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HOUSE
FILE
833
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
153)
A
BILL
FOR
An
Act
relating
to
services
and
support
for
youth,
including
1
treatment,
physical
assessments,
and
behavioral
health
2
evaluations
for
youth
involved
in
involuntary
commitment,
3
juvenile
delinquency,
child
in
need
of
assistance,
and
4
family
in
need
of
assistance
proceedings;
the
licensing
5
and
certification
of
certain
residential
facilities;
6
the
provision
of
home
and
community-based
services
and
7
habilitation
services
to
certain
youth
by
residential
8
programs;
administration
and
supervision
of
juvenile
court
9
services;
and
the
suspension
of
Hawki
eligibility
for
10
inmates
of
public
institutions.
11
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
12
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DIVISION
I
1
SERVICES
AND
SUPPORT
FOR
CHILDREN
AND
YOUTH
2
Section
1.
Section
125.13,
subsection
2,
Code
2025,
is
3
amended
by
adding
the
following
new
paragraph:
4
NEW
PARAGRAPH
.
k.
A
psychiatric
medical
institution
for
5
children
licensed
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
with
18
standards
comparable
to
the
entities
listed
in
paragraphs
“a”
19
through
“c”
that
are
acceptable
under
federal
regulations.
20
e.
An
entity
specified
by
rule
adopted
by
the
department
in
21
consultation
with
the
department
of
health
and
human
services.
22
1.
2.
“Department”
means
the
department
of
inspections,
23
appeals,
and
licensing.
24
2.
3.
“Direction”
means
authoritative
policy
or
procedural
25
guidance
for
the
accomplishment
of
a
function
or
an
activity.
26
3.
4.
“Licensee”
means
the
holder
of
a
license
issued
to
27
operate
a
psychiatric
medical
institution
for
children.
28
4.
5.
“Medical
care
plan”
means
a
plan
of
care
and
services
29
designed
to
eliminate
the
need
for
inpatient
care
by
improving
30
the
condition
of
a
child
youth
.
Services
must
be
based
upon
a
31
diagnostic
evaluation,
which
includes
an
examination
a
physical
32
assessment
and
behavioral
health
evaluation
of
the
medical,
33
psychological,
social,
behavioral,
and
developmental
aspects
34
of
the
child’s
youth’s
situation,
reflecting
the
need
for
35
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inpatient
care.
1
6.
“Mental
health
disorder”
means
any
of
the
following:
2
a.
A
mental
disorder
as
defined
by
the
most
recent
version
3
of
the
diagnostic
and
statistical
manual
of
mental
disorders
4
published
by
the
American
psychiatric
association.
5
b.
A
mental
disorder
included
in
the
mental,
behavioral,
or
6
neurodevelopmental
disorders
chapter
in
the
most
recent
version
7
of
the
international
classification
of
diseases
published
by
8
the
world
health
organization.
9
5.
7.
“Mental
health
professional”
means
an
individual
who
10
has
all
of
the
following
qualifications:
11
a.
The
individual
holds
at
least
a
master’s
degree
in
a
12
mental
health
field,
including
but
not
limited
to,
psychology,
13
counseling
and
guidance,
nursing,
and
or
social
work,
or
the
14
individual
is
a
physician.
15
b.
The
individual
holds
a
current
Iowa
license
if
practicing
16
in
a
field
covered
by
that
requires
an
Iowa
licensure
law
17
license
.
18
c.
The
individual
has
at
least
two
years
of
post-degree
19
clinical
experience,
supervised
by
another
mental
health
20
professional,
in
assessing
mental
health
needs
and
problems
and
21
in
providing
appropriate
mental
health
services.
22
6.
8.
“Nursing
care”
means
services
which
are
provided
23
under
the
direction
of
a
physician
or
registered
nurse.
24
7.
9.
“Physician”
means
a
person
licensed
under
chapter
25
148
.
26
10.
“Protective
locked
environment”
means
a
setting
that
27
prevents
egress
from
a
building
or
grounds
as
a
protective
28
measure
to
ensure
safety
and
security.
29
8.
11.
“Psychiatric
medical
institution
for
children”
or
30
“psychiatric
institution”
means
an
institution
providing
more
31
than
twenty-four
hours
of
continuous
care
involving
long-term
32
psychiatric
services
to
three
or
more
children
youth
in
33
residence
for
expected
periods
of
fourteen
or
more
days
for
an
34
assessment,
evaluation,
and
diagnosis
and
evaluation
or
for
35
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expected
periods
of
ninety
days
or
more
for
treatment.
1
9.
12.
“Psychiatric
services”
means
services
provided
under
2
the
direction
of
a
physician
which
address
mental,
emotional,
3
medical,
or
behavioral
problems.
4
13.
“Record
check
evaluation
system”
means
the
same
as
5
defined
in
section
135C.1.
6
10.
14.
“Rehabilitative
services”
means
services
to
7
encourage
and
assist
restoration
of
a
resident’s
optimum
mental
8
and
physical
capabilities.
9
11.
15.
“Resident”
means
a
person
who
is
less
than
10
twenty-one
years
of
age
and
youth
who
has
been
admitted
by
a
11
physician
to
a
psychiatric
medical
institution
for
children.
12
16.
“Serious
emotional
disturbance”
means
a
diagnosable
13
disorder
of
sufficient
duration
to
meet
diagnostic
criteria
14
specified
within
the
most
current
diagnostic
and
statistical
15
manual
of
mental
disorders
published
by
the
American
16
psychiatric
association
that
results
in
a
functional
17
impairment.
“Serious
emotional
disturbance”
does
not
include
a
18
substance
use
or
developmental
disorder
unless
such
disorder
19
co-occurs
with
such
a
diagnosable
mental,
behavioral,
or
20
emotional
disorder.
21
17.
“Substance
use
disorder”
means
the
same
as
defined
in
22
section
125.2.
23
12.
18.
“Supervision”
means
direct
oversight
and
inspection
24
of
the
an
act
of
accomplishing
that
accomplishes
a
function
or
25
activity.
26
19.
“Youth”
means
a
person
who
is
less
than
twenty-one
years
27
of
age.
28
Sec.
3.
Section
135H.3,
Code
2025,
is
amended
to
read
as
29
follows:
30
135H.3
Nature
of
care.
31
1.
a.
A
psychiatric
medical
institution
for
children
32
shall
provide
shelter,
food,
supervision,
care,
assessment,
33
evaluation,
diagnosis,
treatment,
counseling,
rehabilitative
34
services,
and
related
professional-directed
services
to
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youth
who
have
a
serious
emotional
disturbance,
a
substance
1
use
disorder,
or
both,
with
the
intention
of
reducing
or
2
ameliorating
the
disorder,
the
symptoms
of
the
disorder,
or
the
3
effects
of
the
disorder.
4
b.
A
psychiatric
medical
institution
for
children
shall
5
utilize
a
team
of
professionals
to
direct
an
organized
program
6
of
diagnostic
services,
psychiatric
services,
nursing
care,
7
and
rehabilitative
services
to
meet
the
needs
of
residents
8
in
accordance
with
a
medical
care
plan
developed
for
each
9
resident.
The
membership
of
the
team
of
professionals
10
may
include
but
is
not
limited
to
an
advanced
registered
11
nurse
practitioner
or
a
physician
assistant.
Social
and
12
rehabilitative
services
shall
be
provided
under
the
direction
13
of
a
qualified
mental
health
professional.
14
2.
If
a
child
youth
is
diagnosed
with
a
biologically
15
based
mental
illness
as
defined
in
section
514C.22
and
meets
16
the
medical
assistance
program
criteria
for
admission
to
a
17
psychiatric
medical
institution
for
children,
the
child
youth
18
shall
be
deemed
to
meet
the
acuity
criteria
for
medically
19
necessary
inpatient
benefits
under
a
group
policy,
contract,
or
20
plan
providing
for
third-party
payment
or
prepayment
of
health,
21
medical,
and
surgical
coverage
benefits
issued
by
a
carrier,
as
22
defined
in
section
513B.2
,
that
is
subject
to
section
514C.22
.
23
Such
medically
necessary
benefits
shall
not
be
excluded
or
24
denied
as
care
that
is
substantially
custodial
in
nature
under
25
section
514C.22,
subsection
8
,
paragraph
“b”
.
26
Sec.
4.
Section
135H.4,
Code
2025,
is
amended
to
read
as
27
follows:
28
135H.4
Licensure
——
scope
of
license
.
29
1.
A
person
shall
not
establish,
operate,
or
maintain
a
30
psychiatric
medical
institution
for
children
unless
the
person
31
obtains
a
license
for
the
institution
under
this
chapter
and
32
either
holds
a
license
under
section
237.3,
subsection
2
,
33
paragraph
“a”
,
as
a
comprehensive
residential
facility
for
34
children
or
holds
a
license
under
section
125.13
,
if
the
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facility
provides
substance
use
disorder
treatment
.
1
2.
A
licensee
shall
only
provide
serious
emotional
2
disturbance
or
substance
use
disorder
services
for
which
the
3
licensee
is
licensed
under
this
chapter.
4
Sec.
5.
Section
135H.5,
Code
2025,
is
amended
to
read
as
5
follows:
6
135H.5
Application
for
license
——
initial
application
and
7
annual
fees
.
8
1.
An
application
for
a
license
under
this
chapter
shall
9
be
submitted
on
a
form
requesting
information
required
by
10
the
department
,
which
.
The
application
may
include
require
11
affirmative
evidence
of
the
applicant’s
ability
to
comply
with
12
the
rules
for
standards
adopted
pursuant
to
this
chapter
.
The
13
application
shall
require
the
applicant
to
specify
whether
the
14
applicant
intends
to
provide
services
for
serious
emotional
15
disturbances,
substance
use
disorders,
or
both.
16
2.
An
application
for
a
license
shall
be
accompanied
by
the
17
required
license
fee
which
shall
be
credited
to
the
general
18
fund
of
the
state.
The
initial
application
fee
and
the
annual
19
license
fee
is
twenty-five
dollars.
20
Sec.
6.
Section
135H.6,
subsections
1,
4,
and
5,
Code
2025,
21
are
amended
to
read
as
follows:
22
1.
The
department
shall
issue
a
license
to
an
applicant
23
under
this
chapter
if
all
the
following
conditions
exist:
24
a.
