Print
Senate File 526 - IntroducedA Bill ForAn Act 1relating to the emergency detention of a person
2experiencing a mental health or substance use crisis and
3access centers.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 125.34, subsections 1, 2, 3, 4, 6, and 7,
2Code 2021, are amended to read as follows:
31. A person with a substance-related disorder due to
4intoxication or substance-induced incapacitation may come
5voluntarily to a facility for emergency treatment. A person
6who appears to be intoxicated or incapacitated by a substance
7in a public place and in need of help may be taken to a facility
8or an access center by a peace officer under section 125.91.
9If the person refuses the proffered help, the person may be
10arrested and charged with intoxication under section 123.46,
11if applicable.
122. If no facility or access center is readily available
13the person may be taken to an emergency medical service
14customarily used for incapacitated persons. The peace officer
15in detaining the person and in taking the person to a facility
16or an access center shall make every reasonable effort to
17protect the person’s health and safety. In detaining the
18person the detaining officer may take reasonable steps for
19self-protection. Detaining a person under section 125.91 is
20not an arrest and no entry or other record shall be made to
21indicate that the person who is detained has been arrested or
22charged with a crime.
233. A person who arrives at a facility or an access center
24 and voluntarily submits to examination shall be examined by a
25licensed physician and surgeon or osteopathic physician and
26surgeon or mental health professional as soon as possible after
27the person arrives at the facility or access center. The
28person may then be admitted as a patient or referred to another
29health facility. The referring facility or access center shall
30arrange for transportation.
314. If a person is voluntarily admitted to a facility or
32an access center, the person’s family or next of kin shall be
33notified as promptly as possible. If an adult patient who is
34not incapacitated requests that there be no notification, the
35request shall be respected.
-1- 16. If the physician and surgeon or osteopathic physician
2and surgeon in charge of the facility or access center
3 determines it is for the patient’s benefit, the patient shall
4be encouraged to agree to further diagnosis and appropriate
5voluntary treatment.
67. A licensed physician and surgeon or osteopathic
7physician and surgeon, mental health professional, facility
8administrator, access center administrator, or an employee or a
9person acting as or on behalf of an access center administrator
10 or an employee or a person acting as or on behalf of the
11facility administrator, is not criminally or civilly liable
12for acts in conformity with this chapter, unless the acts
13constitute willful malice or abuse.
14 Sec. 2. Section 125.34, Code 2021, is amended by adding the
15following new subsection:
16 NEW SUBSECTION. 8. For the purposes of this section,
17“access center” means the same as defined in section 331.388.
18 Sec. 3. Section 125.91, subsections 2, 3, and 4, Code 2021,
19are amended to read as follows:
202. a. A peace officer who has reasonable grounds to
21believe that the circumstances described in subsection 1 are
22applicable may, without a warrant, take or cause that person
23to be taken to the nearest available facility referred to in
24section 125.81, subsection 2, paragraph “b” or “c”, or an access
25center. Such a person with a substance-related disorder due
26to intoxication or substance-induced incapacitation who also
27demonstrates a significant degree of distress or dysfunction
28may also be delivered to a facility or an access center by
29someone other than a peace officer upon a showing of reasonable
30grounds. Upon delivery of the person to a facility or an
31access center under this section, the attending physician
32and surgeon or osteopathic physician and surgeon may order
33treatment of the person, but only to the extent necessary
34to preserve the person’s life or to appropriately control
35the person’s behavior if the behavior is likely to result
-2-1in physical injury to the person or others if allowed to
2continue. The peace officer or other person who delivered the
3person to the facility or access center shall describe the
4circumstances of the matter to the attending physician and
5surgeon or osteopathic physician and surgeon. If the person
6is a peace officer, the peace officer may do so either in
7person or by written report. If the attending physician and
8surgeon or osteopathic physician and surgeon has reasonable
9grounds to believe that the circumstances in subsection
101 are applicable, the attending physician shall at once
11communicate with the nearest available magistrate as defined
12in section 801.4, subsection 10. The magistrate shall, based
13upon the circumstances described by the attending physician
14and surgeon or osteopathic physician and surgeon, give the
15attending physician and surgeon or osteopathic physician and
16surgeon oral instructions either directing that the person be
17released forthwith, or authorizing the person’s detention in an
18appropriate facility or access center. The magistrate may also
19give oral instructions and order that the detained person be
20transported to an appropriate facility or access center.
