HF 385 (LSB 2015HV (2) 91)

HOUSE FILE 385

BY  COMMITTEE ON HEALTH AND HUMAN SERVICES

(SUCCESSOR TO HF 124)

(As Amended and Passed by the House 2025-03-20)

A BILL FOR

An Act relating to discharge of involuntarily committed persons from a facility or a hospital.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 125.2, Code 2025, is amended by adding the following new subsections:
   NEW SUBSECTION.  01.  “Administrative services organization” means the same as defined in section 225A.1.
   001.  “Behavioral health district” means the same as defined in section 225A.1.
    Sec. 2.  Section 125.85, subsection 4, Code 2025, is amended by striking the subsection.
    Sec. 3.  Section 125.85, Code 2025, is amended by adding the following new subsections:
   NEW SUBSECTION.  6.  Prior to a discharge of a respondent under this section, the facility treating the respondent shall do all of the following:
   a.  Refer the respondent to an administrative services organization for evaluation, system navigation, and postdischarge services.
   b.  Assess the respondent for suicide risk.
   c.  Provide the respondent with a fifteen-day supply of each medication prescribed for the respondent before or during the respondent’s treatment, including psychiatric and nonpsychiatric medications. If payment for a medication provided under this paragraph is not covered by insurance or Medicaid, the facility may make a request for reimbursement from an administrative services organization for the cost of the medication.
   d.  Provide the respondent or the respondent’s legal representative with a discharge report. The discharge report shall include all of the following:
   (1)  The respondent’s name and address.
   (2)  The dates, times, and locations of all postdischarge appointments scheduled for the respondent.
   (3)  A list of each medication provided to the respondent under paragraph “c”.
   (4)  Contact information for the administrative services organization to which the respondent was referred under paragraph “a”.
   (5)  A written patient-centered aftercare plan, including crisis prevention and steps to address the respondent’s ongoing care needs.
   (6)  (a)  Educational materials for the respondent and individuals who are willing to support the respondent after the respondent’s discharge.
   (b)  Educational materials shall be developed by the department for distribution to facilities. Educational materials shall include but not be limited to all of the following:
   (i)  Descriptions of the symptoms of a substance use disorder.
   (ii)  Warning signs of decompensation.
   (iii)  Information regarding the availability of other educational services, services offered in the respondent’s community, and services offered statewide.
   e.  Notify all of the following persons:
   (1)  The administrative services organization to which the respondent was referred under paragraph “a”.
   (2)  The respondent’s legal guardian, parent, spouse, attorney in fact under chapter 144B, or adult siblings, as applicable.
   NEW SUBSECTION.  7.  a.  The administrative services organization to which a respondent was referred under subsection 6, paragraph “a”, shall do all of the following in relation to the discharged respondent:
   (1)  Coordinate postdischarge care, including but not limited to contacting the respondent to ensure the respondent attends scheduled appointments and receives necessary care and services.
   (2)  Follow up with the respondent in a timely manner. Follow-ups shall include but not be limited to home visits, telephone calls, and other means of contacting the respondent.
   b.  An administrative services organization may delegate duties required under this subsection to a managed care organization acting pursuant to a contract with the department to administer the Medicaid program under chapter 249A, if the respondent referred to the administrative services organization qualifies for Medicaid.
   NEW SUBSECTION.  8.  a.  Each administrative services organization shall make a quarterly report to the department, and the report shall include all of the following:
   (1)  The number of respondents discharged and referred to the administrative services organization during the reporting period.
   (2)  The outcome of each discharged respondent.
   (3)  Any issues encountered while ensuring each respondent’s postdischarge continuity of care.
   b.  A report under this section shall be considered a confidential record under section 22.7.
   c.  A report under this section shall comply with the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
   NEW SUBSECTION.  9.  Following a respondent’s discharge from a facility or from treatment, the administrator of the facility shall immediately report the discharge to the court which ordered the respondent’s commitment or treatment. The court shall issue an order confirming the respondent’s discharge and terminating the proceedings in which the respondent’s commitment or treatment was ordered. Copies of the order confirming the discharge and terminating the proceedings shall be sent by regular mail to the facility and the respondent.
   NEW SUBSECTION.  10.  The department shall adopt rules pursuant to chapter 17A to implement and administer this section.
    Sec. 4.  Section 229.1, Code 2025, is amended by adding the following new subsections:
