H.F. _____ Section 1. NEW SECTION . 331.910 Interstate contracts for 1 mental health and substance-related disorder treatment. 2 1. Purpose. The purpose of this section is to enable 3 appropriate care and treatment to be provided to a person 4 with a substance-related disorder or a mental illness, across 5 state lines from the person’s state of residence, in qualified 6 hospitals, centers, and facilities that are closer to the 7 person’s home than are hospitals, centers, and facilities 8 available in the person’s home state. 9 2. Definitions. For the purposes of this section: 10 a. “Bordering state” means Illinois, Minnesota, Missouri, 11 Nebraska, South Dakota, or Wisconsin. 12 b. “County” mean a county that has been exempted by the 13 director of the department of human services from being 14 required to be part of a region. 15 c. “Receiving agency” means a public or private hospital, 16 mental health center, substance abuse treatment and 17 rehabilitation facility, or detoxification center, which 18 provides substance abuse or mental health care and treatment to 19 a person from a state other than the state in which a hospital, 20 center, or facility is located. 21 d. “Receiving state” means the state in which a receiving 22 agency is located. 23 e. “Region” means a mental health and disability services 24 region formed in accordance with section 331.389. 25 f. “Sending agency” means a state or county agency located 26 in a state which sends a person to a bordering state for 27 substance abuse or mental health care and treatment under this 28 section. 29 g. “Sending state” means the state in which a sending agency 30 is located. 31 3. Voluntary commitments. 32 a. A region or county may contract with a receiving agency 33 in a bordering state to secure substance abuse or mental health 34 care and treatment under this subsection for persons who 35 -1- LSB 2092YC (4) 86 rh/rj 1/ 6

H.F. _____ receive substance abuse or mental health care and treatment 1 pursuant to section 125.33 or 229.2 through a region or county. 2 b. This subsection shall not apply to a person who is any 3 of the following: 4 (1) Serving a criminal sentence. 5 (2) On probation or parole. 6 (3) The subject of a presentence investigation. 7 c. A region or county may contract with a sending agency 8 in a bordering state to provide care and treatment under this 9 subsection for residents of the bordering state in approved 10 substance abuse and mental health care and treatment hospitals, 11 centers, and facilities in this state, except that care and 12 treatment shall not be provided for residents of the bordering 13 state who are involved in criminal proceedings substantially 14 similar to the involvement described in paragraph “b” . 15 4. Involuntary commitments. 16 a. A person who is detained, committed, or placed on an 17 involuntary basis under section 125.75 or 229.6 may be confined 18 and treated in another state pursuant to a contract under this 19 section. 20 b. A person who is detained, committed, or placed on 21 an involuntary basis under the civil commitment laws of a 22 bordering state substantially similar to section 125.75 or 23 229.6 may be confined and treated in this state pursuant to a 24 contract under this section. 25 c. A law enforcement officer acting under the authority of a 26 sending state may transport a person to a receiving agency that 27 provides substance abuse or mental health care and treatment 28 pursuant to a contract under this subsection and may transport 29 the person back to the sending state under the laws of the 30 sending state. 31 d. Court orders valid under the law of the sending state 32 are granted recognition and reciprocity in the receiving state 33 for a person covered by a contract under this subsection to 34 the extent that the court orders relate to confinement for 35 -2- LSB 2092YC (4) 86 rh/rj 2/ 6

H.F. _____ substance abuse or mental health care and treatment. Such care 1 and treatment may include care and treatment for co-occurring 2 substance-related and mental health disorders. Such court 3 orders are not subject to legal challenge in the courts of the 4 receiving state. 5 e. A person who is detained, committed, or placed under the 6 laws of a sending state and who is transferred to a receiving 7 state under this section shall be considered to be in the legal 8 custody of the authority responsible for the person under the 9 laws of the sending state. Except in an emergency, such a 10 person shall not be transferred, removed, or furloughed from a 11 hospital, center, or facility of the receiving agency without 12 the specific approval of the authority responsible for the 13 person under the laws of the sending state. 14 f. While in the receiving state pursuant to a contract 15 under this subsection, a person shall be subject to all laws 16 and regulations applicable to persons detained, committed, 17 or placed pursuant to the corresponding laws and regulations 18 of the receiving state, except those laws and regulations 19 of the receiving state relating to length of confinement, 20 reexaminations, and extensions of confinement. A person shall 21 not be sent to a receiving state pursuant to a contract under 22 this section until the receiving state has enacted a law 23 recognizing the validity and applicability of this subsection. 24 g. If a person receiving care and treatment pursuant to 25 a contract under this subsection escapes from the receiving 26 agency and the person at the time of the escape is subject 27 to involuntary confinement under the laws of the sending 28 state, the receiving agency shall use all reasonable means to 29 recapture the escapee. The receiving agency shall immediately 30 report the escape of the person to the sending agency. The 31 receiving state has the primary responsibility for, and the 32 authority to direct, the pursuit, retaking, and prosecution of 33 escaped persons within its borders and is liable for the cost 34 of such action to the extent that it would be liable for costs 35 -3- LSB 2092YC (4) 86 rh/rj 3/ 6

