House File 2473 HOUSE FILE BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HF 2354) Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to mental health, mental retardation, and 2 developmental disabilities services by revising involuntary 3 hospitalization procedures involving the county single entry 4 point process and patient advocates and authorizing counties 5 to create a special program fund for these services. 6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 7 HF 2473 8 jp/es/25 PAG LIN 1 1 Section 1. Section 229.1B, Code 2003, is amended to read 1 2 as follows: 1 3 229.1B SINGLE ENTRY POINT PROCESS. 1 4 1. Notwithstanding any provision of this chapter to the 1 5 contrary, any person whose hospitalization expenses are 1 6 payable in whole or in part by a county shall be subject to 1 7 all requirements of the single entry point process. The 1 8 single entry point process administrator or the 1 9 administrator's designee shall assist the court by determining 1 10 the person's county of legal settlement and notifying the 1 11 court of the determination. In addition, the administrator or 1 12 designee shall identify one or more appropriate hospitals or 1 13 facilities with an opening available for placement of the 1 14 person and provide this information to the court along with a 1 15 placement recommendation. 1 16 2. The county single entry point process administrator 1 17 shall develop a plan for addressing emergency examinations and 1 18 placements made under this chapter. The plan shall be 1 19 developed in consultation with representatives of the 1 20 community mental health centers and hospitals providing 1 21 emergency services in that county. The plan shall include but 1 22 is not limited to a process for the administrator or the 1 23 administrator's designee to provide the court with a placement 1 24 recommendation as required by this chapter. 1 25 3. A person who receives confidential information under 1 26 this chapter due to the person's responsibilities relating to 1 27 the single entry point process is subject to the requirements 1 28 of chapter 228, the federal Health Insurance Portability and 1 29 Accountability Act of 1996, Pub. L. No. 104-191, and other 1 30 applicable requirements intended to protect the 1 31 confidentiality of information pertaining to a respondent or 1 32 person subject to a commitment order under this chapter. 1 33 Sec. 2. Section 229.8, subsection 2, Code 2003, is amended 1 34 to read as follows: 1 35 2. Cause copies of the application and supporting 2 1 documentation to be sent to the county attorney or the county 2 2 attorney's attorney=designate for review, and to the county's 2 3 single entry point process administrator. 2 4 Sec. 3. Section 229.9A, Code 2003, is amended to read as 2 5 follows: 2 6 229.9A PATIENT ADVOCATE INFORMED. 2 7 The court shall direct the clerk to furnish the patient 2 8 advocate of the respondent's county of legal settlement with a 2 9 copy of application and any order issued pursuant to section 2 10 229.8, subsection 3. If an order is issued, the clerk shall 2 11 also provide a copy of the order to the single entry point 2 12 process administrator of the respondent's county of legal 2 13 settlement. The advocate may attend the hospitalization 2 14 hearing of any respondent for whom the advocate has received 2 15 notice of a hospitalization hearing. 2 16 Sec. 4. Section 229.11, unnumbered paragraph 1, Code 2003, 2 17 is amended to read as follows: 2 18 If the applicant requests that the respondent be taken into 2 19 immediate custody and the judge, upon reviewing the 2 20 application and accompanying documentation, finds probable 2 21 cause to believe that the respondent has a serious mental 2 22 impairment and is likely to injure the respondent or other 2 23 persons if allowed to remain at liberty, the judge may enter a 2 24 written order directing that the respondent be taken into 2 25 immediate custody by the sheriff or the sheriff's deputy and 2 26 be detained until the hospitalization hearing. The 2 27 hospitalization hearing shall be held no more than five days 2 28 after the date of the order, except that if the fifth day 2 29 after the date of the order is a Saturday, Sunday, or a 2 30 holiday, the hearing may be held on the next succeeding 2 31 business day. If the expenses of a respondent are payable in 2 32 whole or in part by a county, for a placement in accordance 2 33 with subsection 1, the judge shall give notice of the 2 34 placement to the single entry point process, and for a 2 35 placement in accordance with subsection 2 or 3, the judge 3 1 shall order the placement in a hospital or facility designated 3 2 through the single entry point process. Prior to the hearing, 3 3 the single entry point