HF 722 (LSB 2690HV (1) 88)

HOUSE FILE 722

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO HF 619)

A BILL FOR

An Act relating to the voluntary or involuntary commitment or hospitalization of a person with a serious mental impairment or a substance-related disorder.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 125.33, Code 2019, is amended by adding the following new subsection:
   NEW SUBSECTION.  5A.  If a patient leaves a facility, with or against the advice of the administrator in charge of the facility, the facility shall provide the patient with a discharge report which shall include the patient’s name and address, all postdischarge appointments scheduled for the patient, and all information necessary for the patient’s postdischarge care.
    Sec. 2.  Section 125.74, Code 2019, is amended to read as follows:
   125.74  Preapplication screening assessment —— program.
   Prior to filing an application pursuant to section 125.75, the clerk of the district court or the clerk’s designee shall inform the interested person referred to in section 125.75 about the option of requesting a preapplication screening assessment through a preapplication screening assessment program, which may include a preapplication screening assessment delivered through telehealth, if available. The state court administrator shall prescribe practices and procedures for implementation of the preapplication screening assessment program.
    Sec. 3.  Section 125.85, Code 2019, is amended by adding the following new subsection:
   NEW SUBSECTION.  3A.  Prior to a respondent’s discharge from a facility or from treatment, the administrator of the facility shall provide a discharge report to the respondent which shall include the respondent’s name and address, all postdischarge appointments scheduled for the respondent, and all information necessary for the respondent’s postdischarge care.
    Sec. 4.  Section 125.89, subsection 1, Code 2019, is amended to read as follows:
   1.  If a court orders a respondent placed at a facility for evaluation and treatment under section 125.83 at a time when the respondent has been convicted of a public offense, or when there is pending against the respondent an unresolved formal charge of a public offense, and the respondent’s liberty has therefore been restricted in any manner, the findings of fact required by section 125.83 shall clearly so inform the administrator of the facility where the respondent is placed.  The court may order the facility to notify the appropriate law enforcement agency prior to the discharge or transfer of the respondent from the facility.
    Sec. 5.  Section 125.91, subsection 2, paragraphs a and b, Code 2019, are amended to read as follows:
   a.  A peace officer who has reasonable grounds to believe that the circumstances described in subsection 1 are applicable may, without a warrant, take or cause that person to be taken to the nearest available facility referred to in section 125.81, subsection 2, paragraph “b” or “c”. Such a person with a substance-related disorder due to intoxication or substance-induced incapacitation who also demonstrates a significant degree of distress or dysfunction may also be delivered to a facility by someone other than a peace officer upon a showing of reasonable grounds. Upon delivery of the person to a facility under this section, the attending physician and surgeon or osteopathic physician and surgeon may order treatment of the person, but only to the extent necessary to preserve the person’s life or to appropriately control the person’s behavior if the behavior is likely to result in physical injury to the person or others if allowed to continue. The peace officer or other person who delivered the person to the facility shall describe the circumstances of the matter to the attending physician and surgeon or osteopathic physician and surgeon. If the person is a peace officer, the peace officer may do so either in person or by written report. If the attending physician and surgeon or osteopathic physician and surgeon has reasonable grounds to believe that the circumstances in subsection 1 are applicable, the attending physician shall at once communicate with the nearest available magistrate as defined in section 801.4, subsection 10. The magistrate shall, based upon the circumstances described by the attending physician and surgeon or osteopathic physician and surgeon, give the attending physician and surgeon or osteopathic physician and surgeon oral instructions either directing that the person be released forthwith, or authorizing the person’s detention in an appropriate facility.  A peace officer from the law enforcement agency that took the person into custody, if available, during the communication with the magistrate, may inform the magistrate that an arrest warrant has been issued for or charges are pending against the person and request that any oral or written order issued under this subsection require the facility to notify the law enforcement agency about the discharge or transfer of the person prior to the discharge or transfer. The magistrate may also give oral instructions and order that the detained person be transported to an appropriate facility.
