S.F. 207 Section 1. NEW SECTION . 229.46 Interstate contracts for 1 services under this chapter. 2 1. Purpose and policy. The purpose of this section is 3 to enable appropriate mental health treatment to be provided 4 to a person, across state lines from the person’s state of 5 residence, in qualified facilities that are closer to the 6 person’s home than are facilities available in the person’s 7 home state. 8 2. Definitions. For the purposes of this section: 9 a. “Bordering state” means Illinois, Minnesota, Missouri, 10 Nebraska, South Dakota, or Wisconsin. 11 b. “County” means a county that has been exempted from the 12 requirements of section 331.389. 13 c. “Receiving agency” means a public or private agency, 14 region, or county which, under this section, provides mental 15 health treatment to a person from a state other than the state 16 in which the agency, region, or county is located. 17 d. “Receiving state” means the state in which a receiving 18 agency is located. 19 e. “Region” means a mental health and disability services 20 region formed in accordance with section 331.389. 21 f. “Sending agency” means a public or private agency located 22 in a state which sends a person to a bordering state for mental 23 health treatment under this section. 24 g. “Sending state” means the state in which a sending agency 25 is located. 26 3. Purchase of services. 27 a. A region or county may contract with a public or private 28 agency in a bordering state to secure services under this 29 chapter for persons who receive services through the region or 30 county. 31 b. This subsection shall not apply to a person who is any 32 of the following: 33 (1) Serving a criminal sentence. 34 (2) On probation or parole. 35 -1- LSB 1062XS (2) 86 rh/rj 1/ 7

S.F. 207 (3) Is the subject of a presentence investigation. 1 4. Provision of services. A region or county may contract 2 with a public or private agency in a bordering state to provide 3 services under this chapter for residents of the bordering 4 state in approved mental health treatment facilities in this 5 state, except that services shall not be provided for residents 6 of the bordering state who are involved in criminal proceedings 7 substantially similar to the provisions of subsection 3, 8 paragraph “b” , subparagraphs (1) through (3). 9 5. Contract approval. A contract under this section shall 10 not be validly executed until the director of human services 11 has reviewed and approved the provisions of the contract, 12 determined that the receiving agency provides services in 13 accordance with the standards of this state, and has certified 14 that the receiving state’s laws governing patient rights are 15 substantially similar to those of this state. 16 6. Residence not established. A person shall not establish 17 legal residence in the state where the receiving agency is 18 located while the person is receiving services pursuant to a 19 contract under this section. 20 7. Treatment records. Section 228.2 applies to mental 21 health treatment records of a person receiving services 22 pursuant to a contract under this section through a receiving 23 agency in this state, except that the sending agency has the 24 same right of access to the mental health treatment records of 25 the person as provided under section 228.5. 26 8. Involuntary commitments. 27 a. A person who is detained, committed, or placed on an 28 involuntary basis under this chapter may be confined and 29 treated in another state pursuant to a contract under this 30 section. 31 b. A person who is detained, committed, or placed on an 32 involuntary basis under the civil law of a bordering state may 33 be confined and treated in this state pursuant to a contract 34 under this section. 35 -2- LSB 1062XS (2) 86 rh/rj 2/ 7

S.F. 207 c. Court orders valid under the law of the sending state 1 are granted recognition and reciprocity in the receiving state 2 for a person covered by a contract under this section to the 3 extent that the court orders relate to confinement for mental 4 health treatment. Such court orders are not subject to legal 5 challenge in the courts of the receiving state. 6 d. A person who is detained, committed, or placed under the 7 law of a sending state and who is transferred to a receiving 8 state under this section shall be considered to be in the legal 9 custody of the authority responsible for the person under the 10 law of the sending state. Except in an emergency, such a 11 person shall not be transferred, removed, or furloughed from a 12 facility of the receiving agency without the specific approval 13 of the authority responsible for the person under the law of 14 the sending state. 15 9. Applicable laws. While in the receiving state pursuant 16 to a contract under this section, a person shall be subject 17 to all of the provisions of law and regulations applicable 18 to persons detained, committed, or placed pursuant to the 19 corresponding laws and regulations of the receiving state, 20 except those laws and regulations of the receiving state 21 relating to length of confinement, reexaminations, and 22 extensions of confinement. A person shall not be sent to 23 another state pursuant to a contract under this section until 24 the receiving state has enacted a law recognizing the validity 25 and applicability of this section. 26 10. Escaped persons. If a person receiving services 27 pursuant to a contract under this section escapes from the 28 receiving agency and the person at the time of the escape is 29 subject to involuntary confinement under the law of the sending 30 state, the receiving agency shall use all reasonable means to 31 recapture the escapee. The receiving agency shall immediately 32 report the escaped person to the sending agency. The receiving 33 state has the primary responsibility for, and the authority 34 to direct, the pursuit, retaking, and prosecution of escaped 35 -3- LSB 1062XS (2) 86 rh/rj 3/ 7

