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House File 319 - IntroducedA Bill ForAn Act 1authorizing mental health professionals to perform
2certain functions relating to persons with substance-related
3disorders and persons with mental illness.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 125.2, Code 2017, is amended by adding
2the following new subsection:
3 NEW SUBSECTION. 10A. “Mental health professional” means the
4same as defined in section 228.1.
5 Sec. 2. Section 125.12, subsection 3, Code 2017, is amended
6to read as follows:
73. The director shall provide for adequate and appropriate
8treatment for persons with substance-related disorders and
9concerned family members admitted under sections 125.33 and
10125.34, or under section 125.75, 125.81, or 125.91. Treatment
11shall not be provided at a correctional institution except
12for inmates. A mental health professional, as defined in
13section 228.1, who is employed by a treatment provider under
14the program may provide treatment to a person with co-occurring
15substance-related and mental health disorders. Such treatment
16may also be provided by a person employed by such a treatment
17provider who is receiving the supervision required to meet the
18definition of mental health professional but has not completed
19the supervision component.
20 Sec. 3. Section 125.33, subsections 1 and 3, Code 2017, are
21amended to read as follows:
221. A person with a substance-related disorder may apply for
23voluntary treatment or rehabilitation services directly to a
24facility or to a licensed physician and surgeon or osteopathic
25physician and surgeon or to a mental health professional. If
26the proposed patient is a minor or an incompetent person, a
27parent, a legal guardian or other legal representative may
28make the application. The licensed physician and surgeon or
29osteopathic physician and surgeon, mental health professional,
30 or any employee or person acting under the direction or
31supervision of the physician and surgeon or osteopathic
32physician and surgeon, mental health professional, or the
33 facility shall not report or disclose the name of the person or
34the fact that treatment was requested or has been undertaken
35to any law enforcement officer or law enforcement agency; nor
-1-1shall such information be admissible as evidence in any court,
2grand jury, or administrative proceeding unless authorized
3by the person seeking treatment. If the person seeking such
4treatment or rehabilitation is a minor who has personally made
5application for treatment, the fact that the minor sought
6treatment or rehabilitation or is receiving treatment or
7rehabilitation services shall not be reported or disclosed to
8the parents or legal guardian of such minor without the minor’s
9consent, and the minor may give legal consent to receive such
10treatment and rehabilitation.
113. A person with a substance-related disorder seeking
12treatment or rehabilitation and who is either addicted or
13dependent on a chemical substance may first be examined and
14evaluated by a licensed physician and surgeon or osteopathic
15physician and surgeon or a mental health professional who may
16prescribe, if authorized or licensed to do so, a proper course
17of treatment and medication, if needed. The licensed physician
18and surgeon or osteopathic physician and surgeon or mental
19health professional may further prescribe a course of treatment
20or rehabilitation and authorize another licensed physician and
21surgeon or osteopathic physician and surgeon, mental health
22professional, or facility to provide the prescribed treatment
23or rehabilitation services. Treatment or rehabilitation
24services may be provided to a person individually or in
25a group. A facility providing or engaging in treatment
26or rehabilitation shall not report or disclose to a law
27enforcement officer or law enforcement agency the name of any
28person receiving or engaged in the treatment or rehabilitation;
29nor shall a person receiving or participating in treatment or
30rehabilitation report or disclose the name of any other person
31engaged in or receiving treatment or rehabilitation or that the
32program is in existence, to a law enforcement officer or law
33enforcement agency. Such information shall not be admitted
34in evidence in any court, grand jury, or administrative
35proceeding. However, a person engaged in or receiving
-2-1treatment or rehabilitation may authorize the disclosure of the
2person’s name and individual participation.
3 Sec. 4. Section 125.34, subsections 3 and 7, Code 2017, are
4amended to read as follows:
53. A person who arrives at a facility and voluntarily
6submits to examination shall be examined by a licensed
7physician or mental health professional as soon as possible
8after the person arrives at the facility. The person
9may then be admitted as a patient or referred to another
10health facility. The referring facility shall arrange for
11transportation.
127. A licensed physician and surgeon or osteopathic
13physician and surgeon, mental health professional, facility
14administrator, or an employee or a person acting as or on
15behalf of the facility administrator, is not criminally or
16civilly liable for acts in conformity with this chapter, unless
17the acts constitute willful malice or abuse.
18 Sec. 5. Section 125.75, subsection 2, paragraph c,
19subparagraph (1), Code 2017, is amended to read as follows:
20(1) A written statement of a licensed physician or mental
21health professional in support of the application.
22 Sec. 6. Section 125.78, subsection 3, paragraph b, Code
232017, is amended to read as follows:
24b. Requiring an examination of the respondent, prior to
25the hearing, by one or more licensed physicians or mental
26health professionals who shall submit a written report of the
27examination to the court as required by section 125.80.
28 Sec. 7. Section 125.80, Code 2017, is amended to read as
29follows:
30125.80 Physician’s or mental health professional’s
31 examination — report — scheduling of hearing.
321. a. An examination of the respondent shall be conducted
33within a reasonable time and prior to the commitment hearing by
34one or more licensed physicians or mental health professionals
35 as required by the court’s order. If the respondent is taken
-3-1into custody under section 125.81, the examination shall be
2conducted within twenty-four hours after the respondent is
3taken into custody. If the respondent desires, the respondent
4may have a separate examination by a licensed physician or
5mental health professional of the respondent’s own choice.
