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Last updated January 2004
§ 229.1 Definitions.
As used in this
chapter, unless the context clearly requires otherwise:
1. "Administrator" means
the administrator of the department of human services assigned, in accordance
with section 218.1, to control the state mental health institutes, or that
administrator's designee.
2. "Auditor" means the
county auditor or the auditor's designee.
3. "Chemotherapy" means
treatment of an individual by use of a drug or substance which cannot legally
be delivered or administered to the ultimate user without a physician's
prescription or medical order.
4. "Chief medical officer"
means the medical director in charge of a public or private hospital, or that
individual's physician-designee. This chapter does not negate the authority
otherwise reposed by law in the respective superintendents of each of the state
hospitals for persons with mental illness, established by chapter 226, to make
decisions regarding the appropriateness of admissions or discharges of patients
of that hospital, however it is the intent of this chapter that if the
superintendent is not a licensed physician the decisions by the superintendent
shall be corroborated by the chief medical officer of the hospital.
5. "Clerk" means the clerk
of the district court.
6. "Hospital" means either
a public hospital or a private hospital.
7. "Licensed physician"
means an individual licensed under the provisions of chapter 148, 150, or 150A
to practice medicine and surgery, osteopathy, or osteopathic medicine and
surgery.
8. "Mental illness" means
every type of mental disease or mental disorder, except that it does not refer
to mental retardation as defined in section 222.2, subsection 4, or to
insanity, diminished responsibility, or mental incompetency as the terms are
defined and used in the Iowa criminal code or in the rules of criminal
procedure, Iowa court rules.
9. "Patient" means a person
who has been hospitalized or ordered hospitalized to receive treatment pursuant
to section 229.14.
10. "Private hospital" means
any hospital or institution not directly supported by public funds, or a part
thereof, which is equipped and staffed to provide inpatient care to persons
with mental illness.
11. "Public hospital" means:
a. A state mental health institute established
by chapter 226; or
b. The state psychiatric hospital
established by chapter 225; or
c. Any other publicly supported hospital or
institution, or part of such hospital or institution, which is equipped and
staffed to provide inpatient care to persons with mental illness, except the
Iowa medical and classification center established by chapter 904.
12. "Qualified mental health
professional" means an individual experienced in the study and
treatment of mental disorders in the capacity of:
a. A psychologist certified under chapter
154B; or
b. A registered nurse licensed under chapter
152; or
c. A social worker licensed under chapter
154C.
13. "Respondent" means any
person against whom an application has been filed under section 229.6, but who
has not been finally ordered committed for full-time custody, care and
treatment in a hospital.
14. "Serious emotional injury"
is an injury which does not necessarily exhibit any physical characteristics,
but which can be recognized and diagnosed by a licensed physician or other
qualified mental health professional and which can be causally connected with
the act or omission of a person who is, or is alleged to be, mentally ill.
15. "Seriously mentally
impaired" or "serious mental impairment" describes the
condition of a person with mental illness and because of that illness lacks
sufficient judgment to make responsible decisions with respect to the person's
hospitalization or treatment, and who because of that illness meets any of the
following criteria:
a. Is likely to physically injure the
person's self or others if allowed to remain at liberty without treatment.
b. Is likely to inflict serious emotional
injury on members of the person's family or others who lack reasonable
opportunity to avoid contact with the person with mental illness if the person
with mental illness is allowed to remain at liberty without treatment.
c. Is unable to satisfy the person's needs
for nourishment, clothing, essential medical care, or shelter so that it is
likely that the person will suffer physical injury, physical debilitation, or
death.
16. "Single entry point process"
means the same as defined in section 331.440.
§ 229.1A Legislative
intent.
As mental illness
is often a continuing condition which is subject to wide and unpredictable
changes in condition and fluctuations in reoccurrence and remission, this
chapter shall be liberally construed to give recognition to these medical
facts.
§ 229.1B Single
entry point process.
Notwithstanding
any provision of this chapter to the contrary, any person whose hospitalization
expenses are payable in whole or in part by a county shall be subject to all
requirements of the single entry point process.
§ 229.2 Application
for voluntary admission -- authority to receive voluntary patients.
1. An
application for admission to a public or private hospital for observation,
diagnosis, care, and treatment as a voluntary patient may be made by any person
who is mentally ill or has symptoms of mental illness.