   b.  If the magistrate orders that the person be detained, the magistrate shall, by the close of business on the next working day, file a written order with the clerk in the county where it is anticipated that an application may be filed under section 125.75. The order may be filed by facsimile if necessary.  A peace officer from the law enforcement agency that took the person into custody, if no request was made under paragraph “a”, may inform the magistrate that an arrest warrant has been issued for or charges are pending against the person and request that any written order issued under this paragraph require the facility to notify the law enforcement agency about the discharge or transfer of the person prior to the discharge or transfer. The order shall state the circumstances under which the person was taken into custody or otherwise brought to a facility and the grounds supporting the finding of probable cause to believe that the person is a person with a substance-related disorder likely to result in physical injury to the person or others if not detained.  The order shall also include any law enforcement agency notification requirements if applicable. The order shall confirm the oral order authorizing the person’s detention including any order given to transport the person to an appropriate facility.  A peace officer from the law enforcement agency that took the person into custody may also request an order, separate from the written order, requiring the facility to notify the law enforcement agency about the discharge or transfer of the person prior to the discharge or transfer. The clerk shall provide a copy of that order to the attending physician and surgeon or osteopathic physician and surgeon at the facility to which the person was originally taken, any subsequent facility to which the person was transported, and to any law enforcement department or ambulance service that transported the person pursuant to the magistrate’s order.
    Sec. 6.  Section 125.91, subsection 3, Code 2019, is amended to read as follows:
   3.  The attending physician and surgeon or osteopathic physician and surgeon shall examine and may detain the person pursuant to the magistrate’s order for a period not to exceed forty-eight seventy-two hours from the time the order is dated, excluding Saturdays, Sundays, and holidays, unless the order is dismissed by a magistrate. The facility may provide treatment which is necessary to preserve the person’s life or to appropriately control the person’s behavior if the behavior is likely to result in physical injury to the person or others if allowed to continue or is otherwise deemed medically necessary by the attending physician and surgeon or osteopathic physician and surgeon or mental health professional, but shall not otherwise provide treatment to the person without the person’s consent. The person shall be discharged from the facility and released from detention no later than the expiration of the forty-eight-hour seventy-two-hour period, unless an application for involuntary commitment is filed with the clerk pursuant to section 125.75. The detention of a person by the procedure in this section, and not in excess of the period of time prescribed by this section, shall not render the peace officer, attending physician and surgeon or osteopathic physician and surgeon, or facility detaining the person liable in a criminal or civil action for false arrest or false imprisonment if the peace officer, attending physician and surgeon or osteopathic physician and surgeon, mental health professional, or facility had reasonable grounds to believe that the circumstances described in subsection 1 were applicable.
    Sec. 7.  Section 229.3, Code 2019, is amended to read as follows:
   229.3  Discharge of voluntary patients.
   1.  Any voluntary patient who has recovered, or whose hospitalization the chief medical officer of the hospital determines is no longer advisable, shall be discharged. Any voluntary patient may be discharged if to do so would in the judgment of the chief medical officer contribute to the most effective use of the hospital in the care and treatment of that patient and of other persons with mental illness.
   2.  If the chief medical officer of the hospital is informed that an arrest warrant has been issued for or charges are pending against a voluntary patient of the hospital, the chief medical officer may notify the appropriate law enforcement agency about the discharge of the patient prior to the patient’s discharge.
    Sec. 8.  Section 229.5A, Code 2019, is amended to read as follows:
   229.5A  Preapplication screening assessment —— program.
   Prior to filing an application pursuant to section 229.6, the clerk of the district court or the clerk’s designee shall inform the interested person referred to in section 229.6, subsection 1, about the option of requesting a preapplication screening assessment through a preapplication screening assessment program, which may include a preapplication screening assessment delivered through telehealth, if available. 
    Sec. 9.  Section 229.16, Code 2019, is amended to read as follows:
   229.16  Discharge and termination of proceeding.
   1.  When the condition of a patient who is hospitalized pursuant to a report issued under section 229.14, subsection 1, paragraph “b”, or is receiving treatment pursuant to a report issued under section 229.14, subsection 1, paragraph “c”, or is in full-time care and custody pursuant to a report issued under section 229.14, subsection 1, paragraph “d”, is such that in the opinion of the chief medical officer the patient no longer requires treatment or care for serious mental impairment, the chief medical officer shall tentatively discharge the patient and immediately report that fact to the court which ordered the patient’s hospitalization or care and custody. Upon receiving the report, the court shall issue an order confirming the patient’s discharge from the hospital or from care and custody, as the case may be, and shall terminate the proceedings pursuant to which the order was issued. Copies of the order shall be sent by regular mail to the hospital, the patient, and the applicant if the applicant has filed a written waiver signed by the patient.
