Senate File 2290 - Introduced
SENATE FILE
BY BEALL and OLIVE
(COMPANION TO LSB 6350HH
BY UPMEYER)
Passed Senate, Date Passed House, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the authority of certain licensed physicians,
2 licensed psychiatrists, psychiatric advanced registered nurse
3 practitioners, and physician assistants regarding the
4 evaluation and treatment of certain persons including chronic
5 substance abusers and persons with mental illness, and making
6 a penalty applicable.
7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
8 TLSB 6350SS 82
9 rh/rj/5
PAG LIN
1 1 Section 1. Section 125.2, subsection 4, Code 2007, is
1 2 amended by striking the subsection.
1 3 Sec. 2. Section 125.2, Code 2007, is amended by adding the
1 4 following new subsections:
1 5 NEW SUBSECTION. 13A. "Licensed physician" means an
1 6 individual licensed under the provisions of chapter 148, 150,
1 7 or 150A to practice medicine and surgery, osteopathy, or
1 8 osteopathic medicine and surgery.
1 9 NEW SUBSECTION. 13B. "Licensed psychiatrist" means an
1 10 individual licensed under the provisions of chapter 148, 150,
1 11 or 150A to practice medicine and surgery, osteopathy, or
1 12 osteopathic medicine and surgery with a specialty in the field
1 13 of psychiatry.
1 14 NEW SUBSECTION. 13C. "Psychiatric advanced registered
1 15 nurse practitioner" means an individual licensed as a
1 16 registered nurse under chapter 152 or 152E who holds a
1 17 national certification in psychiatric health care and who is
1 18 registered with the board of nursing as an advanced registered
1 19 nurse practitioner.
1 20 Sec. 3. Section 125.38, subsection 3, Code 2007, is
1 21 amended to read as follows:
1 22 3. The patient shall be provided an opportunity to receive
1 23 prompt evaluation, emergency services and care as indicated by
1 24 sound medical practice and treatment which, in the judgment of
1 25 the chief medical officer licensed physician, licensed
1 26 psychiatrist, or psychiatric advanced registered nurse
1 27 practitioner of a facility, is most likely to result in the
1 28 individual's recovery or in the mitigation of the individual's
1 29 condition to an extent sufficient to permit the individual's
1 30 discharge from the facility.
1 31 Sec. 4. Section 125.81, subsection 2, Code 2007, is
1 32 amended to read as follows:
1 33 2. In a suitable hospital, the chief medical officer of
1 34 which licensed physician, licensed psychiatrist, or
1 35 psychiatric advanced registered nurse practitioner of which
2 1 shall be informed of the reasons why immediate custody has
2 2 been ordered. The hospital may provide treatment which is
2 3 necessary to preserve the respondent's life, or to
2 4 appropriately control the respondent's behavior which is
2 5 likely to result in physical injury to the person or to others
2 6 if allowed to continue, and other treatment as deemed
2 7 appropriate by the chief medical officer licensed physician,
2 8 licensed psychiatrist, or psychiatric advanced registered
2 9 nurse practitioner.
2 10 Sec. 5. Section 125.83, Code 2007, is amended to read as
2 11 follows:
2 12 125.83 PLACEMENT FOR EVALUATION.
2 13 If upon completion of the commitment hearing, the court
2 14 finds that the contention that the respondent is a chronic
2 15 substance abuser has been sustained by clear and convincing
2 16 evidence, the court shall order the respondent placed at a
2 17 facility or under the care of a suitable facility on an
2 18 outpatient basis as expeditiously as possible for a complete
2 19 evaluation and appropriate treatment. The court shall furnish
2 20 to the facility at the time of admission or outpatient
2 21 placement, a written statement of facts setting forth the
2 22 evidence on which the finding is based. The administrator of
2 23 the facility shall report to the court no more than fifteen
2 24 days after the individual is admitted to or placed under the
2 25 care of the facility, which shall include the chief medical
2 26 officer's recommendation of the licensed physician, licensed
2 27 psychiatrist, or psychiatric advanced registered nurse
2 28 practitioner of the facility concerning substance abuse
2 29 treatment. An extension of time may be granted for a period
2 30 not to exceed seven days upon a showing of good cause. A copy
2 31 of the report shall be sent to the respondent's attorney who
2 32 may contest the need for an extension of time if one is
2 33 requested. If the request is contested, the court shall make
2 34 an inquiry as it deems appropriate and may either order the
2 35 respondent released from the facility or grant extension of
3 1 time for further evaluation. If the administrator fails to
3 2 report to the court within fifteen days after the individual
3 3 is admitted to the facility, and no extension of time has been
3 4 requested, the administrator is guilty of contempt and shall
3 5 be punished under chapter 665. The court shall order a
3 6 rehearing on the application to determine whether the
3 7 respondent should continue to be held at the facility.
3 8 Sec. 6. Section 125.83A, subsections 1 and 2, Code 2007,
3 9 are amended to read as follows:
3 10 1. If upon completion of the commitment hearing, the court
3 11 finds that the contention that the respondent is a chronic
3 12 substance abuser has been sustained by clear and convincing
3 13 evidence, and the court is furnished evidence that the
3 14 respondent is eligible for care and treatment in a facility
3 15 operated by the veterans administration or another agency of
3 16 the United States government and that the facility is willing
3 17 to receive the respondent, the court may so order. The
3 18 respondent, when so placed in a facility operated by the
3 19 veterans administration or another agency of the United States
3 20 government within or outside of this state, shall be subject
3 21 to the rules of the veterans administration or other agency,
3 22 but shall not lose any procedural rights afforded the
3 23 respondent by this chapter. The chief officer of the facility
3 24 shall have, with respect to the respondent so placed, the same
3 25 powers and duties as the chief medical officer licensed
3 26 physician, licensed psychiatrist, or psychiatric advanced
3 27 registered nurse practitioner of a hospital in this state
3 28 would have in regard to submission of reports to the court,
3 29 retention of custody, transfer, convalescent leave, or
3 30 discharge. Jurisdiction is retained in the court to maintain
3 31 surveillance of the respondent's treatment and care, and at
3 32 any time to inquire into the respondent's condition and the
3 33 need for continued care and custody.
3 34 2. Upon receipt of a certificate stating that a respondent
3 35 placed under this chapter is eligible for care and treatment
4 1 in a facility operated by the veterans administration or
4 2 another agency of the United States government which is
4 3 willing to receive the respondent without charge to the state
4 4 of Iowa or any county in the state, the chief medical officer
4 5 licensed physician, licensed psychiatrist, or psychiatric
4 6 advanced registered nurse practitioner may transfer the
4 7 respondent to that facility. Upon so doing, the chief medical
4 8 officer licensed physician, licensed psychiatrist, or
4 9 psychiatric advanced registered nurse practitioner shall
4 10 notify the court which ordered the respondent's placement in
4 11 the same manner as would be required in the case of a transfer
4 12 under section 125.86, subsection 2, and the respondent
4 13 transferred shall be entitled to the same rights as the
4 14 respondent would have under that subsection. No respondent
4 15 shall be transferred under this section who is confined
4 16 pursuant to conviction of a public offense or whose placement
4 17 was ordered upon contention of incompetence to stand trial by
4 18 reason of mental illness, without prior approval of the court
4 19 which ordered that respondent's placement.
4 20 Sec. 7. Section 125.84, unnumbered paragraph 1, Code 2007,
4 21 is amended to read as follows:
4 22 The facility administrator's report to the court of the
4 23 chief medical officer's respondent's substance abuse
4 24 evaluation of the respondent prepared by the licensed
4 25 physician, licensed psychiatrist, or psychiatric advanced
4 26 registered nurse practitioner of the facility shall be made no
4 27 later than the expiration of the time specified in section
4 28 125.83. At least two copies of the report shall be filed with
4 29 the clerk, who shall distribute the copies in the manner
4 30 described by section 125.80, subsection 2. The report shall
4 31 state one of the four following alternative findings:
4 32 Sec. 8. Section 125.84, subsections 3 and 4, Code 2007,
4 33 are amended to read as follows:
4 34 3. That the respondent is a chronic substance abuser who
4 35 is in need of treatment, but does not require full=time
5 1 placement in a facility. If the report so states, the report
5 2 shall include the chief medical officer's recommendation of
5 3 the licensed physician, licensed psychiatrist, or psychiatric
5 4 advanced registered nurse practitioner for treatment of the
5 5 respondent on an outpatient or other appropriate basis, and
5 6 the court shall enter an order which may direct the respondent
5 7 to submit to the recommended treatment. The order shall
5 8 provide that if the respondent fails or refuses to submit to
5 9 treatment, as directed by the court's order, the court may
5 10 order that the respondent be taken into immediate custody as
5 11 provided by section 125.81 and, following notice and hearing
5 12 held in accordance with the procedures of sections 125.77 and
5 13 125.82, may order the respondent treated as a patient
5 14 requiring full=time custody, care, and treatment as provided
5 15 in subsection 2, and may order the respondent involuntarily
5 16 committed to a facility.
5 17 4. That the respondent is a chronic substance abuser who
5 18 is in need of treatment, but in the opinion of the chief
5 19 medical officer licensed physician, licensed psychiatrist, or
5 20 psychiatric advanced registered nurse practitioner is not
5 21 responding to the treatment provided. If the report so
5 22 states, the report shall include the facility administrator's
5 23 recommendation for alternative placement, and the court shall
5 24 enter an order which may direct the respondent's transfer to
5 25 the recommended placement or to another placement after
5 26 consultation with respondent's attorney and the facility
5 27 administrator who made the report under this subsection.
