House Study Bill 153 - Introduced SENATE/HOUSE FILE _____ BY (PROPOSED DEPARTMENT OF HEALTH AND HUMAN SERVICES BILL) A BILL FOR An Act relating to services and support for youth, including 1 treatment, physical assessments, and behavioral health 2 evaluations; exemptions from childrens residential facility 3 certification; the director of juvenile court services and 4 chief juvenile court officers; and suspension of Hawki 5 eligibility for public institution inmates. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 1457XD (16) 91 dg/ko
S.F. _____ H.F. _____ DIVISION I 1 TREATMENT, PHYSICAL ASSESSMENTS, AND BEHAVIORAL HEALTH 2 EVALUATIONS 3 Section 1. Section 125.13, subsection 2, Code 2025, is 4 amended by adding the following new paragraph: 5 NEW PARAGRAPH . k. A licensee under chapter 135H. 6 Sec. 2. Section 135H.1, Code 2025, is amended to read as 7 follows: 8 135H.1 Definitions. 9 As used in this chapter , unless the context otherwise 10 requires: 11 1. Approved qualifying organization means any of the 12 following: 13 a. The joint commission. 14 b. The commission on accreditation of rehabilitation 15 facilities. 16 c. The council on accreditation. 17 d. A nationally recognized accrediting organization that 18 operates in conformance with federal regulations and has 19 accreditation standards comparable to the entities under 20 paragraphs a through c . 21 e. An entity specified by rule promulgated by the department 22 in consultation with the department of health and human 23 services. 24 1. 2. Department means the department of inspections, 25 appeals, and licensing. 26 2. 3. Direction means authoritative policy or procedural 27 guidance for the accomplishment of a function or an activity. 28 3. 4. Licensee means the holder of a license issued to 29 operate a psychiatric medical institution for children. 30 4. 5. Medical care plan means a plan of care and services 31 designed to eliminate the need for inpatient care by improving 32 the condition of a child youth . Services must be based upon a 33 diagnostic evaluation, which includes an examination a physical 34 assessment and behavioral health evaluation of the medical, 35 -1- LSB 1457XD (16) 91 dg/ko 1/ 38
S.F. _____ H.F. _____ psychological, social, behavioral, and developmental aspects 1 of the childs youths situation, reflecting the need for 2 inpatient care. 3 6. Mental health disorder means any of the following: 4 a. A mental disorder as defined by the most recent version 5 of the diagnostic and statistical manual of mental disorders 6 published by the American psychiatric association. 7 b. A mental disorder as defined in the most recent version 8 of the international classification of diseases published by 9 the world health organization. 10 5. 7. Mental health professional means an individual who 11 has all of the following qualifications: 12 a. The individual holds at least a masters degree in a 13 mental health field, including but not limited to, psychology, 14 counseling and guidance, nursing, and or social work, or the 15 individual is a physician. 16 b. The individual holds a current Iowa license if practicing 17 in a field covered by that requires an Iowa licensure law 18 license . 19 c. The individual has at least two years of post-degree 20 clinical experience, supervised by another mental health 21 professional, in assessing mental health needs and problems and 22 in providing appropriate mental health services. 23 6. 8. Nursing care means services which are provided 24 under the direction of a physician or registered nurse. 25 7. 9. Physician means a person licensed under chapter 26 148 . 27 10. Protective locked environment means a setting that 28 prevents egress from a building or grounds as a protective 29 measure to ensure safety and security. 30 8. 11. Psychiatric medical institution for children or 31 psychiatric institution means an institution providing more 32 than twenty-four hours of continuous care involving long-term 33 psychiatric services to three or more children youth in 34 residence for expected periods of fourteen or more days for 35 -2- LSB 1457XD (16) 91 dg/ko 2/ 38
S.F. _____ H.F. _____ diagnosis and evaluation or for expected periods of ninety days 1 or more for treatment. 2 9. 12. Psychiatric services means services provided under 3 the direction of a physician which address mental, emotional, 4 medical, or behavioral problems. 5 13. Record check evaluation system means the same as 6 defined in section 135C.1. 7 10. 14. Rehabilitative services means services to 8 encourage and assist restoration of a residents optimum mental 9 and physical capabilities. 10 11. 15. Resident means a person who is less than 11 twenty-one years of age and youth who has been admitted by a 12 physician to a psychiatric medical institution for children. 13 16. Serious emotional disturbance disorder means a 14 diagnosable mental, behavioral, or emotional disorder of 15 sufficient duration to result in a functional impairment, 16 and that meets the diagnostic criteria in the most current 17 diagnostic and statistical manual of mental disorders published 18 by the American psychiatric association. Serious emotional 19 disturbance disorder does not include a substance use or 20 developmental disorder unless such disorder co-occurs with a 21 diagnosable disorder that would otherwise constitute a serious 22 emotional disturbance disorder. 23 17. Substance use disorder means the same as defined in 24 section 125.2. 25 12. 18. Supervision means direct oversight and inspection 26 of the an act of accomplishing that accomplishes a function or 27 activity. 28 19. Youth means a person who is less than twenty-one years 29 of age. 30 Sec. 3. Section 135H.3, Code 2025, is amended to read as 31 follows: 32 135H.3 Nature of care. 33 1. a. A psychiatric medical institution for children 34 shall provide shelter, food, supervision, care, evaluation, 35 -3- LSB 1457XD (16) 91 dg/ko 3/ 38
S.F. _____ H.F. _____ diagnosis, treatment, counseling, rehabilitative services, 1 and related professional-directed services to youth who 2 have a serious emotional disturbance disorder, a substance 3 use disorder, or both, with the intention of reducing or 4 ameliorating the disorder, the symptoms of the disorder, or the 5 effects of the disorder. 6 b. A psychiatric medical institution for children shall 7 utilize a team of professionals to direct an organized program 8 of diagnostic services, psychiatric services, nursing care, 9 and rehabilitative services to meet the needs of residents 10 in accordance with a medical care plan developed for each 11 resident. The membership of the team of professionals 12 may include but is not limited to an advanced registered 13 nurse practitioner or a physician assistant. Social and 14 rehabilitative services shall be provided under the direction 15 of a qualified mental health professional. 16 2. If a child youth is diagnosed with a biologically 17 based mental illness as defined in section 514C.22 and meets 18 the medical assistance program criteria for admission to a 19 psychiatric medical institution for children, the child youth 20 shall be deemed to meet the acuity criteria for medically 21 necessary inpatient benefits under a group policy, contract, or 22 plan providing for third-party payment or prepayment of health, 23 medical, and surgical coverage benefits issued by a carrier, as 24 defined in section 513B.2 , that is subject to section 514C.22 . 25 Such medically necessary benefits shall not be excluded or 26 denied as care that is substantially custodial in nature under 27 section 514C.22, subsection 8 , paragraph b . 28 Sec. 4. Section 135H.4, Code 2025, is amended to read as 29 follows: 30 135H.4 Licensure scope of license . 31 1. A person shall not establish, operate, or maintain a 32 psychiatric medical institution for children unless the person 33 obtains a license for the institution under this chapter and 34 either holds a license under section 237.3, subsection 2 , 35 -4- LSB 1457XD (16) 91 dg/ko 4/ 38
S.F. _____ H.F. _____ paragraph a , as a comprehensive residential facility for 1 children or holds a license under section 125.13 , if the 2 facility provides substance use disorder treatment . 3 2. A licensee shall only provide serious emotional 4 disturbance disorder or substance use disorder services for 5 which the licensee is licensed under this chapter. 6 Sec. 5. Section 135H.5, Code 2025, is amended to read as 7 follows: 8 135H.5 Application for license initial application and 9 annual fees . 10 1. An application for a license under this chapter shall 11 be submitted on a form requesting information required by 12 the department , which . The application may include require 13 affirmative evidence of the applicants ability to comply with 14 the rules for standards adopted pursuant to this chapter . The 15 application shall require the applicant to specify whether the 16 applicant intends to provide services for serious emotional 17 disturbance disorders, substance use disorders, or both. 18 2. An application for a license shall be accompanied by the 19 required license fee which shall be credited to the general 20 fund of the state. The initial application fee and the annual 21 license fee is twenty-five dollars. 22 Sec. 6. Section 135H.6, subsections 1, 4, and 5, Code 2025, 23 are amended to read as follows: 24 1. The department shall issue a license to an applicant 25 under this chapter if all the following conditions exist: 26 a. The department has ascertained that the applicants 27 medical facilities and staff are adequate to provide the care 28 and services required of a psychiatric medical institution for 29 children . 30 b. The proposed psychiatric institution is accredited 31 by the joint commission on the accreditation of health 32 care organizations, the commission on accreditation of 33 rehabilitation facilities, the council on accreditation of 34 services for families and children, or by any other recognized 35 -5- LSB 1457XD (16) 91 dg/ko 5/ 38