In the case of a
minor, the parent, guardian, or custodian may make application for admission of
the minor as a voluntary patient.
a. Upon receipt of an application for
voluntary admission of a minor, the chief medical officer shall provide
separate prescreening interviews and consultations with the parent, guardian or
custodian and the minor to assess the family environment and the
appropriateness of the application for admission.
b. During the interview and consultation the
chief medical officer shall inform the minor orally and in writing that the
minor has a right to object to the admission. If the chief medical officer of
the hospital to which application is made determines that the admission is
appropriate but the minor objects to the admission, the parent, guardian or custodian
must petition the juvenile court for approval of the admission before the minor
is actually admitted.
c. As soon as is practicable after the
filing of a petition for juvenile court approval of the admission of the minor,
the juvenile court shall determine whether the minor has an attorney to
represent the minor in the hospitalization proceeding, and if not, the court
shall assign to the minor an attorney. If the minor is financially unable to
pay for an attorney, the attorney shall be compensated by the county at an
hourly rate to be established by the county board of supervisors in
substantially the same manner as provided in section 815.7.
d. The juvenile court shall determine
whether the admission is in the best interest of the minor and is consistent
with the minor's rights.
e. The juvenile court shall order
hospitalization of a minor, over the minor's objections, only after a hearing
in which it is shown by clear and convincing evidence that:
(1) The
minor needs and will substantially benefit from treatment.
(2) No
other setting which involves less restriction of the minor's liberties is
feasible for the purposes of treatment.
f. Upon approval of the admission of a minor
over the minor's objections, the juvenile court shall appoint an individual to
act as an advocate representing the interests of the minor in the same manner
as an advocate representing the interests of patients involuntarily
hospitalized pursuant to section 229.19.
2. Upon
receiving an application for admission as a voluntary patient, made pursuant to
subsection 1:
a. The chief medical officer of a public
hospital shall receive and may admit the person whose admission is sought,
subject in cases other than medical emergencies to availability of suitable
accommodations and to the provisions of sections 229.41 and 229.42.
b. The chief medical officer of a private
hospital may receive and may admit the person whose admission is sought.
§ 229.2A Dual
filings.
An application
for involuntary hospitalization of a respondent under this chapter may be filed
contemporaneously with an application for involuntary commitment or treatment
of the respondent under chapter 125.
§ 229.3 Discharge
of voluntary patients.
Any voluntary
patient who has recovered, or whose hospitalization the chief medical officer
of the hospital determines is no longer advisable, shall be discharged. Any
voluntary patient may be discharged if to do so would in the judgment of the
chief medical officer contribute to the most effective use of the hospital in
the care and treatment of that patient and of other persons with mental
illness.
§ 229.4 Right
to release on application.
A voluntary
patient who requests release or whose release is requested, in writing, by the
patient's legal guardian, parent, spouse or adult next of kin shall be released
from the hospital forthwith, except that:
1. If
the patient was admitted on the patient's own application and the request for
release is made by some other person, release may be conditioned upon the
agreement of the patient.
2. If
the patient is a minor who was admitted on the application of the patient's
parent, guardian or custodian pursuant to section 229.2, subsection 1, the
patient's release prior to becoming eighteen years of age may be conditioned upon
the consent of the parent, guardian or custodian, or upon the approval of the
juvenile court if the admission was approved by the juvenile court; and
3. If
the chief medical officer of the hospital, not later than the end of the next
secular day on which the office of the clerk of the district court for the
county in which the hospital is located is open and which follows the
submission of the written request for release of the patient, files with that
clerk a certification that in the chief medical officer's opinion the patient
is seriously mentally impaired, the release may be postponed for the period of
time the court determines is necessary to permit commencement of judicial
procedure for involuntary hospitalization. That period of time may not exceed
five days, exclusive of days on which the clerk's office is not open unless the
period of time is extended by order of a district court judge for good cause
shown. Until disposition of the application for involuntary hospitalization of
the patient, if one is timely filed, the chief medical officer may detain the
patient in the hospital and may provide treatment which is necessary to
preserve the patient's life, or to appropriately control behavior by the
patient which is likely to result in physical injury to the patient or to
others if allowed to continue, but may not otherwise provide treatment to the
patient without the patient's consent.
§ 229.5 Departure
without notice.
If a voluntary
patient departs from the hospital without notice, and in the opinion of the
chief medical officer the patient is seriously mentally impaired, the chief
medical officer may file an application for involuntary hospitalization of the
departed voluntary patient, and request that an order for immediate custody be
entered by the court pursuant to section 229.11.
§ 229.6 Application
for order of involuntary hospitalization.
Proceedings for
the involuntary hospitalization of an individual may be commenced by any
interested person by filing a verified application with the clerk of the
district court of the county where the respondent is presently located, or
which is the respondent's place of residence. The clerk, or the clerk's
designee, shall assist the applicant in completing the application. The
application shall:
1. State
the applicant's belief that the respondent is seriously mentally impaired.