The
department
has
ascertained
that
the
applicant’s
25
medical
facilities
and
staff
are
adequate
to
provide
the
care
26
and
services
required
of
a
psychiatric
medical
institution
for
27
children
.
28
b.
The
proposed
psychiatric
institution
is
accredited
29
by
the
joint
commission
on
the
accreditation
of
health
30
care
organizations,
the
commission
on
accreditation
of
31
rehabilitation
facilities,
the
council
on
accreditation
of
32
services
for
families
and
children,
or
by
any
other
recognized
33
accrediting
organization
with
comparable
standards
acceptable
34
under
federal
regulation
an
approved
qualifying
organization
.
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c.
The
applicant
complies
with
applicable
state
rules
1
and
standards
for
a
psychiatric
institution
adopted
by
the
2
department
in
accordance
with
federal
requirements
under
42
3
C.F.R.
§441.150
–
441.156.
4
d.
The
department
of
health
and
human
services
has
submitted
5
written
approval
of
the
application
based
on
the
department
6
of
health
and
human
services’
determination
of
need.
The
7
department
of
health
and
human
services
shall
identify
the
8
location
and
number
of
children
youth
in
the
state
who
require
9
the
services
of
a
psychiatric
medical
institution
for
children.
10
Approval
of
an
application
shall
be
based
upon
the
location
11
of
the
proposed
psychiatric
institution
relative
to
the
need
12
for
services
identified
by
the
department
of
health
and
human
13
services
and
an
analysis
of
the
applicant’s
ability
to
provide
14
services
and
support
consistent
with
requirements
under
chapter
15
232
,
particularly
regarding
specifically
community-based
16
treatment.
If
the
proposed
psychiatric
institution
is
not
17
freestanding
from
a
facility
licensed
under
chapter
135B
or
18
135C
,
approval
under
this
paragraph
shall
not
be
given
unless
19
the
department
of
health
and
human
services
certifies
that
20
the
proposed
psychiatric
institution
is
capable
of
providing
21
a
resident
with
a
living
environment
similar
to
the
living
22
environment
provided
by
a
licensee
which
is
freestanding
from
a
23
facility
licensed
under
chapter
135B
or
135C
.
24
e.
The
proposed
psychiatric
institution
is
under
the
25
direction
of
an
agency
which
has
operated
a
facility
licensed
26
under
section
237.3,
subsection
2
,
paragraph
“a”
,
as
a
27
comprehensive
residential
facility
for
children
for
three
years
28
or
of
an
agency
which
has
operated
a
facility
for
three
years
29
providing
psychiatric
services
exclusively
to
children
or
30
adolescents
and
the
facility
meets
or
exceeds
requirements
for
31
licensure
under
section
237.3,
subsection
2
,
paragraph
“a”
,
as
a
32
comprehensive
residential
facility
for
children.
33
f.
e.
If
a
child
youth
has
an
a
serious
emotional
,
34
behavioral,
or
mental
health
disorder
disturbance
,
the
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psychiatric
institution
does
not
require
court
any
of
the
1
following
as
a
condition
for
the
youth
to
obtain
treatment:
2
(1)
Court
proceedings
to
be
initiated
or
that
a
child’s
.
3
(2)
For
the
youth’s
parent,
guardian,
or
custodian
must
4
to
terminate
parental
rights
over
,
or
transfer
legal
custody
5
of
,
the
child
for
the
purposes
of
obtaining
treatment
from
the
6
psychiatric
institution
for
the
child
youth
.
7
(3)
Relinquishment
of
a
child’s
the
youth’s
custody
shall
8
not
be
a
condition
of
the
child
receiving
services
.
9
4.
The
department
of
health
and
human
services
may
give
10
approval
to
approve
a
conversion
of
beds
approved
under
11
subsection
2
,
to
if
the
beds
which
are
specialized
to
provide
12
substance
use
disorder
treatment.
However,
the
total
number
of
13
beds
approved
under
subsection
2
and
this
subsection
shall
not
14
exceed
four
hundred
thirty
,
unless
approved
for
good
cause
by
15
the
director
pursuant
to
subsection
2
.
Beds
The
limitations
16
on
the
number
of
beds
under
this
section
shall
not
apply
to
17
beds
for
children
youth
who
do
not
reside
in
this
state
and
18
whose
service
costs
are
not
paid
by
public
funds
in
this
state
19
are
not
subject
to
the
limitations
on
the
number
of
beds
20
requirements
otherwise
applicable
under
this
section
.
21
5.
A
psychiatric
institution
licensed
prior
to
July
1,
1999,
22
may
exceed
the
number
of
beds
authorized
under
subsection
2
23
if
the
excess
beds
are
used
to
provide
services
funded
from
24
a
source
other
than
the
medical
assistance
program
under
25
chapter
249A
.
Notwithstanding
subsection
1
,
paragraph
“d”
,
and
26
subsection
2
,
the
provision
of
services
using
those
excess
beds
27
does
not
require
a
review
by
the
department
of
health
and
human
28
services.
29
Sec.
7.
Section
135H.7,
subsection
2,
paragraph
a,
Code
30
2025,
is
amended
to
read
as
follows:
31
a.
If
a
person
who
has
been
convicted
of
a
crime
or
has
a
32
record
of
founded
child
abuse
is
being
considered
for
licensure
33
under
this
chapter
,
or
for
employment
with
a
psychiatric
34
institution
involving
direct
responsibility
for
a
child
youth
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or
with
access
to
a
child
youth
when
the
child
youth
is
alone,
1
by
a
licensed
psychiatric
institution,
or
if
a
person
will
2
reside
residence
in
a
facility
utilized
by
a
licensee,
and
if
3
the
person
has
been
convicted
of
a
crime
or
has
a
record
of
4
founded
child
abuse,
the
record
check
evaluation
system
and
5
the
licensee
for
an
employee
of
the
licensee
considering
the
6
person
for
employment
shall
perform
an
evaluation
to
determine
7
whether
the
crime
or
founded
child
abuse
warrants
prohibition
8
of
licensure,
employment,
or
residence
in
the
facility
utilized
9
by
a
licensee
.
The
record
check
evaluation
system
of
the
10
department
of
health
and
human
services
shall
conduct
criminal
11
and
child
abuse
record
checks
in
this
state
and
may
conduct
12
these
checks
in
other
states.
The
record
check
evaluation
13
shall
be
performed
in
accordance
with
procedures
adopted
for
14
this
purpose
by
the
department
of
health
and
human
services.
15
Sec.
8.
NEW
SECTION
.
135H.7A
Protective
locked
environment
16
——
rules.
17
The
department,
in
cooperation
with
the
department
of
health
18
and
human
services,
shall
adopt
rules
pursuant
to
chapter
17A
19
relating
to
the
application
of
a
protective
locked
environment
20
in
a
psychiatric
medial
institution
for
children.
21
Sec.
9.
Section
135H.10,
subsection
2,
Code
2025,
is
amended
22
to
read
as
follows:
23
2.
This
chapter
shall
not
be
construed
as
prohibiting
24
the
use
of
to
prohibit
funds
appropriated
for
foster
care
to
25
from
being
used
to
provide
payment
to
a
psychiatric
medical
26
institution
for
children
for
the
financial
participation
27
required
of
a
child
youth
whose
foster
care
placement
is
in
a
28
psychiatric
medical
institution
for
children.
In
accordance
29
with
established
policies
and
procedures
for
foster
care,
the
30
department
of
health
and
human
services
shall
act
to
recover
31
any
such
payment
for
financial
participation,
apply
to
be
named
32
payee
for
the
child’s
youth’s
unearned
income,
and
recommend
33
parental
liability
for
the
costs
of
a
court-ordered
foster
care
34
placement
in
a
psychiatric
medical
institution.
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Sec.
10.
Section
135H.13,
subsection
1,
Code
2025,
is
1
amended
to
read
as
follows:
2
1.
The
department’s
final
findings
and
the
survey
findings
3
of
the
joint
commission
on
the
accreditation
of
health
care
4
organizations
an
approved
qualifying
organization
regarding
5
licensure
or
program
accreditation
shall
be
made
available
6
to
the
public
in
a
readily
available
form
and
place.
Other
7
information
relating
to
the
psychiatric
institution
is
8
confidential
and
shall
not
be
made
available
to
the
public
9
except
in
proceedings
a
proceeding
involving
licensure,
a
10
civil
suit
involving
a
resident,
or
an
administrative
action
11
involving
a
resident.
12
Sec.
11.
Section
229.13,
subsection
1,
paragraph
c,
Code
13
2025,
is
amended
to
read
as
follows:
14
c.
(1)
If
the
court
orders
evaluation
and
treatment
of
15
the
respondent
on
an
inpatient
basis
under
this
section
,
the
16
court
may
order
the
respondent
placed
under
the
care
of
an
17
appropriate
subacute
care
facility
licensed
under
chapter
135G
.
18
(2)
If
the
court
orders
evaluation
and
treatment
of
a
minor
19
respondent
on
an
inpatient
basis
under
this
section,
the
court
20
may
order
the
minor
respondent
placed
under
the
care
of
an
21
appropriate
public
hospital.
22
Sec.
12.
Section
229.13,
subsection
5,
Code
2025,
is
amended
23
to
read
as
follows:
24
5.
a.
(1)
The
chief
medical
officer
of
the
hospital
or
25
facility
at
which
the
respondent
is
placed
shall
report
to
the
26
court
and
make
a
recommendation
for
disposition
of
the
matter
27
no
more
than
fifteen
days
after
the
date
the
respondent
is
28
placed
,
making
a
recommendation
for
disposition
of
the
matter
29
at
the
hospital
or
facility
.
An
30
(2)
If
the
respondent
is
a
minor
and
is
placed
under
the
31
care
of
a
public
hospital
pursuant
to
subsection
1,
paragraph
32
“c”
,
subparagraph
(2),
the
chief
medical
officer
of
the
public
33
hospital
shall
report
to
the
court
and
make
a
recommendation
34
for
disposition
no
later
than
thirty
calendar
days
after
the
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date
the
minor
respondent
is
placed
under
the
care
of
the
1
public
hospital.
2
b.
A
copy
of
the
chief
medical
officer’s
report
shall
be
3
sent
to
the
respondent’s
attorney.
4
c.