21b. If the magistrate orders that the person be detained, the
22magistrate shall, by the close of business on the next working
23day, file a written order with the clerk in the county where it
24is anticipated that an application may be filed under section
25125.75. The order may be filed by facsimile if necessary. The
26order shall state the circumstances under which the person
27was taken into custody or otherwise brought to a facility or
28an access center and the grounds supporting the finding of
29probable cause to believe that the person is a person with
30a substance-related disorder likely to result in physical
31injury to the person or others if not detained. The order
32shall confirm the oral order authorizing the person’s detention
33including any order given to transport the person to an
34appropriate facility or access center. The clerk shall provide
35a copy of that order to the attending physician and surgeon or
-3-1osteopathic physician and surgeon at the facility or access
2center to which the person was originally taken, any subsequent
3facility or access center to which the person was transported,
4and to any law enforcement department or ambulance service that
5transported the person pursuant to the magistrate’s order.
63. The attending physician and surgeon or osteopathic
7physician and surgeon shall examine and may detain the person
8pursuant to the magistrate’s order for a period not to exceed
9forty-eight hours from the time the order is dated, excluding
10Saturdays, Sundays, and holidays, unless the order is dismissed
11by a magistrate. The facility or access center may provide
12treatment which is necessary to preserve the person’s life or
13to appropriately control the person’s behavior if the behavior
14is likely to result in physical injury to the person or
15others if allowed to continue or is otherwise deemed medically
16necessary by the attending physician and surgeon or osteopathic
17physician and surgeon or mental health professional, but shall
18not otherwise provide treatment to the person without the
19person’s consent. The person shall be discharged from the
20facility or access center and released from detention no later
21than the expiration of the forty-eight-hour period, unless
22an application for involuntary commitment is filed with the
23clerk pursuant to section 125.75. The detention of a person
24by the procedure in this section, and not in excess of the
25period of time prescribed by this section, shall not render the
26peace officer, attending physician and surgeon or osteopathic
27physician and surgeon, or facility, or access center detaining
28the person liable in a criminal or civil action for false
29arrest or false imprisonment if the peace officer, attending
30physician and surgeon or osteopathic physician and surgeon,
31mental health professional, or facility, or access center had
32reasonable grounds to believe that the circumstances described
33in subsection 1 were applicable.
344. The cost of detention in a facility or an access center
35 under the procedure prescribed in this section shall be paid
-4-1in the same way as if the person had been committed to the
2facility or access center pursuant to an application filed
3under section 125.75.
4 Sec. 4. Section 125.91, Code 2021, is amended by adding the
5following new subsection:
6 NEW SUBSECTION. 5. For the purposes of this section,
7“access center” means the same as defined in section 331.388.
8 Sec. 5. Section 229.22, subsections 2, 3, 5, and 6, Code
92021, are amended to read as follows:
102. a. (1) In the circumstances described in subsection
111, any peace officer who has reasonable grounds to believe
12that a person is mentally ill, and because of that illness is
13likely to physically injure the person’s self or others if
14not immediately detained, may without a warrant take or cause
15that person to be taken to the nearest available facility or
16hospital as defined referred to in section 229.11, subsection
171, paragraphs “b” and “c”, or an access center. A person
18believed mentally ill, and likely to injure the person’s self
19or others if not immediately detained, may be delivered to a
20facility or hospital or an access center by someone other than
21a peace officer.
22(2) Upon delivery of the person believed mentally ill to
23the facility, or hospital, or access center, the examining
24physician, examining physician assistant, examining mental
25health professional, or examining psychiatric advanced
26registered nurse practitioner may order treatment of that
27person, including chemotherapy, but only to the extent
28necessary to preserve the person’s life or to appropriately
29control behavior by the person which is likely to result
30in physical injury to that person or others if allowed to
31continue.
32(3) The peace officer who took the person into custody,
33or other party who brought the person to the facility, or
34 hospital, or access center, shall describe the circumstances
35of the matter to the examining physician, examining physician
-5-1assistant, examining mental health professional, or examining
2psychiatric advanced registered nurse practitioner. If the
3person is a peace officer, the peace officer may do so either
4in person or by written report.
