H.F. 386 Section 1. Section 229.13, subsection 7, paragraph a, 1 subparagraph (1), Code 2017, is amended to read as follows: 2 (1) (a) The respondent’s mental health professional acting 3 within the scope of the mental health professional’s practice 4 shall notify the committing court, with preference given to 5 the committing judge, if available, in the appropriate county 6 and the court shall enter a written order directing that the 7 respondent be taken into immediate protective custody by the 8 appropriate sheriff or sheriff’s deputy. The appropriate 9 sheriff or sheriff’s deputy shall exercise all due diligence 10 in taking the respondent into protective custody to a hospital 11 or other suitable facility. The court’s written order shall 12 include a statement that the respondent has not been compliant 13 with the committing court’s outpatient treatment order. The 14 clerk of the district court shall enter notice of the court’s 15 order into the Iowa criminal justice information system or the 16 national crime information center system, and shall send a copy 17 of the order to the outpatient treatment facility at which 18 the respondent was previously ordered to undergo outpatient 19 treatment. 20 (b) If the respondent’s mental health professional is 21 unable to contact the committing court during regular business 22 hours, the mental health professional shall notify the 23 appropriate sheriff or sheriff’s deputy who shall take the 24 respondent into immediate protective custody. The respondent’s 25 mental health professional shall provide notice of such action 26 to the committing court on the next business day and the 27 committing court shall proceed as provided in subparagraph 28 division (a). The respondent’s mental health professional 29 shall also provide such notice to the outpatient treatment 30 facility at which the respondent was previously ordered to 31 undergo outpatient treatment. 32 (c) If charges are pending against the respondent, 33 the respondent may be detained in protective custody in a 34 hospital or other suitable facility for a period not to exceed 35 -1- LSB 1722YH (8) 87 rh/rj 1/ 6

H.F. 386 seventy-two hours from the time the respondent is taken into 1 protective custody for crisis observation and treatment before 2 formal charges can be filed against the respondent. 3 Sec. 2. Section 229.13, subsection 7, paragraph a, 4 subparagraph (3), Code 2017, is amended to read as follows: 5 (3) If the respondent chooses to be treated by the 6 appropriate medication which may include the use of injectable 7 antipsychotic medicine but the mental health professional 8 acting within the scope of the mental health professional’s 9 practice at the outpatient psychiatric clinic, hospital, or 10 other suitable facility determines , or a family member of the 11 respondent provides sufficient information to the mental health 12 professional or any of the respondent’s outpatient treatment 13 providers to the mental health professional or outpatient 14 treatment provider to conclude that the respondent’s behavior 15 continues to be likely to result in physical injury to the 16 respondent’s self or others if allowed to continue, the mental 17 health professional acting within the scope of the mental 18 health professional’s practice shall comply with the provisions 19 of subparagraph (1) and, following notice and hearing held in 20 accordance with the procedures in section 229.12 , the court may 21 order the respondent treated on an inpatient basis requiring 22 full-time custody, care, and treatment in a hospital or other 23 suitable facility until such time as the chief medical officer 24 reports that the respondent does not require further treatment 25 for serious mental impairment or has indicated the respondent 26 is willing to submit to treatment on another basis as ordered 27 by the court. 28 Sec. 3. Section 229.13, subsection 7, Code 2017, is amended 29 by adding the following new paragraph: 30 NEW PARAGRAPH . c. For the purposes of this subsection, 31 “other suitable facility” may include an appropriate subacute 32 care facility licensed under chapter 135G but shall not include 33 a jail or other correctional facility. 34 Sec. 4. DEPARTMENT OF INSPECTIONS AND APPEALS —— RULES. 35 -2- LSB 1722YH (8) 87 rh/rj 2/ 6

H.F. 386 1. The department of inspections and appeals shall 1 adopt rules pursuant to chapter 17A relating to eligibility 2 requirements for the receipt of individualized subacute mental 3 health services in subacute care facilities licensed under 4 chapter 135G to allow for the care and treatment of a person 5 with a serious and persistent mental illness on a long-term 6 basis if the person is in court-ordered outpatient treatment 7 and any of the following applies: 8 a. The person is not complying with the court-ordered 9 outpatient treatment. 10 b. The person’s outpatient mental health professional 11 is not available for appointments and follow up necessary to 12 assist the person in remaining compliant with the outpatient 13 court-ordered treatment. 14 c. The person has visited a hospital emergency room or 15 emergency clinic multiple times but has not been admitted to 16 the hospital as an inpatient, or the person has been admitted 17 to a hospital as an inpatient but, based upon information 18 received from family members or mental health professionals, 19 the person continues to be noncompliant with the court-ordered 20 outpatient treatment. 21 d. Protective treatment in a hospital or other suitable 22 facility is not available. 23 e. Pursuant to section 229.13, subsection 7, the person 24 has been taken into custody by the county sheriff for 25 noncompliance with the court-ordered outpatient treatment, and 26 protective treatment in a hospital or other suitable facility 27 is available. 28 2. For the purposes of this section, “other suitable 29 facility” shall not include a jail or other correctional 30 facility. 31 Sec. 5. DEPARTMENT OF HUMAN SERVICES —— RULES. 32 1. The department of human services, in coordination with 33 regional administrators of county mental health and disability 34 services regions, the state mental health and disability 35 -3- LSB 1722YH (8) 87 rh/rj 3/ 6