2. State
any other pertinent facts.
3. Be
accompanied by:
a. A written statement of a licensed
physician in support of the application; or
b. One or more supporting affidavits
otherwise corroborating the application; or
c. Corroborative information obtained and
reduced to writing by the clerk or the clerk's designee, but only when
circumstances make it infeasible to comply with, or when the clerk considers it
appropriate to supplement the information supplied pursuant to, either
paragraph "a" or paragraph "b" of this
subsection.
§ 229.6A Hospitalization
of minors -- jurisdiction -- due process.
1. Notwithstanding
section 229.11, the juvenile court has exclusive original jurisdiction in
proceedings concerning a minor for whom an application for involuntary
admission is filed under section 229.6 or for whom an application for voluntary
admission is made under section 229.2, subsection 1, to which the minor
objects. In proceedings under this chapter concerning a minor, notwithstanding
section 229.11, the term "court", "judge", or
"clerk" means the juvenile court, judge, or clerk.
2. The
procedural requirements of this chapter are applicable to minors involved in
hospitalization proceedings pursuant to subsection 1 and placement proceedings
pursuant to section 229.14A.
3. It
is the intent of this chapter that when a minor is involuntarily or voluntarily
hospitalized or hospitalized with juvenile court approval over the minor's
objection the minor's family shall be included in counseling sessions offered
during the minor's stay in a hospital when feasible. Prior to the discharge of
the minor the juvenile court may, after a hearing, order that the minor's
family be evaluated and therapy ordered if necessary to facilitate the return
of the minor to the family setting.
§ 229.7 Service
of notice upon respondent.
Upon the filing
of an application for involuntary hospitalization, the clerk shall docket the
case and immediately notify a district court judge, district associate judge,
or magistrate who is admitted to the practice of law in this state, who shall
review the application and accompanying documentation. If the application is
adequate as to form, the court may set a time and place for a hearing on the
application, if feasible, but the hearing shall not be held less than
forty-eight hours after notice to the respondent unless the respondent waives
such minimum prior notice requirement. The court shall direct the clerk to send
copies of the application and supporting documentation, together with a notice
informing the respondent of the procedures required by this chapter, to the
sheriff or the sheriff's deputy for immediate service upon the respondent. If
the respondent is taken into custody under section 229.11, service of the
application, documentation and notice upon the respondent shall be made at the
time the respondent is taken into custody.
§ 229.8 Procedure
after application is filed.
As soon as
practicable after the filing of an application for involuntary hospitalization,
the court shall:
1. Determine
whether the respondent has an attorney who is able and willing to represent the
respondent in the hospitalization proceeding, and if not, whether the
respondent is financially able to employ an attorney and capable of
meaningfully assisting in selecting one. In accordance with those
determinations, the court shall if necessary allow the respondent to select, or
shall assign to the respondent, an attorney. If the respondent is financially
unable to pay an attorney, the attorney shall be compensated by the county at
an hourly rate to be established by the county board of supervisors in
substantially the same manner as provided in section 815.7.
2. Cause
copies of the application and supporting documentation to be sent to the county
attorney or the county attorney's attorney-designate for review.
3. Issue
a written order which shall:
a. If not
previously done, set a time and place for a hospitalization hearing, which
shall be at the earliest practicable time not less than forty-eight hours after
notice to the respondent, unless the respondent waives such minimum prior
notice requirement; and
b. Order an
examination of the respondent, prior to the hearing, by one or more licensed
physicians who shall submit a written report on the examination to the court as
required by section 229.10.
§ 229.9 Respondent's
attorney informed.
The court shall
direct the clerk to furnish at once to the respondent's attorney copies of the
application for involuntary hospitalization of the respondent and the
supporting documentation, and of the court's order issued pursuant to section
229.8, subsection 3. If the respondent is taken into custody under section
229.11, the attorney shall also be advised of that fact. The respondent's
attorney shall represent the respondent at all stages of the proceedings, and
shall attend the hospitalization hearing.
§ 229.9A Advocate
informed.
The court shall
direct the clerk to furnish the advocate of the respondent's county of legal
settlement with a copy of application and any order issued pursuant to section
229.8, subsection 3. The advocate may attend the hospitalization hearing of any
respondent for whom the advocate has received notice of a hospitalization
hearing.
§ 229.10 Physicians'
examination -- report.