S.F. _____ H.F. _____ accrediting organization with comparable standards acceptable 1 under federal regulation an approved qualifying organization . 2 c. The applicant complies with applicable state rules 3 and standards for a psychiatric institution adopted by the 4 department in accordance with federal requirements under 42 5 C.F.R. 441.150 441.156. 6 d. The department of health and human services has submitted 7 written approval of the application based on the department 8 of health and human services determination of need. The 9 department of health and human services shall identify the 10 location and number of children youth in the state who require 11 the services of a psychiatric medical institution for children. 12 Approval of an application shall be based upon the location 13 of the proposed psychiatric institution relative to the need 14 for services identified by the department of health and human 15 services and an analysis of the applicants ability to provide 16 services and support consistent with requirements under chapter 17 232 , particularly regarding specifically community-based 18 treatment. If the proposed psychiatric institution is not 19 freestanding from a facility licensed under chapter 135B or 20 135C , approval under this paragraph shall not be given unless 21 the department of health and human services certifies that 22 the proposed psychiatric institution is capable of providing 23 a resident with a living environment similar to the living 24 environment provided by a licensee which is freestanding from a 25 facility licensed under chapter 135B or 135C . 26 e. The proposed psychiatric institution is under the 27 direction of an agency which has operated a facility licensed 28 under section 237.3, subsection 2 , paragraph a , as a 29 comprehensive residential facility for children for three years 30 or of an agency which has operated a facility for three years 31 providing psychiatric services exclusively to children or 32 adolescents and the facility meets or exceeds requirements for 33 licensure under section 237.3, subsection 2 , paragraph a , as a 34 comprehensive residential facility for children. 35 -6- LSB 1457XD (16) 91 dg/ko 6/ 38
S.F. _____ H.F. _____ f. e. If a child youth has an a serious emotional , 1 behavioral, or mental health disturbance disorder, the 2 psychiatric medical institution for children does not require 3 court any of the following as a condition to obtain treatment 4 for the youth from the psychiatric institution: 5 (1) Court proceedings to be initiated or that a childs . 6 (2) For the youths parent, guardian, or custodian must 7 to terminate parental rights over , or transfer legal custody 8 of , the child for the purpose of obtaining treatment from the 9 psychiatric institution for the child youth . Relinquishment 10 of a childs custody shall not be a condition of the child 11 receiving services. 12 4. The department of health and human services may give 13 approval to approve a conversion of beds approved under 14 subsection 2 , to if the beds which are specialized to provide 15 substance use disorder treatment. However, the total number of 16 beds approved under subsection 2 and this subsection shall not 17 exceed four hundred thirty , unless approved for good cause by 18 the director pursuant to subsection 2 . Beds The limitations 19 on the number of beds under this section shall not apply to 20 beds for children youth who do not reside in this state and 21 whose service costs are not paid by public funds in this state 22 are not subject to the limitations on the number of beds 23 requirements otherwise applicable under this section . 24 5. A psychiatric institution licensed prior to July 1, 1999, 25 may exceed the number of beds authorized under subsection 2 26 if the excess beds are used to provide services funded from 27 a source other than the medical assistance program under 28 chapter 249A . Notwithstanding subsection 1 , paragraph d , and 29 subsection 2 , the provision of services using those excess beds 30 does not require a review by the department of health and human 31 services. 32 Sec. 7. Section 135H.7, subsection 2, paragraph a, Code 33 2025, is amended to read as follows: 34 a. If a person who has been convicted of a crime or has a 35 -7- LSB 1457XD (16) 91 dg/ko 7/ 38
S.F. _____ H.F. _____ record of founded child abuse is being considered for licensure 1 under this chapter , or for employment with a psychiatric 2 institution involving direct responsibility for a child youth 3 or with access to a child youth when the child youth is alone, 4 by a licensed psychiatric institution, or if a person will 5 reside residence in a facility utilized by a licensee, and if 6 the person has been convicted of a crime or has a record of 7 founded child abuse, the record check evaluation system and 8 the licensee for an employee of the licensee considering the 9 person for employment shall perform an evaluation to determine 10 whether the crime or founded child abuse warrants prohibition 11 of licensure, employment, or residence in the facility utilized 12 by a licensee . The record check evaluation system of the 13 department of health and human services shall conduct criminal 14 and child abuse record checks in this state and may conduct 15 these checks in other states. The record check evaluation 16 shall be performed in accordance with procedures adopted for 17 this purpose promulgated by rule by the department of health 18 and human services. 19 Sec. 8. NEW SECTION . 135H.7A Protective locked environment 20 rules. 21 The department, in cooperation with the department of health 22 and human services, shall adopt rules pursuant to chapter 17A 23 to allow licensees to use a protective locked environment at 24 the licensees facilities. 25 Sec. 9. Section 135H.10, subsection 2, Code 2025, is amended 26 to read as follows: 27 2. This chapter shall not be construed as prohibiting 28 the use of to prohibit funds appropriated for foster care to 29 from being used to provide payment to a psychiatric medical 30 institution for children for the financial participation 31 required of a child youth whose foster care placement is in a 32 psychiatric medical institution for children. In accordance 33 with established policies and procedures for foster care, the 34 department of health and human services shall act to recover 35 -8- LSB 1457XD (16) 91 dg/ko 8/ 38
S.F. _____ H.F. _____ any such payment for financial participation, apply to be named 1 payee for the childs youths unearned income, and recommend 2 parental liability for the costs of a court-ordered foster care 3 placement in a psychiatric medical institution. 4 Sec. 10. Section 135H.13, subsection 1, Code 2025, is 5 amended to read as follows: 6 1. The departments final findings and the survey findings 7 of the joint commission on the accreditation of health care 8 organizations an approved qualifying organization regarding 9 licensure or program accreditation shall be made available 10 to the public in a readily available form and place. Other 11 information relating to the psychiatric institution is 12 confidential and shall not be made available to the public 13 except in proceedings a proceeding involving licensure, a 14 civil suit involving a resident, or an administrative action 15 involving a resident. 16 Sec. 11. Section 229.13, subsection 1, paragraph c, Code 17 2025, is amended to read as follows: 18 c. (1) If the court orders evaluation and treatment of 19 the respondent on an inpatient basis under this section , the 20 court may order the respondent placed under the care of an 21 appropriate subacute care facility licensed under chapter 135G . 22 (2) If the court orders evaluation and treatment of a minor 23 respondent on an inpatient basis under this section, the court 24 may order the minor respondent placed under the care of a 25 public hospital. 26 Sec. 12. Section 229.13, subsection 5, Code 2025, is amended 27 to read as follows: 28 5. a. (1) The chief medical officer of the hospital or 29 facility at which the respondent is placed shall report to the 30 court and make a recommendation for disposition of the matter 31 no more than fifteen days after the date the respondent is 32 placed , making a recommendation for disposition of the matter 33 at the hospital or facility . An 34 (2) If the respondent is a minor and is placed under the 35 -9- LSB 1457XD (16) 91 dg/ko 9/ 38
