S.F. 2144 DIVISION I 1 DISCLOSURE OF BEHAVIORAL HEALTH INFORMATION 2 Section 1. Section 125.37, subsection 3, Code 2016, is 3 amended to read as follows: 4 3. Notwithstanding the provisions of subsection 1 of this 5 section , a patient’s records may be disclosed to only under any 6 of the following circumstances: 7 a. To medical personnel in a medical emergency with or 8 without the patient’s consent. 9 b. For purposes of care coordination as defined in 10 section 135.154 if not otherwise restricted by federal law or 11 regulation. 12 Sec. 2. Section 228.2, Code 2016, is amended to read as 13 follows: 14 228.2 Mental health information disclosure prohibited —— 15 exceptions —— record of disclosure. 16 1. Except as specifically authorized in subsection 4, 17 section 228.3 , 228.5 , 228.6 , 228.7 , or 228.8 , or for the 18 purposes of care coordination as defined in section 135.154 if 19 not otherwise restricted by federal law or regulation, a mental 20 health professional, data collector, or employee or agent of 21 a mental health professional, of a data collector, or of or 22 for a mental health facility shall not disclose or permit the 23 disclosure of mental health information. 24 2. a. Upon disclosure of mental health information pursuant 25 to subsection 4, section 228.3 , 228.5 , 228.6 , 228.7 , or 26 228.8 , or for the purposes of care coordination as defined in 27 section 135.154 if not otherwise restricted by federal law or 28 regulation, the person disclosing the mental health information 29 shall enter a notation on and maintain the notation with the 30 individual’s record of mental health information, stating the 31 date of the disclosure and the name of the recipient of mental 32 health information. 33 b. The person disclosing the mental health information shall 34 give the recipient of the information a statement which informs 35 -1- LSB 5580SV (3) 86 rh/lh 1/ 5

S.F. 2144 the recipient that disclosures may only be made pursuant to 1 the written authorization of an individual or an individual’s 2 legal representative, or as otherwise provided in this chapter , 3 that the unauthorized disclosure of mental health information 4 is unlawful, and that civil damages and criminal penalties may 5 be applicable to the unauthorized disclosure of mental health 6 information. 7 3. A recipient of mental health information shall not 8 disclose the information received, except as specifically 9 authorized for initial disclosure in subsection 4, section 10 228.3 , 228.5 , 228.6 , 228.7 , or 228.8 , or for the purposes 11 of care coordination as defined in section 135.154 if not 12 otherwise restricted by federal law or regulation . 13 4. However, mental Mental health information may be 14 transferred at any time to another facility, physician, or 15 mental health professional in cases of a medical emergency or 16 if the individual or the individual’s legal representative 17 requests the transfer in writing for the purposes of receipt of 18 medical or mental health professional services, at which time 19 the requirements of subsection 2 shall be followed. 20 Sec. 3. EFFECTIVE UPON ENACTMENT. This division of this 21 Act, being deemed of immediate importance, takes effect upon 22 enactment. 23 DIVISION II 24 CONDITIONAL ENACTMENT 25 Sec. 4. Section 125.37, subsection 3, Code 2016, as amended 26 in this Act, is amended to read as follows: 27 3. Notwithstanding the provisions of subsection 1 , a 28 patient’s records may be disclosed only under any of the 29 following circumstances: 30 a. To medical personnel in a medical emergency with or 31 without the patient’s consent. 32 b. For purposes of care coordination as defined in section 33 135.154 135D.2 if not otherwise restricted by federal law or 34 regulation. 35 -2- LSB 5580SV (3) 86 rh/lh 2/ 5