(1)
Upon
request,
the
court
may
grant
the
chief
medical
5
officer
an
extension
of
time
may
be
granted
,
not
to
exceed
6
seven
days
,
upon
a
showing
of
cause.
A
copy
of
the
report
shall
7
be
sent
to
the
The
respondent’s
attorney
,
who
may
contest
the
8
need
for
an
extension
of
time
if
one
is
requested
.
An
9
(2)
The
court
shall
grant
an
extension
of
time
shall
be
10
granted
upon
request
unless
the
request
is
contested,
in
which
11
case
the
court
shall
make
such
inquiry
as
it
deems
appropriate
12
and
may
either
order
the
respondent’s
release
from
the
hospital
13
or
facility
,
or
grant
an
extension
of
time
for
psychiatric
14
evaluation.
15
d.
If
the
chief
medical
officer
fails
to
report
to
the
16
court
within
fifteen
days
after
the
individual
is
placed
under
17
the
care
of
the
hospital
or
facility
the
time
specified
in
18
paragraph
“a”
,
and
an
extension
of
time
has
not
been
requested
19
granted
,
the
chief
medical
officer
is
guilty
of
contempt
20
and
shall
be
punished
under
chapter
665.
The
court
shall
21
order
a
rehearing
on
the
application
to
determine
whether
the
22
respondent
should
continue
to
be
detained
at
or
placed
under
23
the
care
of
the
hospital
or
facility.
24
Sec.
13.
Section
229.14,
subsection
2,
paragraph
e,
Code
25
2025,
is
amended
to
read
as
follows:
26
e.
(1)
If
the
court
orders
placement
and
treatment
of
the
27
a
respondent
on
an
inpatient
basis
under
this
section
,
the
28
court
may
order
the
respondent
placed
under
the
care
of
an
29
appropriate
subacute
care
facility
licensed
under
chapter
135G
.
30
(2)
If
the
court
orders
placement
and
treatment
of
a
minor
31
respondent
on
an
inpatient
basis
under
this
section,
the
court
32
may
order
the
minor
respondent
placed
under
the
care
of
an
33
appropriate
public
hospital.
34
Sec.
14.
Section
232.2,
Code
2025,
is
amended
by
adding
the
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following
new
subsections:
1
NEW
SUBSECTION
.
3A.
“Behavioral
health
condition”
means
2
a
serious
emotional
disturbance,
a
mental
health
disorder,
3
a
substance
abuse
disorder,
life
stressors
and
crises,
and
4
stress-related
physical
symptoms.
5
NEW
SUBSECTION
.
3B.
“Behavioral
health
evaluation”
means
a
6
process
used
to
assess
an
individual’s
behavioral
health
status
7
and
functioning
for
purposes
including
but
not
limited
to
the
8
diagnosis
of
a
behavioral
health
condition
or
to
determine
the
9
need
for
treatment
or
intervention.
10
NEW
SUBSECTION
.
38A.
“Mental
health
disorder”
means
the
11
same
as
defined
in
section
135H.1.
12
NEW
SUBSECTION
.
48A.
“Physical
assessment”
means
13
direct
physical
touching,
viewing,
and
medically
necessary
14
manipulation
of
any
area
of
a
child’s
body
by
a
physician
15
licensed
under
chapter
148.
16
NEW
SUBSECTION
.
58A.
“Serious
emotional
disturbance”
means
17
the
same
as
defined
in
section
135H.1.
18
NEW
SUBSECTION
.
64A.
“Substance
use
disorder”
means
the
19
same
as
defined
in
section
125.2.
20
Sec.
15.
Section
232.2,
subsections
34
and
58,
Code
2025,
21
are
amended
to
read
as
follows:
22
34.
“Juvenile
court
social
records”
or
“social
records”
means
23
all
records
,
other
than
official
records,
made
with
respect
to
24
a
child
in
connection
with
proceedings
over
which
the
court
has
25
jurisdiction
under
this
chapter
other
than
official
records
and
26
includes
but
is
not
limited
to
the
records
made
and
compiled
27
by
intake
officers,
predisposition
reports,
and
reports
of
28
physical
assessments
and
mental
examinations
behavioral
health
29
evaluations
.
30
58.
“Secure
facility”
means
a
physically
restricting
31
facility
in
which
children
adjudicated
to
have
committed
32
a
delinquent
act
a
child
may
be
placed
pursuant
to
a
33
dispositional
order
of
the
court.
34
Sec.
16.
Section
232.8,
subsection
4,
Code
2025,
is
amended
35
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to
read
as
follows:
1
4.
In
a
proceeding
concerning
a
child
who
is
alleged
to
2
have
committed
a
second
delinquent
act
or
a
second
violation
3
excluded
from
the
jurisdiction
of
the
juvenile
court,
the
court
4
or
the
juvenile
court
shall
determine
whether
there
is
reason
5
to
believe
that
the
child
regularly
abuses
alcohol
or
other
6
controlled
substance
has
a
behavioral
health
condition
and
may
7
be
in
need
of
treatment.
If
the
court
so
determines,
the
court
8
shall
advise
appropriate
juvenile
authorities
and
refer
such
9
offenders
to
the
juvenile
court
for
disposition
pursuant
to
10
section
232.52A
.
11
Sec.
17.
Section
232.49,
Code
2025,
is
amended
to
read
as
12
follows:
13
232.49
Physical
assessments
and
mental
examinations
14
behavioral
health
evaluations
——
juvenile
delinquency
.
15
1.
a.
Following
Any
time
after
the
entry
of
an
order
16
of
adjudication
under
section
232.47
,
the
court
may,
after
17
a
hearing
which
may
be
simultaneous
with
the
adjudicatory
18
hearing
,
order
a
physical
assessment
or
mental
examination
19
behavioral
health
evaluation
of
a
child
if
it
the
court
finds
20
that
an
examination
a
physical
assessment
or
a
behavioral
21
health
evaluation
is
necessary
to
determine
the
child’s
22
physical
condition
or
mental
to
determine
if
the
child
has
a
23
behavioral
health
condition.
24
b.
The
court
may
consider
chemical
dependency
as
either
25
a
physical
condition
or
mental
behavioral
health
condition
26
and
may
consider
a
chemical
dependency
evaluation
as
either
a
27
physical
assessment
or
mental
examination
behavioral
health
28
evaluation
.
If
the
examination
29
c.
A
hearing
to
order
a
physical
assessment
or
behavioral
30
health
evaluation
may
be
held
at
the
same
time
as
the
31
adjudicatory
hearing.
32
2.
Unless
otherwise
ordered
by
the
court,
if
a
physical
33
assessment
or
behavioral
health
evaluation
indicates
the
child
34
has
behaved
in
a
manner
that
threatened
the
safety
of
another
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person,
has
committed
a
violent
act
causing
bodily
injury
to
1
another
person,
or
has
been
a
victim
or
perpetrator
of
sexual
2
abuse,
unless
otherwise
ordered
by
the
court,
the
child’s
3
parent,
guardian,
or
foster
parent
,
or
other
person
with
4
custody
of
the
child
shall
be
provided
with
that
information.
5
2.
3.
a.
When
possible
an
examination
,
a
physical
6
assessment
or
behavioral
health
evaluation
shall
be
conducted
7
on
an
outpatient
basis
,
but
.
However,
if
deemed
necessary
by
8
the
court,
the
court
may
,
if
it
deems
necessary
commit
order
9
the
child
to
a
suitable
hospital,
facility
,
or
institution
for
10
the
purpose
of
examination
an
inpatient
physical
assessment
or
11
an
inpatient
behavioral
health
evaluation
.
12
b.
Commitment
for
examination
An
inpatient
physical
13
assessment
or
an
inpatient
behavioral
health
evaluation
shall
14
not
exceed
thirty
days
and
the
civil
commitment
provisions
of
15
chapter
229
shall
not
apply
.
16
3.
4.
a.
At
any
Any
time
after
the
filing
of
a
delinquency
17
petition
,
the
court
may
order
a
physical
assessment
or
mental
18
examination
behavioral
health
evaluation
of
the
child
if
all
of
19
the
following
circumstances
apply:
20
(1)
The
court
finds
such
examination
a
physical
assessment
21
or
a
behavioral
health
evaluation
to
be
in
the
best
interest
22
of
the
child
;
and
.
23
(2)
The
parent,
guardian,
or
custodian
and
the
child’s
24
counsel
agree
to
the
physical
assessment
or
behavioral
health
25
evaluation
.
26
b.
(1)
An
examination
A
physical
assessment
or
behavioral
27
health
evaluation
shall
be
conducted
on
an
outpatient
basis
28
unless
the
court,
the
child’s
counsel,
and
the
child’s
29
parent,
guardian,
or
custodian
agree
that
it
is
necessary
the
30
child
should
be
committed
ordered
to
a
suitable
hospital,
31
facility,
or
institution
for
the
purpose
of
examination
an
32
inpatient
physical
assessment
or
an
inpatient
behavioral
health
33
evaluation
.
Commitment
for
examination
34
Sec.
18.
Section
232.52A,
subsection
1,
Code
2025,
is
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amended
to
read
as
follows:
1
1.
In
addition
to
any
other
order
of
the
juvenile
court,
2
a
person
under
age
eighteen,
child
who
may
be
in
need
of
3
treatment
,
as
determined
under
section
232.8
,
may
be
ordered
4
to
participate
in
an
alcohol
or
controlled
substance
education
5
or
a
physical
assessment
or
behavioral
health
evaluation
6
program
approved
by
the
juvenile
court.
If
recommended
after
7
evaluation,
the
The
court
may
also
order
the
person
child
to
8
participate
in
a
treatment
program
approved
by
the
court
if
the
9
treatment
program
is
recommended
after
the
child’s
physical
10
assessment
or
behavioral
health
evaluation
.
The
juvenile
court
11
may
also
require
the
custodial
parent
or
parents
,
or
other
12
legal
guardian
,
to
participate
in
an
educational
program
with
13
the
person
under
age
eighteen
child
if
the
court
determines
14
that
such
participation
is
in
the
best
interests
of
the
person
15
under
age
eighteen
child
.
16
Sec.
19.
Section
232.68,
subsection
3,
unnumbered
paragraph
17
1,
Code
2025,
is
amended
to
read
as
follows:
18
“Confidential
access
to
a
child”
means
access
to
a
child,
19
during
an
assessment
of
an
alleged
act
of
child
abuse,
who
is
20
alleged
to
be
the
victim
of
the
child
abuse
,
during
a
child
21
abuse
assessment
.
