Bill Text: IA SSB1133 | 2017-2018 | 87th General Assembly | Introduced

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Bill Title: A bill for an act authorizing mental health professionals to perform certain functions relating to persons with substance-related disorders and persons with mental illness.

Spectrum: Committee Bill

Status: (N/A - Dead) 2017-03-01 - Subcommittee recommends passage. [SSB1133 Detail]

Download: Iowa-2017-SSB1133-Introduced.html

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Senate Study Bill 1133 - Introduced
SENATE FILE _____
BY (PROPOSED COMMITTEE ON
HUMAN RESOURCES BILL BY
CHAIRPERSON SEGEBART)
A BILL FOR
An Act authorizing mental health professionals to perform
certain functions relating to persons with substance-related
disorders and persons with mental illness.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. Section 125.2, Code 2017, is amended by adding
the following new subsection:
NEW SUBSECTION . 10A. “Mental health professional” means the
same as defined in section 228.1.
Sec. 2. Section 125.12, subsection 3, Code 2017, is amended
to read as follows:
3. The director shall provide for adequate and appropriate
treatment for persons with substance-related disorders and
concerned family members admitted under sections 125.33 and
125.34 , or under section 125.75 , 125.81 , or 125.91 . Treatment
shall not be provided at a correctional institution except
for inmates. A mental health professional , as defined in
section 228.1 , who is employed by a treatment provider under
the program may provide treatment to a person with co-occurring
substance-related and mental health disorders. Such treatment
may also be provided by a person employed by such a treatment
provider who is receiving the supervision required to meet the
definition of mental health professional but has not completed
the supervision component.
Sec. 3. Section 125.33, subsections 1 and 3, Code 2017, are
amended to read as follows:
1. A person with a substance-related disorder may apply for
voluntary treatment or rehabilitation services directly to a
facility or to a licensed physician and surgeon or osteopathic
physician and surgeon or to a mental health professional . If
the proposed patient is a minor or an incompetent person, a
parent, a legal guardian or other legal representative may
make the application. The licensed physician and surgeon or
osteopathic physician and surgeon , mental health professional,
or any employee or person acting under the direction or
supervision of the physician and surgeon or osteopathic
physician and surgeon, mental health professional, or the
facility shall not report or disclose the name of the person or
the fact that treatment was requested or has been undertaken
to any law enforcement officer or law enforcement agency; nor
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shall such information be admissible as evidence in any court,
grand jury, or administrative proceeding unless authorized
by the person seeking treatment. If the person seeking such
treatment or rehabilitation is a minor who has personally made
application for treatment, the fact that the minor sought
treatment or rehabilitation or is receiving treatment or
rehabilitation services shall not be reported or disclosed to
the parents or legal guardian of such minor without the minor’s
consent, and the minor may give legal consent to receive such
treatment and rehabilitation.
3. A person with a substance-related disorder seeking
treatment or rehabilitation and who is either addicted or
dependent on a chemical substance may first be examined and
evaluated by a licensed physician and surgeon or osteopathic
physician and surgeon or a mental health professional who may
prescribe , if authorized or licensed to do so, a proper course
of treatment and medication, if needed. The licensed physician
and surgeon or osteopathic physician and surgeon or mental
health professional may further prescribe a course of treatment
or rehabilitation and authorize another licensed physician and
surgeon or osteopathic physician and surgeon , mental health
professional, or facility to provide the prescribed treatment
or rehabilitation services. Treatment or rehabilitation
services may be provided to a person individually or in
a group. A facility providing or engaging in treatment
or rehabilitation shall not report or disclose to a law
enforcement officer or law enforcement agency the name of any
person receiving or engaged in the treatment or rehabilitation;
nor shall a person receiving or participating in treatment or
rehabilitation report or disclose the name of any other person
engaged in or receiving treatment or rehabilitation or that the
program is in existence, to a law enforcement officer or law
enforcement agency. Such information shall not be admitted
in evidence in any court, grand jury, or administrative
proceeding. However, a person engaged in or receiving
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treatment or rehabilitation may authorize the disclosure of the
person’s name and individual participation.