1. An
examination of the respondent shall be conducted by one or more licensed
physicians, as required by the court's order, within a reasonable time. If the
respondent is detained pursuant to section 229.11, subsection 2, the
examination shall be conducted within twenty-four hours. If the respondent is
detained pursuant to section 229.11, subsection 1 or 3, 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
of the respondent's own choice. The reasonable cost of such separate
examination shall, if the respondent lacks sufficient funds to pay the cost, be
paid from county funds upon order of the court.
Any licensed
physician conducting an examination pursuant to this section may consult with
or request the participation in the examination of any qualified mental health
professional, and may include with or attach to the written report of the
examination any findings or observations by any qualified mental health
professional who has been so consulted or has so participated in the
examination.
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 licensed
physician or physicians 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 licensed physician or physicians.
2. A
written report of the examination by the court-designated physician or
physicians 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:
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.
3. If
the report of the court-designated physician or physicians 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 the court-designated physician or physicians 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.
§ 229.11 Judge
may order immediate custody.
If the applicant
requests that the respondent be taken into immediate custody and the judge,
upon reviewing the application and accompanying documentation, finds probable
cause to believe that the respondent has a serious mental impairment and is
likely to injure the respondent or other persons if allowed to remain at
liberty, the judge may enter a written order directing that the respondent be
taken into immediate custody by the sheriff or the sheriff's deputy and be
detained until the hospitalization hearing. The hospitalization hearing shall
be held no more than five days after the date of the order, except that if the
fifth day after the date of the order is a Saturday, Sunday, or a holiday, the
hearing may be held on the next succeeding business day. If the expenses of a
respondent are payable in whole or in part by a county, for a placement in
accordance with subsection 1, the judge shall give notice of the placement to
the single entry point process, and for a placement in accordance with
subsection 2 or 3, the judge shall order the placement in a hospital or
facility designated through the single entry point process. The judge may order
the respondent detained for the period of time until the hearing is held, and
no longer, in accordance with subsection 1 if possible, and if not then in
accordance with subsection 2 or, only if neither of these alternatives is
available, in accordance with subsection 3. Detention may be:
1. In
the custody of a relative, friend or other suitable person who is willing to
accept responsibility for supervision of the respondent, and the respondent may
be placed under such reasonable restrictions as the judge may order including,
but not limited to, restrictions on or a prohibition of any expenditure,
encumbrance or disposition of the respondent's funds or property; or
2. In
a suitable hospital the chief medical officer of which shall be informed of the
reasons why immediate custody has been ordered and may provide treatment which
is necessary to preserve the respondent's life, or to appropriately control
behavior by the respondent which is likely to result in physical injury to the
respondent or to others if allowed to continue, but may not otherwise provide
treatment to the respondent without the respondent's consent; or
3. In
the nearest facility in the community which is licensed to care for persons
with mental illness or substance abuse, provided that detention in a jail or
other facility intended for confinement of those accused or convicted of crime
shall not be ordered.
The clerk shall
furnish copies of any orders to the respondent and to the applicant if the
applicant files a written waiver signed by the respondent.
§ 229.12 Hearing
procedure.
1. At
the hospitalization hearing, evidence in support of the contentions made in the
application shall be presented by the county attorney. During the hearing the
applicant and the respondent shall be afforded an opportunity to testify and to
present and cross-examine witnesses, and the court may receive the testimony of
any other interested person. The respondent has the right to be present at the
hearing. If the respondent exercises that right and has been medicated within
twelve hours, or such longer period of time as the court may designate, prior
to the beginning of the hearing or an adjourned session thereof, the judge
shall be informed of that fact and of the probable effects of the medication
upon convening of the hearing.
2. All
persons not necessary for the conduct of the proceeding shall be excluded,
except that the court may admit persons having a legitimate interest in the
proceeding and shall permit the advocate from the respondent's county of legal
settlement to attend the hearing. Upon motion of the county attorney, the judge
may exclude the respondent from the hearing during the testimony of any
particular witness if the judge determines that witness's testimony is likely
to cause the respondent severe emotional trauma.
3. The
respondent's welfare shall be paramount and the hearing shall be conducted in
as informal a manner as may be consistent with orderly procedure, but
consistent therewith the issue shall be tried as a civil matter. Such discovery
as is permitted under the
4. If
the respondent is not taken into custody under section 229.11, but the court
subsequently finds good cause to believe that the respondent is about to depart
from the jurisdiction of the court, the court may order such limited detention
of the respondent as is authorized by section 229.11 and is necessary to insure
that the respondent will not depart from the jurisdiction of the court without
the court's approval until the proceeding relative to the respondent has been
concluded.
5. The
clerk shall furnish copies of any orders to the respondent and to the applicant
if the applicant files a written waiver signed by the respondent.