S.F. _____ H.F. _____ care of a public hospital pursuant to subsection 1, paragraph 1 c , subparagraph (2), the chief medical officer of the public 2 hospital shall report to the court and make a recommendation 3 for disposition no later than thirty calendar days after the 4 date the minor respondent is placed under the care of the 5 public hospital. 6 b. A copy of the chief medical officers report shall be 7 sent to the respondents attorney. 8 c. (1) Upon request, the court may grant the chief medical 9 officer an extension of time may be granted , not to exceed 10 seven days , upon a showing of cause. A copy of the report shall 11 be sent to the The respondents attorney , who may contest the 12 need for an extension of time if one is requested . An 13 (2) The court shall grant an extension of time shall be 14 granted upon request unless the request is contested, in which 15 case the court shall make such inquiry as it deems appropriate 16 and may either order the respondents release from the hospital 17 or facility , or grant an extension of time for psychiatric 18 evaluation. 19 d. If the chief medical officer fails to report to the 20 court within fifteen days after the individual is placed under 21 the care of the hospital or facility the time specified in 22 paragraph a , and an extension of time has not been requested 23 granted , the chief medical officer is guilty of contempt 24 and shall be punished under chapter 665 . The court shall 25 order a rehearing on the application to determine whether the 26 respondent should continue to be detained at or placed under 27 the care of the hospital or facility. 28 Sec. 13. Section 229.14, subsection 2, paragraph e, Code 29 2025, is amended to read as follows: 30 e. (1) If the court orders placement and treatment of the 31 a respondent on an inpatient basis under this section , the 32 court may order the respondent placed under the care of an 33 appropriate subacute care facility licensed under chapter 135G . 34 (2) If the court orders placement and treatment of a minor 35 -10- LSB 1457XD (16) 91 dg/ko 10/ 38
S.F. _____ H.F. _____ respondent on an inpatient basis under this section, the court 1 may order the minor respondent placed under the care of a 2 public hospital. 3 Sec. 14. Section 232.2, Code 2025, is amended by adding the 4 following new subsections: 5 NEW SUBSECTION . 3A. Behavioral health condition means 6 a substantial limitation in a major life activity due to 7 a mental, behavioral, or addictive disorder or condition 8 diagnosed in accordance with the criteria in the most current 9 edition of the diagnostic and statistical manual of mental 10 disorders published by the American psychiatric association. 11 NEW SUBSECTION . 3B. Behavioral health evaluation means a 12 process used to assess an individuals behavioral health status 13 and functioning for purposes including but not limited to the 14 diagnosis of a behavioral health condition or to determine the 15 need for treatment or intervention. 16 NEW SUBSECTION . 38A. Mental health disorder means the 17 same as defined in section 135H.1. 18 NEW SUBSECTION . 48A. Physical assessment means 19 direct physical touching, viewing, and medically necessary 20 manipulation of any area of a childs body by a physician 21 licensed under chapter 148. 22 NEW SUBSECTION . 58A. Serious emotional disturbance 23 disorder means the same as defined in section 135H.1. 24 NEW SUBSECTION . 64A. Substance use disorder means the 25 same as defined in section 125.2. 26 Sec. 15. Section 232.2, subsections 34 and 58, Code 2025, 27 are amended to read as follows: 28 34. Juvenile court social records or social records means 29 all records , other than official records, made with respect to 30 a child in connection with proceedings over which the court has 31 jurisdiction under this chapter other than official records and 32 includes but is not limited to the records made and compiled 33 by intake officers, predisposition reports, and reports of 34 physical assessments and mental examinations behavioral health 35 -11- LSB 1457XD (16) 91 dg/ko 11/ 38
S.F. _____ H.F. _____ evaluations . 1 58. Secure facility means a physically restricting 2 facility in which children adjudicated to have committed 3 a delinquent act a child may be placed pursuant to a 4 dispositional order of the court. 5 Sec. 16. Section 232.8, subsection 4, Code 2025, is amended 6 to read as follows: 7 4. In a proceeding concerning a child who is alleged to 8 have committed a second delinquent act or a second violation 9 excluded from the jurisdiction of the juvenile court, the court 10 or the juvenile court shall determine whether there is reason 11 to believe that the child regularly abuses alcohol or other 12 controlled substance has a behavioral health condition and may 13 be in need of treatment. If the court so determines, the court 14 shall advise appropriate juvenile authorities and refer such 15 offenders to the juvenile court for disposition pursuant to 16 section 232.52A . 17 Sec. 17. Section 232.49, Code 2025, is amended to read as 18 follows: 19 232.49 Physical assessments and mental examinations 20 behavioral health evaluations juvenile delinquency . 21 1. a. Following the Any time after entry of an order of 22 adjudication under section 232.47 , the court may , after hold 23 a hearing which may be simultaneous with the adjudicatory 24 hearing, to order a physical assessment or mental examination 25 behavioral health evaluation of the child if it the court finds 26 that an examination a physical assessment or behavioral health 27 evaluation is necessary to determine the childs physical or 28 mental condition or to determine if the child has a behavioral 29 health condition . 30 b. The court may consider chemical dependency as either 31 a physical condition or mental behavioral health condition 32 and may consider a chemical dependency evaluation as either a 33 physical assessment or mental examination behavioral health 34 evaluation . If the examination 35 -12- LSB 1457XD (16) 91 dg/ko 12/ 38
S.F. _____ H.F. _____ c. A hearing to order a physical assessment or behavioral 1 health evaluation may be held at the same time as the 2 adjudicatory hearing. 3 2. Unless otherwise ordered by the court, if a physical 4 assessment or behavioral health evaluation indicates the child 5 has behaved in a manner that threatened the safety of another 6 person, has committed a violent act causing bodily injury to 7 another person, or has been a victim or perpetrator of sexual 8 abuse, unless otherwise ordered by the court, the childs 9 parent, guardian, or foster parent , or other person with 10 custody of the child shall be provided with that information. 11 2. 3. a. When possible an examination , a physical 12 assessment or behavioral health evaluation shall be conducted 13 on an outpatient basis , but the . The court may , if it deems 14 necessary, commit order the child to receive an inpatient 15 physical assessment or an inpatient behavioral health 16 evaluation at a suitable hospital, facility , or institution for 17 the purpose of examination . 18 b. Commitment for examination an inpatient physical 19 assessment or an inpatient behavioral health evaluation shall 20 not exceed thirty days and the civil commitment provisions of 21 chapter 229 shall not apply . 22 3. 4. a. At any Any time after the filing of a delinquency 23 petition , the court may order a physical assessment or mental 24 examination behavioral health evaluation of the child if all of 25 the following circumstances apply: 26 (1) The court finds such examination a physical assessment 27 or a behavioral health evaluation to be in the best interest 28 of the child ; and . 29 (2) The parent, guardian, or custodian and the childs 30 counsel agree to the physical assessment or behavioral health 31 evaluation . 32 b. (1) An examination A physical assessment or behavioral 33 health evaluation shall be conducted on an outpatient basis 34 unless the court, the childs counsel, and the childs parent, 35 -13- LSB 1457XD (16) 91 dg/ko 13/ 38
S.F. _____ H.F. _____ guardian, or custodian agree that it is necessary the child 1 should be committed to a suitable hospital, facility, or 2 institution for the purpose of examination ordered to receive 3 a physical assessment or behavioral health evaluation on an 4 inpatient basis . Commitment for examination 5 (2) An inpatient physical assessment or inpatient 6 behavioral health evaluation shall not exceed thirty days and 7 the civil commitment provisions of chapter 229 shall not apply . 8 Sec. 18. Section 232.52A, subsection 1, Code 2025, is 9 amended to read as follows: 10 1. In addition to any other order of the juvenile court, 11 a person under age eighteen, child who may be in need of 12 treatment , as determined under section 232.8 , may be ordered 13 to participate in an alcohol or controlled substance education 14 or a physical assessment or behavioral health evaluation 15 program approved by the juvenile court. If recommended after 16 evaluation, the The court may also order the person child to 17 participate in a treatment program approved by the court if the 18 treatment program is recommended after the childs physical 19 assessment or behavioral health evaluation . The juvenile court 20 may also require the custodial parent or parents , or other 21 legal guardian , to participate in an educational program with 22 the person under age eighteen child if the court determines 23 that such participation is in the best interests of the person 24 under age eighteen child . 25 Sec. 19. Section 232.68, subsection 3, unnumbered paragraph 26 1, Code 2025, is amended to read as follows: 27 Confidential access to a child means access to a child, 28 during an assessment of an alleged act of child abuse, who is 29 alleged to be the victim of the child abuse , during a child 30 abuse assessment . The access may be accomplished by interview, 31 observation, or examination physical assessment of the child. 32 As used in this subsection and this part: 33 Sec. 20. Section 232.68, subsection 3, paragraph c, Code 34 2025, is amended by striking the paragraph. 35 -14- LSB 1457XD (16) 91 dg/ko 14/ 38