Sec. 4. Section 125.34, subsections 3 and 7, Code 2017, are
amended to read as follows:
3. A person who arrives at a facility and voluntarily
submits to examination shall be examined by a licensed
physician or mental health professional as soon as possible
after the person arrives at the facility. The person
may then be admitted as a patient or referred to another
health facility. The referring facility shall arrange for
transportation.
7. A licensed physician and surgeon or osteopathic
physician and surgeon, mental health professional, facility
administrator, or an employee or a person acting as or on
behalf of the facility administrator, is not criminally or
civilly liable for acts in conformity with this chapter , unless
the acts constitute willful malice or abuse.
Sec. 5. Section 125.75, subsection 2, paragraph c,
subparagraph (1), Code 2017, is amended to read as follows:
(1) A written statement of a licensed physician or mental
health professional in support of the application.
Sec. 6. Section 125.78, subsection 3, paragraph b, Code
2017, is amended to read as follows:
b. Requiring an examination of the respondent, prior to
the hearing, by one or more licensed physicians or mental
health professionals who shall submit a written report of the
examination to the court as required by section 125.80 .
Sec. 7. Section 125.80, Code 2017, is amended to read as
follows:
125.80 Physician’s or mental health professional’s
examination —— report —— scheduling of hearing.
1. a. An examination of the respondent shall be conducted
within a reasonable time and prior to the commitment hearing by
one or more licensed physicians or mental health professionals
as required by the court’s order. If the respondent is taken
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into custody under section 125.81 , the examination shall be
conducted within twenty-four hours after the respondent is
taken into custody. If the respondent desires, the respondent
may have a separate examination by a licensed physician or
mental health professional of the respondent’s own choice.
The court shall notify the respondent of the right to choose
a licensed physician or mental health professional for a
separate examination. The reasonable cost of the examinations
shall be paid from county funds upon order of the court if the
respondent lacks sufficient funds to pay the cost.
b. A licensed physician or mental health professional
conducting an examination pursuant to this section may consult
with or request the participation in the examination of
facility personnel, and may include with or attach to the
written report of the examination any findings or observations
by facility personnel who have been consulted or have
participated in the examination.
c. If the respondent is not taken into custody under
section 125.81 , but the court is subsequently informed that the
respondent has declined to be examined by a licensed physician
or mental health professional pursuant to the court order,
the court may order limited detention of the respondent as
necessary to facilitate the examination of the respondent by
the licensed physician or mental health professional .
2. A written report of the examination by a court-designated
licensed physician or mental health professional shall be filed
with the clerk prior to the hearing date. A written report
of an examination by a licensed physician or mental health
professional chosen by the respondent may be similarly filed.
The clerk shall immediately:
a. Cause a report to be shown to the judge who issued the
order.
b. Cause the respondent’s attorney to receive a copy of
the report of a court-designated licensed physician or mental
health professional .
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3. If the report of a court-designated licensed physician or
mental health professional is to the effect that the respondent
is not a person with a substance-related disorder, the court,
without taking further action, may terminate the proceeding and
dismiss the application on its own motion and without notice.
4. If the report of a court-designated licensed physician or
mental health professional is to the effect that the respondent
is a person with a substance-related disorder, the court shall
schedule a commitment hearing as soon as possible. The hearing
shall be held not more than forty-eight hours after the report
is filed, excluding Saturdays, Sundays, and holidays, unless
an extension for good cause is requested by the respondent,
or as soon thereafter as possible if the court considers that
sufficient grounds exist for delaying the hearing.
