Iowa House Bill HF2673 Latest Draft

                            House File 2673 - Enrolled   House File 2673   AN ACT   RELATED TO STATE BEHAVIORAL HEALTH, DISABILITY, AND ADDICTIVE   DISORDER SERVICES AND RELATED PROGRAMS, INCLUDING THE   TRANSITION OF BEHAVIORAL HEALTH SERVICES FROM A MENTAL   HEALTH AND DISABILITY SERVICES SYSTEM TO A BEHAVIORAL HEALTH   SERVICE SYSTEM, THE TRANSFER OF DISABILITY SERVICES TO THE   DIVISION OF AGING AND DISABILITY SERVICES OF THE DEPARTMENT   OF HEALTH AND HUMAN SERVICES, THE ELIMINATION OF THE   COMMISSION ON AGING, THE ELIMINATION OF SPECIAL INTELLECTUAL   DISABILITY UNITS AT STATE MENTAL HEALTH INSTITUTES, MAKING   APPROPRIATIONS, AND INCLUDING EFFECTIVE DATE PROVISIONS.   BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:    DIVISION I    BEHAVIORAL HEALTH SERVICE SYSTEM    Section 1. NEW SECTION   . 225A.1 Definitions.    As used in this chapter unless the context otherwise    requires:    1. Administrative services organization means an entity    designated by the department pursuant to section 225A.4, to    develop and perform planning and administrative services in    accordance with a district behavioral health service system    plan.    2. Behavioral health condition means a substantial    limitation in major life activities due to a mental,    

  House File 2673, p. 2   behavioral, or addictive disorder or condition diagnosed in    accordance with the criteria provided in the most current    edition of the diagnostic and statistical manual of mental    disorders, published by the American psychiatric association.    3. Behavioral health district or district means a    geographic, multicounty, sub-state area as designated by the    department under section 225A.4.    4. Behavioral health provider or provider means an    individual, firm, corporation, association, or institution    that, pursuant to this chapter, is providing or has been    approved by the department to provide services to an individual    with a behavioral health condition.    5. Behavioral health service system means the behavioral    health service system established in section 225A.3.    6. Caregiver means an adult family member, or other    individual, who is providing care to a person outside of a    formal program.    7. Community mental health center means an entity    designated by the department to address the mental health needs    of one or more counties.    8. Department means the department of health and human    services.    9. Director means the director of the department of health    and human services.    10. District behavioral health advisory council    or advisory council means a council established by an    administrative services organization under section 225A.5, to    identify opportunities, address challenges, and advise the    administrative services organization in accordance with section    225A.5.    11. District behavioral health service system plan or    district behavioral health plan means a plan developed by    an administrative services organization and approved by the    department to outline the services intended to be provided    within the administrative services organizations behavioral    health district.      12. Indicated prevention means prevention activities    designed to prevent the onset of substance use disorders in   

  House File 2673, p. 3   individuals who do not meet the medical criteria for addiction,    but who show early signs of developing a substance use disorder    in the future.    13. Selective prevention means prevention activities    designed to target subsets of the total population who are    considered at-risk for a substance use disorder by virtue of    their membership in a particular segment of the population.    Selective prevention targets the entire subgroup, regardless of    the degree of risk of any individual within the group.    14. State behavioral health service system plan or    state behavioral health plan means the plan developed by the    department that describes the key components of the states    behavioral health service system.    15. Universal prevention means prevention activities    designed to address an entire population class for the purpose    of preventing or delaying the use of alcohol, tobacco, and    other drugs. Population classes include but are not limited    to the national population, local populations, community    populations, school populations, and neighborhood populations.    Sec. 2. NEW SECTION   . 225A.2 State mental health authority     state agency for substance abuse.      1. The department is designated as the state mental health    authority as defined in 42 U.S.C. 201(m) for the purpose of    directing benefits from the federal community mental health    services block grant, 42 U.S.C. 300x et seq., and the state    authority designated for the purpose of directing benefits    from the federal substance abuse prevention and treatment    block grant, 42 U.S.C. 300x-21 et seq. This designation    does not preclude the state board of regents from authorizing    or directing any institution under the board of regents    jurisdiction to carry out educational, prevention, and research    activities in the areas of mental health and intellectual    disability.    2. The department is designated as the single state agency    for substance abuse for the purposes of 42 U.S.C. 1396a et    seq.    3. For the purposes of effectuating the departments roles    designated in this section, the department shall have the    following powers and the authority to take all of the following    

  House File 2673, p. 4   actions:    a. Plan, establish, and maintain prevention, education,    early intervention, treatment, recovery support, and crisis    services programs as necessary or desirable for the behavioral    health service system established in section 225A.3.    b. Develop and submit a state plan as required by, and in    accordance with, 42 U.S.C. 300x-1.    c. Review and approve district behavioral health service    system plans developed in accordance with the state behavioral    health service system plan.    d. Perform all necessary acts to cooperate with any state    agency, political subdivision, or federal government agency to    apply for grants.    e. Solicit and accept for use any gift of money by will or    otherwise, and any grant of money or services from the federal    government, the state, or any political subdivision thereof,    or any private source.    f. Collect and maintain records, engage in studies and    analyses, and gather relevant statistics.    g. Take any other actions as necessary to execute the    duties granted to the department in this chapter, or that    are otherwise required to maintain compliance with federal    requirements related to the departments roles as designated in    this section.    Sec. 3. NEW SECTION   . 225A.3 Behavioral health service    system  department powers and duties.    1. a. A behavioral health service system is established    under the control of the department for the purposes of    implementing a statewide system of prevention, education, early    intervention, treatment, recovery support, and crisis services    related to mental health and addictive disorders, including but    not limited to alcohol use, substance use, tobacco use, and      problem gambling.    b. The behavioral health service system shall support    equitable statewide access to all services offered through    the behavioral health service system and offer specialized    services with a focus on at-risk populations including but not    limited to children, youth, young adults, individuals with    disabilities, pregnant and parenting women, older adults, and    

  House File 2673, p. 5   people with limited access to financial resources.    c. Services offered through the behavioral health service    system shall, at a minimum, include all of the following:    (1) Prevention intervention services and education    programs designed to reduce and mitigate behavioral health    conditions and future behavioral health conditions. Prevention    intervention programs shall incorporate indicated prevention,    selective prevention, and universal prevention activities.    (2) Evidence-based and evidence-informed early intervention    and treatment services.    (3) Comprehensive recovery support services with a focus on    community-based services that avoid, divert, or offset the need    for long-term inpatient services, law enforcement involvement,    or incarceration.    (4) Crisis services with a focus on reducing the escalation    of crisis situations, relieving the immediate distress of    individuals experiencing a crisis situation, and reducing the    risk that individuals in a crisis situation harm themselves.    2. To the extent funding is available, the department shall    perform all of the following duties to develop and administer    the behavioral health service system:    a. (1) Develop a state behavioral health service system    plan that accomplishes all of the following:    (a) Identifies the goals, objectives, and targeted outcomes    for the behavioral health service system.    (b) Identifies the strategies to meet system objectives and    ensure equitable access statewide to prevention, education,    early intervention, treatment, recovery support, and crisis    services.    (c) Is consistent with the state health improvement plan    developed under section 217.17.    (d) Is consistent with the departments agency strategic    plan adopted pursuant to section 8E.206.    (2) The department shall do all of the following when    developing the state behavioral health service system plan:    (a) Collaborate with stakeholders including but not limited    to county supervisors and other local elected officials,    experienced behavioral health providers, and organizations that    represent populations, including but not limited to children,   

  House File 2673, p. 6   served by the behavioral health service system.    (b) Publish the proposed state behavioral health service    system plan on the departments internet site and allow the    public to review and comment on the proposed state behavioral    health system plan prior to the adoption of the proposed state    behavioral health plan.    b. Administer and distribute state appropriations, federal    aid, and grants that have been deposited into the behavioral    health fund established in section 225A.7.    c. Oversee, provide technical assistance to, and    monitor administrative services organizations to ensure the    administrative services organizations compliance with district    behavioral health plans.    d. Collaborate with the department of inspections, appeals,    and licensing on the accreditation, certification, and    licensure of behavioral health providers including but not    limited to the approval, denial, revocation, or suspension of    a behavioral health providers accreditation, certification,    or licensure.    e. Develop and adopt minimum accreditation standards for    the maintenance and operation of community mental health    centers to ensure that each community mental health center,    and each entity that provides services under contract with a    community mental health center, furnishes high-quality mental    health services to the community that the community mental    health center serves in accordance with rules adopted by the    department.    f. Designate community mental health centers.    g. Conduct formal accreditation reviews of community mental    health centers based on minimum accreditation standards adopted    by the department pursuant to paragraph e .    h. Establish and maintain a data collection and management    information system to identify, collect, and analyze service    outcome and performance data to address the needs of patients,    providers, the department, and programs operating within the    behavioral health service system.    i. Collect, monitor, and utilize information including but    not limited to behavioral health service system patient records    and syndromic surveillance data to understand emerging needs,   

  House File 2673, p. 7   and to deploy information, resources, and technical assistance    in response.    j. Collaborate with the department of revenue for    enforcement of tobacco laws, regulations, and ordinances and    engage in tobacco control activities.    k. Adopt rules pursuant to chapter 17A to administer this    chapter. Such rules shall include but not be limited to rules    that provide for all of the following:    (1) Minimum access standards to ensure equitable access to    services provided through the behavioral health service system    including but not limited to when services are available, who    is eligible for services, and where services are available.    (2) Methods to ensure each individual who is eligible    for services receives an uninterrupted continuum of care for    prevention, education, early intervention, treatment, recovery    support, and crisis services.    (3) Standards for the implementation and maintenance    of behavioral health programs and services offered by the    behavioral health service system, and by each administrative    services organization.    (4) Procedures for the management and oversight of    behavioral health providers to ensure compliance with the terms    of the behavioral health providers contracts relating to the    behavioral health service system, and with state and federal    law and rules.    (5) Procedures for the suspension of an administrative    services organizations services due to the administrative    services organizations failure to comply with the terms and    conditions of its contract with the department.    (6) Procedures for the reallocation of funds from    an administrative services organization that is not in    compliance with the terms of its contract with the department    to an alternative administrative services organization or    a behavioral health provider to provide for services the    noncompliant administrative services organization failed to    provide.    (7) Procedures for the termination of an administrative    services organizations designation as an administrative    services organization.   

  House File 2673, p. 8   (8) Procedures for the collection, utilization, and    maintenance of the data necessary to establish a central data    repository in accordance with section 225A.6.    (9) Any other requirements the department deems necessary    to ensure that an administrative services organization    fulfills the administrative services organizations duties    as established in this chapter, and as established in the    administrative services organizations district behavioral    health plan.    Sec. 4. NEW SECTION   . 225A.4 Behavioral health service    system  districts and administrative services organizations.    1. a. The department shall divide the entirety of the    state into designated behavioral health districts. Behavioral    health prevention, education, early intervention, treatment,    recovery support, and crisis services related to mental health    and addictive disorders, including but not limited to alcohol    use, substance use, tobacco use, and problem gambling, shall    be made available through each behavioral health district in a    manner consistent with directives each district receives from    the department.    b. For the purpose of providing equitable access to all    services provided through the behavioral health service    system, the department shall consider all of the following when    designating behavioral health districts:    (1) City and county lines.    (2) The maximum population size that behavioral health    services available in an area are able to effectively serve.    (3) Areas of high need for behavioral health services.    (4) Patterns various populations exhibit when accessing or    receiving behavioral health services.    c. Notwithstanding chapter 17A, the manner in which the    department designates behavioral health districts including but    not limited to the determination of the boundaries for each    district shall not be subject to judicial review.    2. a. The department shall designate an administrative    services organization for each behavioral health district to    oversee and organize each district and the behavioral health    services associated with the district. The department shall    issue requests for proposals for administrative services    

  House File 2673, p. 9   organization candidates.    b. At the departments discretion, the department may    designate any of the following entities as an administrative    services organization:    (1) An organization that coordinated administrative    services or mental health and disability services for a mental    health and disability services region formed on or before June    30, 2024.    (2) A public or private nonprofit agency located in a    behavioral health district, or any separate organizational    unit within the public or private nonprofit agency, that has    the capabilities to engage in the planning or provision of a    broad range of behavioral health prevention, education, early    intervention, treatment, recovery support, and crisis services    related to mental health and addictive disorders, including but    not limited to alcohol use, substance use, tobacco use, and    problem gambling, only as directed by the department.    c. The department shall consider all of the following    factors in determining whether to designate an entity as an    administrative services organization:    (1) Whether the entity has demonstrated the capacity to    manage and utilize available resources in a manner required of    an administrative services organization.    (2) Whether the entity has demonstrated the ability to    ensure the delivery of behavioral health services within the    district as required by the department by rule.    (3) Whether the entity has demonstrated the ability to    fulfill the monitoring, oversight, and provider compliance    responsibilities as required by the department by rule.    (4) Whether the entity has demonstrated the capacity to    function as a subrecipient for the purposes of the federal    community mental health services block grant, 42 U.S.C.    300x et seq., and the federal substance abuse prevention and    treatment block grant, 42 U.S.C. 300x-21 et seq., and the    ability to comply with all federal requirements applicable to    subrecipients under the block grants.    3. a. Upon designation by the department, an administrative    services organization shall be considered an instrumentality of    the state and shall adhere to all state and federal mandates   

  House File 2673, p. 10   and prohibitions applicable to an instrumentality of the state.    b. An entitys designation as an administrative services    organization shall continue until the designation is removed    by the department, the administrative services organization    withdraws, or a change in state or federal law necessitates the    removal of the designation.    4. Each administrative services organization shall function    as a subrecipient for the purposes of the federal community    mental health services block grant, 42 U.S.C. 300x et seq.,    and the federal substance abuse prevention and treatment block    grant, 42 U.S.C. 300x-21 et seq., and shall comply with all    federal requirements applicable to subrecipients under the    block grants.    5. Each administrative services organization shall perform    all of the following duties:    a. Develop and administer a district behavioral health plan    in accordance with the standards adopted by the department by    rule.    b. Coordinate the administration of the district behavioral    health plan with federal, state, and local resources in order    to develop a comprehensive and coordinated local behavioral    health service system.    c. Enter into contracts necessary to provide services under    the district behavioral health plan.    d. Oversee, provide technical assistance to, and monitor    the compliance of providers contracted by the administrative    services organization to provide behavioral health services in    accordance with the district behavioral health plan.    e. Establish a district behavioral health advisory council    pursuant to section 225A.5.    Sec. 5. NEW SECTION   . 225A.5 District behavioral health    advisory councils.    1. Each administrative services organization shall    establish a district behavioral health advisory council that    shall do all of the following:    a. Identify opportunities and address challenges based on    updates received from the administrative services organization    regarding the implementation of the district behavioral health    plan.    