5 28 Sec. 9. Section 125.86, Code 2007, is amended to read as
5 29 follows:
5 30 125.86 PERIODIC REPORTS REQUIRED.
5 31 1. No more than thirty days after entry of a court order
5 32 for commitment to a facility under section 125.84, subsection
5 33 2, and thereafter at successive intervals not to exceed ninety
5 34 days for as long as involuntary commitment of the respondent
5 35 continues, the administrator of the facility shall report to
6 1 the court which entered the order. The report shall be
6 2 submitted in the manner required by section 125.84, shall
6 3 state whether in the opinion of the chief medical officer
6 4 licensed physician, licensed psychiatrist, or psychiatric
6 5 advanced registered nurse practitioner of the facility the
6 6 respondent's condition has improved, remains unchanged, or has
6 7 deteriorated, and shall indicate the further length of time
6 8 the respondent will be required to remain at the facility.
6 9 2. No more than sixty days after entry of a court order
6 10 for treatment of a respondent under section 125.84, subsection
6 11 3, and thereafter at successive intervals not to exceed ninety
6 12 days for as long as involuntary treatment continues, the
6 13 administrator of the facility shall report to the court which
6 14 entered the order. The report shall be submitted in the
6 15 manner required by section 125.84, shall state whether in the
6 16 opinion of the chief medical officer licensed physician,
6 17 licensed psychiatrist, or psychiatric advanced registered
6 18 nurse practitioner of the facility the respondent's condition
6 19 has improved, remains unchanged, or has deteriorated, and
6 20 shall indicate the further length of time the respondent will
6 21 require treatment by the facility. If the respondent fails or
6 22 refuses to submit to treatment as ordered by the court, the
6 23 administrator of the facility shall at once notify the court,
6 24 which shall order the respondent committed for treatment as
6 25 provided by section 125.84, subsection 3, unless the court
6 26 finds that the failure or refusal was with good cause, and
6 27 that the respondent is willing to receive treatment as
6 28 provided in the court's order, or in a revised order if the
6 29 court sees fit to enter one. If the administrator of the
6 30 facility reports to the court that the respondent requires
6 31 full=time custody, care, and treatment in a facility, and the
6 32 respondent is willing to be admitted voluntarily to the
6 33 facility for these purposes, the court may enter an order
6 34 approving the placement upon consultation with the
6 35 administrator of the facility in which the respondent is to be
7 1 placed. If the respondent is unwilling to be admitted
7 2 voluntarily to the facility, the procedure for determining
7 3 involuntary commitment, as provided in section 125.84,
7 4 subsection 3, shall be followed.
7 5 Sec. 10. Section 125.91, subsection 2, paragraph b, Code
7 6 2007, is amended to read as follows:
7 7 b. If the magistrate orders that the person be detained,
7 8 the magistrate shall, by the close of business on the next
7 9 working day, file a written order with the clerk in the county
7 10 where it is anticipated that an application may be filed under
7 11 section 125.75. The order may be filed by facsimile if
7 12 necessary. The order shall state the circumstances under
7 13 which the person was taken into custody or otherwise brought
7 14 to a facility and the grounds supporting the finding of
7 15 probable cause to believe that the person is a chronic
7 16 substance abuser likely to result in physical injury to the
7 17 person or others if not detained. The order shall confirm the
7 18 oral order authorizing the person's detention including any
7 19 order given to transport the person to an appropriate
7 20 facility. The clerk shall provide a copy of that order to the
7 21 chief medical officer licensed physician, licensed
7 22 psychiatrist, or psychiatric advanced registered nurse
7 23 practitioner of the facility to which the person was
7 24 originally taken, any subsequent facility to which the person
7 25 was transported, and to any law enforcement department or
7 26 ambulance service that transported the person pursuant to the
7 27 magistrate's order.
7 28 Sec. 11. Section 125.91, subsection 3, Code 2007, is
7 29 amended to read as follows:
7 30 3. The chief medical officer licensed physician, licensed
7 31 psychiatrist, or psychiatric advanced registered nurse
7 32 practitioner of the facility shall examine and may detain the
7 33 person pursuant to the magistrate's order for a period not to
7 34 exceed forty=eight hours from the time the order is dated,
7 35 excluding Saturdays, Sundays, and holidays, unless the order
8 1 is dismissed by a magistrate. The facility may provide
8 2 treatment which is necessary to preserve the person's life or
8 3 to appropriately control the person's behavior if the behavior
8 4 is likely to result in physical injury to the person or others
8 5 if allowed to continue or is otherwise deemed medically
8 6 necessary by the chief medical officer licensed physician,
8 7 licensed psychiatrist, or psychiatric advanced registered
8 8 nurse practitioner, but shall not otherwise provide treatment
8 9 to the person without the person's consent. The person shall
8 10 be discharged from the facility and released from detention no
8 11 later than the expiration of the forty=eight=hour period,
8 12 unless an application for involuntary commitment is filed with
8 13 the clerk pursuant to section 125.75. The detention of a
8 14 person by the procedure in this section, and not in excess of
8 15 the period of time prescribed by this section, shall not
8 16 render the peace officer, physician, or facility detaining the
8 17 person liable in a criminal or civil action for false arrest
8 18 or false imprisonment if the peace officer, physician, or
8 19 facility had reasonable grounds to believe that the
8 20 circumstances described in subsection 1 were applicable.
8 21 Sec. 12. Section 125.92, subsection 2, Code 2007, is
8 22 amended to read as follows:
8 23 2. Render informed consent, except for treatment provided
8 24 pursuant to sections 125.81 and 125.91. If the person is
8 25 incompetent treatment may be consented to by the person's next
8 26 of kin or guardian notwithstanding the person's refusal. If
8 27 the person refuses treatment which in the opinion of the chief
8 28 medical officer licensed physician, licensed psychiatrist, or
8 29 psychiatric advanced registered nurse practitioner of the
8 30 facility is necessary or if the person is incompetent and the
8 31 next of kin or guardian refuses to consent to the treatment or
8 32 no next of kin or guardian is available the facility may
8 33 petition a court of appropriate jurisdiction for approval to
8 34 treat the person.
8 35 Sec. 13. Section 225C.2, Code 2007, is amended by adding
9 1 the following new subsections:
9 2 NEW SUBSECTION. 7A. "Licensed physician" means an
9 3 individual licensed under the provisions of chapter 148, 150,
9 4 or 150A to practice medicine and surgery, osteopathy, or
9 5 osteopathic medicine and surgery.
9 6 NEW SUBSECTION. 7B. "Licensed psychiatrist" means an
9 7 individual licensed under the provisions of chapter 148, 150,
9 8 or 150A to practice medicine and surgery, osteopathy, or
9 9 osteopathic medicine and surgery with a specialty in the field
9 10 of psychiatry.
9 11 NEW SUBSECTION. 9. "Psychiatric advanced registered nurse
9 12 practitioner" means an individual currently licensed as a
9 13 registered nurse under chapter 152 or 152E who holds a
9 14 national certification in psychiatric health care and who is
9 15 registered with the board of nursing as an advanced registered
9 16 nurse practitioner.
9 17 Sec. 14. Section 225C.14, subsection 2, Code 2007, is
9 18 amended to read as follows:
9 19 2. As used in this section and sections 225C.15, 225C.16
9 20 and 225C.17, the term "medical emergency" means a situation in
9 21 which a prospective patient is received at a state mental
9 22 health institute in a condition which, in the opinion of the
9 23 chief medical officer, or that officer's physician designee
9 24 licensed physician, licensed psychiatrist, or psychiatric
9 25 advanced registered nurse practitioner, requires the immediate
9 26 admission of the person notwithstanding the policy stated in
9 27 subsection 1.
9 28 Sec. 15. Section 225C.16, subsections 1, 2, and 4, Code
9 29 2007, are amended to read as follows:
9 30 1. The chief medical officer licensed physician, licensed
9 31 psychiatrist, or psychiatric advanced registered nurse
9 32 practitioner of a state mental health institute, or that
9 33 officer's physician designee, shall advise a person residing
9 34 in that county who applies for voluntary admission, or a
9 35 person applying for the voluntary admission of another person
10 1 who resides in that county, in accordance with section 229.41,
10 2 that the board of supervisors has implemented the policy
10 3 stated in section 225C.14, and shall advise that a preliminary
10 4 diagnostic evaluation of the prospective patient be sought, if
10 5 that has not already been done. This subsection does not
10 6 apply when voluntary admission is sought in accordance with
10 7 section 229.41 under circumstances which, in the opinion of
10 8 the chief medical officer or that officer's physician designee
10 9 licensed physician, licensed psychiatrist, or psychiatric
10 10 advanced registered nurse practitioner, constitute a medical
10 11 emergency.
10 12 2. The clerk of the district court in that county shall
10 13 refer a person applying for authorization for voluntary
10 14 admission, or for authorization for voluntary admission of
10 15 another person, in accordance with section 229.42, to the
10 16 appropriate entity designated through the central point of
10 17 coordination process under section 225C.14 for the preliminary
10 18 diagnostic evaluation unless the applicant furnishes a written
10 19 statement from the appropriate entity which indicates that the
10 20 evaluation has been performed and that the person's admission
10 21 to a state mental health institute is appropriate. This
10 22 subsection does not apply when authorization for voluntary
10 23 admission is sought under circumstances which, in the opinion
10 24 of the chief medical officer or that officer's physician
10 25 designee licensed physician, licensed psychiatrist, or
10 26 psychiatric advanced registered nurse practitioner, constitute
10 27 a medical emergency.
