profit
corporation,
nonprofit
corporation,
or
county
hospital
providing
mental
health
services
to
county
residents
pursuant
to
a
waiver
approved
under
section
225C.7,
subsection
3,
Code
2011,
as
of
October
1,
2010,
may
also
be
designated
as
a
community
mental
health
center.
Sec.
18.
NEW
SECTION
.
230A.108
Administrative,
diagnostic,
and
demographic
information.
Release
of
administrative
and
diagnostic
information,
as
defined
in
section
228.1,
and
demographic
information
necessary
for
aggregated
reporting
to
meet
the
data
requirements
established
by
the
division,
relating
to
an
individual
who
receives
services
from
a
community
mental
health
center,
may
be
made
a
condition
of
support
of
that
center
by
the
division.
Sec.
19.
NEW
SECTION
.
230A.109
Funding
——
legislative
intent.
1.
It
is
the
intent
of
the
general
assembly
that
public
funding
for
community
mental
health
centers
designated
in
accordance
with
this
chapter
shall
be
provided
as
a
combination
of
all
funding
sources.
2.
It
is
the
intent
of
the
general
assembly
that
the
state
funding
provided
to
centers
be
a
sufficient
amount
for
the
core
services
and
support
addressing
the
basic
mental
health
and
safety
needs
of
the
residents
of
the
catchment
area
served
by
each
center
to
be
provided
regardless
of
individual
ability
to
pay
for
the
services
and
support.
3.
While
a
community
mental
health
center
must
comply
with
the
core
services
requirements
and
other
standards
associated
with
designation,
provision
of
services
is
subject
to
the
Senate
File
525,
p.
19
availability
of
a
payment
source
for
the
services.
Sec.
20.
NEW
SECTION
.
230A.110
Standards.
1.
The
division
shall
recommend
and
the
commission
shall
adopt
standards
for
designated
community
mental
health
centers
and
comprehensive
community
mental
health
programs,
with
the
overall
objective
of
ensuring
that
each
center
and
each
affiliate
providing
services
under
contract
with
a
center
furnishes
high-quality
mental
health
services
within
a
framework
of
accountability
to
the
community
it
serves.
The
standards
adopted
shall
conform
with
federal
standards
applicable
to
community
mental
health
centers
and
shall
be
in
substantial
conformity
with
the
applicable
behavioral
health
standards
adopted
by
the
joint
commission,
formerly
known
as
the
joint
commission
on
accreditation
of
health
care
organizations,
and
other
recognized
national
standards
for
evaluation
of
psychiatric
facilities
unless
in
the
judgment
of
the
division,
with
approval
of
the
commission,
there
are
sound
reasons
for
departing
from
the
standards.
2.
When
recommending
standards
under
this
section,
the
division
shall
designate
an
advisory
committee
representing
boards
of
directors
and
professional
staff
of
designated
community
mental
health
centers
to
assist
in
the
formulation
or
revision
of
standards.
The
membership
of
the
advisory
committee
shall
include
representatives
of
professional
and
nonprofessional
staff
and
other
appropriate
individuals.
3.
The
standards
recommended
under
this
section
shall
include
requirements
that
each
community
mental
health
center
designated
under
this
chapter
do
all
of
the
following:
a.
Maintain
and
make
available
to
the
public
a
written
statement
of
the
services
the
center
offers
to
residents
of
the
catchment
area
being
served.
The
center
shall
employ
or
contract
for
services
with
affiliates
to
employ
staff
who
are
appropriately
credentialed
or
meet
other
qualifications
in
order
to
provide
services.
b.
If
organized
as
a
nonprofit
corporation,
be
governed
by
a
board
of
directors
which
adequately
represents
interested
professions,
consumers
of
the
center’s
services,
socioeconomic,
cultural,
and
age
groups,
and
various
geographical
areas
in
the
catchment
area
served
by
the
center.
If
organized
as
a
for-profit
corporation,
the
corporation’s
policy
structure
shall
incorporate
such
representation.
c.
Arrange
for
the
financial
condition
and
transactions
of
the
community
mental
health
center
to
be
audited
once
each
year
Senate
File
525,
p.
20
by
the
auditor
of
state.
However,
in
lieu
of
an
audit
by
state
accountants,
the
local
governing
body
of
a
community
mental
health
center
organized
under
this
chapter
may
contract
with
or
employ
certified
public
accountants
to
conduct
the
audit,
pursuant
to
the
applicable
terms
and
conditions
prescribed
by
sections
11.6
and
11.19
and
audit
format
prescribed
by
the
auditor
of
state.
Copies
of
each
audit
shall
be
furnished
by
the
accountant
to
the
administrator
of
the
division
of
mental
health
and
disability
services.
d.
Comply
with
the
accreditation
standards
applicable
to
the
center.
Sec.
21.
NEW
SECTION
.
230A.111
Review
and
evaluation.
1.
The
review
and
evaluation
of
designated
centers
shall
be
performed
through
a
formal
accreditation
review
process
as
recommended
by
the
division
and
approved
by
the
commission.
The
accreditation
process
shall
include
all
of
the
following:
a.
Specific
time
intervals
for
full
accreditation
reviews
based
upon
levels
of
accreditation.
b.
Use
of
random
or
complaint-specific,
on-site
limited
accreditation
reviews
in
the
interim
between
full
accreditation
reviews,
as
a
quality
review
approach.
The
results
of
such
reviews
shall
be
presented
to
the
commission.
c.
Use
of
center
accreditation
self-assessment
tools
to
gather
data
regarding
quality
of
care
and
outcomes,
whether
used
during
full
or
limited
reviews
or
at
other
times.
2.
The
accreditation
process
shall
include
but
is
not
limited
to
addressing
all
of
the
following:
a.
Measures
to
address
centers
that
do
not
meet
standards,
including
authority
to
revoke
accreditation.
b.
Measures
to
address
noncompliant
centers
that
do
not
develop
a
corrective
action
plan
or
fail
to
implement
steps
included
in
a
corrective
action
plan
accepted
by
the
division.
c.
Measures
to
appropriately
recognize
centers
that
successfully
complete
a
corrective
action
plan.
d.
Criteria
to
determine
when
a
center’s
accreditation
should
be
denied,
revoked,
suspended,
or
made
provisional.
Sec.
22.
REPEAL.
Sections
230A.1
through
230A.18,
Code
2011,
are
repealed.
Sec.
23.
IMPLEMENTATION
——
EFFECTIVE
DATE.
1.
Community
mental
health
centers
operating
under
the
provisions
of
chapter
230A,
Code
2011,
and
associated
standards,
rules,
and
other
requirements
as
of
June
30,
2012,
may
continue
to
operate
under
such
requirements
until
the
Senate
File
525,
p.