S.F. _____ H.F. _____ Sec. 21. Section 232.69, subsection 3, paragraph b, Code 1 2025, is amended to read as follows: 2 b. (1) A person required to make a report under subsection 3 1 , other than a physician whose professional practice does not 4 regularly involve providing primary health care to children, 5 shall complete the core training curriculum relating to 6 the identification and reporting of child abuse within six 7 months of initial employment or self-employment involving 8 the examination physical assessments or behavioral health 9 evaluations , or attending, counseling, or treatment of treating 10 children on a regular basis. 11 (2) Within one month of initial employment or 12 self-employment, the person shall obtain a statement of the 13 abuse reporting requirements from the persons employer or, if 14 self-employed, from the department. 15 (3) The person shall complete the at least one hour of 16 core training curriculum relating to the identification and 17 reporting of child abuse every three years. 18 Sec. 22. Section 232.71B, subsection 10, Code 2025, is 19 amended to read as follows: 20 10. Physical examination assessment . If the department 21 refers a child to a physician or physician assistant for a 22 physical examination assessment , the department shall contact 23 the physician or physician assistant regarding the examination 24 physical assessment within twenty-four hours of making the 25 referral. If the physician or physician assistant who performs 26 the examination upon referral by the department physical 27 assessment reasonably believes the child has been abused, the 28 physician or physician assistant shall report to the department 29 within twenty-four hours of performing the examination physical 30 assessment . 31 Sec. 23. Section 232.77, subsection 1, Code 2025, is amended 32 to read as follows: 33 1. a. A person who is required to report suspected child 34 abuse may take or perform, or cause to be taken or performed , 35 -15- LSB 1457XD (16) 91 dg/ko 15/ 38
S.F. _____ H.F. _____ at public expense, photographs, X rays, or other a physical 1 examinations assessment, or tests other test of a child which 2 would provide medical indication of allegations arising from 3 an assessment. 4 b. A health practitioner may, if medically indicated, 5 cause to be performed a radiological examination, a physical 6 examination assessment , or other medical tests of test to be 7 performed on the child. 8 c. A person who takes any photographs or , takes X rays , or 9 performs a physical examinations assessment, or other tests 10 performs another test pursuant to this section shall notify 11 the department that the photographs or X rays have been taken , 12 or the examinations physical assessment or other tests have 13 test has been performed . The person who made notification , 14 and shall retain the photographs , or X rays or examination , 15 physical assessment findings, or other test findings for a 16 reasonable time following the notification. 17 d. Whenever the a person is required to report under section 18 232.69 , in that persons capacity as a member of the staff 19 of a medical or other private or public institution, agency , 20 or facility, that person shall immediately notify the person 21 in charge of the institution, agency, or facility , or that 22 persons designated delegate , of the need for photographs , or X 23 rays or examinations , physical assessments, or other tests. 24 Sec. 24. Section 232.78, subsection 1, paragraph a, Code 25 2025, is amended to read as follows: 26 a. Any of the following circumstances exist: 27 (1) The person responsible for the care of the child 28 consents to the removal. 29 (2) The person responsible for the care of the child is 30 absent , or though present, . 31 (3) The person responsible for the care of the child was 32 asked and refused to consent to the removal of the child and 33 was informed of an intent to apply for an order under this 34 section , or there . 35 -16- LSB 1457XD (16) 91 dg/ko 16/ 38
S.F. _____ H.F. _____ (4) There is reasonable cause to believe that a request for 1 consent would further endanger the child , or there . 2 (5) There is reasonable cause to believe that a request for 3 consent will cause the parent, guardian, or legal custodian 4 person responsible for the care of the child to take flight 5 with the child. 6 Sec. 25. Section 232.78, subsection 1, paragraph c, 7 subparagraph (1), Code 2025, is amended to read as follows: 8 (1) The refusal or failure of the person responsible for 9 the care of the child to comply with the request of a peace 10 officer, juvenile court officer, or child protection worker 11 for such the person to obtain and provide to the requester 12 the results of a physical assessment or mental examination 13 behavioral health evaluation of the child. The request for a 14 physical examination assessment of the child may specify the 15 performance of a medically relevant test. 16 Sec. 26. Section 232.78, subsection 5, Code 2025, is amended 17 to read as follows: 18 5. The juvenile court, before or after the filing of a 19 petition under this chapter , may enter an ex parte order 20 authorizing a physician or physician assistant or hospital to 21 conduct an inpatient or outpatient physical examination or 22 authorizing a physician or physician assistant, a psychologist 23 certified under section 154B.7 , or a community mental health 24 center accredited pursuant to chapter 230A to conduct an 25 outpatient mental examination assessment or an inpatient or 26 outpatient behavioral health evaluation of a child if necessary 27 to identify the nature, extent, and cause of injuries to the 28 child as required by section 232.71B , provided all of the 29 following apply: 30 a. Any of the following circumstances exist: 31 (1) The childs parent, guardian, or custodian consents to 32 the physical assessment or behavioral health evaluation. 33 (2) The childs parent, guardian, or legal custodian is 34 absent , or though present, . 35 -17- LSB 1457XD (16) 91 dg/ko 17/ 38
S.F. _____ H.F. _____ (3) The childs parent, guardian, or custodian was asked and 1 refused to provide written consent to the examination physical 2 assessment or behavioral health evaluation . 3 b. The juvenile court has entered an ex parte order 4 directing the removal of the child from the childs home or a 5 child care facility under this section . 6 c. There is not enough sufficient time to file a petition 7 and to hold a hearing as provided in section 232.98 . 8 Sec. 27. Section 232.79, subsection 1, paragraph b, Code 9 2025, is amended to read as follows: 10 b. There is not enough sufficient time to apply for an order 11 under section 232.78 . 12 Sec. 28. Section 232.79, subsection 5, Code 2025, is amended 13 to read as follows: 14 5. When there has been an emergency removal or keeping of a 15 child without a court order, a physical examination assessment 16 of the child by a licensed medical practitioner shall be 17 performed within twenty-four hours of such the emergency 18 removal or keeping of a child , unless the child is returned 19 to the childs home within twenty-four hours of the emergency 20 removal or keeping of a child . 21 Sec. 29. Section 232.83, subsection 2, Code 2025, is amended 22 to read as follows: 23 2. Anyone authorized to conduct a preliminary investigation 24 in response to a complaint may apply for, or the court on its 25 own motion may enter, an ex parte order authorizing a physician 26 or physician assistant or hospital to conduct an inpatient or 27 outpatient physical examination or authorizing a physician or 28 physician assistant, a psychologist certified under section 29 154B.7 , or a community mental health center accredited pursuant 30 to chapter 230A to conduct an outpatient mental examination 31 of a child if necessary to identify the nature, extent, and 32 causes of any injuries, emotional damage, or other such needs 33 of a child as specified in section 232.96A, subsection 3, 5, or 34 6 , assessment or an inpatient or outpatient behavioral health 35 -18- LSB 1457XD (16) 91 dg/ko 18/ 38
S.F. _____ H.F. _____ evaluation provided that all of the following apply: 1 a. Any of the following circumstances exist: 2 (1) The parent, guardian, or custodian consents to the 3 physical assessment or behavioral health evaluation. 4 (2) The parent, guardian, or legal custodian is absent , or 5 though present, . 6 (3) The parent, guardian, or custodian was asked and refused 7 to authorize the examination physical assessment or behavioral 8 health evaluation . 9 b. There is not enough sufficient time to file a petition 10 and hold a hearing under this chapter . 11 c. The parent, guardian, or legal custodian has not provided 12 care and treatment related to their the childs alleged 13 victimization. 14 Sec. 30. Section 232.98, Code 2025, is amended to read as 15 follows: 16 232.98 Physical and mental examinations assessments and 17 behavioral health evaluations child in need of assistance . 18 1. a. Except as provided in section 232.78, subsection 5 , 19 a physical assessment or mental examination behavioral health 20 evaluation of the a child may be ordered only after the filing 21 of a petition pursuant to section 232.87 , and after a hearing 22 to determine whether an examination a physical assessment 23 or behavioral health evaluation is necessary to determine 24 the childs physical condition or mental if the child has a 25 behavioral health condition. 26 b. The court may consider chemical dependency as either 27 a physical or mental behavioral health condition and may 28 consider a chemical dependency evaluation as either a physical 29 assessment or mental examination behavioral health evaluation . 30 a. c. The hearing required by this section may be held 31 simultaneously with the adjudicatory hearing. 32 b. d. An examination A physical assessment or behavioral 33 health evaluation ordered prior to the adjudication shall 34 be conducted on an outpatient basis when possible, but if 35 -19- LSB 1457XD (16) 91 dg/ko 19/ 38