S.F. 207 persons within its borders and is liable for the cost of such 1 action to the extent that it would be liable for costs if its 2 own resident escaped. 3 11. Contract provisions. The terms of a contract entered 4 into under this section shall do all of the following: 5 a. Describe the mental health treatment services to be 6 provided. 7 b. Establish responsibility for the costs of all services to 8 be provided under the contract. 9 c. Establish responsibility for the transportation of 10 clients to and from receiving facilities. 11 d. Require the receiving agency to report to the sending 12 agency on the condition of each person covered by the contract. 13 e. Provide for arbitration of disputes arising out of the 14 provisions of the contract which cannot be settled through 15 discussion between the contracting parties and specify how 16 arbitrators will be chosen. 17 f. Include provisions ensuring the nondiscriminatory 18 treatment, as required by law, of employees, clients, and 19 applicants for employment and services. 20 g. Establish the responsibility for providing legal 21 representation for clients in legal proceedings involving the 22 legality of confinement and the conditions of confinement. 23 h. Establish the responsibility for providing legal 24 representation for employees of the contracting parties in 25 legal proceedings initiated by persons receiving mental health 26 treatment pursuant to the contract. 27 i. Include provisions concerning the length of the contract 28 and the means by which the contract can be terminated. 29 j. Establish the right of qualified employees and 30 representatives of the sending agency and sending state to 31 inspect, at all reasonable times, the records of the receiving 32 agency and its mental health treatment facilities to determine 33 if appropriate standards of care are being met. 34 k. Require the sending agency to provide the receiving 35 -4- LSB 1062XS (2) 86 rh/rj 4/ 7

S.F. 207 agency with copies of all relevant legal documents authorizing 1 confinement of persons who are confined pursuant to law of the 2 sending state and receiving services pursuant to a contract 3 under this section. 4 l. Include provisions specifying when a receiving facility 5 can refuse to admit or retain a person. 6 EXPLANATION 7 The inclusion of this explanation does not constitute agreement with 8 the explanation’s substance by the members of the general assembly. 9 This bill relates to interstate contracts for mental health 10 services. 11 CONTRACT FOR TREATMENT. The bill provides that a region 12 or county as defined in the bill in Iowa may contract with 13 a public or private agency in a bordering state to secure 14 mental health treatment for persons in both voluntary and 15 involuntary commitment cases under Code chapter 229 who receive 16 services through a region or county in Iowa. Similarly, 17 a region or county may contract with a public or private 18 agency in a bordering state to provide services for residents 19 of the bordering state in approved treatment facilities in 20 this state. A person serving a criminal sentence, who is on 21 probation or parole, or who is the subject of a presentence 22 investigation is not eligible to receive such interstate mental 23 health treatment. The bill defines “bordering state” to mean 24 Illinois, Minnesota, Missouri, Nebraska, South Dakota, or 25 Wisconsin, “county” to mean a county that has been exempted by 26 the director of human services from being required to enter 27 into a regional mental health and disability services system, 28 and “region” to mean a mental health and disability services 29 region formed in accordance with Code section 331.389. 30 The bill provides that a contract shall not be validly 31 executed until the director of human services has reviewed 32 and approved the contract, determined that the receiving 33 agency provides services in accordance with the standards of 34 this state, and has certified that the receiving state’s laws 35 -5- LSB 1062XS (2) 86 rh/rj 5/ 7

S.F. 207 governing patient rights are substantially similar to those of 1 this state. The bill specifies certain provisions that must be 2 included in the contract. 3 TREATMENT RECORDS. The bill provides that Code section 4 228.2 relating to prohibitions on the disclosure of mental 5 health information applies to mental health treatment records 6 of a person receiving services pursuant to a contract under 7 the bill through a receiving agency in this state, except that 8 the sending agency has the same right of access to the mental 9 health treatment records of the person as provided under Code 10 section 228.5 (administrative disclosures). 11 INVOLUNTARY COMMITMENTS. The bill provides that a person 12 who is detained, committed, or placed on an involuntary basis 13 under Code chapter 229 may be confined and treated in another 14 state pursuant to a contract executed under the bill and a 15 person who is detained, committed, or placed on an involuntary 16 basis under the civil law of a bordering state may be confined 17 and treated pursuant to a contract executed under the bill. 18 Court orders valid under the law of the sending state are 19 granted recognition and reciprocity in the receiving state for 20 a person covered by a contract. A person who is detained, 21 committed, or placed under the law of a sending state and who 22 is transferred to a receiving state is considered to be in the 23 legal custody of the authority responsible for the person under 24 the law of the sending state. Except in an emergency, such a 25 person shall not be transferred, removed, or furloughed from a 26 facility of the receiving agency without the specific approval 27 of the authority responsible for the person under the law of 28 the sending state. 29 APPLICABLE LAW. While in the receiving state pursuant to a 30 contract executed under the bill, a person is subject to all 31 of the provisions of law and regulations applicable to persons 32 detained, committed, or placed pursuant to the corresponding 33 laws of the receiving state, except those laws and regulations 34 of the receiving state relating to length of confinement, 35 -6- LSB 1062XS (2) 86 rh/rj 6/ 7

S.F. 207 reexaminations, and extensions of confinement. 1 ESCAPE. If a person receiving services pursuant to a 2 contract under this Code section escapes from the receiving 3 agency and the person at the time of the escape is subject to 4 involuntary confinement under the law of the sending state, the 5 receiving agency shall use all reasonable means to recapture 6 the escapee. The receiving agency shall immediately report 7 the escape to the sending agency. The receiving state has the 8 primary responsibility for, and the authority to direct, the 9 pursuit, retaking, and prosecution of escaped persons within 10 its borders and is liable for the cost of such action to the 11 extent that it would be liable for costs if its own resident 12 escaped. 13 -7- LSB 1062XS (2) 86 rh/rj 7/ 7