S.F. 2144 Sec. 5. Section 228.2, Code 2016, as amended in this Act, 1 is amended to read as follows: 2 228.2 Mental health information disclosure prohibited —— 3 exceptions —— record of disclosure. 4 1. Except as specifically authorized in subsection 5 4, section 228.3 , 228.5 , 228.6 , 228.7 , or 228.8 , or for 6 the purposes of care coordination as defined in section 7 135.154 135D.2 if not otherwise restricted by federal law or 8 regulation, a mental health professional, data collector, or 9 employee or agent of a mental health professional, of a data 10 collector, or of or for a mental health facility shall not 11 disclose or permit the disclosure of mental health information. 12 2. a. Upon disclosure of mental health information pursuant 13 to subsection 4, section 228.3 , 228.5 , 228.6 , 228.7 , or 228.8 , 14 or for the purposes of care coordination as defined in section 15 135.154 135D.2 if not otherwise restricted by federal law or 16 regulation, the person disclosing the mental health information 17 shall enter a notation on and maintain the notation with the 18 individual’s record of mental health information, stating the 19 date of the disclosure and the name of the recipient of mental 20 health information. 21 b. The person disclosing the mental health information shall 22 give the recipient of the information a statement which informs 23 the recipient that disclosures may only be made pursuant to 24 the written authorization of an individual or an individual’s 25 legal representative, or as otherwise provided in this chapter , 26 that the unauthorized disclosure of mental health information 27 is unlawful, and that civil damages and criminal penalties may 28 be applicable to the unauthorized disclosure of mental health 29 information. 30 3. A recipient of mental health information shall not 31 disclose the information received, except as specifically 32 authorized for initial disclosure in subsection 4, section 33 228.3 , 228.5 , 228.6 , 228.7 , or 228.8 , or for the purposes of 34 care coordination as defined in section 135.154 135D.2 if not 35 -3- LSB 5580SV (3) 86 rh/lh 3/ 5

S.F. 2144 otherwise restricted by federal law or regulation. 1 4. Mental health information may be transferred at any time 2 to another facility, physician, or mental health professional 3 in cases of a medical emergency or if the individual or the 4 individual’s legal representative requests the transfer in 5 writing for the purposes of receipt of medical or mental health 6 professional services, at which time the requirements of 7 subsection 2 shall be followed. 8 Sec. 6. EFFECTIVE DATE. This division of this Act 9 takes effect upon the assumption of the administration and 10 governance, including but not limited to the assumption of the 11 assets and liabilities, of the Iowa health information network 12 by the designated entity. The department of public health 13 shall notify the Code editor of the date of such assumption by 14 the designated entity. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill relates to the disclosure of mental health 19 information for the purpose of the coordination of a patient’s 20 care, and includes effective date provisions. The bill is 21 organized by divisions. 22 DIVISION I —— DISCLOSURE OF BEHAVIORAL HEALTH INFORMATION. 23 Under current law, a mental health professional, data 24 collector, or employee or agent of a mental health 25 professional, or data collector, or of or for a mental health 26 facility, is prohibited from disclosing or permitting the 27 disclosure of certain mental health information, except as 28 specifically authorized by law. A recipient of mental health 29 information is also prohibited from disclosing mental health 30 information received, except as specifically authorized by law. 31 Records of licensed facilities providing treatment and care 32 of persons with substance-related disorders are confidential 33 except that a patient’s records may be disclosed for purposes 34 of a medical emergency. The bill amends these provisions to 35 -4- LSB 5580SV (3) 86 rh/lh 4/ 5

S.F. 2144 include in the exception disclosures made by such persons for 1 purposes of a patient’s care coordination if not otherwise 2 restricted by federal law or regulation. “Care coordination” 3 is defined in Code section 135.154 as the management of all 4 aspects of a patient’s care to improve health care quality. 5 This division is effective upon enactment. 6 DIVISION II —— CONDITIONAL ENACTMENT. 2015 Iowa Acts, ch 7 73 (HF 381), division I, creates a new Code chapter 135D which 8 provides for the administration and governance of an Iowa 9 health information network, currently under the authority of 10 the department of public health (DPH), by a nonprofit entity 11 to be designated by DPH through a competitive process. Code 12 chapter 135D will take effect only upon the assumption of the 13 administration and governance of the network by the designated 14 entity from DPH. HF 381 also contains certain transition 15 provisions, including the repeal of Code section 135.154, upon 16 assumption of the administration and governance of the Iowa 17 health information network by the designated entity. 18 This division amends Code sections 125.37 and 228.2 to 19 replace the reference to the definition of care coordination in 20 Code section 135.154 with the corresponding reference to the 21 replacement definition in chapter 135D, contingent upon the 22 assumption of the designated entity of the administration and 23 governance of the network. 24 -5- LSB 5580SV (3) 86 rh/lh 5/ 5