5(4) If the examining physician, examining physician
6assistant, examining mental health professional, or examining
7psychiatric advanced registered nurse practitioner finds
8that there is reason to believe that the person is seriously
9mentally impaired, and because of that impairment is likely
10to physically injure the person’s self or others if not
11immediately detained, the examining physician, examining
12physician assistant, examining mental health professional, or
13examining psychiatric advanced registered nurse practitioner
14shall at once communicate with the nearest available magistrate
15as defined in section 801.4, subsection 10.
16(5) The magistrate shall, based upon the circumstances
17described by the examining physician, examining physician
18assistant, examining mental health professional, or examining
19psychiatric advanced registered nurse practitioner, give the
20examining physician, examining physician assistant, examining
21mental health professional, or examining psychiatric advanced
22registered nurse practitioner oral instructions either
23directing that the person be released forthwith or authorizing
24the person’s detention in an appropriate facility or access
25center. A peace officer from the law enforcement agency
26that took the person into custody, if available, during the
27communication with the magistrate, may inform the magistrate
28that an arrest warrant has been issued for or charges are
29pending against the person and request that any oral or written
30order issued under this subsection require the facility, or
31 hospital, or access center to notify the law enforcement agency
32about the discharge of the person prior to discharge. The
33magistrate may also give oral instructions and order that the
34detained person be transported to an appropriate facility.
35b. If the magistrate orders that the person be detained,
-6-1the magistrate shall, by the close of business on the next
2working day, file a written order with the clerk in the county
3where it is anticipated that an application may be filed
4under section 229.6. The order may be filed by facsimile if
5necessary. A peace officer from the law enforcement agency
6that took the person into custody, if no request was made
7under paragraph “a”, may inform the magistrate that an arrest
8warrant has been issued for or charges are pending against
9the person and request that any written order issued under
10this paragraph require the facility, or hospital, or access
11center to notify the law enforcement agency about the discharge
12of the person prior to discharge. The order shall state the
13circumstances under which the person was taken into custody
14or otherwise brought to a facility or hospital or an access
15center, and the grounds supporting the finding of probable
16cause to believe that the person is seriously mentally impaired
17and likely to injure the person’s self or others if not
18immediately detained. The order shall also include any law
19enforcement agency notification requirements if applicable.
20The order shall confirm the oral order authorizing the person’s
21detention including any order given to transport the person
22to an appropriate facility, or hospital, or access center. A
23peace officer from the law enforcement agency that took the
24person into custody may also request an order, separate from
25the written order, requiring the facility, or hospital, or
26access center to notify the law enforcement agency about the
27discharge of the person prior to discharge. The clerk shall
28provide a copy of the written order or any separate order to
29the chief medical officer of the facility, or hospital, or
30access center to which the person was originally taken, to
31any 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.
5c. If an arrest warrant has been issued for or charges are
6pending against the person, but no court order exists requiring
7notification to a law enforcement agency under paragraph “a”
8or “b”, and if the peace officer delivers the person to a
9facility or hospital or an access center and the peace officer
10notifies the facility, or hospital, or access center in writing
11on a form prescribed by the department of public safety that
12the facility, or hospital, or access center notify the law
13enforcement agency about the discharge of the person prior to
14discharge, the facility, or hospital, or access center shall
15do all of the following:
16(1) Notify the dispatch of the law enforcement agency that
17employs the peace officer by telephone prior to the discharge
18of the person from the facility, or hospital, or access center.
19(2) Notify the law enforcement agency that employs the peace
20officer by electronic mail prior to the discharge of the person
21from the facility, or hospital, or access center.