10 28 4. The chief medical officer licensed physician, licensed
10 29 psychiatrist, or psychiatric advanced registered nurse
10 30 practitioner of a state mental health institute shall promptly
10 31 submit to the appropriate entity designated through the
10 32 central point of coordination process under section 225C.14 a
10 33 report of the voluntary admission of a patient under the
10 34 medical emergency clauses of subsections 1 and 2. The report
10 35 shall explain the nature of the emergency which necessitated
11 1 the admission of the patient without a preliminary diagnostic
11 2 evaluation by the designated entity.
11 3 Sec. 16. Section 227.10, Code 2007, is amended to read as
11 4 follows:
11 5 227.10 TRANSFERS FROM COUNTY OR PRIVATE INSTITUTIONS.
11 6 Patients who have been admitted at public expense to any
11 7 institution to which this chapter is applicable may be
11 8 involuntarily transferred to the proper state hospital for
11 9 persons with mental illness in the manner prescribed by
11 10 sections 229.6 to 229.13. The application required by section
11 11 229.6 may be filed by the administrator of the division or the
11 12 administrator's designee, or by the administrator of the
11 13 institution where the patient is then being maintained or
11 14 treated. If the patient was admitted to that institution
11 15 involuntarily, the administrator of the division may arrange
11 16 and complete the transfer, and shall report it as required of
11 17 a chief medical officer the licensed physician, licensed
11 18 psychiatrist, or psychiatric advanced registered nurse
11 19 practitioner under section 229.15, subsection 4. The transfer
11 20 shall be made at county expense, and the expense recovered, as
11 21 provided in section 227.7. However, transfer under this
11 22 section of a patient whose expenses are payable in whole or in
11 23 part by a county is subject to an authorization for the
11 24 transfer through the central point of coordination process.
11 25 Sec. 17. Section 227.11, Code 2007, is amended to read as
11 26 follows:
11 27 227.11 TRANSFERS FROM STATE HOSPITALS.
11 28 A county chargeable with the expense of a patient in a
11 29 state hospital for persons with mental illness shall transfer
11 30 the patient to a county or private institution for persons
11 31 with mental illness that is in compliance with the applicable
11 32 rules when the administrator of the division or the
11 33 administrator's designee orders the transfer on a finding that
11 34 the patient is suffering from chronic mental illness or from
11 35 senility and will receive equal benefit by being so
12 1 transferred. A county shall transfer to its county care
12 2 facility any patient in a state hospital for persons with
12 3 mental illness upon request of the superintendent of the state
12 4 hospital in which the patient is confined pursuant to the
12 5 superintendent's authority under section 229.15, subsection 4,
12 6 and approval by the board of supervisors of the county of the
12 7 patient's residence. In no case shall a patient be thus
12 8 transferred except upon compliance with section 229.14A or
12 9 without the written consent of a relative, friend, or guardian
12 10 if such relative, friend, or guardian pays the expense of the
12 11 care of such patient in a state hospital. Patients
12 12 transferred to a public or private facility under this section
12 13 may subsequently be placed on convalescent or limited leave or
12 14 transferred to a different facility for continued full=time
12 15 custody, care, and treatment when, in the opinion of the
12 16 attending physician or the chief medical officer licensed
12 17 physician, licensed psychiatrist, or psychiatric advanced
12 18 registered nurse practitioner of the hospital from which the
12 19 patient was so transferred, the best interest of the patient
12 20 would be served by such leave or transfer. For any patient
12 21 who is involuntarily committed, any transfer made under this
12 22 section is subject to the placement hearing requirements of
12 23 section 229.14A.
12 24 Sec. 18. Section 229.1, subsection 4, Code 2007, is
12 25 amended to read as follows:
12 26 4. "Chemotherapy" means treatment of an individual by use
12 27 of a drug or substance which cannot legally be delivered or
12 28 administered to the ultimate user without a physician's an
12 29 authorized prescription or medical order.
12 30 Sec. 19. Section 229.1, subsection 5, Code 2007, is
12 31 amended by striking the subsection.
12 32 Sec. 20. Section 229.1, Code 2007, is amended by adding
12 33 the following new subsections:
12 34 NEW SUBSECTION. 8A. "Licensed psychiatrist" means an
12 35 individual licensed under the provisions of chapter 148, 150,
13 1 or 150A to practice medicine and surgery, osteopathy, or
13 2 osteopathic medicine and surgery with a specialty in
13 3 psychiatry.
13 4 NEW SUBSECTION. 11A. "Psychiatric advanced registered
13 5 nurse practitioner" means an individual currently licensed as
13 6 a registered nurse under chapter 152 or 152E who holds a
13 7 national certification in psychiatric health care and who is
13 8 registered with the board of nursing as an advanced registered
13 9 nurse practitioner.
13 10 Sec. 21. Section 229.1, subsection 13, Code 2007, is
13 11 amended to read as follows:
13 12 13. "Qualified mental health professional" means an
13 13 individual experienced in the study and treatment of mental
13 14 disorders in the capacity of any of the following capacities:
13 15 a. A psychologist certified under chapter 154B; or.
13 16 b. A registered nurse licensed under chapter 152; or with
13 17 three years of work experience in psychiatric health care.
13 18 c. A social worker licensed under chapter 154C.
13 19 d. A physician assistant licensed under chapter 148C with
13 20 three years of work experience in psychiatric health care.
13 21 e. A psychiatric advanced registered nurse practitioner.
13 22 Sec. 22. Section 229.2, subsection 1, paragraphs a and b,
13 23 Code 2007, are amended to read as follows:
13 24 a. Upon receipt of an application for voluntary admission
13 25 of a minor, the chief medical officer licensed physician,
13 26 licensed psychiatrist, or psychiatric advanced registered
13 27 nurse practitioner of the hospital shall provide separate
13 28 prescreening interviews and consultations with the parent,
13 29 guardian or custodian and the minor to assess the family
13 30 environment and the appropriateness of the application for
13 31 admission.
13 32 b. During the interview and consultation the chief medical
13 33 officer licensed physician, licensed psychiatrist, or
13 34 psychiatric advanced registered nurse practitioner shall
13 35 inform the minor orally and in writing that the minor has a
14 1 right to object to the admission. If the chief medical
14 2 officer licensed physician, licensed psychiatrist, or
14 3 psychiatric advanced registered nurse practitioner of the
14 4 hospital to which application is made determines that the
14 5 admission is appropriate but the minor objects to the
14 6 admission, the parent, guardian or custodian must petition the
14 7 juvenile court for approval of the admission before the minor
14 8 is actually admitted.
14 9 Sec. 23. Section 229.2, subsection 2, paragraphs a and b,
14 10 Code 2007, are amended to read as follows:
14 11 a. The chief medical officer licensed physician, licensed
14 12 psychiatrist, or psychiatric advanced registered nurse
14 13 practitioner of a public hospital shall receive and may admit
14 14 the person whose admission is sought, subject in cases other
14 15 than medical emergencies to availability of suitable
14 16 accommodations and to the provisions of sections 229.41 and
14 17 229.42.
14 18 b. The chief medical officer licensed physician, licensed
14 19 psychiatrist, or psychiatric advanced registered nurse
14 20 practitioner of a private hospital may receive and may admit
14 21 the person whose admission is sought.
14 22 Sec. 24. Section 229.3, Code 2007, is amended to read as
14 23 follows:
14 24 229.3 DISCHARGE OF VOLUNTARY PATIENTS.
14 25 Any voluntary patient who has recovered, or whose
14 26 hospitalization the chief medical officer licensed physician,
14 27 licensed psychiatrist, or psychiatric advanced registered
14 28 nurse practitioner of the hospital determines is no longer
14 29 advisable, shall be discharged. Any voluntary patient may be
14 30 discharged if to do so would in the judgment of the chief
14 31 medical officer contribute to the most effective use of the
14 32 hospital in the care and treatment of that patient and of
14 33 other persons with mental illness.
14 34 Sec. 25. Section 229.4, subsection 3, Code 2007, is
14 35 amended to read as follows:
15 1 3. If the chief medical officer licensed physician,
15 2 licensed psychiatrist, or psychiatric advanced registered
15 3 nurse practitioner of the hospital, not later than the end of
15 4 the next secular day on which the office of the clerk of the
15 5 district court for the county in which the hospital is located
15 6 is open and which follows the submission of the written
15 7 request for release of the patient, files with that clerk a
15 8 certification that in the chief medical officer's opinion of
15 9 the licensed physician, licensed psychiatrist, or psychiatric
15 10 advanced registered nurse practitioner the patient is
15 11 seriously mentally impaired, the release may be postponed for
15 12 the period of time the court determines is necessary to permit
15 13 commencement of judicial procedure for involuntary
15 14 hospitalization. That period of time may not exceed five
15 15 days, exclusive of days on which the clerk's office is not
15 16 open unless the period of time is extended by order of a
15 17 district court judge for good cause shown. Until disposition
15 18 of the application for involuntary hospitalization of the
15 19 patient, if one is timely filed, the chief medical officer
15 20 licensed physician, licensed psychiatrist, or psychiatric
15 21 advanced registered nurse practitioner may detain the patient
15 22 in the hospital and may provide treatment which is necessary
15 23 to preserve the patient's life, or to appropriately control
15 24 behavior by the patient which is likely to result in physical
15 25 injury to the patient or to others if allowed to continue, but
15 26 may not otherwise provide treatment to the patient without the
15 27 patient's consent.
15 28 Sec. 26. Section 229.5, Code 2007, is amended to read as
15 29 follows:
15 30 229.5 DEPARTURE WITHOUT NOTICE.
