House File 385 - Reprinted HOUSE FILE 385 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO HF 124) (As Amended and Passed by the House March 20, 2025 ) A BILL FOR An Act relating to discharge of involuntarily committed persons 1 from a facility or a hospital. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 HF 385 (2) 91 dg/ko/md

H.F. 385 Section 1. Section 125.2, Code 2025, is amended by adding 1 the following new subsections: 2 NEW SUBSECTION . 01. “Administrative services organization” 3 means the same as defined in section 225A.1. 4 001. “Behavioral health district” means the same as defined 5 in section 225A.1. 6 Sec. 2. Section 125.85, subsection 4, Code 2025, is amended 7 by striking the subsection. 8 Sec. 3. Section 125.85, Code 2025, is amended by adding the 9 following new subsections: 10 NEW SUBSECTION . 6. Prior to a discharge of a respondent 11 under this section, the facility treating the respondent shall 12 do all of the following: 13 a. Refer the respondent to an administrative services 14 organization for evaluation, system navigation, and 15 postdischarge services. 16 b. Assess the respondent for suicide risk. 17 c. Provide the respondent with a fifteen-day supply of 18 each medication prescribed for the respondent before or 19 during the respondent’s treatment, including psychiatric and 20 nonpsychiatric medications. If payment for a medication 21 provided under this paragraph is not covered by insurance or 22 Medicaid, the facility may make a request for reimbursement 23 from an administrative services organization for the cost of 24 the medication. 25 d. Provide the respondent or the respondent’s legal 26 representative with a discharge report. The discharge report 27 shall include all of the following: 28 (1) The respondent’s name and address. 29 (2) The dates, times, and locations of all postdischarge 30 appointments scheduled for the respondent. 31 (3) A list of each medication provided to the respondent 32 under paragraph “c” . 33 (4) Contact information for the administrative services 34 organization to which the respondent was referred under 35 -1- HF 385 (2) 91 dg/ko/md 1/ 6

H.F. 385 paragraph “a” . 1 (5) A written patient-centered aftercare plan, including 2 crisis prevention and steps to address the respondent’s ongoing 3 care needs. 4 (6) (a) Educational materials for the respondent and 5 individuals who are willing to support the respondent after the 6 respondent’s discharge. 7 (b) Educational materials shall be developed by the 8 department for distribution to facilities. Educational 9 materials shall include but not be limited to all of the 10 following: 11 (i) Descriptions of the symptoms of a substance use 12 disorder. 13 (ii) Warning signs of decompensation. 14 (iii) Information regarding the availability of other 15 educational services, services offered in the respondent’s 16 community, and services offered statewide. 17 e. Notify all of the following persons: 18 (1) The administrative services organization to which the 19 respondent was referred under paragraph “a” . 20 (2) The respondent’s legal guardian, parent, spouse, 21 attorney in fact under chapter 144B, or adult siblings, as 22 applicable. 23 NEW SUBSECTION . 7. a. The administrative services 24 organization to which a respondent was referred under 25 subsection 6, paragraph “a” , shall do all of the following in 26 relation to the discharged respondent: 27 (1) Coordinate postdischarge care, including but not 28 limited to contacting the respondent to ensure the respondent 29 attends scheduled appointments and receives necessary care and 30 services. 31 (2) Follow up with the respondent in a timely manner. 32 Follow-ups shall include but not be limited to home visits, 33 telephone calls, and other means of contacting the respondent. 34 b. An administrative services organization may delegate 35 -2- HF 385 (2) 91 dg/ko/md 2/ 6

H.F. 385 duties required under this subsection to a managed care 1 organization acting pursuant to a contract with the department 2 to administer the Medicaid program under chapter 249A, if the 3 respondent referred to the administrative services organization 4 qualifies for Medicaid. 5 NEW SUBSECTION . 8. a. Each administrative services 6 organization shall make a quarterly report to the department, 7 and the report shall include all of the following: 8 (1) The number of respondents discharged and referred to 9 the administrative services organization during the reporting 10 period. 11 (2) The outcome of each discharged respondent. 12 (3) Any issues encountered while ensuring each respondent’s 13 postdischarge continuity of care. 14 b. A report under this section shall be considered a 15 confidential record under section 22.7. 16 c. A report under this section shall comply with the federal 17 Health Insurance Portability and Accountability Act of 1996, 18 Pub. L. No. 104-191. 19 NEW SUBSECTION . 9. Following a respondent’s discharge from 20 a facility or from treatment, the administrator of the facility 21 shall immediately report the discharge to the court which 22 ordered the respondent’s commitment or treatment. The court 23 shall issue an order confirming the respondent’s discharge 24 and terminating the proceedings in which the respondent’s 25 commitment or treatment was ordered. Copies of the order 26 confirming the discharge and terminating the proceedings shall 27 be sent by regular mail to the facility and the respondent. 28 NEW SUBSECTION . 10. The department shall adopt rules 29 pursuant to chapter 17A to implement and administer this 30 section. 31 Sec. 4. Section 229.1, Code 2025, is amended by adding the 32 following new subsections: 33 NEW SUBSECTION . 01. “Administrative services organization” 34 means the same as defined in section 225A.1. 35 -3- HF 385 (2) 91 dg/ko/md 3/ 6