S.F. _____ H.F. _____ necessary , the court may commit order the child to a suitable 1 nonsecure receive an inpatient physical assessment or inpatient 2 behavioral health evaluation at a hospital, facility, or 3 institution for the purpose of examination for a period not to 4 exceed fifteen thirty days if all of the following are found to 5 be present circumstances exist : 6 (1) Probable cause exists to believe that the child is 7 a child in need of assistance pursuant to section 232.96A, 8 subsection 5 or 6 . 9 (2) Commitment An inpatient physical assessment or 10 inpatient behavioral health evaluation is necessary to 11 determine whether there is clear and convincing evidence that 12 the child is a child in need of assistance. 13 (3) The childs attorney agrees to the commitment an 14 inpatient physical assessment or inpatient behavioral health 15 evaluation . 16 c. e. An examination A physical assessment or behavioral 17 health evaluation ordered after adjudication shall be conducted 18 on an outpatient basis when possible, but if necessary , the 19 court may commit order the child to a suitable nonsecure 20 receive an inpatient physical assessment or inpatient 21 behavioral health evaluation at a hospital, facility, or 22 institution for the purpose of examination for a period not to 23 exceed thirty days. 24 d. f. The childs parent, guardian, or custodian shall 25 be included in counseling sessions offered during the childs 26 stay in a hospital, facility, or institution when feasible, and 27 when in the best interests of the child and the childs parent, 28 guardian, or custodian. If separate counseling sessions are 29 conducted for the child and the childs parent, guardian, or 30 custodian, a joint counseling session shall be offered prior 31 to the release of the child from the hospital, facility, or 32 institution. The court shall require that notice be provided 33 to the childs guardian ad litem of the counseling sessions , 34 and of the counseling session participants , and results the 35 -20- LSB 1457XD (16) 91 dg/ko 20/ 38
S.F. _____ H.F. _____ outcomes of the counseling sessions. 1 2. Following an adjudication that a child is a child in 2 need of assistance, the court may , after a hearing , order the 3 a physical assessment or mental examination behavioral health 4 evaluation of the childs parent, guardian, or custodian if 5 that persons ability to care for the child is at issue. 6 Sec. 31. Section 232.102, subsection 5, Code 2025, is 7 amended to read as follows: 8 5. a. The child shall not be placed in the state training 9 school. 10 b. (1) Paragraph a shall not be construed to prohibit the 11 court from ordering a child to receive an inpatient physical 12 assessment, an inpatient behavioral health evaluation, or both, 13 at the state training school upon the departments request at a 14 hearing under section 232.98. 15 (2) An inpatient physical assessment or inpatient 16 behavioral health evaluation of a child conducted at a facility 17 on the state training school campus shall not exceed thirty 18 days. 19 (3) A child ordered to receive an inpatient physical 20 assessment or an inpatient behavioral health evaluation at the 21 state training school shall be separated at all times from 22 children ordered to be placed in the state training school. 23 (4) The department shall adopt rules pursuant to chapter 17A 24 to administer this paragraph. 25 Sec. 32. Section 232.127, subsection 7, Code 2025, is 26 amended to read as follows: 27 7. a. The court may shall not order the child placed on 28 probation, in a foster home , or in a nonsecure facility unless 29 the child requests and agrees to such supervision or placement. 30 In no event shall the 31 b. The court shall not order the child placed in the state 32 training school or other secure facility . 33 c. (1) Paragraph b shall not be construed to prohibit the 34 court from ordering a child to receive an inpatient physical 35 -21- LSB 1457XD (16) 91 dg/ko 21/ 38
S.F. _____ H.F. _____ assessment, an inpatient behavioral health evaluation, or both, 1 at the state training school upon the departments request at a 2 hearing under section 232.98. 3 (2) An inpatient physical assessment or inpatient 4 behavioral health evaluation of a child conducted at a facility 5 on the state training school campus shall not exceed thirty 6 days. 7 (3) A child ordered to receive an inpatient physical 8 assessment or an inpatient behavioral health evaluation at the 9 state training school shall be separated at all times from 10 children ordered to be placed in the state training school. 11 (4) The department shall adopt rules pursuant to chapter 17A 12 to administer this paragraph. 13 Sec. 33. Section 232.141, subsection 1, Code 2025, is 14 amended to read as follows: 15 1. Except as otherwise provided by law, the court shall 16 inquire into the ability of the child or the childs parent 17 to pay expenses incurred pursuant to subsections 2, 4, and 18 8 . After giving the parent a reasonable opportunity to be 19 heard, the court may order the parent to pay all or part of the 20 costs of the childs care, examination physical assessment, 21 behavioral health evaluation , treatment, legal expenses, or 22 other expenses. An order entered under this section does not 23 obligate a parent paying child support under a custody decree, 24 except that part of the monthly support payment may be used to 25 satisfy the obligations imposed by the order entered pursuant 26 to this section . If a parent fails to pay as ordered, without 27 good reason, the court may proceed against the parent for 28 contempt and may inform the county attorney who shall proceed 29 against the parent to collect the unpaid amount. Any payment 30 ordered by the court shall be a judgment against each of the 31 childs parents and a lien as provided in section 624.23 . If 32 all or part of the amount that the parents are ordered to pay is 33 subsequently paid by the county or state, the judgment and lien 34 shall thereafter be against each of the parents in favor of the 35 -22- LSB 1457XD (16) 91 dg/ko 22/ 38
S.F. _____ H.F. _____ county to the extent of the countys payments and in favor of 1 the state to the extent of the states payments. 2 Sec. 34. Section 232.141, subsection 4, paragraph b, Code 3 2025, is amended to read as follows: 4 b. Expenses for mental or physical examinations assessments 5 or behavioral health evaluations of a child if ordered by the 6 court. 7 Sec. 35. Section 232.141, subsection 6, Code 2025, is 8 amended to read as follows: 9 6. If a child is given A physical or mental examinations 10 assessment, behavioral health evaluation, or any treatment 11 relating to an assessment performed pursuant to conducted 12 under section 232.71B , shall be paid by the state if the 13 physical assessment, behavioral health evaluation, or other 14 treatment was performed with the consent of the childs parent, 15 guardian, or legal custodian and no other provision of law 16 otherwise requires payment for the costs of the examination and 17 treatment, the costs shall be paid by the state . Reimbursement 18 for The department shall reimburse costs of services described 19 in under this subsection is subject to in accordance with 20 subsection 5 . 21 Sec. 36. Section 237.1, Code 2025, is amended by adding the 22 following new subsection: 23 NEW SUBSECTION . 8A. Protective locked environment means a 24 setting that prevents egress from a building or grounds as a 25 protective measure to ensure safety and security. 26 Sec. 37. Section 237.3, Code 2025, is amended by adding the 27 following new subsection: 28 NEW SUBSECTION . 13. The department shall adopt rules 29 pursuant to chapter 17A relating to the use of a protective 30 locked environment. 31 Sec. 38. Section 237.4, Code 2025, is amended by adding the 32 following new subsection: 33 NEW SUBSECTION . 9. A licensee under chapter 135H. 34 Sec. 39. Section 237C.1, Code 2025, is amended by adding the 35 -23- LSB 1457XD (16) 91 dg/ko 23/ 38
S.F. _____ H.F. _____ following new subsection: 1 NEW SUBSECTION . 5. Protective locked environment means a 2 setting that prevents egress from a building or grounds as a 3 protective measure to ensure safety and security. 4 Sec. 40. Section 237C.4, Code 2025, is amended by adding the 5 following new subsection: 6 NEW SUBSECTION . 6A. The department shall adopt rules 7 pursuant to chapter 17A relating to the use of a protective 8 locked environment. 9 Sec. 41. DEPARTMENT OF HEALTH AND HUMAN SERVICES 10 DEPARTMENT OF INSPECTIONS, APPEALS, AND LICENSING 11 ADMINISTRATIVE RULES. 12 1. The department of health and human services and the 13 department of inspections, appeals, and licensing shall each 14 adopt rules pursuant to chapter 17A to administer this division 15 of this Act. The departments shall coordinate in their 16 respective rulemaking processes to ensure each departments 17 rules properly implement the duties of that department while 18 functioning in concert with the rules of the other department. 19 Rules adopted by each department shall allow individuals to 20 fully utilize the array of behavioral health services available 21 through the state. 22 2. a. Rules relating to residential facilities for 23 individuals under twenty-one years of age under chapters 135H, 24 237, and 237C shall include the following: 25 (1) To the extent possible, uniform application of 26 rules relating to the use of restraints and seclusion at a 27 psychiatric medical institution for children subject to chapter 28 135H, a facility subject to chapter 237, or a childrens 29 residential facility subject to chapter 237C. 30 (2) The identification of unmet care needs at psychiatric 31 medical institutions for children, foster care facilities, and 32 childrens residential facilities, and adaptation of licensing 33 and certification requirements to provide for the unmet care 34 needs. 35 -24- LSB 1457XD (16) 91 dg/ko 24/ 38