15 31 If a voluntary patient departs from the hospital without
15 32 notice, and in the opinion of the chief medical officer
15 33 licensed physician, licensed psychiatrist, or psychiatric
15 34 advanced registered nurse practitioner of the hospital the
15 35 patient is seriously mentally impaired, the chief medical
16 1 officer licensed physician, licensed psychiatrist, or
16 2 psychiatric advanced registered nurse practitioner may file an
16 3 application for involuntary hospitalization of the departed
16 4 voluntary patient, and request that an order for immediate
16 5 custody be entered by the court pursuant to section 229.11.
16 6 Sec. 27. Section 229.6, subsection 3, Code 2007, is
16 7 amended to read as follows:
16 8 3. Be accompanied by all of the following:
16 9 a. A written statement of a licensed physician, licensed
16 10 psychiatrist, or psychiatric advanced registered nurse
16 11 practitioner in support of the application; or.
16 12 b. One or more supporting affidavits otherwise
16 13 corroborating the application; or.
16 14 c. Corroborative information obtained and reduced to
16 15 writing by the clerk or the clerk's designee, but only when
16 16 circumstances make it infeasible to comply with, or when the
16 17 clerk considers it appropriate to supplement the information
16 18 supplied pursuant to, either paragraph "a" or paragraph "b" of
16 19 this subsection.
16 20 Sec. 28. Section 229.8, subsection 3, paragraph b, Code
16 21 2007, is amended to read as follows:
16 22 b. Order an examination of the respondent, prior to the
16 23 hearing, by one or more licensed physicians, licensed
16 24 psychiatrists, or psychiatric advanced registered nurse
16 25 practitioners who shall submit a written report on the
16 26 examination to the court as required by section 229.10.
16 27 Sec. 29. Section 229.10, Code 2007, is amended to read as
16 28 follows:
16 29 229.10 PHYSICIANS' EXAMINATION == REPORT.
16 30 1. An examination of the respondent shall be conducted by
16 31 one or more licensed physicians, licensed psychiatrists, or
16 32 psychiatric advanced registered nurse practitioners as
16 33 required by the court's order, within a reasonable time. If
16 34 the respondent is detained pursuant to section 229.11,
16 35 subsection 2, the examination shall be conducted within
17 1 twenty=four hours. If the respondent is detained pursuant to
17 2 section 229.11, subsection 1 or 3, the examination shall be
17 3 conducted within forty=eight hours. If the respondent so
17 4 desires, the respondent shall be entitled to a separate
17 5 examination by a licensed physician, licensed psychiatrist, or
17 6 psychiatric advanced registered nurse practitioner of the
17 7 respondent's own choice. The reasonable cost of the
17 8 examinations shall, if the respondent lacks sufficient funds
17 9 to pay the cost, be paid from county funds upon order of the
17 10 court.
17 11 Any licensed physician, licensed psychiatrist, or
17 12 psychiatric advanced registered nurse practitioner conducting
17 13 an examination pursuant to this section may consult with or
17 14 request the participation in the examination of any qualified
17 15 mental health professional, and may include with or attach to
17 16 the written report of the examination any findings or
17 17 observations by any qualified mental health professional who
17 18 has been so consulted or has so participated in the
17 19 examination.
17 20 If the respondent is not taken into custody under section
17 21 229.11, but the court is subsequently informed that the
17 22 respondent has declined to be examined by the licensed
17 23 physician or physicians, licensed psychiatrist, or psychiatric
17 24 advanced registered nurse practitioner pursuant to the court
17 25 order, the court may order such limited detention of the
17 26 respondent as is necessary to facilitate the examination of
17 27 the respondent by the licensed physician or physicians,
17 28 licensed psychiatrist, or psychiatric advanced registered
17 29 nurse practitioner.
17 30 2. A written report of the examination by the
17 31 court=designated licensed physician or physicians, licensed
17 32 psychiatrist, or psychiatric advanced registered nurse
17 33 practitioner shall be filed with the clerk prior to the time
17 34 set for hearing. A written report of any examination by a
17 35 licensed physician, licensed psychiatrist, or psychiatric
18 1 advanced registered nurse practitioner chosen by the
18 2 respondent may be similarly filed. The clerk shall
18 3 immediately do all of the following:
18 4 a. Cause the report or reports to be shown to the judge
18 5 who issued the order; and.
18 6 b. Cause the respondent's attorney to receive a copy of
18 7 the report of the court=designated licensed physician or
18 8 physicians, licensed psychiatrist, or psychiatric advanced
18 9 registered nurse practitioner.
18 10 3. If the report of the court=designated licensed
18 11 physician or physicians, licensed psychiatrist, or psychiatric
18 12 advanced registered nurse practitioner is to the effect that
18 13 the individual is not seriously mentally impaired, the court
18 14 may without taking further action terminate the proceeding and
18 15 dismiss the application on its own motion and without notice.
18 16 4. If the report of the court=designated licensed
18 17 physician or physicians, licensed psychiatrist, or psychiatric
18 18 advanced registered nurse practitioner is to the effect that
18 19 the respondent is seriously mentally impaired, the court shall
18 20 schedule a hearing on the application as soon as possible.
18 21 The hearing shall be held not more than forty=eight hours
18 22 after the report is filed, excluding Saturdays, Sundays and
18 23 holidays, unless an extension for good cause is requested by
18 24 the respondent, or as soon thereafter as possible if the court
18 25 considers that sufficient grounds exist for delaying the
18 26 hearing.
18 27 Sec. 30. Section 229.11, subsection 2, Code 2007, is
18 28 amended to read as follows:
18 29 2. In a suitable hospital the chief medical officer of
18 30 which licensed physician, licensed psychiatrist, or
18 31 psychiatric advanced registered nurse practitioner of the
18 32 hospital shall be informed of the reasons why immediate
18 33 custody has been ordered and may provide treatment which is
18 34 necessary to preserve the respondent's life, or to
18 35 appropriately control behavior by the respondent which is
19 1 likely to result in physical injury to the respondent or to
19 2 others if allowed to continue, but may not otherwise provide
19 3 treatment to the respondent without the respondent's consent;
19 4 or
19 5 Sec. 31. Section 229.13, subsections 4, 5, and 6, Code
19 6 2007, are amended to read as follows:
19 7 4. The court shall furnish to the chief medical officer
19 8 licensed physician, licensed psychiatrist, or psychiatric
19 9 advanced registered nurse practitioner of the hospital or
19 10 facility at the time the respondent arrives at the hospital or
19 11 facility for inpatient or outpatient treatment a written
19 12 finding of fact setting forth the evidence on which the
19 13 finding is based. If the respondent is ordered to undergo
19 14 outpatient treatment, the order shall also require the
19 15 respondent to cooperate with the treatment provider and comply
19 16 with the course of treatment.
19 17 5. The chief medical officer licensed physician, licensed
19 18 psychiatrist, or psychiatric advanced registered nurse
19 19 practitioner of the hospital or facility at which the
19 20 respondent is placed shall report to the court no more than
19 21 fifteen days after the respondent is placed, making a
19 22 recommendation for disposition of the matter. An extension of
19 23 time may be granted, not to exceed seven days upon a showing
19 24 of cause. A copy of the report shall be sent to the
19 25 respondent's attorney, who may contest the need for an
19 26 extension of time if one is requested. An extension of time
19 27 shall be granted upon request unless the request is contested,
19 28 in which case the court shall make such inquiry as it deems
19 29 appropriate and may either order the respondent's release from
19 30 the hospital or facility or grant an extension of time for
19 31 psychiatric evaluation. If the chief medical officer licensed
19 32 physician, licensed psychiatrist, or psychiatric advanced
19 33 registered nurse practitioner fails to report to the court
19 34 within fifteen days after the individual is placed under the
19 35 care of the hospital or facility, and an extension of time has
20 1 not been requested, the chief medical officer licensed
20 2 physician, licensed psychiatrist, or psychiatric advanced
20 3 registered nurse practitioner is guilty of contempt and shall
20 4 be punished under chapter 665. The court shall order a
20 5 rehearing on the application to determine whether the
20 6 respondent should continue to be detained at or placed under
20 7 the care of the facility.
20 8 6. If, after placement of a respondent in or under the
20 9 care of a hospital or other suitable facility for inpatient
20 10 treatment, the respondent departs from the hospital or
20 11 facility or fails to appear for treatment as ordered without
20 12 prior proper authorization from the chief medical officer
20 13 licensed physician, licensed psychiatrist, or psychiatric
20 14 advanced registered nurse practitioner, upon receipt of
20 15 notification of the respondent's departure or failure to
20 16 appear by the chief medical officer licensed physician,
20 17 licensed psychiatrist, or psychiatric advanced registered
20 18 nurse practitioner, a peace officer of the state shall without
20 19 further order of the court exercise all due diligence to take
20 20 the respondent into protective custody and return the
20 21 respondent to the hospital or facility.
20 22 Sec. 32. Section 229.14, Code 2007, is amended to read as
20 23 follows:
20 24 229.14 CHIEF MEDICAL OFFICER'S EVALUATOR'S REPORT.
20 25 1. The chief medical officer's report to the court on the
20 26 psychiatric evaluation of the respondent prepared by the
20 27 licensed physician, licensed psychiatrist, or psychiatric
20 28 advanced registered nurse practitioner of the hospital shall
20 29 be made not later than the expiration of the time specified in
20 30 section 229.13. At least two copies of the report shall be
20 31 filed with the clerk, who shall dispose of them in the manner
20 32 prescribed by section 229.10, subsection 2. The report shall
20 33 state one of the four following alternative findings:
20 34 a. That the respondent does not, as of the date of the
20 35 report, require further treatment for serious mental
21 1 impairment. If the report so states, the court shall order
21 2 the respondent's immediate release from involuntary
21 3 hospitalization and terminate the proceedings.