6The court shall notify the respondent of the right to choose
7a licensed physician or mental health professional for a
8separate examination. The reasonable cost of the examinations
9shall be paid from county funds upon order of the court if the
10respondent lacks sufficient funds to pay the cost.
11b. A licensed physician or mental health professional
12 conducting an examination pursuant to this section may consult
13with or request the participation in the examination of
14facility personnel, and may include with or attach to the
15written report of the examination any findings or observations
16by facility personnel who have been consulted or have
17participated in the examination.
18c. If the respondent is not taken into custody under
19section 125.81, but the court is subsequently informed that the
20respondent has declined to be examined by a licensed physician
21or mental health professional pursuant to the court order,
22the court may order limited detention of the respondent as
23necessary to facilitate the examination of the respondent by
24the licensed physician or mental health professional.
252. A written report of the examination by a court-designated
26licensed physician or mental health professional shall be filed
27with the clerk prior to the hearing date. A written report
28of an examination by a licensed physician or mental health
29professional chosen by the respondent may be similarly filed.
30The clerk shall immediately:
31a. Cause a report to be shown to the judge who issued the
32order.
33b. Cause the respondent’s attorney to receive a copy of
34the report of a court-designated licensed physician or mental
35health professional.
-4- 13. If the report of a court-designated licensed physician or
2mental health professional is to the effect that the respondent
3is not a person with a substance-related disorder, the court,
4without taking further action, may terminate the proceeding and
5dismiss the application on its own motion and without notice.
64. If the report of a court-designated licensed physician or
7mental health professional is to the effect that the respondent
8is a person with a substance-related disorder, the court shall
9schedule a commitment hearing as soon as possible. The hearing
10shall be held not more than forty-eight hours after the report
11is filed, excluding Saturdays, Sundays, and holidays, unless
12an extension for good cause is requested by the respondent,
13or as soon thereafter as possible if the court considers that
14sufficient grounds exist for delaying the hearing.
15 Sec. 8. Section 125.82, subsection 3, Code 2017, is amended
16to read as follows:
173. The person who filed the application and a licensed
18physician, mental health professional as defined in section
19228.1, or certified alcohol and drug counselor certified by the
20nongovernmental Iowa board of substance abuse certification who
21has examined the respondent in connection with the commitment
22hearing shall be present at the hearing, unless the court
23for good cause finds that their presence or testimony is not
24necessary. The applicant, respondent, and the respondent’s
25attorney may waive the presence or telephonic appearance of the
26licensed physician, mental health professional, or certified
27alcohol and drug counselor who examined the respondent and
28agree to submit as evidence the written report of the licensed
29physician, mental health professional, or certified alcohol
30and drug counselor. The respondent’s attorney shall inform
31the court if the respondent’s attorney reasonably believes
32that the respondent, due to diminished capacity, cannot make
33an adequately considered waiver decision. “Good cause” for
34finding that the testimony of the licensed physician, mental
35health professional, or certified alcohol and drug counselor
-5-1who examined the respondent is not necessary may include, but
2is not limited to, such a waiver. If the court determines
3that the testimony of the licensed physician, mental health
4professional, or certified alcohol and drug counselor is
5necessary, the court may allow the licensed physician, mental
6health professional, or certified alcohol and drug counselor to
7testify by telephone. The respondent shall be present at the
8hearing unless prior to the hearing the respondent’s attorney
9stipulates in writing that the attorney has conversed with the
10respondent, and that in the attorney’s judgment the respondent
11cannot make a meaningful contribution to the hearing, or that
12the respondent has waived the right to be present, and the
13basis for the attorney’s conclusions. A stipulation to the
14respondent’s absence shall be reviewed by the court before the
15hearing, and may be rejected if it appears that insufficient
16grounds are stated or that the respondent’s interests would not
17be served by the respondent’s absence.
18 Sec. 9. Section 125.86, subsection 3, paragraph b, Code
192017, is amended to read as follows:
20b. An advanced registered nurse practitioner who is
21not certified as a psychiatric advanced registered nurse
22practitioner but who meets the qualifications set forth in the
23definition of a mental health professional in section 228.1,
24 may complete periodic reports pursuant to paragraph “a”.
25 Sec. 10. Section 125.91, subsection 3, Code 2017, is amended
26to read as follows:
273. The attending physician shall examine and may detain
28the person pursuant to the magistrate’s order for a period not
29to exceed forty-eight hours from the time the order is dated,
30excluding Saturdays, Sundays, and holidays, unless the order is
31dismissed by a magistrate. The facility may provide treatment
32which is necessary to preserve the person’s life or to
33appropriately control the person’s behavior if the behavior is
34likely to result in physical injury to the person or others if
35allowed to continue or is otherwise deemed medically necessary
-6-1by the attending physician or mental health professional,
2but shall not otherwise provide treatment to the person
3without the person’s consent. The person shall be discharged
4from the facility and released from detention no later than
5the expiration of the forty-eight-hour period, unless an
6application for involuntary commitment is filed with the clerk
7pursuant to section 125.75. The detention of a person by the
8procedure in this section, and not in excess of the period of
9time prescribed by this section, shall not render the peace
10officer, attending physician, or facility detaining the person
11liable in a criminal or civil action for false arrest or false
12imprisonment if the peace officer, attending physician, mental
13health professional, or facility had reasonable grounds to
14believe that the circumstances described in subsection 1 were
15applicable.