H.F. 385 001. “Behavioral health district” means the same as defined 1 in section 225A.1. 2 Sec. 5. Section 229.16, Code 2025, is amended to read as 3 follows: 4 229.16 Discharge and termination of proceeding. 5 1. When the condition of , in the opinion of the chief 6 medical officer, a patient who is hospitalized pursuant to a 7 report issued whose treatment was recommended under section 8 229.14, subsection 1 , paragraph “b” , or is receiving treatment 9 pursuant to a report issued under section 229.14, subsection 10 1 , paragraph “c” , or is in full-time care and custody pursuant 11 to a report issued under section 229.14, subsection 1 , 12 paragraph “d” , is such that in the opinion of the chief medical 13 officer the patient no longer requires treatment or care for 14 serious mental impairment, the chief medical officer shall 15 tentatively discharge the patient and immediately report that 16 fact the discharge to the court which ordered the patient’s 17 hospitalization or care and custody treatment . Upon receiving 18 the report, the court shall issue an order confirming the 19 patient’s discharge from the hospital or from care and custody, 20 as the case may be, and shall terminate terminating the 21 proceedings pursuant to in which the order patient’s treatment 22 was issued ordered . Copies of the order shall be sent by 23 regular mail to the hospital, the patient, and the applicant if 24 the applicant has filed a written waiver signed by the patient. 25 2. If a patient is receiving inpatient care, prior to a 26 discharge of the patient under subsection 1, the facility or 27 hospital treating the patient shall do all of the following: 28 a. Refer the patient to an administrative services 29 organization for evaluation, system navigation, and 30 postdischarge services. 31 b. Assess the patient for suicide risk. 32 c. Provide the patient with a fifteen-day supply of each 33 medication prescribed for the patient before or during the 34 patient’s treatment, including psychiatric and nonpsychiatric 35 -4- HF 385 (2) 91 dg/ko/md 4/ 6

H.F. 385 medications. If payment for a medication provided under this 1 paragraph is not covered by insurance or Medicaid, the facility 2 may make a request for reimbursement from an administrative 3 services organization for the cost of the medication. 4 d. Provide the patient or the patient’s legal representative 5 with a discharge report. The discharge report shall include 6 all of the following: 7 (1) The patient’s name and address. 8 (2) The dates, times, and locations of all postdischarge 9 appointments scheduled for the patient. 10 (3) A list of each medication provided to the patient under 11 paragraph “c” . 12 (4) Contact information for the administrative services 13 organization to which the patient was referred under paragraph 14 “a” . 15 (5) A written patient-centered aftercare plan, including 16 crisis prevention and steps to address the patient’s ongoing 17 care needs. 18 (6) (a) Educational materials for the patient and 19 individuals who are willing to support the patient after the 20 patient’s discharge. 21 (b) Educational materials shall be developed by the 22 department for distribution to facilities and hospitals 23 treating persons with a mental illness. Educational materials 24 shall include but not be limited to all of the following: 25 (i) Descriptions of the symptoms of mental illness. 26 (ii) Warning signs of decompensation. 27 (iii) Information regarding the availability of other 28 educational services, services offered in the patient’s 29 community, and services offered statewide. 30 e. Notify all of the following persons: 31 (1) The administrative services organization to which the 32 patient was referred under paragraph “a” . 33 (2) The patient’s legal guardian, parent, spouse, attorney 34 in fact under chapter 144B, or adult siblings, as applicable. 35 -5- HF 385 (2) 91 dg/ko/md 5/ 6

H.F. 385 3. a. The administrative services organization to which a 1 patient was referred under subsection 2, paragraph “a” , shall do 2 all of the following in relation to the discharged patient: 3 (1) Coordinate postdischarge care, including but not 4 limited to contacting the patient to ensure the patient 5 attends scheduled appointments and receives necessary care and 6 services. 7 (2) Follow up with the patient in a timely manner. 8 Follow-ups shall include but not be limited to home visits, 9 telephone calls, and other means of contacting the patient. 10 b. An administrative services organization may delegate 11 duties required under this subsection to a managed care 12 organization acting pursuant to a contract with the department 13 to administer the Medicaid program under chapter 249A, if the 14 patient referred to the administrative services organization 15 qualifies for Medicaid. 16 4. a. Each administrative services organization shall make 17 a quarterly report to the department, and the report shall 18 include all of the following: 19 (1) The number of patients discharged and referred to the 20 administrative services organization during the reporting 21 period. 22 (2) The outcomes of each discharged patient. 23 (3) Any issue encountered while ensuring each patient’s 24 postdischarge continuity of care. 25 b. A report under this section shall be considered a 26 confidential record under section 22.7. 27 c. A report under this section shall comply with the federal 28 Health Insurance Portability and Accountability Act of 1996, 29 Pub. L. No. 104-191. 30 5. The department shall adopt rules pursuant to chapter 17A 31 to implement this section. 32 -6- HF 385 (2) 91 dg/ko/md 6/ 6