House File 280 - Introduced HOUSE FILE BY CARROLL Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to mental health, mental retardation, and 2 developmental disabilities services by revising involuntary 3 hospitalization procedures involving the county central point 4 of coordination process and patient advocates and authorizing 5 counties to create a special program fund for these services. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 TLSB 1957YH 81 8 jp/gg/14 PAG LIN 1 1 Section 1. Section 229.1B, Code 2005, is amended to read 1 2 as follows: 1 3 229.1B CENTRAL POINT OF COORDINATION PROCESS. 1 4 1. Notwithstanding any provision of this chapter to the 1 5 contrary, any person whose hospitalization expenses are 1 6 payable in whole or in part by a county shall be subject to 1 7 all requirements of the central point of coordination process. 1 8 The county central point of coordination process administrator 1 9 or the administrator's designee shall assist the court by 1 10 determining the person's county of legal settlement and 1 11 notifying the court of the determination. In addition, the 1 12 administrator or designee shall identify one or more 1 13 appropriate hospitals or facilities with an opening available 1 14 for placement of the person and provide this information to 1 15 the court along with a placement recommendation. 1 16 2. The county central point of coordination process 1 17 administrator shall develop a plan for addressing emergency 1 18 examinations and placements made under this chapter. The plan 1 19 shall be developed in consultation with representatives of the 1 20 community mental health centers and hospitals providing 1 21 emergency services in that county. The plan shall include but 1 22 is not limited to a process for the administrator or the 1 23 administrator's designee to provide the court with a placement 1 24 recommendation as required by this chapter. 1 25 3. A person who receives confidential information under 1 26 this chapter due to the person's responsibilities relating to 1 27 the central point of coordination process is subject to the 1 28 requirements of chapter 228, the federal Health Insurance 1 29 Portability and Accountability Act of 1996, Pub. L. No. 104= 1 30 191, and other applicable requirements intended to protect the 1 31 confidentiality of information pertaining to a respondent or 1 32 person subject to a commitment order under this chapter. 1 33 Sec. 2. Section 229.8, subsection 2, Code 2005, is amended 1 34 to read as follows: 1 35 2. Cause copies of the application and supporting 2 1 documentation to be sent to the county attorney or the county 2 2 attorney's attorney=designate for review and to the county's 2 3 central point of coordination process administrator. 2 4 Sec. 3. Section 229.9A, Code 2005, is amended to read as 2 5 follows: 2 6 229.9A PATIENT ADVOCATE INFORMED. 2 7 The court shall direct the clerk to furnish the patient 2 8 advocate of the respondent's county of legal settlement with a 2 9 copy of application and any order issued pursuant to section 2 10 229.8, subsection 3. If an order is issued, the clerk shall 2 11 also provide a copy of the order to the central point of 2 12 coordination process administrator of the respondent's county 2 13 of legal settlement. The advocate may attend the 2 14 hospitalization hearing of any respondent for whom the 2 15 advocate has received notice of a hospitalization hearing. 2 16 Sec. 4. Section 229.11, unnumbered paragraph 1, Code 2005, 2 17 is amended to read as follows: 2 18 If the applicant requests that the respondent be taken into 2 19 immediate custody and the judge, upon reviewing the 2 20 application and accompanying documentation, finds probable 2 21 cause to believe that the respondent has a serious mental 2 22 impairment and is likely to injure the respondent or other 2 23 persons if allowed to remain at liberty, the judge may enter a 2 24 written order directing that the respondent be taken into 2 25 immediate custody by the sheriff or the sheriff's deputy and 2 26 be detained until the hospitalization hearing. The 2 27 hospitalization hearing shall be held no more than five days 2 28 after the date of the order, except that if the fifth day 2 29 after the date of the order is a Saturday, Sunday, or a 2 30 holiday, the hearing may be held on the next succeeding 2 31 business day. If the expenses of a respondent are payable in 2 32 whole or in part by a county, for a placement in accordance 2 33 with subsection 1, the judge shall give notice of the 2 34 placement to the central point of coordination