21
department
of
human
services,
division
of
mental
health
and
disability
services,
and
the
mental
health
and
disability
services
commission
have
completed
the
rules
adoption
process
to
implement
the
amendments
to
chapter
230A
enacted
by
this
Act,
identified
catchment
areas,
and
completed
designations
of
centers.
2.
The
division
and
the
commission
shall
complete
the
rules
adoption
process
and
other
requirements
addressed
in
subsection
1
on
or
before
June
30,
2012.
3.
Except
for
this
section,
which
shall
take
effect
July
1,
2011,
this
division
of
this
Act
takes
effect
July
1,
2012.
DIVISION
V
PERSONS
WITH
SUBSTANCE-RELATED
DISORDERS
AND
PERSONS
WITH
MENTAL
ILLNESS
Sec.
24.
Section
125.1,
subsection
1,
Code
2011,
is
amended
to
read
as
follows:
1.
That
substance
abusers
and
persons
suffering
from
chemical
dependency
persons
with
substance-related
disorders
be
afforded
the
opportunity
to
receive
quality
treatment
and
directed
into
rehabilitation
services
which
will
help
them
resume
a
socially
acceptable
and
productive
role
in
society.
Sec.
25.
Section
125.2,
subsection
2,
Code
2011,
is
amended
by
striking
the
subsection.
Sec.
26.
Section
125.2,
subsection
5,
Code
2011,
is
amended
by
striking
the
subsection
and
inserting
in
lieu
thereof
the
following:
5.
“Substance-related
disorder”
means
a
diagnosable
substance
abuse
disorder
of
sufficient
duration
to
meet
diagnostic
criteria
specified
within
the
most
current
diagnostic
and
statistical
manual
of
mental
disorders
published
by
the
American
psychiatric
association
that
results
in
a
functional
impairment.
Sec.
27.
Section
125.2,
subsection
9,
Code
2011,
is
amended
to
read
as
follows:
9.
“Facility”
means
an
institution,
a
detoxification
center,
or
an
installation
providing
care,
maintenance
and
treatment
for
substance
abusers
persons
with
substance-related
disorders
licensed
by
the
department
under
section
125.13
,
hospitals
licensed
under
chapter
135B
,
or
the
state
mental
health
institutes
designated
by
chapter
226
.
Sec.
28.
Section
125.2,
subsections
13,
17,
and
18,
Code
2011,
are
amended
by
striking
the
subsections.
Sec.
29.
Section
125.9,
subsections
2
and
4,
Code
2011,
are
Senate
File
525,
p.
22
amended
to
read
as
follows:
2.
Make
contracts
necessary
or
incidental
to
the
performance
of
the
duties
and
the
execution
of
the
powers
of
the
director,
including
contracts
with
public
and
private
agencies,
organizations
and
individuals
to
pay
them
for
services
rendered
or
furnished
to
substance
abusers,
chronic
substance
abusers,
or
intoxicated
persons
persons
with
substance-related
disorders
.
4.
Coordinate
the
activities
of
the
department
and
cooperate
with
substance
abuse
programs
in
this
and
other
states,
and
make
contracts
and
other
joint
or
cooperative
arrangements
with
state,
local
or
private
agencies
in
this
and
other
states
for
the
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
and
for
the
common
advancement
of
substance
abuse
programs.
Sec.
30.
Section
125.10,
subsections
2,
3,
4,
5,
7,
8,
9,
11,
13,
15,
and
17,
Code
2011,
are
amended
to
read
as
follows:
2.
Develop,
encourage,
and
foster
statewide,
regional
and
local
plans
and
programs
for
the
prevention
of
substance
abuse
misuse
and
the
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
in
cooperation
with
public
and
private
agencies,
organizations
and
individuals,
and
provide
technical
assistance
and
consultation
services
for
these
purposes.
3.
Coordinate
the
efforts
and
enlist
the
assistance
of
all
public
and
private
agencies,
organizations
and
individuals
interested
in
the
prevention
of
substance
abuse
and
the
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
.
4.
Cooperate
with
the
department
of
human
services
and
the
Iowa
department
of
public
health
in
establishing
and
conducting
programs
to
provide
treatment
for
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
.
5.
Cooperate
with
the
department
of
education,
boards
of
education,
schools,
police
departments,
courts,
and
other
public
and
private
agencies,
organizations,
and
individuals
in
establishing
programs
for
the
prevention
of
substance
abuse
and
the
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
,
and
in
preparing
relevant
curriculum
materials
for
Senate
File
525,
p.
23
use
at
all
levels
of
school
education.
7.
Develop
and
implement,
as
an
integral
part
of
treatment
programs,
an
educational
program
for
use
in
the
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
,
which
program
shall
include
the
dissemination
of
information
concerning
the
nature
and
effects
of
chemical
substances.
8.
Organize
and
implement,
in
cooperation
with
local
treatment
programs,
training
programs
for
all
persons
engaged
in
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
.
9.
Sponsor
and
implement
research
in
cooperation
with
local
treatment
programs
into
the
causes
and
nature
of
substance
abuse
misuse
and
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
,
and
serve
as
a
clearing
house
for
information
relating
to
substance
abuse.
11.
Develop
and
implement,
with
the
counsel
and
approval
of
the
board,
the
comprehensive
plan
for
treatment
of
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
in
accordance
with
this
chapter
.
13.
Utilize
the
support
and
assistance
of
interested
persons
in
the
community,
particularly
recovered
substance
abusers
and
chronic
substance
abusers,
persons
who
are
recovering
from
substance-related
disorders
to
encourage
substance
abusers
and
chronic
substance
abusers
persons
with
substance-related
disorders
to
voluntarily
undergo
treatment.
15.
Encourage
general
hospitals
and
other
appropriate
health
facilities
to
admit
without
discrimination
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
persons
with
substance-related
disorders
and
to
provide
them
with
adequate
and
appropriate
treatment.
The
director
may
negotiate
and
implement
contracts
with
hospitals
and
other
appropriate
health
facilities
with
adequate
detoxification
facilities.
17.
Review
all
state
health,
welfare,
education
and
treatment
proposals
to
be
submitted
for
federal
funding
under
federal
legislation,
and
advise
the
governor
on
provisions
to
be
included
relating
to
substance
abuse,
substance
abusers,
chronic
substance
abusers,
and
intoxicated
persons
and
persons
with
substance-related
disorders
.
Senate
File
525,
p.
24
Sec.
31.
Section
125.12,
subsections
1
and
3,
Code
2011,
are
amended
to
read
as
follows:
1.
The
board
shall
review
the
comprehensive
substance
abuse
program
implemented
by
the
department
for
the
treatment
of
substance
abusers,
chronic
substance
abusers,
intoxicated
persons
persons
with
substance-related
disorders
,
and
concerned
family
members.
Subject
to
the
review
of
the
board,
the
director
shall
divide
the
state
into
appropriate
regions
for
the
conduct
of
the
program
and
establish
standards
for
the
development
of
the
program
on
the
regional
level.