Sec. 8. Section 125.82, subsection 3, Code 2017, is amended
to read as follows:
3. The person who filed the application and a licensed
physician, mental health professional as defined in section
228.1 , or certified alcohol and drug counselor certified by the
nongovernmental Iowa board of substance abuse certification who
has examined the respondent in connection with the commitment
hearing shall be present at the hearing, unless the court
for good cause finds that their presence or testimony is not
necessary. The applicant, respondent, and the respondent’s
attorney may waive the presence or telephonic appearance of the
licensed physician, mental health professional, or certified
alcohol and drug counselor who examined the respondent and
agree to submit as evidence the written report of the licensed
physician, mental health professional, or certified alcohol
and drug counselor. The respondent’s attorney shall inform
the court if the respondent’s attorney reasonably believes
that the respondent, due to diminished capacity, cannot make
an adequately considered waiver decision. “Good cause” for
finding that the testimony of the licensed physician, mental
health professional, or certified alcohol and drug counselor
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who examined the respondent is not necessary may include, but
is not limited to, such a waiver. If the court determines
that the testimony of the licensed physician, mental health
professional, or certified alcohol and drug counselor is
necessary, the court may allow the licensed physician, mental
health professional, or certified alcohol and drug counselor to
testify by telephone. The respondent shall be present at the
hearing unless prior to the hearing the respondent’s attorney
stipulates in writing that the attorney has conversed with the
respondent, and that in the attorney’s judgment the respondent
cannot make a meaningful contribution to the hearing, or that
the respondent has waived the right to be present, and the
basis for the attorney’s conclusions. A stipulation to the
respondent’s absence shall be reviewed by the court before the
hearing, and may be rejected if it appears that insufficient
grounds are stated or that the respondent’s interests would not
be served by the respondent’s absence.
Sec. 9. Section 125.86, subsection 3, paragraph b, Code
2017, is amended to read as follows:
b. An advanced registered nurse practitioner who is
not certified as a psychiatric advanced registered nurse
practitioner but who meets the qualifications set forth in the
definition of a mental health professional in section 228.1 ,
may complete periodic reports pursuant to paragraph “a” .
Sec. 10. Section 125.91, subsection 3, Code 2017, is amended
to read as follows:
3. The attending physician shall examine and may detain
the person pursuant to the magistrate’s order for a period not
to exceed forty-eight hours from the time the order is dated,
excluding Saturdays, Sundays, and holidays, unless the order is
dismissed by a magistrate. The facility may provide treatment
which is necessary to preserve the person’s life or to
appropriately control the person’s behavior if the behavior is
likely to result in physical injury to the person or others if
allowed to continue or is otherwise deemed medically necessary
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by the attending physician or mental health professional ,
but shall not otherwise provide treatment to the person
without the person’s consent. The person shall be discharged
from the facility and released from detention no later than
the expiration of the forty-eight-hour period, unless an
application for involuntary commitment is filed with the clerk
pursuant to section 125.75 . The detention of a person by the
procedure in this section , and not in excess of the period of
time prescribed by this section , shall not render the peace
officer, attending physician, or facility detaining the person
liable in a criminal or civil action for false arrest or false
imprisonment if the peace officer, attending physician, mental
health professional, or facility had reasonable grounds to
believe that the circumstances described in subsection 1 were
applicable.
Sec. 11. Section 125.92, subsection 4, Code 2017, is amended
to read as follows:
4. Enjoy all legal, medical, religious, social, political,
personal, and working rights and privileges, which the person
would enjoy if not detained, taken into immediate custody,
or committed, consistent with the effective treatment of the
person and of the other persons in the facility. If the
person’s rights are restricted, the physician’s or mental
health professional’s direction to that effect shall be noted
in the person’s record. The person or the person’s next of
kin or guardian shall be advised of the person’s rights and
be provided a written copy upon the person’s admission to or
arrival at the facility.
Sec. 12. Section 229.6, subsection 2, paragraph c,
subparagraph (1), Code 2017, is amended to read as follows:
(1) A written statement of a licensed physician or mental
health professional in support of the application.
Sec. 13. Section 229.8, subsection 3, paragraph b, Code
2017, is amended to read as follows:
b. Order an examination of the respondent, prior to
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the hearing, by one or more licensed physicians or mental
health professionals who shall submit a written report on the
examination to the court as required by section 229.10 .
Sec. 14. Section 229.10, Code 2017, is amended to read as
follows:
229.10 Physicians’ or mental health professionals’
examination —— report.