  House File 2673, p. 11   b. Advise the administrative services organization while the    administrative services organization is developing behavioral    health policies.    c. Advise the administrative services organization on    how to best provide access to behavioral health prevention,    education, early intervention, treatment, recovery support,    and crisis services related to mental health and addictive    disorders, including but not limited to alcohol use, substance    use, tobacco use, and problem gambling, throughout the district    as directed by the department.    2. An advisory council shall consist of ten members.    Members shall be appointed by the administrative services    organization subject to the following requirements:    a. Three members shall be local elected public officials    currently holding office within the behavioral health district,    or the public officials designated representative.    b. Three members shall be chosen in accordance with    procedures established by the administrative services    organization to ensure representation of the populations    served within the behavioral health district. At least one    member chosen under this paragraph shall represent child and    adolescent persons.    c. Three members shall be chosen who have experience    or education related to core behavioral health functions,    essential behavioral health services, behavioral health    prevention, behavioral health treatment, population-based    behavioral health services, or community-based behavioral    health initiatives.    d. One member shall be a law enforcement representative from    within the behavioral health district.      3. An advisory council shall perform the duties required    under this section regardless of whether any seat on the    advisory council is vacant.    Sec. 6. NEW SECTION   . 225A.6 Behavioral health service    system  data collection and use.    1. The department shall take all of the following actions    for data related to the behavioral health service system:    a. Collect and analyze the data, including but not    limited to Medicaid and community services network data, as    

  House File 2673, p. 12   necessary to issue cost estimates for serving populations,    providing treatment, making and receiving payments, conducting    operations, and performing prevention and health promotion    activities. In doing so, the department shall maintain    compliance with applicable federal and state privacy laws    to ensure the confidentiality and integrity of individually    identifiable data. The department shall periodically assess    the status of the departments compliance to ensure that data    collected by and stored with the department is protected.    b. Establish and administer a central data repository for    collecting and analyzing state, behavioral health district, and    contracted behavioral health provider data.    c. Establish a record for each individual receiving publicly    funded services from an administrative services organization.    Each record shall include a unique client identifier for the    purposes of identifying and tracking the individuals record.    d. Consult with administrative services organizations,    behavioral health service providers, and other behavioral    health service system stakeholders on an ongoing basis to    implement and maintain the central data repository.    e. Engage with all entities that maintain information the    department is required to collect pursuant to this section in    order to integrate all data concerning individuals receiving    services within the behavioral health service system.    f. Engage with all entities that maintain general population    data relating to behavioral health in order to develop action    plans, create projections relating to a populations behavioral    health needs, develop policies concerning behavioral health,    and otherwise perform acts as necessary to enhance the states    overall behavioral health.      2. Administrative services organizations shall report all    data required to be maintained in the central data repository    to the department in a manner as established by the department    by rule. For the purpose of making such data reports, an    administrative services organization shall do one of the    following:    a. Utilize a data system that integrates with the data    systems used by the department.    b. Utilize a data system that has the capacity to securely   

  House File 2673, p. 13   exchange information with the department, other behavioral    health districts, contractors, and other entities involved with    the behavioral health service system who are authorized to    access the central data repository.    3. Data and information maintained by and exchanged between    an administrative services organization and the department    shall be labeled consistently, share the same definitions,    utilize the same common coding and nomenclature, and be in a    form and format as required by the department by rule.    4. Administrative services organizations shall report    to the department, in a manner specified by the department,    information including but not limited to demographic    information, expenditure data, and data concerning the    behavioral health services and other support provided to    individuals in the administrative service organizations    district.    5. The department shall ensure that public and private    agencies, organizations, and individuals that operate within    the behavioral health service system, or that make formal    requests for the release of data collected by the department,    maintain uniform methods for keeping statistical information    relating to behavioral health service system outcomes and    performance.    6. The department shall develop and implement a    communication plan that details how outcome and performance    data will be shared with stakeholders including but not limited    to the public, persons involved with the behavioral health    service system, and the general assembly.    Sec. 7. NEW SECTION   . 225A.7 Behavioral health fund.    1. For purposes of this section:    a. Population means, as of July 1 of the fiscal year    preceding the fiscal year in which the population figure is    applied, the population shown by the latest preceding certified    federal census or the latest applicable population estimate    issued by the United States census bureau, whichever is most    recent.      b. State growth factor for a fiscal year means an amount    equal to the dollar amount used to calculate the appropriation    under this section for the immediately preceding fiscal year    

  House File 2673, p. 14   multiplied by the percent increase, if any, in the amount of    sales tax revenue deposited into the general fund of the state    under section 423.2A, subsection 1, paragraph a , less the    transfers required under section 423.2A, subsection 2, between    the fiscal year beginning three years prior to the applicable    fiscal year and the fiscal year beginning two years prior    to the applicable year, but not to exceed one and one-half    percent.    2. A behavioral health fund is established in the state    treasury under the control of the department. The fund shall    consist of moneys deposited into the fund pursuant to this    section and section 426B.1, gifts of money or property accepted    by the state or the department to support any services under    this chapter or chapter 231, and moneys otherwise appropriated    by the general assembly. Moneys in the fund are appropriated    to the department to implement and administer the behavioral    health service system and related programs including but not    limited to all of the following:    a. Distributions to administrative services organizations    to provide services as outlined in the organizations district    behavioral health plan.    b. Distributions to providers of mental health services    and addictive disorder services, including but not limited to    tobacco use services, substance use disorder services, and    problem gambling services.    c. Funding of disability services pursuant to chapter 231.    This paragraph is repealed July 1, 2028.    3. For the fiscal year beginning July 1, 2025, there    is transferred from the general fund of the state to the    behavioral health fund an amount equal to forty-two dollars    multiplied by the states population for the fiscal year.    4. For the fiscal year beginning July 1, 2026, and each    succeeding fiscal year, there is transferred from the general    fund of the state to the behavioral health fund an amount equal    to the states population for the fiscal year multiplied by    the sum of the dollar amount used to calculate the transfer    from the general fund to the behavioral health fund for the    immediately preceding fiscal year, plus the state growth factor    for the fiscal year for which the transfer is being made.   

  House File 2673, p. 15   5. For each fiscal year, an administrative services    organization shall not spend on administrative costs an amount    more than seven percent of the total amount distributed to the    administrative services organization through this section and    all other appropriations for the same fiscal year.    6. Moneys in the behavioral health fund may be used by the    department for cash flow purposes, provided that any moneys so    allocated are returned to the behavioral health fund by the end    of each fiscal year.    7. Notwithstanding section 12C.7, subsection 2, interest    or earnings on moneys deposited in the behavioral health fund    shall be credited to the behavioral health fund.    8. 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.    Sec. 8. NEW SECTION . 225A.8 Addictive disorders prevention     prohibitions.    1. For purposes of this section, entity means a    manufacturer, distributor, wholesaler, retailer, or    distributing agent, or an agent of a manufacturer, distributor,    wholesaler, retailer, or distributing agent as those terms are    defined in section 453A.1.    2. To promote comprehensive tobacco use prevention and    control initiatives outlined in the state behavioral health    service system plan, an entity shall not perform any of the    following acts:    a. Give away cigarettes or tobacco products.    b. Provide free articles, products, commodities, gifts, or    concessions in any exchange for the purchase of cigarettes or    tobacco products.    3. The prohibitions in this section shall not apply to    transactions between manufacturers, distributors, wholesalers,    or retailers as those terms are defined in section 453A.1.      Sec. 9. NEW SECTION   . 225A.9 Application for services     minors.    A minor who is twelve years of age or older shall have    the legal capacity to act and give consent to the provision    of tobacco cessation coaching services pursuant to a tobacco     

  House File 2673, p. 16   cessation telephone and internet-based program approved by    the department through the behavioral health service system    established in section 225A.3. Consent shall not be subject to    later disaffirmance by reason of such minority. The consent of    another person, including but not limited to the consent of a    spouse, parent, custodian, or guardian, shall not be necessary.    Sec. 10. CODE EDITOR DIRECTIVE. The Code editor is directed    to do all of the following:    1. Designate sections 225A.1 through 225A.9, as enacted    in this division of this Act, as Code chapter 225A entitled    Department of Health and Human Services  Behavioral Health    Service System.    2. Correct internal references in the Code and in any    enacted legislation as necessary due to the enactment of this    division of this Act.    Sec. 11. EFFECTIVE DATE. This division of this Act takes    effect July 1, 2025.    DIVISION II    BEHAVIORAL HEALTH SERVICE SYSTEM  CONFORMING CHANGES    Sec. 12. Section 11.6, subsection 1, paragraph b, Code 2024,    is amended to read as follows:    b. The financial condition and transactions of community      mental health centers organized under chapter 230A , substance    use disorder programs organized   licensed under chapter 125 , and    community action agencies organized under chapter 216A , shall    be audited at least once each year.    Sec. 13. Section 97B.1A, subsection 8, paragraph a,    subparagraph (13), Code 2024, is amended by striking the    subparagraph.    Sec. 14. Section 123.17, subsection 5, Code 2024, is amended    to read as follows:    5. After any transfer provided for in subsection 3 is made,    the department shall transfer into a special revenue account    in the general fund of the state, a sum of money at least equal    to seven percent of the gross amount of sales made by the    department from the beer and liquor control fund on a monthly    basis but not less than nine million dollars annually. Of    the amounts transferred, two   three million dollars, plus an    additional amount determined by the general assembly, shall be               

  House File 2673, p. 17   appropriated to the department of health and human services for      use by the staff who administer the comprehensive substance use    disorder program under chapter 125 for substance use disorder      treatment and prevention programs   shall be transferred to the    behavioral health fund established under section 225A.7 . Any    amounts received in excess of the amounts appropriated to the      department of health and human services for use by the staff      who administer the comprehensive substance use disorder program    under chapter 125   transferred to the behavioral health fund    shall be considered part of the general fund balance.    Sec. 15. Section 123.17, subsection 8, Code 2024, is amended    by striking the subsection.    Sec. 16. Section 123.17, subsection 9, Code 2024, is amended    to read as follows:    9. After any transfers provided for in subsections 3, 5,    6, and   7 , and 8 are made, and before any other transfer to the    general fund, the department shall transfer to the economic    development authority from the beer and liquor control fund the    lesser of two hundred fifty thousand dollars or one percent of    the gross sales of native distilled spirits by all class A    native distilled spirits license holders made by the department    for the purposes of promoting Iowa wine, beer, and spirits.    Sec. 17. Section 124.409, subsection 2, Code 2024, is    amended by striking the subsection.    Sec. 18. Section 125.2, subsections 4, 5, and 10, Code 2024,    are amended by striking the subsections.    Sec. 19. Section 125.91, subsection 1, Code 2024, is amended    to read as follows:    1. The procedure prescribed by this section shall only    be used for a person with a substance use 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 an application has not been filed    naming the person as the respondent pursuant to section 125.75    and the person cannot be ordered into immediate custody and    detained pursuant to section 125.81 .    Sec. 20. Section 125.93, Code 2024, is amended to read as                 

  House File 2673, p. 18   follows:    125.93 Commitment records  confidentiality.    Records of the identity, diagnosis, prognosis, or treatment    of a person which are maintained in connection with the    provision of substance use disorder treatment services are    confidential, consistent with the requirements of section    125.37   , and with the federal confidentiality regulations    authorized by the federal Drug Abuse Office and Treatment Act ,    42 U.S.C. 290ee and   the federal Comprehensive Alcohol Abuse    and Alcoholism Prevention, Treatment and Rehabilitation Act, 42    U.S.C. 290dd-2. However, such records may be disclosed to an    employee of the department of corrections, if authorized by the    director of the department of corrections, or to an employee    of a judicial district department of correctional services, if    authorized by the director of the judicial district department    of correctional services.    Sec. 21. Section 135.11, subsection 11, Code 2024, is    amended to read as follows:    11. Administer chapters 125, 136A , 136C , 139A , 142 ,    142A   , 144 , and 147A .    Sec. 22. Section 135C.2, subsection 5, unnumbered paragraph    1, Code 2024, is amended to read as follows:    The department shall establish a special classification    within the residential care facility category in order to    foster the development of residential care facilities which    serve persons with an intellectual disability, chronic mental    illness, a developmental disability, or brain injury, as      described under section 225C.26 , and which contain five or    fewer residents. A facility within the special classification    established pursuant to this subsection is exempt from the    requirements of section 10A.713 . The department shall adopt    rules which are consistent with rules previously developed for    the waiver   demonstration waiver project pursuant to 1986 Iowa    Acts, ch. 1246, 206 , and which include all of the following    provisions:    Sec. 23. Section 135C.6, subsection 1, Code 2024, is amended      to read as follows:    1. A person or governmental unit acting severally or    jointly with any other person or governmental unit shall not                   

  House File 2673, p. 19   establish or operate a health care facility in this state    without a license for the facility. A supported community    living service, as defined in section 225C.21   249A.38A , is not    required to be licensed under this chapter , but is subject to    approval under section 225C.21   249A.38A in order to receive    public funding.    Sec. 24. Section 135C.23, subsection 1, unnumbered    paragraph 1, Code 2024, is amended to read as follows:    Each resident shall be covered by a contract executed    by the resident, or the residents legal representative,      and the health care facility   at or prior to the time of the    residents admission or prior thereto by the resident, or the    legal representative, and the health care facility, except as    otherwise provided by   subsection 5 with respect to residents    admitted at public expense to a county care facility operated    under   chapter 347B . Each party to the contract shall be    entitled to a duplicate of the original thereof contract , and    the health care facility shall keep on file all contracts    which it has with residents and shall not destroy or otherwise    dispose of any such contract for at least one year after its    expiration. Each such contract shall expressly set forth:    Sec. 25. Section 135C.23, subsection 2, paragraph b, Code    2024, is amended to read as follows:    b. This section does not prohibit the admission of a    patient with a history of dangerous or disturbing behavior to    an intermediate care facility for persons with mental illness,    intermediate care facility for persons with an intellectual    disability, or   nursing facility , or county care facility when    the intermediate care facility for persons with mental illness,    intermediate care facility for persons with an intellectual    disability, or   nursing facility , or county care facility has a    program which has received prior approval from the department    to properly care for and manage the patient. An intermediate    care facility for persons with mental illness, intermediate    care facility for persons with an intellectual disability,    or   nursing facility , or county care facility is required to    transfer or discharge a resident with dangerous or disturbing    behavior when the intermediate care facility for persons with    mental illness, intermediate care facility for persons with an                             

  House File 2673, p. 20   intellectual disability, or   nursing facility , or county care    facility cannot control the residents dangerous or disturbing    behavior. The department , in coordination with the state      mental health and disability services commission created in      section 225C.5 , shall adopt rules pursuant to chapter 17A for    programs to be required in intermediate care facilities for    persons with mental illness, intermediate care facilities    for persons with an intellectual disability, and   nursing    facilities , and county care facilities   that admit patients    or have residents with histories of dangerous or disturbing    behavior.    Sec. 26. Section 135C.23, subsection 5, Code 2024, is    amended by striking the subsection.    Sec. 27. Section 135C.24, subsection 5, Code 2024, is    amended by striking the subsection.    Sec. 28. Section 135G.1, subsection 12, Code 2024, is    amended to read as follows:    12. a.   Subacute mental health services means the same    as defined in   section 225C.6 services that provide all of the    following:    (1) A comprehensive set of wraparound services for a    person who has had, or is at imminent risk of having, acute or      crisis mental health symptoms that do not permit the person to    remain in or threatens removal of the person from the persons      home and community, but who has been determined by a mental    health professional and a licensed health care professional,    subject to the professionals scope of practice, not to need    inpatient acute hospital services. For the purposes of this    subparagraph,   licensed health care professional means a person    licensed under chapter 148, an advanced registered nurse    practitioner, or a physician assistant.      (2) Intensive, recovery-oriented treatment and monitoring    of a person. Treatment may be provided directly or remotely      by a licensed psychiatrist or an advanced registered nurse    practitioner.      (3) An outcome-focused, interdisciplinary approach designed    to return a person to living successfully in the community.      b. Subacute mental health services may include services    provided in a wide array of settings ranging from a persons                                               

  House File 2673, p. 21   home to a specialized facility with restricted means of egress.      c. Subacute mental health services shall be limited to a    period not to exceed ten calendar days or another time period      determined in accordance with rules adopted by the department      for this purpose, whichever is longer .    Sec. 29. Section 142.1, Code 2024, is amended to read as    follows:    142.1 Delivery of bodies.    The body of every person dying   who died in a public asylum,    hospital, county care facility, penitentiary, or reformatory    in this state, or found dead within the state, or which   who    is to be buried at public expense in this state, except those    buried under the provisions of chapter 144C or 249 , and which    is suitable for scientific purposes, shall be delivered to the    medical college of the state university, or some osteopathic    or chiropractic college or school located in this state, which    has been approved under the law regulating the practice of    osteopathic medicine or chiropractic; but no such body shall    be delivered to any such college or school if the deceased    person expressed a desire during the persons last illness    that the persons body should be buried or cremated, nor if    such is the desire of the persons relatives. Such bodies    shall be equitably distributed among said colleges and schools    according to their needs for teaching anatomy in accordance    with such rules as may be adopted by the department of health    and human services. The expense of transporting said bodies to    such college or school shall be paid by the college or school    receiving the same. If the deceased person has not expressed    a desire during the persons last illness that the persons    body should be buried or cremated and no person authorized to    control the deceased persons remains under section 144C.5    requests the persons body for burial or cremation, and if a    friend objects to the use of the deceased persons body for    scientific purposes, said deceased persons body shall be    forthwith   delivered to such friend for burial or cremation at      no expense to the state or county. Unless such friend provides    for burial and burial expenses within five days, the body shall    be used for scientific purposes under this chapter .    Sec. 30. Section 142.3, Code 2024, is amended to read as                

  House File 2673, p. 22   follows:    142.3 Notification of department.    Every county medical examiner, funeral director or embalmer,    and the managing officer of every public asylum, hospital,    county care facility,   penitentiary, or reformatory, as soon as    any dead body shall come into the persons custody which may be    used for scientific purposes as provided in sections 142.1 and    142.2 , shall at once notify the nearest relative or friend of    the deceased, if known, and the department of health and human    services, and hold such body unburied for forty-eight hours.    Upon receipt of notification, the department shall issue verbal    or written instructions relative to the disposition to be made    of said body. Complete jurisdiction over said bodies is vested    exclusively in the department of health and human services. No    autopsy or post mortem, except as are legally ordered by county    medical examiners, shall be performed on any of said bodies    prior to their delivery to the medical schools.    Sec. 31. NEW SECTION   . 217.17 State health improvement plan.    1. The department shall develop, implement, and administer    a state health improvement plan to identify health priorities,    goals, and measurable objectives, and outline strategies to    improve health statewide.    2. The state health improvement plan shall be developed    and updated in collaboration and in coordination with other    state departments, stakeholders, and statewide organizations    the department determines to be relevant.    3. The state health improvement plan may be updated by the    department at the departments discretion.    Sec. 32. NEW SECTION   . 217.37 Recovery of payment       assignment of liens  county attorney to enforce.    1. For purposes of this section, assistance means all of    the following:    a. A payment by the state for services rendered through    the behavioral health service system established under section    225A.3.    b. A payment by the state for aging and disability services    rendered in accordance with chapter 231.    2. The department shall have the authority to investigate if    a person is eligible to have assistance paid on the persons      