H.F. 386 services commission, service providers, and other stakeholders, 1 shall develop a methodology to establish appropriate medical 2 assistance program reimbursement rates for the actual cost 3 of mental health treatment services and associated room and 4 board costs in a subacute mental health facility licensed under 5 chapter 135G for eligible persons pursuant to this Act. 6 2. The department of human services shall adopt rules 7 pursuant to chapter 17A to administer the provisions of this 8 Act. 9 Sec. 6. CITATION. This Act may, along with its formal 10 citation, be cited as “Jackie’s Law”. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill relates to the provision and financing of 15 long-term care services in subacute care mental health care 16 facilities for persons with serious and persistent mental 17 illness. 18 The bill amends Code section 229.13 relating to a person 19 (respondent) who is under a court order to undergo outpatient 20 treatment for mental illness upon the conclusion of an 21 involuntary hospitalization proceeding. Under current law, 22 if the respondent is ordered to undergo outpatient treatment 23 and the respondent’s failure to comply with the course of 24 treatment results in behavior by the respondent which, in 25 the opinion of the respondent’s mental health professional, 26 is likely to result in physical injury to the respondent’s 27 self or others if allowed to continue, the respondent may be 28 taken into protective custody. Once in protective custody, 29 the respondent shall be given the choice of being treated 30 by the appropriate medication at an outpatient psychiatric 31 clinic, hospital, or other suitable facility or being placed 32 for treatment under the care of a hospital or other suitable 33 facility for inpatient treatment. If the respondent chooses to 34 be treated by the appropriate medication but the mental health 35 -4- LSB 1722YH (8) 87 rh/rj 4/ 6

H.F. 386 professional at the outpatient psychiatric clinic, hospital, 1 or other suitable facility determines that the respondent’s 2 behavior continues to be likely to result in physical injury 3 to the respondent’s self or others if allowed to continue, the 4 mental health professional is required to notify the committing 5 court, and after proper notice and hearing, the court may 6 order the respondent treated on an inpatient basis requiring 7 full-time custody, care, and treatment in a hospital until it 8 is determined that the respondent does not require further 9 treatment for serious mental impairment or has indicated 10 the respondent is willing to submit to other court-ordered 11 treatment. 12 The bill provides that the court’s written order shall 13 include a statement that the respondent has not been compliant 14 with the committing court’s outpatient treatment order. The 15 clerk of the district court shall enter notice of the court’s 16 order into the Iowa criminal justice information system or 17 the national crime information center system, and shall send 18 a copy of the order to the outpatient treatment facility 19 at which the respondent was previously ordered to undergo 20 outpatient treatment. If the respondent’s mental health 21 professional is unable to contact the committing court during 22 regular business hours, the mental health professional shall 23 notify the appropriate sheriff or sheriff’s deputy who shall 24 take the respondent into immediate protective custody. The 25 respondent’s mental health professional shall provide notice of 26 such action to the committing court on the next business day 27 and the committing court shall proceed as provided in the bill. 28 The respondent’s mental health professional shall also provide 29 such notice to the outpatient treatment facility at which 30 the respondent was previously ordered to undergo outpatient 31 treatment. If charges are pending against the respondent, the 32 respondent may be detained in protective custody in a hospital 33 or other suitable facility for a 72-hour period for crisis 34 observation and treatment before formal charges can be filed 35 -5- LSB 1722YH (8) 87 rh/rj 5/ 6

H.F. 386 against the respondent. 1 The bill allows a family member of the respondent to provide 2 information to the mental health professional or any of the 3 respondent’s outpatient treatment providers from which the 4 mental health professional or outpatient treatment provider 5 may conclude that the respondent’s behavior continues to be 6 likely to result in physical injury to the respondent’s self 7 or others. The bill then provides that the court may order the 8 respondent treated on an inpatient basis in a suitable facility 9 in addition to a hospital. The bill defines other suitable 10 facility to include an appropriate subacute care facility 11 licensed under Code chapter 135G but excludes a jail or other 12 correctional facility. 13 The bill requires the department of inspections and appeals 14 to adopt rules relating to eligibility requirements for 15 individualized subacute mental health services in subacute care 16 facilities licensed under Code chapter 135G to allow for the 17 treatment of a person with a serious and persistent mental 18 illness that requires inpatient care on a long-term basis if 19 the person is in court-ordered outpatient treatment and certain 20 circumstances apply. 21 The department of human services, in coordination with 22 regional administrators of county mental health and disability 23 services regions, the state mental health and disability 24 services commission, service providers, and other stakeholders, 25 is required to develop a methodology to establish appropriate 26 medical assistance program reimbursement rates for the actual 27 cost of mental health treatment services and associated room 28 and board costs in a subacute care facility licensed under 29 Code chapter 135G for eligible persons under the bill. The 30 department is required to adopt rules pursuant to chapter 17A 31 to administer the provisions of the bill. 32 -6- LSB 1722YH (8) 87 rh/rj 6/ 6