223. The chief medical officer of the facility, or hospital,
23or access center shall examine and may detain and care for the
24person taken into custody under the magistrate’s order for a
25period not to exceed forty-eight hours from the time such order
26is dated, excluding Saturdays, Sundays and holidays, unless
27the order is sooner dismissed by a magistrate. The facility,
28 or hospital, or access center may provide treatment which is
29necessary to preserve the person’s life, or to appropriately
30control behavior by the person which is likely to result in
31physical injury to the person’s self or others if allowed to
32continue, but may not otherwise provide treatment to the person
33without the person’s consent. The person shall be discharged
34from the facility, or hospital, or access center and released
35from custody not later than the expiration of that period,
-8-1unless an application is sooner filed with the clerk pursuant
2to section 229.6. Prior to such discharge, the facility, or
3 hospital, or access center shall, if required by this section,
4notify the law enforcement agency requesting such notification
5about the discharge of the person. The law enforcement
6agency shall retrieve the person no later than six hours after
7notification from the facility, or hospital, or access center
8 but in no circumstances shall the detention of the person
9exceed the period of time prescribed for detention by this
10subsection. The detention of any person by the procedure
11and not in excess of the period of time prescribed by this
12section shall not render the peace officer, physician, mental
13health professional, facility, or hospital, or access center
14 so detaining that person liable in a criminal or civil action
15for false arrest or false imprisonment if the peace officer,
16physician, mental health professional, facility, or hospital,
17or access center had reasonable grounds to believe the person
18so detained was mentally ill and likely to physically injure
19the person’s self or others if not immediately detained, or
20if the facility, or hospital, or access center was required
21to notify a law enforcement agency by this section, and
22the law enforcement agency requesting notification prior to
23discharge retrieved the person no later than six hours after
24the notification, and the detention prior to the retrieval of
25the person did not exceed the period of time prescribed for
26detention by this subsection.
275. The department of public safety shall prescribe the form
28to be used when a law enforcement agency desires notification
29under this section from a facility or hospital or an access
30center prior to discharge of a person admitted to the facility,
31 or hospital, or access center and for whom an arrest warrant
32has been issued or against whom charges are pending. The
33form shall be consistent with all laws, regulations, and
34rules relating to the confidentiality or privacy of personal
35information or medical records, including but not limited to
-9-1the federal Health Insurance Portability and Accountability Act
2of 1996, Pub.L. No.104-191, and regulations promulgated in
3accordance with that Act and published in 45 C.F.R. pts.160
4– 164.
56. A facility or hospital or an access center, which has
6been notified by a peace officer or a law enforcement agency by
7delivery of a form as prescribed by the department of public
8safety indicating that an arrest warrant has been issued
9for or charges are pending against a person admitted to the
10facility, or hospital, or access center that does not notify
11the law enforcement agency about the discharge of the person
12as required by subsection 2, paragraph “c”, shall pay a civil
13penalty as provided in section 805.8C, subsection 9.
14 Sec. 6. Section 229.22, Code 2021, is amended by adding the
15following new subsection:
16 NEW SUBSECTION. 7. For the purposes of this section,
17“access center” means the same as defined in section 331.388.
18 Sec. 7. Section 331.388, Code 2021, is amended by adding the
19following new subsection:
20 NEW SUBSECTION. 01. “Access center” means the coordinated
21provision of intake assessment, screening for co-occurring
22conditions, care coordination, crisis stabilization residential
23services, subacute mental health services, and substance abuse
24treatment for persons experiencing a mental health or substance
25use crisis who do not need inpatient psychiatric hospital
26treatment, but who do need significant amounts of supports
27and services not available in other home and community-based
28settings.
29 Sec. 8. Section 331.397, subsection 5, paragraph a,
30subparagraph (1), Code 2021, is amended to read as follows:
31(1) Access centers that are located in crisis residential
32and subacute residential settings with sixteen beds or fewer
33that provide immediate, short-term assessments for persons with
34serious mental illness or substance use disorders who do not
35need inpatient psychiatric hospital treatment, but who do need
-10-1significant amounts of supports and services not available in
2the persons’ homes or communities.
3EXPLANATION
4The inclusion of this explanation does not constitute agreement with
5the explanation’s substance by the members of the general assembly.
6This bill relates to the emergency detention of a person
7experiencing a mental health or substance use crisis and access
8centers.
9The bill amends Code sections 124.34 (treatment and
10services for persons with substance-related disorders due to
11intoxication and substance-induced incapacitation), 125.91
12(emergency detention for persons with substance-related
13disorders), and 229.22 (emergency hospitalization for persons
14with a serious mental impairment) to allow emergency detention
15and treatment services in an access center for persons
16experiencing a mental health or substance use crisis.
17The bill defines an “access center” as the coordinated
18provision of intake assessment, screening for co-occurring
19conditions, care coordination, crisis stabilization residential
20services, subacute mental health services, and substance abuse
21treatment for persons experiencing a mental health or substance
22use crisis who do not need inpatient psychiatric hospital
23treatment, but who do need significant amounts of supports
24and services not available in other home and community-based
25settings.
26The bill makes a conforming change to Code section 331.397
27relating to intensive mental health services provided in mental
28health and disability services regions.