S.F. _____ H.F. _____ b. When adopting rules pursuant to this subsection, each 1 department shall consider the nature of the services and 2 programming provided by psychiatric medical institutions 3 for children, child foster care facilities, and childrens 4 residential facilities and applicable federal requirements 5 including those for psychiatric residential treatment 6 facilities as described in 42 C.F.R. 483.352. 7 3. The department of health and human services shall adopt 8 rules pursuant to chapter 17A relating to the application of 9 a protective locked environment to detention and shelter care 10 as those terms are defined in section 232.2. For the purposes 11 of this subsection, protective locked environment means a 12 setting that prevents egress from a building or grounds as a 13 protective measure to ensure safety and security. 14 Sec. 42. REPEAL. 2024 Iowa Acts, chapter 1161, sections 97 15 and 98, are repealed. 16 DIVISION II 17 EXEMPTION FROM CHILDRENS RESIDENTIAL FACILITY CERTIFICATION 18 Sec. 43. Section 237C.1, subsection 2, Code 2025, is amended 19 by adding the following new paragraph: 20 NEW PARAGRAPH . j. Care furnished by a live-in facility that 21 provides intensive medical care and support for individuals who 22 require ongoing treatment if all of the following apply: 23 (1) The facility only furnishes care to persons sixteen 24 years of age and older. 25 (2) The department pays for each persons care from the 26 facility under a federally approved home and community-based 27 services waiver, or under chapter 249A. 28 DIVISION III 29 DIRECTOR OF JUVENILE COURT SERVICES CHIEF JUVENILE COURT 30 OFFICERS 31 Sec. 44. Section 602.1101, Code 2025, is amended by adding 32 the following new subsection: 33 NEW SUBSECTION . 5A. Director of juvenile court services 34 means the same as defined in the Iowa court rules of juvenile 35 -25- LSB 1457XD (16) 91 dg/ko 25/ 38
S.F. _____ H.F. _____ court services directed programs as prescribed by the supreme 1 court. 2 Sec. 45. Section 602.1217, Code 2025, is amended to read as 3 follows: 4 602.1217 Chief juvenile court officer. 5 1. The chief judge of director of juvenile court services 6 shall appoint a chief juvenile court officer for each judicial 7 district , after consultation with the judges of the judicial 8 district, shall appoint a chief juvenile court officer and may 9 remove the a chief juvenile court officer for cause. 10 2. The chief juvenile court officer is subject to the 11 immediate supervision and direction of the chief judge of the 12 judicial district director of juvenile court services . 13 3. The chief juvenile court officer, in addition to 14 performing the duties of a juvenile court officer, shall 15 supervise juvenile court officers and administer juvenile court 16 services within the judicial district in a uniform manner, 17 under the supervision and direction of the director of juvenile 18 court services, in accordance with applicable law and with the 19 rules, and in accordance with the directives , and procedures of 20 the judicial branch and the judicial district. 21 4. The chief juvenile court officer shall assist the state 22 court administrator and the district court administrator 23 director of juvenile court services in implementing 24 administrative rules, directives, and procedures of the 25 judicial branch and the judicial district. 26 5. A chief juvenile court officer shall have other duties 27 as prescribed by the supreme court or by the chief judge of the 28 judicial district director of juvenile court services . 29 Sec. 46. Section 602.7201, subsection 3, Code 2025, is 30 amended to read as follows: 31 3. The chief juvenile court officer may employ, shall 32 supervise, and may remove for cause with due process 33 secretarial, clerical, and other staff within juvenile court 34 service offices as authorized by the chief judge director of 35 -26- LSB 1457XD (16) 91 dg/ko 26/ 38
S.F. _____ H.F. _____ juvenile court services . 1 Sec. 47. Section 602.7202, subsections 1 and 3, Code 2025, 2 are amended to read as follows: 3 1. Subject to the approval of the chief judge of the 4 judicial district, the The chief juvenile court officer shall 5 appoint juvenile court officers to serve the juvenile court. 6 Juvenile court officers may be required to serve in two or more 7 counties within the judicial district. 8 3. Juvenile court officers shall have the duties prescribed 9 in chapter 232 , subject to the direction of the judges of the 10 juvenile court director of juvenile court services . A judge 11 of the juvenile court shall not attempt to direct or influence 12 a juvenile court officer in the performance of the officers 13 duties. 14 DIVISION IV 15 HAWKI ELIGIBILITY PUBLIC INSTITUTION INMATES 16 Sec. 48. Section 514I.2, Code 2025, is amended by adding the 17 following new subsection: 18 NEW SUBSECTION . 9A. Public institution means the same as 19 defined in 42 C.F.R. 435.1010. 20 Sec. 49. Section 514I.8, subsection 2, paragraph g, Code 21 2025, is amended to read as follows: 22 g. Is not an inmate of a public institution or a patient in 23 an institution for mental diseases. 24 Sec. 50. NEW SECTION . 514I.8B Inmates suspension of 25 Hawki program eligibility. 26 1. The department shall suspend, but not terminate, Hawki 27 program eligibility for an eligible child who is described by 28 all of the following: 29 a. Thirty calendar days have elapsed since the date the 30 eligible child was committed to a public institution. 31 b. The eligible child is an inmate of a public institution. 32 c. The eligible child was enrolled in Hawki at the time the 33 eligible child was committed to the public institution. 34 d. The eligible child remains eligible for the Hawki program 35 -27- LSB 1457XD (16) 91 dg/ko 27/ 38
S.F. _____ H.F. _____ except for the eligible childs status as an inmate of a public 1 institution. 2 2. Suspension of an eligible childs Hawki program 3 eligibility under subsection 1 shall continue during the 4 entire period of the eligible childs commitment to the public 5 institution. 6 3. To the extent possible, the public institution to which 7 an eligible child is committed and the department shall comply 8 with reporting requirements, and expedite the restoration of 9 an eligible childs medical assistance benefits, in a manner 10 consistent with section 249A.38, upon the eligible childs 11 discharge from the public institution. 12 4. The department shall adopt rules pursuant to chapter 17A 13 to administer this section. 14 DIVISION V 15 CORRECTIVE CHANGES 16 Sec. 51. Section 125.13, subsection 2, paragraphs a, i, and 17 j, Code 2025, are amended to read as follows: 18 a. A hospital providing care or treatment to persons with 19 a substance use disorder licensed under chapter 135B which is 20 accredited by the joint commission on the accreditation of 21 health care organizations , the commission on accreditation 22 of rehabilitation facilities, the American osteopathic 23 association, or another recognized organization approved by 24 the department. All survey reports from the accrediting or 25 licensing body must be sent to the department. 26 i. A substance use disorder treatment program not funded 27 by the department which is accredited or licensed by the joint 28 commission on the accreditation of health care organizations , 29 the commission on the accreditation of rehabilitation 30 facilities, the American osteopathic association, or another 31 recognized organization approved by the department. All survey 32 reports from the accrediting or licensing body must be sent to 33 the department. 34 j. A hospital substance use disorder treatment program 35 -28- LSB 1457XD (16) 91 dg/ko 28/ 38
