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| 1 | - | House File 385 - | |
| 1 | + | House File 385 - Introduced HOUSE FILE 385 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO HF 124) A BILL FOR An Act relating to discharge of involuntarily committed persons 1 from a facility or a hospital. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2015HV (1) 91 dg/ko | |
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| 3 | - | H.F. 385 Section 1. Section 125.2, Code 2025, is amended by adding 1 the following new | |
| 3 | + | H.F. 385 Section 1. Section 125.2, Code 2025, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 01. Administrative services organization 3 means the same as defined in section 225A.1. 4 Sec. 2. Section 125.85, subsection 4, Code 2025, is amended 5 by striking the subsection. 6 Sec. 3. Section 125.85, Code 2025, is amended by adding the 7 following new subsections: 8 NEW SUBSECTION . 6. Prior to a discharge of a respondent 9 under this section, the facility treating the respondent shall 10 do all of the following: 11 a. Refer the respondent to an administrative services 12 organization for evaluation, case management, and postdischarge 13 services. 14 b. Assess the respondent for suicide risk. 15 c. Provide the respondent with a thirty-day supply of 16 each medication prescribed for the respondent before or 17 during the respondents treatment, including psychiatric and 18 nonpsychiatric medications. 19 d. Provide the respondent or the respondents legal 20 representative with a discharge report. The discharge report 21 shall include all of the following: 22 (1) The respondents name and address. 23 (2) The dates, times, and locations of all postdischarge 24 appointments scheduled for the respondent. 25 (3) A list of each medication provided to the respondent 26 under paragraph c . 27 (4) Contact information for the administrative services 28 organization to which the respondent was referred under 29 paragraph a . 30 (5) A written patient-centered aftercare plan, including 31 crisis prevention and steps to address the respondents ongoing 32 care needs. 33 (6) (a) Educational materials for the respondent and 34 individuals who are willing to support the respondent after the 35 -1- LSB 2015HV (1) 91 dg/ko 1/ 7 | |
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| 5 | - | H.F. 385 | |
| 5 | + | H.F. 385 respondents discharge. 1 (b) Educational materials shall be developed by the 2 department for distribution to facilities. Educational 3 materials shall include but not be limited to all of the 4 following: 5 (i) Descriptions of the symptoms of a substance use 6 disorder. 7 (ii) Warning signs of decompensation. 8 (iii) Information regarding the availability of other 9 educational services, services offered in the respondents 10 community, and services offered statewide. 11 e. Notify all of the following persons: 12 (1) The administrative services organization to which the 13 respondent was referred under paragraph a . 14 (2) The respondents legal guardian, parent, spouse, 15 attorney in fact under chapter 144B, or adult siblings, as 16 applicable. 17 NEW SUBSECTION . 7. The administrative services 18 organization to which a respondent was referred under 19 subsection 6, paragraph a , shall do all of the following in 20 relation to the discharged respondent: 21 a. Coordinate postdischarge care, including but not 22 limited to contacting the respondent to ensure the respondent 23 attends scheduled appointments and receives necessary care and 24 services. 25 b. Follow up with the respondent in a timely manner. 26 Follow-ups shall include but not be limited to home visits, 27 telephone calls, and other means of contacting the respondent. 28 NEW SUBSECTION . 8. a. Each administrative services 29 organization shall make a quarterly report to the department, 30 and the report shall include all of the following: 31 (1) The number of respondents discharged and referred to 32 the administrative services organization during the reporting 33 period. 34 (2) The outcome of each discharged respondent. 35 -2- LSB 2015HV (1) 91 dg/ko 2/ 7 | |
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| 7 | - | H.F. 385 | |