-11-dg/rh
2experiencing a mental health or substance use crisis and
3access centers.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 125.34, subsections 1, 2, 3, 4, 6, and 7,
2Code 2021, are amended to read as follows:
31. A person with a substance-related disorder due to
4intoxication or substance-induced incapacitation may come
5voluntarily to a facility for emergency treatment. A person
6who appears to be intoxicated or incapacitated by a substance
7in a public place and in need of help may be taken to a facility
8or an access center by a peace officer under section 125.91.
9If the person refuses the proffered help, the person may be
10arrested and charged with intoxication under section 123.46,
11if applicable.
122. If no facility or access center is readily available
13the person may be taken to an emergency medical service
14customarily used for incapacitated persons. The peace officer
15in detaining the person and in taking the person to a facility
16or an access center shall make every reasonable effort to
17protect the person’s health and safety. In detaining the
18person the detaining officer may take reasonable steps for
19self-protection. Detaining a person under section 125.91 is
20not an arrest and no entry or other record shall be made to
21indicate that the person who is detained has been arrested or
22charged with a crime.
233. A person who arrives at a facility or an access center
24 and voluntarily submits to examination shall be examined by a
25licensed physician and surgeon or osteopathic physician and
26surgeon or mental health professional as soon as possible after
27the person arrives at the facility or access center. The
28person may then be admitted as a patient or referred to another
29health facility. The referring facility or access center shall
30arrange for transportation.
314. If a person is voluntarily admitted to a facility or
32an access center, the person’s family or next of kin shall be
33notified as promptly as possible. If an adult patient who is
34not incapacitated requests that there be no notification, the
35request shall be respected.
-1- 16. If the physician and surgeon or osteopathic physician
2and surgeon in charge of the facility or access center
3 determines it is for the patient’s benefit, the patient shall
4be encouraged to agree to further diagnosis and appropriate
5voluntary treatment.
67. A licensed physician and surgeon or osteopathic
7physician and surgeon, mental health professional, facility
8administrator, access center administrator, or an employee or a
9person acting as or on behalf of an access center administrator
10 or an employee or a person acting as or on behalf of the
11facility administrator, is not criminally or civilly liable
12for acts in conformity with this chapter, unless the acts
13constitute willful malice or abuse.
14 Sec. 2. Section 125.34, Code 2021, is amended by adding the
15following new subsection:
16 NEW SUBSECTION. 8. For the purposes of this section,
17“access center” means the same as defined in section 331.388.
18 Sec. 3. Section 125.91, subsections 2, 3, and 4, Code 2021,
19are amended to read as follows:
202. a. A peace officer who has reasonable grounds to
21believe that the circumstances described in subsection 1 are
22applicable may, without a warrant, take or cause that person
23to be taken to the nearest available facility referred to in
24section 125.81, subsection 2, paragraph “b” or “c”, or an access
25center. Such a person with a substance-related disorder due
26to intoxication or substance-induced incapacitation who also
27demonstrates a significant degree of distress or dysfunction
28may also be delivered to a facility or an access center by
29someone other than a peace officer upon a showing of reasonable
30grounds. Upon delivery of the person to a facility or an
31access center under this section, the attending physician
32and surgeon or osteopathic physician and surgeon may order
33treatment of the person, but only to the extent necessary
34to preserve the person’s life or to appropriately control
35the person’s behavior if the behavior is likely to result
-2-1in physical injury to the person or others if allowed to
2continue. The peace officer or other person who delivered the
3person to the facility or access center shall describe the
4circumstances of the matter to the attending physician and
5surgeon or osteopathic physician and surgeon. If the person
6is a peace officer, the peace officer may do so either in
7person or by written report. If the attending physician and
8surgeon or osteopathic physician and surgeon has reasonable
9grounds to believe that the circumstances in subsection
101 are applicable, the attending physician shall at once
11communicate with the nearest available magistrate as defined
12in section 801.4, subsection 10. The magistrate shall, based
13upon the circumstances described by the attending physician
14and surgeon or osteopathic physician and surgeon, give the
15attending physician and surgeon or osteopathic physician and
16surgeon oral instructions either directing that the person be
17released forthwith, or authorizing the person’s detention in an
18appropriate facility or access center. The magistrate may also
19give oral instructions and order that the detained person be
20transported to an appropriate facility or access center.