  House File 2673, p. 23   behalf and whether payment of assistance was proper.    3. Notwithstanding any provision of law to the contrary,    assistance shall not be recoverable unless the department    finds that the assistance was paid for the benefit of a person    who was not entitled to have assistance paid on the persons    behalf.    4. Assistance paid for the benefit of a person who was    not entitled to have assistance paid on the persons behalf    shall be recoverable from the entity to which the assistance    was paid, from the person on whose behalf assistance was paid,    or from a third party who is liable for the persons debts or    support.    5. Upon the death of a person who was not entitled to    have assistance paid on the persons behalf, the department    shall have a lien equivalent in priority to liens described    in section 633.425, subsection 6, against the persons estate    for the portion of the assistance improperly paid which the    department had not recovered at the time of the persons death.    6. The department may waive all or a portion of improperly    paid assistance, or a lien created under subsection 5, if    the department finds that collection would result in undue    hardship.    7. The department shall adopt rules pursuant to chapter 17A    to implement and administer this section.    Sec. 33. Section 218.30, Code 2024, is amended to read as    follows:    218.30 Investigation of other facilities.    The director may investigate or cause the investigation of    charges of abuse, neglect, or mismanagement on the part of an    officer or employee of a private facility which is subject to    the directors supervision or control. The director shall also      investigate or cause the investigation of charges concerning    county care facilities in which persons with mental illness are      served.      Sec. 34. Section 218.78, subsection 1, Code 2024, is amended      to read as follows:    1. All institutional receipts of the department, including    funds received from client participation at the state resource    centers under section 222.78 and at the state mental health          

  House File 2673, p. 24   institutes under   section 230.20 , shall be deposited in the    general fund except for reimbursements for services provided    to another institution or state agency, for receipts deposited    in the revolving farm fund under section 904.706 , for deposits    into the medical assistance fund under section 249A.11 , and for    rentals charged to employees or others for room, apartment, or    house and meals, which shall be available to the institutions.    Sec. 35. Section 222.1, subsection 1, Code 2024, is amended    to read as follows:    1. This chapter addresses the public and private services    available in this state to meet the needs of persons with an    intellectual disability. The responsibility of the mental      health and disability services regions formed by counties and    of the state for the costs and administration of publicly      funded services shall be as set out in section 222.60 and other    pertinent sections of   this chapter .    Sec. 36. Section 222.2, Code 2024, is amended by adding the    following new subsection:    NEW SUBSECTION   . 01. Administrative services organization    means the same as defined in section 225A.1.    Sec. 37. Section 222.2, subsections 6 and 7, Code 2024, are    amended by striking the subsections.    Sec. 38. Section 222.12, subsection 2, Code 2024, is amended    by striking the subsection.    Sec. 39. Section 222.13, Code 2024, is amended to read as    follows:    222.13 Voluntary admissions.    1. If an adult person is believed to be a person with an    intellectual disability, the adult person or the adult persons    guardian may apply to the department and the superintendent of    any state resource center for the voluntary admission of the    adult person either as an inpatient or an outpatient of the    resource center. If the expenses of the persons admission      or placement are payable in whole or in part by the persons      county of residence, application for the admission shall be      made through the regional administrator. An application for    admission to a special unit of any adult person believed to be      in need of any of the services provided by the special unit    under section 222.88 may be made in the same manner. The                        

  House File 2673, p. 25   superintendent shall accept the application if a preadmission    diagnostic evaluation confirms or establishes the need for    admission, except that an application shall not be accepted if    the institution does not have adequate facilities available or    if the acceptance will result in an overcrowded condition.    2. If the resource center does not have an appropriate    program for the treatment of an adult or minor person with an    intellectual disability applying under this section or section    222.13A , the regional administrator for the persons county      of residence or the department , as applicable, shall arrange    for the placement of the person in any public or private    facility within or without   outside of the state, approved by    the director, which offers appropriate services for the person.    If the expenses of the placement are payable in whole or in      part by a county, the placement shall be made by the regional    administrator for the county.      3. If the expenses of an admission of an adult to a resource    center or a special unit, or of the placement of the person    in a public or private facility are payable in whole or in      part by a mental health and disability services region, the    regional administrator shall make a full investigation into    the financial circumstances of the person and those liable for      the persons support under section 222.78 to determine whether    or not any of them are able to pay the expenses arising out of      the admission of the person to a resource center, special unit,    or public or private facility. If the regional administrator    finds that the person or those legally responsible for    the person are presently unable to pay the expenses, the    regional administrator shall pay the expenses. The regional      administrator may review such a finding at any subsequent    time while the person remains at the resource center, or is      otherwise receiving care or treatment for which this chapter    obligates the region to pay. If the regional administrator      finds upon review that the person or those legally responsible    for the person are presently able to pay the expenses, the      finding shall apply only to the charges incurred during the    period beginning on the date of the review and continuing      thereafter, unless and until the regional administrator again    changes such a finding. If the regional administrator finds                                       

  House File 2673, p. 26   that the person or those legally responsible for the person      are able to pay the expenses, the regional administrator shall    collect the charges to the extent required by   section 222.78 ,    and the regional administrator shall be responsible for the      payment of the remaining charges.    Sec. 40. Section 222.13A, subsections 3 and 4, Code 2024,    are amended to read as follows:    3. During the preadmission diagnostic evaluation, the    minor shall be informed both orally and in writing that the    minor has the right to object to the voluntary admission. If      Notwithstanding section 222.33, if   the preadmission diagnostic    evaluation determines that the voluntary admission is    appropriate but the minor objects to the admission, the minor    shall not be admitted to the state resource center unless the    court approves of the admission. A petition for approval of    the minors admission may be submitted to the juvenile court by    the minors parent, guardian, or custodian.    4. As soon as practicable after the filing of a petition for    approval of the voluntary admission, the court shall determine    whether the minor has an attorney to represent the minor in the    proceeding. If the minor does not have an attorney, the court    shall assign an attorney   to the minor an attorney . If the    minor is unable to pay for an attorney, the attorney shall be    compensated by the mental health and disability services region      an administrative services organization at an hourly rate to be    established by the regional administrator in substantially the    same manner as provided in section 815.7 .    Sec. 41. Section 222.14, Code 2024, is amended to read as    follows:    222.14 Care by region   pending admission.    If the institution is unable to receive a patient, the    superintendent shall notify the regional administrator for the      county of residence of the prospective patient   an administrative    services organization . Until such time as the patient is able    to be received by the institution, or when application has been    made for admission to a public or private facility as provided    in section 222.13 and the application is pending, the care    of the patient shall be provided as arranged by the regional      administrator administrative services organization .                         

  House File 2673, p. 27   Sec. 42. NEW SECTION   . 222.33 State resource center     admissions and discharge.    1. The department shall make all final determinations    concerning whether a person may be admitted to a state resource    center.    2. If a patient is admitted to a state resource center    pursuant to section 222.13 or 222.13A, and the patient    wishes to be placed outside of the state resource center, the    discharge of the patient shall be made in accordance with    section 222.15.    Sec. 43. NEW SECTION   . 222.35 State  payor of last resort.    The department shall implement services and adopt rules    pursuant to chapter 17A in a manner that ensures that the state    is the payor of last resort, and that the department shall not    make any payments for services that have been provided until    the department has determined that the services provided are    not payable by a third-party source.    Sec. 44. Section 222.73, subsections 2 and 4, Code 2024, are    amended by striking the subsections.    Sec. 45. Section 222.77, Code 2024, is amended to read as    follows:    222.77 Patients on leave.    The cost of support of patients placed on convalescent leave    or removed as a habilitation measure from a resource center,    or a special unit,   except when living in the home of a person    legally bound for the support of the patient, shall be paid by    the county of residence or the state as provided in section    222.60 .    Sec. 46. Section 222.78, subsection 1, Code 2024, is amended    to read as follows:      1. The father and mother of any patient admitted to a    resource center or to a special unit   , as either an inpatient    or an outpatient, and any person, firm, or corporation bound    by contract made for support of the patient ,   are liable for    the support of the patient. The patient and those legally    bound for the support of the patient shall be liable to    the county or   state , as applicable, for all sums advanced    in accordance with the provisions of sections 222.60 and    222.77 relating to reasonable attorney fees and court costs for                   

  House File 2673, p. 28   the patients admission to the resource center, and for the      treatment, training, instruction, care, habilitation, support,    transportation, or other expenditures made on behalf of the      patient pursuant to this chapter   .    Sec. 47. Section 222.79, Code 2024, is amended to read as    follows:    222.79 Certification statement presumed correct.    In actions to enforce the liability imposed by section    222.78 , the superintendent or the county of residence, as      applicable, shall submit a certification statement stating    the sums charged, and the certification statement shall be    considered presumptively correct.    Sec. 48. Section 222.80, Code 2024, is amended to read as    follows:    222.80 Liability to county or   state.    A person admitted to a county institution or home   or admitted    at county or state expense to a private hospital, sanitarium,    or other facility for treatment, training, instruction, care,    habilitation, and support as a patient with an intellectual    disability shall be liable to the county or   state , as    applicable, for the reasonable cost of the support as provided    in section 222.78 .    Sec. 49. Section 222.82, Code 2024, is amended to read as    follows:    222.82 Collection of liabilities and claims.    If liabilities and claims exist as provided in section    222.78 or any   other provision of this chapter , the county of    residence or the state , as applicable, may proceed as provided    in this section . If the liabilities and claims are owed to      a county of residence, the countys board of supervisors may    direct the county attorney to proceed with the collection of      the liabilities and claims as a part of the duties of the    county attorneys office when the board of supervisors deems      such action advisable. If the liabilities and claims are owed    to the state, the state shall proceed with the collection.      The board of supervisors or the state , as applicable, may    compromise any and all liabilities to the county or   state    arising under this chapter when such compromise is deemed to be    in the best interests of the county or state. Any collections                              

  House File 2673, p. 29   and liens shall be limited in conformance to section 614.1,    subsection 4 .    Sec. 50. Section 222.85, subsection 2, Code 2024, is amended    to read as follows:    2. Moneys paid to a resource center from any source other    than state appropriated funds and intended to pay all or a    portion of the cost of care of a patient, which cost would    otherwise be paid from state or county   funds or from the    patients own funds, shall not be deemed funds belonging to a    patient for the purposes of this section .    Sec. 51. Section 222.86, Code 2024, is amended to read as    follows:    222.86 Payment for care from fund.    If a patient is not receiving medical assistance under    chapter 249A and the amount in the account of any patient    in the patients personal deposit fund exceeds two hundred    dollars, the department may apply any amount of the excess to    reimburse the county of residence or the   state for liability    incurred by the county or   the state for the payment of care,    support, and maintenance of the patient , when billed by the    county or state , as applicable .    Sec. 52. Section 222.92, subsection 1, Code 2024, is amended    to read as follows:    1. The department shall operate the state resource centers    on the basis of net appropriations from the general fund of    the state. The appropriation amounts shall be the net amounts    of state moneys projected to be needed for the state resource    centers for the fiscal year of the appropriations. The purpose    of utilizing net appropriations is to encourage the state    resource centers to operate with increased self-sufficiency, to    improve quality and efficiency, and to support collaborative    efforts between the state resource centers and counties and      other   providers of funding for the services available from    the state resource centers. The state resource centers shall    not be operated under the net appropriations in a manner that    results in a cost increase to the state or in cost shifting    between the state, the medical assistance program, counties,   or    other sources of funding for the state resource centers.    Sec. 53. Section 222.92, subsection 3, paragraph a, Code            

  House File 2673, p. 30   2024, is amended by striking the paragraph.    Sec. 54. Section 225.1, subsection 2, Code 2024, is amended    to read as follows:    2. For the purposes of this chapter , unless the context    otherwise requires:    a. Mental health and disability services region means    a mental health and disability services region approved in      accordance with section 225C.56 . Administrative services    organization   means the same as defined in section 225A.1.    b. Regional administrator means the administrator of a    mental health and disability services region, as defined in      section 225C.55 . Department means the department of health    and human services.    c. Respondent means the same as defined in section 229.1 .    Sec. 55. NEW SECTION   . 225.4 State psychiatric hospital     admissions.    The department shall make all final determinations    concerning whether a person may be admitted to the state    psychiatric hospital.    Sec. 56. Section 225.11, Code 2024, is amended to read as    follows:    225.11 Initiating commitment procedures.    When a court finds upon completion of a hearing held pursuant    to section 229.12 that the contention that a respondent is    seriously mentally impaired has been sustained by clear and    convincing evidence, and the application filed under section    229.6 also contends or the court otherwise concludes that it    would be appropriate to refer the respondent to the state    psychiatric hospital for a complete psychiatric evaluation and    appropriate treatment pursuant to section 229.13 , the judge    may order that a financial investigation be made in the manner    prescribed by section 225.13 . If the costs of a respondents    evaluation or treatment are payable in whole or in part by a      county an administrative services organization , an order under    this section shall be for referral of the respondent through      the regional administrator for the respondents county of    residence   by an administrative services organization for an    evaluation and referral of the respondent to an appropriate    placement or service, which may include the state psychiatric                            

  House File 2673, p. 31   hospital for additional evaluation or treatment.    Sec. 57. Section 225.12, Code 2024, is amended to read as    follows:    225.12 Voluntary public patient  physicians or physician    assistants report.    A physician or a physician assistant who meets the    qualifications set forth in the definition of a mental    health professional in section 228.1 filing information under      section 225.10   shall include a written report to the regional    administrator for the county of residence of the person named    in the information, giving   shall submit a detailed history of    the case to an administrative services organization as will be    likely to aid in the observation, treatment, and hospital care    of the person and describing the history in detail   .    Sec. 58. Section 225.13, Code 2024, is amended to read as    follows:    225.13 Financial condition.    The regional administrator for the county of residence of      a person being admitted to the state psychiatric hospital is      Administrative services organizations shall be responsible for    investigating the financial condition of the a person and of    those legally responsible for the persons support.    Sec. 59. Section 225.15, Code 2024, is amended to read as    follows:    225.15 Examination and treatment.    1.   When a respondent arrives at the state psychiatric    hospital, the admitting physician, or a physician assistant    who meets the qualifications set forth in the definition of a    mental health professional in section 228.1 , shall examine the    respondent and determine whether or not, in the physicians    or physician assistants judgment, the respondent is a fit    subject for observation, treatment, and hospital care. If,    upon examination, the physician or physician assistant who    meets the qualifications set forth in the definition of a    mental health professional in section 228.1 decides that the    respondent should be admitted to the hospital, the respondent    shall be provided a proper bed in the hospital. The physician    or physician assistant who meets the qualifications set forth    in the definition of a mental health professional in section                  

  House File 2673, p. 32   228.1 who has charge of the respondent shall proceed with    observation, medical treatment, and hospital care as in the    physicians or physician assistants judgment are proper and    necessary, in compliance with sections 229.13 , 229.14 , this    section , and section 229.16 . After the respondents admission,    the observation, medical treatment, and hospital care of the    respondent may be provided by a mental health professional,    as defined in section 228.1 , who is licensed as a physician,    advanced registered nurse practitioner, or physician assistant.    2.   A proper and competent nurse shall also be assigned to    look after and care for the respondent during observation,      treatment, and care. Observation, treatment, and hospital    care under this section which are payable in whole or in part    by a county shall only be provided as determined through      the regional administrator for the respondents county of    residence.      Sec. 60. Section 225.16, subsection 1, Code 2024, is amended    to read as follows:    1. If the regional administrator for a persons county of      residence department finds from the physicians information    or from the information of a physician assistant who    meets the qualifications set forth in the definition of    a mental health professional in section 228.1 which was    filed under the provisions of section 225.10   225.12 that it    would be appropriate for the person to be admitted to the    state psychiatric hospital, and the report of the regional    administrator made pursuant to section 225.13 shows the    department finds that the person and those who are legally    responsible for the person are not able to pay the expenses    incurred at the hospital, or are able to pay only a part of    the expenses, the person shall be considered to be a voluntary    public patient and the regional administrator shall direct that      the person   shall be sent to the state psychiatric hospital at    the state university of Iowa for observation, treatment, and    hospital care.    Sec. 61. Section 225.17, subsection 2, Code 2024, is amended      to read as follows:    2. When the respondent arrives at the hospital, the    respondent shall receive the same treatment as is provided for                             

