House File 722 - IntroducedA Bill ForAn Act 1relating to the voluntary or involuntary commitment or
2hospitalization of a person with a serious mental impairment
3or a substance-related disorder.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1   Section 1.  Section 125.33, Code 2019, is amended by adding
2the following new subsection:
3   NEW SUBSECTION.  5A.  If a patient leaves a facility,
4with or against the advice of the administrator in charge of
5the facility, the facility shall provide the patient with
6a discharge report which shall include the patient’s name
7and address, all postdischarge appointments scheduled for
8the patient, and all information necessary for the patient’s
9postdischarge care.
10   Sec. 2.  Section 125.74, Code 2019, is amended to read as
11follows:
   12125.74  Preapplication screening assessment — program.
   13Prior to filing an application pursuant to section 125.75,
14the clerk of the district court or the clerk’s designee shall
15inform the interested person referred to in section 125.75
16about the option of requesting a preapplication screening
17assessment through a preapplication screening assessment
18program, which may include a preapplication screening
19assessment delivered through telehealth,
if available. The
20state court administrator shall prescribe practices and
21procedures for implementation of the preapplication screening
22assessment program.
23   Sec. 3.  Section 125.85, Code 2019, is amended by adding the
24following new subsection:
25   NEW SUBSECTION.  3A.  Prior to a respondent’s discharge from
26a facility or from treatment, the administrator of the facility
27shall provide a discharge report to the respondent which shall
28include the respondent’s name and address, all postdischarge
29appointments scheduled for the respondent, and all information
30necessary for the respondent’s postdischarge care.
31   Sec. 4.  Section 125.89, subsection 1, Code 2019, is amended
32to read as follows:
   331.  If a court orders a respondent placed at a facility
34for evaluation and treatment under section 125.83 at a time
35when the respondent has been convicted of a public offense,
-1-1or when there is pending against the respondent an unresolved
2formal charge of a public offense, and the respondent’s liberty
3has therefore been restricted in any manner, the findings of
4fact required by section 125.83 shall clearly so inform the
5administrator of the facility where the respondent is placed.
 6The court may order the facility to notify the appropriate law
7enforcement agency prior to the discharge or transfer of the
8respondent from the facility.

9   Sec. 5.  Section 125.91, subsection 2, paragraphs a and b,
10Code 2019, are amended to read as follows:
   11a.  A peace officer who has reasonable grounds to believe
12that the circumstances described in subsection 1 are applicable
13may, without a warrant, take or cause that person to be taken
14to the nearest available facility referred to in section
15125.81, subsection 2, paragraph “b” or “c”. Such a person
16with a substance-related disorder due to intoxication or
17substance-induced incapacitation who also demonstrates a
18significant degree of distress or dysfunction may also be
19delivered to a facility by someone other than a peace officer
20upon a showing of reasonable grounds. Upon delivery of
21the person to a facility under this section, the attending
22physician and surgeon or osteopathic physician and surgeon
23may order treatment of the person, but only to the extent
24necessary to preserve the person’s life or to appropriately
25control the person’s behavior if the behavior is likely to
26result in physical injury to the person or others if allowed to
27continue. The peace officer or other person who delivered the
28person to the facility shall describe the circumstances of the
29matter to the attending physician and surgeon or osteopathic
30physician and surgeon. If the person is a peace officer,
31the peace officer may do so either in person or by written
32report. If the attending physician and surgeon or osteopathic
33physician and surgeon has reasonable grounds to believe that
34the circumstances in subsection 1 are applicable, the attending
35physician shall at once communicate with the nearest available
-2-1magistrate as defined in section 801.4, subsection 10. The
2magistrate shall, based upon the circumstances described by
3the attending physician and surgeon or osteopathic physician
4and surgeon, give the attending physician and surgeon or
5osteopathic physician and surgeon oral instructions either
6directing that the person be released forthwith, or authorizing
7the person’s detention in an appropriate facility. A peace
8officer from the law enforcement agency that took the person
9into custody, if available, during the communication with the
10magistrate, may inform the magistrate that an arrest warrant
11has been issued for or charges are pending against the person
12and request that any oral or written order issued under this
13subsection require the facility to notify the law enforcement
14agency about the discharge or transfer of the person prior to
15the discharge or transfer.