The
access
may
be
accomplished
by
interview,
22
observation,
or
examination
physical
assessment
of
the
child.
23
As
used
in
this
subsection
and
this
part:
24
Sec.
20.
Section
232.68,
subsection
3,
paragraph
c,
Code
25
2025,
is
amended
by
striking
the
paragraph.
26
Sec.
21.
Section
232.69,
subsection
3,
paragraph
b,
Code
27
2025,
is
amended
to
read
as
follows:
28
b.
A
person
required
to
make
a
report
under
subsection
1,
29
other
than
a
physician
whose
professional
practice
does
not
30
regularly
involve
providing
primary
health
care
to
children,
31
shall
complete
the
core
training
curriculum
relating
to
32
the
identification
and
reporting
of
child
abuse
within
six
33
months
of
initial
employment
or
self-employment
involving
34
the
examination
physical
assessments
or
behavioral
health
35
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evaluations
,
or
attending,
counseling,
or
treatment
of
treating
1
children
on
a
regular
basis.
Within
one
month
of
initial
2
employment
or
self-employment,
the
person
shall
obtain
a
3
statement
of
the
abuse
reporting
requirements
from
the
person’s
4
employer
or,
if
self-employed,
from
the
department.
The
person
5
shall
complete
the
core
training
curriculum
relating
to
the
6
identification
and
reporting
of
child
abuse
every
three
years.
7
Sec.
22.
Section
232.71B,
subsection
10,
Code
2025,
is
8
amended
to
read
as
follows:
9
10.
Physical
examination
assessment
.
If
the
department
10
refers
a
child
to
a
physician
or
physician
assistant
for
a
11
physical
examination
assessment
,
the
department
shall
contact
12
the
physician
or
physician
assistant
regarding
the
examination
13
physical
assessment
within
twenty-four
hours
of
making
the
14
referral.
If
the
physician
or
physician
assistant
who
performs
15
the
examination
upon
referral
by
the
department
physical
16
assessment
reasonably
believes
the
child
has
been
abused,
the
17
physician
or
physician
assistant
shall
report
to
the
department
18
within
twenty-four
hours
of
performing
the
examination
physical
19
assessment
.
20
Sec.
23.
Section
232.77,
subsection
1,
Code
2025,
is
amended
21
to
read
as
follows:
22
1.
a.
A
person
who
is
required
to
report
suspected
23
child
abuse
may
take
or
perform,
or
may
cause
to
be
taken
or
24
performed
,
at
public
expense,
photographs,
X
rays,
or
other
25
physical
examinations
assessments,
or
other
tests
of
a
child
26
which
would
provide
medical
indication
of
allegations
arising
27
from
an
assessment.
28
b.
A
health
practitioner
may,
if
medically
indicated,
29
cause
to
be
performed
a
radiological
examination,
physical
30
examination
assessment
,
or
other
medical
tests
test
of
the
31
child.
32
c.
A
person
who
takes
any
photographs
or
X
rays
or
33
performs
any
physical
examinations
assessments
or
other
tests
34
pursuant
to
this
section
shall
notify
the
department
that
the
35
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photographs
or
X
rays
have
been
taken
or
the
examinations
1
physical
assessments
or
other
tests
have
been
performed
.
The
2
person
who
made
notification
,
and
shall
retain
the
photographs
,
3
or
X
rays
,
or
examination
physical
assessment
or
other
test
4
findings
for
a
reasonable
time
following
the
notification.
5
d.
Whenever
the
person
is
required
to
report
under
section
6
232.69
,
in
that
person’s
capacity
as
a
member
of
the
staff
of
7
a
medical
or
other
private
or
public
institution,
agency
or
8
facility,
that
person
shall
immediately
notify
the
person
in
9
charge
of
the
institution,
agency,
or
facility
or
that
person’s
10
designated
delegate
of
the
need
for
photographs
,
or
X
rays
or
11
examinations
,
physical
assessments,
or
other
tests.
12
Sec.
24.
Section
232.78,
subsection
1,
paragraph
a,
Code
13
2025,
is
amended
to
read
as
follows:
14
a.
Any
of
the
following
circumstances
exist:
15
(1)
The
person
responsible
for
the
care
of
the
child
16
consents
to
the
removal.
17
(2)
The
person
responsible
for
the
care
of
the
child
is
18
absent
,
or
.
19
(3)
The
person
responsible
for
the
care
of
the
child,
though
20
present,
was
asked
and
refused
to
consent
to
the
removal
of
the
21
child
and
was
informed
of
an
intent
to
apply
for
an
order
under
22
this
section
,
or
there
.
23
(4)
There
is
reasonable
cause
to
believe
that
a
request
for
24
consent
would
further
endanger
the
child
,
or
there
.
25
(5)
There
is
reasonable
cause
to
believe
that
a
request
for
26
consent
will
cause
the
parent,
guardian,
or
legal
custodian
27
person
responsible
for
the
care
of
the
child
to
take
flight
28
with
the
child.
29
Sec.
25.
Section
232.78,
subsection
1,
paragraph
c,
30
subparagraph
(1),
Code
2025,
is
amended
to
read
as
follows:
31
(1)
The
refusal
or
failure
of
the
person
responsible
for
32
the
care
of
the
child
to
comply
with
the
request
of
a
peace
33
officer,
juvenile
court
officer,
or
child
protection
worker
34
for
such
the
person
to
obtain
and
provide
to
the
requester
35
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the
results
of
a
physical
assessment
or
mental
examination
1
behavioral
health
evaluation
of
the
child.
The
request
for
a
2
physical
examination
assessment
of
the
child
may
specify
the
3
performance
of
a
medically
relevant
test.
4
Sec.
26.
Section
232.78,
subsection
5,
Code
2025,
is
amended
5
to
read
as
follows:
6
5.
The
juvenile
court,
before
or
after
the
filing
of
a
7
petition
under
this
chapter
,
may
enter
an
ex
parte
order
8
authorizing
a
physician
or
physician
assistant
or
hospital
to
9
conduct
an
inpatient
or
outpatient
physical
examination
or
10
authorizing
a
physician
or
physician
assistant,
a
psychologist
11
certified
under
section
154B.7
,
or
a
community
mental
health
12
center
accredited
pursuant
to
chapter
230A
to
conduct
an
13
outpatient
mental
examination
assessment
or
an
inpatient
or
14
outpatient
behavioral
health
evaluation
of
a
child
if
necessary
15
to
identify
the
nature,
extent,
and
cause
of
injuries
to
the
16
child
as
required
by
section
232.71B
,
provided
all
of
the
17
following
apply:
18
a.
Any
of
the
following
circumstances
exist:
19
(1)
The
child’s
parent,
guardian,
or
custodian
consents
to
20
the
physical
assessment
or
the
behavioral
health
evaluation.
21
(2)
The
child’s
parent,
guardian,
or
legal
custodian
is
22
absent
,
or
.
23
(3)
The
child’s
parent,
guardian,
or
custodian,
though
24
present,
was
asked
and
refused
to
provide
written
consent
to
25
the
examination
physical
assessment
or
the
behavioral
health
26
evaluation
.
27
b.
The
juvenile
court
has
entered
an
ex
parte
order
28
directing
the
removal
of
the
child
from
the
child’s
home
or
a
29
child
care
facility
under
this
section.
30
c.
There
is
not
enough
time
to
file
a
petition
and
to
hold
31
a
hearing
as
provided
in
section
232.98.
32
Sec.
27.
Section
232.79,
subsection
5,
Code
2025,
is
amended
33
to
read
as
follows:
34
5.
When
there
has
been
an
emergency
removal
or
keeping
of
a
35
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child
without
a
court
order,
a
physical
examination
assessment
1
of
the
child
by
a
licensed
medical
practitioner
shall
be
2
performed
within
twenty-four
hours
of
such
the
emergency
3
removal
or
keeping
of
a
child
,
unless
the
child
is
returned
4
to
the
child’s
home
within
twenty-four
hours
of
the
emergency
5
removal
or
keeping
of
a
child
.
6
Sec.
28.
Section
232.83,
subsection
2,
Code
2025,
is
amended
7
to
read
as
follows:
8
2.
Anyone
authorized
to
conduct
a
preliminary
investigation
9
in
response
to
a
complaint
may
apply
for,
or
the
court
on
its
10
own
motion
may
enter,
an
ex
parte
order
authorizing
a
physician
11
or
physician
assistant
or
hospital
to
conduct
an
inpatient
or
12
outpatient
physical
examination
or
authorizing
a
physician
or
13
physician
assistant,
a
psychologist
certified
under
section
14
154B.7
,
or
a
community
mental
health
center
accredited
pursuant
15
to
chapter
230A
to
conduct
an
outpatient
mental
examination
16
of
a
child
if
necessary
to
identify
the
nature,
extent,
and
17
causes
of
any
injuries,
emotional
damage,
or
other
such
needs
18
of
a
child
as
specified
in
section
232.96A,
subsection
3,
5,
or
19
6
,
assessment
or
an
inpatient
or
outpatient
behavioral
health
20
evaluation
provided
that
all
of
the
following
apply:
21
a.
Any
of
the
following
circumstances
exist:
22
(1)
The
parent,
guardian,
or
custodian
consents
to
the
23
physical
assessment
or
the
behavioral
health
evaluation.
24
(2)
The
parent,
guardian,
or
legal
custodian
is
absent
,
or
.
25
(3)
The
parent,
guardian,
or
custodian,
though
present,
26
was
asked
and
refused
to
authorize
the
examination
physical
27
assessment
or
the
behavioral
health
evaluation
.
28
b.
There
is
not
enough
time
to
file
a
petition
and
hold
a
29
hearing
under
this
chapter.
30
c.
The
parent,
guardian,
or
legal
custodian
has
not
provided
31
care
and
treatment
related
to
their
the
child’s
alleged
32
victimization.
33
Sec.
29.
Section
232.98,
Code
2025,
is
amended
to
read
as
34
follows:
35
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232.98
Physical
and
mental
examinations
assessments
and
1
behavioral
health
evaluations
——
child
in
need
of
assistance
.
2
1.
a.