  House File 2673, p. 33   committed public patients in section 225.15 , in compliance    with sections 229.13 through 229.16 . However, observation,      treatment, and hospital care under   this section of a respondent    whose expenses are payable in whole or in part by a county      shall only be provided as determined through the regional    administrator for the respondents county of residence.      Sec. 62. Section 225.18, Code 2024, is amended to read as    follows:    225.18 Attendants.    The regional administrator   An administrative services    organization   may appoint an attendant to accompany the    committed public patient or the voluntary public patient    or the committed private patient from the place where the    patient may be to the state psychiatric hospital, or to    accompany the patient from the hospital to a place as may    be designated by the regional administrator   administrative    services organization . If a patient is moved pursuant to this    section , at least one attendant shall be of the same gender as    the patient.    Sec. 63. Section 225.22, Code 2024, is amended to read as    follows:    225.22 Liability of private patients  payment.    Every committed private patient, if the patient has an    estate sufficient for that purpose, or if those legally    responsible for the patients support are financially able,    shall be liable to the county and   state for all expenses paid    by them in the state on behalf of such patient. All bills    for the care, nursing, observation, treatment, medicine, and    maintenance of such patients shall be paid by the director of    the department of administrative services in the same manner as    those of committed and voluntary public patients as provided in    this chapter , unless the patient or those legally responsible    for the patient make such settlement with the state psychiatric    hospital.    Sec. 64. Section 225.24, Code 2024, is amended to read as    follows:      225.24 Collection of preliminary expense.    Unless a committed private patient or those legally    responsible for the patients support offer to settle the                   

  House File 2673, p. 34   amount of the claims, the regional administrator for the      persons county of residence department shall collect, by    action if necessary, the amount of all claims for per diem and    expenses that have been approved by the regional administrator    for the county an administrative services organization and    paid by the regional administrator as provided under   section    225.21   administrative services organization . Any amount    collected shall be credited to the mental health and disability    services region combined account created   behavioral health fund    established in accordance with section 225C.58 225A.7 .    Sec. 65. Section 225.27, Code 2024, is amended to read as    follows:    225.27 Discharge  transfer.    The state psychiatric hospital may, at any time, discharge    any patient as recovered, as improved, or as not likely to    be benefited by further treatment. If the patient being so    discharged was involuntarily hospitalized, the hospital shall    notify the committing judge or court of the discharge as    required by section 229.14 or section 229.16 , whichever is   as    applicable , and the applicable regional administrator . Upon    receiving the notification, the court shall issue an order    confirming the patients discharge from the hospital or from    care and custody, as the case may be, and shall terminate the    proceedings pursuant to which the order was issued. The court    or judge shall, if necessary, appoint a person to accompany the    discharged patient from the state psychiatric hospital to such    place as the hospital or the court may designate, or authorize    the hospital to appoint such attendant.    Sec. 66. Section 226.1, subsection 4, Code 2024, is amended    by adding the following new paragraph:    NEW PARAGRAPH   . 0a. Administrative services organization    means the same as defined in section 225A.1.      Sec. 67. Section 226.1, subsection 4, paragraphs d and f,    Code 2024, are amended by striking the paragraphs.    Sec. 68. Section 226.8, subsection 2, Code 2024, is amended      to read as follows:    2. Charges for the care of any person with a diagnosis of    an intellectual disability admitted to a state mental health    institute shall be made by the institute in the manner provided                        

  House File 2673, p. 35   by chapter 230 , but the liability of any other person to any      mental health and disability services region the state for the    cost of care of such person with a diagnosis of an intellectual    disability shall be as prescribed by section 222.78 .    Sec. 69. Section 226.32, Code 2024, is amended to read as    follows:    226.32 Overcrowded conditions.    The director shall order the discharge or removal from the    mental health institute of incurable and harmless patients    whenever it is necessary to make room for recent cases. If      a patient who is to be discharged entered the mental health      institute voluntarily, the director shall notify the regional    administrator for the county interested at least ten days in    advance of the day of actual discharge.      Sec. 70. Section 226.34, subsection 2, paragraph d, Code    2024, is amended by striking the paragraph.    Sec. 71. Section 228.6, subsection 1, Code 2024, is amended    to read as follows:    1. A mental health professional or an employee of or    agent for a mental health facility may disclose mental health    information if and to the extent necessary, to meet the    requirements of section 229.24 , 229.25 , 230.20   , 230.21 , 230.25 ,    230.26 , 230A.108 , 232.74 , or 232.147 , or to meet the compulsory    reporting or disclosure requirements of other state or federal    law relating to the protection of human health and safety.    Sec. 72. Section 229.1, Code 2024, is amended by adding the    following new subsection:    NEW SUBSECTION   . 01. Administrative services organization    means the same as defined in section 225A.1.    Sec. 73. Section 229.1, subsections 11, 18, and 19, Code    2024, are amended by striking the subsections.    Sec. 74. Section 229.1B, Code 2024, is amended to read as      follows:      229.1B Regional administrator   Administrative services    organization   .    Notwithstanding any provision of this chapter to the    contrary, any person whose hospitalization expenses are    payable in whole or in part by a mental health and disability      services region an administrative services organization                          

  House File 2673, p. 36   shall be subject to all administrative requirements of the    regional administrator for the county   administrative services    organization   .    Sec. 75. Section 229.2, subsection 1, paragraph b,    subparagraph (3), Code 2024, is amended to read as follows:    (3) As soon as is practicable after the filing of a    petition for juvenile court approval of the admission of the    minor, the juvenile court shall determine whether the minor    has an attorney to represent the minor in the hospitalization    proceeding, and if not, the court shall assign to the minor    an attorney. If the minor is financially unable to pay for    an attorney, the attorney shall be compensated by the mental    health and disability services region an administrative    services organization   at an hourly rate to be established    by the regional administrator for the county in which the    proceeding is held   administrative services organization in    substantially the same manner as provided in section 815.7 .    Sec. 76. Section 229.2, subsection 2, paragraph a, Code    2024, is amended to read as follows:    a. The chief medical officer of a public hospital shall    receive and may admit the person whose admission is sought,    subject in cases other than medical emergencies to availability    of suitable accommodations and to the provisions of sections      section   229.41 and 229.42 .    Sec. 77. Section 229.8, subsection 1, Code 2024, is amended    to read as follows:    1. Determine whether the respondent has an attorney    who is able and willing to represent the respondent in the    hospitalization proceeding, and if not, whether the respondent    is financially able to employ an attorney and capable of    meaningfully assisting in selecting one. In accordance with    those determinations, the court shall if necessary allow the    respondent to select, or shall assign to the respondent, an    attorney. If the respondent is financially unable to pay an    attorney, the attorney shall be compensated by the mental      health and disability services region an administrative    services organization   at an hourly rate to be established    by the regional administrator for the county in which the    proceeding is held administrative services organization in                        

  House File 2673, p. 37   substantially the same manner as provided in section 815.7 .    Sec. 78. Section 229.10, subsection 1, paragraph a, Code    2024, is amended to read as follows:    a. An examination of the respondent shall be conducted by    one or more licensed physicians or mental health professionals,    as required by the courts order, within a reasonable time.    If the respondent is detained pursuant to section 229.11,    subsection 1 , paragraph b , the examination shall be conducted    within twenty-four hours. If the respondent is detained    pursuant to section 229.11, subsection 1 , paragraph a or    c , the examination shall be conducted within forty-eight    hours. If the respondent so desires, the respondent shall be    entitled to a separate examination by a licensed physician or    mental health professional of the respondents own choice. The    reasonable cost of the examinations shall, if the respondent    lacks sufficient funds to pay the cost, be paid by the regional    administrator from mental health and disability services region    funds an administrative services organization upon order of the    court.    Sec. 79. Section 229.11, subsection 1, unnumbered paragraph    1, Code 2024, is amended to read as follows:    If the applicant requests that the respondent be taken into    immediate custody and the judge, upon reviewing the application    and accompanying documentation, finds probable cause to believe    that the respondent has a serious mental impairment and is    likely to injure the respondent or other persons if allowed    to remain at liberty, the judge may enter a written order    directing that the respondent be taken into immediate custody    by the sheriff or the sheriffs deputy and be detained until    the hospitalization hearing. The hospitalization hearing shall    be held no more than five days after the date of the order,    except that if the fifth day after the date of the order is    a Saturday, Sunday, or a holiday, the hearing may be held    on the next succeeding business day. If the expenses of a    respondent are payable in whole or in part by a mental health      and disability services region an administrative services    organization   , for a placement in accordance with paragraph a ,    the judge shall give notice of the placement to the regional    administrator for the county in which the court is located an              

  House File 2673, p. 38   administrative services organization   , and for a placement in    accordance with paragraph b or c , the judge shall order    the placement in a hospital or facility designated through      the regional administrator   by an administrative services    organization . The judge may order the respondent detained for    the period of time until the hearing is held, and no longer,    in accordance with paragraph a , if possible, and if not then    in accordance with paragraph b , or, only if neither of these    alternatives is available, in accordance with paragraph c .    Detention may be in any of the following:    Sec. 80. Section 229.13, subsection 1, paragraph a, Code    2024, is amended to read as follows:    a. The court shall order a respondent whose expenses are    payable in whole or in part by a mental health and disability      services region an administrative services organization    placed under the care of an appropriate hospital or facility    designated through the regional administrator for the county      by an administrative services organization on an inpatient or    outpatient basis.    Sec. 81. Section 229.13, subsection 7, paragraph b, Code    2024, is amended to read as follows:    b. A region   An administrative services organization shall    contract with mental health professionals to provide the    appropriate treatment including treatment by the use of oral    medicine or injectable antipsychotic medicine pursuant to this    section .    Sec. 82. Section 229.14, subsection 2, paragraph a, Code    2024, is amended to read as follows:    a. For a respondent whose expenses are payable in whole    or in part by a mental health and disability services region      an administrative services organization   , placement as    designated through the regional administrator for the county    by an administrative services organization   in the care of an    appropriate hospital or facility on an inpatient or outpatient    basis, or other appropriate treatment, or in an appropriate    alternative placement.    Sec. 83. Section 229.14A, subsections 7 and 9, Code 2024,    are amended to read as follows:    7. If a respondents expenses are payable in whole or in                   

  House File 2673, p. 39   part by a mental health and disability services region through      the regional administrator for the county an administrative    services organization   , notice of a placement hearing shall be    provided to the county attorney and the regional administrator      an administrative services organization . At the hearing, the    county may present evidence regarding appropriate placement.    9. A placement made pursuant to an order entered under    section 229.13 or 229.14 or this section shall be considered to    be authorized through the regional administrator for the county      by an administrative services organization .    Sec. 84. Section 229.15, subsection 4, Code 2024, is amended    to read as follows:    4. When a patient has been placed in an alternative facility    other than a hospital pursuant to a report issued under section    229.14, subsection 1 , paragraph d , a report on the patients    condition and prognosis shall be made to the court which placed    the patient, at least once every six months, unless the court    authorizes annual reports. If an evaluation of the patient is      performed pursuant to   section 227.2, subsection 4 , a copy of    the evaluation report shall be submitted to the court within    fifteen days of the evaluations completion. The court may in    its discretion waive the requirement of an additional report      between the annual evaluations. If the department exercises    the authority to remove residents or patients from a county      care facility or other county or private facility under section    227.6 , the department shall promptly notify each court which    placed in that facility any resident or patient removed.    Sec. 85. Section 229.19, subsection 1, paragraphs a and b,    Code 2024, are amended to read as follows:    a. In each county the board of supervisors shall appoint    an individual who has demonstrated by prior activities an    informed concern for the welfare and rehabilitation of persons    with mental illness, and who is not an officer or employee of    the department , an officer or employee of a region, an officer      or employee of a county performing duties for a region,   or    an officer or employee of any agency or facility providing    care or treatment to persons with mental illness, to act as an    advocate representing the interests of patients involuntarily    hospitalized by the court, in any matter relating to the                           

  House File 2673, p. 40   patients hospitalization or treatment under section 229.14 or    229.15 .    b. The committing court shall assign the advocate for the    county where the patient is located. A county or region   may    seek reimbursement from the patients county of residence or    from the region in which the patients county of residence is      located   an administrative services organization .    Sec. 86. Section 229.19, subsection 4, unnumbered paragraph    1, Code 2024, is amended to read as follows:    The state mental health and disability services commission      created in section 225C.5   department , in consultation with    advocates and county and judicial branch representatives, shall    adopt rules pursuant to chapter 17A relating to advocates that    include but are not limited to all of the following topics:    Sec. 87. Section 229.22, subsection 2, paragraph b, Code    2024, is amended to read as follows:    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 229.6 . The order may be filed by facsimile if    necessary. A peace officer from the law enforcement agency    that took the person into custody, if no request was made    under paragraph a , may inform the magistrate that an arrest    warrant has been issued for or charges are pending against the    person and request that any written order issued under this    paragraph require the facility or hospital to notify the law    enforcement agency about the discharge of the person prior to    discharge. The order shall state the circumstances under which    the person was taken into custody or otherwise brought to a    facility or hospital, and the grounds supporting the finding    of probable cause to believe that the person is seriously    mentally impaired and likely to injure the persons self or    others if not immediately detained. The order shall also    include any law enforcement agency notification requirements if    applicable. The order shall confirm the oral order authorizing    the persons detention including any order given to transport    the person to an appropriate facility or hospital. A peace    officer from the law enforcement agency that took the person           

  House File 2673, p. 41   into custody may also request an order, separate from the    written order, requiring the facility or hospital to notify the    law enforcement agency about the discharge of the person prior    to discharge. The clerk shall provide a copy of the written    order or any separate order to the chief medical officer of    the facility or hospital to which the person was originally    taken, to any subsequent facility to which the person was    transported, and to any law enforcement department, ambulance    service, or transportation service under contract with a      mental health and disability services region an administrative    services organization   that transported the person pursuant    to the magistrates order. A transportation service that    contracts with a mental health and disability services region    an administrative services organization   for purposes of this    paragraph shall provide a secure transportation vehicle and    shall employ staff that has received or is receiving mental    health training.    Sec. 88. Section 229.24, subsection 3, unnumbered paragraph    1, Code 2024, is amended to read as follows:    If all or part of the costs associated with hospitalization    of an individual under this chapter are chargeable to a county      of residence   an administrative services organization , the    clerk of the district court shall provide to the regional    administrator for the county of residence and to the regional      administrator for the county in which the hospitalization    order is entered an administrative services organization the    following information pertaining to the individual which would    be confidential under subsection 1 :    Sec. 89. Section 229.38, Code 2024, is amended to read as    follows:    229.38 Cruelty or official misconduct.    If any person having the care of a person with mental illness    who has voluntarily entered a hospital or other facility for    treatment or care, or who is responsible for psychiatric    examination care, treatment, and maintenance of any person    involuntarily hospitalized under sections 229.6 through 229.15 ,    whether in a hospital or elsewhere, with or without proper    authority, shall treat such patient with unnecessary severity,    harshness, or cruelty, or in any way abuse the patient or if                 

  House File 2673, p. 42   any person unlawfully detains or deprives of liberty any person    with mental illness or any person who is alleged to have mental    illness, or if any officer required by the provisions of this    chapter and chapters   chapter 226 and 227 , to perform any act    shall willfully refuse or neglect to perform the same, the    offending person shall, unless otherwise provided, be guilty of    a serious misdemeanor.    Sec. 90. Section 230.1, Code 2024, is amended by adding the    following new subsection:    NEW SUBSECTION   . 01. Administrative service organization    means the same as defined in section 225A.1.    Sec. 91. Section 230.1, subsections 4 and 5, Code 2024, are    amended by striking the subsections.    Sec. 92. Section 230.10, Code 2024, is amended to read as    follows:    230.10 Payment of costs.    All legal costs and expenses for the taking into custody,    care, investigation, and admission or commitment of a person to    a state mental health institute under a finding that the person      has residency in another county of this state shall be charged    against the regional administrator of the persons county of    residence   to an administrative services organization .    Sec. 93. Section 230.11, Code 2024, is amended to read as    follows:    230.11 Recovery of costs from state.    Costs and expenses for the taking into custody, care, and    investigation of a person who has been admitted or committed    to a state mental health institute, United States department    of veterans affairs hospital, or other agency of the United    States government, for persons with mental illness and    who has no residence in this state or whose residence is      unknown, including cost of commitment, if any, shall be paid    as approved by the department. The amount of the costs and    expenses approved by the department is appropriated to the    department from any moneys in the state treasury not otherwise    appropriated. Payment shall be made by the department on      itemized vouchers executed by the regional administrator of      the persons county which has paid them, and approved by the      department.                   