process administrator or the 3 4 administrator's designee shall provide the court with a 3 5 placement recommendation identifying one or more appropriate 3 6 hospitals or facilities with an opening available for 3 7 placement of the respondent. If determined to be in the best 3 8 interest of the respondent, the judge may order placement of 3 9 the respondent in an alternative facility in which an opening 3 10 is available. The judge may order the respondent detained for 3 11 the period of time until the hearing is held, and no longer, 3 12 in accordance with subsection 1 if possible, and if not then 3 13 in accordance with subsection 2 or, only if neither of these 3 14 alternatives is available, in accordance with subsection 3. 3 15 Detention may be: 3 16 Sec. 5. Section 229.13, subsection 1, paragraph a, Code 3 17 2003, is amended to read as follows: 3 18 a. The court shall order a respondent whose expenses are 3 19 payable in whole or in part by a county placed under the care 3 20 of an appropriate hospital or facility designated through the 3 21 single entry point process on an inpatient or outpatient 3 22 basis. The single entry point process administrator or the 3 23 administrator's designee shall provide the court with a 3 24 placement recommendation identifying one or more appropriate 3 25 hospitals or facilities with an opening available for 3 26 placement of the respondent. If determined to be in the best 3 27 interest of the respondent, the judge may order placement of 3 28 the respondent in an alternative facility in which an opening 3 29 is available. 3 30 Sec. 6. Section 229.14, subsection 2, paragraph a, Code 3 31 2003, is amended to read as follows: 3 32 a. For a respondent whose expenses are payable in whole or 3 33 in part by a county, placement as designated through the 3 34 single entry point process in the care of an appropriate 3 35 hospital or facility on an inpatient or outpatient basis, or 4 1 other appropriate treatment, or in an appropriate alternative 4 2 placement. The single entry point process administrator or 4 3 the administrator's designee shall provide the court with a 4 4 placement recommendation identifying one or more appropriate 4 5 hospitals or facilities with an opening available for 4 6 placement of the respondent. If determined to be in the best 4 7 interest of the respondent, the judge may order placement of 4 8 the respondent in an alternative facility in which an opening 4 9 is available. 4 10 Sec. 7. Section 229.14A, subsection 1, Code 2003, is 4 11 amended to read as follows: 4 12 1. With respect to a chief medical officer's report made 4 13 pursuant to section 229.14, subsection 1, paragraph "b", "c", 4 14 or "d", or any other provision of this chapter related to 4 15 involuntary commitment for which the court issues a placement 4 16 order or a transfer of placement is authorized, the court 4 17 shall provide notice to the respondent and the respondent's 4 18 attorney ormental healthpatient advocate pursuant to section 4 19 229.19 concerning the placement order and the respondent's 4 20 right to request a placement hearing to determine if the order 4 21 for placement or transfer of placement is appropriate. A copy 4 22 of the placement order or transfer authorization shall also be 4 23 provided to the single entry point process administrator of 4 24 the respondent's county of legal settlement. 4 25 Sec. 8. Section 229.14A, subsection 7, Code 2003, is 4 26 amended to read as follows: 4 27 7. If a respondent's expenses are payable in whole or in 4 28 part by a county through the single entry point process, 4 29 notice of a placement hearing shall be provided to the county 4 30 attorney and the county's single entry point process 4 31 administrator. At the hearing, the county may present 4 32 evidence regarding appropriate placement. The single entry 4 33 point process administrator or the administrator's designee 4 34 shall provide the court with a placement recommendation 4 35 identifying one or more appropriate hospitals or facilities 5 1 with an opening available for placement of the respondent. 