S.F. _____ H.F. _____ that is accredited or licensed by the joint commission on the 1 accreditation of health care organizations , the commission on 2 the accreditation of rehabilitation facilities, the American 3 osteopathic association, or another recognized organization 4 approved by the department. All survey reports for the 5 hospital substance use disorder treatment program from the 6 accrediting or licensing body shall be sent to the department. 7 Sec. 52. Section 125.43A, Code 2025, is amended to read as 8 follows: 9 125.43A Prescreening exception. 10 Except in cases of medical emergency or court-ordered 11 admissions, a person shall be admitted to a state mental 12 health institute for treatment of a substance use disorder 13 only after a preliminary intake and assessment by a 14 department-licensed treatment facility or a hospital providing 15 care or treatment for persons with a substance use disorder 16 licensed under chapter 135B and accredited by the joint 17 commission on the accreditation of health care organizations , 18 the commission on accreditation of rehabilitation facilities, 19 the American osteopathic association, or another recognized 20 organization approved by the department, or by a designee of 21 a department-licensed treatment facility or a hospital other 22 than a state mental health institute, which confirms that the 23 admission is appropriate to the persons substance use disorder 24 service needs. A county board of supervisors may seek an 25 admission of a patient to a state mental health institute who 26 has not been confirmed for appropriate admission and the county 27 shall be responsible for one hundred percent of the cost of 28 treatment and services of the patient. 29 Sec. 53. Section 135B.12, Code 2025, is amended to read as 30 follows: 31 135B.12 Confidentiality. 32 The departments final findings or the final survey findings 33 of the joint commission on the accreditation of health care 34 organizations or the American osteopathic association with 35 -29- LSB 1457XD (16) 91 dg/ko 29/ 38
S.F. _____ H.F. _____ respect to compliance by a hospital or rural emergency hospital 1 with requirements for licensing or accreditation shall be made 2 available to the public in a readily available form and place. 3 Other information relating to a hospital or rural emergency 4 hospital obtained by the department which does not constitute 5 the departments findings from an inspection of the hospital 6 or rural emergency hospital or the final survey findings of 7 the joint commission on the accreditation of health care 8 organizations or the American osteopathic association shall 9 not be made available to the public, except in proceedings 10 involving the denial, suspension, or revocation of a license 11 under this chapter . The name of a person who files a complaint 12 with the department shall remain confidential and shall not 13 be subject to discovery, subpoena, or other means of legal 14 compulsion for its release to a person other than department 15 employees or agents involved in the investigation of the 16 complaint. 17 Sec. 54. Section 135B.20, subsection 4, Code 2025, is 18 amended to read as follows: 19 4. Joint conference committee shall mean the joint 20 conference committee as required by the joint commission on 21 accreditation of health care organizations or, in a hospital 22 having no such committee, a similar committee, an equal number 23 of which shall be members of the medical staff selected by the 24 staff and an equal number of which shall be selected by the 25 governing board of the hospital. 26 Sec. 55. Section 135C.2, subsection 7, Code 2025, is amended 27 to read as follows: 28 7. The rules adopted by the department regarding nursing 29 facilities shall provide that a nursing facility may choose 30 to be inspected either by the department or by the joint 31 commission on accreditation of health care organizations . 32 The rules regarding acceptance of inspection by the joint 33 commission on accreditation of health care organizations shall 34 include recognition, in lieu of inspection by the department, 35 -30- LSB 1457XD (16) 91 dg/ko 30/ 38
S.F. _____ H.F. _____ of comparable inspections and inspection findings of the joint 1 commission on accreditation of health care organizations , 2 if the department is provided with copies of all requested 3 materials relating to the inspection process. 4 Sec. 56. Section 135C.6, subsection 10, Code 2025, is 5 amended to read as follows: 6 10. Notwithstanding section 135C.9 , nursing facilities 7 which are accredited by the joint commission on accreditation 8 of health care organizations shall be licensed without 9 inspection by the department, if the nursing facility has 10 chosen to be inspected by the joint commission on accreditation 11 of health care organizations in lieu of inspection by the 12 department. 13 Sec. 57. Section 232.2, subsection 4, paragraph i, Code 14 2025, is amended to read as follows: 15 i. If reasonable efforts to place a child for adoption or 16 with a guardian are made concurrently with reasonable efforts 17 as defined in section 232.102 232.102A , the concurrent goals 18 and timelines may be identified. Concurrent case permanency 19 plan goals for reunification, and for adoption or for other 20 permanent out-of-home placement of a child shall not be 21 considered inconsistent in that the goals reflect divergent 22 possible outcomes for a child in an out-of-home placement. 23 Sec. 58. Section 232.36, subsection 3, paragraph b, 24 subparagraph (3), Code 2025, is amended to read as follows: 25 (3) Legal custodian Custodian of the child. 26 Sec. 59. Section 232.37, subsection 2, Code 2025, is amended 27 to read as follows: 28 2. Notice of the pendency of the case shall be served upon 29 the known parents, guardians, or legal custodians of a child 30 if these persons are not summoned to appear as provided in 31 subsection 1 . Notice shall also be served upon the child and 32 upon the childs guardian ad litem, if any. The notice shall 33 attach a copy of the petition and shall give notification of 34 the right to counsel provided for in section 232.11 . 35 -31- LSB 1457XD (16) 91 dg/ko 31/ 38
S.F. _____ H.F. _____ Sec. 60. Section 232.101A, subsection 1, paragraph c, Code 1 2025, is amended to read as follows: 2 c. The parent of the child does not appear at the 3 dispositional hearing, or the parent appears at the 4 dispositional hearing, does not object to the transfer of 5 guardianship, and agrees to waive the requirement for making 6 reasonable efforts as defined in section 232.102 232.102A . 7 Sec. 61. Section 232.102A, subsection 3, Code 2025, is 8 amended to read as follows: 9 3. The performance of reasonable efforts to place a child 10 for adoption or with a guardian may be made concurrently with 11 making reasonable efforts as defined in this section . 12 Sec. 62. Section 232B.5, subsection 19, unnumbered 13 paragraph 1, Code 2025, is amended to read as follows: 14 A party seeking an involuntary foster care placement of 15 or termination of parental rights over an Indian child shall 16 provide evidence to the court that active efforts have been 17 made to provide remedial services and rehabilitative programs 18 designed to prevent the breakup of the Indian family and that 19 these efforts have proved unsuccessful. The court shall not 20 order the placement or termination, unless the evidence of 21 active efforts shows there has been a vigorous and concerted 22 level of casework beyond the level that typically constitutes 23 reasonable efforts as defined in sections 232.57 and 232.102 24 232.102A . Reasonable efforts shall not be construed to be 25 active efforts. The active efforts must be made in a manner 26 that takes into account the prevailing social and cultural 27 values, conditions, and way of life of the Indian childs 28 tribe. Active efforts shall utilize the available resources 29 of the Indian childs extended family, tribe, tribal and 30 other Indian social service agencies, and individual Indian 31 caregivers. Active efforts shall include but are not limited 32 to all of the following: 33 Sec. 63. Section 233.2, subsection 5, Code 2025, is amended 34 to read as follows: 35 -32- LSB 1457XD (16) 91 dg/ko 32/ 38
S.F. _____ H.F. _____ 5. Reasonable efforts, as defined in section 232.102 1 232.102A , that are made in regard to the newborn infant shall 2 be limited to the efforts made in a timely manner to finalize a 3 permanency plan for the newborn infant. 4 Sec. 64. Section 237.3, subsection 7, Code 2025, is amended 5 to read as follows: 6 7. If an agency is accredited by the joint commission on 7 the accreditation of health care organizations under the joint 8 commissions consolidated standards for residential settings 9 or by the council on accreditation of services for families 10 and children , the department shall modify facility licensure 11 standards applied to the agency in order to avoid duplicating 12 standards applied through accreditation. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanations substance by the members of the general assembly. 16 This bill relates to services and support for youth and is 17 organized by divisions. 18 DIVISION I TREATMENT, PHYSICAL ASSESSMENTS, AND 19 BEHAVIORAL HEALTH EVALUATIONS. Under current law, a 20 psychiatric medical institution for children (PMIC) is an 21 institution providing more than 24 hours of continuous care 22 involving long-term psychiatric services to 3 or more children 23 in residence for expected periods of 14 days or more for 24 diagnosis and evaluation, or for expected periods of 90 days 25 or more for treatment. 26 The bill exempts PMICs from licensing requirements for 27 maintaining or conducting programs with the primary purpose 28 of treating and rehabilitating persons with a substance use 29 disorder. 30 The bill defines approved qualifying organization as 31 the joint commission, the commission on the accreditation of 32 rehabilitation facilities, the council on accreditation, a 33 nationally recognized accrediting organization that operates 34 in conformance with federal regulations and has accreditation 35 -33- LSB 1457XD (16) 91 dg/ko 33/ 38