The magistrate may also give oral
16instructions and order that the detained person be transported
17to an appropriate facility.
   18b.  If the magistrate orders that the person be detained, the
19magistrate shall, by the close of business on the next working
20day, file a written order with the clerk in the county where it
21is anticipated that an application may be filed under section
22125.75. The order may be filed by facsimile if necessary. A
23peace officer from the law enforcement agency that took the
24person into custody, if no request was made under paragraph
25“a”, may inform the magistrate that an arrest warrant has
26been issued for or charges are pending against the person and
27request that any written order issued under this paragraph
28require the facility to notify the law enforcement agency
29about the discharge or transfer of the person prior to the
30discharge or transfer.
The order shall state the circumstances
31under which the person was taken into custody or otherwise
32brought to a facility and the grounds supporting the finding
33of probable cause to believe that the person is a person with a
34substance-related disorder likely to result in physical injury
35to the person or others if not detained. The order shall also
-3-1include any law enforcement agency notification requirements if
2applicable.
The order shall confirm the oral order authorizing
3the person’s detention including any order given to transport
4the person to an appropriate facility. A peace officer from
5the law enforcement agency that took the person into custody
6may also request an order, separate from the written order,
7requiring the facility to notify the law enforcement agency
8about the discharge or transfer of the person prior to the
9discharge or transfer.
The clerk shall provide a copy of that
10order to the attending physician and surgeon or osteopathic
11physician and surgeon at the facility to which the person was
12originally taken, any subsequent facility to which the person
13was transported, and to any law enforcement department or
14ambulance service that transported the person pursuant to the
15magistrate’s order.
16   Sec. 6.  Section 125.91, subsection 3, Code 2019, is amended
17to read as follows:
   183.  The attending physician and surgeon or osteopathic
19physician and surgeon shall examine and may detain the person
20pursuant to the magistrate’s order for a period not to exceed
21forty-eight seventy-two hours from the time the order is dated,
22excluding Saturdays, Sundays, and holidays, unless the order is
23dismissed by a magistrate. The facility may provide treatment
24which is necessary to preserve the person’s life or to
25appropriately control the person’s behavior if the behavior is
26likely to result in physical injury to the person or others if
27allowed to continue or is otherwise deemed medically necessary
28by the attending physician and surgeon or osteopathic physician
29and surgeon or mental health professional, but shall not
30otherwise provide treatment to the person without the person’s
31consent. The person shall be discharged from the facility and
32released from detention no later than the expiration of the
33forty-eight-hour seventy-two-hour period, unless an application
34for involuntary commitment is filed with the clerk pursuant to
35section 125.75. The detention of a person by the procedure
-4-1in this section, and not in excess of the period of time
2prescribed by this section, shall not render the peace officer,
3attending physician and surgeon or osteopathic physician and
4surgeon, or facility detaining the person liable in a criminal
5or civil action for false arrest or false imprisonment if the
6peace officer, attending physician and surgeon or osteopathic
7physician and surgeon, mental health professional, or facility
8had reasonable grounds to believe that the circumstances
9described in subsection 1 were applicable.
10   Sec. 7.  Section 229.3, Code 2019, is amended to read as
11follows:
   12229.3  Discharge of voluntary patients.
   131.  Any voluntary patient who has recovered, or whose
14hospitalization the chief medical officer of the hospital
15determines is no longer advisable, shall be discharged. Any
16voluntary patient may be discharged if to do so would in the
17judgment of the chief medical officer contribute to the most
18effective use of the hospital in the care and treatment of that
19patient and of other persons with mental illness.