21 4 b. That the respondent is seriously mentally impaired and
21 5 in need of full=time custody, care and inpatient treatment in
21 6 a hospital, and is considered likely to benefit from
21 7 treatment. The report shall include the chief medical
21 8 officer's recommendation of the licensed physician, licensed
21 9 psychiatrist, or psychiatric advanced registered nurse
21 10 practitioner for further treatment.
21 11 c. That the respondent is seriously mentally impaired and
21 12 in need of treatment, but does not require full=time
21 13 hospitalization. If the report so states, it shall include
21 14 the chief medical officer's recommendation of the licensed
21 15 physician, licensed psychiatrist, or psychiatric advanced
21 16 registered nurse practitioner for treatment of the respondent
21 17 on an outpatient or other appropriate basis.
21 18 d. The respondent is seriously mentally impaired and in
21 19 need of full=time custody and care, but is unlikely to benefit
21 20 from further inpatient treatment in a hospital. The report
21 21 shall include the chief medical officer's recommendation of
21 22 the licensed physician, licensed psychiatrist, or psychiatric
21 23 advanced registered nurse practitioner for an appropriate
21 24 alternative placement for the respondent.
21 25 2. Following receipt of the chief medical officer's report
21 26 of the licensed physician, licensed psychiatrist, or
21 27 psychiatric advanced registered nurse practitioner under
21 28 subsection 1, paragraph "b", "c", or "d", the court shall
21 29 issue an order for appropriate treatment as follows:
21 30 a. For a respondent whose expenses are payable in whole or
21 31 in part by a county, placement as designated through the
21 32 central point of coordination process in the care of an
21 33 appropriate hospital or facility on an inpatient or outpatient
21 34 basis, or other appropriate treatment, or in an appropriate
21 35 alternative placement.
22 1 b. For any other respondent, placement in the care of an
22 2 appropriate hospital or facility on an inpatient or outpatient
22 3 basis, or other appropriate treatment, or an appropriate
22 4 alternative placement.
22 5 c. For a respondent who is an inmate in the custody of the
22 6 department of corrections, the court may order the respondent
22 7 to receive mental health services in a correctional program.
22 8 d. If the court orders treatment of the respondent on an
22 9 outpatient or other appropriate basis as described in the
22 10 chief medical officer's report of the licensed physician,
22 11 licensed psychiatrist, or psychiatric advanced registered
22 12 nurse practitioner pursuant to subsection 1, paragraph "c",
22 13 the order shall provide that, should the respondent fail or
22 14 refuse to submit to treatment in accordance with the court's
22 15 order, the court may order that the respondent be taken into
22 16 immediate custody as provided by section 229.11 and, following
22 17 notice and hearing held in accordance with the procedures of
22 18 section 229.12, may order the respondent treated on an
22 19 inpatient basis requiring full=time custody, care, and
22 20 treatment in a hospital until such time as the chief medical
22 21 officer licensed physician, licensed psychiatrist, or
22 22 psychiatric advanced registered nurse practitioner reports
22 23 that the respondent does not require further treatment for
22 24 serious mental impairment or has indicated the respondent is
22 25 willing to submit to treatment on another basis as ordered by
22 26 the court. If a patient is transferred for treatment to
22 27 another provider under this paragraph, the treatment provider
22 28 who will be providing the outpatient or other appropriate
22 29 treatment shall be provided with copies of relevant court
22 30 orders by the former treatment provider.
22 31 Sec. 33. Section 229.14A, subsection 1, Code 2007, is
22 32 amended to read as follows:
22 33 1. With respect to a chief medical officer's report of the
22 34 licensed physician, licensed psychiatrist, or psychiatric
22 35 advanced registered nurse practitioner made pursuant to
23 1 section 229.14, subsection 1, paragraph "b", "c", or "d", or
23 2 any other provision of this chapter related to involuntary
23 3 commitment for which the court issues a placement order or a
23 4 transfer of placement is authorized, the court shall provide
23 5 notice to the respondent and the respondent's attorney or
23 6 mental health advocate pursuant to section 229.19 concerning
23 7 the placement order and the respondent's right to request a
23 8 placement hearing to determine if the order for placement or
23 9 transfer of placement is appropriate.
23 10 Sec. 34. Section 229.14B, Code 2007, is amended to read as
23 11 follows:
23 12 229.14B ESCAPE FROM CUSTODY.
23 13 A person who is placed in a hospital or other suitable
23 14 facility for evaluation under section 229.13 or who is
23 15 required to remain hospitalized for treatment under section
23 16 229.14 shall remain at that hospital or facility unless
23 17 discharged or otherwise permitted to leave by the court or the
23 18 chief medical officer licensed physician, licensed
23 19 psychiatrist, or psychiatric advanced registered nurse
23 20 practitioner of the hospital or facility. If a person placed
23 21 at a hospital or facility or required to remain at a hospital
23 22 or facility leaves the facility without permission or without
23 23 having been discharged, the chief medical officer licensed
23 24 physician, licensed psychiatrist, or psychiatric advanced
23 25 registered nurse practitioner may notify the sheriff of the
23 26 person's absence and the sheriff shall take the person into
23 27 custody and return the person promptly to the hospital or
23 28 facility.
23 29 Sec. 35. Section 229.15, subsections 1 and 2, Code 2007,
23 30 are amended to read as follows:
23 31 1. Not more than thirty days after entry of an order for
23 32 continued hospitalization of a patient under section 229.14,
23 33 subsection 1, paragraph "b", and thereafter at successive
23 34 intervals of not more than sixty days continuing so long as
23 35 involuntary hospitalization of the patient continues, the
24 1 chief medical officer licensed physician, licensed
24 2 psychiatrist, or psychiatric advanced registered nurse
24 3 practitioner of the hospital shall report to the court which
24 4 entered the order. The report shall be submitted in the
24 5 manner required by section 229.14, shall state whether the
24 6 patient's condition has improved, remains unchanged, or has
24 7 deteriorated, and shall indicate if possible the further
24 8 length of time the patient will be required to remain at the
24 9 hospital. The chief medical officer licensed physician,
24 10 licensed psychiatrist, or psychiatric advanced registered
24 11 nurse practitioner may at any time report to the court a
24 12 finding as stated in section 229.14, subsection 1, and the
24 13 court shall act upon the finding as required by section
24 14 229.14, subsection 2.
24 15 2. Not more than sixty days after the entry of a court
24 16 order for treatment of a patient pursuant to a report issued
24 17 under section 229.14, subsection 1, paragraph "c", and
24 18 thereafter at successive intervals as ordered by the court but
24 19 not to exceed ninety days so long as that court order remains
24 20 in effect, the medical director of the facility treating the
24 21 patient shall report to the court which entered the order.
24 22 The report shall state whether the patient's condition has
24 23 improved, remains unchanged, or has deteriorated, and shall
24 24 indicate if possible the further length of time the patient
24 25 will require treatment by the facility. If at any time the
24 26 patient without good cause fails or refuses to submit to
24 27 treatment as ordered by the court, the medical director shall
24 28 at once so notify the court, which shall order the patient
24 29 hospitalized as provided by section 229.14, subsection 2,
24 30 paragraph "d", unless the court finds that the failure or
24 31 refusal was with good cause and that the patient is willing to
24 32 receive treatment as provided in the court's order, or in a
24 33 revised order if the court sees fit to enter one. If at any
24 34 time the medical director reports to the court that in the
24 35 director's opinion the patient requires full=time custody,
25 1 care and treatment in a hospital, and the patient is willing
25 2 to be admitted voluntarily to the hospital for these purposes,
25 3 the court may enter an order approving hospitalization for
25 4 appropriate treatment upon consultation with the chief medical
25 5 officer licensed physician, licensed psychiatrist, or
25 6 psychiatric advanced registered nurse practitioner of the
25 7 hospital in which the patient is to be hospitalized. If the
25 8 patient is unwilling to be admitted voluntarily to the
25 9 hospital, the procedure for determining involuntary
25 10 hospitalization, as set out in section 229.14, subsection 2,
25 11 paragraph "d", shall be followed.
25 12 Sec. 36. Section 229.15, subsection 4, paragraph a, Code
25 13 2007, is amended to read as follows:
25 14 a. When in the opinion of the chief medical officer
25 15 licensed physician, licensed psychiatrist, or psychiatric
25 16 advanced registered nurse practitioner, the best interest of a
25 17 patient would be served by a convalescent or limited leave,
25 18 the chief medical officer licensed physician, licensed
25 19 psychiatrist, or psychiatric advanced registered nurse
25 20 practitioner may authorize the leave and, if authorized, shall
25 21 promptly report the leave to the court. When in the opinion
25 22 of the chief medical officer licensed physician, licensed
25 23 psychiatrist, or psychiatric advanced registered nurse
25 24 practitioner the best interest of a patient would be served by
25 25 a transfer to a different hospital for continued full=time
25 26 custody, care, and treatment, the chief medical officer
25 27 licensed physician, licensed psychiatrist, or psychiatric
25 28 advanced registered nurse practitioner shall promptly send a
25 29 report to the court. The court shall act upon the report in
25 30 accordance with section 229.14A.
25 31 Sec. 37. Section 229.16, Code 2007, is amended to read as
25 32 follows:
25 33 229.16 DISCHARGE AND TERMINATION OF PROCEEDING.