  House File 2673, p. 43   Sec. 94. Section 230.15, subsections 1 and 2, Code 2024, are    amended to read as follows:    1. A person with mental illness and a person legally liable    for the persons support remain liable for the support of    the person with mental illness as provided in this section .    Persons legally liable for the support of a person with mental    illness include the spouse of the person, and any person    bound by contract for support of the person. The regional      administrator of the persons county of residence, subject to      the direction of the regions governing board, shall enforce    the obligation created in   this section as to all sums advanced    by the regional administrator. The liability to the regional    administrator incurred by a person with mental illness or a    person legally liable for the persons support under this    section is limited to an amount equal to one hundred percent    of the cost of care and treatment of the person with mental    illness at a state mental health institute for one hundred    twenty days of hospitalization. This limit of liability may    be reached by payment of the cost of care and treatment of the    person with mental illness subsequent to a single admission    or multiple admissions to a state mental health institute or,      if the person is not discharged as cured, subsequent to a      single transfer or multiple transfers to a county care facility    pursuant to   section 227.11 . After reaching this limit of    liability, a person with mental illness or a person legally    liable for the persons support is liable to the regional    administrator state for the care and treatment of the person    with mental illness at a state mental health institute or,    if transferred but not discharged as cured, at a county care      facility in an amount not in excess of to exceed the average    minimum cost of the maintenance of an individual who is    physically and mentally healthy residing in the individuals    own home , which standard shall be   as established and may be    revised by the department by rule . A lien imposed by section    230.25   shall not exceed the amount of the liability which may    be incurred under this section on account of a person with    mental illness.      2. A person with a substance use disorder is legally    liable for the total amount of the cost of providing care,                                      

  House File 2673, p. 44   maintenance, and treatment for the person with a substance    use disorder while a voluntary or committed patient. When    a portion of the cost is paid by a county   an administrative    services organization   , the person with a substance use disorder    is legally liable to the county administrative services    organization   for the amount paid. The person with a substance    use disorder shall assign any claim for reimbursement under any    contract of indemnity, by insurance or otherwise, providing    for the persons care, maintenance, and treatment in a state    mental health institute to the state. Any payments received      by the state from or on behalf of a person with a substance use      disorder shall be in part credited to the county in proportion    to the share of the costs paid by the county.    Sec. 95. NEW SECTION   . 230.23 State  payor of last resort.    The department shall implement services and adopt rules    pursuant to chapter 17A in a manner that ensures that the state    is the payor of last resort, and that the department does not    make any payments for services that have been provided until    the department has determined that the services provided are    not payable by a third-party source.    Sec. 96. Section 230.30, Code 2024, is amended to read as    follows:    230.30 Claim against estate.    On the death of a person receiving or who has received    assistance under the provisions of this chapter , and whom the    board   department has previously found , under section 230.25 ,    is able to pay , there shall be allowed against the estate of    such decedent a claim of the sixth class for that portion of    the total amount paid for that persons care which exceeds    the total amount of all claims of the first through the fifth    classes, inclusive, as defined in section 633.425 , which are    allowed against that estate.    Sec. 97. Section 232.78, subsection 5, unnumbered paragraph    1, Code 2024, is amended to read as follows:      The juvenile court, before or after the filing of a petition    under this chapter , may enter an ex parte order authorizing    a physician or physician assistant or hospital to conduct an    outpatient physical examination or authorizing a physician or    physician assistant, a psychologist certified under section                    

  House File 2673, p. 45   154B.7, or a community mental health center accredited pursuant    to chapter 230A   section 225A.3 to conduct an outpatient mental    examination of a child if necessary to identify the nature,    extent, and cause of injuries to the child as required by    section 232.71B , provided all of the following apply:    Sec. 98. Section 232.83, subsection 2, unnumbered paragraph    1, Code 2024, is amended to read as follows:    Anyone authorized to conduct a preliminary investigation in    response to a complaint may apply for, or the court on its own    motion may enter, an ex parte order authorizing a physician    or physician assistant or hospital to conduct an outpatient    physical examination or authorizing a physician or physician    assistant, a psychologist certified under section 154B.7, or a    community mental health center accredited pursuant to chapter      230A section 225A.3 to conduct an outpatient mental examination    of a child if necessary to identify the nature, extent, and    causes of any injuries, emotional damage, or other such needs    of a child as specified in section 232.96A, subsection 3, 5, or    6 , provided that all of the following apply:    Sec. 99. Section 235.7, subsection 2, Code 2024, is amended    to read as follows:    2. Membership. The department may authorize the governance    boards of decategorization of child welfare and juvenile    justice funding projects established under section 232.188 to    appoint the transition committee membership and may utilize    the boundaries of decategorization projects to establish    the service areas for transition committees. The committee    membership may include but is not limited to department staff    involved with foster care, child welfare, and adult services,    juvenile court services staff, staff involved with county    general assistance or emergency relief under chapter 251 or    252, or a regional administrator of the county mental health      and disability services region, as defined in section 225C.55,      in the area, school district and area education agency staff    involved with special education, and a childs court appointed    special advocate, guardian ad litem, service providers, and    other persons knowledgeable about the child.    Sec. 100. Section 235A.15, subsection 2, paragraph c,    subparagraphs (5) and (8), Code 2024, are amended by striking           

  House File 2673, p. 46   the subparagraphs.    Sec. 101. Section 249A.4, subsection 15, Code 2024, is    amended by striking the subsection.    Sec. 102. Section 249A.12, subsection 4, Code 2024, is    amended by striking the subsection.    Sec. 103. NEW SECTION . 249A.38A Supported community living    services.    1. As used in this section, supported community living    service means a service provided in a noninstitutional setting    to persons sixteen years of age and older with mental illness,    an intellectual disability, brain injury, or developmental    disabilities to meet the persons daily living needs.    2. The department shall adopt rules pursuant to chapter 17A    establishing minimum standards for supported community living    services.    3. The department shall determine whether to grant, deny, or    revoke approval for any supported community living service.    4. Approved supported community living services may receive    funding from the state, federal and state social services block    grant funds, and other appropriate funding sources, consistent    with state legislation and federal regulations. The funding    may be provided on a per diem, per hour, or grant basis, as    appropriate.    Sec. 104. Section 249N.8, Code 2024, is amended by striking    the section and inserting in lieu thereof the following:    249N.8 Behavioral health services reports.    The department shall annually submit a report to the    governor and the general assembly with details related to the    departments review of the funds administered by, and the    outcomes and effectiveness of, the behavioral health services      provided by, the behavioral health service system established    in section 225A.3.    Sec. 105. Section 252.24, subsections 1 and 3, Code 2024,      are amended to read as follows:    1. The county of residence, as defined in section 225C.61      331.190 , shall be liable to the county granting assistance for    all reasonable charges and expenses incurred in the assistance    and care of a poor person.    3. This section shall apply to assistance or maintenance      

  House File 2673, p. 47   provided by a county   through the countys mental health    and disability services behavioral health service system    implemented under   chapter 225C established in section 225A.3 .    Sec. 106. Section 256.25, subsections 2 and 3, Code 2024,    are amended to read as follows:    2. A school district, which may collaborate and partner    with one or more school districts, area education agencies,    accredited nonpublic schools, nonprofit agencies, and    institutions that provide childrens mental health services,    located in mental health and disability services regions      providing childrens behavioral health services in accordance      with chapter 225C, subchapter VII operating within the states    behavioral health service system under chapter 225A , may apply    for a grant under this program to establish a therapeutic    classroom in the school district in accordance with this    section .    3. The department shall develop a grant application    and selection and evaluation criteria. Selection criteria    shall include a method for prioritizing grant applications    submitted by school districts. First priority shall be    given to applications submitted by school districts that    submitted an application pursuant to this section for the    previous   immediately preceding fiscal year. Second priority    shall be given to applications submitted by school districts    that, pursuant to subsection 2 , are collaborating and    partnering with one or more school districts, area education    agencies, accredited nonpublic schools, nonprofit agencies,    or institutions that provide mental health services for    children. Third priority shall be given to applications    submitted by school districts located in mental health and      disability services regions   behavioral health districts as    defined in section 225A.1, and that are providing behavioral    health services for children in accordance with chapter 225C,      subchapter VII 225A . Grant awards shall be distributed as    equitably as possible among small, medium, and large school    districts. For purposes of this subsection , a small school    district is a district with an actual enrollment of fewer than    six hundred pupils; a medium school district is a district    with an actual enrollment that is at least six hundred pupils,                         

  House File 2673, p. 48   but less than two thousand five hundred pupils; and a large    school district is a district with an actual enrollment of two    thousand five hundred or more pupils.    Sec. 107. Section 321.189, subsection 10, Code 2024, is    amended to read as follows:    10. Autism spectrum disorder status. A licensee who has    autism spectrum disorder, as defined in section 514C.28 , may    request that the license be marked to reflect the licensees    autism spectrum disorder status on the face of the license    when the licensee applies for the issuance or renewal of a    license. The department may adopt rules pursuant to chapter    17A establishing criteria under which a license may be marked,    including requiring the licensee to submit medical proof of the    licensees autism spectrum disorder status. When a drivers    license is so marked, the licensees autism spectrum disorder    status shall be noted in the electronic database used by    the department and law enforcement to access registration,    titling, and drivers license information. The department, in    consultation with the mental health and disability services      commission department of health and human services , shall    develop educational media to raise awareness of a licensees    ability to request the license be marked to reflect the    licensees autism spectrum disorder status.    Sec. 108. Section 321.190, subsection 1, paragraph b,    subparagraph (6), Code 2024, is amended to read as follows:    (6) An applicant for a nonoperators identification    card who has autism spectrum disorder, as defined in section    514C.28 , may request that the card be marked to reflect    the applicants autism spectrum disorder status on the face    of the card when the applicant applies for the issuance or    renewal of a card. The department may adopt rules pursuant to    chapter 17A establishing criteria under which a card may be    marked, including requiring the applicant to submit medical    proof of the applicants autism spectrum disorder status.    The department, in consultation with the mental health and      disability services commission department of health and human    services   , shall develop educational media to raise awareness of    an applicants ability to request the card be marked to reflect    the applicants autism spectrum disorder status.          

  House File 2673, p. 49   Sec. 109. Section 321J.25, subsection 1, paragraph b, Code    2024, is amended to read as follows:    b. Program means a substance use disorder awareness    program , licensed under chapter 125, and   provided under a    contract entered into between the provider and the department    of health and human services under chapter 125   or an    administrative services organization as defined in section      225A.1 .    Sec. 110. Section 321J.25, subsection 2, unnumbered    paragraph 1, Code 2024, is amended to read as follows:    A substance use disorder awareness program is established    in each of the regions established by the director of health      and human services pursuant to section 125.12 behavioral    health district designated pursuant to section 225A.4   . The    program shall consist of an insight class and a substance    use disorder evaluation, which shall be attended by the    participant, to discuss issues related to the potential    consequences of substance use disorder. The parent or parents    of the participant shall also be encouraged to participate    in the program. The program provider shall consult with the    participant or the parents of the participant in the program    to determine the timing and appropriate level of participation    for the participant and any participation by the participants    parents. The program may also include a supervised educational    tour by the participant to any or all of the following:    Sec. 111. Section 331.321, subsection 1, paragraph e, Code    2024, is amended by striking the paragraph.    Sec. 112. Section 331.323, subsection 1, paragraph a,    subparagraph (7), Code 2024, is amended by striking the    subparagraph.    Sec. 113. Section 331.381, subsections 4 and 5, Code 2024,    are amended to read as follows:    4. Comply with chapter 222 , including but not limited to      sections 222.13 , 222.14 , 222.59 through 222.70 , 222.73 through    222.75   , and 222.77 through 222.82 , in regard to the care of    persons with an intellectual disability.    5. Comply with chapters 227,   229 and 230 , including but not    limited to sections 227.11 , 227.14 , 229.42 , 230.25 , 230.27 , and    230.35 , in regard to the care of persons with mental illness.                                        

  House File 2673, p. 50   Sec. 114. Section 331.382, subsection 1, paragraphs e, f,    and g, Code 2024, are amended by striking the paragraphs.    Sec. 115. Section 331.382, subsection 3, Code 2024, is    amended by striking the subsection.    Sec. 116. Section 331.432, subsection 3, Code 2024, is    amended by striking the subsection.    Sec. 117. Section 331.502, subsection 10, Code 2024, is    amended by striking the subsection.    Sec. 118. Section 331.502, subsection 12, Code 2024, is    amended to read as follows:    12. Carry out duties relating to the hospitalization and    support of persons with mental illness as provided in sections    229.42,   230.3 , 230.11 , and 230.15 , 230.21 , 230.22 , 230.25 , and    230.26   .    Sec. 119. Section 331.552, subsection 13, Code 2024, is    amended by striking the subsection.    Sec. 120. Section 331.756, subsections 25, 38, and 41, Code    2024, are amended by striking the subsections.    Sec. 121. Section 331.910, subsection 2, Code 2024, is    amended by adding the following new paragraph:    NEW PARAGRAPH   . 0a. Administrative services organization    means the same as defined in section 225A.1.    Sec. 122. Section 331.910, subsection 2, paragraph d, Code    2024, is amended by striking the paragraph.    Sec. 123. Section 331.910, subsection 3, paragraphs a and c,    Code 2024, are amended to read as follows:    a. A region   An administrative services organization may    contract with a receiving agency in a bordering state to secure    substance use disorder or mental health care and treatment    under this subsection for persons who receive substance use    disorder or mental health care and treatment pursuant to    section 125.33, 125.91 , 229.2 , or 229.22 through a region   .    c. A region   An administrative services organization may    contract with a sending agency in a bordering state to provide    care and treatment under this subsection for residents of    the bordering state in approved substance use disorder and    mental health care and treatment hospitals, centers, and    facilities in this state, except that care and treatment shall    not be provided for residents of the bordering state who are                      

  House File 2673, p. 51   involved in criminal proceedings substantially similar to the    involvement described in paragraph b .    Sec. 124. Section 347.16, subsection 3, Code 2024, is    amended to read as follows:    3. Care and treatment may be furnished in a county public    hospital to any sick or injured person who has residence    outside the county which maintains the hospital, subject to    such policies and rules as the board of hospital trustees    may adopt. If care and treatment is provided under this    subsection to a person who is indigent, the persons county of    residence, as defined in section 225C.61   331.190 , shall pay to    the board of hospital trustees the fair and reasonable cost of    the care and treatment provided by the county public hospital    unless the cost of the indigent persons care and treatment is    otherwise provided for. If care and treatment is provided to    an indigent person under this subsection , the county public    hospital furnishing the care and treatment shall immediately    notify, by regular mail, the auditor of the county of residence    of the indigent person of the provision of care and treatment    to the indigent person including care and treatment provided    by a county   through the countys mental health and disability    services system implemented under chapter 225C   behavioral    health service system established in section 225A.3 .    Sec. 125. Section 423.3, subsection 18, paragraph d, Code    2024, is amended to read as follows:    d. Community mental health centers accredited by the    department of health and human services pursuant to chapter      225C section 225A.3 .    Sec. 126. Section 426B.1, subsection 2, Code 2024, is    amended to read as follows:    2. Moneys shall be distributed from the property tax relief    fund to the mental health and disability services regional      service system for mental health and disability services,      behavioral health fund established in section 225A.7 in    accordance with the appropriations made to the fund and other    statutory requirements.    Sec. 127. Section 437A.8, subsection 4, paragraph d, Code    2024, is amended to read as follows:      d. (1)   Notwithstanding paragraph a , a taxpayer who owns                 

  House File 2673, p. 52   or leases a new electric power generating plant and who has    no other operating property in the state of Iowa except for    operating property directly serving the new electric power    generating plant as described in section 437A.16 shall pay    the replacement generation tax associated with the allocation    of the local amount to the county treasurer of the county in    which the local amount is located and shall remit the remaining    replacement generation tax, if any, to the director according    to paragraph a for remittance of the tax to county treasurers.    The director shall notify each taxpayer on or before August 31    following a tax year of its remaining replacement generation    tax to be remitted to the director. All remaining replacement    generation tax revenues received by the director shall be    deposited in the property tax relief fund created in section    426B.1 , and shall be distributed as provided in section 426B.2   .    (2)   If a taxpayer has paid an amount of replacement tax,    penalty, or interest which was deposited into the property tax    relief fund and which was not due, all of the provisions of    section 437A.14, subsection 1 , paragraph b , shall apply with    regard to any claim for refund or credit filed by the taxpayer.    The director shall have sole discretion as to whether the    erroneous payment will be refunded to the taxpayer or credited    against any replacement tax due, or to become due, from the    taxpayer that would be subject to deposit in the property tax    relief fund.    Sec. 128. Section 437A.15, subsection 3, paragraph f, Code    2024, is amended to read as follows:    f. Notwithstanding the provisions of this section , if    a taxpayer is a municipal utility or a municipal owner of    an electric power facility financed under the provisions    of chapter 28F or 476A , the assessed value, other than the    local amount, of a new electric power generating plant shall    be allocated to each taxing district in which the municipal    utility or municipal owner is serving customers and has    electric meters in operation in the ratio that the number of    operating electric meters of the municipal utility or municipal    owner located in the taxing district bears to the total number    of operating electric meters of the municipal utility or    municipal owner in the state as of January 1 of the tax year.     