process 2 35 administrator, and for a placement in accordance with 3 1 subsection 2 or 3, the judge shall order the placement in a 3 2 hospital or facility designated through the central point of 3 3 coordination process. Prior to the hearing, the central point 3 4 of coordination process administrator or the administrator's 3 5 designee shall provide the court with a placement 3 6 recommendation identifying one or more appropriate hospitals 3 7 or facilities with an opening available for placement of the 3 8 respondent. If determined to be in the best interest of the 3 9 respondent, the judge may order placement of the respondent in 3 10 an alternative facility in which an opening is available. The 3 11 judge may order the respondent detained for the period of time 3 12 until the hearing is held, and no longer, in accordance with 3 13 subsection 1 if possible, and if not then in accordance with 3 14 subsection 2 or, only if neither of these alternatives is 3 15 available, in accordance with subsection 3. Detention may be: 3 16 Sec. 5. Section 229.13, subsection 1, paragraph a, Code 3 17 2005, is amended to read as follows: 3 18 a. The court shall order a respondent whose expenses are 3 19 payable in whole or in part by a county placed under the care 3 20 of an appropriate hospital or facility designated through the 3 21 central point of coordination process on an inpatient or 3 22 outpatient basis. The central point of coordination process 3 23 administrator or the administrator's designee shall provide 3 24 the court with a placement recommendation identifying one or 3 25 more appropriate hospitals or facilities with an opening 3 26 available for placement of the respondent. If determined to 3 27 be in the best interest of the respondent, the judge may order 3 28 placement of the respondent in an alternative facility in 3 29 which an opening is available. 3 30 Sec. 6. Section 229.14, subsection 2, paragraph a, Code 3 31 2005, is amended to read as follows: 3 32 a. For a respondent whose expenses are payable in whole or 3 33 in part by a county, placement as designated through the 3 34 central point of coordination process in the care of an 3 35 appropriate hospital or facility on an inpatient or outpatient 4 1 basis, or other appropriate treatment, or in an appropriate 4 2 alternative placement. The central point of coordination 4 3 process administrator or the administrator's designee shall 4 4 provide the court with a placement recommendation identifying 4 5 one or more appropriate hospitals or facilities with an 4 6 opening available for placement of the respondent. If 4 7 determined to be in the best interest of the respondent, the 4 8 judge may order placement of the respondent in an alternative 4 9 facility in which an opening is available. 4 10 Sec. 7. Section 229.14A, subsection 1, Code 2005, is 4 11 amended to read as follows: 4 12 1. With respect to a chief medical officer's report made 4 13 pursuant to section 229.14, subsection 1, paragraph "b", "c", 4 14 or "d", or any other provision of this chapter related to 4 15 involuntary commitment for which the court issues a placement 4 16 order or a transfer of placement is authorized, the court 4 17 shall provide notice to the respondent and the respondent's 4 18 attorney ormental healthpatient advocate pursuant to section 4 19 229.19 concerning the placement order and the respondent's 4 20 right to request a placement hearing to determine if the order 4 21 for placement or transfer of placement is appropriate. A copy 4 22 of the placement order or transfer authorization shall also be 4 23 provided to the central point of coordination process 4 24 administrator of the respondent's county of legal settlement. 4 25 Sec. 8. Section 229.14A, subsection 7, Code 2005, is 4 26 amended to read as follows: 4 27 7. If a respondent's expenses are payable in whole or in 4 28 part by a county through the central point of coordination 4 29 process, notice of a placement hearing shall be provided to 4 30 the county attorney and the county's central point of 4 31 coordination process administrator. At the hearing, the 4 32 county may present evidence regarding appropriate placement. 4 33 The central point of coordination process administrator or the 4 34 administrator's designee shall provide the court with a 4 35 placement recommendation identifying one or more appropriate 5 1 hospitals or facilities with an opening available for 5 2 placement of the respondent. 