In
establishing
the
regions,
consideration
shall
be
given
to
city
and
county
lines,
population
concentrations,
and
existing
substance
abuse
treatment
services.
3.
The
director
shall
provide
for
adequate
and
appropriate
treatment
for
substance
abusers,
chronic
substance
abusers,
intoxicated
persons
persons
with
substance-related
disorders
,
and
concerned
family
members
admitted
under
sections
125.33
and
125.34
,
or
under
section
125.75
,
125.81
,
or
125.91
.
Treatment
shall
not
be
provided
at
a
correctional
institution
except
for
inmates.
Sec.
32.
Section
125.13,
subsection
1,
paragraph
a,
Code
2011,
is
amended
to
read
as
follows:
a.
Except
as
provided
in
subsection
2
,
a
person
shall
not
maintain
or
conduct
any
chemical
substitutes
or
antagonists
program,
residential
program,
or
nonresidential
outpatient
program,
the
primary
purpose
of
which
is
the
treatment
and
rehabilitation
of
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
without
having
first
obtained
a
written
license
for
the
program
from
the
department.
Sec.
33.
Section
125.13,
subsection
2,
paragraphs
a
and
c,
Code
2011,
are
amended
to
read
as
follows:
a.
A
hospital
providing
care
or
treatment
to
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
licensed
under
chapter
135B
which
is
accredited
by
the
joint
commission
on
the
accreditation
of
health
care
organizations,
the
commission
on
accreditation
of
rehabilitation
facilities,
the
American
osteopathic
association,
or
another
recognized
organization
approved
by
the
board.
All
survey
reports
from
the
accrediting
or
licensing
body
must
be
sent
to
the
department.
c.
Private
institutions
conducted
by
and
for
persons
who
adhere
to
the
faith
of
any
well
recognized
church
or
religious
Senate
File
525,
p.
25
denomination
for
the
purpose
of
providing
care,
treatment,
counseling,
or
rehabilitation
to
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
and
who
rely
solely
on
prayer
or
other
spiritual
means
for
healing
in
the
practice
of
religion
of
such
church
or
denomination.
Sec.
34.
Section
125.15,
Code
2011,
is
amended
to
read
as
follows:
125.15
Inspections.
The
department
may
inspect
the
facilities
and
review
the
procedures
utilized
by
any
chemical
substitutes
or
antagonists
program,
residential
program,
or
nonresidential
outpatient
program
that
has
as
a
primary
purpose
the
treatment
and
rehabilitation
of
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
,
for
the
purpose
of
ensuring
compliance
with
this
chapter
and
the
rules
adopted
pursuant
to
this
chapter
.
The
examination
and
review
may
include
case
record
audits
and
interviews
with
staff
and
patients,
consistent
with
the
confidentiality
safeguards
of
state
and
federal
law.
Sec.
35.
Section
125.32,
unnumbered
paragraph
1,
Code
2011,
is
amended
to
read
as
follows:
The
department
shall
adopt
and
may
amend
and
repeal
rules
for
acceptance
of
persons
into
the
treatment
program,
subject
to
chapter
17A
,
considering
available
treatment
resources
and
facilities,
for
the
purpose
of
early
and
effective
treatment
of
substance
abusers,
chronic
substance
abusers,
intoxicated
persons,
persons
with
substance-related
disorders
and
concerned
family
members.
In
establishing
the
rules
the
department
shall
be
guided
by
the
following
standards:
Sec.
36.
Section
125.33,
subsections
1,
3,
and
4,
Code
2011,
are
amended
to
read
as
follows:
1.
A
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
may
apply
for
voluntary
treatment
or
rehabilitation
services
directly
to
a
facility
or
to
a
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon.
If
the
proposed
patient
is
a
minor
or
an
incompetent
person,
a
parent,
a
legal
guardian
or
other
legal
representative
may
make
the
application.
The
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon
or
any
employee
or
person
acting
under
the
direction
or
supervision
of
the
physician
and
surgeon
or
osteopathic
physician
and
surgeon,
or
the
facility
shall
not
report
or
disclose
the
name
of
the
person
or
the
fact
that
treatment
Senate
File
525,
p.
26
was
requested
or
has
been
undertaken
to
any
law
enforcement
officer
or
law
enforcement
agency;
nor
shall
such
information
be
admissible
as
evidence
in
any
court,
grand
jury,
or
administrative
proceeding
unless
authorized
by
the
person
seeking
treatment.
If
the
person
seeking
such
treatment
or
rehabilitation
is
a
minor
who
has
personally
made
application
for
treatment,
the
fact
that
the
minor
sought
treatment
or
rehabilitation
or
is
receiving
treatment
or
rehabilitation
services
shall
not
be
reported
or
disclosed
to
the
parents
or
legal
guardian
of
such
minor
without
the
minor’s
consent,
and
the
minor
may
give
legal
consent
to
receive
such
treatment
and
rehabilitation.
3.
A
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
seeking
treatment
or
rehabilitation
and
who
is
either
addicted
or
dependent
on
a
chemical
substance
may
first
be
examined
and
evaluated
by
a
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon
who
may
prescribe
a
proper
course
of
treatment
and
medication,
if
needed.
The
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon
may
further
prescribe
a
course
of
treatment
or
rehabilitation
and
authorize
another
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon
or
facility
to
provide
the
prescribed
treatment
or
rehabilitation
services.
Treatment
or
rehabilitation
services
may
be
provided
to
a
person
individually
or
in
a
group.
A
facility
providing
or
engaging
in
treatment
or
rehabilitation
shall
not
report
or
disclose
to
a
law
enforcement
officer
or
law
enforcement
agency
the
name
of
any
person
receiving
or
engaged
in
the
treatment
or
rehabilitation;
nor
shall
a
person
receiving
or
participating
in
treatment
or
rehabilitation
report
or
disclose
the
name
of
any
other
person
engaged
in
or
receiving
treatment
or
rehabilitation
or
that
the
program
is
in
existence,
to
a
law
enforcement
officer
or
law
enforcement
agency.
Such
information
shall
not
be
admitted
in
evidence
in
any
court,
grand
jury,
or
administrative
proceeding.
However,
a
person
engaged
in
or
receiving
treatment
or
rehabilitation
may
authorize
the
disclosure
of
the
person’s
name
and
individual
participation.
4.
If
a
patient
receiving
inpatient
or
residential
care
leaves
a
facility,
the
patient
shall
be
encouraged
to
consent
to
appropriate
outpatient
or
halfway
house
treatment.
If
it
appears
to
the
administrator
in
charge
of
the
facility
that
the
patient
is
a
substance
abuser
or
chronic
substance
abuser
Senate
File
525,
p.
27
person
with
a
substance-related
disorder
who
requires
help,
the
director
may
arrange
for
assistance
in
obtaining
supportive
services.
Sec.
37.