| 7 | + | H.F. 385 (3) Any issues encountered while ensuring each respondents 1 postdischarge continuity of care. 2 b. A report under this section shall be considered a 3 confidential record under section 22.7. 4 c. A report under this section shall comply with the federal 5 Health Insurance Portability and Accountability Act of 1996, 6 Pub. L. No. 104-191. 7 NEW SUBSECTION . 9. Following a respondents discharge from 8 a facility or from treatment, the administrator of the facility 9 shall immediately report the discharge to the court which 10 ordered the respondents commitment or treatment. The court 11 shall issue an order confirming the respondents discharge 12 and terminating the proceedings in which the respondents 13 commitment or treatment was ordered. Copies of the order 14 confirming the discharge and terminating the proceedings shall 15 be sent by regular mail to the facility and the respondent. 16 NEW SUBSECTION . 10. The department shall adopt rules 17 pursuant to chapter 17A to implement and administer this 18 section. 19 Sec. 4. Section 229.1, Code 2025, is amended by adding the 20 following new subsection: 21 NEW SUBSECTION . 01. Administrative services organization 22 means the same as defined in section 225A.1. 23 Sec. 5. Section 229.16, Code 2025, is amended to read as 24 follows: 25 229.16 Discharge and termination of proceeding. 26 1. When the condition of , in the opinion of the chief 27 medical officer, a patient who is hospitalized pursuant to a 28 report issued whose treatment was recommended under section 29 229.14, subsection 1 , paragraph b , or is receiving treatment 30 pursuant to a report issued under section 229.14, subsection 31 1 , paragraph c , or is in full-time care and custody pursuant 32 to a report issued under section 229.14, subsection 1 , 33 paragraph d , is such that in the opinion of the chief medical 34 officer the patient no longer requires treatment or care for 35 -3- LSB 2015HV (1) 91 dg/ko 3/ 7 | |
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| 9 | - | H.F. 385 | |
| 9 | + | H.F. 385 serious mental impairment, the chief medical officer shall 1 tentatively discharge the patient and immediately report that 2 fact the discharge to the court which ordered the patients 3 hospitalization or care and custody treatment . Upon receiving 4 the report, the court shall issue an order confirming the 5 patients discharge from the hospital or from care and custody, 6 as the case may be, and shall terminate terminating the 7 proceedings pursuant to in which the order patients treatment 8 was issued ordered . Copies of the order shall be sent by 9 regular mail to the hospital, the patient, and the applicant if 10 the applicant has filed a written waiver signed by the patient. 11 2. If a patient is receiving inpatient care, prior to a 12 discharge of the patient under subsection 1, the facility or 13 hospital treating the patient shall do all of the following: 14 a. Refer the patient to an administrative services 15 organization for evaluation, case management, and postdischarge 16 services. 17 b. Assess the patient for suicide risk. 18 c. Provide the patient with a thirty-day supply of each 19 medication prescribed for the patient before or during the 20 patients treatment, including psychiatric and nonpsychiatric 21 medications. 22 d. Provide the patient or the patients legal representative 23 with a discharge report. The discharge report shall include 24 all of the following: 25 (1) The patients name and address. 26 (2) The dates, times, and locations of all postdischarge 27 appointments scheduled for the patient. 28 (3) A list of each medication provided to the patient under 29 paragraph c . 30 (4) Contact information for the administrative services 31 organization to which the patient was referred under paragraph 32 a . 33 (5) A written patient-centered aftercare plan, including 34 crisis prevention and steps to address the patients ongoing 35 -4- LSB 2015HV (1) 91 dg/ko 4/ 7 | |
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| 11 | - | H.F. 385 | |
| 11 | + | H.F. 385 care needs. 1 (6) (a) Educational materials for the patient and 2 individuals who are willing to support the patient after the 3 patients discharge. 4 (b) Educational materials shall be developed by the 5 department for distribution to facilities and hospitals 6 treating persons with a mental illness. Educational materials 7 shall include but not be limited to all of the following: 8 (i) Descriptions of the symptoms of mental illness. 9 (ii) Warning signs of decompensation. 10 (iii) Information regarding the availability of other 11 educational services, services offered in the patients 12 community, and services offered statewide. 13 e. Notify all of the following persons: 14 (1) The administrative services organization to which the 15 patient was referred under paragraph a . 16 (2) The patients legal guardian, parent, spouse, attorney 17 in fact under chapter 144B, or adult siblings, as applicable. 18 3. The administrative services organization to which a 19 patient was referred under subsection 2, paragraph a , shall do 20 all of the following in relation to the discharged patient: 21 a. Coordinate postdischarge care, including but not 22 limited to contacting the patient to ensure the patient 23 attends scheduled appointments and receives necessary care and 24 services. 25 b. Follow up with the patient in a timely manner. 26 Follow-ups shall include but not be limited to home visits, 27 telephone calls, and other means of contacting the patient. 28 4. a. Each administrative services organization shall make 29 a quarterly report to the department, and the report shall 30 include all of the following: 31 (1) The number of patients discharged and referred to the 32 administrative services organization during the reporting 33 period. 34 (2) The outcomes of each discharged patient. 35 -5- LSB 2015HV (1) 91 dg/ko 5/ 7 | |