5 3 Sec. 9. Section 229.22, subsection 2, unnumbered paragraph 5 4 2, Code 2005, is amended to read as follows: 5 5 If the magistrate orders that the person be detained, the 5 6 magistrate shall, by the close of business on the next working 5 7 day, file a written order with the clerk in the county where 5 8 it is anticipated that an application may be filed under 5 9 section 229.6. The order may be filed by facsimile if 5 10 necessary. The order shall state the circumstances under 5 11 which the person was taken into custody or otherwise brought 5 12 to a facility, and the grounds supporting the finding of 5 13 probable cause to believe that the person is seriously 5 14 mentally impaired and likely to injure the person's self or 5 15 others if not immediately detained. The order shall confirm 5 16 the oral order authorizing the person's detention including 5 17 any order given to transport the person to an appropriate 5 18 facility. The clerk shall provide a copy of that order to the 5 19 central point of coordination process administrator of the 5 20 county where it is anticipated that an application may be 5 21 filed under section 229.6, to the chief medical officer of the 5 22 facility to which the person was originally taken, to any 5 23 subsequent facility to which the person was transported, and 5 24 to any law enforcement department or ambulance service that 5 25 transported the person pursuant to the magistrate's order. 5 26 Sec. 10. Section 229.24, subsection 1, Code 2005, is 5 27 amended to read as follows: 5 28 1. All papers and records pertaining to any involuntary 5 29 hospitalization or application for involuntary hospitalization 5 30 of any person under this chapter, whether part of the 5 31 permanent record of the court or a county or of a file in the 5 32 department of human services, are subject to inspection only 5 33 upon an order of the court for good cause shown. Nothing in 5 34 this section shall prohibit a hospital from complying with the 5 35 requirements of this chapter and of chapter 230 relative to 6 1 financial responsibility for the cost of care and treatment 6 2 provided a patient in that hospital, nor from properly billing 6 3 any responsible relative or third=party payer for such care 6 4 and treatment. 6 5 Sec. 11. Section 331.424A, Code 2005, is amended by adding 6 6 the following new subsection: 6 7 NEW SUBSECTION. 6. a. Notwithstanding contrary 6 8 provisions of this section, a county may request approval of a 6 9 waiver by the department of management to create a special 6 10 program fund to receive moneys and to pay the direct and 6 11 indirect costs of special program services provided to persons 6 12 eligible for services payable from the services fund. In 6 13 requesting the waiver, the county shall provide information 6 14 detailing how the special fund will be used, the basis upon 6 15 which moneys will be credited and expended from the special 6 16 fund, and other information specified by the department of 6 17 management in order for the department to determine whether 6 18 the special fund will be used in a manner that is appropriate 6 19 to distinguish those uses from the uses of the services fund. 6 20 The department of management may authorize a waiver for a 6 21 specific term or an indefinite term and a waiver is subject to 6 22 other conditions that the department may apply to ensure that 6 23 the special fund is operated solely for the purposes for which 6 24 the special fund is authorized. The department's approval of 6 25 a waiver shall be based upon the department's determination 6 26 that the special fund will only be used for managing money for 6 27 special program services provided to persons eligible for 6 28 services paid from the services fund and are appropriate to 6 29 distinguish those uses from the uses of the services fund. 6 30 b. The special program services may be provided to persons 6 31 whose service costs are attributable to the county that 6 32 created the special program fund or to other counties. In 6 33 addition to receipts from the services fund of the county that 6 34 created the special program fund, receipts from federal, 6 35 state, and other county and governments, and any other 7 1 revenues associated with the provision of special program 7 2 services shall be credited to the special program fund. The 7 3 levy limitation established pursuant to subsection 4 is not 7 4 subject to increase as a result of the creation or 7 5 administration of the special program fund. The management 7 6 plans approved pursuant to section 331.439 for the counties 7 7 purchasing services from the special program fund shall 7 8 address the services payable from the special program fund and 7 9 the administration of the special program fund. 7 10 Sec. 12. STUDY GROUP. The supreme court is requested to 7 11 convene a study group to consider issues relating to the 7 12 functions performed by patient advocates appointed under 7 13 chapter 229 and the interaction of patient advocates with 7 14 other portions of the legal and service systems for persons 7 15 with mental illness. If established, the study group shall 7 16 issue a report to the judicial branch, governor, and general 7 17 assembly with findings and recommendations on or before 7 18 December 15, 2005. 