16 Sec. 11. Section 125.92, subsection 4, Code 2017, is amended
17to read as follows:
184. Enjoy all legal, medical, religious, social, political,
19personal, and working rights and privileges, which the person
20would enjoy if not detained, taken into immediate custody,
21or committed, consistent with the effective treatment of the
22person and of the other persons in the facility. If the
23person’s rights are restricted, the physician’s or mental
24health professional’s direction to that effect shall be noted
25in the person’s record. The person or the person’s next of
26kin or guardian shall be advised of the person’s rights and
27be provided a written copy upon the person’s admission to or
28arrival at the facility.
29 Sec. 12. Section 229.6, subsection 2, paragraph c,
30subparagraph (1), Code 2017, is amended to read as follows:
31(1) A written statement of a licensed physician or mental
32health professional in support of the application.
33 Sec. 13. Section 229.8, subsection 3, paragraph b, Code
342017, is amended to read as follows:
35b. Order an examination of the respondent, prior to
-7-1the hearing, by one or more licensed physicians or mental
2health professionals who shall submit a written report on the
3examination to the court as required by section 229.10.
4 Sec. 14. Section 229.10, Code 2017, is amended to read as
5follows:
6229.10 Physicians’ or mental health professionals’
7 examination — report.
81. a. An examination of the respondent shall be
9conducted by one or more licensed physicians or mental health
10professionals, as required by the court’s order, within a
11reasonable time. If the respondent is detained pursuant to
12section 229.11, subsection 1, paragraph “b”, the examination
13shall be conducted within twenty-four hours. If the respondent
14is detained pursuant to section 229.11, subsection 1,
15paragraph “a” or “c”, the examination shall be conducted
16within forty-eight hours. If the respondent so desires,
17the respondent shall be entitled to a separate examination
18by a licensed physician or mental health professional of
19the respondent’s own choice. The reasonable cost of the
20examinations shall, if the respondent lacks sufficient funds to
21pay the cost, be paid by the regional administrator from mental
22health and disability services region funds upon order of the
23court.
24b. Any licensed physician or mental health professional
25 conducting an examination pursuant to this section may consult
26with or request the participation in the examination of any
27consulting mental health professional, and may include with or
28attach to the written report of the examination any findings
29or observations by any consulting mental health professional
30who has been so consulted or has so participated in the
31examination.
32c. If the respondent is not taken into custody under
33section 229.11, but the court is subsequently informed that
34the respondent has declined to be examined by the one or more
35 licensed physician or physicians or mental health professionals
-8-1 pursuant to the court order, the court may order such limited
2detention of the respondent as is necessary to facilitate the
3examination of the respondent by the one or more licensed
4physician or physicians or mental health professionals.
52. A written report of the examination by the one or more
6 court-designated physician or physicians or mental health
7professionals shall be filed with the clerk prior to the time
8set for hearing. A written report of any examination by a
9physician chosen by the respondent may be similarly filed. The
10clerk shall immediately do all of the following:
11a. Cause the report or reports to be shown to the judge who
12issued the order; and.
13b. Cause the respondent’s attorney to receive a copy of
14the report of the court-designated physician or physicians or
15reports.
163. If the report of one or more of the court-designated
17physician or physicians or mental health professionals is
18to the effect that the individual is not seriously mentally
19impaired, the court may without taking further action terminate
20the proceeding and dismiss the application on its own motion
21and without notice.
224. If the report of one or more of the court-designated
23physician or physicians or mental health professionals is
24to the effect that the respondent is seriously mentally
25impaired, the court shall schedule a hearing on the application
26as soon as possible. The hearing shall be held not more
27than forty-eight hours after the report is filed, excluding
28Saturdays, Sundays and holidays, unless an extension for good
29cause is requested by the respondent, or as soon thereafter as
30possible if the court considers that sufficient grounds exist
31for delaying the hearing.
32 Sec. 15. Section 229.22, subsection 2, paragraph a,
33subparagraphs (2), (3), (4), and (5), Code 2017, are amended
34to read as follows:
35(2) Upon delivery of the person believed mentally ill to
-9-1the facility or hospital, the examining physician, examining
2physician assistant, examining mental health professional, or
3examining psychiatric advanced registered nurse practitioner
4may order treatment of that person, including chemotherapy,
5but only to the extent necessary to preserve the person’s life
6or to appropriately control behavior by the person which is
7likely to result in physical injury to that person or others
8if allowed to continue.
9(3) The peace officer who took the person into custody,
10or other party who brought the person to the facility or
11hospital, shall describe the circumstances of the matter to the
12examining physician, examining physician assistant, examining
13mental health professional, or examining psychiatric advanced
14registered nurse practitioner. If the person is a peace
15officer, the peace officer may do so either in person or by
16written report.
17(4) If the examining physician, examining physician
18assistant, examining mental health professional, or examining
19psychiatric advanced registered nurse practitioner finds
20that there is reason to believe that the person is seriously
21mentally impaired, and because of that impairment is likely
22to physically injure the person’s self or others if not
23immediately detained, the examining physician, examining
24physician assistant, examining mental health professional, or
25examining psychiatric advanced registered nurse practitioner
26shall at once communicate with the nearest available magistrate
27as defined in section 801.4, subsection 10.