25 34 When the condition of a patient who is hospitalized
25 35 pursuant to a report issued under section 229.14, subsection
26 1 1, paragraph "b", or is receiving treatment pursuant to a
26 2 report issued under section 229.14, subsection 1, paragraph
26 3 "c", or is in full=time care and custody pursuant to a report
26 4 issued under section 229.14, subsection 1, paragraph "d", is
26 5 such that in the opinion of the chief medical officer licensed
26 6 physician, licensed psychiatrist, or psychiatric advanced
26 7 registered nurse practitioner the patient no longer requires
26 8 treatment or care for serious mental impairment, the chief
26 9 medical officer licensed physician, licensed psychiatrist, or
26 10 psychiatric advanced registered nurse practitioner shall
26 11 tentatively discharge the patient and immediately report that
26 12 fact to the court which ordered the patient's hospitalization
26 13 or care and custody. Upon receiving the report, the court
26 14 shall issue an order confirming the patient's discharge from
26 15 the hospital or from care and custody, as the case may be, and
26 16 shall terminate the proceedings pursuant to which the order
26 17 was issued. Copies of the order shall be sent by regular mail
26 18 to the hospital, the patient, and the applicant if the
26 19 applicant has filed a written waiver signed by the patient.
26 20 Sec. 38. Section 229.19, subsection 2, Code Supplement
26 21 2007, is amended to read as follows:
26 22 2. The hospital or facility to which a patient is
26 23 committed shall grant all reasonable requests of the advocate
26 24 to visit the patient, to communicate with medical personnel
26 25 all qualified mental health professionals treating the
26 26 patient, and to review the patient's medical records pursuant
26 27 to section 229.25. An advocate shall not disseminate
26 28 information from a patient's medical records to any other
26 29 person unless done for official purposes in connection with
26 30 the advocate's duties pursuant to this chapter or when
26 31 required by law.
26 32 Sec. 39. Section 229.21, subsection 4, Code 2007, is
26 33 amended to read as follows:
26 34 4. If the appellant is in custody under the jurisdiction
26 35 of the district court at the time of service of the notice of
27 1 appeal, the appellant shall be discharged from custody unless
27 2 an order that the appellant be taken into immediate custody
27 3 has previously been issued under section 229.11 or section
27 4 125.81, in which case the appellant shall be detained as
27 5 provided in that section until the hospitalization or
27 6 commitment hearing before the district judge. If the
27 7 appellant is in the custody of a hospital or facility at the
27 8 time of service of the notice of appeal, the appellant shall
27 9 be discharged from custody pending disposition of the appeal
27 10 unless the chief medical officer licensed physician, licensed
27 11 psychiatrist, or psychiatric advanced registered nurse
27 12 practitioner of the hospital or facility, not later than the
27 13 end of the next secular day on which the office of the clerk
27 14 is open and which follows service of the notice of appeal,
27 15 files with the clerk a certification that in the chief medical
27 16 officer's opinion of the licensed physician, licensed
27 17 psychiatrist, or psychiatric advanced registered nurse
27 18 practitioner, the appellant is seriously mentally ill or a
27 19 substance abuser. In that case, the appellant shall remain in
27 20 custody of the hospital or facility until the hospitalization
27 21 or commitment hearing before the district court.
27 22 Sec. 40. Section 229.22, subsection 2, unnumbered
27 23 paragraph 2, Code 2007, is amended to read as follows:
27 24 If the magistrate orders that the person be detained, the
27 25 magistrate shall, by the close of business on the next working
27 26 day, file a written order with the clerk in the county where
27 27 it is anticipated that an application may be filed under
27 28 section 229.6. The order may be filed by facsimile if
27 29 necessary. The order shall state the circumstances under
27 30 which the person was taken into custody or otherwise brought
27 31 to a facility, and the grounds supporting the finding of
27 32 probable cause to believe that the person is seriously
27 33 mentally impaired and likely to injure the person's self or
27 34 others if not immediately detained. The order shall confirm
27 35 the oral order authorizing the person's detention including
28 1 any order given to transport the person to an appropriate
28 2 facility. The clerk shall provide a copy of that order to the
28 3 chief medical officer licensed physician, licensed
28 4 psychiatrist, or psychiatric advanced registered nurse
28 5 practitioner of the facility to which the person was
28 6 originally taken, to any subsequent facility to which the
28 7 person was transported, and to any law enforcement department
28 8 or ambulance service that transported the person pursuant to
28 9 the magistrate's order.
28 10 Sec. 41. Section 229.22, subsection 3, Code 2007, is
28 11 amended to read as follows:
28 12 3. The chief medical officer licensed physician, licensed
28 13 psychiatrist, or psychiatric advanced registered nurse
28 14 practitioner of the hospital shall examine and may detain and
28 15 care for the person taken into custody under the magistrate's
28 16 order for a period not to exceed forty=eight hours from the
28 17 time such order is dated, excluding Saturdays, Sundays and
28 18 holidays, unless the order is sooner dismissed by a
28 19 magistrate. The hospital may provide treatment which is
28 20 necessary to preserve the person's life, or to appropriately
28 21 control behavior by the person which is likely to result in
28 22 physical injury to the person's self or others if allowed to
28 23 continue, but may not otherwise provide treatment to the
28 24 person without the person's consent. The person shall be
28 25 discharged from the hospital and released from custody not
28 26 later than the expiration of that period, unless an
28 27 application for the person's involuntary hospitalization is
28 28 sooner filed with the clerk pursuant to section 229.6. The
28 29 detention of any person by the procedure and not in excess of
28 30 the period of time prescribed by this section shall not render
28 31 the peace officer, licensed physician, licensed psychiatrist,
28 32 or psychiatric advanced registered nurse practitioner, or
28 33 hospital so detaining that person liable in a criminal or
28 34 civil action for false arrest or false imprisonment if the
28 35 peace officer, licensed physician, licensed psychiatrist, or
29 1 psychiatric advanced registered nurse practitioner, or
29 2 hospital had reasonable grounds to believe the person so
29 3 detained was mentally ill and likely to physically injure the
29 4 person's self or others if not immediately detained.
29 5 Sec. 42. Section 229.23, subsections 2 and 3, Code 2007,
29 6 are amended to read as follows:
29 7 2. The right to refuse treatment by shock therapy or
29 8 chemotherapy, unless the use of these treatment modalities is
29 9 specifically consented to by the patient's next of kin or
29 10 guardian. The patient's right to refuse treatment by
29 11 chemotherapy shall not apply during any period of custody
29 12 authorized by section 229.4, subsection 3, section 229.11 or
29 13 section 229.22, but this exception shall extend only to
29 14 chemotherapy treatment which is, in the chief medical
29 15 officer's treating qualified mental health professional's
29 16 judgment, necessary to preserve the patient's life or to
29 17 appropriately control behavior by the person which is likely
29 18 to result in physical injury to that person or others if
29 19 allowed to continue. The patient's right to refuse treatment
29 20 by chemotherapy shall also not apply during any period of
29 21 custody authorized by the court pursuant to section 229.13 or
29 22 229.14. In any other situation in which, in the chief medical
29 23 officer's treating qualified mental health professional's
29 24 judgment, chemotherapy is appropriate for the patient but the
29 25 patient refuses to consent thereto and there is no next of kin
29 26 or guardian to give consent, the chief medical officer
29 27 treating qualified mental health professional may request an
29 28 order authorizing treatment of the patient by chemotherapy
29 29 from the district court which ordered the patient's
29 30 hospitalization.
29 31 3. In addition to protection of the person's
29 32 constitutional rights, enjoyment of other legal, medical,
29 33 religious, social, political, personal and working rights and
29 34 privileges which the person would enjoy if the person were not
29 35 so hospitalized or detained, so far as is possible consistent
30 1 with effective treatment of that person and of the other
30 2 patients of the hospital. If the patient's rights are
30 3 restricted, the physician's treating qualified mental health
30 4 professional's direction to that effect shall be noted on the
30 5 patient's record. The department of human services shall, in
30 6 accordance with chapter 17A establish rules setting forth the
30 7 specific rights and privileges to which persons so
30 8 hospitalized or detained are entitled under this section, and
30 9 the exceptions provided by section 17A.2, subsection 11,
30 10 paragraphs "a" and "k", shall not be applicable to the rules
30 11 so established. The patient or the patient's next of kin or
30 12 friend shall be advised of these rules and be provided a
30 13 written copy upon the patient's admission to or arrival at the
30 14 hospital.
30 15 Sec. 43. Section 229.25, Code 2007, is amended to read as
30 16 follows:
30 17 229.25 MEDICAL RECORDS TO BE CONFIDENTIAL == EXCEPTIONS.
30 18 The records maintained by a hospital or other facility
30 19 relating to the examination, custody, care and treatment of
30 20 any person in that hospital or facility pursuant to this
30 21 chapter shall be confidential, except that the chief medical
30 22 officer licensed physician, licensed psychiatrist, or
30 23 psychiatric advanced registered nurse practitioner of the
30 24 hospital or facility, or treating qualified mental health
30 25 professional shall release appropriate information under any
30 26 of the following circumstances:
30 27 1. The information is requested by a licensed physician,
30 28 attorney, or advocate who provides the chief medical officer
30 29 licensed physician, licensed psychiatrist, psychiatric
30 30 advanced registered nurse practitioner, or treating qualified
30 31 mental health professional with a written waiver signed by the
30 32 person about whom the information is sought.
30 33 2. The information is sought by a court order.
30 34 3. The person who is hospitalized or that person's
30 35 guardian, if the person is a minor or is not legally competent
31 1 to do so, signs an informed consent to release information.
31 2 Each signed consent shall designate specifically the person or
31 3 agency to whom the information is to be sent, and the
31 4 information may be sent only to that person or agency.