21b. If the magistrate orders that the person be detained, the
22magistrate shall, by the close of business on the next working
23day, file a written order with the clerk in the county where it
24is anticipated that an application may be filed under section
25125.75. The order may be filed by facsimile if necessary. The
26order shall state the circumstances under which the person
27was taken into custody or otherwise brought to a facility or
28an access center and the grounds supporting the finding of
29probable cause to believe that the person is a person with
30a substance-related disorder likely to result in physical
31injury to the person or others if not detained. The order
32shall confirm the oral order authorizing the person’s detention
33including any order given to transport the person to an
34appropriate facility or access center. The clerk shall provide
35a copy of that order to the attending physician and surgeon or
-3-1osteopathic physician and surgeon at the facility or access
2center to which the person was originally taken, any subsequent
3facility or access center to which the person was transported,
4and to any law enforcement department or ambulance service that
5transported the person pursuant to the magistrate’s order.
63. The attending physician and surgeon or osteopathic
7physician and surgeon shall examine and may detain the person
8pursuant to the magistrate’s order for a period not to exceed
9forty-eight hours from the time the order is dated, excluding
10Saturdays, Sundays, and holidays, unless the order is dismissed
11by a magistrate. The facility or access center may provide
12treatment which is necessary to preserve the person’s life or
13to appropriately control the person’s behavior if the behavior
14is likely to result in physical injury to the person or
15others if allowed to continue or is otherwise deemed medically
16necessary by the attending physician and surgeon or osteopathic
17physician and surgeon or mental health professional, but shall
18not otherwise provide treatment to the person without the
19person’s consent. The person shall be discharged from the
20facility or access center and released from detention no later
21than the expiration of the forty-eight-hour period, unless
22an application for involuntary commitment is filed with the
23clerk pursuant to section 125.75. The detention of a person
24by the procedure in this section, and not in excess of the
25period of time prescribed by this section, shall not render the
26peace officer, attending physician and surgeon or osteopathic
27physician and surgeon, or facility, or access center detaining
28the person liable in a criminal or civil action for false
29arrest or false imprisonment if the peace officer, attending
30physician and surgeon or osteopathic physician and surgeon,
31mental health professional, or facility, or access center had
32reasonable grounds to believe that the circumstances described
33in subsection 1 were applicable.
344. The cost of detention in a facility or an access center
35 under the procedure prescribed in this section shall be paid
-4-1in the same way as if the person had been committed to the
2facility or access center pursuant to an application filed
3under section 125.75.
4 Sec. 4. Section 125.91, Code 2021, is amended by adding the
5following new subsection:
6 NEW SUBSECTION. 5. For the purposes of this section,
7“access center” means the same as defined in section 331.388.
8 Sec. 5. Section 229.22, subsections 2, 3, 5, and 6, Code
92021, are amended to read as follows:
102. a. (1) In the circumstances described in subsection
111, any peace officer who has reasonable grounds to believe
12that a person is mentally ill, and because of that illness is
13likely to physically injure the person’s self or others if
14not immediately detained, may without a warrant take or cause
15that person to be taken to the nearest available facility or
16hospital as defined referred to in section 229.11, subsection
171, paragraphs “b” and “c”, or an access center. A person
18believed mentally ill, and likely to injure the person’s self
19or others if not immediately detained, may be delivered to a
20facility or hospital or an access center by someone other than
21a peace officer.
22(2) Upon delivery of the person believed mentally ill to
23the facility, or hospital, or access center, the examining
24physician, examining physician assistant, examining mental
25health professional, or examining psychiatric advanced
26registered nurse practitioner may order treatment of that
27person, including chemotherapy, but only to the extent
28necessary to preserve the person’s life or to appropriately
29control behavior by the person which is likely to result
30in physical injury to that person or others if allowed to
31continue.
32(3) The peace officer who took the person into custody,
33or other party who brought the person to the facility, or
34 hospital, or access center, shall describe the circumstances
35of the matter to the examining physician, examining physician
-5-1assistant, examining mental health professional, or examining
2psychiatric advanced registered nurse practitioner. If the
3person is a peace officer, the peace officer may do so either
4in person or by written report.