Section
125.34,
Code
2011,
is
amended
to
read
as
follows:
125.34
Treatment
and
services
for
intoxicated
persons
and
persons
incapacitated
by
alcohol
persons
with
substance-related
disorders
due
to
intoxication
and
substance-induced
incapacitation
.
1.
An
intoxicated
A
person
with
a
substance-related
disorder
due
to
intoxication
or
substance-induced
incapacitation
may
come
voluntarily
to
a
facility
for
emergency
treatment.
A
person
who
appears
to
be
intoxicated
or
incapacitated
by
a
chemical
substance
in
a
public
place
and
in
need
of
help
may
be
taken
to
a
facility
by
a
peace
officer
under
section
125.91
.
If
the
person
refuses
the
proffered
help,
the
person
may
be
arrested
and
charged
with
intoxication
under
section
123.46
,
if
applicable.
2.
If
no
facility
is
readily
available
the
person
may
be
taken
to
an
emergency
medical
service
customarily
used
for
incapacitated
persons.
The
peace
officer
in
detaining
the
person
and
in
taking
the
person
to
a
facility
shall
make
every
reasonable
effort
to
protect
the
person’s
health
and
safety.
In
detaining
the
person
the
detaining
officer
may
take
reasonable
steps
for
self-protection.
Detaining
a
person
under
section
125.91
is
not
an
arrest
and
no
entry
or
other
record
shall
be
made
to
indicate
that
the
person
who
is
detained
has
been
arrested
or
charged
with
a
crime.
3.
A
person
who
arrives
at
a
facility
and
voluntarily
submits
to
examination
shall
be
examined
by
a
licensed
physician
as
soon
as
possible
after
the
person
arrives
at
the
facility.
The
person
may
then
be
admitted
as
a
patient
or
referred
to
another
health
facility.
The
referring
facility
shall
arrange
for
transportation.
4.
If
a
person
is
voluntarily
admitted
to
a
facility,
the
person’s
family
or
next
of
kin
shall
be
notified
as
promptly
as
possible.
If
an
adult
patient
who
is
not
incapacitated
requests
that
there
be
no
notification,
the
request
shall
be
respected.
5.
A
peace
officer
who
acts
in
compliance
with
this
section
is
acting
in
the
course
of
the
officer’s
official
duty
and
is
not
criminally
or
civilly
liable
therefor,
unless
such
acts
constitute
willful
malice
or
abuse.
Senate
File
525,
p.
28
6.
If
the
physician
in
charge
of
the
facility
determines
it
is
for
the
patient’s
benefit,
the
patient
shall
be
encouraged
to
agree
to
further
diagnosis
and
appropriate
voluntary
treatment.
7.
A
licensed
physician
and
surgeon
or
osteopathic
physician
and
surgeon,
facility
administrator,
or
an
employee
or
a
person
acting
as
or
on
behalf
of
the
facility
administrator,
is
not
criminally
or
civilly
liable
for
acts
in
conformity
with
this
chapter
,
unless
the
acts
constitute
willful
malice
or
abuse.
Sec.
38.
Section
125.43,
Code
2011,
is
amended
to
read
as
follows:
125.43
Funding
at
mental
health
institutes.
Chapter
230
governs
the
determination
of
the
costs
and
payment
for
treatment
provided
to
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
in
a
mental
health
institute
under
the
department
of
human
services,
except
that
the
charges
are
not
a
lien
on
real
estate
owned
by
persons
legally
liable
for
support
of
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
and
the
daily
per
diem
shall
be
billed
at
twenty-five
percent.
The
superintendent
of
a
state
hospital
shall
total
only
those
expenditures
which
can
be
attributed
to
the
cost
of
providing
inpatient
treatment
to
substance
abusers
or
chronic
substance
abusers
persons
with
substance-related
disorders
for
purposes
of
determining
the
daily
per
diem.
Section
125.44
governs
the
determination
of
who
is
legally
liable
for
the
cost
of
care,
maintenance,
and
treatment
of
a
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
and
of
the
amount
for
which
the
person
is
liable.
Sec.
39.
Section
125.43A,
Code
2011,
is
amended
to
read
as
follows:
125.43A
Prescreening
——
exception.
Except
in
cases
of
medical
emergency
or
court-ordered
admissions,
a
person
shall
be
admitted
to
a
state
mental
health
institute
for
substance
abuse
treatment
only
after
a
preliminary
intake
and
assessment
by
a
department-licensed
treatment
facility
or
a
hospital
providing
care
or
treatment
for
substance
abusers
persons
with
substance-related
disorders
licensed
under
chapter
135B
and
accredited
by
the
joint
commission
on
the
accreditation
of
health
care
organizations,
the
commission
on
accreditation
of
rehabilitation
facilities,
the
American
osteopathic
association,
or
another
recognized
Senate
File
525,
p.
29
organization
approved
by
the
board,
or
by
a
designee
of
a
department-licensed
treatment
facility
or
a
hospital
other
than
a
state
mental
health
institute,
which
confirms
that
the
admission
is
appropriate
to
the
person’s
substance
abuse
service
needs.
A
county
board
of
supervisors
may
seek
an
admission
of
a
patient
to
a
state
mental
health
institute
who
has
not
been
confirmed
for
appropriate
admission
and
the
county
shall
be
responsible
for
one
hundred
percent
of
the
cost
of
treatment
and
services
of
the
patient.
Sec.
40.
Section
125.44,
Code
2011,
is
amended
to
read
as
follows:
125.44
Agreements
with
facilities
——
liability
for
costs.
The
director
may,
consistent
with
the
comprehensive
substance
abuse
program,
enter
into
written
agreements
with
a
facility
as
defined
in
section
125.2
to
pay
for
one
hundred
percent
of
the
cost
of
the
care,
maintenance,
and
treatment
of
substance
abusers
and
chronic
substance
abusers
persons
with
substance-related
disorders
,
except
when
section
125.43A
applies.
All
payments
for
state
patients
shall
be
made
in
accordance
with
the
limitations
of
this
section
.
Such
contracts
shall
be
for
a
period
of
no
more
than
one
year.
The
contract
may
be
in
the
form
and
contain
provisions
as
agreed
upon
by
the
parties.
The
contract
shall
provide
that
the
facility
shall
admit
and
treat
substance
abusers
and
chronic
substance
abusers
persons
with
substance-related
disorders
regardless
of
where
they
have
residence.
If
one
payment
for
care,
maintenance,
and
treatment
is
not
made
by
the
patient
or
those
legally
liable
for
the
patient,
the
payment
shall
be
made
by
the
department
directly
to
the
facility.
Payments
shall
be
made
each
month
and
shall
be
based
upon
the
rate
of
payment
for
services
negotiated
between
the
department
and
the
contracting
facility.
If
a
facility
projects
a
temporary
cash
flow
deficit,
the
department
may
make
cash
advances
at
the
beginning
of
each
fiscal
year
to
the
facility.