Except
as
provided
in
section
232.78,
subsection
5
,
3
a
physical
assessment
or
mental
examination
behavioral
health
4
evaluation
of
the
a
child
may
be
ordered
only
after
the
filing
5
of
a
petition
pursuant
to
section
232.87
,
and
after
a
hearing
6
to
determine
whether
an
examination
a
physical
assessment
7
or
behavioral
health
evaluation
is
necessary
to
determine
8
the
child’s
physical
condition
or
mental
if
the
child
has
a
9
behavioral
health
condition.
10
b.
The
court
may
consider
chemical
dependency
as
either
11
a
physical
or
mental
behavioral
health
condition
and
may
12
consider
a
chemical
dependency
evaluation
as
either
a
physical
13
assessment
or
mental
examination
behavioral
health
evaluation
.
14
a.
c.
The
hearing
required
by
this
section
may
be
held
15
simultaneously
with
the
adjudicatory
hearing.
16
b.
d.
An
examination
A
physical
assessment
or
a
behavioral
17
health
evaluation
ordered
prior
to
the
adjudication
shall
18
be
conducted
on
an
outpatient
basis
when
possible
,
but
.
19
However,
if
deemed
necessary
by
the
court,
the
court
may
20
commit
order
the
child
to
a
suitable
nonsecure
hospital,
21
facility,
or
institution
for
the
purpose
of
examination
an
22
inpatient
physical
assessment
or
an
inpatient
behavioral
health
23
evaluation
for
a
period
not
to
exceed
fifteen
thirty
days
if
24
all
of
the
following
are
found
to
be
present
circumstances
25
exist
:
26
(1)
Probable
cause
exists
to
believe
that
the
child
is
27
a
child
in
need
of
assistance
pursuant
to
section
232.96A,
28
subsection
5
or
6
.
29
(2)
Commitment
An
inpatient
physical
assessment
or
30
inpatient
behavioral
health
evaluation
is
necessary
to
31
determine
whether
there
is
clear
and
convincing
evidence
that
32
the
child
is
a
child
in
need
of
assistance.
33
(3)
The
child’s
attorney
agrees
to
the
commitment
an
34
inpatient
physical
assessment
or
inpatient
behavioral
health
35
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evaluation
.
1
c.
e.
An
examination
A
physical
assessment
or
a
behavioral
2
health
evaluation
ordered
after
the
adjudication
shall
3
be
conducted
on
an
outpatient
basis
when
possible
,
but
.
4
However,
if
deemed
necessary
by
the
court,
the
court
may
5
commit
order
the
child
to
a
suitable
nonsecure
hospital,
6
facility,
or
institution
for
the
purpose
of
examination
an
7
inpatient
physical
assessment
or
an
inpatient
behavioral
health
8
evaluation
for
a
period
not
to
exceed
thirty
days.
9
d.
f.
The
child’s
parent,
guardian,
or
custodian
shall
10
be
included
in
counseling
sessions
offered
during
the
child’s
11
stay
in
a
hospital,
facility,
or
institution
when
feasible,
and
12
when
in
the
best
interests
of
the
child
and
the
child’s
parent,
13
guardian,
or
custodian.
If
separate
counseling
sessions
are
14
conducted
for
the
child
and
the
child’s
parent,
guardian,
or
15
custodian,
a
joint
counseling
session
shall
be
offered
prior
16
to
the
release
of
the
child
from
the
hospital,
facility,
or
17
institution.
The
court
shall
require
that
notice
be
provided
18
to
the
child’s
guardian
ad
litem
of
the
counseling
sessions
,
19
and
of
the
counseling
session
participants
,
and
results
the
20
outcomes
of
the
counseling
sessions.
21
2.
Following
an
adjudication
that
a
child
is
a
child
in
22
need
of
assistance,
the
court
may
,
after
a
hearing
,
order
the
23
a
physical
assessment
or
mental
examination
behavioral
health
24
evaluation
of
the
child’s
parent,
guardian,
or
custodian
if
25
that
person’s
ability
to
care
for
the
child
is
at
issue.
26
Sec.
30.
Section
232.102,
subsection
5,
Code
2025,
is
27
amended
to
read
as
follows:
28
5.
a.
The
child
shall
not
be
placed
in
the
state
training
29
school.
30
b.
(1)
Paragraph
“a”
shall
not
preclude
the
department’s
31
use
of
the
facilities
of
the
state
training
school
for
the
32
purposes
of
conducting
a
physical
assessment,
a
behavioral
33
health
evaluation,
or
both,
as
described
in
section
232.98,
of
34
a
male
child
for
a
period
not
to
exceed
thirty
days.
Such
use
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of
the
facilities
of
the
state
training
school
shall
be
subject
1
to
the
director’s
authorization
and
approval
for
any
request
to
2
obtain
a
court
order
for
these
purposes.
Following
review
of
3
the
authorized
and
approved
departmental
request,
the
court
may
4
order
such
use
of
the
facilities
of
the
state
training
school.
5
(2)
A
male
child
temporarily
located
at
the
state
training
6
school
pursuant
to
subparagraph
(1)
shall
at
all
times
be
7
separated
from
children
adjudicated
to
have
committed
a
8
delinquent
act
who
are
placed
at
the
state
training
school.
9
(3)
The
department
shall
adopt
rules
pursuant
to
chapter
17A
10
to
administer
this
paragraph.
11
Sec.
31.
Section
232.127,
subsection
7,
Code
2025,
is
12
amended
to
read
as
follows:
13
7.
a.
The
court
may
not
order
the
child
placed
on
14
probation,
in
a
foster
home
or
in
a
nonsecure
facility
unless
15
the
child
requests
and
agrees
to
such
supervision
or
placement.
16
In
no
event
shall
the
17
b.
The
court
shall
not
order
the
child
placed
in
a
secure
18
facility
or
in
the
state
training
school
or
other
secure
19
facility
.
20
c.
(1)
Paragraph
“b”
shall
not
preclude
the
department’s
21
use
of
the
facilities
of
the
state
training
school
for
the
22
purposes
of
conducting
a
physical
assessment,
a
behavioral
23
health
evaluation,
or
both,
as
described
in
section
232.98,
of
24
a
male
child
for
a
period
not
to
exceed
thirty
days.
Such
use
25
of
the
facilities
of
the
state
training
school
shall
be
subject
26
to
the
director’s
authorization
and
approval
for
any
request
to
27
obtain
a
court
order
for
these
purposes.
Following
review
of
28
the
authorized
and
approved
departmental
request,
the
court
may
29
order
such
use
of
the
facilities
of
the
state
training
school.
30
(2)
A
male
child
temporarily
located
at
the
state
training
31
school
pursuant
to
subparagraph
(1)
shall
at
all
times
be
32
separated
from
children
adjudicated
to
have
committed
a
33
delinquent
act
who
are
placed
at
the
state
training
school.
34
(3)
The
department
shall
adopt
rules
pursuant
to
chapter
17A
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to
administer
this
paragraph.
1
Sec.
32.
Section
232.141,
subsection
1,
Code
2025,
is
2
amended
to
read
as
follows:
3
1.
Except
as
otherwise
provided
by
law,
the
court
shall
4
inquire
into
the
ability
of
the
child
or
the
child’s
parent
5
to
pay
expenses
incurred
pursuant
to
subsections
2,
4,
and
6
8
.
After
giving
the
parent
a
reasonable
opportunity
to
be
7
heard,
the
court
may
order
the
parent
to
pay
all
or
part
of
the
8
costs
of
the
child’s
care,
examination
physical
assessment,
9
behavioral
health
evaluation
,
treatment,
legal
expenses,
or
10
other
expenses.
An
order
entered
under
this
section
does
not
11
obligate
a
parent
paying
child
support
under
a
custody
decree,
12
except
that
part
of
the
monthly
support
payment
may
be
used
to
13
satisfy
the
obligations
imposed
by
the
order
entered
pursuant
14
to
this
section
.
If
a
parent
fails
to
pay
as
ordered,
without
15
good
reason,
the
court
may
proceed
against
the
parent
for
16
contempt
and
may
inform
the
county
attorney
who
shall
proceed
17
against
the
parent
to
collect
the
unpaid
amount.
Any
payment
18
ordered
by
the
court
shall
be
a
judgment
against
each
of
the
19
child’s
parents
and
a
lien
as
provided
in
section
624.23
.
If
20
all
or
part
of
the
amount
that
the
parents
are
ordered
to
pay
is
21
subsequently
paid
by
the
county
or
state,
the
judgment
and
lien
22
shall
thereafter
be
against
each
of
the
parents
in
favor
of
the
23
county
to
the
extent
of
the
county’s
payments
and
in
favor
of
24
the
state
to
the
extent
of
the
state’s
payments.
25
Sec.
33.
Section
232.141,
subsection
4,
paragraph
b,
Code
26
2025,
is
amended
to
read
as
follows:
27
b.
Expenses
for
mental
or
physical
examinations
assessments
28
or
behavioral
health
evaluations
of
a
child
if
ordered
by
the
29
court.
30
Sec.
34.
Section
232.141,
subsection
6,
Code
2025,
is
31
amended
to
read
as
follows:
32
6.
If
a
child
is
given
A
physical
or
mental
examinations
33
assessment,
behavioral
health
evaluation,
or
any
treatment
34
relating
to
an
assessment
performed
pursuant
to
section
35
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232.71B
,
shall
be
paid
by
the
state
if
physical
assessment,
1
behavioral
health
evaluation,
or
other
treatment
was
performed
2
with
the
consent
of
the
child’s
parent,
guardian,
or
legal
3
custodian
and
no
other
provision
of
law
otherwise
requires
4
payment
for
the
costs
of
the
examination
and
treatment,
the
5
costs
shall
be
paid
by
the
state
.
Reimbursement
for
The
6
department
shall
reimburse
costs
of
services
described
in
under
7
this
subsection
is
subject
to
in
accordance
with
subsection
5
.
8
Sec.
35.
Section
237.1,
Code
2025,
is
amended
by
adding
the
9
following
new
subsection:
10
NEW
SUBSECTION
.
8A.
“Protective
locked
environment”
means
a
11
setting
that
prevents
egress
from
a
building
or
grounds
as
a
12
protective
measure
to
ensure
safety
and
security.
13
Sec.
36.
Section
237.3,
Code
2025,
is
amended
by
adding
the
14
following
new
subsection:
15
NEW
SUBSECTION
.