5(4) If the examining physician, examining physician
6assistant, examining mental health professional, or examining
7psychiatric advanced registered nurse practitioner finds
8that there is reason to believe that the person is seriously
9mentally impaired, and because of that impairment is likely
10to physically injure the person’s self or others if not
11immediately detained, the examining physician, examining
12physician assistant, examining mental health professional, or
13examining psychiatric advanced registered nurse practitioner
14shall at once communicate with the nearest available magistrate
15as defined in section 801.4, subsection 10.
16(5) The magistrate shall, based upon the circumstances
17described by the examining physician, examining physician
18assistant, examining mental health professional, or examining
19psychiatric advanced registered nurse practitioner, give the
20examining physician, examining physician assistant, examining
21mental health professional, or examining psychiatric advanced
22registered nurse practitioner oral instructions either
23directing that the person be released forthwith or authorizing
24the person’s detention in an appropriate facility or access
25center. A peace officer from the law enforcement agency
26that took the person into custody, if available, during the
27communication with the magistrate, may inform the magistrate
28that an arrest warrant has been issued for or charges are
29pending against the person and request that any oral or written
30order issued under this subsection require the facility, or
31 hospital, or access center to notify the law enforcement agency
32about the discharge of the person prior to discharge. The
33magistrate may also give oral instructions and order that the
34detained person be transported to an appropriate facility.
35b. If the magistrate orders that the person be detained,
-6-1the magistrate shall, by the close of business on the next
2working day, file a written order with the clerk in the county
3where it is anticipated that an application may be filed
4under section 229.6. The order may be filed by facsimile if
5necessary. A peace officer from the law enforcement agency
6that took the person into custody, if no request was made
7under paragraph “a”, may inform the magistrate that an arrest
8warrant has been issued for or charges are pending against
9the person and request that any written order issued under
10this paragraph require the facility, or hospital, or access
11center to notify the law enforcement agency about the discharge
12of the person prior to discharge. The order shall state the
13circumstances under which the person was taken into custody
14or otherwise brought to a facility or hospital or an access
15center, and the grounds supporting the finding of probable
16cause to believe that the person is seriously mentally impaired
17and likely to injure the person’s self or others if not
18immediately detained. The order shall also include any law
19enforcement agency notification requirements if applicable.
20The order shall confirm the oral order authorizing the person’s
21detention including any order given to transport the person
22to an appropriate facility, or hospital, or access center. A
23peace officer from the law enforcement agency that took the
24person into custody may also request an order, separate from
25the written order, requiring the facility, or hospital, or
26access center to notify the law enforcement agency about the
27discharge of the person prior to discharge. The clerk shall
28provide a copy of the written order or any separate order to
29the chief medical officer of the facility, or hospital, or
30access center to which the person was originally taken, to
31any 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.
5c. If an arrest warrant has been issued for or charges are
6pending against the person, but no court order exists requiring
7notification to a law enforcement agency under paragraph “a”
8or “b”, and if the peace officer delivers the person to a
9facility or hospital or an access center and the peace officer
10notifies the facility, or hospital, or access center in writing
11on a form prescribed by the department of public safety that
12the facility, or hospital, or access center notify the law
13enforcement agency about the discharge of the person prior to
14discharge, the facility, or hospital, or access center shall
15do all of the following:
16(1) Notify the dispatch of the law enforcement agency that
17employs the peace officer by telephone prior to the discharge
18of the person from the facility, or hospital, or access center.
19(2) Notify the law enforcement agency that employs the peace
20officer by electronic mail prior to the discharge of the person
21from the facility, or hospital, or access center.