28(5) The magistrate shall, based upon the circumstances
29described by the examining physician, examining physician
30assistant, examining mental health professional, or examining
31psychiatric advanced registered nurse practitioner, give the
32examining physician, examining physician assistant, examining
33mental health professional, or examining psychiatric advanced
34registered nurse practitioner oral instructions either
35directing that the person be released forthwith or authorizing
-10-1the person’s detention in an appropriate facility. A peace
2officer from the law enforcement agency that took the person
3into custody, if available, during the communication with the
4magistrate, may inform the magistrate that an arrest warrant
5has been issued for or charges are pending against the person
6and request that any oral or written order issued under this
7subsection require the facility or hospital to notify the law
8enforcement agency about the discharge of the person prior to
9discharge. The magistrate may also give oral instructions and
10order that the detained person be transported to an appropriate
11facility.
12 Sec. 16. Section 229.22, subsection 3, Code 2017, is amended
13to read as follows:
143. The chief medical officer of the facility or hospital
15shall examine and may detain and care for the person taken
16into custody under the magistrate’s order for a period not to
17exceed forty-eight hours from the time such order is dated,
18excluding Saturdays, Sundays and holidays, unless the order is
19sooner dismissed by a magistrate. The facility or hospital may
20provide treatment which is necessary to preserve the person’s
21life, or to appropriately control behavior by the person
22which is likely to result in physical injury to the person’s
23self or others if allowed to continue, but may not otherwise
24provide treatment to the person without the person’s consent.
25The person shall be discharged from the facility or hospital
26and released from custody not later than the expiration of
27that period, unless an application is sooner filed with the
28clerk pursuant to section 229.6. Prior to such discharge the
29facility or hospital shall, if required by this section, notify
30the law enforcement agency requesting such notification about
31the discharge of the person. The law enforcement agency shall
32retrieve the person no later than six hours after notification
33from the facility or hospital but in no circumstances shall the
34detention of the person exceed the period of time prescribed
35for detention by this subsection. The detention of any person
-11-1by the procedure and not in excess of the period of time
2prescribed by this section shall not render the peace officer,
3physician, mental health professional, facility, or hospital
4so detaining that person liable in a criminal or civil action
5for false arrest or false imprisonment if the peace officer,
6physician, mental health professional, facility, or hospital
7had reasonable grounds to believe the person so detained was
8mentally ill and likely to physically injure the person’s self
9or others if not immediately detained, or if the facility
10or hospital was required to notify a law enforcement agency
11by this section, and the law enforcement agency requesting
12notification prior to discharge retrieved the person no later
13than six hours after the notification, and the detention prior
14to the retrieval of the person did not exceed the period of
15time prescribed for detention by this subsection.
16 Sec. 17. Section 229.23, subsection 3, Code 2017, is amended
17to read as follows:
183. In addition to protection of the person’s constitutional
19rights, enjoyment of other legal, medical, religious, social,
20political, personal and working rights and privileges which
21the person would enjoy if the person were not so hospitalized
22or detained, so far as is possible consistent with effective
23treatment of that person and of the other patients of the
24hospital. If the patient’s rights are restricted, the
25physician’s or mental health professional’s direction to
26that effect shall be noted on the patient’s record. The
27department of human services shall, in accordance with chapter
2817A establish rules setting forth the specific rights and
29privileges to which persons so hospitalized or detained are
30entitled under this section, and the exceptions provided by
31section 17A.2, subsection 11, paragraphs “a” and “k”, shall not
32be applicable to the rules so established. The patient or the
33patient’s next of kin or friend shall be advised of these rules
34and be provided a written copy upon the patient’s admission to
35or arrival at the hospital.
-12-1 Sec. 18. Section 229.25, subsection 1, paragraph a,
2subparagraph (1), Code 2017, is amended to read as follows:
3(1) The information is requested by a licensed physician or
4mental health professional, attorney, or advocate who provides
5the chief medical officer with a written waiver signed by the
6person about whom the information is sought.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill allows mental health professionals to perform
11examinations, treat and prescribe treatment or medication, if
12authorized to do so, and submit written statements and reports
13as required or ordered by a court in accordance with certain
14voluntary and involuntary hospitalization and commitment
15proceedings for persons with a substance-related disorder or
16serious mental illness.
17A mental health professional is defined in Code section
18228.1 as an individual who either holds at least a master’s
19degree in a mental health field, a current license in this
20state if practicing a licensed profession, and has at least two
21years of post-degree clinical experience under the supervision
22of another mental health professional assessing mental health
23needs and providing appropriate mental health services; or the
24individual holds a current license in this state if practicing
25a licensed profession and is a psychiatrist, a licensed
26advanced registered nurse practitioner who holds a national
27certification in psychiatric mental health care, a physician
28assistant practicing under the supervision of a psychiatrist,
29or is licensed by the board of psychology and holds a doctorate
30degree in psychology.
31The bill allows a mental health professional to examine a
32person when it appears that the person should be immediately
33detained due to a serious mental impairment but an application
34has not been filed naming the person as the respondent and the
35person cannot be ordered into immediate custody and detained or
-13-1when necessary to preserve the person’s life or appropriately
2control the person’s behavior if physical injury to the
3person or others is likely. The bill excludes mental health
4professionals from liability for detaining a person in this
5situation.
6The bill excludes mental health professionals from civil or
7criminal liability for the professional’s role in admitting a
8person to a facility or hospital or providing treatment to a
9person.