31 5 Such records may be released by the chief medical officer
31 6 licensed physician, licensed psychiatrist, psychiatric
31 7 advanced registered nurse practitioner, or treating qualified
31 8 mental health professional when requested for the purpose of
31 9 research into the causes, incidence, nature and treatment of
31 10 mental illness, however information shall not be provided in a
31 11 way that discloses patients' names or which otherwise
31 12 discloses any patient's identity.
31 13 When the chief medical officer licensed physician, licensed
31 14 psychiatrist, psychiatric advanced registered nurse
31 15 practitioner, or treating qualified mental health professional
31 16 deems it to be in the best interest of the patient and the
31 17 patient's next of kin to do so, the chief medical officer
31 18 licensed physician, licensed psychiatrist, licensed
31 19 psychologist, psychiatric advanced registered nurse
31 20 practitioner, or treating qualified mental health professional
31 21 may release appropriate information during a consultation
31 22 which the hospital or facility shall arrange with the next of
31 23 kin of a voluntary or involuntary patient, if requested by the
31 24 patient's next of kin.
31 25 Sec. 44. Section 229.28, Code 2007, is amended to read as
31 26 follows:
31 27 229.28 HOSPITALIZATION IN CERTAIN FEDERAL FACILITIES.
31 28 When a court finds that the contention that a respondent is
31 29 seriously mentally impaired has been sustained or proposes to
31 30 order continued hospitalization of any person, or an
31 31 alternative placement, as described under section 229.14,
31 32 subsection 1, paragraph "b" or "d", and the court is furnished
31 33 evidence that the respondent or patient is eligible for care
31 34 and treatment in a facility operated by the veterans
31 35 administration or another agency of the United States
32 1 government and that the facility is willing to receive the
32 2 respondent or patient, the court may so order. The respondent
32 3 or patient, when so hospitalized or placed in a facility
32 4 operated by the veterans administration or another agency of
32 5 the United States government within or outside of this state,
32 6 shall be subject to the rules of the veterans administration
32 7 or other agency, but shall not thereby lose any procedural
32 8 rights afforded the respondent or patient by this chapter.
32 9 The chief officer of the facility shall have, with respect to
32 10 the person so hospitalized or placed, the same powers and
32 11 duties as the chief medical officer licensed physician,
32 12 licensed psychiatrist, or psychiatric advanced registered
32 13 nurse practitioner of a hospital in this state would have in
32 14 regard to submission of reports to the court, retention of
32 15 custody, transfer, convalescent leave or discharge.
32 16 Jurisdiction is retained in the court to maintain surveillance
32 17 of the person's treatment and care, and at any time to inquire
32 18 into that person's mental condition and the need for continued
32 19 hospitalization or care and custody.
32 20 Sec. 45. Section 229.29, Code 2007, is amended to read as
32 21 follows:
32 22 229.29 TRANSFER TO CERTAIN FEDERAL FACILITIES.
32 23 Upon receipt of a certificate stating that any person
32 24 involuntarily hospitalized under this chapter is eligible for
32 25 care and treatment in a facility operated by the veterans
32 26 administration or another agency of the United States
32 27 government which is willing to receive the person without
32 28 charge to the state of Iowa or any county in the state, the
32 29 chief medical officer licensed physician, licensed
32 30 psychiatrist, or psychiatric advanced registered nurse
32 31 practitioner may transfer the person to that facility. Upon
32 32 so doing, the chief medical officer licensed physician,
32 33 licensed psychiatrist, or psychiatric advanced registered
32 34 nurse practitioner shall notify the court which ordered the
32 35 person's hospitalization in the same manner as would be
33 1 required in the case of a transfer under section 229.15,
33 2 subsection 4, and the person transferred shall be entitled to
33 3 the same rights as the person would have under that
33 4 subsection. No person shall be transferred under this section
33 5 who is confined pursuant to conviction of a public offense or
33 6 whose hospitalization was ordered upon contention of
33 7 incompetence to stand trial by reason of mental illness,
33 8 without prior approval of the court which ordered that
33 9 person's hospitalization.
33 10 Sec. 46. Section 229.31, Code 2007, is amended to read as
33 11 follows:
33 12 229.31 COMMISSION OF INQUIRY.
33 13 A sworn complaint, alleging that a named person is not
33 14 seriously mentally impaired and is unjustly deprived of
33 15 liberty in any hospital in the state, may be filed by any
33 16 person with the clerk of the district court of the county in
33 17 which such named person is so confined, or of the county in
33 18 which such named person has a legal settlement, and thereupon
33 19 a judge of said court shall appoint a commission of not more
33 20 than three persons to inquire into the truth of said
33 21 allegations. One of said commissioners shall be a physician
33 22 licensed psychiatrist or psychiatric advanced registered nurse
33 23 practitioner and if additional commissioners are appointed,
33 24 one of such commissioners shall be a lawyer.
33 25 Sec. 47. Section 229.32, Code 2007, is amended to read as
33 26 follows:
33 27 229.32 DUTY OF COMMISSION.
33 28 Said commission shall at once proceed to the place where
33 29 said person is confined and make a thorough and discreet
33 30 examination for the purpose of determining the truth of said
33 31 allegations and shall promptly report its findings to said
33 32 judge in writing. Said report shall be accompanied by a
33 33 written statement of the case signed by the chief medical
33 34 officer licensed physician, licensed psychiatrist, or
33 35 psychiatric advanced registered nurse practitioner of the
34 1 hospital in which the person is confined.
34 2 Sec. 48. Section 229.34, Code 2007, is amended to read as
34 3 follows:
34 4 229.34 FINDING AND ORDER FILED.
34 5 The finding and order of the judge, with the report and
34 6 other papers, shall be filed in the office of the clerk of the
34 7 court where the complaint was filed. Said clerk shall enter a
34 8 memorandum thereof on the appropriate record, and forthwith
34 9 notify the chief medical officer licensed physician, licensed
34 10 psychiatrist, or psychiatric advanced registered nurse
34 11 practitioner of the hospital of the finding and order of the
34 12 judge, and the chief medical officer licensed physician,
34 13 licensed psychiatrist, or psychiatric advanced registered
34 14 nurse practitioner shall carry out the order.
34 15 Sec. 49. Section 321.180A, subsection 1, Code 2007, is
34 16 amended to read as follows:
34 17 1. Notwithstanding other provisions of this chapter, a
34 18 person with a physical disability, who is not suffering from a
34 19 convulsive disorder and who can provide a favorable medical
34 20 report, whose license renewal has been denied under section
34 21 321.177, subsection 6 or 7, or whose driver's license has been
34 22 suspended under section 321.210, subsection 1, paragraph "c",
34 23 upon meeting the requirements of section 321.186, other than a
34 24 driving demonstration or the person's limitations which caused
34 25 the denial under section 321.177, subsection 6 or 7, or
34 26 suspension under section 321.210, subsection 1, paragraph "c",
34 27 and upon paying the fee required in section 321.191, shall be
34 28 issued a special instruction permit by the department. Upon
34 29 issuance of the permit the denial or suspension shall be
34 30 stayed and the stay shall remain in effect as long as the
34 31 permit is valid. For purposes of this subsection, "medical
34 32 report" means a report made by a licensed physician, licensed
34 33 psychiatrist, or psychiatric advanced registered nurse
34 34 practitioner, as defined in section 229.1, attesting to a
34 35 person's physical or mental capability to operate a motor
35 1 vehicle safely, submitted on a form prescribed by the
35 2 department or, if appropriate, signed by the licensed
35 3 physician, licensed psychiatrist, or psychiatric advanced
35 4 registered nurse practitioner and submitted on the
35 5 professional letterhead of the licensed physician, licensed
35 6 psychiatrist, or psychiatric advanced registered nurse
35 7 practitioner.
35 8 Sec. 50. Section 483A.24, subsections 12, 13, and 14, Code
35 9 Supplement 2007, are amended to read as follows:
35 10 12. The department may issue a permit, subject to
35 11 conditions established by the department, which authorizes
35 12 patients of a substance abuse facility, residents of health
35 13 care facilities licensed under chapter 135C, tenants of elder
35 14 group homes licensed under chapter 231B, tenants of assisted
35 15 living program facilities licensed under chapter 231C,
35 16 participants who attend adult day services programs licensed
35 17 under chapter 231D, participants in services funded under a
35 18 federal home and community=based services waiver implemented
35 19 under the medical assistance program as defined in chapter
35 20 249A, and persons cared for in juvenile shelter care homes as
35 21 provided for in chapter 232 to fish without a license as a
35 22 supervised group. A person supervising a group pursuant to
35 23 this subsection may fish with the group pursuant to the permit
35 24 and is not required to obtain a fishing license. Such a
35 25 permit may be issued on a form furnished by the department
35 26 upon written application by a licensed physician, licensed
35 27 psychiatrist, or psychiatric advanced registered nurse
35 28 practitioner, as defined in section 229.1.
35 29 13. Upon payment of the fee of five dollars for a lifetime
35 30 fishing license or lifetime hunting and fishing combined
35 31 license, the department shall issue a lifetime fishing license
35 32 or lifetime hunting and fishing combined license to a resident
35 33 of Iowa who is a veteran, as defined in section 35.1, or
35 34 served in the armed forces of the United States for a minimum
35 35 aggregate of ninety days of active federal service and who was
36 1 disabled or was a prisoner of war during that veteran's
36 2 military service. The department shall prepare an application
36 3 to be used by a person requesting a lifetime fishing license
36 4 or lifetime hunting and fishing combined license under this
36 5 subsection. The department of veterans affairs shall assist
36 6 the department in verifying the status or claims of applicants
36 7 under this subsection. As used in this subsection, "disabled"
36 8 means entitled to compensation under the United States Code,
36 9 Title 38, ch. 11. Such a permit may be issued on a form
36 10 furnished by the department upon written application by a
36 11 licensed physician, licensed psychiatrist, or psychiatric
36 12 advanced registered nurse practitioner, as defined in section
36 13 229.1.