223. The chief medical officer of the facility, or hospital,
23or access center shall examine and may detain and care for the
24person taken into custody under the magistrate’s order for a
25period not to exceed forty-eight hours from the time such order
26is dated, excluding Saturdays, Sundays and holidays, unless
27the order is sooner dismissed by a magistrate. The facility,
28 or hospital, or access center may provide treatment which is
29necessary to preserve the person’s life, or to appropriately
30control behavior by the person which is likely to result in
31physical injury to the person’s self or others if allowed to
32continue, but may not otherwise provide treatment to the person
33without the person’s consent. The person shall be discharged
34from the facility, or hospital, or access center and released
35from custody not later than the expiration of that period,
-8-1unless an application is sooner filed with the clerk pursuant
2to section 229.6. Prior to such discharge, the facility, or
3 hospital, or access center shall, if required by this section,
4notify the law enforcement agency requesting such notification
5about the discharge of the person. The law enforcement
6agency shall retrieve the person no later than six hours after
7notification from the facility, or hospital, or access center
8 but in no circumstances shall the detention of the person
9exceed the period of time prescribed for detention by this
10subsection. The detention of any person by the procedure
11and not in excess of the period of time prescribed by this
12section shall not render the peace officer, physician, mental
13health professional, facility, or hospital, or access center
14 so detaining that person liable in a criminal or civil action
15for false arrest or false imprisonment if the peace officer,
16physician, mental health professional, facility, or hospital,
17or access center had reasonable grounds to believe the person
18so detained was mentally ill and likely to physically injure
19the person’s self or others if not immediately detained, or
20if the facility, or hospital, or access center was required
21to notify a law enforcement agency by this section, and
22the law enforcement agency requesting notification prior to
23discharge retrieved the person no later than six hours after
24the notification, and the detention prior to the retrieval of
25the person did not exceed the period of time prescribed for
26detention by this subsection.
275. The department of public safety shall prescribe the form
28to be used when a law enforcement agency desires notification
29under this section from a facility or hospital or an access
30center prior to discharge of a person admitted to the facility,
31 or hospital, or access center and for whom an arrest warrant
32has been issued or against whom charges are pending. The
33form shall be consistent with all laws, regulations, and
34rules relating to the confidentiality or privacy of personal
35information or medical records, including but not limited to
-9-1the federal Health Insurance Portability and Accountability Act
2of 1996, Pub.L. No.104-191, and regulations promulgated in
3accordance with that Act and published in 45 C.F.R. pts.160
4– 164.
56. A facility or hospital or an access center, which has
6been notified by a peace officer or a law enforcement agency by
7delivery of a form as prescribed by the department of public
8safety indicating that an arrest warrant has been issued
9for or charges are pending against a person admitted to the
10facility, or hospital, or access center that does not notify
11the law enforcement agency about the discharge of the person
12as required by subsection 2, paragraph “c”, shall pay a civil
13penalty as provided in section 805.8C, subsection 9.
14 Sec. 6. Section 229.22, Code 2021, is amended by adding the
15following new subsection:
16 NEW SUBSECTION. 7. For the purposes of this section,
17“access center” means the same as defined in section 331.388.
18 Sec. 7. Section 331.388, Code 2021, is amended by adding the
19following new subsection:
20 NEW SUBSECTION. 01. “Access center” means the coordinated
21provision of intake assessment, screening for co-occurring
22conditions, care coordination, crisis stabilization residential
23services, subacute mental health services, and substance abuse
24treatment for persons experiencing a mental health or substance
25use crisis who do not need inpatient psychiatric hospital
26treatment, but who do need significant amounts of supports
27and services not available in other home and community-based
28settings.
29 Sec. 8. Section 331.397, subsection 5, paragraph a,
30subparagraph (1), Code 2021, is amended to read as follows:
31(1) Access centers that are located in crisis residential
32and subacute residential settings with sixteen beds or fewer
33that provide immediate, short-term assessments for persons with
34serious mental illness or substance use disorders who do not
35need inpatient psychiatric hospital treatment, but who do need
-10-1significant amounts of supports and services not available in
2the persons’ homes or communities.
3EXPLANATION
4The inclusion of this explanation does not constitute agreement with
5the explanation’s substance by the members of the general assembly.
6This bill relates to the emergency detention of a person
7experiencing a mental health or substance use crisis and access
8centers.
9The bill amends Code sections 124.34 (treatment and
10services for persons with substance-related disorders due to
11intoxication and substance-induced incapacitation), 125.91
12(emergency detention for persons with substance-related
13disorders), and 229.22 (emergency hospitalization for persons
14with a serious mental impairment) to allow emergency detention
15and treatment services in an access center for persons
16experiencing a mental health or substance use crisis.
17The bill defines an “access center” as the coordinated
18provision of intake assessment, screening for co-occurring
19conditions, care coordination, crisis stabilization residential
20services, subacute mental health services, and substance abuse
21treatment for persons experiencing a mental health or substance
22use crisis who do not need inpatient psychiatric hospital
23treatment, but who do need significant amounts of supports
24and services not available in other home and community-based
25settings.
26The bill makes a conforming change to Code section 331.397
27relating to intensive mental health services provided in mental
28health and disability services regions.
-11-dg/rh