The
repayment
schedule
for
advances
shall
be
part
of
the
contract
between
the
department
and
the
facility.
This
section
does
not
pertain
to
patients
treated
at
the
mental
health
institutes.
If
the
appropriation
to
the
department
is
insufficient
to
meet
the
requirements
of
this
section
,
the
department
shall
request
a
transfer
of
funds
and
section
8.39
shall
apply.
The
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
is
legally
liable
to
the
Senate
File
525,
p.
30
facility
for
the
total
amount
of
the
cost
of
providing
care,
maintenance,
and
treatment
for
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
while
a
voluntary
or
committed
patient
in
a
facility.
This
section
does
not
prohibit
any
individual
from
paying
any
portion
of
the
cost
of
treatment.
The
department
is
liable
for
the
cost
of
care,
treatment,
and
maintenance
of
substance
abusers
and
chronic
substance
abusers
persons
with
substance-related
disorders
admitted
to
the
facility
voluntarily
or
pursuant
to
section
125.75
,
125.81
,
or
125.91
or
section
321J.3
or
124.409
only
to
those
facilities
that
have
a
contract
with
the
department
under
this
section
,
only
for
the
amount
computed
according
to
and
within
the
limits
of
liability
prescribed
by
this
section
,
and
only
when
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
is
unable
to
pay
the
costs
and
there
is
no
other
person,
firm,
corporation,
or
insurance
company
bound
to
pay
the
costs.
The
department’s
maximum
liability
for
the
costs
of
care,
treatment,
and
maintenance
of
substance
abusers
and
chronic
substance
abusers
persons
with
substance-related
disorders
in
a
contracting
facility
is
limited
to
the
total
amount
agreed
upon
by
the
parties
and
specified
in
the
contract
under
this
section
.
Sec.
41.
Section
125.46,
Code
2011,
is
amended
to
read
as
follows:
125.46
County
of
residence
determined.
The
facility
shall,
when
a
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
is
admitted,
or
as
soon
thereafter
as
it
receives
the
proper
information,
determine
and
enter
upon
its
records
the
Iowa
county
of
residence
of
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
,
or
that
the
person
resides
in
some
other
state
or
country,
or
that
the
person
is
unclassified
with
respect
to
residence.
Sec.
42.
Section
125.75,
unnumbered
paragraph
1,
Code
2011,
is
amended
to
read
as
follows:
Proceedings
for
the
involuntary
commitment
or
treatment
of
a
chronic
substance
abuser
person
with
a
substance-related
disorder
to
a
facility
may
be
commenced
by
the
county
attorney
or
an
interested
person
by
filing
a
verified
application
with
the
clerk
of
the
district
court
of
the
county
where
the
respondent
is
presently
located
or
which
is
the
respondent’s
Senate
File
525,
p.
31
place
of
residence.
The
clerk
or
the
clerk’s
designee
shall
assist
the
applicant
in
completing
the
application.
The
application
shall:
Sec.
43.
Section
125.75,
subsection
1,
Code
2011,
is
amended
to
read
as
follows:
1.
State
the
applicant’s
belief
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
.
Sec.
44.
Section
125.80,
subsections
3
and
4,
Code
2011,
are
amended
to
read
as
follows:
3.
If
the
report
of
a
court-designated
physician
is
to
the
effect
that
the
respondent
is
not
a
chronic
substance
abuser
person
with
a
substance-related
disorder
,
the
court,
without
taking
further
action,
may
terminate
the
proceeding
and
dismiss
the
application
on
its
own
motion
and
without
notice.
4.
If
the
report
of
a
court-designated
physician
is
to
the
effect
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
,
the
court
shall
schedule
a
commitment
hearing
as
soon
as
possible.
The
hearing
shall
be
held
not
more
than
forty-eight
hours
after
the
report
is
filed,
excluding
Saturdays,
Sundays,
and
holidays,
unless
an
extension
for
good
cause
is
requested
by
the
respondent,
or
as
soon
thereafter
as
possible
if
the
court
considers
that
sufficient
grounds
exist
for
delaying
the
hearing.
Sec.
45.
Section
125.81,
subsection
1,
Code
2011,
is
amended
to
read
as
follows:
1.
If
a
person
filing
an
application
requests
that
a
respondent
be
taken
into
immediate
custody,
and
the
court
upon
reviewing
the
application
and
accompanying
documentation,
finds
probable
cause
to
believe
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
who
is
likely
to
injure
the
person
or
other
persons
if
allowed
to
remain
at
liberty,
the
court
may
enter
a
written
order
directing
that
the
respondent
be
taken
into
immediate
custody
by
the
sheriff,
and
be
detained
until
the
commitment
hearing,
which
shall
be
held
no
more
than
five
days
after
the
date
of
the
order,
except
that
if
the
fifth
day
after
the
date
of
the
order
is
a
Saturday,
Sunday,
or
a
holiday,
the
hearing
may
be
held
on
the
next
business
day.
The
court
may
order
the
respondent
detained
for
the
period
of
time
until
the
hearing
is
held,
and
no
longer
except
as
provided
in
section
125.88
,
in
accordance
with
subsection
2
,
paragraph
“a”
,
if
possible,
and
if
not,
then
in
accordance
with
subsection
2
,
paragraph
“b”
,
or,
only
if
Senate
File
525,
p.
32
neither
of
these
alternatives
is
available
in
accordance
with
subsection
2
,
paragraph
“c”
.
Sec.
46.
Section
125.82,
subsection
4,
Code
2011,
is
amended
to
read
as
follows:
4.
The
respondent’s
welfare
is
paramount,
and
the
hearing
shall
be
tried
as
a
civil
matter
and
conducted
in
as
informal
a
manner
as
is
consistent
with
orderly
procedure.
Discovery
as
permitted
under
the
Iowa
rules
of
civil
procedure
is
available
to
the
respondent.
The
court
shall
receive
all
relevant
and
material
evidence,
but
the
court
is
not
bound
by
the
rules
of
evidence.
A
presumption
in
favor
of
the
respondent
exists,
and
the
burden
of
evidence
and
support
of
the
contentions
made
in
the
application
shall
be
upon
the
person
who
filed
the
application.
If
upon
completion
of
the
hearing
the
court
finds
that
the
contention
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
has
not
been
sustained
by
clear
and
convincing
evidence,
the
court
shall
deny
the
application
and
terminate
the
proceeding.
Sec.
47.
Section
125.83,
Code
2011,
is
amended
to
read
as
follows:
125.83
Placement
for
evaluation.
If
upon
completion
of
the
commitment
hearing,
the
court
finds
that
the
contention
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
has
been
sustained
by
clear
and
convincing
evidence,
the
court
shall
order
the
respondent
placed
at
a
facility
or
under
the
care
of
a
suitable
facility
on
an
outpatient
basis
as
expeditiously
as
possible
for
a
complete
evaluation
and
appropriate
treatment.