S.F. _____ H.F. _____ standards comparable to the previously mentioned entities, or 1 an entity specified by the department of inspections, appeals, 2 and licensing (DIAL) by rule created in consultation with the 3 department of health and human services (HHS). 4 The bill defines mental health disorder as a mental 5 disorder as defined in the most recent version of the 6 diagnostic and statistical manual of mental disorders published 7 by the American psychiatric association, or a mental disorder 8 as defined in the most recent version of the international 9 classification of diseases published by the world health 10 organization. 11 The bill defines protective locked environment as a 12 setting that prevents egress from a building or grounds as a 13 protective measure to ensure safety and security. 14 The bill defines record check evaluation system as the 15 record check evaluation system of HHS used to perform child and 16 dependent adult abuse record checks and to evaluate criminal 17 history and abuse records. 18 The bill defines serious emotional disturbance disorder 19 as a diagnosable mental, behavioral, or emotional disorder 20 of sufficient duration to result in a functional impairment 21 and that meets the diagnostic criteria in the most current 22 diagnostic and statistical manual of mental disorders published 23 by the American psychiatric association. Serious emotional 24 disturbance disorder does not include a substance use or 25 developmental disorder unless such disorder co-occurs with a 26 diagnosable disorder that would otherwise constitute a serious 27 emotional disturbance disorder. 28 The bill defines substance use disorder as a diagnosable 29 substance use disorder of sufficient duration to meet 30 diagnostic criteria specified within the most current 31 diagnostic and statistical manual of mental disorders published 32 by the American psychiatric association that results in a 33 functional impairment. 34 The bill defines youth as a person who is less than 21 35 -34- LSB 1457XD (16) 91 dg/ko 34/ 38
S.F. _____ H.F. _____ years of age. 1 The bill describes the nature of care a PMIC must offer youth 2 with a serious emotional disturbance disorder (SEDD), substance 3 use disorder (SUD), or both. 4 Under current law, a person who establishes a PMIC must 5 also hold a license under Code chapter 237 (child foster 6 care facilities) as a comprehensive residential facility for 7 children, or hold a license under Code chapter 125 (substance 8 use disorders) if the facility provides SUD treatment. The 9 bill eliminates the requirement that a PMIC holds either 10 of these additional licenses, and instead requires that an 11 applicant for a PMIC license specify whether the applicant will 12 provide SEDD services, SUD services, or both. A PMIC may only 13 provide services for which it is licensed. 14 The bill eliminates the requirement that a proposed PMIC be 15 under the direction of an agency which has previously operated 16 a facility for children or adolescents and meets or exceeds 17 requirements for licensure as a comprehensive residential 18 facility for children. 19 The bill requires DIAL, in cooperation with HHS, to adopt 20 rules to allow a PMIC to use a protective locked environment 21 at the PMIC. 22 Under current law, following the hospitalization hearing 23 on an involuntary commitment petition, if the court finds 24 by clear and convincing evidence that the respondent has a 25 serious mental impairment, the court shall order the respondent 26 committed for a complete psychiatric evaluation and appropriate 27 treatment. The chief medical officer (CMO) of the hospital or 28 facility at which a respondent is committed must report to the 29 court no more than 15 days after the date the respondent is 30 placed, making a recommendation for disposition of the matter. 31 The bill allows a court to place a minor respondent in a public 32 hospital and allows a CMO of the hospital no more than 30 33 days after the date the minor respondent is placed to make a 34 recommendation for disposition of the matter. 35 -35- LSB 1457XD (16) 91 dg/ko 35/ 38
S.F. _____ H.F. _____ The bill defines behavioral health evaluation as a 1 comprehensive evaluation of a persons mental and behavioral 2 health by a person licensed under Code chapter 154B 3 (psychology), 154C (social work), or 154D (behavioral science) 4 for purposes including but not limited to identifying a 5 possible behavioral health condition. 6 The bill defines physical assessment as direct physical 7 touching, viewing, and medically necessary manipulation of any 8 area of a childs body by a licensed physician. 9 The bill also defines behavioral health condition for 10 purposes of Code chapter 232 (juvenile justice). 11 The bill replaces several references to a physical or mental 12 examination with references to a physical assessment (PA) or 13 behavioral health evaluation (BHE) and replaces references to a 14 persons abuse of alcohol or other controlled substances with 15 references to the person having a behavioral health condition. 16 Under current law, one of several specific circumstances 17 must exist before a juvenile court has the authority to enter 18 an ex parte order to direct a peace officer or a juvenile court 19 officer to take custody of a child before or after the filing 20 of a petition under Code chapter 232 (juvenile justice). The 21 bill adds the circumstance when the childs parent, guardian, 22 or legal custodian consents to the removal as a condition that 23 would permit a juvenile court to enter such an ex parte order. 24 The bill creates similar provisions for when a juvenile court 25 may enter an ex parte order for a child to undergo an inpatient 26 PA or an inpatient BHE and when a person authorized to conduct 27 a preliminary investigation in response to a complaint 28 may motion to ask the court to order a child to undergo an 29 inpatient PA or an inpatient BHE. 30 The bill authorizes a court, after a dispositional hearing, 31 to order a child in a child in need of assistance (CINA) 32 proceeding or a family in need of assistance (FINA) proceeding 33 to receive an inpatient PA, an inpatient BHE, or both, at the 34 state training school (STS) if HHS requests such an order. 35 -36- LSB 1457XD (16) 91 dg/ko 36/ 38
S.F. _____ H.F. _____ A child ordered to the STS pursuant to a CINA proceeding 1 or a FINA proceeding must be separated at all times from 2 children placed in the STS pursuant to a juvenile delinquency 3 proceeding. Under current law, the court in a CINA or FINA 4 proceeding is prohibited from placing a child in the STS for 5 any reason. 6 The bill exempts a PMIC from licensing requirements for 7 child foster care. 8 The bill directs HHS and DIAL to adopt rules pertaining to 9 the use of seclusion and restraints at certain facilities as 10 detailed in the bill. 11 The bill makes conforming changes to Code chapters 135H 12 (psychiatric medical institutions for children) and 232 13 (juvenile justice). The bill repeals 2024 Iowa Acts, chapter 14 1161, sections 97 and 98. 15 DIVISION II EXEMPTION FROM CHILDRENS RESIDENTIAL 16 FACILITY CERTIFICATION. The bill provides an exception from 17 the definition of childrens residential facility under Code 18 chapter 237C, for care furnished by a live-in facility that 19 provides intensive medical care and support for individuals 20 who require ongoing treatment if the facility only furnishes 21 care to persons 16 years of age and older and HHS is paying for 22 each persons care from the facility under a federally approved 23 home and community-based services waiver or under another 24 provision of the medical assistance program. By operation of 25 law, the excepted live-in facilities are exempt from childrens 26 residential facility requirements, including certification. 27 DIVISION III DIRECTOR OF JUVENILE COURT SERVICES 28 CHIEF JUVENILE COURT OFFICERS. Under current law, the chief 29 juvenile court officers are appointed, terminated for cause, 30 and otherwise act under the direction and supervision of the 31 chief judge for the judicial district in which the chief 32 juvenile court officer was appointed. The bill transfers the 33 chief judges authority over chief juvenile court officers to 34 the director of juvenile court services. 35 -37- LSB 1457XD (16) 91 dg/ko 37/ 38
S.F. _____ H.F. _____ DIVISION IV HAWKI ELIGIBILITY PUBLIC INSTITUTION 1 INMATES. The bill defines public institution to mean the 2 same as defined in 42 C.F.R. 435.1010. 3 Current law does not permit a child who is an inmate in a 4 public institution to be eligible for the Hawki program. The 5 bill requires HHS to suspend, but not terminate, Hawki program 6 eligibility for a child in a public institution if the child 7 is otherwise eligible for the Hawki program except for the 8 childs status as an inmate, the child was enrolled in the 9 Hawki program at the time the child was committed to the public 10 institution, and 30 calendar days have elapsed since the date 11 the child was committed to the public institution. A childs 12 suspension of Hawki benefits must continue for the duration of 13 the childs commitment to a public institution. 14 The bill requires the public institution to which a child 15 is committed and HHS to provide monthly reports and expedite 16 the restoration of the childs Hawki benefits upon the childs 17 discharge from the public institution. The bill requires HHS 18 to adopt rules to administer the bills provisions related to 19 Hawki benefits for children committed to a public institution. 20 DIVISION V CORRECTIVE CHANGES. The bill updates 21 references to certain accrediting organizations through the 22 Code, corrects a reference throughout the Code related to 23 the citation for the definition of reasonable efforts, 24 and changes the term legal custodian to the defined term 25 custodian. 26 -38- LSB 1457XD (16) 91 dg/ko 38/ 38