-14-tr/rh
2certain functions relating to persons with substance-related
3disorders and persons with mental illness.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 125.2, Code 2017, is amended by adding
2the following new subsection:
3 NEW SUBSECTION. 10A. “Mental health professional” means the
4same as defined in section 228.1.
5 Sec. 2. Section 125.12, subsection 3, Code 2017, is amended
6to read as follows:
73. The director shall provide for adequate and appropriate
8treatment for persons with substance-related disorders and
9concerned family members admitted under sections 125.33 and
10125.34, or under section 125.75, 125.81, or 125.91. Treatment
11shall not be provided at a correctional institution except
12for inmates. A mental health professional, as defined in
13section 228.1, who is employed by a treatment provider under
14the program may provide treatment to a person with co-occurring
15substance-related and mental health disorders. Such treatment
16may also be provided by a person employed by such a treatment
17provider who is receiving the supervision required to meet the
18definition of mental health professional but has not completed
19the supervision component.
20 Sec. 3. Section 125.33, subsections 1 and 3, Code 2017, are
21amended to read as follows:
221. A person with a substance-related disorder may apply for
23voluntary treatment or rehabilitation services directly to a
24facility or to a licensed physician and surgeon or osteopathic
25physician and surgeon or to a mental health professional. If
26the proposed patient is a minor or an incompetent person, a
27parent, a legal guardian or other legal representative may
28make the application. The licensed physician and surgeon or
29osteopathic physician and surgeon, mental health professional,
30 or any employee or person acting under the direction or
31supervision of the physician and surgeon or osteopathic
32physician and surgeon, mental health professional, or the
33 facility shall not report or disclose the name of the person or
34the fact that treatment was requested or has been undertaken
35to any law enforcement officer or law enforcement agency; nor
-1-1shall such information be admissible as evidence in any court,
2grand jury, or administrative proceeding unless authorized
3by the person seeking treatment. If the person seeking such
4treatment or rehabilitation is a minor who has personally made
5application for treatment, the fact that the minor sought
6treatment or rehabilitation or is receiving treatment or
7rehabilitation services shall not be reported or disclosed to
8the parents or legal guardian of such minor without the minor’s
9consent, and the minor may give legal consent to receive such
10treatment and rehabilitation.
113. A person with a substance-related disorder seeking
12treatment or rehabilitation and who is either addicted or
13dependent on a chemical substance may first be examined and
14evaluated by a licensed physician and surgeon or osteopathic
15physician and surgeon or a mental health professional who may
16prescribe, if authorized or licensed to do so, a proper course
17of treatment and medication, if needed. The licensed physician
18and surgeon or osteopathic physician and surgeon or mental
19health professional may further prescribe a course of treatment
20or rehabilitation and authorize another licensed physician and
21surgeon or osteopathic physician and surgeon, mental health
22professional, or facility to provide the prescribed treatment
23or rehabilitation services. Treatment or rehabilitation
24services may be provided to a person individually or in
25a group. A facility providing or engaging in treatment
26or rehabilitation shall not report or disclose to a law
27enforcement officer or law enforcement agency the name of any
28person receiving or engaged in the treatment or rehabilitation;
29nor shall a person receiving or participating in treatment or
30rehabilitation report or disclose the name of any other person
31engaged in or receiving treatment or rehabilitation or that the
32program is in existence, to a law enforcement officer or law
33enforcement agency. Such information shall not be admitted
34in evidence in any court, grand jury, or administrative
35proceeding. However, a person engaged in or receiving
-2-1treatment or rehabilitation may authorize the disclosure of the
2person’s name and individual participation.
3 Sec. 4. Section 125.34, subsections 3 and 7, Code 2017, are
4amended to read as follows:
53. A person who arrives at a facility and voluntarily
6submits to examination shall be examined by a licensed
7physician or mental health professional as soon as possible
8after the person arrives at the facility. The person
9may then be admitted as a patient or referred to another
10health facility. The referring facility shall arrange for
11transportation.
127. A licensed physician and surgeon or osteopathic
13physician and surgeon, mental health professional, facility
14administrator, or an employee or a person acting as or on
15behalf of the facility administrator, is not criminally or
16civilly liable for acts in conformity with this chapter, unless
17the acts constitute willful malice or abuse.
18 Sec. 5. Section 125.75, subsection 2, paragraph c,
19subparagraph (1), Code 2017, is amended to read as follows:
20(1) A written statement of a licensed physician or mental
21health professional in support of the application.
22 Sec. 6. Section 125.78, subsection 3, paragraph b, Code
232017, is amended to read as follows:
24b. Requiring an examination of the respondent, prior to
25the hearing, by one or more licensed physicians or mental
26health professionals who shall submit a written report of the
27examination to the court as required by section 125.80.
28 Sec. 7. Section 125.80, Code 2017, is amended to read as
29follows:
30125.80 Physician’s or mental health professional’s
31 examination — report — scheduling of hearing.
321. a. An examination of the respondent shall be conducted
33within a reasonable time and prior to the commitment hearing by
34one or more licensed physicians or mental health professionals
35 as required by the court’s order. If the respondent is taken
-3-1into custody under section 125.81, the examination shall be
2conducted within twenty-four hours after the respondent is
3taken into custody. If the respondent desires, the respondent
4may have a separate examination by a licensed physician or
5mental health professional of the respondent’s own choice.