  House File 2673, p. 53   If the municipal utility or municipal owner of an electric    power facility financed under the provisions of chapter 28F    or 476A has a new electric power generating plant but the    municipal utility or municipal owner has no operating electric    meters in this state, the municipal utility or municipal owner    shall pay the replacement generation tax associated with the    new electric power generating plant allocation of the local    amount to the county treasurer of the county in which the local    amount is located and shall remit the remaining replacement    generation tax, if any, to the director at the times contained    in section 437A.8, subsection 4 , for remittance of the tax to    the county treasurers. All remaining replacement generation    tax revenues received by the director shall be deposited in the    property tax relief   behavioral health fund created established    in section 426B.1, and shall be distributed as provided in    section 426B.2   225A.7 .    Sec. 129. Section 483A.24, subsection 7, Code 2024, is    amended to read as follows:    7. A license shall not be required of minor pupils of the    Iowa school for the deaf or of minor residents of other state    institutions under the control of the department of health    and human services. In addition, a person who is on active    duty with the armed forces of the United States, on authorized    leave from a duty station located outside of this state, and    a resident of the state of Iowa shall not be required to    have a license to hunt or fish in this state. The military    person shall carry the persons leave papers and a copy of    the persons current earnings statement showing a deduction    for Iowa income taxes while hunting or fishing. In lieu of    carrying the persons earnings statement, the military person    may also claim residency if the person is registered to vote    in this state. If a deer or wild turkey is taken, the military    person shall immediately contact a state conservation officer    to obtain an appropriate tag to transport the animal. A    license shall not be required of residents of county care      facilities or any person who is receiving supplementary    assistance under chapter 249 .    Sec. 130. Section 602.8102, subsection 39, Code 2024, is      amended to read as follows:            

  House File 2673, p. 54   39. Refer persons applying for voluntary admission to a    community mental health center accredited by the department      of health and human services under section 225A.3,   for a    preliminary diagnostic evaluation as provided in   section    225C.16, subsection 2 .    Sec. 131. Section 714.8, subsection 12, Code 2024, is    amended to read as follows:    12. Knowingly transfers or assigns a legal or equitable    interest in property, as defined in section 702.14 , for less    than fair consideration, with the intent to obtain public    assistance under chapters 16 , 35B , and   35D , and 347B , or Title    VI, subtitles 2 through 6 , or accepts a transfer of or an    assignment of a legal or equitable interest in property, as    defined in section 702.14 , for less than fair consideration,    with the intent of enabling the party transferring the property    to obtain public assistance under chapters 16 , 35B , and   35D ,    and 347B , or Title VI, subtitles 2 through 6 . A transfer or    assignment of property for less than fair consideration within    one year prior to an application for public assistance benefits    shall be evidence of intent to transfer or assign the property    in order to obtain public assistance for which a person is    not eligible by reason of the amount of the persons assets.    If a person is found guilty of a fraudulent practice in the    transfer or assignment of property under this subsection the    maximum sentence shall be the penalty established for a serious    misdemeanor and sections 714.9 , 714.10 , and 714.11 shall not    apply.    Sec. 132. Section 812.6, subsection 1, Code 2024, is amended    to read as follows:    1. If the court finds the defendant does not pose a danger    to the public peace and safety, is otherwise qualified for    pretrial release, and is willing to cooperate with treatment,    the court shall order, as a condition of pretrial release,    that the defendant obtain mental health treatment designed to    restore the defendant to competency. The costs of treatment    pursuant to this subsection shall be paid by the mental      health and disability services region for the county of the      defendants residency pursuant to chapter 225C regardless of      whether the defendant meets financial eligibility requirements                    

  House File 2673, p. 55   under section 225C.62 or 225C.66   an administrative services    organization designated pursuant to section 225A.4 .    Sec. 133. Section 904.201, subsection 8, Code 2024, is    amended to read as follows:    8. Chapter 230 governs the determination of costs and    charges for the care and treatment of persons with mental    illness admitted to the forensic psychiatric hospital ,      except that charges for the care and treatment of any person    transferred to the forensic psychiatric hospital from an adult      correctional institution or from a state training school shall    be paid entirely from state funds   . Charges for all other    persons at the forensic psychiatric hospital shall be billed to    the respective counties at the same ratio as for patients at    state mental health institutes under section 230.20.      Sec. 134. REPEAL. Chapters 142A, 225C, 227, 230A, and 347B,    Code 2024, are repealed.    Sec. 135. REPEAL. Sections 125.1, 125.3, 125.7, 125.9,    125.10, 125.12, 125.25, 125.32A, 125.34, 125.37, 125.38,    125.39, 125.40, 125.41, 125.42, 125.43, 125.43A, 125.46,    125.48, 125.54, 125.55, 125.58, 125.59, 125.60, 135B.18,    218.99, 222.59, 222.60, 222.61, 222.62, 222.63, 222.64, 222.65,    222.66, 222.67, 222.68, 222.69, 222.70, 222.74, 222.75, 225.10,    225.19, 225.21, 226.45, 229.42, 230.1A, 230.2, 230.3, 230.4,    230.5, 230.6, 230.9, 230.12, 230.16, 230.17, 230.18, 230.19,    230.20, 230.21, 230.22, 230.25, 230.26, 230.27, 426B.2, 426B.4,    and 426B.5, Code 2024, are repealed.    Sec. 136. CODE EDITOR DIRECTIVE. The Code editor is    directed to correct internal references in the Code and in any    enacted legislation as necessary due to the enactment of this    division of this Act.    Sec. 137. EFFECTIVE DATE. This division of this Act takes    effect July 1, 2025.    DIVISION III      AGING AND DISABILITY      Sec. 138. Section 231.3, Code 2024, is amended to read as      follows:      231.3 State policy and objectives.    1.   The general assembly declares that it is the policy of    the state to work toward attainment of the following objectives                

  House File 2673, p. 56   for Iowas older individuals and individuals with disabilities   :    1. a. An adequate income.    2.   b. Access to physical and mental health care and    long-term living and community support services without regard    to economic status.    3.   c. Suitable and affordable housing that reflects the    needs of older   individuals.    4. d. Access to comprehensive information and a community    navigation system providing all available options related to    long-term living and community support services that assist    older   individuals in the preservation of personal assets and    the ability to entirely avoid or significantly delay reliance    on entitlement programs.    5.   e. Full restorative services for those who require    institutional care, and a comprehensive array of long-term    living and community support services adequate to sustain older      people in their communities and, whenever possible, in their    homes, including support for caregivers.    6.   f. Pursuit of meaningful activity within the widest    range of civic, cultural, educational, recreational, and    employment opportunities.    7.   g. Suitable community transportation systems to assist    in the attainment of independent movement.    8.   h. Freedom, independence, and the free exercise of    individual initiative in planning and managing their own lives.    9. i. Freedom from abuse, neglect, and exploitation.    2. The general assembly declares that the state of Iowa    recognizes a brain injury as a disability, and each agency and    subdivision of this state shall recognize a brain injury as a      distinct disability.    3.   It is the policy of this state that each state agency    shall make reasonable efforts to identify those persons with    brain injuries among the persons served by the state agency.      Sec. 139. Section 231.4, subsection 1, Code 2024, is amended      by adding the following new paragraph:    NEW PARAGRAPH   . 0c. Brain injury means the same as defined    in section 135.22.      Sec. 140. Section 231.4, subsection 1, paragraph d, Code    2024, is amended to read as follows:                                     

  House File 2673, p. 57   d. Commission   means the commission on aging. Council    means the council on health and human services created in    section 217.2.      Sec. 141. Section 231.14, Code 2024, is amended to read as    follows:    231.14 Commission   Council duties and authority.    1.   The commission is the policymaking body of the sole state    agency responsible for administration of the federal Act. The    commission   council shall do all of the following :    a. 1. Approve Make recommendations to the department    regarding approval of the   state plan on aging developed under    section 231.31 and area plans on aging , developed under section    231.33 .    b.   2. Adopt Recommend policies to coordinate state    activities related to the purposes of this chapter .    c.   3. Serve as an effective and visible advocate for older    individuals and individuals with disabilities by establishing    recommending policies for reviewing and commenting upon    all state plans, budgets, and policies   which affect older    individuals and for providing technical assistance to any    agency, organization, association, or individual representing    the needs of older   individuals with disabilities .    d. Divide the state into distinct planning and service    areas after considering the geographical distribution of      older individuals in the state, the incidence of the need    for supportive services, nutrition services, multipurpose    senior centers, and legal services, the distribution of older    individuals who have low incomes residing in such areas, the    distribution of resources available to provide such services      or centers, the boundaries of existing areas within the    state which are drawn for the planning or administration of      supportive services programs, the location of units of general    purpose, local government within the state, and any other      relevant factors.    e.   Designate for each planning and service area a public or    private nonprofit agency or organization as the area agency on    aging for that area. The commission may revoke the designation      of an area agency on aging pursuant to section 231.32 .    f. 4. Adopt policies to assure Make recommendations to                                                                    

  House File 2673, p. 58   ensure   that the department will take into account the views    of older individuals and individuals with disabilities in the    development of policy.    g. Adopt a method for the distribution of federal    Act and state funds taking into account, to the maximum    extent feasible, the best available data on the geographic      distribution of older individuals in the state, and publish the      method for review and comment.    h.   5. Adopt Recommend policies and measures to assure    ensure that preference will be given to providing services to    older individuals and individuals with disabilities   with the    greatest economic or social needs, with particular attention to    low-income minority older individuals, older individuals with    limited English proficiency, and older   individuals residing in    rural areas.    i.   6. Adopt Recommend policies to administer state programs    authorized by this chapter .    j. 7. Adopt Recommend policies and administrative rules    pursuant to   chapter 17A that support the capabilities of the    area agencies on aging and the aging and disabilities resource    centers to serve older individuals and persons individuals    with disabilities experiencing Alzheimers disease or related    dementias.    2.   The commission shall adopt administrative rules pursuant    to chapter 17A to administer the duties specified in this    chapter and in all other chapters under the departments    jurisdiction.    Sec. 142. Section 231.21, Code 2024, is amended to read as    follows:    231.21 Administration of chapter  department of health and    human services.    The department of health and human services shall administer      this chapter   under the policy direction of the commission    on aging consider the recommendations of the council when    administering this chapter   .    Sec. 143. Section 231.23, Code 2024, is amended to read as      follows:      231.23 Department  duties and authority.    The department shall:                                                   

  House File 2673, p. 59   1. Develop and administer a   Administer the state plan on    aging developed pursuant to section 231.31 .    2. Assist the commission in the review and approval of      Review and approve   area plans developed under section 231.33 .    3. Pursuant to commission policy, coordinate Coordinate    state activities related to the purposes of this chapter and      all other chapters under the departments jurisdiction   .    State activities shall include, at a minimum, home and    community-based services such as employment support, community      living, and service coordination.    4. Advocate for older individuals and individuals with      disabilities by reviewing and commenting upon all state plans,    budgets, laws, rules, regulations, and policies which affect    older individuals or individuals with disabilities   and by    providing technical assistance to any agency, organization,    association, or individual representing the needs of older    individuals or individuals with disabilities   .    5. Assist the commission in dividing Divide the state into    distinct planning and service areas after considering the      geographical distribution of older individuals and individuals    with disabilities in the state, the incidence of the need    for supportive services, nutrition services, multipurpose      senior centers, and legal services, the distribution of older    individuals and individuals with disabilities with low income      residing in such areas, the distribution of resources available    to provide such services or centers, the boundaries of existing    areas within the state which are drawn for the planning or    administration of supportive services programs, the location of    units of general purpose, local government within the state,      and any other relevant factors .    6. Assist the commission in designating   Designate for each    area a public or private nonprofit agency or organization as    the area agency on aging for that area. The department may      revoke the designation of an area agency on aging pursuant to    section 231.32.      7. Pursuant to commission policy, take Take into account the    views of older Iowans and Iowans with disabilities   .    8. Assist the commission in adopting Adopt a method for    the distribution of funds available from the federal Act                                             

  House File 2673, p. 60   and state appropriations and allocations that takes into      account, to the extent feasible, the best available data on the    geographic distribution of older individuals and individuals      with disabilities in the state   .    9. Assist the commission in assuring Adopt policies and    measures to ensure   that preference will be given to providing    services to older individuals and individuals with disabilities      with the greatest economic or social needs, with particular    attention to low-income minority older   individuals, older    individuals with limited English proficiency, and older    individuals residing in rural areas.    10. Assist the commission in developing, adopting, and      enforcing Develop, adopt, and enforce administrative rules,    including   by issuing necessary forms and procedures , to    administer the duties specified in this chapter .    11. Apply for, receive, and administer grants, devises,    donations, and   gifts , or bequests of real or personal property    from any source to conduct projects consistent with the    purposes of the department. Notwithstanding section 8.33 ,    moneys received by the department pursuant to this section are    not subject to reversion to the general fund of the state.    12. Administer state authorized programs.    13. Establish a procedure for an area agency on aging to    use in selection of members of the agencys board of directors.    The selection procedure shall be incorporated into the bylaws    of the board of directors.    14.   Adopt rules pursuant to chapter 17A that support the    capabilities of the area agencies on aging, and aging and    disabilities resource centers, to serve older individuals and      individuals with disabilities.    Sec. 144. Section 231.23A, subsections 1 and 3, Code 2024,    are amended to read as follows:    1. Services for older individuals, persons with      disabilities eighteen years of age and older, family    caregivers, and veterans as defined by the department in the    most current version of the departments reporting manual and    pursuant to the federal Act and regulations.    3. The aging   Aging and disability resource center centers .    Sec. 145. Section 231.23A, Code 2024, is amended by adding                                  

  House File 2673, p. 61   the following new subsection:    NEW SUBSECTION   . 7A. Services and supports available to    individuals with disabilities including but not limited to    individuals with mental illness, an intellectual disability or    other developmental disability, or a brain injury.    Sec. 146. Section 231.31, Code 2024, is amended to read as    follows:    231.31 State plan on aging.    The department shall develop , and submit to the commission      on aging for approval, a multiyear state plan on aging.    The state plan on aging shall meet all applicable federal    requirements.    Sec. 147. Section 231.32, Code 2024, is amended to read as    follows:    231.32 Criteria for designation of area agencies on aging.    1. The commission   department shall designate an area    agency on aging for each planning and service area. The    commission shall continue the designation shall continue until    an area agency on agings designation is removed for cause as    determined by the commission   department , until the time of    renewal or the annual update of an area plan, until the agency    voluntarily withdraws as an area agency on aging, or until a    change in the designation of planning and service areas or area    agencies on aging is required by state or federal law. In that    event, the commission   department shall proceed in accordance    with subsections 2, 3, and 4 . Designated area agencies on    aging shall comply with the requirements of the federal Act.    2. The commission department shall designate an area    agency on aging   to serve each planning and service area, after    consideration of the views offered by units of general purpose    local government. An area agency on aging   may be:    a. An established office of aging which is operating within    a planning and service area designated by the commission      department   .    b. Any office or agency of a unit of general purpose local    government, which is designated to function only for the    purpose of serving as an area agency on aging by the chief    elected official of such unit.    c. Any office or agency designated by the appropriate                    

  House File 2673, p. 62   chief elected officials of any combination of units of    general purpose local government to act only on behalf of such    combination for such purpose.    d. Any public or nonprofit private agency in a planning and    service area or any separate organizational unit within such    agency which is under the supervision or direction for this    purpose of the department and which can and will engage only in    the planning or provision of a broad range of long-term living    and community support services or nutrition services within the    planning and service area.    3. When the commission   department designates a new area    agency on aging , the commission department shall give the right    of first refusal to a unit of general purpose local government    if:    a. Such unit can meet the requirements of subsection 1 .    b. The boundaries of such a unit and the boundaries of the    area are reasonably contiguous.    4. Each area agency on aging   shall provide assurance,    determined adequate by the commission   department , that the    area agency on aging has the ability to develop an area plan    and to carry out, directly or through contractual or other    arrangements, a program in accordance with the plan within the    planning and service area. In designating an area agency on    aging within the planning and service area, the commission      department shall give preference to an established office of    aging, unless the commission department finds that no such    office within the planning and service area has the capacity to    carry out the area plan.    5. Upon designation, an area agency on aging shall be    considered an instrumentality of the state and shall adhere to    all state and federal mandates applicable to an instrumentality    of the state.      Sec. 148. Section 231.33, subsections 1 and 13, Code 2024,      are amended to read as follows:    1. Develop and administer an area plan on aging   approved by    the commission department .    13. Submit all fiscal and performance reports in accordance    with the policies of the commission   department .    Sec. 149. NEW SECTION . 231.35 Procedures related to                        