§ 229.13 Evaluation
order -- treatment -- unauthorized departure or failure to appear.
1. If
upon completion of the hospitalization hearing the court finds by clear and
convincing evidence that the respondent has a serious mental impairment, the
court shall order the respondent committed as expeditiously as possible for a
complete psychiatric evaluation and appropriate treatment as follows:
a. The court shall
order a respondent whose expenses are payable in whole or in part by a county
placed under the care of an appropriate hospital or facility designated through
the single entry point process on an inpatient or outpatient basis.
b. The court shall
order any other respondent placed under the care of an appropriate hospital or
facility licensed to care for persons with mental illness or substance abuse on
an inpatient or outpatient basis.
2. The
court shall provide notice to the respondent and the respondent's attorney of
the placement order under subsection 1. The court shall advise the respondent
and the respondent's attorney that the respondent has a right to request a
placement hearing held in accordance with the requirements of section 229.14A.
3. If
the respondent is ordered at a hearing to undergo outpatient treatment, the
outpatient treatment provider must be notified and agree to provide the
treatment prior to placement of the respondent under the treatment provider's
care.
4. The
court shall furnish to the chief medical officer of the hospital or facility at
the time the respondent arrives at the hospital or facility for inpatient or
outpatient treatment a written finding of fact setting forth the evidence on
which the finding is based. If the respondent is ordered to undergo outpatient
treatment, the order shall also require the respondent to cooperate with the
treatment provider and comply with the course of treatment.
5. The
chief medical officer of the hospital or facility at which the respondent is
placed shall report to the court no more than fifteen days after the respondent
is placed, making a recommendation for disposition of the matter. An extension
of time may be granted, not to exceed seven days upon a showing of cause. A
copy of the report shall be sent to the respondent's attorney, who may contest
the need for an extension of time if one is requested. An extension of time
shall be granted upon request unless the request is contested, in which case
the court shall make such inquiry as it deems appropriate and may either order
the respondent's release from the hospital or facility or grant an extension of
time for psychiatric evaluation. If the chief medical officer fails to report
to the court within fifteen days after the individual is placed under the care
of the hospital or facility, and an extension of time has not been requested,
the chief medical officer is guilty of contempt and shall be punished under
chapter 665. The court shall order a rehearing on the application to determine
whether the respondent should continue to be detained at or placed under the
care of the facility.
6. If,
after placement of a respondent in or under the care of a hospital or other
suitable facility for inpatient treatment, the respondent departs from the
hospital or facility or fails to appear for treatment as ordered without prior
proper authorization from the chief medical officer, upon receipt of
notification of the respondent's departure or failure to appear by the chief
medical officer, a peace officer of the state shall without further order of
the court exercise all due diligence to take the respondent into protective
custody and return the respondent to the hospital or facility.
§ 229.14 Chief
medical officer's report.
1. The
chief medical officer's report to the court on the psychiatric evaluation of
the respondent shall be made not later than the expiration of the time
specified in section 229.13. At least two copies of the report shall be filed
with the clerk, who shall dispose of them in the manner prescribed by section
229.10, subsection 2. The report shall state one of the four following
alternative findings:
a. That the
respondent does not, as of the date of the report, require further treatment
for serious mental impairment. If the report so states, the court shall order
the respondent's immediate release from involuntary hospitalization and terminate
the proceedings.
b. That the
respondent is seriously mentally impaired and in need of full-time custody,
care and inpatient treatment in a hospital, and is considered likely to benefit
from treatment. The report shall include the chief medical officer's
recommendation for further treatment.
c. That the
respondent is seriously mentally impaired and in need of treatment, but does
not require full-time hospitalization. If the report so states, it shall
include the chief medical officer's recommendation for treatment of the
respondent on an outpatient or other appropriate basis.
d. The respondent
is seriously mentally impaired and in need of full-time custody and care, but
is unlikely to benefit from further inpatient treatment in a hospital. The
report shall include the chief medical officer's recommendation for an
appropriate alternative placement for the respondent.