   2.  When a patient who is hospitalized pursuant to a report issued under section 229.14, subsection 1, paragraph “b”, is receiving treatment pursuant to a report issued under section 229.14, subsection 1, paragraph “c”, or is in full-time care and custody pursuant to a report issued under section 229.14, subsection 1, paragraph “d”, is discharged from the hospital or from care and custody, the patient shall be provided a discharge report which shall include the patient’s name and address, all postdischarge appointments scheduled for the patient, and all information necessary for the patient’s postdischarge care.
    Sec. 10.  Section 229.22, subsection 2, paragraph b, Code 2019, is amended to read as follows:
   b.  If the magistrate orders that the person be detained, the magistrate shall, by the close of business on the next working day, file a written order with the clerk in the county where it is anticipated that an application may be filed under section 229.6. The order may be filed by facsimile if necessary. A peace officer from the law enforcement agency that took the person into custody, if no request was made under paragraph “a”, may inform the magistrate that an arrest warrant has been issued for or charges are pending against the person and request that any written order issued under this paragraph require the facility or hospital to notify the law enforcement agency about the discharge or transfer of the person prior to discharge or transfer. The order shall state the circumstances under which the person was taken into custody or otherwise brought to a facility or hospital, and the grounds supporting the finding of probable cause to believe that the person is seriously mentally impaired and likely to injure the person’s self or others if not immediately detained. The order shall also include any law enforcement agency notification requirements if applicable. The order shall confirm the oral order authorizing the person’s detention including any order given to transport the person to an appropriate facility or hospital. A peace officer from the law enforcement agency that took the person into custody may also request an order, separate from the written order, requiring the facility or hospital to notify the law enforcement agency about the discharge or transfer of the person prior to discharge or transfer. The clerk shall provide a copy of the written order or any separate order to the chief medical officer of the facility or hospital to which the person was originally taken, to any subsequent facility to which the person was transported, and to any law enforcement department, ambulance service, or transportation service under contract with a mental health and disability services region that transported the person pursuant to the magistrate’s order. A transportation service that contracts with a mental health and disability services region for purposes of this paragraph shall provide a secure transportation vehicle and shall employ staff that has received or is receiving mental health training.
    Sec. 11.  Section 229.22, subsection 2, paragraph c, Code 2019, is amended by adding the following new subparagraphs:
   NEW SUBPARAGRAPH.  (3)  Notify the law enforcement agency that employs the peace officer by telephone prior to the transfer of the person from the facility or hospital.
   NEW SUBPARAGRAPH.  (4)  Notify the law enforcement agency that employs the peace officer by electronic mail prior to the transfer of the person from the facility or hospital.
    Sec. 12.  Section 229.22, subsection 3, Code 2019, is amended to read as follows:
   3.  The chief medical officer of the facility or hospital shall examine and may detain and care for the person taken into custody under the magistrate’s order for a period not to exceed forty-eight seventy-two hours from the time such order is dated, excluding Saturdays, Sundays and holidays, unless the order is sooner dismissed by a magistrate. The facility or hospital may provide treatment which is necessary to preserve the person’s life, or to appropriately control behavior by the person which is likely to result in physical injury to the person’s self or others if allowed to continue, but may not otherwise provide treatment to the person without the person’s consent. The person shall be discharged from the facility or hospital and released from custody not later than the expiration of that period, unless an application is sooner filed with the clerk pursuant to section 229.6. Prior to such discharge the facility or hospital shall, if required by this section, notify the law enforcement agency requesting such notification about the discharge of the person. The law enforcement agency shall retrieve the person no later than six hours after notification from the facility or hospital but in no circumstances shall the detention of the person exceed the period of time prescribed for detention by this subsection. The detention of any person by the procedure and not in excess of the period of time prescribed by this section shall not render the peace officer, physician, mental health professional, facility, or hospital so detaining that person liable in a criminal or civil action for false arrest or false imprisonment if the peace officer, physician, mental health professional, facility, or hospital had reasonable grounds to believe the person so detained was mentally ill and likely to physically injure the person’s self or others if not immediately detained, or if the facility or hospital was required to notify a law enforcement agency by this section, and the law enforcement agency requesting notification prior to discharge retrieved the person no later than six hours after the notification, and the detention prior to the retrieval of the person did not exceed the period of time prescribed for detention by this subsection.
    Sec. 13.  DEPARTMENTS OF HUMAN SERVICES AND PUBLIC HEALTH —— COMMITMENT PROCESS REVIEW.  The department of human services and the department of public health shall review the commitment processes under chapters 125 and 229 and shall make recommendations for combining the commitment processes into a single chapter. The departments shall consider the recommendations from the report submitted by the commitment process review work group to the general assembly on December 31, 2018, when reviewing the commitment processes. The departments shall submit recommendations including proposed legislation to the governor and the general assembly by November 15, 2019.