13.
The
department
shall
adopt
rules
16
pursuant
to
chapter
17A
relating
to
the
application
of
a
17
protective
locked
environment
to
child
foster
care
licensees.
18
Sec.
37.
Section
237.4,
Code
2025,
is
amended
by
adding
the
19
following
new
subsection:
20
NEW
SUBSECTION
.
9.
A
psychiatric
medical
institution
for
21
children
licensed
under
chapter
135H.
22
Sec.
38.
Section
237C.1,
Code
2025,
is
amended
by
adding
the
23
following
new
subsection:
24
NEW
SUBSECTION
.
5.
“Protective
locked
environment”
means
a
25
setting
that
prevents
egress
from
a
building
or
grounds
as
a
26
protective
measure
to
ensure
safety
and
security.
27
Sec.
39.
Section
237C.4,
Code
2025,
is
amended
by
adding
the
28
following
new
subsection:
29
NEW
SUBSECTION
.
6A.
Rules
governing
the
application
of
30
a
protective
locked
environment
to
a
children’s
residential
31
facility
shall
be
adopted
by
the
department.
32
Sec.
40.
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
——
33
DEPARTMENT
OF
INSPECTIONS,
APPEALS,
AND
LICENSING
——
34
ADMINISTRATIVE
RULES.
35
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1.
The
department
of
health
and
human
services
and
the
1
department
of
inspections,
appeals,
and
licensing
shall
each
2
adopt
rules
pursuant
to
chapter
17A
to
administer
this
division
3
of
this
Act.
The
departments
shall
coordinate
in
developing
4
their
respective
rules
to
provide
continuity
for,
and
maximize
5
utilization
of
the
array
of
behavioral
health
services
6
available
by,
affected
individuals.
7
2.
a.
The
department
of
health
and
human
services
and
8
the
department
of
inspections,
appeals,
and
licensing
shall
9
review
applicable
existing
rules
and
shall
each
adopt
rules
10
pursuant
to
chapter
17A
to
provide
for
the
following
relative
11
to
facilities
licensed
or
certified
under
chapters
135H,
237,
12
and
237C:
13
(1)
Consistency
to
the
greatest
extent
possible
regarding
14
the
use
of
restraints
and
seclusion
across
these
facilities.
15
(2)
Adaptation
in
application
of
licensing
and
16
certification
requirements
to
provide
for
the
unmet
residential
17
care
needs
of
affected
individuals.
18
b.
In
reviewing
and
adopting
the
rules,
the
departments
19
shall
consider
the
nature
of
the
services
and
programming
20
provided
by
the
specific
type
of
facility
and
applicable
21
federal
requirements,
including
those
for
psychiatric
22
residential
treatment
facilities
as
described
in
42
C.F.R.
23
§483.352.
24
3.
The
department
of
health
and
human
services
shall
adopt
25
rules
pursuant
to
chapter
17A
relating
to
the
application
of
26
a
protective
locked
environment
to
detention
and
shelter
care
27
as
defined
in
section
232.2.
For
purposes
of
this
subsection,
28
“protective
locked
environment”
means
a
setting
that
prevents
29
egress
from
a
building
or
grounds
as
a
protective
measure
to
30
ensure
safety
and
security.
31
Sec.
41.
REPEAL.
2024
Iowa
Acts,
chapter
1161,
sections
97
32
and
98,
are
repealed.
33
DIVISION
II
34
HOME
AND
COMMUNITY-BASED
SERVICES
——
HABILITATION
SERVICES
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PROVIDED
BY
A
RESIDENTIAL
PROGRAM
——
EXCLUSION
FROM
CHILDREN’S
1
RESIDENTIAL
FACILITY
DEFINITION
2
Sec.
42.
Section
237C.1,
subsection
2,
Code
2025,
is
amended
3
by
adding
the
following
new
paragraph:
4
NEW
PARAGRAPH
.
j.
Care
furnished
to
persons
sixteen
5
years
of
age
and
older
by
a
residential
program
to
which
the
6
department
applies
accreditation,
certification,
or
standards
7
of
review
under
the
provisions
of
a
federally
approved
medical
8
assistance
home
and
community-based
services
waiver,
or
other
9
provision
of
the
medical
assistance
program.
10
DIVISION
III
11
DIRECTOR
OF
JUVENILE
COURT
SERVICES
——
CHIEF
JUVENILE
COURT
12
OFFICERS
13
Sec.
43.
Section
602.1101,
Code
2025,
is
amended
by
adding
14
the
following
new
subsection:
15
NEW
SUBSECTION
.
5A.
“Director
of
juvenile
court
services”
16
means
the
same
as
defined
in
the
Iowa
court
rules
of
juvenile
17
court
services
directed
programs
and
includes
the
deputy
18
director
of
juvenile
court
services.
19
Sec.
44.
Section
602.1217,
Code
2025,
is
amended
to
read
as
20
follows:
21
602.1217
Chief
juvenile
court
officer.
22
1.
The
chief
judge
of
director
of
juvenile
court
services
23
shall
appoint
a
chief
juvenile
court
officer
for
each
judicial
24
district
,
after
consultation
with
the
judges
of
the
judicial
25
district,
shall
appoint
a
chief
juvenile
court
officer
and
may
26
remove
the
a
chief
juvenile
court
officer
for
cause.
27
2.
The
chief
juvenile
court
officer
is
subject
to
the
28
immediate
supervision
and
direction
of
the
chief
judge
of
the
29
judicial
district
director
of
juvenile
court
services
.
30
3.
The
chief
juvenile
court
officer,
in
addition
to
31
performing
the
duties
of
a
juvenile
court
officer,
shall
32
supervise
juvenile
court
officers
and
administer
juvenile
court
33
services
within
the
judicial
district
in
a
uniform
manner,
34
under
the
supervision
and
direction
of
the
director
of
juvenile
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court
services,
in
accordance
with
law
and
with
the
rules,
1
directives,
and
procedures
of
the
judicial
branch
and
the
2
judicial
district.
3
4.
The
chief
juvenile
court
officer
shall
assist
the
state
4
court
administrator
and
the
district
court
administrator
5
director
of
juvenile
court
services
in
implementing
the
rules,
6
directives,
and
procedures
of
the
judicial
branch
and
the
7
judicial
district.
8
5.
A
chief
juvenile
court
officer
shall
have
other
duties
9
as
prescribed
by
the
supreme
court
or
by
the
chief
judge
of
the
10
judicial
district
director
of
juvenile
court
services
.
11
Sec.
45.
Section
602.7201,
subsections
2
and
3,
Code
2025,
12
are
amended
to
read
as
follows:
13
2.
The
juvenile
court
officers
and
other
personnel
14
employed
in
juvenile
court
service
offices
are
subject
to
15
the
supervision
of
the
chief
juvenile
court
officer.
The
16
chief
juvenile
court
officer
is
subject
to
the
supervision
and
17
direction
of
the
director
of
juvenile
court
services.
18
3.
The
chief
juvenile
court
officer
may
employ,
shall
19
supervise,
and
may
remove
for
cause
with
due
process
20
secretarial,
clerical,
and
other
staff
within
juvenile
court
21
service
offices
as
authorized
by
the
chief
judge
director
of
22
juvenile
court
services
.
23
Sec.
46.
Section
602.7202,
subsections
1
and
3,
Code
2025,
24
are
amended
to
read
as
follows:
25
1.
Subject
to
the
approval
of
the
chief
judge
of
the
26
judicial
district
director
of
juvenile
court
services
,
the
27
chief
juvenile
court
officer
shall
appoint
juvenile
court
28
officers
to
serve
the
juvenile
court.
Juvenile
court
officers
29
may
be
required
to
serve
in
two
or
more
counties
within
the
30
judicial
district.
31
3.
Juvenile
court
officers
shall
have
the
duties
prescribed
32
in
chapter
232
,
subject
to
the
direction
of
the
judges
of
the
33
juvenile
court
director
of
juvenile
court
services
.
A
judge
34
of
the
juvenile
court
shall
not
attempt
to
direct
or
influence
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a
juvenile
court
officer
in
the
performance
of
the
officer’s
1
duties.
2
DIVISION
IV
3
HAWKI
ELIGIBILITY
——
PUBLIC
INSTITUTION
INMATES
4
Sec.
47.
Section
514I.8,
subsection
2,
paragraph
g,
Code
5
2025,
is
amended
to
read
as
follows:
6
g.
Is
not
an
inmate
of
a
public
institution
or
a
patient
in
7
an
institution
for
mental
diseases.
8
Sec.
48.
NEW
SECTION
.
514I.8B
Inmates
of
public
9
institutions
——
suspension
of
medical
assistance.
10
1.
Following
the
first
thirty
days
of
commitment,
the
11
department
shall
suspend,
but
not
terminate,
the
eligibility
of
12
an
eligible
child
who
is
an
inmate
of
a
public
institution
as
13
defined
in
42
C.F.R.
§435.1010,
who
is
enrolled
in
the
medical
14
assistance
program
under
this
chapter
at
the
time
of
commitment
15
to
the
public
institution,
and
who
remains
eligible
for
medical
16
assistance
under
this
chapter
except
for
the
eligible
child’s
17
institutional
status,
during
the
entire
period
of
the
eligible
18
child’s
commitment
to
the
public
institution.
19
2.
To
the
extent
applicable,
the
public
institution
and
the
20
department
shall
comply
with
the
reporting
requirements
and
the
21
expediting
of
the
restoration
of
an
eligible
child’s
medical
22
assistance
benefits
under
this
chapter
upon
the
eligible
23
child’s
discharge,
consistent
with
section
249A.38.
24
3.
The
department
shall
adopt
rules
pursuant
to
chapter
17A
25
to
administer
this
section.
26
DIVISION
V
27
CORRECTIVE
CHANGES
28
Sec.
49.
Section
125.13,
subsection
2,
paragraphs
a,
i,
and
29
j,
Code
2025,
are
amended
to
read
as
follows:
30
a.
A
hospital
providing
care
or
treatment
to
persons
with
31
a
substance
use
disorder
licensed
under
chapter
135B
which
is
32
accredited
by
the
joint
commission
on
the
accreditation
of
33
health
care
organizations
,
the
commission
on
accreditation
34
of
rehabilitation
facilities,
the
American
osteopathic
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association,
or
another
recognized
organization
approved
by
1
the
department.