2. Following
receipt of the chief medical officer's report under subsection 1, paragraph "b",
"c", or "d", the court shall issue an order
for appropriate treatment as follows:
a. For a
respondent whose expenses are payable in whole or in part by a county,
placement as designated through the single entry point process in the care of
an appropriate hospital or facility on an inpatient or outpatient basis, or
other appropriate treatment, or in an appropriate alternative placement.
b. For any other
respondent, placement in the care of an appropriate hospital or facility on an
inpatient or outpatient basis, or other appropriate treatment, or an
appropriate alternative placement.
c. For a respondent who is an inmate in the
custody of the department of corrections, the court may order the respondent to
receive mental health services in a correctional program.
d. If the court orders treatment of the
respondent on an outpatient or other appropriate basis as described in the
chief medical officer's report pursuant to subsection 1, paragraph "c",
the order shall provide that, should the respondent fail or refuse to submit to
treatment in accordance with the court's order, the court may order that the
respondent be taken into immediate custody as provided by section 229.11 and,
following notice and hearing held in accordance with the procedures of section
229.12, may order the respondent treated on an inpatient basis requiring
full-time custody, care, and treatment in a hospital until such time as the
chief medical officer reports that the respondent does not require further
treatment for serious mental impairment or has indicated the respondent is
willing to submit to treatment on another basis as ordered by the court. If a
patient is transferred for treatment to another provider under this paragraph,
the treatment provider who will be providing the outpatient or other
appropriate treatment shall be provided with copies of relevant court orders by
the former treatment provider.
§ 229.14A Placement
order -- notice and hearing.
1. With
respect to a chief medical officer's report made pursuant to section 229.14,
subsection 1, paragraph "b", "c", or "d",
or any other provision of this chapter related to involuntary commitment for
which the court issues a placement order or a transfer of placement is
authorized, the court shall provide notice to the respondent and the
respondent's attorney or mental health advocate pursuant to section 229.19
concerning the placement order and the respondent's right to request a
placement hearing to determine if the order for placement or transfer of
placement is appropriate.
2. The
notice shall provide that a request for a placement hearing must be in writing
and filed with the clerk within seven days of issuance of the placement order.
3. A
request for a placement hearing may be signed by the respondent, the
respondent's next friend, guardian, or attorney.
4. The
court, on its own motion, may order a placement hearing to be held.
5.
a. A placement
hearing shall be held no sooner than four days and no later than seven days
after the request for the placement hearing is filed unless otherwise agreed to
by the parties.
b. The respondent may be transferred to the
placement designated by the court's placement order and receive treatment
unless a request for hearing is filed prior to the transfer. If the request for
a placement hearing is filed prior to the transfer, the court shall determine
where the respondent shall be detained and treated until the date of the
hearing.
c. If the respondent's attorney has
withdrawn pursuant to section 229.19, the court shall appoint an attorney for
the respondent in the manner described in section 229.8, subsection 1.
6. Time
periods shall be calculated for the purposes of this section excluding weekends
and official holidays.
7. If
a respondent's expenses are payable in whole or in part by a county through the
single entry point process, notice of a placement hearing shall be provided to
the county attorney and the county's single entry point process administrator.
At the hearing, the county may present evidence regarding appropriate
placement.
8. In
a placement hearing, the court shall determine a placement for the respondent
in accordance with the requirements of section 229.23, taking into
consideration the evidence presented by all the parties.
9. A
placement made pursuant to an order entered under section 229.13 or 229.14 or
this section shall be considered to be authorized through the single entry
point process.
§ 229.14B Escape
from custody.
A person who is
placed in a hospital or other suitable facility for evaluation under section
229.13 or who is required to remain hospitalized for treatment under section
229.14 shall remain at that hospital or facility unless discharged or otherwise
permitted to leave by the court or the chief medical officer of the hospital or
facility. If a person placed at a hospital or facility or required to remain at
a hospital or facility leaves the facility without permission or without having
been discharged, the chief medical officer may notify the sheriff of the
person's absence and the sheriff shall take the person into custody and return
the person promptly to the hospital or facility.
§ 229.15 Periodic
reports required.
1. Not
more than thirty days after entry of an order for continued hospitalization of
a patient under section 229.14, subsection 1, paragraph "b",
and thereafter at successive intervals of not more than sixty days continuing
so long as involuntary hospitalization of the patient continues, the chief
medical officer of the hospital shall report to the court which entered the
order. The report shall be submitted in the manner required by section 229.14,
shall state whether the patient's condition has improved, remains unchanged, or
has deteriorated, and shall indicate if possible the further length of time the
patient will be required to remain at the hospital. The chief medical officer
may at any time report to the court a finding as stated in section 229.14,
subsection 1, and the court shall act upon the finding as required by section
229.14, subsection 2.