The
court
shall
furnish
to
the
facility
at
the
time
of
admission
or
outpatient
placement,
a
written
statement
of
facts
setting
forth
the
evidence
on
which
the
finding
is
based.
The
administrator
of
the
facility
shall
report
to
the
court
no
more
than
fifteen
days
after
the
individual
is
admitted
to
or
placed
under
the
care
of
the
facility,
which
shall
include
the
chief
medical
officer’s
recommendation
concerning
substance
abuse
treatment.
An
extension
of
time
may
be
granted
for
a
period
not
to
exceed
seven
days
upon
a
showing
of
good
cause.
A
copy
of
the
report
shall
be
sent
to
the
respondent’s
attorney
who
may
contest
the
need
for
an
extension
of
time
if
one
is
requested.
If
the
request
is
contested,
the
court
shall
make
an
inquiry
as
it
deems
appropriate
and
may
either
order
the
respondent
released
from
the
facility
or
grant
extension
of
time
for
Senate
File
525,
p.
33
further
evaluation.
If
the
administrator
fails
to
report
to
the
court
within
fifteen
days
after
the
individual
is
admitted
to
the
facility,
and
no
extension
of
time
has
been
requested,
the
administrator
is
guilty
of
contempt
and
shall
be
punished
under
chapter
665
.
The
court
shall
order
a
rehearing
on
the
application
to
determine
whether
the
respondent
should
continue
to
be
held
at
the
facility.
Sec.
48.
Section
125.83A,
subsection
1,
Code
2011,
is
amended
to
read
as
follows:
1.
If
upon
completion
of
the
commitment
hearing,
the
court
finds
that
the
contention
that
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
has
been
sustained
by
clear
and
convincing
evidence,
and
the
court
is
furnished
evidence
that
the
respondent
is
eligible
for
care
and
treatment
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government
and
that
the
facility
is
willing
to
receive
the
respondent,
the
court
may
so
order.
The
respondent,
when
so
placed
in
a
facility
operated
by
the
United
States
department
of
veterans
affairs
or
another
agency
of
the
United
States
government
within
or
outside
of
this
state,
shall
be
subject
to
the
rules
of
the
United
States
department
of
veterans
affairs
or
other
agency,
but
shall
not
lose
any
procedural
rights
afforded
the
respondent
by
this
chapter
.
The
chief
officer
of
the
facility
shall
have,
with
respect
to
the
respondent
so
placed,
the
same
powers
and
duties
as
the
chief
medical
officer
of
a
hospital
in
this
state
would
have
in
regard
to
submission
of
reports
to
the
court,
retention
of
custody,
transfer,
convalescent
leave,
or
discharge.
Jurisdiction
is
retained
in
the
court
to
maintain
surveillance
of
the
respondent’s
treatment
and
care,
and
at
any
time
to
inquire
into
the
respondent’s
condition
and
the
need
for
continued
care
and
custody.
Sec.
49.
Section
125.84,
subsections
2,
3,
and
4,
Code
2011,
are
amended
to
read
as
follows:
2.
That
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
who
is
in
need
of
full-time
custody,
care,
and
treatment
in
a
facility,
and
is
considered
likely
to
benefit
from
treatment.
If
the
report
so
states,
the
court
shall
enter
an
order
which
may
require
the
respondent’s
continued
placement
and
commitment
to
a
facility
for
appropriate
treatment.
3.
That
the
respondent
is
a
chronic
substance
abuser
person
Senate
File
525,
p.
34
with
a
substance-related
disorder
who
is
in
need
of
treatment,
but
does
not
require
full-time
placement
in
a
facility.
If
the
report
so
states,
the
report
shall
include
the
chief
medical
officer’s
recommendation
for
treatment
of
the
respondent
on
an
outpatient
or
other
appropriate
basis,
and
the
court
shall
enter
an
order
which
may
direct
the
respondent
to
submit
to
the
recommended
treatment.
The
order
shall
provide
that
if
the
respondent
fails
or
refuses
to
submit
to
treatment,
as
directed
by
the
court’s
order,
the
court
may
order
that
the
respondent
be
taken
into
immediate
custody
as
provided
by
section
125.81
and,
following
notice
and
hearing
held
in
accordance
with
the
procedures
of
sections
125.77
and
125.82
,
may
order
the
respondent
treated
as
a
patient
requiring
full-time
custody,
care,
and
treatment
as
provided
in
subsection
2
,
and
may
order
the
respondent
involuntarily
committed
to
a
facility.
4.
That
the
respondent
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
who
is
in
need
of
treatment,
but
in
the
opinion
of
the
chief
medical
officer
is
not
responding
to
the
treatment
provided.
If
the
report
so
states,
the
report
shall
include
the
facility
administrator’s
recommendation
for
alternative
placement,
and
the
court
shall
enter
an
order
which
may
direct
the
respondent’s
transfer
to
the
recommended
placement
or
to
another
placement
after
consultation
with
respondent’s
attorney
and
the
facility
administrator
who
made
the
report
under
this
subsection
.
Sec.
50.
Section
125.91,
subsections
1,
2,
and
3,
Code
2011,
are
amended
to
read
as
follows:
1.
The
procedure
prescribed
by
this
section
shall
only
be
used
for
an
intoxicated
a
person
with
a
substance-related
disorder
due
to
intoxication
or
substance-induced
incapacitation
who
has
threatened,
attempted,
or
inflicted
physical
self-harm
or
harm
on
another,
and
is
likely
to
inflict
physical
self-harm
or
harm
on
another
unless
immediately
detained,
or
who
is
incapacitated
by
a
chemical
substance,
if
that
person
cannot
be
taken
into
immediate
custody
under
sections
125.75
and
125.81
because
immediate
access
to
the
court
is
not
possible.
2.
a.
A
peace
officer
who
has
reasonable
grounds
to
believe
that
the
circumstances
described
in
subsection
1
are
applicable
may,
without
a
warrant,
take
or
cause
that
person
to
be
taken
to
the
nearest
available
facility
referred
to
in
section
125.81,
subsection
2
,
paragraph
“b”
or
“c”
.
Such
an
intoxicated
or
incapacitated
a
person
with
a
substance-related
disorder
due
Senate
File
525,
p.
35
to
intoxication
or
substance-induced
incapacitation
who
also
demonstrates
a
significant
degree
of
distress
or
dysfunction
may
also
be
delivered
to
a
facility
by
someone
other
than
a
peace
officer
upon
a
showing
of
reasonable
grounds.
Upon
delivery
of
the
person
to
a
facility
under
this
section
,
the
examining
physician
may
order
treatment
of
the
person,
but
only
to
the
extent
necessary
to
preserve
the
person’s
life
or
to
appropriately
control
the
person’s
behavior
if
the
behavior
is
likely
to
result
in
physical
injury
to
the
person
or
others
if
allowed
to
continue.
