S.F. _____ H.F. _____ Section 1. Section 80B.11, subsection 1, paragraph c, Code 1 2011, is amended by adding the following new subparagraph: 2 NEW SUBPARAGRAPH . (3) In-service training under this 3 paragraph “c” shall include the requirement that all law 4 enforcement officers complete a twelve-hour course on 5 mental health first aid at least once every three years. In 6 developing the requirements for this training, the director 7 shall seek input from mental health care consumers. 8 Sec. 2. Section 125.91, subsection 1, Code Supplement 2011, 9 is amended to read as follows: 10 1. The procedure prescribed by this section shall only be 11 used for an intoxicated person who has threatened, attempted, 12 or inflicted physical self-harm or harm on another, and is 13 likely to inflict physical self-harm or harm on another unless 14 immediately detained, or who is incapacitated by a chemical 15 substance, if that person cannot be taken into immediate 16 custody under sections 125.75 and 125.81 because immediate 17 access to the court is not possible an application has not been 18 filed naming the person as the respondent pursuant to section 19 125.75 and the person cannot be ordered into immediate custody 20 and detained pursuant to section 125.81 . 21 Sec. 3. Section 135C.4, Code 2011, is amended to read as 22 follows: 23 135C.4 Residential care facilities. 24 1. Each facility licensed as a residential care facility 25 shall provide an organized continuous twenty-four-hour program 26 of care commensurate with the needs of the residents of the 27 home and under the immediate direction of a person approved 28 and certified by the department whose combined training 29 and supervised experience is such as to ensure adequate and 30 competent care. 31 2. All admissions to residential care facilities shall be 32 based on an order written by a physician certifying that the 33 individual being admitted does not require nursing services or 34 that the individual’s need for nursing services can be avoided 35 -1- LSB 5422XI (11) 84 rh/rj 1/ 10

S.F. _____ H.F. _____ if home and community-based services, other than nursing care, 1 as defined by this chapter and departmental rule, are provided. 2 3. For the purposes of this section, the home and 3 community-based services to be provided shall be limited to the 4 type included under the medical assistance program provided 5 pursuant to chapter 249A, shall be subject to cost limitations 6 established by the department of human services under the 7 medical assistance program, and except as otherwise provided by 8 the department of inspections and appeals with the concurrence 9 of the department of human services, shall be limited in 10 capacity to the number of licensed residential care facilities 11 and the number of licensed residential care facility beds in 12 the state as of December 1, 2003. 13 4. A residential care facility is not required to admit 14 an individual through court order, referral, or other means 15 without the express prior approval of the executive director of 16 the residential care facility. 17 Sec. 4. Section 228.1, subsection 6, Code 2011, is amended 18 by striking the subsection and inserting in lieu thereof the 19 following: 20 6. “Mental health professional” means an individual who has 21 either of the following qualifications: 22 a. The individual meets all of the following requirements: 23 (1) The individual holds at least a master’s degree in a 24 mental health field, including but not limited to psychology, 25 counseling and guidance, nursing, and social work, or is an 26 advanced registered nurse practitioner or a physician and 27 surgeon or an osteopathic physician and surgeon. 28 (2) The individual holds a current Iowa license if 29 practicing in a field covered by an Iowa licensure law. 30 (3) The individual has at least two years of post-degree 31 clinical experience, supervised by another mental health 32 professional, in assessing mental health needs and problems and 33 in providing appropriate mental health services. 34 b. The individual holds a current Iowa license if 35 -2- LSB 5422XI (11) 84 rh/rj 2/ 10

S.F. _____ H.F. _____ practicing in a field covered by an Iowa licensure law and is 1 a psychiatrist, an advanced registered nurse practitioner who 2 holds a national certification in psychiatric mental health 3 care registered by the board of nursing, or an individual who 4 holds a doctorate degree in psychology and is licensed by the 5 board of psychology. 6 Sec. 5. Section 229.1, subsection 14, Code Supplement 2011, 7 is amended by striking the subsection. 8 Sec. 6. Section 229.1, subsection 16, Code Supplement 2011, 9 is amended to read as follows: 10 16. “Serious emotional injury” is an injury which does not 11 necessarily exhibit any physical characteristics, but which can 12 be recognized and diagnosed by a licensed physician or other 13 qualified mental health professional and which can be causally 14 connected with the act or omission of a person who is, or is 15 alleged to be, mentally ill. 16 Sec. 7. NEW SECTION . 229.5A Preapplication screening 17 assessment —— program. 18 Prior to filing an application for involuntary 19 hospitalization pursuant to section 229.6, the clerk of 20 the district court or the clerk’s designee shall inform 21 the interested person referred to in section 229.6, 22 subsection 1, about the option of requesting a preapplication 23 screening assessment through a preapplication screening 24 assessment program. The state court administrator shall 25 prescribe practices and procedures for implementation of the 26 preapplication screening assessment program. 27 Sec. 8. Section 229.6, Code 2011, is amended to read as 28 follows: 29 229.6 Application for order of involuntary hospitalization. 30 1. Proceedings for the involuntary hospitalization of an 31 individual may be commenced by any interested person by filing 32 a verified application with the clerk of the district court of 33 the county where the respondent is presently located, or which 34 is the respondent’s place of residence. The clerk, or the 35 -3- LSB 5422XI (11) 84 rh/rj 3/ 10