All
survey
reports
from
the
accrediting
or
2
licensing
body
must
be
sent
to
the
department.
3
i.
A
substance
use
disorder
treatment
program
not
funded
4
by
the
department
which
is
accredited
or
licensed
by
the
joint
5
commission
on
the
accreditation
of
health
care
organizations
,
6
the
commission
on
the
accreditation
of
rehabilitation
7
facilities,
the
American
osteopathic
association,
or
another
8
recognized
organization
approved
by
the
department.
All
survey
9
reports
from
the
accrediting
or
licensing
body
must
be
sent
to
10
the
department.
11
j.
A
hospital
substance
use
disorder
treatment
program
12
that
is
accredited
or
licensed
by
the
joint
commission
on
the
13
accreditation
of
health
care
organizations
,
the
commission
on
14
the
accreditation
of
rehabilitation
facilities,
the
American
15
osteopathic
association,
or
another
recognized
organization
16
approved
by
the
department.
All
survey
reports
for
the
17
hospital
substance
use
disorder
treatment
program
from
the
18
accrediting
or
licensing
body
shall
be
sent
to
the
department.
19
Sec.
50.
Section
125.43A,
Code
2025,
is
amended
to
read
as
20
follows:
21
125.43A
Prescreening
——
exception.
22
Except
in
cases
of
medical
emergency
or
court-ordered
23
admissions,
a
person
shall
be
admitted
to
a
state
mental
24
health
institute
for
treatment
of
a
substance
use
disorder
25
only
after
a
preliminary
intake
and
assessment
by
a
26
department-licensed
treatment
facility
or
a
hospital
providing
27
care
or
treatment
for
persons
with
a
substance
use
disorder
28
licensed
under
chapter
135B
and
accredited
by
the
joint
29
commission
on
the
accreditation
of
health
care
organizations
,
30
the
commission
on
accreditation
of
rehabilitation
facilities,
31
the
American
osteopathic
association,
or
another
recognized
32
organization
approved
by
the
department,
or
by
a
designee
of
33
a
department-licensed
treatment
facility
or
a
hospital
other
34
than
a
state
mental
health
institute,
which
confirms
that
the
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admission
is
appropriate
to
the
person’s
substance
use
disorder
1
service
needs.
A
county
board
of
supervisors
may
seek
an
2
admission
of
a
patient
to
a
state
mental
health
institute
who
3
has
not
been
confirmed
for
appropriate
admission
and
the
county
4
shall
be
responsible
for
one
hundred
percent
of
the
cost
of
5
treatment
and
services
of
the
patient.
6
Sec.
51.
Section
135B.12,
Code
2025,
is
amended
to
read
as
7
follows:
8
135B.12
Confidentiality.
9
The
department’s
final
findings
or
the
final
survey
findings
10
of
the
joint
commission
on
the
accreditation
of
health
care
11
organizations
or
the
American
osteopathic
association
with
12
respect
to
compliance
by
a
hospital
or
rural
emergency
hospital
13
with
requirements
for
licensing
or
accreditation
shall
be
made
14
available
to
the
public
in
a
readily
available
form
and
place.
15
Other
information
relating
to
a
hospital
or
rural
emergency
16
hospital
obtained
by
the
department
which
does
not
constitute
17
the
department’s
findings
from
an
inspection
of
the
hospital
18
or
rural
emergency
hospital
or
the
final
survey
findings
of
19
the
joint
commission
on
the
accreditation
of
health
care
20
organizations
or
the
American
osteopathic
association
shall
21
not
be
made
available
to
the
public,
except
in
proceedings
22
involving
the
denial,
suspension,
or
revocation
of
a
license
23
under
this
chapter
.
The
name
of
a
person
who
files
a
complaint
24
with
the
department
shall
remain
confidential
and
shall
not
25
be
subject
to
discovery,
subpoena,
or
other
means
of
legal
26
compulsion
for
its
release
to
a
person
other
than
department
27
employees
or
agents
involved
in
the
investigation
of
the
28
complaint.
29
Sec.
52.
Section
135B.20,
subsection
4,
Code
2025,
is
30
amended
to
read
as
follows:
31
4.
“Joint
conference
committee”
shall
mean
the
joint
32
conference
committee
as
required
by
the
joint
commission
on
33
accreditation
of
health
care
organizations
or,
in
a
hospital
34
having
no
such
committee,
a
similar
committee,
an
equal
number
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of
which
shall
be
members
of
the
medical
staff
selected
by
the
1
staff
and
an
equal
number
of
which
shall
be
selected
by
the
2
governing
board
of
the
hospital.
3
Sec.
53.
Section
135C.2,
subsection
7,
Code
2025,
is
amended
4
to
read
as
follows:
5
7.
The
rules
adopted
by
the
department
regarding
nursing
6
facilities
shall
provide
that
a
nursing
facility
may
choose
7
to
be
inspected
either
by
the
department
or
by
the
joint
8
commission
on
accreditation
of
health
care
organizations
.
9
The
rules
regarding
acceptance
of
inspection
by
the
joint
10
commission
on
accreditation
of
health
care
organizations
shall
11
include
recognition,
in
lieu
of
inspection
by
the
department,
12
of
comparable
inspections
and
inspection
findings
of
the
joint
13
commission
on
accreditation
of
health
care
organizations
,
14
if
the
department
is
provided
with
copies
of
all
requested
15
materials
relating
to
the
inspection
process.
16
Sec.
54.
Section
135C.6,
subsection
10,
Code
2025,
is
17
amended
to
read
as
follows:
18
10.
Notwithstanding
section
135C.9
,
nursing
facilities
19
which
are
accredited
by
the
joint
commission
on
accreditation
20
of
health
care
organizations
shall
be
licensed
without
21
inspection
by
the
department,
if
the
nursing
facility
has
22
chosen
to
be
inspected
by
the
joint
commission
on
accreditation
23
of
health
care
organizations
in
lieu
of
inspection
by
the
24
department.
25
Sec.
55.
Section
135J.2,
subsection
2,
Code
2025,
is
amended
26
to
read
as
follows:
27
2.
The
hospice
program
shall
meet
the
criteria
pursuant
to
28
section
135J.3
before
a
license
is
issued.
The
department
is
29
responsible
to
provide
the
necessary
personnel
to
inspect
the
30
hospice
program,
the
home
care
and
inpatient
care
provided
and
31
the
hospital
or
facility
used
by
the
hospice
to
determine
if
32
the
hospice
complies
with
necessary
standards
before
a
license
33
is
issued.
Hospices
that
are
certified
as
Medicare
hospice
34
providers
by
the
department
,
or
are
accredited
as
hospices
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by
the
joint
commission
on
the
accreditation
of
health
care
1
organizations
,
shall
be
licensed
without
inspection
by
the
2
department.
3
Sec.
56.
Section
144F.5,
subsection
1,
Code
2025,
is
amended
4
to
read
as
follows:
5
1.
The
standards
for
accreditation
adopted
by
the
joint
6
commission
on
the
accreditation
of
health
care
organizations
7
or
any
other
nationally
recognized
hospital
accreditation
8
organization.
9
Sec.
57.
Section
155A.13,
subsection
4,
paragraph
a,
10
subparagraph
(4),
Code
2025,
is
amended
to
read
as
follows:
11
(4)
Give
recognition
to
the
standards
of
the
joint
12
commission
on
the
accreditation
of
health
care
organizations
13
and
the
American
osteopathic
association
,
and
to
the
conditions
14
of
participation
under
Medicare.
15
Sec.
58.
Section
232.2,
subsection
4,
paragraph
i,
Code
16
2025,
is
amended
to
read
as
follows:
17
i.
If
reasonable
efforts
to
place
a
child
for
adoption
or
18
with
a
guardian
are
made
concurrently
with
reasonable
efforts
19
as
defined
in
section
232.102
232.102A
,
the
concurrent
goals
20
and
timelines
may
be
identified.
Concurrent
case
permanency
21
plan
goals
for
reunification,
and
for
adoption
or
for
other
22
permanent
out-of-home
placement
of
a
child
shall
not
be
23
considered
inconsistent
in
that
the
goals
reflect
divergent
24
possible
outcomes
for
a
child
in
an
out-of-home
placement.
25
Sec.
59.
Section
232.36,
subsection
3,
paragraph
b,
26
subparagraph
(3),
Code
2025,
is
amended
to
read
as
follows:
27
(3)
Legal
custodian
Custodian
of
the
child.
28
Sec.
60.
Section
232.37,
subsection
2,
Code
2025,
is
amended
29
to
read
as
follows:
30
2.
Notice
of
the
pendency
of
the
case
shall
be
served
upon
31
the
known
parents,
guardians,
or
legal
custodians
of
a
child
32
if
these
persons
are
not
summoned
to
appear
as
provided
in
33
subsection
1
.
Notice
shall
also
be
served
upon
the
child
and
34
upon
the
child’s
guardian
ad
litem,
if
any.
The
notice
shall
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attach
a
copy
of
the
petition
and
shall
give
notification
of
1
the
right
to
counsel
provided
for
in
section
232.11
.
2
Sec.
61.
Section
232.101A,
subsection
1,
paragraph
c,
Code
3
2025,
is
amended
to
read
as
follows:
4
c.
The
parent
of
the
child
does
not
appear
at
the
5
dispositional
hearing,
or
the
parent
appears
at
the
6
dispositional
hearing,
does
not
object
to
the
transfer
of
7
guardianship,
and
agrees
to
waive
the
requirement
for
making
8
reasonable
efforts
as
defined
in
section
232.102
232.102A
.
9
Sec.
62.
Section
232.102A,
subsection
3,
Code
2025,
is
10
amended
to
read
as
follows:
11
3.
The
performance
of
reasonable
efforts
to
place
a
child
12
for
adoption
or
with
a
guardian
may
be
made
concurrently
with
13
making
reasonable
efforts
as
defined
in
this
section
.
14
Sec.
63.
Section
232B.5,
subsection
19,
unnumbered
15
paragraph
1,
Code
2025,
is
amended
to
read
as
follows:
16
A
party
seeking
an
involuntary
foster
care
placement
of
17
or
termination
of
parental
rights
over
an
Indian
child
shall
18
provide
evidence
to
the
court
that
active
efforts
have
been
19
made
to
provide
remedial
services
and
rehabilitative
programs
20
designed
to
prevent
the
breakup
of
the
Indian
family
and
that
21
these
efforts
have
proved
unsuccessful.