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| 13 | - | H.F. 385 3. a. The administrative services organization to which a 1 patient was referred under subsection 2, paragraph a , shall do 2 all of the following in relation to the discharged patient: 3 (1) Coordinate postdischarge care, including but not 4 limited to contacting the patient to ensure the patient 5 attends scheduled appointments and receives necessary care and 6 services. 7 (2) Follow up with the patient in a timely manner. 8 Follow-ups shall include but not be limited to home visits, 9 telephone calls, and other means of contacting the patient. 10 b. An administrative services organization may delegate 11 duties required under this subsection to a managed care 12 organization acting pursuant to a contract with the department 13 to administer the Medicaid program under chapter 249A, if the 14 patient referred to the administrative services organization 15 qualifies for Medicaid. 16 4. a. Each administrative services organization shall make 17 a quarterly report to the department, and the report shall 18 include all of the following: 19 (1) The number of patients discharged and referred to the 20 administrative services organization during the reporting 21 period. 22 (2) The outcomes of each discharged patient. 23 (3) Any issue encountered while ensuring each patients 24 postdischarge continuity of care. 25 b. A report under this section shall be considered a 26 confidential record under section 22.7. 27 c. A report under this section shall comply with the federal 28 Health Insurance Portability and Accountability Act of 1996, 29 Pub. L. No. 104-191. 30 5. The department shall adopt rules pursuant to chapter 17A 31 to implement this section. 32 -6- HF 385 (2) 91 dg/ko/md 6/ 6 | |
| 13 | + | H.F. 385 (3) Any issue encountered while ensuring each patients 1 postdischarge continuity of care. 2 b. A report under this section shall be considered a 3 confidential record under section 22.7. 4 c. A report under this section shall comply with the federal 5 Health Insurance Portability and Accountability Act of 1996, 6 Pub. L. No. 104-191. 7 5. The department shall adopt rules pursuant to chapter 17A 8 to implement this section. 9 EXPLANATION 10 The inclusion of this explanation does not constitute agreement with 11 the explanations substance by the members of the general assembly. 12 This bill relates to discharge of involuntarily committed 13 persons from a facility or a hospital (facility). 14 The bill requires, prior to the discharge of a person that 15 was committed for a substance use disorder or hospitalized 16 for inpatient care for a serious mental impairment, that 17 the facility treating the person refer the person to an 18 administrative services organization (ASO) for evaluation, 19 case management, and postdischarge services; assess the person 20 for suicide risk; provide the person with a 30-day supply of 21 all medications prescribed for the person before or during the 22 persons treatment; provide the person or the persons legal 23 representative with a discharge report; and notify certain 24 persons listed in the bill. The bill details the information 25 that must be included in the discharge report. The bill 26 requires the department of health and human services (HHS) to 27 develop educational materials for distribution to facilities 28 for a facility to provide with the persons discharge report. 29 The bill details the contents of the educational materials. 30 The bill requires the ASO to which the person was referred 31 to coordinate the discharged persons postdischarge care 32 by contacting the discharged person to ensure the person 33 attends scheduled appointments and receives necessary care and 34 services, and following up with the discharged person in a 35 -6- LSB 2015HV (1) 91 dg/ko 6/ 7 | |
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| 15 | + | H.F. 385 timely manner. 1 The bill requires ASOs to make quarterly reports to HHS. The 2 bill details the information that must be included in an ASOs 3 quarterly report. An ASOs quarterly report is considered a 4 confidential record and must comply with the federal Health 5 Insurance Portability and Accountability Act of 1996. 6 The bill requires HHS to adopt rules to implement and 7 administer the bill. 8 The bill makes conforming changes to Code sections 9 125.2 (substance use disorders definitions) and 229.1 10 (hospitalization of persons with mental illness definitions) 11 by adding a definition for administrative services 12 organization. 13 -7- LSB 2015HV (1) 91 dg/ko 7/ 7 |