  House File 2673, p. 63   expenditure of state and federal funds.    1. The department shall establish and enforce procedures    relating to expenditure of state and federal funds by area    agencies on aging that require compliance with both state and    federal laws, rules, and regulations, including but not limited    to all of the following:    a. Requiring that expenditures are incurred only for goods    or services received or performed prior to the end of the    fiscal period designated for use of the funds.    b. Prohibiting prepayment for goods or services not received    or performed prior to the end of the fiscal period designated    for use of the funds.    c. Prohibiting prepayment for goods or services not defined    specifically by good or service, time period, or recipient.    d. Prohibiting the establishment of accounts from which    future goods or services which are not defined specifically by    good or service, time period, or recipient, may be purchased.    2. The procedures shall provide that if any funds are    expended in a manner that is not in compliance with the    procedures and applicable federal and state laws, rules, and    regulations, and are subsequently subject to repayment, the    area agency on aging expending such funds in contravention of    such procedures, laws, rules and regulations, not the state,    shall be liable for such repayment.    Sec. 150. Section 231.56, Code 2024, is amended to read as    follows:    231.56 Services and programs.    The department shall administer long-term living and    community support services and programs that allow older    individuals and individuals with disabilities   to secure and      maintain maximum independence and dignity in a home environment    that provides for self-care with appropriate supportive    services, assist in removing individual and social barriers    to economic and personal independence for older individuals    and individuals with disabilities   , and provide a continuum of    care for older individuals and individuals with disabilities.    Funds appropriated for this purpose shall be allocated based    on administrative   rules adopted by the commission department    pursuant to chapter 17A . The department shall require such          

  House File 2673, p. 64   records as needed   adopt rules pursuant to chapter 17A that    allow the department to collect information as necessary from    long-term living and community support services, program      providers, and patients   to administer this section .    Sec. 151. Section 231.57, Code 2024, is amended to read as    follows:    231.57 Coordination of advocacy.    The department shall administer a program for the    coordination of information and assistance provided within    the state to assist older individuals and individuals with      disabilities,   and their caregivers , in obtaining and protecting    their rights and benefits. State and local agencies providing    information and assistance to older individuals and individuals    with disabilities,   and their caregivers , in seeking their    rights and benefits shall cooperate with the department in    administering this program.    Sec. 152. Section 231.58, Code 2024, is amended to read as    follows:    231.58 Long-term living coordination.    The director may convene meetings, as necessary, of the    director and the director of inspections, appeals, and    licensing, to assist in the coordination of policy, service    delivery, and long-range planning relating to the long-term    living system and older Iowans and Iowans with disabilities      in the state. The group may consult with individuals,    institutions, and entities with expertise in the area of the    long-term living system and older Iowans and Iowans with    disabilities , as necessary, to facilitate the groups efforts.    Sec. 153. Section 231.64, Code 2024, is amended to read as    follows:    231.64 Aging and disability resource center   centers .    1. The aging and disability resource center shall be    administered by the department consistent with the   federal Act .    The department shall designate area agencies on aging and    disability resource centers   to establish, in consultation with    other stakeholders including organizations representing the    disability community, a coordinated local aging and disability      service system for providing . In addition to services required    by the department by rules adopted pursuant to chapter 17A,                                 

  House File 2673, p. 65   aging and disability resource centers shall provide for   all of    the following:    a. Comprehensive information, referral, and assistance    regarding the full range of available public and private    long-term living and community support services, options,    service providers, and resources within a community, including    information on the availability of integrated long-term care.    b. Options counseling to assist individuals in assessing    their existing or anticipated long-term care needs and    developing and implementing a plan for long-term living and    community support services designed to meet their specific    needs and circumstances. The plan for long-term living    and community support services may include support with    person-centered care transitions to assist consumers and family    caregivers with transitions between home and care settings.    c. Consumer access to the range of publicly-supported    long-term living and community support services for which    consumers may be eligible, by serving as a convenient point    of entry for such services. The aging   Aging and disability    resource center centers shall offer information online and    be available via a toll-free telephone number, electronic    communications, and in person.    2.   The following entities shall be eligible to be designated    as an aging and disability resource center by the department:      a. An area agency on aging established on or before June 30,    2024.    b. A public or private nonprofit agency, or any separate    organizational unit within the public or private nonprofit    agency, that has the capabilities to engage in the planning or      provision of aging and disability services only as directed by    the department.      2. 3. The aging Aging and disability resource center    centers   shall assist older individuals, persons individuals    with disabilities age eighteen or older , family caregivers,    and people who inquire about or request assistance on behalf    of members of these groups, as they seek long-term living and    community support services.    4.   The department shall adopt rules pursuant to chapter 17A    to implement this section.                                    

  House File 2673, p. 66   Sec. 154. NEW SECTION   . 231.75 Scope.    The service quality standards and rights in this subchapter    VII shall apply to any person with an intellectual disability,    a developmental disability, brain injury, or chronic mental    illness who receives services which are funded in whole or in    part by public funds, or services which are permitted under    Iowa law.    Sec. 155. NEW SECTION   . 231.76 Service quality standards.    As the state participates more fully in funding services    and other support for persons with an intellectual disability,    developmental disability, brain injury, or chronic mental    illness, it is the intent of the general assembly that the    state shall seek to attain the following quality standards in    the provision of services and other supports:    1. Provide comprehensive evaluation and diagnosis adapted    to the cultural background, primary language, and ethnic origin    of a person.    2. Provide an individual treatment, habilitation, and    program services plan.    3. Provide treatment, habilitation, and program services    that are individualized, flexible, cost-effective, and produce    results.    4. Provide periodic review of an individuals treatment,    habilitation, and program services plan.    5. Provide for the least restrictive environment, and    age-appropriate services.    6. Provide appropriate training and employment    opportunities so that a persons ability to contribute to, and    participate in, the community is maximized.    7. Provide an ongoing process to determine the degree of    access to, and the effectiveness of, the services and other    supports in achieving the disability service outcomes and    indicators identified by the department.    Sec. 156. NEW SECTION   . 231.77 Rights.    All of the following rights shall apply to a person with an    intellectual disability, a developmental disability, a brain    injury, or a chronic mental illness:    1. Wage protection. A person engaged in a work program    shall be paid wages commensurate with the going rate for      

  House File 2673, p. 67   comparable work and productivity.    2. Insurance protection. Pursuant to section 507B.4,    subsection 3, paragraph g , a person or designated group    of persons shall not be unfairly discriminated against for    purposes of insurance coverage.    3. Citizenship. A person retains the right to citizenship    in accordance with the laws of the state.    4. Participation in planning activities. A person has    the right to participate in the formulation of an individual    treatment, habilitation, and program plan developed for the    person.    Sec. 157. NEW SECTION   . 231.78 Compliance.    1. A persons sole remedy for a violation of a rule adopted    by the department to implement sections 231.75 through 231.77    shall be to initiate a proceeding with the department by    request pursuant to chapter 17A.    a. Any decision of the department shall be in accordance    with due process of law. A person or party who is aggrieved or    adversely affected by the departments action may seek judicial    review pursuant to section 17A.19. A person or party who is    aggrieved or adversely affected by a final judgment of the    district court may appeal under section 17A.20.    b. Either the department or a party in interest may apply    to the Iowa district court for an order to enforce a final    decision of the department.    2. Any rules adopted by the department to implement sections    231.76 and 231.77 shall not create any right, entitlement,    property or liberty right or interest, or private cause of    action for damages against the state or a political subdivision    of the state, or for which the state or a political subdivision    of the state would be responsible.    3. Notwithstanding subsection 1, any violation of section    231.77, subsection 2, shall be subject to enforcement by the    commissioner of insurance pursuant to chapter 507B.    Sec. 158. NEW SECTION   . 231.79 Appeals process.    The department shall establish an appeals process by which a    person or the persons representative may appeal a decision of    the department concerning the provision or denial of aging or    disability services to the person.     

  House File 2673, p. 68   Sec. 159. Section 231E.3, Code 2024, is amended to read as    follows:    231E.3 Definitions.    As used in this chapter , unless the context otherwise    requires:    1. Client means an individual for whom a representative    payee is appointed.    2.   Commission means the commission on aging.    3.   2. Conservator means conservator as defined in section    633.3 .    4.   3. Court means court as defined in section 633.3 .    5. 4. Department means the department of health and human    services.    6.   5. Director means the director of health and human    services.    7.   6. Guardian means guardian as defined in section    633.3 .    8. 7. Incompetent means incompetent as defined in section    633.3 .    9.   8. Local office means a local office of public    guardian.    10.   9. Local public guardian means an individual under    contract with the department to act as a guardian, conservator,    or representative payee.    11.   10. Public guardian means the state public guardian    or a local public guardian.    12. 11. Public guardianship services means guardianship,    conservatorship, or representative payee services provided by    the state public guardian or a local public guardian.    13.   12. Representative payee means an individual    appointed by a government entity to receive funds on behalf of    a client pursuant to federal regulation.    14.   13. State agency means any executive department,    commission, board, institution, division, bureau, office,      agency, or other executive entity of state government.    15.   14. State office means the state office of public    guardian.    16.   15. State public guardian means the administrator of    the state office of public guardian.                                   

  House File 2673, p. 69   17.   16. Ward means the individual for whom a guardianship    or conservatorship is established.    Sec. 160. REPEAL. Sections 231.11, 231.12, and 231.13, Code    2024, are repealed.    Sec. 161. CODE EDITOR DIRECTIVE. The Code editor is    directed to do all of the following:    1. Entitle Code chapter 231 Department of Health and Human    Services  Aging and Disability Services.    2. Designate sections 231.75 through 231.79, as enacted in    this division of this Act, as subchapter VII entitled Bill    of Rights and Service Quality Standards for Persons with an    Intellectual Disability, Developmental Disability, Brain    Injury, or Chronic Mental Illness.    3. Correct internal references in the Code and in any    enacted legislation as necessary due to the enactment of this    division of this Act.    Sec. 162. EFFECTIVE DATE. The following take effect July    1, 2025:    1. The parts of the sections of this division of this Act    amending the following:    a. Section 231.3.    b. Section 231.4, subsection 1.    c. Section 231.23, subsections 4 and 7.    d. Section 231.23A, subsection 1.    e. Sections 231.56, 231.57, and 231.58.    f. Section 231.64, subsection 2.    2. The parts of the sections of this division of this Act    enacting the following: sections 231.23A, subsection 7A,    231.75, 231.76, 231.77, 231.78, and 231.79.    DIVISION IV    TRANSITION PROVISIONS      Sec. 163. DEPARTMENT OF HEALTH AND HUMAN SERVICES       TRANSITION OF MENTAL HEALTH SERVICES, ADDICTIVE DISORDER      SERVICES, AND DISABILITY SERVICES.      1. For purposes of this division:    a. Administrative services organization means the same    as defined in section 225A.1, as enacted in division I of this      Act.      b. Behavioral health district means the same as defined in     

  House File 2673, p. 70   section 225A.1, as enacted in division I of this Act.    c. Department means the department of health and human    services.    d. District behavioral health service system plan means    the same as defined in section 225A.1, as enacted in division    I of this Act.    e. Mental health and disability services region means the    same as defined in section 225C.2, subsection 9.    f. State behavioral health service system means the state    behavioral health service system as established in section    225A.3, as enacted in division I of this Act.    g. State behavioral health service system plan means the    same as defined in section 225A.1, as enacted in division I of    this Act.    h. Transition period means the period beginning on the    date of enactment of this division of this Act and concluding    on June 30, 2025.    2. There is created a behavioral health service system under    the control of the department. For the fiscal year beginning    July 1, 2025, and each succeeding fiscal year, the behavioral    health service system shall be responsible for implementing and    maintaining a statewide system of prevention, education, early    intervention, treatment, recovery support, and crisis services    related to mental health and addictive disorders, including    but not limited to substance use, tobacco use, and problem    gambling. For the fiscal year beginning July 1, 2025, and each    succeeding fiscal year, the departments division of aging    and disability services shall be responsible for disability    services.    3. During the transition period, the department may    exercise all policymaking functions and regulatory powers    established in division I of this Act, as necessary to    establish the state behavioral health service system.    4. To ensure the state behavioral health service system    and the division of aging and disability services are able to    operate as intended at the conclusion of the transition period,    the department shall perform all the following duties:    a. Make contracts as necessary to set up services and    administrative functions.   

  House File 2673, p. 71   b. Adopt rules as necessary to establish and administer the    states behavioral health service system.    c. Establish policies as necessary to ensure efficient    implementation and operation of the behavioral health service    system.    d. Prepare forms necessary for the implementation and    administration of behavioral health services.    e. Prepare a state behavioral health service system plan for    the state behavioral health service system.    f. Designate behavioral health districts on or before    August 1, 2024. The behavioral health district designation    process shall include an opportunity for the public to    review and to comment on proposed behavioral health district    boundaries.    g. Designate an administrative services organization for    each behavioral health district on or before December 31, 2024.    h. Review and approve district behavioral health service    system plans for services related to the behavioral health    service system.    i. Issue all necessary licenses and certifications.    j. Establish contractual rights, privileges, and    responsibilities as necessary to establish and implement the    state behavioral health service system.    k. Develop and implement a plan to ensure that persons    currently receiving disability services or early intervention,    treatment, recovery support, or crisis services related    to mental health or addictive disorders, including but not    limited to alcohol use, substance use, tobacco use, and problem    gambling, have an uninterrupted continuum of care.    l. Establish a central data repository as described in    section 225A.6, as enacted in division I of this Act.    m. Collaborate with the department of revenue for    enforcement of tobacco laws, regulations, and ordinances and    engage in tobacco control activities.    n. Submit a report to the general assembly no later    than January 13, 2025, that details the administrative and    operational costs for the establishment, implementation, and    administration of the state behavioral health service system.    5. If the department determines that a federal waiver or   

  House File 2673, p. 72   authorization is necessary to administer any provision of this    division of this Act or to effectuate the state behavioral    health service system by the conclusion of the transition    period, the department shall timely request the federal waiver    or authorization. Notwithstanding any other effective date to    the contrary, a provision the department determines requires a    federal waiver or authorization shall be effective only upon    receipt of federal approval for the waiver or authorization.    6. a. On or before July 1, 2024, the department shall    publish on the departments internet site an initial transition    plan for establishing the state behavioral health service    system. The transition plan shall describe, at a minimum, all    of the following:    (1) All tasks that require completion before July 1, 2025.    The description of tasks shall include a description of how the    department will solicit comments from stakeholders, including    employees of the department, persons served by the department,    partners of the department, members of the public, and members    of the general assembly, and a detailed timeline for the    completion of the tasks described.    (2) The proposed organizational structure of the state    behavioral health service system.    (3) The transition of service delivery sites from locations    where people currently receive behavioral health services to    where the people will receive behavioral health services under    the state behavioral health service system.    (4) Procedures for the transfer and reconciliation of    budgeting and funding between the mental health and disability    services regions and the department.    (5) A description of how responsibilities for disability    services programs will be transferred from current program    administrators to the departments division of aging and    disability services by the end of the transition period.    (6) Any additional known tasks that may require completion    after the transition on July 1, 2025.    b. The transition plan published under paragraph a shall:    (1) Be updated no less than quarterly during the transition    period with the current status of completing the tasks    identified in paragraph a, subparagraph (1).   

