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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
May 02, 2026
The Honorable Paul Pate
Secretary of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 2543, an Act relating to subacute mental health care facilities and services,
and including effective date provisions.
The above House File is hereby approved on this date.
Governor of Iowa
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
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House File 2543
AN ACT
RELATING TO SUBACUTE MENTAL HEALTH CARE FACILITIES AND
SERVICES, AND INCLUDING EFFECTIVE DATE PROVISIONS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
Section 1. Section 135G.1, subsection 12, paragraph c, Code
2026, is amended by striking the paragraph.
Sec. 2. Section 135G.3, Code 2026, is amended by adding the
following new subsection:
NEW SUBSECTION . 1A. Within twenty-four hours of a
resident's admission to a subacute care facility, the subacute
care facility shall develop an initial treatment plan with the
resident .
Sec. 3. NEW SECTION . 135G.3A Insurance authorization.
1. If a mental health professional submits an electronic
request through an internet portal designated by the department
of health and human services for prior authorization for
insurance coverage for an individual's subacute mental health
care service under chapter 249A or chapter 249N, the department
of health and human services or the managed care organization
responsible for administering the individual's medical
assistance shall provide a determination to the mental health
professional for the preauthorization request as follows:
a. Within forty-eight hours after the date of receipt of an
urgent preauthorization request.
House File 2543, p. 2
b. Within five calendar days after the date of receipt of a
nonurgent preauthorization request.
c. Within ten calendar days after the date of receipt of a
nonurgent preauthorization request involving complex or unique
circumstances .
2. The director of health and human services shall adopt
rules pursuant to chapter 17A as necessary to administer this
section .
Sec. 4. NEW SECTION . 135H.9A Bed tracking system.
The department of health and human services shall establish
an electronic system to track the availability of beds at each
psychiatric medical institution for children.
Sec. 5. DEPARTMENTS OF INSPECTIONS, APPEALS, AND LICENSING
AND HEALTH AND HUMAN SERVICES - ADMINISTRATIVE RULE
REVIEW. The department of inspections, appeals, and licensing
and the department of health and human services shall do all
of the following:
1. Collaborate to review each department's administrative
rules adopted pursuant to section 135G.10 and eliminate any
rule the departments determine impedes any of the following
goals without providing an equal or greater benefit:
a. Establishment of new subacute mental health care
facilities and services.
b. Expansion of existing subacute mental health care
facilities and services.
c. Ease of access to subacute mental health care facilities
and services.
2. Modify the departments' respective rules so that the
requirements to employ an individual at a subacute mental
health care facility are less stringent than the requirements
for the same employment at a state mental health institute.
Sec. 6. DEPARTMENT OF HEALTH AND HUMAN SERVICES - SUBACUTE
MENTAL HEALTH CARE SERVICES.
1. a. The department of health and human services shall
review the state's capability to establish subacute mental
health care services, and additional psychiatric inpatient
services at the state mental health institute at Independence,
beginning on July 1, 2027.
b. At a minimum, the department's review shall assess
House File 2543, p. 3
the operational costs, bed capacity, staffing capabilities,
necessary infrastructure improvements, and reasonable
implementation time frames.
c. The department's review shall investigate the
possibility of partnering with private operators to provide
subacute mental health care services at the state mental health
institute at Independence.
d. The department shall submit a report on the department's
findings to the chairpersons of the house of representatives
committee on health and human services, the senate committee
on health and human services, the house committee on
appropriations, and the senate committee on appropriations no
later than January 4, 2027.
2. Following the review under subsection 1, if the director
of health and human services determines on or after July
1, 2026, that the department can provide subacute mental
health care services at the state mental health institute at
Independence within the department's budget, the department
may provide such services until the general assembly directs
otherwise .
Sec. 7. EFFECTIVE DATE. This Act, being deemed of immediate
importance, takes effect upon enactment.
_
PAT GRASSLEy AMY SINCLAIR
Speaker on/the House President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 2543, Ninety-first General Assembly.
MEi NELSON
Approved 2026
Chief C^erk of the House
KIM REYNOLDS fA
Governor