    Sec. 14.  SUPREME COURT TRAINING —— INVOLUNTARY COMMITMENTS AND HOSPITALIZATIONS OF PERSONS WITH SERIOUS MENTAL IMPAIRMENTS OR SUBSTANCE-RELATED DISORDERS.  The supreme court shall establish educational training for judges, clerks of court, and attorneys related to the involuntary commitment of a person with a serious mental impairment or a substance-related disorder. The supreme court shall develop the training based on recommendations from the report submitted by the commitment process review work group to the general assembly on December 31, 2018.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the commitment or hospitalization of a person with a serious mental impairment or a substance-related disorder.
   POSTDISCHARGE REPORT. The bill provides that a person with a serious mental impairment or a substance-related disorder who is discharged from a voluntary or an involuntary commitment or hospitalization under Code chapter 125 or 229 shall be provided a discharge report which shall include the patient’s name and address, all scheduled postdischarge appointments, and all information relevant to the patient’s postdischarge care. 
   PREAPPLICATION SCREENING ASSESSMENT. Under current law, prior to filing an application for involuntary hospitalization under Code section 229.6 or involuntary commitment under Code section 125.75, the clerk of the district court or the clerk’s designee shall inform the person filing the application about the option of requesting a preapplication screening assessment through a preapplication screening assessment program. The bill expands current law to provide a preapplication screening assessment program may include a preapplication screening assessment delivered through telehealth, if available.
   EMERGENCY DETENTION AND HOSPITALIZATION —— LAW ENFORCEMENT NOTIFICATION AND DETENTION PERIODS. Under Code sections 125.91 (emergency detention —— substance-related disorders) and 229.22 (emergency hospitalization —— serious mental impairment), when it appears that a person should be immediately detained due to a substance-related disorder or a serious mental impairment but an involuntary application for hospitalization has not been filed naming the person as the respondent and the person cannot be ordered into immediate custody and detained, the person may be immediately detained by a peace officer who has reasonable grounds for the detention, and the peace officer, without a warrant, may take or cause that person to be taken to the nearest available facility or hospital. A person who is not a peace officer may also bring a person under similar circumstances to a facility or hospital. If the appropriate examining health care practitioner finds that there is reason to believe that the person suffers from a substance-related disorder or is seriously mentally impaired and is likely to physically injure the person’s self or others if not immediately detained, the health care practitioner is required to immediately communicate with the nearest available magistrate. 
   The bill provides that if a magistrate authorizes a person with a substance-related disorder, under the circumstances described in Code section 125.91, to be detained in an appropriate facility, a peace officer from the law enforcement agency that took the person into custody may inform the magistrate that an arrest warrant has been issued for or charges are pending against the person and request that any oral or written order issued require the facility or hospital to notify the law enforcement agency about the discharge or transfer of the person prior to the person’s discharge or transfer. The bill amends the same law enforcement notification provisions currently in Code section 229.22 to allow such law enforcement notification when a person with a serious mental impairment is transferred from a facility or hospital.
   Under current law, a hospital or facility may detain a person with a substance-related disorder pursuant to Code section 125.91 or a serious mental impairment pursuant to Code section 229.22, under a magistrate’s order for a period not to exceed 48 hours from the time such an order is dated, excluding Saturdays, Sundays, and holidays, unless the order is dismissed earlier by a magistrate. The bill extends the period a hospital or facility may detain such persons to 72 hours from the time such an order is dated, excluding Saturdays, Sundays, and holidays, unless the order is dismissed earlier by a magistrate.
   DEPARTMENTS OF HUMAN SERVICES AND PUBLIC HEALTH —— COMMITMENT PROCESS REVIEW. The bill directs the department of human services and the department of public health to review the commitment processes under Code chapters 125 and 229 and make recommendations and propose legislation for combining the Code chapters to the governor and the general assembly by November 15, 2019.
   SUPREME COURT —— EDUCATIONAL TRAINING. The bill directs the supreme court to develop and provide educational training relating to involuntary commitments and hospitalizations of persons with serious mental impairments and substance-related disorders for judges, clerks of court, and attorneys. The bill provides that the supreme court shall develop the training based upon recommendations from the December 30, 2018, report submitted by the commitment process review work group.