5 2 Sec. 9. Section 229.22, subsection 2, unnumbered paragraph 5 3 2, Code Supplement 2003, is amended to read as follows: 5 4 If the magistrate orders that the person be detained, the 5 5 magistrate shall, by the close of business on the next working 5 6 day, file a written order with the clerk in the county where 5 7 it is anticipated that an application may be filed under 5 8 section 229.6. The order may be filed by facsimile if 5 9 necessary. The order shall state the circumstances under 5 10 which the person was taken into custody or otherwise brought 5 11 to a facility, and the grounds supporting the finding of 5 12 probable cause to believe that the person is seriously 5 13 mentally impaired and likely to injure the person's self or 5 14 others if not immediately detained. The order shall confirm 5 15 the oral order authorizing the person's detention including 5 16 any order given to transport the person to an appropriate 5 17 facility. The clerk shall provide a copy of that order to the 5 18 single entry point process administrator of the county where 5 19 it is anticipated that an application may be filed under 5 20 section 229.6, to the chief medical officer of the facility to 5 21 which the person was originally taken, to any subsequent 5 22 facility to which the person was transported, and to any law 5 23 enforcement department or ambulance service that transported 5 24 the person pursuant to the magistrate's order. 5 25 Sec. 10. Section 229.24, subsection 1, Code 2003, is 5 26 amended to read as follows: 5 27 1. All papers and records pertaining to any involuntary 5 28 hospitalization or application for involuntary hospitalization 5 29 of any person under this chapter, whether part of the 5 30 permanent record of the court or a county or of a file in the 5 31 department of human services, are subject to inspection only 5 32 upon an order of the court for good cause shown. Nothing in 5 33 this section shall prohibit a hospital from complying with the 5 34 requirements of this chapter and of chapter 230 relative to 5 35 financial responsibility for the cost of care and treatment 6 1 provided a patient in that hospital, nor from properly billing 6 2 any responsible relative or third=party payer for such care 6 3 and treatment. 6 4 Sec. 11. Section 331.424A, Code Supplement 2003, is 6 5 amended by adding the following new subsection: 6 6 NEW SUBSECTION. 6. a. Notwithstanding contrary 6 7 provisions of this section, a county may request approval of a 6 8 waiver by the department of management to create a special 6 9 program fund to receive moneys and to pay the direct and 6 10 indirect costs of special program services provided to persons 6 11 eligible for services payable from the services fund. In 6 12 requesting the waiver, the county shall provide information 6 13 detailing how the special fund will be used, the basis upon 6 14 which moneys will be credited and expended from the special 6 15 fund, and other information specified by the department of 6 16 management in order for the department to determine whether 6 17 the special fund will be used in a manner that is appropriate 6 18 to distinguish those uses from the uses of the services fund. 6 19 The department of management may authorize a waiver for a 6 20 specific term or an indefinite term and a waiver is subject to 6 21 other conditions that the department may apply to ensure that 6 22 the special fund is operated solely for the purposes for which 6 23 the special fund is authorized. The department's approval of 6 24 a waiver shall be based upon the department's determination 6 25 that the special fund will be only be used for managing money 6 26 for special program services provided to persons eligible for 6 27 services paid from the services fund and are appropriate to 6 28 distinguish those uses from the uses of the services fund. 6 29 b. The special program services may be provided to persons 6 30 whose service costs are attributable to the county that 6 31 created the special program fund or to other counties. In 6 32 addition to receipts from the services fund of the county that 6 33 created the special program fund, receipts from federal, 6 34 state, and other county and governments, and any other 6 35 revenues associated with the provision of special program 7 1 services shall be credited to the special program fund. The 7 2 levy limitation established pursuant to subsection 4 is not 7 3 subject to increase as a result of the creation or 7 4 administration of the special program fund. The management 7 5 plans approved pursuant to section 331.439 for the counties 7 6 purchasing services from the special program fund shall 7 7 address the services payable from the special program fund and 7 8 the administration of the special program fund. 7 9 Sec. 12. STUDY GROUP. The supreme court is requested to 7 10 convene a study group to consider issues relating to the 7 11 functions performed by patient advocates appointed under 7 12 chapter 229 and the interaction of patient advocates with 7 13 other portions of the legal and service systems for persons 7 14 with mental illness. If established, the study group shall 7 15 issue a report to the judicial branch, governor, and general 7 16 assembly with findings and recommendations on or before 7 17 December 15, 2004. 7 18 Sec. 13. IMPLEMENTATION OF ACT. Section 25B.2, subsection 7 19 3, shall not apply to this Act. 7 20 HF 2473 7 21 jp/es/25