   202.  If the chief medical officer of the hospital is informed
21that an arrest warrant has been issued for or charges are
22pending against a voluntary patient of the hospital, the chief
23medical officer may notify the appropriate law enforcement
24agency about the discharge of the patient prior to the
25patient’s discharge.
26   Sec. 8.  Section 229.5A, Code 2019, is amended to read as
27follows:
   28229.5A  Preapplication screening assessment — program.
   29Prior to filing an application pursuant to section 229.6,
30the clerk of the district court or the clerk’s designee shall
31inform the interested person referred to in section 229.6,
32subsection 1, about the option of requesting a preapplication
33screening assessment through a preapplication screening
34assessment program, which may include a preapplication
35screening assessment delivered through telehealth,
if
-5-1available.
2   Sec. 9.  Section 229.16, Code 2019, is amended to read as
3follows:
   4229.16  Discharge and termination of proceeding.
   51.  When the condition of a patient who is hospitalized
6pursuant to a report issued under section 229.14, subsection 1,
7paragraph “b”, or is receiving treatment pursuant to a report
8issued under section 229.14, subsection 1, paragraph “c”, or is
9in full-time care and custody pursuant to a report issued under
10section 229.14, subsection 1, paragraph “d”, is such that in
11the opinion of the chief medical officer the patient no longer
12requires treatment or care for serious mental impairment, the
13chief medical officer shall tentatively discharge the patient
14and immediately report that fact to the court which ordered the
15patient’s hospitalization or care and custody. Upon receiving
16the report, the court shall issue an order confirming the
17patient’s discharge from the hospital or from care and custody,
18as the case may be, and shall terminate the proceedings
19pursuant to which the order was issued. Copies of the order
20shall be sent by regular mail to the hospital, the patient,
21and the applicant if the applicant has filed a written waiver
22signed by the patient.
   232.  When a patient who is hospitalized pursuant to a report
24issued under section 229.14, subsection 1, paragraph “b”, is
25receiving treatment pursuant to a report issued under section
26229.14, subsection 1, paragraph “c”, or is in full-time care
27and custody pursuant to a report issued under section 229.14,
28subsection 1, paragraph “d”, is discharged from the hospital
29or from care and custody, the patient shall be provided a
30discharge report which shall include the patient’s name and
31address, all postdischarge appointments scheduled for the
32patient, and all information necessary for the patient’s
33postdischarge care.
34   Sec. 10.  Section 229.22, subsection 2, paragraph b, Code
352019, is amended to read as follows:
-6-   1b.  If the magistrate orders that the person be detained,
2the magistrate shall, by the close of business on the next
3working day, file a written order with the clerk in the county
4where it is anticipated that an application may be filed
5under section 229.6. The order may be filed by facsimile if
6necessary. A peace officer from the law enforcement agency
7that took the person into custody, if no request was made
8under paragraph “a”, may inform the magistrate that an arrest
9warrant has been issued for or charges are pending against
10the person and request that any written order issued under
11this paragraph require the facility or hospital to notify the
12law enforcement agency about the discharge or transfer of the
13person prior to discharge or transfer. The order shall state
14the circumstances under which the person was taken into custody
15or otherwise brought to a facility or hospital, and the grounds
16supporting the finding of probable cause to believe that the
17person is seriously mentally impaired and likely to injure the
18person’s self or others if not immediately detained. The order
19shall also include any law enforcement agency notification
20requirements if applicable. The order shall confirm the oral
21order authorizing the person’s detention including any order
22given to transport the person to an appropriate facility or
23hospital. A peace officer from the law enforcement agency
24that took the person into custody may also request an order,
25separate from the written order, requiring the facility
26or hospital to notify the law enforcement agency about the
27discharge or transfer of the person prior to discharge or
28transfer
. The clerk shall provide a copy of the written order
29or any separate order to the chief medical officer of the
30facility or hospital to which the person was originally taken,
31to any subsequent facility to which the person was transported,
32and to any law enforcement department, ambulance service, or
33transportation service under contract with a mental health
34and disability services region that transported the person
35pursuant to the magistrate’s order. A transportation service
-7-1that contracts with a mental health and disability services
2region for purposes of this paragraph shall provide a secure
3transportation vehicle and shall employ staff that has received
4or is receiving mental health training.