The
peace
officer
or
other
person
who
delivered
the
person
to
the
facility
shall
describe
the
circumstances
of
the
matter
to
the
examining
physician.
If
the
person
is
a
peace
officer,
the
peace
officer
may
do
so
either
in
person
or
by
written
report.
If
the
examining
physician
has
reasonable
grounds
to
believe
that
the
circumstances
in
subsection
1
are
applicable,
the
examining
physician
shall
at
once
communicate
with
the
nearest
available
magistrate
as
defined
in
section
801.4,
subsection
10
.
The
magistrate
shall,
based
upon
the
circumstances
described
by
the
examining
physician,
give
the
examining
physician
oral
instructions
either
directing
that
the
person
be
released
forthwith,
or
authorizing
the
person’s
detention
in
an
appropriate
facility.
The
magistrate
may
also
give
oral
instructions
and
order
that
the
detained
person
be
transported
to
an
appropriate
facility.
b.
If
the
magistrate
orders
that
the
person
be
detained,
the
magistrate
shall,
by
the
close
of
business
on
the
next
working
day,
file
a
written
order
with
the
clerk
in
the
county
where
it
is
anticipated
that
an
application
may
be
filed
under
section
125.75
.
The
order
may
be
filed
by
facsimile
if
necessary.
The
order
shall
state
the
circumstances
under
which
the
person
was
taken
into
custody
or
otherwise
brought
to
a
facility
and
the
grounds
supporting
the
finding
of
probable
cause
to
believe
that
the
person
is
a
chronic
substance
abuser
person
with
a
substance-related
disorder
likely
to
result
in
physical
injury
to
the
person
or
others
if
not
detained.
The
order
shall
confirm
the
oral
order
authorizing
the
person’s
detention
including
any
order
given
to
transport
the
person
to
an
appropriate
facility.
The
clerk
shall
provide
a
copy
of
that
order
to
the
chief
medical
officer
of
the
facility
attending
physician,
to
which
the
person
was
originally
taken,
any
subsequent
facility
to
which
the
person
was
transported,
and
to
any
law
enforcement
department
or
ambulance
service
that
transported
the
person
pursuant
to
the
magistrate’s
order.
Senate
File
525,
p.
36
3.
The
chief
medical
officer
of
the
facility
attending
physician
shall
examine
and
may
detain
the
person
pursuant
to
the
magistrate’s
order
for
a
period
not
to
exceed
forty-eight
hours
from
the
time
the
order
is
dated,
excluding
Saturdays,
Sundays,
and
holidays,
unless
the
order
is
dismissed
by
a
magistrate.
The
facility
may
provide
treatment
which
is
necessary
to
preserve
the
person’s
life
or
to
appropriately
control
the
person’s
behavior
if
the
behavior
is
likely
to
result
in
physical
injury
to
the
person
or
others
if
allowed
to
continue
or
is
otherwise
deemed
medically
necessary
by
the
chief
medical
officer
attending
physician
,
but
shall
not
otherwise
provide
treatment
to
the
person
without
the
person’s
consent.
The
person
shall
be
discharged
from
the
facility
and
released
from
detention
no
later
than
the
expiration
of
the
forty-eight-hour
period,
unless
an
application
for
involuntary
commitment
is
filed
with
the
clerk
pursuant
to
section
125.75
.
The
detention
of
a
person
by
the
procedure
in
this
section
,
and
not
in
excess
of
the
period
of
time
prescribed
by
this
section
,
shall
not
render
the
peace
officer,
attending
physician,
or
facility
detaining
the
person
liable
in
a
criminal
or
civil
action
for
false
arrest
or
false
imprisonment
if
the
peace
officer,
physician,
or
facility
had
reasonable
grounds
to
believe
that
the
circumstances
described
in
subsection
1
were
applicable.
Sec.
51.
Section
226.9C,
subsection
2,
paragraph
c,
Code
2011,
is
amended
to
read
as
follows:
c.
(1)
Prior
to
an
individual’s
admission
for
dual
diagnosis
treatment,
the
individual
shall
have
been
prescreened.
The
person
performing
the
prescreening
shall
be
either
the
mental
health
professional,
as
defined
in
section
228.1,
who
is
contracting
with
the
county
central-point-of-coordination
process
to
provide
the
prescreening
or
a
mental
health
professional
with
the
requisite
qualifications.
A
mental
health
professional
with
the
requisite
qualifications
shall
meet
all
of
the
following
qualifications:
is
a
mental
health
professional
as
defined
in
section
228.1,
is
a
certified
alcohol
and
drug
counselor
certified
by
the
nongovernmental
Iowa
board
of
substance
abuse
certification,
and
is
employed
by
or
providing
services
for
a
facility,
as
defined
in
section
125.2.
(2)
Prior
to
an
individual’s
admission
for
dual
diagnosis
treatment,
the
individual
shall
have
been
screened
through
a
county’s
central
point
of
coordination
process
implemented
Senate
File
525,
p.
37
pursuant
to
section
331.440
to
determine
the
appropriateness
of
the
treatment.
Sec.
52.
Section
229.1,
subsection
12,
Code
2011,
is
amended
to
read
as
follows:
12.
“Psychiatric
advanced
registered
nurse
practitioner”
means
an
individual
currently
licensed
as
a
registered
nurse
under
chapter
152
or
152E
who
holds
a
national
certification
in
psychiatric
mental
health
care
and
who
is
registered
with
the
board
of
nursing
as
an
advanced
registered
nurse
practitioner.
Sec.
53.
Section
229.15,
subsection
3,
paragraph
a,
Code
2011,
is
amended
to
read
as
follows:
a.
A
psychiatric
advanced
registered
nurse
practitioner
treating
a
patient
previously
hospitalized
under
this
chapter
may
complete
periodic
reports
pursuant
to
this
section
on
the
patient
if
the
patient
has
been
recommended
for
treatment
on
an
outpatient
or
other
appropriate
basis
pursuant
to
section
229.14,
subsection
1
,
paragraph
“c”
,
and
if
a
psychiatrist
licensed
pursuant
to
chapter
148
personally
evaluates
the
patient
on
at
least
an
annual
basis
.
Sec.
54.
Section
229.21,
subsection
2,
Code
2011,
is
amended
to
read
as
follows:
2.
When
an
application
for
involuntary
hospitalization
under
this
chapter
or
an
application
for
involuntary
commitment
or
treatment
of
chronic
substance
abusers
persons
with
substance-related
disorders
under
sections
125.75
to
125.94
is
filed
with
the
clerk
of
the
district
court
in
any
county
for
which
a
judicial
hospitalization
referee
has
been
appointed,
and
no
district
judge,
district
associate
judge,
or
magistrate
who
is
admitted
to
the
practice
of
law
in
this
state
is
accessible,
the
clerk
shall
immediately
notify
the
referee
in
the
manner
required
by
section
229.7
or
section
125.77
.