S.F. _____ H.F. _____ clerk’s designee, shall assist the applicant in completing the 1 application. The application shall: 2 1. a. State the applicant’s belief that the respondent is 3 seriously mentally impaired. 4 2. b. State any other pertinent facts. 5 3. c. Be accompanied by any of the following : 6 a. (1) A written statement of a licensed physician in 7 support of the application ; or . 8 b. (2) One or more supporting affidavits otherwise 9 corroborating the application ; or . 10 c. (3) Corroborative information obtained and reduced to 11 writing by the clerk or the clerk’s designee, but only when 12 circumstances make it infeasible to comply with, or when the 13 clerk considers it appropriate to supplement the information 14 supplied pursuant to, either paragraph “a” or paragraph “b” of 15 this subsection subparagraph (1) or (2) . 16 2. Prior to the filing of an application pursuant to this 17 section, the clerk or the clerk’s designee shall inform the 18 interested person referred to in subsection 1 about the option 19 of requesting a preapplication screening assessment pursuant 20 to section 229.5A. 21 Sec. 9. Section 229.10, subsection 1, paragraph b, Code 22 2011, is amended by striking the paragraph. 23 Sec. 10. Section 229.12, subsection 3, paragraph b, Code 24 2011, is amended to read as follows: 25 b. The licensed physician or qualified mental health 26 professional who examined the respondent shall be present at 27 the hearing unless the court for good cause finds that the 28 licensed physician’s or qualified mental health professional’s 29 presence or testimony is not necessary. The applicant, 30 respondent, and the respondent’s attorney may waive the 31 presence or the telephonic appearance of the licensed physician 32 or qualified mental health professional who examined the 33 respondent and agree to submit as evidence the written 34 report of the licensed physician or qualified mental health 35 -4- LSB 5422XI (11) 84 rh/rj 4/ 10

S.F. _____ H.F. _____ professional . The respondent’s attorney shall inform the 1 court if the respondent’s attorney reasonably believes that 2 the respondent, due to diminished capacity, cannot make an 3 adequately considered waiver decision. “Good cause” for finding 4 that the testimony of the licensed physician or qualified 5 mental health professional who examined the respondent is not 6 necessary may include but is not limited to such a waiver. 7 If the court determines that the testimony of the licensed 8 physician or qualified mental health professional is necessary, 9 the court may allow the licensed physician or the qualified 10 mental health professional to testify by telephone. 11 Sec. 11. Section 229.19, subsection 1, paragraph d, Code 12 2011, is amended by adding the following new subparagraph: 13 NEW SUBPARAGRAPH . (7) To utilize the related best practices 14 for the duties identified in this paragraph “d” developed and 15 promulgated by the judicial council. 16 Sec. 12. Section 229.19, subsection 1, Code 2011, is amended 17 by adding the following new paragraph: 18 NEW PARAGRAPH . e. An advocate may also be appointed 19 pursuant to this section for an individual who has 20 been diagnosed with a co-occurring mental illness and 21 substance-related disorder. 22 Sec. 13. Section 229.22, subsection 1, Code Supplement 23 2011, is amended to read as follows: 24 1. The procedure prescribed by this section shall not be 25 used unless when it appears that a person should be immediately 26 detained due to serious mental impairment, but that person 27 cannot be immediately detained by the procedure prescribed 28 in sections 229.6 and 229.11 because there is no means of 29 immediate access to the district court an application has not 30 been filed naming the person as the respondent pursuant to 31 section 229.6, and the person cannot be ordered into immediate 32 custody and detained pursuant to section 229.11 . 33 Sec. 14. Section 602.1209, Code 2011, is amended by adding 34 the following new subsection: 35 -5- LSB 5422XI (11) 84 rh/rj 5/ 10