The
court
shall
not
22
order
the
placement
or
termination,
unless
the
evidence
of
23
active
efforts
shows
there
has
been
a
vigorous
and
concerted
24
level
of
casework
beyond
the
level
that
typically
constitutes
25
reasonable
efforts
as
defined
in
sections
232.57
and
232.102
26
232.102A
.
Reasonable
efforts
shall
not
be
construed
to
be
27
active
efforts.
The
active
efforts
must
be
made
in
a
manner
28
that
takes
into
account
the
prevailing
social
and
cultural
29
values,
conditions,
and
way
of
life
of
the
Indian
child’s
30
tribe.
Active
efforts
shall
utilize
the
available
resources
31
of
the
Indian
child’s
extended
family,
tribe,
tribal
and
32
other
Indian
social
service
agencies,
and
individual
Indian
33
caregivers.
Active
efforts
shall
include
but
are
not
limited
34
to
all
of
the
following:
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Sec.
64.
Section
233.2,
subsection
5,
Code
2025,
is
amended
1
to
read
as
follows:
2
5.
Reasonable
efforts,
as
defined
in
section
232.102
3
232.102A
,
that
are
made
in
regard
to
the
newborn
infant
shall
4
be
limited
to
the
efforts
made
in
a
timely
manner
to
finalize
a
5
permanency
plan
for
the
newborn
infant.
6
Sec.
65.
Section
237.3,
subsection
7,
Code
2025,
is
amended
7
to
read
as
follows:
8
7.
If
an
agency
is
accredited
by
the
joint
commission
on
9
the
accreditation
of
health
care
organizations
under
the
joint
10
commission’s
consolidated
standards
for
residential
settings
11
or
by
the
council
on
accreditation
of
services
for
families
12
and
children
,
the
department
shall
modify
facility
licensure
13
standards
applied
to
the
agency
in
order
to
avoid
duplicating
14
standards
applied
through
accreditation.
15
EXPLANATION
16
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
17
the
explanation’s
substance
by
the
members
of
the
general
assembly.
18
This
bill
relates
to
services
and
support
for
youth
and
is
19
organized
by
divisions.
20
DIVISION
I
——
TREATMENT,
PHYSICAL
ASSESSMENTS,
AND
21
BEHAVIORAL
HEALTH
EVALUATIONS.
Under
current
law,
a
22
psychiatric
medical
institution
for
children
(PMIC)
is
an
23
institution
providing
more
than
24
hours
of
continuous
care
24
involving
long-term
psychiatric
services
to
3
or
more
children
25
in
residence
for
expected
periods
of
14
days
or
more
for
26
diagnosis
and
evaluation,
or
for
expected
periods
of
90
days
27
or
more
for
treatment.
28
The
bill
exempts
PMICs
from
licensing
requirements
for
29
maintaining
or
conducting
programs
with
the
primary
purpose
30
of
treating
and
rehabilitating
persons
with
a
substance
use
31
disorder.
32
The
bill
defines
“approved
qualifying
organization”
as
33
the
joint
commission,
the
commission
on
the
accreditation
of
34
rehabilitation
facilities,
the
council
on
accreditation,
or
a
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nationally
recognized
accrediting
organization
with
standards
1
comparable
to
the
joint
commission
and
commission
on
the
2
accreditation
of
rehabilitation
facilities
that
are
acceptable
3
under
federal
regulations.
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”
as
a
19
diagnosable
disorder
of
sufficient
duration
to
meet
diagnostic
20
criteria
specified
within
the
most
current
diagnostic
and
21
statistical
manual
of
mental
disorders
published
by
the
22
American
psychiatric
association
that
results
in
a
functional
23
impairment.
“Serious
emotional
disturbance”
does
not
include
a
24
substance
use
disorder
or
developmental
disorder
unless
such
25
disorder
co-occurs
with
such
diagnosable
mental,
behavioral,
26
or
emotional
disorder.
27
The
bill
defines
“substance
use
disorder”
as
a
diagnosable
28
substance
use
disorder
of
sufficient
duration
to
meet
29
diagnostic
criteria
specified
within
the
most
current
30
diagnostic
and
statistical
manual
of
mental
disorders
published
31
by
the
American
psychiatric
association
that
results
in
a
32
functional
impairment.
33
The
bill
defines
“youth”
as
a
person
who
is
less
than
21
34
years
of
age.
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The
bill
describes
the
nature
of
care
a
PMIC
must
offer
youth
1
with
a
serious
emotional
disturbance
(SED),
a
substance
use
2
disorder
(SUD),
or
both.
3
Under
current
law,
a
person
who
establishes
a
PMIC
must
4
also
hold
a
license
under
Code
chapter
237
(child
foster
5
care
facilities)
as
a
comprehensive
residential
facility
for
6
children,
or
hold
a
license
under
Code
chapter
125
(substance
7
use
disorders)
if
the
facility
provides
SUD
treatment.
The
8
bill
eliminates
the
requirement
that
a
PMIC
holds
either
9
of
these
additional
licenses,
and
instead
requires
that
an
10
applicant
for
a
PMIC
license
specify
whether
the
applicant
will
11
provide
SED
services,
SUD
services,
or
both.
A
PMIC
may
only
12
provide
services
for
which
it
is
licensed.
13
The
bill
eliminates
the
requirement
that
a
proposed
PMIC
be
14
under
the
direction
of
an
agency
which
has
previously
operated
15
a
facility
for
children
or
adolescents
and
meets
or
exceeds
16
requirements
for
licensure
as
a
comprehensive
residential
17
facility
for
children.
18
The
bill
requires
the
department
of
inspections,
appeals
19
and
licensing
(DIAL),
in
cooperation
with
the
department
of
20
health
and
human
services
(HHS),
to
adopt
rules
relating
to
the
21
application
of
a
protective
locked
environment
in
a
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.
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The
bill
defines
“behavioral
health
evaluation”
as
a
1
comprehensive
evaluation
of
a
person’s
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
child’s
body
by
a
licensed
physician.
9
The
bill
replaces
several
references
to
a
physical
or
mental
10
examination
with
references
to
a
physical
assessment
(PA)
or
11
behavioral
health
evaluation
(BHE)
and
replaces
references
to
a
12
person’s
abuse
of
alcohol
or
other
controlled
substances
with
13
references
to
the
person
having
a
behavioral
health
condition.
14
Under
current
law,
one
of
several
specific
circumstances
15
must
exist
before
a
juvenile
court
has
the
authority
to
enter
16
an
ex
parte
order
to
direct
a
peace
officer
or
a
juvenile
court
17
officer
to
take
custody
of
a
child
before
or
after
the
filing
18
of
a
petition
under
Code
chapter
232
(juvenile
justice).
The
19
bill
adds
the
circumstance
when
the
child’s
parent,
guardian,
20
or
legal
custodian
consents
to
the
removal
as
a
condition
that
21
would
permit
a
juvenile
court
to
enter
such
an
ex
parte
order.
22
The
bill
creates
similar
provisions
for
when
a
juvenile
court
23
may
enter
an
ex
parte
order
for
a
child
to
undergo
an
inpatient
24
PA
or
an
inpatient
BHE
and
when
a
person
authorized
to
conduct
25
a
preliminary
investigation
in
response
to
a
complaint
26
may
motion
to
ask
the
court
to
order
a
child
to
undergo
an
27
inpatient
PA
or
an
inpatient
BHE.
28
The
bill
authorizes
a
court,
after
a
dispositional
hearing,
29
to
order
a
male
child
in
a
child
in
need
of
assistance
(CINA)
30
proceeding
or
a
family
in
need
of
assistance
(FINA)
proceeding
31
to
receive
an
inpatient
PA,
an
inpatient
BHE,
or
both,
at
the
32
state
training
school
(STS).
A
request
for
the
use
of
the
STS
33
for
purposes
of
a
PA
or
BHE
must
be
approved
by
the
director
of
34
HHS.
A
child
ordered
to
the
STS
pursuant
to
a
CINA
proceeding
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or
a
FINA
proceeding
must
be
separated
at
all
times
from
1
children
placed
in
the
STS
pursuant
to
a
juvenile
delinquency
2
proceeding.
Under
current
law,
the
court
in
a
CINA
or
FINA
3
proceeding
is
prohibited
from
placing
a
child
in
the
STS
for
4
any
reason.
5
The
bill
exempts
a
PMIC
from
licensing
requirements
for
6
child
foster
care.
7
The
bill
defines
“protective
locked
environment”
as
a
8
setting
that
prevents
egress
from
a
building
or
grounds
as
a
9
protective
measure
to
ensure
safety
and
security.
The
bill
10
directs
HHS
and
DIAL
to
adopt
rules
relating
to
the
application
11
of
a
protective
locked
environment
to
child
foster
care
12
licensees.
13
The
bill
directs
HHS
and
DIAL
to
coordinate
in
developing
14
rules
related
to
this
division
of
the
bill.
The
bill
outlines
15
goals
and
considerations
each
department
must
take
into
account
16
while
adopting
such
rules.
17
The
bill
makes
conforming
changes
to
Code
chapters
135H
18
(psychiatric
medical
institutions
for
children)
and
232
19
(juvenile
justice).
The
bill
repeals
2024
Iowa
Acts,
chapter
20
1161,
sections
97
and
98.
21
DIVISION
II
——
HOME
AND
COMMUNITY-BASED
SERVICES
——
22
HABILITATION
SERVICES
PROVIDED
BY
A
RESIDENTIAL
PROGRAM
——
23
EXCLUSION
FROM
CHILDREN’S
RESIDENTIAL
FACILITY
DEFINITION.
The
24
bill
excludes
care
furnished
to
persons
16
years
of
age
or
25
older
by
certain
residential
programs
detailed
in
the
bill
from
26
the
definition
of
a
children’s
residential
facility.
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.
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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
child’s
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
child’s
12
suspension
of
Hawki
benefits
must
continue
for
the
duration
of
13
the
child’s
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
child’s
Hawki
benefits
upon
the
child’s
17
discharge
from
the
public
institution.
The
bill
requires
HHS
18
to
adopt
rules
to
administer
the
bill’s
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”.
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