SF 2144 (LSB 5580SV (3) 86)

SENATE FILE 2144

BY  COMMITTEE ON HUMAN RESOURCES

(SUCCESSOR TO SF 2032)

A BILL FOR

An Act relating to the disclosure of behavioral health information for the purpose of patient care coordination, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
DISCLOSURE OF BEHAVIORAL HEALTH INFORMATION

    Section 1.  Section 125.37, subsection 3, Code 2016, is amended to read as follows:
   3.  Notwithstanding the provisions of subsection 1 of this section, a patient’s records may be disclosed to only under any of the following circumstances:
   a.  To medical personnel in a medical emergency with or without the patient’s consent.
   b.  For purposes of care coordination as defined in section 135.154 if not otherwise restricted by federal law or regulation.
    Sec. 2.  Section 228.2, Code 2016, is amended to read as follows:
   228.2  Mental health information disclosure prohibited —— exceptions —— record of disclosure.
   1.  Except as specifically authorized in subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 if not otherwise restricted by federal law or regulation, a mental health professional, data collector, or employee or agent of a mental health professional, of a data collector, or of or for a mental health facility shall not disclose or permit the disclosure of mental health information.
   2.  a.  Upon disclosure of mental health information pursuant to subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 if not otherwise restricted by federal law or regulation, the person disclosing the mental health information shall enter a notation on and maintain the notation with the individual’s record of mental health information, stating the date of the disclosure and the name of the recipient of mental health information.
   b.  The person disclosing the mental health information shall give the recipient of the information a statement which informs the recipient that disclosures may only be made pursuant to the written authorization of an individual or an individual’s legal representative, or as otherwise provided in this chapter, that the unauthorized disclosure of mental health information is unlawful, and that civil damages and criminal penalties may be applicable to the unauthorized disclosure of mental health information.
   3.  A recipient of mental health information shall not disclose the information received, except as specifically authorized for initial disclosure in subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 if not otherwise restricted by federal law or regulation.
   4.  However, mental Mental health information may be transferred at any time to another facility, physician, or mental health professional in cases of a medical emergency or if the individual or the individual’s legal representative requests the transfer in writing for the purposes of receipt of medical or mental health professional services, at which time the requirements of subsection 2 shall be followed.
    Sec. 3.  EFFECTIVE UPON ENACTMENT.  This division of this Act, being deemed of immediate importance, takes effect upon enactment.
DIVISION II
CONDITIONAL ENACTMENT

    Sec. 4.  Section 125.37, subsection 3, Code 2016, as amended in this Act, is amended to read as follows:
   3.  Notwithstanding the provisions of subsection 1, a patient’s records may be disclosed only under any of the following circumstances:
   a.  To medical personnel in a medical emergency with or without the patient’s consent.
   b.  For purposes of care coordination as defined in section 135.154 135D.2 if not otherwise restricted by federal law or regulation.
    Sec. 5.  Section 228.2, Code 2016, as amended in this Act, is amended to read as follows:
   228.2  Mental health information disclosure prohibited —— exceptions —— record of disclosure.
   1.  Except as specifically authorized in subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 135D.2 if not otherwise restricted by federal law or regulation, a mental health professional, data collector, or employee or agent of a mental health professional, of a data collector, or of or for a mental health facility shall not disclose or permit the disclosure of mental health information.
   2.  a.  Upon disclosure of mental health information pursuant to subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 135D.2 if not otherwise restricted by federal law or regulation, the person disclosing the mental health information shall enter a notation on and maintain the notation with the individual’s record of mental health information, stating the date of the disclosure and the name of the recipient of mental health information.
   b.  The person disclosing the mental health information shall give the recipient of the information a statement which informs the recipient that disclosures may only be made pursuant to the written authorization of an individual or an individual’s legal representative, or as otherwise provided in this chapter, that the unauthorized disclosure of mental health information is unlawful, and that civil damages and criminal penalties may be applicable to the unauthorized disclosure of mental health information.
   3.  A recipient of mental health information shall not disclose the information received, except as specifically authorized for initial disclosure in subsection 4, section 228.3, 228.5, 228.6, 228.7, or 228.8, or for the purposes of care coordination as defined in section 135.154 135D.2 if not otherwise restricted by federal law or regulation.
   4.  Mental health information may be transferred at any time to another facility, physician, or mental health professional in cases of a medical emergency or if the individual or the individual’s legal representative requests the transfer in writing for the purposes of receipt of medical or mental health professional services, at which time the requirements of subsection 2 shall be followed.
    Sec. 6.  EFFECTIVE DATE.  This division of this Act takes effect upon the assumption of the administration and governance, including but not limited to the assumption of the assets and liabilities, of the Iowa health information network by the designated entity. The department of public health shall notify the Code editor of the date of such assumption by the designated entity.
EXPLANATION
The inclusion of this explanation does not constitute agreement with

the explanation’s substance by the members of the general assembly.
   This bill relates to the disclosure of mental health information for the purpose of the coordination of a patient’s care, and includes effective date provisions. The bill is organized by divisions.
   DIVISION I —— DISCLOSURE OF BEHAVIORAL HEALTH INFORMATION.  Under current law, a mental health professional, data collector, or employee or agent of a mental health professional, or data collector, or of or for a mental health facility, is prohibited from disclosing or permitting the disclosure of certain mental health information, except as specifically authorized by law. A recipient of mental health information is also prohibited from disclosing mental health information received, except as specifically authorized by law. Records of licensed facilities providing treatment and care of persons with substance-related disorders are confidential except that a patient’s records may be disclosed for purposes of a medical emergency. The bill amends these provisions to include in the exception disclosures made by such persons for purposes of a patient’s care coordination if not otherwise restricted by federal law or regulation. “Care coordination” is defined in Code section 135.154 as the management of all aspects of a patient’s care to improve health care quality.
   This division is effective upon enactment.
   DIVISION II —— CONDITIONAL ENACTMENT. 2015 Iowa Acts, ch 73 (HF 381), division I, creates a new Code chapter 135D which provides for the administration and governance of an Iowa health information network, currently under the authority of the department of public health (DPH), by a nonprofit entity to be designated by DPH through a competitive process. Code chapter 135D will take effect only upon the assumption of the administration and governance of the network by the designated entity from DPH. HF 381 also contains certain transition provisions, including the repeal of Code section 135.154, upon assumption of the administration and governance of the Iowa health information network by the designated entity. 
   This division amends Code sections 125.37 and 228.2 to replace the reference to the definition of care coordination in Code section 135.154 with the corresponding reference to the replacement definition in chapter 135D, contingent upon the assumption of the designated entity of the administration and governance of the network.