S.F. _____ H.F. _____ NEW SUBSECTION . 15A. Prescribe practices and procedures 1 for the implementation of the preapplication screening 2 assessment program referred to in section 229.5A. 3 Sec. 15. CONTINUATION OF WORKGROUP BY JUDICIAL BRANCH AND 4 DEPARTMENT OF HUMAN SERVICES —— CONSOLIDATION OF SERVICES —— 5 PATIENT ADVOCATE. The judicial branch and department of human 6 services shall continue the workgroup implemented pursuant to 7 2010 Iowa Acts, chapter 1192, section 24, subsection 2, and 8 extended pursuant to 2011 Iowa Acts, chapter 121, section 2, to 9 study and make recommendations relating to the consolidation 10 of the processes for involuntary commitment for persons with 11 substance-related disorders under chapter 125, for intellectual 12 disability under chapter 222, and for serious mental illness 13 under chapter 229. The workgroup shall also study and make 14 recommendations concerning the feasibility of establishing an 15 independent statewide patient advocate program for qualified 16 persons representing the interests of patients suffering from 17 mental illness, intellectual disability, or a substance-related 18 disorder and involuntarily committed by the court, in any 19 matter relating to the patients’ hospitalization or treatment 20 under chapters 125, 222, and 229. The workgroup shall also 21 consider the implementation of consistent reimbursement 22 standards for patient advocates supported by a state-funded 23 system and shall also consider the role of the advocate for 24 a person who has been diagnosed with a co-occurring mental 25 illness and substance-related disorder. The workgroup 26 shall solicit input from current mental health advocates and 27 mental health and substance-related disorder care providers 28 and individuals receiving services whose interests would be 29 represented by an independent statewide advocate program and 30 shall submit a report on the study and make recommendations to 31 the governor and the general assembly by December 1, 2012. 32 Sec. 16. COMPREHENSIVE JAIL DIVERSION PROGRAM —— MENTAL 33 HEALTH COURTS —— STUDY. The division of criminal and juvenile 34 justice planning of the department of human rights shall 35 -6- LSB 5422XI (11) 84 rh/rj 6/ 10

S.F. _____ H.F. _____ conduct a study regarding the possible establishment of a 1 comprehensive statewide jail diversion program, including the 2 establishment of mental health courts, for nonviolent criminal 3 offenders who suffer from mental illness. The division 4 shall solicit input from the department of human services, 5 the department of corrections, and other members of the 6 criminal justice system including but not limited to judges, 7 prosecutors, and defense counsel, and mental health treatment 8 providers and consumers. The division shall establish the 9 duties, scope, and membership of the study commission and shall 10 also consider the feasibility of establishing a demonstration 11 mental health court. The division shall submit a report on the 12 study and make recommendations to the governor and the general 13 assembly by December 1, 2012. 14 EXPLANATION 15 This bill relates to persons with mental health illnesses 16 and substance-related disorders. 17 MENTAL HEALTH TRAINING —— LAW ENFORCEMENT. The bill 18 requires the director of the law enforcement academy, subject 19 to the approval of the Iowa law enforcement council, to adopt 20 rules relating to in-service mental health first-aid training 21 for law enforcement officers, with input from mental health 22 care consumers. 23 RESIDENTIAL CARE FACILITIES —— ADMITTANCE. The bill 24 provides that a residential care facility is not required to 25 admit an individual through court order, referral, or other 26 means without the express prior approval of the executive 27 director of the residential care facility. 28 EMERGENCY DETENTION AND HOSPITALIZATION —— PERSONS WITH 29 SUBSTANCE-RELATED DISORDERS AND MENTAL HEALTH ILLNESSES. 30 The bill amends Code sections 125.91 and 229.22 relating to 31 after-hours access to emergency detention and hospitalization 32 procedures for an intoxicated person who has threatened, 33 attempted, or inflicted physical self-harm or harm on another, 34 and is likely to inflict physical self-harm or harm on another 35 -7- LSB 5422XI (11) 84 rh/rj 7/ 10