2. Not
more than sixty days after the entry of a court order for treatment of a
patient pursuant to a report issued under section 229.14, subsection 1,
paragraph "c", and thereafter at successive intervals as
ordered by the court but not to exceed ninety days so long as that court order
remains in effect, the medical director of the facility treating the patient
shall report to the court which entered the order. The report shall state
whether the patient's condition has improved, remains unchanged, or has
deteriorated, and shall indicate if possible the further length of time the
patient will require treatment by the facility. If at any time the patient
without good cause fails or refuses to submit to treatment as ordered by the
court, the medical director shall at once so notify the court, which shall
order the patient hospitalized as provided by section 229.14, subsection 2,
paragraph "d", unless the court finds that the failure or
refusal was with good cause and that the patient is willing to receive
treatment as provided in the court's order, or in a revised order if the court
sees fit to enter one. If at any time the medical director reports to the court
that in the director's opinion the patient requires full-time custody, care and
treatment in a hospital, and the patient is willing to be admitted voluntarily
to the hospital for these purposes, the court may enter an order approving
hospitalization for appropriate treatment upon consultation with the chief
medical officer of the hospital in which the patient is to be hospitalized. If
the patient is unwilling to be admitted voluntarily to the hospital, the
procedure for determining involuntary hospitalization, as set out in section
229.14, subsection 2, paragraph "d", shall be followed.
3. When
a patient has been placed in an alternative facility other than a hospital
pursuant to a report issued under section 229.14, subsection 1, paragraph "d",
a report on the patient's condition and prognosis shall be made to the court
which placed the patient, at least once every six months, unless the court
authorizes annual reports. If an evaluation of the patient is performed
pursuant to section 227.2, subsection 4, a copy of the evaluation report shall
be submitted to the court within fifteen days of the evaluation's completion.
The court may in its discretion waive the requirement of an additional report
between the annual evaluations. If the administrator exercises the authority to
remove residents from a county care facility or other county or private
institution under section 227.6, the administrator shall promptly notify each
court which placed in that facility any resident so removed.
4.
a. When in the
opinion of the chief medical officer the best interest of a patient would be
served by a convalescent or limited leave, the chief medical officer may
authorize the leave and, if authorized, shall promptly report the leave to the
court. When in the opinion of the chief medical officer the best interest of a
patient would be served by a transfer to a different hospital for continued
full-time custody, care, and treatment, the chief medical officer shall
promptly send a report to the court. The court shall act upon the report in
accordance with section 229.14A.
b. This subsection shall not be construed to
add to or restrict the authority otherwise provided by law for transfer of
patients or residents among various state institutions administered by the
department of human services. If a patient is transferred under this
subsection, the treatment provider to whom the patient is transferred shall be
provided with copies of relevant court orders by the former treatment provider.
5. Upon
receipt of any report required or authorized by this section the court shall
furnish a copy to the patient's attorney, or alternatively to the advocate
appointed as required by section 229.19. The court shall examine the report and
take the action thereon which it deems appropriate. Should the court fail to
receive any report required by this section or section 229.14 at the time the
report is due, the court shall investigate the reason for the failure to report
and take whatever action may be necessary in the matter.
§ 229.16 Discharge
and termination of proceeding.
When the
condition of a patient who is hospitalized pursuant to a report issued under
section 229.14, subsection 1, paragraph "b", or is receiving
treatment pursuant to a report issued under section 229.14, subsection 1,
paragraph "c", or is in full-time care and custody pursuant to
a report issued under section 229.14, subsection 1, paragraph "d",
is such that in the opinion of the chief medical officer the patient no longer
requires treatment or care for serious mental impairment, the chief medical
officer shall tentatively discharge the patient and immediately report that
fact to the court which ordered the patient's hospitalization or care and
custody. Upon receiving the report, the court shall issue an order confirming
the patient's discharge from the hospital or from care and custody, as the case
may be, and shall terminate the proceedings pursuant to which the order was
issued. Copies of the order shall be sent by regular mail to the hospital, the
patient, and the applicant if the applicant has filed a written waiver signed
by the patient.
§ 229.17 Status
of respondent during appeal.
If a respondent
appeals to the supreme court from a finding that the contention the respondent
is seriously mentally impaired has been sustained, and the respondent was
previously ordered taken into immediate custody under section 229.11 or has
been hospitalized for psychiatric evaluation and appropriate treatment under
section 229.13 before the court is informed of intent to appeal its finding,
the respondent shall remain in custody as previously ordered by the court, the
time limit stated in section 229.11 notwithstanding, or shall remain in the hospital
subject to compliance by the hospital with sections 229.13 to 229.16, as the
case may be, unless the supreme court orders otherwise. If a respondent appeals
to the supreme court regarding a placement order, the respondent shall remain
in placement unless the supreme court orders otherwise.
§ 229.18 Status
of respondent if hospitalization is delayed.