5   Sec. 11.  Section 229.22, subsection 2, paragraph c, Code
62019, is amended by adding the following new subparagraphs:
7   NEW SUBPARAGRAPH.  (3)  Notify the law enforcement agency
8that employs the peace officer by telephone prior to the
9transfer of the person from the facility or hospital.
10   NEW SUBPARAGRAPH.  (4)  Notify the law enforcement agency
11that employs the peace officer by electronic mail prior to the
12transfer of the person from the facility or hospital.
13   Sec. 12.  Section 229.22, subsection 3, Code 2019, is amended
14to read as follows:
   153.  The chief medical officer of the facility or hospital
16shall examine and may detain and care for the person taken
17into custody under the magistrate’s order for a period not
18to exceed forty-eight seventy-two hours from the time such
19order is dated, excluding Saturdays, Sundays and holidays,
20unless the order is sooner dismissed by a magistrate. The
21facility or hospital may provide treatment which is necessary
22to preserve the person’s life, or to appropriately control
23behavior by the person which is likely to result in physical
24injury to the person’s self or others if allowed to continue,
25but may not otherwise provide treatment to the person without
26the person’s consent. The person shall be discharged from
27the facility or hospital and released from custody not later
28than the expiration of that period, unless an application is
29sooner filed with the clerk pursuant to section 229.6. Prior
30to such discharge the facility or hospital shall, if required
31by this section, notify the law enforcement agency requesting
32such notification about the discharge of the person. The law
33enforcement agency shall retrieve the person no later than
34six hours after notification from the facility or hospital
35but in no circumstances shall the detention of the person
-8-1exceed the period of time prescribed for detention by this
2subsection. The detention of any person by the procedure
3and not in excess of the period of time prescribed by this
4section shall not render the peace officer, physician, mental
5health professional, facility, or hospital so detaining that
6person liable in a criminal or civil action for false arrest
7or false imprisonment if the peace officer, physician, mental
8health professional, facility, or hospital had reasonable
9grounds to believe the person so detained was mentally ill and
10likely to physically injure the person’s self or others if
11not immediately detained, or if the facility or hospital was
12required to notify a law enforcement agency by this section,
13and the law enforcement agency requesting notification prior to
14discharge retrieved the person no later than six hours after
15the notification, and the detention prior to the retrieval of
16the person did not exceed the period of time prescribed for
17detention by this subsection.
18   Sec. 13.  DEPARTMENTS OF HUMAN SERVICES AND PUBLIC HEALTH
19— COMMITMENT PROCESS REVIEW.
  The department of human
20services and the department of public health shall review the
21commitment processes under chapters 125 and 229 and shall
22make recommendations for combining the commitment processes
23into a single chapter. The departments shall consider the
24recommendations from the report submitted by the commitment
25process review work group to the general assembly on December
2631, 2018, when reviewing the commitment processes. The
27departments shall submit recommendations including proposed
28legislation to the governor and the general assembly by
29November 15, 2019.
30   Sec. 14.  SUPREME COURT TRAINING — INVOLUNTARY COMMITMENTS
31AND HOSPITALIZATIONS OF PERSONS WITH SERIOUS MENTAL IMPAIRMENTS
32OR SUBSTANCE-RELATED DISORDERS.
  The supreme court shall
33establish educational training for judges, clerks of court,
34and attorneys related to the involuntary commitment of a
35person with a serious mental impairment or a substance-related
-9-1disorder. The supreme court shall develop the training based
2on recommendations from the report submitted by the commitment
3process review work group to the general assembly on December
431, 2018.
5EXPLANATION
6The inclusion of this explanation does not constitute agreement with
7the explanation’s substance by the members of the general assembly.
   8This bill relates to the commitment or hospitalization of a
9person with a serious mental impairment or a substance-related
10disorder.