1. a. An examination of the respondent shall be
conducted by one or more licensed physicians or mental health
professionals , as required by the court’s order, within a
reasonable time. If the respondent is detained pursuant to
section 229.11, subsection 1 , paragraph “b” , the examination
shall be conducted within twenty-four hours. If the respondent
is detained pursuant to section 229.11, subsection 1 ,
paragraph “a” or “c” , the examination shall be conducted
within forty-eight hours. If the respondent so desires,
the respondent shall be entitled to a separate examination
by a licensed physician or mental health professional of
the respondent’s own choice. The reasonable cost of the
examinations shall, if the respondent lacks sufficient funds to
pay the cost, be paid by the regional administrator from mental
health and disability services region funds upon order of the
court.
b. Any licensed physician or mental health professional
conducting an examination pursuant to this section may consult
with or request the participation in the examination of any
consulting mental health professional, and may include with or
attach to the written report of the examination any findings
or observations by any consulting mental health professional
who has been so consulted or has so participated in the
examination.
c. If the respondent is not taken into custody under
section 229.11 , but the court is subsequently informed that
the respondent has declined to be examined by the one or more
licensed physician or physicians or mental health professionals
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pursuant to the court order, the court may order such limited
detention of the respondent as is necessary to facilitate the
examination of the respondent by the one or more licensed
physician or physicians or mental health professionals .
2. A written report of the examination by the one or more
court-designated physician or physicians or mental health
professionals shall be filed with the clerk prior to the time
set for hearing. A written report of any examination by a
physician chosen by the respondent may be similarly filed. The
clerk shall immediately do all of the following :
a. Cause the report or reports to be shown to the judge who
issued the order ; and .
b. Cause the respondent’s attorney to receive a copy of
the report of the court-designated physician or physicians or
reports .
3. If the report of one or more of the court-designated
physician or physicians or mental health professionals is
to the effect that the individual is not seriously mentally
impaired, the court may without taking further action terminate
the proceeding and dismiss the application on its own motion
and without notice.
4. If the report of one or more of the court-designated
physician or physicians or mental health professionals is
to the effect that the respondent is seriously mentally
impaired, the court shall schedule a hearing on the application
as soon as possible. The hearing shall be held not more
than forty-eight hours after the report is filed, excluding
Saturdays, Sundays and holidays, unless an extension for good
cause is requested by the respondent, or as soon thereafter as
possible if the court considers that sufficient grounds exist
for delaying the hearing.
Sec. 15. Section 229.22, subsection 2, paragraph a,
subparagraphs (2), (3), (4), and (5), Code 2017, are amended
to read as follows:
(2) Upon delivery of the person believed mentally ill to
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the facility or hospital, the examining physician, examining
physician assistant, examining mental health professional, or
examining psychiatric advanced registered nurse practitioner
may order treatment of that person, including chemotherapy,
but only to the extent necessary to preserve the person’s life
or to appropriately control behavior by the person which is
likely to result in physical injury to that person or others
if allowed to continue.
(3) The peace officer who took the person into custody,
or other party who brought the person to the facility or
hospital, shall describe the circumstances of the matter to the
examining physician, examining physician assistant, examining
mental health professional, or examining psychiatric advanced
registered nurse practitioner. If the person is a peace
officer, the peace officer may do so either in person or by
written report.
(4) If the examining physician, examining physician
assistant, examining mental health professional, or examining
psychiatric advanced registered nurse practitioner finds
that there is reason to believe that the person is seriously
mentally impaired, and because of that impairment is likely
to physically injure the person’s self or others if not
immediately detained, the examining physician, examining
physician assistant, examining mental health professional, or
examining psychiatric advanced registered nurse practitioner
shall at once communicate with the nearest available magistrate
as defined in section 801.4, subsection 10 .
(5) The magistrate shall, based upon the circumstances
described by the examining physician, examining physician
assistant, examining mental health professional, or examining
psychiatric advanced registered nurse practitioner, give the
examining physician, examining physician assistant, examining
mental health professional, or examining psychiatric advanced
registered nurse practitioner oral instructions either
directing that the person be released forthwith or authorizing
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the person’s detention in an appropriate facility. A peace
officer from the law enforcement agency that took the person
into custody, if available, during the communication with the
magistrate, may inform the magistrate that an arrest warrant
has been issued for or charges are pending against the person
and request that any oral or written order issued under this
subsection require the facility or hospital to notify the law
enforcement agency about the discharge of the person prior to
discharge. The magistrate may also give oral instructions and
order that the detained person be transported to an appropriate
facility.