6The court shall notify the respondent of the right to choose
7a licensed physician or mental health professional for a
8separate examination. The reasonable cost of the examinations
9shall be paid from county funds upon order of the court if the
10respondent lacks sufficient funds to pay the cost.
11b. A licensed physician or mental health professional
12 conducting an examination pursuant to this section may consult
13with or request the participation in the examination of
14facility personnel, and may include with or attach to the
15written report of the examination any findings or observations
16by facility personnel who have been consulted or have
17participated in the examination.
18c. If the respondent is not taken into custody under
19section 125.81, but the court is subsequently informed that the
20respondent has declined to be examined by a licensed physician
21or mental health professional pursuant to the court order,
22the court may order limited detention of the respondent as
23necessary to facilitate the examination of the respondent by
24the licensed physician or mental health professional.
252. A written report of the examination by a court-designated
26licensed physician or mental health professional shall be filed
27with the clerk prior to the hearing date. A written report
28of an examination by a licensed physician or mental health
29professional chosen by the respondent may be similarly filed.
30The clerk shall immediately:
31a. Cause a report to be shown to the judge who issued the
32order.
33b. Cause the respondent’s attorney to receive a copy of
34the report of a court-designated licensed physician or mental
35health professional.
-4- 13. If the report of a court-designated licensed physician or
2mental health professional is to the effect that the respondent
3is not a person with a substance-related disorder, the court,
4without taking further action, may terminate the proceeding and
5dismiss the application on its own motion and without notice.
64. If the report of a court-designated licensed physician or
7mental health professional is to the effect that the respondent
8is a person with a substance-related disorder, the court shall
9schedule a commitment hearing as soon as possible. The hearing
10shall be held not more than forty-eight hours after the report
11is filed, excluding Saturdays, Sundays, and holidays, unless
12an extension for good cause is requested by the respondent,
13or as soon thereafter as possible if the court considers that
14sufficient grounds exist for delaying the hearing.
15 Sec. 8. Section 125.82, subsection 3, Code 2017, is amended
16to read as follows:
173. The person who filed the application and a licensed
18physician, mental health professional as defined in section
19228.1, or certified alcohol and drug counselor certified by the
20nongovernmental Iowa board of substance abuse certification who
21has examined the respondent in connection with the commitment
22hearing shall be present at the hearing, unless the court
23for good cause finds that their presence or testimony is not
24necessary. The applicant, respondent, and the respondent’s
25attorney may waive the presence or telephonic appearance of the
26licensed physician, mental health professional, or certified
27alcohol and drug counselor who examined the respondent and
28agree to submit as evidence the written report of the licensed
29physician, mental health professional, or certified alcohol
30and drug counselor. The respondent’s attorney shall inform
31the court if the respondent’s attorney reasonably believes
32that the respondent, due to diminished capacity, cannot make
33an adequately considered waiver decision. “Good cause” for
34finding that the testimony of the licensed physician, mental
35health professional, or certified alcohol and drug counselor
-5-1who examined the respondent is not necessary may include, but
2is not limited to, such a waiver. If the court determines
3that the testimony of the licensed physician, mental health
4professional, or certified alcohol and drug counselor is
5necessary, the court may allow the licensed physician, mental
6health professional, or certified alcohol and drug counselor to
7testify by telephone. The respondent shall be present at the
8hearing unless prior to the hearing the respondent’s attorney
9stipulates in writing that the attorney has conversed with the
10respondent, and that in the attorney’s judgment the respondent
11cannot make a meaningful contribution to the hearing, or that
12the respondent has waived the right to be present, and the
13basis for the attorney’s conclusions. A stipulation to the
14respondent’s absence shall be reviewed by the court before the
15hearing, and may be rejected if it appears that insufficient
16grounds are stated or that the respondent’s interests would not
17be served by the respondent’s absence.
18 Sec. 9. Section 125.86, subsection 3, paragraph b, Code
192017, is amended to read as follows:
20b. An advanced registered nurse practitioner who is
21not certified as a psychiatric advanced registered nurse
22practitioner but who meets the qualifications set forth in the
23definition of a mental health professional in section 228.1,
24 may complete periodic reports pursuant to paragraph “a”.
25 Sec. 10. Section 125.91, subsection 3, Code 2017, is amended
26to read as follows:
273. The attending physician shall examine and may detain
28the person pursuant to the magistrate’s order for a period not
29to exceed forty-eight hours from the time the order is dated,
30excluding Saturdays, Sundays, and holidays, unless the order is
31dismissed by a magistrate. The facility may provide treatment
32which is necessary to preserve the person’s life or to
33appropriately control the person’s behavior if the behavior is
34likely to result in physical injury to the person or others if
35allowed to continue or is otherwise deemed medically necessary
-6-1by the attending physician or mental health professional,
2but shall not otherwise provide treatment to the person
3without the person’s consent. The person shall be discharged
4from the facility and released from detention no later than
5the expiration of the forty-eight-hour period, unless an
6application for involuntary commitment is filed with the clerk
7pursuant to section 125.75. The detention of a person by the
8procedure in this section, and not in excess of the period of
9time prescribed by this section, shall not render the peace
10officer, attending physician, or facility detaining the person
11liable in a criminal or civil action for false arrest or false
12imprisonment if the peace officer, attending physician, mental
13health professional, or facility had reasonable grounds to
14believe that the circumstances described in subsection 1 were
15applicable.