36 14 14. The department shall issue without charge a special
36 15 annual fishing or combined hunting and fishing license to
36 16 residents of this state who have permanent disabilities and
36 17 whose income falls below the federal poverty guidelines as
36 18 published by the United States department of health and human
36 19 services or residents of this state who are sixty=five years
36 20 of age or older and whose income falls below the federal
36 21 poverty guidelines as published by the United States
36 22 department of health and human services. The commission shall
36 23 provide for, by rule, an application to be used by an
36 24 applicant requesting a special license. The commission shall
36 25 require proof of age, income, and proof of permanent
36 26 disability. Such a permit may be issued on a form furnished
36 27 by the department upon written application by a licensed
36 28 physician, licensed psychiatrist, or psychiatric advanced
36 29 registered nurse practitioner, as defined in section 229.1.
36 30 Sec. 51. Section 812.3, subsection 2, Code 2007, is
36 31 amended to read as follows:
36 32 2. Upon a finding of probable cause sustaining the
36 33 allegations, the court shall suspend further criminal
36 34 proceedings and order the defendant to undergo a psychiatric
36 35 evaluation to determine whether the defendant is suffering a
37 1 mental disorder which prevents the defendant from appreciating
37 2 the charge, understanding the proceedings, or assisting
37 3 effectively in the defense. The order shall also authorize
37 4 the evaluator to provide treatment necessary and appropriate
37 5 to facilitate the evaluation. If an evaluation has been
37 6 conducted within thirty days of the probable cause finding,
37 7 the court is not required to order a new evaluation and may
37 8 use the recent evaluation during a hearing under this chapter.
37 9 Any party is entitled to a separate psychiatric evaluation by
37 10 a psychiatrist, psychiatric advanced registered nurse
37 11 practitioner, or licensed, doctorate=level psychologist of
37 12 their the party's own choosing. For purposes of this chapter,
37 13 "psychiatric advanced registered nurse practitioner" means an
37 14 individual currently licensed as a registered nurse under
37 15 chapter 152 or 152E who holds a national certification in
37 16 psychiatric health care and who is registered with the board
37 17 of nursing as an advanced registered nurse practitioner.
37 18 Sec. 52. Section 812.7, Code 2007, is amended to read as
37 19 follows:
37 20 812.7 MENTAL STATUS REPORTS.
37 21 The psychiatrist, advanced registered nurse practitioner,
37 22 or licensed doctorate=level psychologist providing outpatient
37 23 treatment to the defendant, or the director of the facility
37 24 where the defendant is being held and treated pursuant to a
37 25 court order, shall provide a written status report to the
37 26 court regarding the defendant's mental disorder within thirty
37 27 days of the defendant's placement pursuant to section 812.6.
37 28 The report shall also state whether it appears that the
37 29 defendant can be restored to competency in a reasonable amount
37 30 of time. Progress reports shall be provided to the court
37 31 every sixty days or less thereafter until the defendant's
37 32 competency is restored or the placement of the defendant is
37 33 terminated.
37 34 Sec. 53. Section 812.8, subsections 1, 2, and 3, Code
37 35 2007, are amended to read as follows:
38 1 1. At any time, upon a finding by a psychiatrist,
38 2 psychiatric advanced registered nurse practitioner, or
38 3 licensed doctorate=level psychologist that there is a
38 4 substantial probability that the defendant has acquired the
38 5 ability to appreciate the charge, understand the proceedings,
38 6 and effectively assist in the defendant's defense, the
38 7 psychiatrist, psychiatric advanced registered nurse
38 8 practitioner, or licensed doctorate=level psychologist
38 9 providing outpatient treatment to the defendant or the
38 10 director of the inpatient facility shall immediately notify
38 11 the court. After receiving notice the court shall proceed as
38 12 provided in subsection 4.
38 13 2. At any time, a treating psychiatrist, psychiatric
38 14 advanced registered nurse practitioner, or licensed
38 15 doctorate=level psychologist may notify the court that the
38 16 defendant receiving outpatient treatment will require
38 17 inpatient services to continue benefiting from treatment or
38 18 that it is appropriate for a defendant receiving inpatient
38 19 treatment services to receive outpatient treatment services.
38 20 Upon receiving notification, the court shall proceed as
38 21 provided under subsection 4.
38 22 3. At any time upon a finding by a treating psychiatrist,
38 23 psychiatric advanced registered nurse practitioner, or
38 24 licensed doctorate=level psychologist that there is no
38 25 substantial probability that the defendant will be restored to
38 26 competency in a reasonable amount of time, the psychiatrist,
38 27 psychiatric advanced registered nurse practitioner, or
38 28 licensed doctorate=level psychologist providing outpatient
38 29 treatment to the defendant or the director of the inpatient
38 30 facility shall immediately notify the court. Upon receiving
38 31 notification, the court shall proceed as provided under
38 32 subsection 4.
38 33 EXPLANATION
38 34 This bill amends provisions in Code chapter 125 and Code
38 35 chapter 229 relating to both voluntary and involuntary civil
39 1 commitment proceedings for chronic substance abusers (Code
39 2 chapter 125) and persons with mental illness (Code chapter
39 3 229). The bill strikes Code references to "chief medical
39 4 officer" defined as the medical director in charge of a public
39 5 or private hospital, or that individual's physician=designee,
39 6 in both Code chapters 125 and 229 and related Code chapters,
39 7 and replaces the term with "licensed physician", "licensed
39 8 psychiatrist", and "psychiatric advanced registered nurse
39 9 practitioner". Current law provides a chief medical officer
39 10 with the authority to receive and admit, examine, evaluate,
39 11 provide reports including court=ordered reports, and detain
39 12 and discharge a person who is impaired due to substance abuse
39 13 or mental illness in a residential substance abuse or hospital
39 14 mental health setting in both voluntary and involuntary
39 15 situations. The bill as amended provides a licensed
39 16 physician, licensed psychiatrist, and psychiatric advanced
39 17 registered nurse practitioner with that same authority. The
39 18 bill makes such persons subject to contempt of court
39 19 proceedings pursuant to Code chapter 665 for failing to submit
39 20 court=ordered reports on chronic substance abusers and persons
39 21 with mental illness.
39 22 The bill defines a "licensed physician" to mean an
39 23 individual licensed under the provisions of Code chapter 148,
39 24 150, or 150A to practice medicine and surgery, osteopathy, or
39 25 osteopathic medicine and surgery, a "licensed psychiatrist" to
39 26 mean an individual licensed under the provisions of Code
39 27 chapter 148, 150, or 150A to practice medicine and surgery,
39 28 osteopathy, or osteopathic medicine and surgery with a
39 29 specialty in the field of psychiatry, and a "psychiatric
39 30 advanced registered nurse practitioner" to mean an individual
39 31 currently licensed as a registered nurse under Code chapter
39 32 152 or 152E who holds a national certification in psychiatric
39 33 health care and who is registered with the board of nursing as
39 34 an advanced registered nurse practitioner.
39 35 The bill amends the definition of a "qualified mental
40 1 health professional" in Code chapter 229 to include a
40 2 physician assistant licensed under Code chapter 148C with
40 3 three years of work experience in psychiatric health care.
40 4 Current law under Code chapter 229 defines a "qualified mental
40 5 health professional" to include a psychologist certified under
40 6 Code chapter 154B, a registered nurse licensed under Code
40 7 chapter 152 and a social worker licensed under Code chapter
40 8 154C, all of whom are experienced in the study and treatment
40 9 of mental disorders.
40 10 The bill provides that a qualified mental health
40 11 professional treating a patient in a hospital or facility in
40 12 which the patient is committed may communicate with a mental
40 13 health advocate about the patient. The bill also allows a
40 14 treating qualified mental health professional to make
40 15 decisions concerning a committed mental health patient's right
40 16 to refuse treatment by shock therapy or chemotherapy and
40 17 authorizes a treating qualified mental health professional to
40 18 monitor the protection of a committed mental health patient's
40 19 rights.
40 20 The bill makes conforming Code changes to Code chapter
40 21 225C, pertaining to a patient who is received and evaluated at
40 22 a state mental health institute due to a mental illness,
40 23 retardation, developmental disability, or brain injury, and
40 24 Code chapter 227, pertaining to county and mental hospitals
40 25 serving persons with mental illness and mental retardation.
40 26 The bill authorizes a licensed physician, licensed
40 27 psychiatrist, or advanced registered nurse practitioner to
40 28 attest to a person's physical or mental capability to operate
40 29 a motor vehicle safely in regard to special instruction
40 30 permits under Code section 321.180A.
40 31 The bill authorizes a licensed physician, licensed
40 32 psychiatrist, or psychiatric advanced registered nurse
40 33 practitioner to apply for special fishing licenses on behalf
40 34 of certain persons, including but not limited to persons who
40 35 are patients of a substance abuse facility and certain health
41 1 care facilities, disabled veterans, and permanently disabled
41 2 persons.
41 3 The bill authorizes a psychiatric advanced registered nurse
41 4 practitioner to complete a psychiatric evaluation and provide
41 5 status reports on a defendant in a criminal case suffering
41 6 from a mental disorder.
41 7 LSB 6350SS 82
41 8 rh/rj/5.1