Sec. 16. Section 229.22, subsection 3, Code 2017, is amended
to read as follows:
3. The chief medical officer of the facility or hospital
shall examine and may detain and care for the person taken
into custody under the magistrate’s order for a period not to
exceed forty-eight hours from the time such order is dated,
excluding Saturdays, Sundays and holidays, unless the order is
sooner dismissed by a magistrate. The facility or hospital may
provide treatment which is necessary to preserve the person’s
life, or to appropriately control behavior by the person
which is likely to result in physical injury to the person’s
self or others if allowed to continue, but may not otherwise
provide treatment to the person without the person’s consent.
The person shall be discharged from the facility or hospital
and released from custody not later than the expiration of
that period, unless an application is sooner filed with the
clerk pursuant to section 229.6 . Prior to such discharge the
facility or hospital shall, if required by this section , notify
the law enforcement agency requesting such notification about
the discharge of the person. The law enforcement agency shall
retrieve the person no later than six hours after notification
from the facility or hospital but in no circumstances shall the
detention of the person exceed the period of time prescribed
for detention by this subsection . The detention of any person
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by the procedure and not in excess of the period of time
prescribed by this section shall not render the peace officer,
physician, mental health professional, facility, or hospital
so detaining that person liable in a criminal or civil action
for false arrest or false imprisonment if the peace officer,
physician, mental health professional, facility, or hospital
had reasonable grounds to believe the person so detained was
mentally ill and likely to physically injure the person’s self
or others if not immediately detained, or if the facility
or hospital was required to notify a law enforcement agency
by this section , and the law enforcement agency requesting
notification prior to discharge retrieved the person no later
than six hours after the notification, and the detention prior
to the retrieval of the person did not exceed the period of
time prescribed for detention by this subsection .
Sec. 17. Section 229.23, subsection 3, Code 2017, is amended
to read as follows:
3. In addition to protection of the person’s constitutional
rights, enjoyment of other legal, medical, religious, social,
political, personal and working rights and privileges which
the person would enjoy if the person were not so hospitalized
or detained, so far as is possible consistent with effective
treatment of that person and of the other patients of the
hospital. If the patient’s rights are restricted, the
physician’s or mental health professional’s direction to
that effect shall be noted on the patient’s record. The
department of human services shall, in accordance with chapter
17A establish rules setting forth the specific rights and
privileges to which persons so hospitalized or detained are
entitled under this section , and the exceptions provided by
section 17A.2, subsection 11 , paragraphs “a” and “k”, shall not
be applicable to the rules so established. The patient or the
patient’s next of kin or friend shall be advised of these rules
and be provided a written copy upon the patient’s admission to
or arrival at the hospital.
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Sec. 18. Section 229.25, subsection 1, paragraph a,
subparagraph (1), Code 2017, is amended to read as follows:
(1) The information is requested by a licensed physician or
mental health professional , attorney , or advocate who provides
the chief medical officer with a written waiver signed by the
person about whom the information is sought.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill allows mental health professionals to perform
examinations, treat and prescribe treatment or medication, if
authorized to do so, and submit written statements and reports
as required or ordered by a court in accordance with certain
voluntary and involuntary hospitalization and commitment
proceedings for persons with a substance-related disorder or
serious mental illness.
A mental health professional is defined in Code section
228.1 as an individual who either holds at least a master’s
degree in a mental health field, a current license in this
state if practicing a licensed profession, and has at least two
years of post-degree clinical experience under the supervision
of another mental health professional assessing mental health
needs and providing appropriate mental health services; or the
individual holds a current license in this state if practicing
a licensed profession and is a psychiatrist, a licensed
advanced registered nurse practitioner who holds a national
certification in psychiatric mental health care, a physician
assistant practicing under the supervision of a psychiatrist,
or is licensed by the board of psychology and holds a doctorate
degree in psychology.
The bill allows a mental health professional to examine a
person when it appears that the person should be immediately
detained due to a serious mental impairment but an application
has not been filed naming the person as the respondent and the
person cannot be ordered into immediate custody and detained or
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when necessary to preserve the person’s life or appropriately
control the person’s behavior if physical injury to the
person or others is likely. The bill excludes mental health
professionals from liability for detaining a person in this
situation.
The bill excludes mental health professionals from civil or
criminal liability for the professional’s role in admitting a
person to a facility or hospital or providing treatment to a
person.
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