135H.3 - NATURE OF CARE.
135H.3 NATURE OF CARE.
1. A psychiatric medical institution for children shall utilize a
team of professionals to direct an organized program of diagnostic
services, psychiatric services, nursing care, and rehabilitative
services to meet the needs of residents in accordance with a medical
care plan developed for each resident. Social and rehabilitative
services shall be provided under the direction of a qualified mental
health professional.
2. If a child is diagnosed with a biologically based mental
illness as defined in section 514C.22 and meets the medical
assistance program criteria for admission to a psychiatric medical
institution for children, the child shall be deemed to meet the
acuity criteria for medically necessary inpatient benefits under a
group policy, contract, or plan providing for third-party payment or
prepayment of health, medical, and surgical coverage benefits issued
by a carrier, as defined in section 513B.2, or by an organized
delivery system authorized under 1993 Iowa Acts, ch. 158, that is
subject to section 514C.22. Such medically necessary benefits shall
not be excluded or denied as care that is substantially custodial in
nature under section 514C.22, subsection 8, paragraph "b". &n;
Section History: Recent Form
89 Acts, ch 283, § 4; 2009 Acts, ch 179, §182