   11POSTDISCHARGE REPORT. The bill provides that a person with
12a serious mental impairment or a substance-related disorder who
13is discharged from a voluntary or an involuntary commitment or
14hospitalization under Code chapter 125 or 229 shall be provided
15a discharge report which shall include the patient’s name and
16address, all scheduled postdischarge appointments, and all
17information relevant to the patient’s postdischarge care.
   18PREAPPLICATION SCREENING ASSESSMENT. Under current law,
19prior to filing an application for involuntary hospitalization
20under Code section 229.6 or involuntary commitment under Code
21section 125.75, the clerk of the district court or the clerk’s
22designee shall inform the person filing the application about
23the option of requesting a preapplication screening assessment
24through a preapplication screening assessment program. The
25bill expands current law to provide a preapplication screening
26assessment program may include a preapplication screening
27assessment delivered through telehealth, if available.
   28EMERGENCY DETENTION AND HOSPITALIZATION — LAW ENFORCEMENT
29NOTIFICATION AND DETENTION PERIODS. Under Code sections 125.91
30(emergency detention — substance-related disorders) and 229.22
31(emergency hospitalization — serious mental impairment), when
32it appears that a person should be immediately detained due to
33a substance-related disorder or a serious mental impairment
34but an involuntary application for hospitalization has not
35been filed naming the person as the respondent and the person
-10-1cannot be ordered into immediate custody and detained, the
2person may be immediately detained by a peace officer who
3has reasonable grounds for the detention, and the peace
4officer, without a warrant, may take or cause that person to
5be taken to the nearest available facility or hospital. A
6person who is not a peace officer may also bring a person
7under similar circumstances to a facility or hospital. If
8the appropriate examining health care practitioner finds that
9there is reason to believe that the person suffers from a
10substance-related disorder or is seriously mentally impaired
11and is likely to physically injure the person’s self or others
12if not immediately detained, the health care practitioner is
13required to immediately communicate with the nearest available
14magistrate.
   15The bill provides that if a magistrate authorizes a person
16with a substance-related disorder, under the circumstances
17described in Code section 125.91, to be detained in an
18appropriate facility, a peace officer from the law enforcement
19agency that took the person into custody may inform the
20magistrate that an arrest warrant has been issued for or
21charges are pending against the person and request that any
22oral or written order issued require the facility or hospital
23to notify the law enforcement agency about the discharge
24or transfer of the person prior to the person’s discharge
25or transfer. The bill amends the same law enforcement
26notification provisions currently in Code section 229.22 to
27allow such law enforcement notification when a person with a
28serious mental impairment is transferred from a facility or
29hospital.
   30Under current law, a hospital or facility may detain a
31person with a substance-related disorder pursuant to Code
32section 125.91 or a serious mental impairment pursuant to
33Code section 229.22, under a magistrate’s order for a period
34not to exceed 48 hours from the time such an order is dated,
35excluding Saturdays, Sundays, and holidays, unless the order is
-11-1dismissed earlier by a magistrate. The bill extends the period
2a hospital or facility may detain such persons to 72 hours
3from the time such an order is dated, excluding Saturdays,
4Sundays, and holidays, unless the order is dismissed earlier by
5a magistrate.
   6DEPARTMENTS OF HUMAN SERVICES AND PUBLIC HEALTH —
7COMMITMENT PROCESS REVIEW. The bill directs the department of
8human services and the department of public health to review
9the commitment processes under Code chapters 125 and 229 and
10make recommendations and propose legislation for combining
11the Code chapters to the governor and the general assembly by
12November 15, 2019.
   13SUPREME COURT — EDUCATIONAL TRAINING. The bill directs
14the supreme court to develop and provide educational training
15relating to involuntary commitments and hospitalizations of
16persons with serious mental impairments and substance-related
17disorders for judges, clerks of court, and attorneys. The bill
18provides that the supreme court shall develop the training
19based upon recommendations from the December 30, 2018, report
20submitted by the commitment process review work group.
-12-
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