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 or mental health patient 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