  House File 2673, p. 73   (2) Describe how information regarding any changes in    service delivery will be provided to persons receiving services    from the mental health and disability services regions or    current behavioral health care providers contracted with the    department.    (3) Describe how the transition is being funded, including    how expenses associated with the transition will be managed.    7. a. Before the end of the transition period, the    governing board of each mental health and disability services    region that maintains a combined account pursuant to section    225C.58, subsection 1, shall transfer all unencumbered and    unobligated moneys remaining in the combined account to the    treasurer of state for deposit into the behavioral health fund    as established in section 225A.7 as enacted in division I of    this Act.    b. Before the end of the transition period, each county    which maintains a county mental health and disability services    fund pursuant to section 225C.58, subsection 1, shall transfer    all unencumbered and unobligated moneys remaining in the mental    health and disability services fund to the treasurer of state    for deposit into the behavioral health fund as established in    section 225A.7 as enacted in division I of this Act.    c. Moneys in the behavioral health fund as established    in section 225A.7 as enacted in division I of this Act are    appropriated to the department for the purposes established in    section 225A.7 as enacted in division I of this Act, and as    otherwise necessary to effectuate this division of this Act.    8. a. All debts, claims, or other liabilities owed to a    county, a mental health and disability services region, or    the state due to services rendered pursuant to chapter 125,    222, 225, 225C, 226, 227, 229, 230, or 230A, Code 2024, at the    conclusion of the transition period shall remain due and owing    after the transition period concludes.    b. After the transition period concludes, each county    auditor shall collect outstanding debts, claims, or other    liabilities owed to the county for services rendered pursuant    to chapter 125, 222, 225, 225C, 226, 227, 229, 230, or 230A,    Code 2024, before the transition period concluded. The county    attorney may bring a judicial action as necessary to collect   

  House File 2673, p. 74   the outstanding debts, claims, or other liabilities.    9. With input from appropriate stakeholders, the department    shall identify each contract that will be impacted by mental    health and disability services being transferred to the state    behavioral health service system, or by responsibilities    being transferred to the departments division of aging and    disabilities, pursuant to this Act. On or before June 30,    2025, a party to a contract identified by the department    under this subsection shall exercise the option, if available    pursuant to the terms of the contract, to terminate the    contract in accordance with the terms of the contract which    provide for termination. Contracts that do not provide for    termination shall not be renewed or extended at the end of the    current contract term.    10. A mental health and disability services region, a    regional administrator as defined in section 225C.55, and    any subdivision of the state shall not enter into, renew, or    extend any contract for services related to mental health and    disability services or addictive disorder services beyond June    30, 2025.    Sec. 164. DEPARTMENT OF HEALTH AND HUMAN SERVICES     TRANSITION FUNDING.    1. Notwithstanding any provision of law to the contrary,    there is appropriated from the region incentive fund of the    mental health and disability services regional service fund    created in section 225C.7A, subsection 8, to the department of    health and human services for the fiscal year beginning July    1, 2024, and ending June 30, 2025, the following amount, or    so much thereof as is necessary, to be used for the purposes    designated:    For the establishment of a central data repository as    described in section 225A.6, subsection 1, as enacted in      division I of this Act:      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 645,179    2. There is appropriated from the region incentive fund    of the mental health and disability services regional service    fund created in section 225C.7A, to the department of health    and human services for the fiscal year beginning July 1, 2024,    and ending June 30, 2025, the following amount, or so much   

  House File 2673, p. 75   thereof as is necessary, to be used to support the statewide    988 suicide and crisis line:    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,000,000    3. There is appropriated from the region incentive fund of    the mental health and disability services regional service fund    created in section 225C.7A, to the department of health and    human services for the fiscal year beginning July 1, 2024, and    ending June 30, 2025, the following amount, or so much thereof    as is necessary, to be used to implement the provisions of this    division of this Act:    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000    4. Notwithstanding section 8.33, moneys appropriated in    this section that remain unencumbered or unobligated at the    close of the fiscal year shall not revert to the credit of    the region incentive fund of the mental health and disability    services regional service fund, but shall be credited to the    behavioral health fund created in section 225A.7, as enacted in    division I of this Act, and are appropriated to the department    of health and human services for expenditure for the purposes    of the behavioral health fund.    Sec. 165. EMERGENCY RULES. The department of health and    human services may adopt emergency rules under section 17A.4,    subsection 3, and section 17A.5, subsection 2, paragraph b,    to implement the provisions of this division of this Act and    the rules shall be effective immediately upon filing unless    a later date is specified in the rules. Any rules adopted    in accordance with this section shall also be published as a    notice of intended action as provided in section 17A.4.    Sec. 166. EFFECTIVE DATE. This division of this Act, being    deemed of immediate importance, takes effect upon enactment.    DIVISION V      ELIMINATION OF SPECIAL INTELLECTUAL DISABILITY UNITS      Sec. 167. Section 222.1, subsection 3, Code 2024, is amended      by striking the subsection.    Sec. 168. Section 222.2, subsection 8, Code 2024, is amended    by striking the subsection.    Sec. 169. Section 222.5, Code 2024, is amended to read as    follows:      222.5 Preadmission diagnostic evaluation.   

  House File 2673, p. 76   A person shall not be eligible for admission to a resource    center or a special unit   until a preadmission diagnostic    evaluation has been made by a resource center or a special unit      which confirms or establishes the need for admission.    Sec. 170. Section 222.7, unnumbered paragraph 1, Code 2024,    is amended to read as follows:    The department may transfer patients from one state resource    center to the other and may at any time transfer patients from    the resource centers to the hospitals for persons with mental    illness , or transfer patients in the resource centers to a      special unit or vice versa   . The department may also transfer    patients from a hospital for persons with mental illness to a    resource center if consent is given or obtained as follows:    Sec. 171. Section 222.8, Code 2024, is amended to read as    follows:    222.8 Communications by patients.    Persons admitted to the resource centers or a special      unit shall have all reasonable opportunity and facility for    communication with their friends. Such persons shall be    permitted to write and send letters, provided the letters    contain nothing of an offensive character. Letters written by    any patient to the director or to any state or county official    shall be forwarded unopened.    Sec. 172. Section 222.9, Code 2024, is amended to read as    follows:    222.9 Unauthorized departures.    If any person with an intellectual disability shall depart    without proper authorization from a resource center or a      special unit   , it shall be the duty of the superintendent    and the superintendents assistants and all peace officers    of any county in which such patient may be found to take    and detain the patient without a warrant or order and to    immediately report such detention to the superintendent who    shall immediately provide for the return of such patient to the    resource center or special unit   .    Sec. 173. Section 222.12, subsection 1, Code 2024, is      amended to read as follows:    1. Upon the death of a patient of a resource center or      special unit , a preliminary investigation of the death shall be              

  House File 2673, p. 77   conducted as required by section 218.64 by the county medical    examiner as provided in section 331.802 . Such a preliminary    investigation shall also be conducted in the event of a sudden    or mysterious death of a patient in a private institution    for persons with an intellectual disability. The chief    administrative officer of any private institution may request    an investigation of the death of any patient by the county    medical examiner.    Sec. 174. Section 222.73, subsections 1, 3, and 5, Code    2024, are amended to read as follows:    1. The superintendent of each resource center and special      unit shall compute by February 1 the average daily patient    charge and outpatient treatment charges for which each county    will be billed for services provided to patients chargeable to    the county during the fiscal year beginning the following July    1. The department shall certify the amount of the charges and    notify the counties of the billing charges.    a. The superintendent shall compute the average daily    patient charge for a resource center or special unit   for    services provided in the following fiscal year, in accordance    with generally accepted accounting procedures, by totaling    the expenditures of the resource center or special unit   for    the immediately preceding calendar year, by adjusting the    expenditures by a percentage not to exceed the percentage    increase in the consumer price index for all urban consumers    for the immediately preceding calendar year, and by dividing    the adjusted expenditures by the total inpatient days of    service provided during the immediately preceding calendar    year.    b. The department shall compute the outpatient treatment    charges, in accordance with generally accepted accounting    procedures, on the basis of the actual cost of the outpatient    treatment provided during the immediately preceding calendar    year.    3.   2. The superintendent shall compute in January the    actual per-patient-per-day cost for each resource center or    special unit   for the immediately preceding calendar year, in    accordance with generally accepted accounting procedures, by    totaling the actual expenditures of the resource center or            

  House File 2673, p. 78   special unit   for the calendar year and by dividing the total    actual expenditures by the total inpatient days of service    provided during the calendar year.    5. 3. A superintendent of a resource center or special    unit may request that the director enter into a contract with    a person for the resource center or special unit   to provide    consultation or treatment services or for fulfilling other    purposes which are consistent with the purposes stated in    section 222.1 . The contract provisions shall include charges    which reflect the actual cost of providing the services. Any    income from a contract authorized under this subsection may    be retained by the resource center or special unit   to defray    the costs of providing the services or fulfilling the other    purposes. Except for a contract voluntarily entered into by a    county under this subsection , the costs or income associated    with a contract authorized under this subsection shall not    be considered in computing charges and per diem costs in    accordance with the provisions of subsections 1 through 4   and    2   .    Sec. 175. Section 222.83, Code 2024, is amended to read as    follows:    222.83 Nonresident patients.    The estates of all nonresident patients who are provided    treatment, training, instruction, care, habilitation, and    support in or by a resource center or a special unit   , and all    persons legally bound for the support of such persons, shall be    liable to the state for the reasonable value of such services.    The certificate of the superintendent of the resource center    or special unit   in which any nonresident is or has been a    patient, showing the amounts drawn from the state treasury or    due therefrom as provided by law on account of such nonresident    patient, shall be presumptive evidence of the reasonable value    of such services furnished such patient by the resource center    or special unit   .    Sec. 176. Section 222.84, Code 2024, is amended to read as    follows:      222.84 Patients personal deposit fund.    There is established at each resource center and special      unit   a patients personal deposit fund. In the case of a                   

  House File 2673, p. 79   special unit, the director may direct that the patients      personal deposit fund be maintained and administered as a part    of the fund established, pursuant to   sections 226.43 through    226.46   , by the state mental health institute where the special    unit is located.    Sec. 177. Section 222.85, subsection 1, Code 2024, is    amended to read as follows:    1. Any funds coming into the possession of the    superintendent or any employee of a resource center or special      unit belonging to any patient in that institution shall be    deposited in the name of the patient in the patients personal    deposit fund, except that if a guardian of the property has    been appointed for the person, the guardian shall have the    right to demand and receive such funds. Funds belonging to a    patient deposited in the patients personal deposit fund may    be used for the purchase of personal incidentals, desires, and    comforts for the patient.    Sec. 178. Section 222.87, Code 2024, is amended to read as    follows:    222.87 Deposit in bank.    The department shall deposit the patients personal deposit    fund in a commercial account of a bank of reputable standing.    When deposits in the commercial account exceed average monthly    withdrawals, the department may deposit the excess at interest.    The savings account shall be in the name of the patients    personal deposit fund and interest paid on the account may be    used for recreational purposes for the patients at the resource    center or special unit   .    Sec. 179. REPEAL. Sections 222.88, 222.89, 222.90, and    222.91, Code 2024, are repealed.    Sec. 180. EFFECTIVE DATE. This division of this Act, being    deemed of immediate importance, takes effect upon enactment.    DIVISION VI      COUNTY OF RESIDENCE DETERMINATIONS      Sec. 181. NEW SECTION   . 331.190 County of residence     dispute resolution.    1. County of residence means the county in this state    in which, at the time a person applies for or receives    services, the person is living and has established an ongoing              

  House File 2673, p. 80   presence with the declared, good faith intention of living    for a permanent or indefinite period of time. The county    of residence of a homeless person is the county in which    the homeless person usually sleeps. A person maintains    residency in the county or state in which the person last    resided during the time period that the person is present in    a different county or state receiving services in a hospital,    a correctional facility, a halfway house for community-based    corrections or substance use disorder treatment, a nursing    facility, an intermediate care facility for persons with an    intellectual disability, a residential care facility, or for    the purpose of attending a college or university.    2. a. The dispute resolution process in this subsection    shall apply to county of residence disputes. The dispute    resolution process shall not be applicable to any of the    following:    (1) Disputes involving persons committed to a state    facility pursuant to chapter 812.    (2) Disputes involving Iowa rule of criminal procedure    2.22(8)(b), commitment for evaluation.    (3) Disputes involving chapter 12 of Iowa court rules, rules    for involuntary hospitalization of mentally ill persons.    b. If a county objects to a billing for services or a    residency determination and asserts that either the person    has residency in a different county or the person is not a    resident of this state, the persons county of residence    shall be determined as provided in this subsection. If the    county asserts that the person has residency in a different    county in this state, the county shall notify that county in    writing within one hundred twenty calendar days of receiving    the billing for services or of the county of residence    determination.      c. The county that receives the notification under paragraph    b shall respond in writing to the county that provided the    notification within forty-five calendar days of receiving the    notification. If the parties cannot agree as to the persons    county of residence within ninety calendar days of the date of    notification, on motion of either of the parties, the matter    shall be referred to the administrative hearings division of   

  House File 2673, p. 81   the department of inspections, appeals, and licensing for    a contested case proceeding under chapter 17A, before an    administrative law judge assigned in accordance with section    10A.801, to determine the persons county of residence.    d. (1) Notwithstanding section 17A.15, the administrative    law judges determination of a persons county of residence    shall be considered final agency action. Judicial review of    the determination may be sought in accordance with section    17A.19.    (2) If following the determination of a persons county of    residence under this subsection additional evidence becomes    available that merits a change in the determination of the    persons county of residence, the affected parties may change    the determination of county of residence by mutual agreement.    Otherwise, a party may move that the matter be reconsidered    by the county, or by an administrative law judge assigned in    accordance with section 10A.801.    e. Unless a petition is filed for judicial review, the    administrative law judges determination of the persons county    of residence shall result in one of the following:    (1) If a county is determined to be the persons county    of residence, that county shall pay any amounts due and shall    reimburse the other county for any amounts paid for services    provided to the person by the other county prior to the county    of residence determination.    (2) If it is determined that the person is not a resident of    this state, neither the state nor either county shall be liable    for payment of amounts due for services provided to the person    prior to the determination of the persons county of residence.    f. (1) The party that does not prevail in a contested    case proceeding or a subsequent judicial review pursuant to    this subsection shall be liable for costs associated with      the proceeding or judicial review, including reimbursement    of the administrative hearings division of the department of    inspections, appeals, and licensings actual costs associated    with the administrative proceeding, court costs, and reasonable    attorney fees.    (2) A payment or reimbursement pursuant to this subsection    shall be remitted within forty-five calendar days of the   

  House File 2673, p. 82   date the county of residence determination is issued by the    administrative law judge or the date the court files an order    determining the persons county of residence, whichever is    later. After forty-five calendar days, the prevailing party    may add a penalty of up to one percent per month to any amounts    due.    Sec. 182. Section 35D.9, Code 2024, is amended to read as    follows:    35D.9 County of residence upon discharge.    A member of the home does not acquire residency in the county    in which the home is located unless the member is voluntarily    or involuntarily discharged from the home and the member    meets county of residence requirements. For purposes of this    section , county of residence means the same as defined in    section 225C.61   331.190 .    Sec. 183. Section 232.141, subsections 7 and 8, Code 2024,    are amended to read as follows:    7. A county charged with the costs and expenses under    subsections 2 and 3 may recover the costs and expenses from the    childs custodial parents county of residence, as defined in    section 225C.61   331.190 , by filing verified claims which are    payable as are other claims against the county. A detailed    statement of the facts upon which a claim is based shall    accompany the claim.    8. This subsection applies only to placements in a juvenile    shelter care home which is publicly owned, operated as a county    or multicounty shelter care home, organized under a chapter    28E agreement, or operated by a private juvenile shelter care    home. If the actual and allowable costs of a childs shelter    care placement exceed the amount the department is authorized    to pay, the unpaid costs may be recovered from the childs    custodial parents county of residence. However, the maximum    amount of the unpaid costs which may be recovered under this    subsection is limited to the difference between the amount    the department is authorized to pay and the statewide average    of the actual and allowable rates as reasonably determined    by the department annually. A home may only be reimbursed    for the lesser of the homes actual and allowable costs or    the statewide average of the actual and allowable rates as       

  House File 2673, p. 83   determined by the department in effect on the date the costs    were paid. The unpaid costs are payable pursuant to filing of    verified claims against the childs custodial parents county    of residence. A detailed statement of the facts upon which a    claim is based shall accompany the claim. Any dispute between    counties arising from filings of claims filed pursuant to this    subsection shall be settled in the manner provided to determine    residency   county of residence in section 225C.61 331.190 .    Sec. 184. EFFECTIVE DATE. This division of this Act takes    effect July 1, 2025.    DIVISION VII    SUBSTANCE USE DISORDER  BEER AND LIQUOR CONTROL FUND    Sec. 185. Section 123.17, subsection 5, Code 2024, is    amended to read as follows:    5. After any transfer provided for in subsection 3 is    made, the department shall transfer into a special revenue    account in the general fund of the state, a sum of money at    least equal to seven percent of the gross amount of sales made    by the department from the beer and liquor control fund on a    monthly basis but not less than nine million dollars annually.    Of the amounts transferred, two million dollars , plus an      additional amount determined by the general assembly,   shall be    appropriated to the department of health and human services for    use by the staff who administer the comprehensive substance use    disorder program under chapter 125 for substance use disorder    treatment and prevention programs. Any amounts received in    excess of the amounts appropriated to the department of health    and human services for use by the staff who administer the    comprehensive substance use disorder program under chapter 125    shall be considered part of the general fund balance.    Sec. 186. EFFECTIVE DATE. This division of this Act, being    deemed of immediate importance, takes effect upon enactment.    DIVISION VIII      SUPPORTED COMMUNITY LIVING SERVICES      Sec. 187. Section 225C.21, subsection 1, Code 2024, is      amended to read as follows:    1. As used in this section , supported community living    services means services provided in a noninstitutional    setting to adult   persons sixteen years of age and older with             

  House File 2673, p. 84   mental illness, an intellectual disability, brain injury,   or    developmental disabilities to meet the persons daily living    needs.    Sec. 188. EFFECTIVE DATE. This division of this Act, being    deemed of immediate importance, takes effect upon enactment.    ______________________________   PAT GRASSLEY   Speaker of the House   ______________________________   AMY SINCLAIR   President of the Senate   I hereby certify that this bill originated in the House and   is known as House File 2673, Ninetieth General Assembly.   ______________________________   MEGHAN NELSON   Chief Clerk of the House   Approved _______________, 2024 ______________________________   KIM REYNOLDS   Governor