   NEW SUBSECTION.  01.  “Administrative services organization” means the same as defined in section 225A.1.
   001.  “Behavioral health district” means the same as defined in section 225A.1.
    Sec. 5.  Section 229.16, Code 2025, is amended to read as follows:
   229.16  Discharge and termination of proceeding.
   1.  When the condition of, in the opinion of the chief medical officer, a patient who is hospitalized pursuant to a report issued whose treatment was recommended under section 229.14, subsection 1, paragraph “b”, or is receiving treatment pursuant to a report issued under section 229.14, subsection 1, paragraph “c”, or is in full-time care and custody pursuant to a report issued under section 229.14, subsection 1, paragraph “d”, is such that in the opinion of the chief medical officer the patient no longer requires treatment or care for serious mental impairment, the chief medical officer shall tentatively discharge the patient and immediately report that fact the discharge to the court which ordered the patient’s hospitalization or care and custody treatment. Upon receiving the report, the court shall issue an order confirming the patient’s discharge from the hospital or from care and custody, as the case may be, and shall terminate terminating the proceedings pursuant to in which the order patient’s treatment was issued ordered. Copies of the order shall be sent by regular mail to the hospital, the patient, and the applicant if the applicant has filed a written waiver signed by the patient.
   2.  If a patient is receiving inpatient care, prior to a discharge of the patient under subsection 1, the facility or hospital treating the patient shall do all of the following:
   a.  Refer the patient to an administrative services organization for evaluation, system navigation, and postdischarge services.
   b.  Assess the patient for suicide risk.
   c.  Provide the patient with a fifteen-day supply of each medication prescribed for the patient before or during the patient’s treatment, including psychiatric and nonpsychiatric medications. If payment for a medication provided under this paragraph is not covered by insurance or Medicaid, the facility may make a request for reimbursement from an administrative services organization for the cost of the medication.
   d.  Provide the patient or the patient’s legal representative with a discharge report. The discharge report shall include all of the following:
   (1)  The patient’s name and address.
   (2)  The dates, times, and locations of all postdischarge appointments scheduled for the patient.
   (3)  A list of each medication provided to the patient under paragraph “c”.
   (4)  Contact information for the administrative services organization to which the patient was referred under paragraph “a”.
   (5)  A written patient-centered aftercare plan, including crisis prevention and steps to address the patient’s ongoing care needs.
   (6)  (a)  Educational materials for the patient and individuals who are willing to support the patient after the patient’s discharge.
   (b)  Educational materials shall be developed by the department for distribution to facilities and hospitals treating persons with a mental illness. Educational materials shall include but not be limited to all of the following:
   (i)  Descriptions of the symptoms of mental illness.
   (ii)  Warning signs of decompensation.
   (iii)  Information regarding the availability of other educational services, services offered in the patient’s community, and services offered statewide.
   e.  Notify all of the following persons:
   (1)  The administrative services organization to which the patient was referred under paragraph “a”.
   (2)  The patient’s legal guardian, parent, spouse, attorney in fact under chapter 144B, or adult siblings, as applicable.
   3.  a.  The administrative services organization to which a patient was referred under subsection 2, paragraph “a”, shall do all of the following in relation to the discharged patient:
   (1)  Coordinate postdischarge care, including but not limited to contacting the patient to ensure the patient attends scheduled appointments and receives necessary care and services.
   (2)  Follow up with the patient in a timely manner. Follow-ups shall include but not be limited to home visits, telephone calls, and other means of contacting the patient.
   b.  An administrative services organization may delegate duties required under this subsection to a managed care organization acting pursuant to a contract with the department to administer the Medicaid program under chapter 249A, if the patient referred to the administrative services organization qualifies for Medicaid.
   4.  a.  Each administrative services organization shall make a quarterly report to the department, and the report shall include all of the following:
   (1)  The number of patients discharged and referred to the administrative services organization during the reporting period.
   (2)  The outcomes of each discharged patient.
   (3)  Any issue encountered while ensuring each patient’s postdischarge continuity of care.
   b.  A report under this section shall be considered a confidential record under section 22.7.
   c.  A report under this section shall comply with the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.
   5.  The department shall adopt rules pursuant to chapter 17A to implement this section.