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House
File
385
-
Reprinted
HOUSE
FILE
385
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HF
124)
(As
Amended
and
Passed
by
the
House
March
20,
2025
)
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
HF
385
(2)
91
dg/ko/md
H.F.
385
Section
1.
Section
125.2,
Code
2025,
is
amended
by
adding
1
the
following
new
subsections:
2
NEW
SUBSECTION
.
01.
“Administrative
services
organization”
3
means
the
same
as
defined
in
section
225A.1.
4
001.
“Behavioral
health
district”
means
the
same
as
defined
5
in
section
225A.1.
6
Sec.
2.
Section
125.85,
subsection
4,
Code
2025,
is
amended
7
by
striking
the
subsection.
8
Sec.
3.
Section
125.85,
Code
2025,
is
amended
by
adding
the
9
following
new
subsections:
10
NEW
SUBSECTION
.
6.
Prior
to
a
discharge
of
a
respondent
11
under
this
section,
the
facility
treating
the
respondent
shall
12
do
all
of
the
following:
13
a.
Refer
the
respondent
to
an
administrative
services
14
organization
for
evaluation,
system
navigation,
and
15
postdischarge
services.
16
b.
Assess
the
respondent
for
suicide
risk.
17
c.
Provide
the
respondent
with
a
fifteen-day
supply
of
18
each
medication
prescribed
for
the
respondent
before
or
19
during
the
respondent’s
treatment,
including
psychiatric
and
20
nonpsychiatric
medications.
If
payment
for
a
medication
21
provided
under
this
paragraph
is
not
covered
by
insurance
or
22
Medicaid,
the
facility
may
make
a
request
for
reimbursement
23
from
an
administrative
services
organization
for
the
cost
of
24
the
medication.
25
d.
Provide
the
respondent
or
the
respondent’s
legal
26
representative
with
a
discharge
report.
The
discharge
report
27
shall
include
all
of
the
following:
28
(1)
The
respondent’s
name
and
address.
29
(2)
The
dates,
times,
and
locations
of
all
postdischarge
30
appointments
scheduled
for
the
respondent.
31
(3)
A
list
of
each
medication
provided
to
the
respondent
32
under
paragraph
“c”
.
33
(4)
Contact
information
for
the
administrative
services
34
organization
to
which
the
respondent
was
referred
under
35
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385
paragraph
“a”
.
1
(5)
A
written
patient-centered
aftercare
plan,
including
2
crisis
prevention
and
steps
to
address
the
respondent’s
ongoing
3
care
needs.
4
(6)
(a)
Educational
materials
for
the
respondent
and
5
individuals
who
are
willing
to
support
the
respondent
after
the
6
respondent’s
discharge.
7
(b)
Educational
materials
shall
be
developed
by
the
8
department
for
distribution
to
facilities.
Educational
9
materials
shall
include
but
not
be
limited
to
all
of
the
10
following:
11
(i)
Descriptions
of
the
symptoms
of
a
substance
use
12
disorder.
13
(ii)
Warning
signs
of
decompensation.
14
(iii)
Information
regarding
the
availability
of
other
15
educational
services,
services
offered
in
the
respondent’s
16
community,
and
services
offered
statewide.
17
e.
Notify
all
of
the
following
persons:
18
(1)
The
administrative
services
organization
to
which
the
19
respondent
was
referred
under
paragraph
“a”
.
20
(2)
The
respondent’s
legal
guardian,
parent,
spouse,
21
attorney
in
fact
under
chapter
144B,
or
adult
siblings,
as
22
applicable.
23
NEW
SUBSECTION
.
7.
a.
The
administrative
services
24
organization
to
which
a
respondent
was
referred
under
25
subsection
6,
paragraph
“a”
,
shall
do
all
of
the
following
in
26
relation
to
the
discharged
respondent:
27
(1)
Coordinate
postdischarge
care,
including
but
not
28
limited
to
contacting
the
respondent
to
ensure
the
respondent
29
attends
scheduled
appointments
and
receives
necessary
care
and
30
services.
31
(2)
Follow
up
with
the
respondent
in
a
timely
manner.
32
Follow-ups
shall
include
but
not
be
limited
to
home
visits,
33
telephone
calls,
and
other
means
of
contacting
the
respondent.
34
b.
An
administrative
services
organization
may
delegate
35
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6
H.F.
385
duties
required
under
this
subsection
to
a
managed
care
1
organization
acting
pursuant
to
a
contract
with
the
department
2
to
administer
the
Medicaid
program
under
chapter
249A,
if
the
3
respondent
referred
to
the
administrative
services
organization
4
qualifies
for
Medicaid.
5
NEW
SUBSECTION
.
8.
a.
Each
administrative
services
6
organization
shall
make
a
quarterly
report
to
the
department,
7
and
the
report
shall
include
all
of
the
following:
8
(1)
The
number
of
respondents
discharged
and
referred
to
9
the
administrative
services
organization
during
the
reporting
10
period.
11
(2)
The
outcome
of
each
discharged
respondent.
12
(3)
Any
issues
encountered
while
ensuring
each
respondent’s
13
postdischarge
continuity
of
care.
14
b.
A
report
under
this
section
shall
be
considered
a
15
confidential
record
under
section
22.7.
16
c.
A
report
under
this
section
shall
comply
with
the
federal
17
Health
Insurance
Portability
and
Accountability
Act
of
1996,
18
Pub.
L.
No.
104-191.
19
NEW
SUBSECTION
.
9.
Following
a
respondent’s
discharge
from
20
a
facility
or
from
treatment,
the
administrator
of
the
facility
21
shall
immediately
report
the
discharge
to
the
court
which
22
ordered
the
respondent’s
commitment
or
treatment.