S.F. _____ H.F. _____ unless immediately detained, or who is incapacitated by a 1 chemical substance, or for a seriously mentally impaired 2 person. Current law provides for the immediate custody of such 3 persons in an emergency situation only after an application 4 for involuntary commitment or hospitalization has been filed, 5 which is an option only during regular court hours. The bill 6 amends the current emergency detention and hospitalization 7 procedures available for such persons to apply only when there 8 is no immediate access to the district court to allow access to 9 emergency detention and treatment services, at all times, even 10 if an application for involuntary commitment or hospitalization 11 has not been filed. 12 QUALIFIED MENTAL HEALTH PROFESSIONAL. The bill eliminates 13 the definition of “qualified mental health professional” in 14 Code chapter 229 (hospitalization of persons with mental 15 illness) and all references to this definition (talk about 16 where this are eliminated). The bill amends the definition of 17 “mental health professional” in Code chapter 228 (relating to 18 the disclosure of mental health and psychological information). 19 PREAPPLICATION SCREENING ASSESSMENT. The bill provides that 20 prior to filing an application for involuntary hospitalization 21 pursuant to Code section 229.6, the clerk of the district court 22 or the clerk’s designee is required to inform the interested 23 person referred to in Code section 229.6, subsection 1, 24 about the option of requesting a preapplication screening 25 assessment through a preapplication screening assessment 26 program. The bill requires the state court administrator to 27 prescribe practices and procedures for implementation of the 28 preapplication screening assessment program. 29 A conforming change is made to Code section 229.6 requiring 30 the district court clerk or the clerk’s designee to inform 31 the interested person about the option of requesting a 32 preapplication screening assessment of the proposed respondent 33 prior to the filing of an application for involuntary 34 commitment. A conforming change is also made to Code 35 -8- LSB 5422XI (11) 84 rh/rj 8/ 10

S.F. _____ H.F. _____ section 602.1209 relating to the duties of the state court 1 administrator. 2 MENTAL HEALTH ADVOCATE. The bill provides that a mental 3 health advocate shall utilize the related best practices for 4 the mental health advocate’s duties identified in Code section 5 229.19 developed and promulgated by the judicial council. 6 The bill allows a mental health advocate to be appointed by 7 the appropriate appointing authority for an individual who 8 has been diagnosed with a co-occurring mental illness and 9 substance-related disorder. 10 CONTINUATION OF WORKGROUP BY JUDICIAL BRANCH AND DEPARTMENT 11 OF HUMAN SERVICES —— CONSOLIDATION OF SERVICES —— PATIENT 12 ADVOCATE. The bill requires the judicial branch and department 13 of human services to continue the workgroup implemented 14 pursuant to 2010 Iowa Acts, chapter 1192, section 24, 15 subsection 2, and extended pursuant to 2011 Iowa Acts, chapter 16 121, section 2, to study and make recommendations relating to 17 the consolidation of the processes for involuntary commitment 18 for persons with substance-related disorders under Code chapter 19 125, for intellectual disability under Code chapter 222, 20 and for serious mental illness under Code chapter 229. The 21 workgroup shall also study and make recommendations concerning 22 the feasibility of establishing an independent statewide 23 patient advocate program for qualified persons representing 24 the interests of patients suffering from mental illness, 25 intellectual disability, or a substance-related disorder and 26 involuntarily committed by the court. The workgroup shall 27 also consider the implementation of consistent reimbursement 28 standards for patient advocates and the role of the advocate 29 for a person who has been diagnosed with a co-occurring mental 30 illness and substance-related disorder. The workgroup shall 31 submit a report on the study and make recommendations to the 32 governor and the general assembly by December 1, 2012. 33 COMPREHENSIVE JAIL DIVERSION PROGRAM —— MENTAL HEALTH 34 COURTS —— STUDY. The bill directs the division of criminal and 35 -9- LSB 5422XI (11) 84 rh/rj 9/ 10

S.F. _____ H.F. _____ juvenile justice planning of the department of human rights 1 to conduct a study regarding the possible establishment of a 2 comprehensive statewide jail diversion program, including the 3 establishment of mental health courts, for nonviolent criminal 4 offenders who suffer from mental illness. The division 5 shall solicit input from the department of human services, 6 the department of corrections, and other members of the 7 criminal justice system including but not limited to judges, 8 prosecutors, and defense counsel, and mental health treatment 9 providers and consumers. The division shall establish the 10 duties, scope, and membership of the study commission and shall 11 also consider the feasibility of establishing a demonstration 12 mental health court. The division shall submit a report on the 13 study and make recommendations to the governor and the general 14 assembly by December 1, 2012. 15 -10- LSB 5422XI (11) 84 rh/rj 10/ 10