16 Sec. 11. Section 125.92, subsection 4, Code 2017, is amended
17to read as follows:
184. Enjoy all legal, medical, religious, social, political,
19personal, and working rights and privileges, which the person
20would enjoy if not detained, taken into immediate custody,
21or committed, consistent with the effective treatment of the
22person and of the other persons in the facility. If the
23person’s rights are restricted, the physician’s or mental
24health professional’s direction to that effect shall be noted
25in the person’s record. The person or the person’s next of
26kin or guardian shall be advised of the person’s rights and
27be provided a written copy upon the person’s admission to or
28arrival at the facility.
29 Sec. 12. Section 229.6, subsection 2, paragraph c,
30subparagraph (1), Code 2017, is amended to read as follows:
31(1) A written statement of a licensed physician or mental
32health professional in support of the application.
33 Sec. 13. Section 229.8, subsection 3, paragraph b, Code
342017, is amended to read as follows:
35b. Order an examination of the respondent, prior to
-7-1the hearing, by one or more licensed physicians or mental
2health professionals who shall submit a written report on the
3examination to the court as required by section 229.10.
4 Sec. 14. Section 229.10, Code 2017, is amended to read as
5follows:
6229.10 Physicians’ or mental health professionals’
7 examination — report.
81. a. An examination of the respondent shall be
9conducted by one or more licensed physicians or mental health
10professionals, as required by the court’s order, within a
11reasonable time. If the respondent is detained pursuant to
12section 229.11, subsection 1, paragraph “b”, the examination
13shall be conducted within twenty-four hours. If the respondent
14is detained pursuant to section 229.11, subsection 1,
15paragraph “a” or “c”, the examination shall be conducted
16within forty-eight hours. If the respondent so desires,
17the respondent shall be entitled to a separate examination
18by a licensed physician or mental health professional of
19the respondent’s own choice. The reasonable cost of the
20examinations shall, if the respondent lacks sufficient funds to
21pay the cost, be paid by the regional administrator from mental
22health and disability services region funds upon order of the
23court.
24b. Any licensed physician or mental health professional
25 conducting an examination pursuant to this section may consult
26with or request the participation in the examination of any
27consulting mental health professional, and may include with or
28attach to the written report of the examination any findings
29or observations by any consulting mental health professional
30who has been so consulted or has so participated in the
31examination.
32c. If the respondent is not taken into custody under
33section 229.11, but the court is subsequently informed that
34the respondent has declined to be examined by the one or more
35 licensed physician or physicians or mental health professionals
-8-1 pursuant to the court order, the court may order such limited
2detention of the respondent as is necessary to facilitate the
3examination of the respondent by the one or more licensed
4physician or physicians or mental health professionals.
52. A written report of the examination by the one or more
6 court-designated physician or physicians or mental health
7professionals shall be filed with the clerk prior to the time
8set for hearing. A written report of any examination by a
9physician chosen by the respondent may be similarly filed. The
10clerk shall immediately do all of the following:
11a. Cause the report or reports to be shown to the judge who
12issued the order; and.
13b. Cause the respondent’s attorney to receive a copy of
14the report of the court-designated physician or physicians or
15reports.
163. If the report of one or more of the court-designated
17physician or physicians or mental health professionals is
18to the effect that the individual is not seriously mentally
19impaired, the court may without taking further action terminate
20the proceeding and dismiss the application on its own motion
21and without notice.
224. If the report of one or more of the court-designated
23physician or physicians or mental health professionals is
24to the effect that the respondent is seriously mentally
25impaired, the court shall schedule a hearing on the application
26as soon as possible. The hearing shall be held not more
27than forty-eight hours after the report is filed, excluding
28Saturdays, Sundays and holidays, unless an extension for good
29cause is requested by the respondent, or as soon thereafter as
30possible if the court considers that sufficient grounds exist
31for delaying the hearing.
32 Sec. 15. Section 229.22, subsection 2, paragraph a,
33subparagraphs (2), (3), (4), and (5), Code 2017, are amended
34to read as follows:
35(2) Upon delivery of the person believed mentally ill to
-9-1the facility or hospital, the examining physician, examining
2physician assistant, examining mental health professional, or
3examining psychiatric advanced registered nurse practitioner
4may order treatment of that person, including chemotherapy,
5but only to the extent necessary to preserve the person’s life
6or to appropriately control behavior by the person which is
7likely to result in physical injury to that person or others
8if allowed to continue.
9(3) The peace officer who took the person into custody,
10or other party who brought the person to the facility or
11hospital, shall describe the circumstances of the matter to the
12examining physician, examining physician assistant, examining
13mental health professional, or examining psychiatric advanced
14registered nurse practitioner. If the person is a peace
15officer, the peace officer may do so either in person or by
16written report.
17(4) If the examining physician, examining physician
18assistant, examining mental health professional, or examining
19psychiatric advanced registered nurse practitioner finds
20that there is reason to believe that the person is seriously
21mentally impaired, and because of that impairment is likely
22to physically injure the person’s self or others if not
23immediately detained, the examining physician, examining
24physician assistant, examining mental health professional, or
25examining psychiatric advanced registered nurse practitioner
26shall at once communicate with the nearest available magistrate
27as defined in section 801.4, subsection 10.