H.F. _____ if its own resident escaped. 1 h. Responsibility for payment for the cost of care and 2 treatment under this subsection shall remain with the sending 3 agency. 4 5. A contract entered into under this section shall, at a 5 minimum, meet all of the following requirements: 6 a. Describe the care and treatment to be provided. 7 b. Establish responsibility for the costs of the care and 8 treatment, except as otherwise provided in subsection 4. 9 c. Establish responsibility for the costs of transporting 10 individuals receiving care and treatment under this section. 11 d. Specify the duration of the contract. 12 e. Specify the means of terminating the contract. 13 f. Specify the terms and conditions for refusal to admit or 14 detain a person. 15 g. Identify the goals to be accomplished by the placement 16 of a person under this section. 17 6. This section shall apply to all of the following: 18 a. Detoxification services that are unrelated to substance 19 abuse or mental health care and treatment regardless of 20 whether the care and treatment are provided on a voluntary or 21 involuntary basis. 22 b. Substance abuse and mental health care and treatment 23 contracts that include emergency care and treatment provided to 24 a resident of this state in a bordering state. 25 EXPLANATION 26 The inclusion of this explanation does not constitute agreement with 27 the explanation’s substance by the members of the general assembly. 28 This bill relates to interstate contracts for substance 29 abuse and mental health care and treatment. 30 CONTRACTS FOR INVOLUNTARY COMMITMENTS. The bill provides 31 that a region or county as defined in the bill may contract 32 with a public or private agency in a bordering state to secure 33 substance abuse or mental health care and treatment for persons 34 who may receive substance abuse or mental health care and 35 -4- LSB 2092YC (4) 86 rh/rj 4/ 6

H.F. _____ treatment pursuant to Code section 125.33 or 229.2 through 1 a region or county in Iowa. Similarly, a region or county 2 may contract with a public or private agency in a bordering 3 state to provide such care and treatment for residents of 4 the bordering state in approved substance abuse or mental 5 health treatment facilities in this state. A person serving 6 a criminal sentence, who is on probation or parole, or who is 7 the subject of a presentence investigation is not eligible to 8 receive such care and treatment. The bill defines “bordering 9 state” to mean Illinois, Minnesota, Missouri, Nebraska, South 10 Dakota, or Wisconsin, “county” to mean a county that has been 11 exempted by the director of the department of human services 12 from being required to be part of a regional mental health 13 and disability services system, and “region” to mean a mental 14 health and disability services region formed in accordance with 15 Code section 331.389. 16 CONTRACTS FOR INVOLUNTARY COMMITMENTS. The bill provides 17 that a person who is detained, committed, or placed on an 18 involuntary basis under Code section 125.75 or 229.6 may 19 be confined and treated in another state pursuant to a 20 contract executed under the bill and a person who is detained, 21 committed, or placed on an involuntary basis under the civil 22 commitment laws of a bordering state substantially similar to 23 Code section 125.75 or 229.6 may be confined and treated in 24 this state pursuant to a contract executed under the bill. 25 Court orders valid under the law of the sending state are 26 granted recognition and reciprocity in the receiving state for 27 a person covered by an involuntary commitment contract under 28 the bill. A person who is detained, committed, or placed 29 under the laws of a sending state and who is transferred to a 30 receiving state is considered to be in the legal custody of 31 the authority responsible for the person under the laws of the 32 sending state. Except in an emergency, such a person shall not 33 be transferred, removed, or furloughed from a hospital, center, 34 or facility of the receiving agency without the specific 35 -5- LSB 2092YC (4) 86 rh/rj 5/ 6

H.F. _____ approval of the authority responsible for the person under the 1 laws of the sending state. 2 While in the receiving state pursuant to an involuntary 3 commitment contract executed under the bill, a person is 4 subject to all laws and regulations applicable to persons 5 detained, committed, or placed pursuant to the corresponding 6 laws of the receiving state, except those laws and regulations 7 of the receiving state relating to length of confinement, 8 reexaminations, and extensions of confinement. 9 If a person receiving care and treatment pursuant to an 10 involuntary commitment contract under the bill escapes from 11 the receiving agency and the person at the time of the escape 12 is subject to involuntary confinement under the laws of the 13 sending state, the receiving agency shall use all reasonable 14 means to recapture the escapee. The receiving agency shall 15 immediately report the escape to the sending agency. The 16 receiving state has the primary responsibility for, and the 17 authority to direct, the pursuit, retaking, and prosecution of 18 escaped persons within its borders and is liable for the cost 19 of such action to the extent that it would be liable for costs 20 if its own resident escaped. 21 MISCELLANEOUS. The bill specifies minimum requirements 22 for contracts entered into under the bill. The bill applies 23 to detoxification services unrelated to substance abuse or 24 mental health care and treatment regardless of whether provided 25 on a voluntary or involuntary basis and to substance abuse 26 and mental health care and treatment contracts that include 27 emergency care and treatment. 28 -6- LSB 2092YC (4) 86 rh/rj 6/ 6