7 19 Sec. 13. IMPLEMENTATION OF ACT. Section 25B.2, subsection 7 20 3, shall not apply to this Act. 7 21 EXPLANATION 7 22 This bill relates to mental health, mental retardation, and 7 23 developmental disabilities services by revising involuntary 7 24 hospitalization procedures involving the county central point 7 25 of coordination process and patient advocates and authorizes 7 26 counties to create a special program fund for these services. 7 27 The bill amends various provisions in Code chapter 229, 7 28 relating to involuntary hospitalization of persons with 7 29 serious mental illness. If a person's hospitalization costs 7 30 are payable in whole or in part by a county, the county 7 31 central point of coordination (CPC) administrator, or the 7 32 administrator's designee, is to assist the court by 7 33 determining the person's county of legal settlement and 7 34 notifying the court of the determination. In addition, the 7 35 administrator or designee is required to identify one or more 8 1 hospitals or facilities with an opening available for 8 2 placement of the person and notify the court. 8 3 In addition, the CPC administrator is required to develop a 8 4 plan for addressing emergency examinations and placements 8 5 under Code chapter 229. Local hospitals and other service 8 6 providers are required to be consulted in developing the plan. 8 7 The bill states that a person who receives confidential 8 8 information due to the person's responsibilities relating to 8 9 the central point of coordination process is subject to 8 10 federal law and other requirements intended to protect 8 11 confidentiality of information. Code section 229.24, 8 12 requiring records of an involuntary hospitalization proceeding 8 13 to be confidential, is amended to apply to county records of 8 14 the proceeding. 8 15 The bill amends Code sections 229.9A and 229.14A, relating 8 16 to information provided to the patient advocate and placement 8 17 orders, to require copies of applications, orders, and 8 18 authorizations to be provided to the county central point of 8 19 coordination process administrator when they are provided to 8 20 the patient advocate. 8 21 Code section 331.424A, creating a county MH/MR/DD services 8 22 fund in each county to which property tax and other receipts 8 23 must be credited, is amended. The bill authorizes counties to 8 24 request a waiver by the department of management to create a 8 25 special program fund to be used for receipts and expenditures 8 26 for special program services provided to persons eligible for 8 27 services payable from the services fund. The department may 8 28 authorize a waiver for a specific term or an indefinite term 8 29 or apply other conditions. The special program services may 8 30 be provided to persons whose service costs are attributable to 8 31 the county that created the fund or to other counties. The 8 32 limitation on county levy authority for the MH/MR/DD services 8 33 fund is not subject to change due to creation and 8 34 administration of a special program fund. The special program 8 35 services and administration of the special program fund are 9 1 required to be addressed in the county management plans of the 9 2 counties purchasing services from the special program fund. 9 3 The bill requests the supreme court to convene a study 9 4 group to consider issues relating to the functions performed 9 5 by patient advocates and the interaction of patient advocates 9 6 with other portions of the legal and service systems for 9 7 persons with mental illness. 9 8 The bill may include a state mandate as defined in Code 9 9 section 25B.3. The bill makes inapplicable Code section 9 10 25B.2, subsection 3, which would relieve a political 9 11 subdivision from complying with a state mandate if funding for 9 12 the cost of the state mandate is not provided or specified. 9 13 Therefore, political subdivisions are required to comply with 9 14 any state mandate included in the bill. 9 15 LSB 1957YH 81 9 16 jp:nh/gg/14