Meeting Public Comments

Katie Morgan [O'BRIEN COUNTY ATTORNEY]

As a rural county attorney, I am, generally, in favor of this bill. I represent the State in the involuntary commitment hearings in O'Brien County. Previous to my role as a county attorney, I represented individuals a commitment was filed against. Our rural ERs are staffed mostly with ARNPs and PAs. Under the current 229 code, ARNPs and PAs cannot complete the written evaluation and testify about the Indvidual's mental health and dangerousness to self and others because of their mental health unless they have a special psychiatric certificate. The vast majority of the ARNPs and PAs in rural ERs do NOT have that certificate and do not feel comfortable evaluating mental health issues, so many rural ERs are utilizing telehealth providers to do the evaluations. The telehealth provider O'Brien County utilizes, called Flowstate, was approached by myself, two of our judges and the mental health advocate and asked to complete the written evaluations and testify, if needed. Flowstate told us that was not part of their contract, and that it was not willing to renegotiate or sign a future contract that provided that its providers would complete the written evaluation or testify. Its reasoning is because it presents a scheduling conflict for their providers. Really, this issue could be alleviated by a telehealth provider with the right credentials that writes the evaluations and testify, if it exists. Why is it important that the right credentialed person author the written report and testify? Because if he/she does not write the report and does not show up to the hearing, by law the Judge has to dismiss the committal under the current law. This has happened in Northwest Iowa where committals have been dismissed because a provider failed to show up over phone or on a videoconference to testify even though they may have been recommending a committal for the individual. That individual is then free to go even though the provider found them a danger to themselves or others because of his/her mental health. This is a major concern and poses a risk to the individual to self harm and/or potential harm to the public.