The
referee
shall
discharge
all
of
the
duties
imposed
upon
the
court
by
sections
229.7
to
229.22
or
sections
125.75
to
125.94
in
the
proceeding
so
initiated.
Subject
to
the
provisions
of
subsection
4
,
orders
issued
by
a
referee,
in
discharge
of
duties
imposed
under
this
section
,
shall
have
the
same
force
and
effect
as
if
ordered
by
a
district
judge.
However,
any
commitment
to
a
facility
regulated
and
operated
under
chapter
135C
,
shall
be
in
accordance
with
section
135C.23
.
Sec.
55.
Section
229.21,
subsection
3,
paragraphs
a
and
b,
Code
2011,
are
amended
to
read
as
follows:
a.
Any
respondent
with
respect
to
whom
the
magistrate
or
judicial
hospitalization
referee
has
found
the
contention
that
Senate
File
525,
p.
38
the
respondent
is
seriously
mentally
impaired
or
a
chronic
substance
abuser
person
with
a
substance-related
disorder
sustained
by
clear
and
convincing
evidence
presented
at
a
hearing
held
under
section
229.12
or
section
125.82
,
may
appeal
from
the
magistrate’s
or
referee’s
finding
to
a
judge
of
the
district
court
by
giving
the
clerk
notice
in
writing,
within
ten
days
after
the
magistrate’s
or
referee’s
finding
is
made,
that
an
appeal
is
taken.
The
appeal
may
be
signed
by
the
respondent
or
by
the
respondent’s
next
friend,
guardian,
or
attorney.
b.
An
order
of
a
magistrate
or
judicial
hospitalization
referee
with
a
finding
that
the
respondent
is
seriously
mentally
impaired
or
a
chronic
substance
abuser
person
with
a
substance-related
disorder
shall
include
the
following
notice,
located
conspicuously
on
the
face
of
the
order:
NOTE:
The
respondent
may
appeal
from
this
order
to
a
judge
of
the
district
court
by
giving
written
notice
of
the
appeal
to
the
clerk
of
the
district
court
within
ten
days
after
the
date
of
this
order.
The
appeal
may
be
signed
by
the
respondent
or
by
the
respondent’s
next
friend,
guardian,
or
attorney.
For
a
more
complete
description
of
the
respondent’s
appeal
rights,
consult
section
229.21
of
the
Code
of
Iowa
or
an
attorney.
Sec.
56.
Section
229.21,
subsection
4,
Code
2011,
is
amended
to
read
as
follows:
4.
If
the
appellant
is
in
custody
under
the
jurisdiction
of
the
district
court
at
the
time
of
service
of
the
notice
of
appeal,
the
appellant
shall
be
discharged
from
custody
unless
an
order
that
the
appellant
be
taken
into
immediate
custody
has
previously
been
issued
under
section
229.11
or
section
125.81
,
in
which
case
the
appellant
shall
be
detained
as
provided
in
that
section
until
the
hospitalization
or
commitment
hearing
before
the
district
judge.
If
the
appellant
is
in
the
custody
of
a
hospital
or
facility
at
the
time
of
service
of
the
notice
of
appeal,
the
appellant
shall
be
discharged
from
custody
pending
disposition
of
the
appeal
unless
the
chief
medical
officer,
not
later
than
the
end
of
the
next
secular
day
on
which
the
office
of
the
clerk
is
open
and
which
follows
service
of
the
notice
of
appeal,
files
with
the
clerk
a
certification
that
in
the
chief
medical
officer’s
opinion
the
appellant
is
seriously
mentally
ill
or
a
substance
abuser
person
with
a
substance-related
disorder
.
In
that
case,
the
appellant
shall
remain
in
custody
of
the
hospital
or
facility
until
the
hospitalization
or
commitment
hearing
before
the
district
Senate
File
525,
p.
39
court.
Sec.
57.
Section
230.15,
unnumbered
paragraph
2,
Code
2011,
is
amended
to
read
as
follows:
A
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
is
legally
liable
for
the
total
amount
of
the
cost
of
providing
care,
maintenance,
and
treatment
for
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
while
a
voluntary
or
committed
patient.
When
a
portion
of
the
cost
is
paid
by
a
county,
the
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
is
legally
liable
to
the
county
for
the
amount
paid.
The
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
shall
assign
any
claim
for
reimbursement
under
any
contract
of
indemnity,
by
insurance
or
otherwise,
providing
for
the
abuser’s
person’s
care,
maintenance,
and
treatment
in
a
state
hospital
to
the
state.
Any
payments
received
by
the
state
from
or
on
behalf
of
a
substance
abuser
or
chronic
substance
abuser
person
with
a
substance-related
disorder
shall
be
in
part
credited
to
the
county
in
proportion
to
the
share
of
the
costs
paid
by
the
county.
Nothing
in
this
section
shall
be
construed
to
prevent
a
relative
or
other
person
from
voluntarily
paying
the
full
actual
cost
or
any
portion
of
the
care
and
treatment
of
any
person
with
mental
illness
,
substance
abuser,
or
chronic
substance
abuser
or
a
substance-related
disorder
as
established
by
the
department
of
human
services.
Sec.
58.
Section
232.116,
subsection
1,
paragraph
l,
subparagraph
(2),
Code
2011,
is
amended
to
read
as
follows:
(2)
The
parent
has
a
severe
,
chronic
substance
abuse
problem,
substance-related
disorder
and
presents
a
danger
to
self
or
others
as
evidenced
by
prior
acts.
Sec.
59.
Section
600A.8,
subsection
8,
paragraph
a,
Code
2011,
is
amended
to
read
as
follows:
a.
The
parent
has
been
determined
to
be
a
chronic
substance
abuser
person
with
a
substance-related
disorder
as
defined
in
section
125.2
and
the
parent
has
committed
a
second
or
subsequent
domestic
abuse
assault
pursuant
to
section
708.2A
.
Sec.
60.
Section
602.4201,
subsection
3,
paragraph
h,
Code
2011,
is
amended
to
read
as
follows:
h.
Involuntary
commitment
or
treatment
of
substance
abusers
persons
with
a
substance-related
disorders
.
Sec.
61.
IMPLEMENTATION
OF
ACT.
Section
25B.2,
subsection
3,
shall
not
apply
to
this
division
of
this
Act.
Senate
File
525,
p.
40
Sec.
62.
EFFECTIVE
DATE.
This
division
of
this
Act
takes
effect
July
1,
2012.
______________________________
JOHN
P.
KIBBIE
President
of
the
Senate
______________________________
KRAIG
PAULSEN
Speaker
of
the
House
I
hereby
certify
that
this
bill
originated
in
the
Senate
and
is
known
as
Senate
File
525,
Eighty-fourth
General
Assembly.
______________________________
MICHAEL
E.
MARSHALL
Secretary
of
the
Senate
Approved
_______________,
2011
______________________________
TERRY
E.
BRANSTAD
Governor