28(5) The magistrate shall, based upon the circumstances
29described by the examining physician, examining physician
30assistant, examining mental health professional, or examining
31psychiatric advanced registered nurse practitioner, give the
32examining physician, examining physician assistant, examining
33mental health professional, or examining psychiatric advanced
34registered nurse practitioner oral instructions either
35directing that the person be released forthwith or authorizing
-10-1the person’s detention in an appropriate facility. A peace
2officer from the law enforcement agency that took the person
3into custody, if available, during the communication with the
4magistrate, may inform the magistrate that an arrest warrant
5has been issued for or charges are pending against the person
6and request that any oral or written order issued under this
7subsection require the facility or hospital to notify the law
8enforcement agency about the discharge of the person prior to
9discharge. The magistrate may also give oral instructions and
10order that the detained person be transported to an appropriate
11facility.
12 Sec. 16. Section 229.22, subsection 3, Code 2017, is amended
13to read as follows:
143. The chief medical officer of the facility or hospital
15shall examine and may detain and care for the person taken
16into custody under the magistrate’s order for a period not to
17exceed forty-eight hours from the time such order is dated,
18excluding Saturdays, Sundays and holidays, unless the order is
19sooner dismissed by a magistrate. The facility or hospital may
20provide treatment which is necessary to preserve the person’s
21life, or to appropriately control behavior by the person
22which is likely to result in physical injury to the person’s
23self or others if allowed to continue, but may not otherwise
24provide treatment to the person without the person’s consent.
25The person shall be discharged from the facility or hospital
26and released from custody not later than the expiration of
27that period, unless an application is sooner filed with the
28clerk pursuant to section 229.6. Prior to such discharge the
29facility or hospital shall, if required by this section, notify
30the law enforcement agency requesting such notification about
31the discharge of the person. The law enforcement agency shall
32retrieve the person no later than six hours after notification
33from the facility or hospital but in no circumstances shall the
34detention of the person exceed the period of time prescribed
35for detention by this subsection. The detention of any person
-11-1by the procedure and not in excess of the period of time
2prescribed by this section shall not render the peace officer,
3physician, mental health professional, facility, or hospital
4so detaining that person liable in a criminal or civil action
5for false arrest or false imprisonment if the peace officer,
6physician, mental health professional, facility, or hospital
7had reasonable grounds to believe the person so detained was
8mentally ill and likely to physically injure the person’s self
9or others if not immediately detained, or if the facility
10or hospital was required to notify a law enforcement agency
11by this section, and the law enforcement agency requesting
12notification prior to discharge retrieved the person no later
13than six hours after the notification, and the detention prior
14to the retrieval of the person did not exceed the period of
15time prescribed for detention by this subsection.
16 Sec. 17. Section 229.23, subsection 3, Code 2017, is amended
17to read as follows:
183. In addition to protection of the person’s constitutional
19rights, enjoyment of other legal, medical, religious, social,
20political, personal and working rights and privileges which
21the person would enjoy if the person were not so hospitalized
22or detained, so far as is possible consistent with effective
23treatment of that person and of the other patients of the
24hospital. If the patient’s rights are restricted, the
25physician’s or mental health professional’s direction to
26that effect shall be noted on the patient’s record. The
27department of human services shall, in accordance with chapter
2817A establish rules setting forth the specific rights and
29privileges to which persons so hospitalized or detained are
30entitled under this section, and the exceptions provided by
31section 17A.2, subsection 11, paragraphs “a” and “k”, shall not
32be applicable to the rules so established. The patient or the
33patient’s next of kin or friend shall be advised of these rules
34and be provided a written copy upon the patient’s admission to
35or arrival at the hospital.
-12-1 Sec. 18. Section 229.25, subsection 1, paragraph a,
2subparagraph (1), Code 2017, is amended to read as follows:
3(1) The information is requested by a licensed physician or
4mental health professional, attorney, or advocate who provides
5the chief medical officer with a written waiver signed by the
6person about whom the information is sought.
7EXPLANATION
8The inclusion of this explanation does not constitute agreement with
9the explanation’s substance by the members of the general assembly.
10This bill allows mental health professionals to perform
11examinations, treat and prescribe treatment or medication, if
12authorized to do so, and submit written statements and reports
13as required or ordered by a court in accordance with certain
14voluntary and involuntary hospitalization and commitment
15proceedings for persons with a substance-related disorder or
16serious mental illness.
17A mental health professional is defined in Code section
18228.1 as an individual who either holds at least a master’s
19degree in a mental health field, a current license in this
20state if practicing a licensed profession, and has at least two
21years of post-degree clinical experience under the supervision
22of another mental health professional assessing mental health
23needs and providing appropriate mental health services; or the
24individual holds a current license in this state if practicing
25a licensed profession and is a psychiatrist, a licensed
26advanced registered nurse practitioner who holds a national
27certification in psychiatric mental health care, a physician
28assistant practicing under the supervision of a psychiatrist,
29or is licensed by the board of psychology and holds a doctorate
30degree in psychology.
31The bill allows a mental health professional to examine a
32person when it appears that the person should be immediately
33detained due to a serious mental impairment but an application
34has not been filed naming the person as the respondent and the
35person cannot be ordered into immediate custody and detained or
-13-1when necessary to preserve the person’s life or appropriately
2control the person’s behavior if physical injury to the
3person or others is likely. The bill excludes mental health
4professionals from liability for detaining a person in this
5situation.
6The bill excludes mental health professionals from civil or
7criminal liability for the professional’s role in admitting a
8person to a facility or hospital or providing treatment to a
9person.
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