The
court
23
shall
issue
an
order
confirming
the
respondent’s
discharge
24
and
terminating
the
proceedings
in
which
the
respondent’s
25
commitment
or
treatment
was
ordered.
Copies
of
the
order
26
confirming
the
discharge
and
terminating
the
proceedings
shall
27
be
sent
by
regular
mail
to
the
facility
and
the
respondent.
28
NEW
SUBSECTION
.
10.
The
department
shall
adopt
rules
29
pursuant
to
chapter
17A
to
implement
and
administer
this
30
section.
31
Sec.
4.
Section
229.1,
Code
2025,
is
amended
by
adding
the
32
following
new
subsections:
33
NEW
SUBSECTION
.
01.
“Administrative
services
organization”
34
means
the
same
as
defined
in
section
225A.1.
35
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HF
385
(2)
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dg/ko/md
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6
H.F.
385
001.
“Behavioral
health
district”
means
the
same
as
defined
1
in
section
225A.1.
2
Sec.
5.
Section
229.16,
Code
2025,
is
amended
to
read
as
3
follows:
4
229.16
Discharge
and
termination
of
proceeding.
5
1.
When
the
condition
of
,
in
the
opinion
of
the
chief
6
medical
officer,
a
patient
who
is
hospitalized
pursuant
to
a
7
report
issued
whose
treatment
was
recommended
under
section
8
229.14,
subsection
1
,
paragraph
“b”
,
or
is
receiving
treatment
9
pursuant
to
a
report
issued
under
section
229.14,
subsection
10
1
,
paragraph
“c”
,
or
is
in
full-time
care
and
custody
pursuant
11
to
a
report
issued
under
section
229.14,
subsection
1
,
12
paragraph
“d”
,
is
such
that
in
the
opinion
of
the
chief
medical
13
officer
the
patient
no
longer
requires
treatment
or
care
for
14
serious
mental
impairment,
the
chief
medical
officer
shall
15
tentatively
discharge
the
patient
and
immediately
report
that
16
fact
the
discharge
to
the
court
which
ordered
the
patient’s
17
hospitalization
or
care
and
custody
treatment
.
Upon
receiving
18
the
report,
the
court
shall
issue
an
order
confirming
the
19
patient’s
discharge
from
the
hospital
or
from
care
and
custody,
20
as
the
case
may
be,
and
shall
terminate
terminating
the
21
proceedings
pursuant
to
in
which
the
order
patient’s
treatment
22
was
issued
ordered
.
Copies
of
the
order
shall
be
sent
by
23
regular
mail
to
the
hospital,
the
patient,
and
the
applicant
if
24
the
applicant
has
filed
a
written
waiver
signed
by
the
patient.
25
2.
If
a
patient
is
receiving
inpatient
care,
prior
to
a
26
discharge
of
the
patient
under
subsection
1,
the
facility
or
27
hospital
treating
the
patient
shall
do
all
of
the
following:
28
a.
Refer
the
patient
to
an
administrative
services
29
organization
for
evaluation,
system
navigation,
and
30
postdischarge
services.
31
b.
Assess
the
patient
for
suicide
risk.
32
c.
Provide
the
patient
with
a
fifteen-day
supply
of
each
33
medication
prescribed
for
the
patient
before
or
during
the
34
patient’s
treatment,
including
psychiatric
and
nonpsychiatric
35
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385
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6
H.F.
385
medications.
If
payment
for
a
medication
provided
under
this
1
paragraph
is
not
covered
by
insurance
or
Medicaid,
the
facility
2
may
make
a
request
for
reimbursement
from
an
administrative
3
services
organization
for
the
cost
of
the
medication.
4
d.
Provide
the
patient
or
the
patient’s
legal
representative
5
with
a
discharge
report.
The
discharge
report
shall
include
6
all
of
the
following:
7
(1)
The
patient’s
name
and
address.
8
(2)
The
dates,
times,
and
locations
of
all
postdischarge
9
appointments
scheduled
for
the
patient.
10
(3)
A
list
of
each
medication
provided
to
the
patient
under
11
paragraph
“c”
.
12
(4)
Contact
information
for
the
administrative
services
13
organization
to
which
the
patient
was
referred
under
paragraph
14
“a”
.
15
(5)
A
written
patient-centered
aftercare
plan,
including
16
crisis
prevention
and
steps
to
address
the
patient’s
ongoing
17
care
needs.
18
(6)
(a)
Educational
materials
for
the
patient
and
19
individuals
who
are
willing
to
support
the
patient
after
the
20
patient’s
discharge.
21
(b)
Educational
materials
shall
be
developed
by
the
22
department
for
distribution
to
facilities
and
hospitals
23
treating
persons
with
a
mental
illness.
Educational
materials
24
shall
include
but
not
be
limited
to
all
of
the
following:
25
(i)
Descriptions
of
the
symptoms
of
mental
illness.
26
(ii)
Warning
signs
of
decompensation.
27
(iii)
Information
regarding
the
availability
of
other
28
educational
services,
services
offered
in
the
patient’s
29
community,
and
services
offered
statewide.
30
e.
Notify
all
of
the
following
persons:
31
(1)
The
administrative
services
organization
to
which
the
32
patient
was
referred
under
paragraph
“a”
.
33
(2)
The
patient’s
legal
guardian,
parent,
spouse,
attorney
34
in
fact
under
chapter
144B,
or
adult
siblings,
as
applicable.
35
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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
patient’s
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
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HF
385
(2)
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dg/ko/md
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6