When the court
directs that a respondent who was previously ordered taken into immediate
custody under section 229.11 be placed in a hospital for psychiatric evaluation
and appropriate treatment under section 229.13, and no suitable hospital can
immediately admit the respondent, the respondent shall remain in custody as
previously ordered by the court, the time limit stated in section 229.11
notwithstanding, until a suitable hospital can admit the respondent. The court
shall take appropriate steps to expedite the admission of the respondent to a
suitable hospital at the earliest feasible time.
§ 229.19 Advocates
-- duties -- compensation -- state and county liability.
The district
court in each county with a population of under three hundred thousand
inhabitants and the board of supervisors in each county with a population of
three hundred thousand or more inhabitants shall appoint an individual who has
demonstrated by prior activities an informed concern for the welfare and
rehabilitation of persons with mental illness, and who is not an officer or
employee of the department of human services nor of any agency or facility
providing care or treatment to persons with mental illness, to act as advocate
representing the interests of patients involuntarily hospitalized by the court,
in any matter relating to the patients' hospitalization or treatment under
section 229.14 or 229.15. The court or, if the advocate is appointed by the
county board of supervisors, the board shall assign the advocate appointed from
a patient's county of legal settlement to represent the interests of the
patient. If a patient has no county of legal settlement, the court or, if the advocate
is appointed by the county board of supervisors, the board shall assign the
advocate appointed from the county where the hospital or facility is located to
represent the interests of the patient. The advocate's responsibility with
respect to any patient shall begin at whatever time the attorney employed or
appointed to represent that patient as respondent in hospitalization
proceedings, conducted under sections 229.6 to 229.13, reports to the court
that the attorney's services are no longer required and requests the court's
approval to withdraw as counsel for that patient. However, if the patient is
found to be seriously mentally impaired at the hospitalization hearing, the
attorney representing the patient shall automatically be relieved of responsibility
in the case and an advocate shall be assigned to the patient at the conclusion
of the hearing unless the attorney indicates an intent to continue the
attorney's services and the court so directs. If the court directs the attorney
to remain on the case the attorney shall assume all the duties of an advocate.
The clerk shall furnish the advocate with a copy of the court's order approving
the withdrawal and shall inform the patient of the name of the patient's
advocate. With regard to each patient whose interests the advocate is required
to represent pursuant to this section, the advocate's duties shall include all
of the following:
1. To
review each report submitted pursuant to sections 229.14 and 229.15.
2. If
the advocate is not an attorney, to advise the court at any time it appears
that the services of an attorney are required to properly safeguard the
patient's interests.
3. To
make the advocate readily accessible to communications from the patient and to
originate communications with the patient within five days of the patient's
commitment.
4. To
visit the patient within fifteen days of the patient's commitment and
periodically thereafter.
5. To
communicate with medical personnel treating the patient and to review the
patient's medical records pursuant to section 229.25.
6. To
file with the court quarterly reports, and additional reports as the advocate
feels necessary or as required by the court, in a form prescribed by the court.
The reports shall state what actions the advocate has taken with respect to
each patient and the amount of time spent.
The hospital or
facility to which a patient is committed shall grant all reasonable requests of
the advocate to visit the patient, to communicate with medical personnel
treating the patient and to review the patient's medical records pursuant to
section 229.25. An advocate shall not disseminate information from a patient's
medical records to any other person unless done for official purposes in
connection with the advocate's duties pursuant to this chapter or when required
by law.
The court or, if
the advocate is appointed by the county board of supervisors, the board shall
prescribe reasonable compensation for the services of the advocate. The
compensation shall be based upon the reports filed by the advocate with the
court. The advocate's compensation shall be paid by the county in which the
court is located, either on order of the court or, if the advocate is appointed
by the county board of supervisors, on the direction of the board. If the advocate
is appointed by the court, the advocate is an employee of the state for
purposes of chapter 669. If the advocate is appointed by the county board of
supervisors, the advocate is an employee of the county for purposes of chapter
670. If the patient or the person who is legally liable for the patient's
support is not indigent, the board shall recover the costs of compensating the
advocate from that person. If that person has an income level as determined
pursuant to section 815.9 greater than one hundred percent but not more than
one hundred fifty percent of the poverty guidelines, at least one hundred
dollars of the advocate's compensation shall be recovered in the manner
prescribed by the county board of supervisors. If that person has an income level
as determined pursuant to section 815.9 greater than one hundred fifty percent
of the poverty guidelines, at least two hundred dollars of the advocate's
compensation shall be recovered in substantially the same manner prescribed by
the county board of supervisors as provided in section 815.7.
§ 229.20 Respondents
charged with or convicted of crime.
Repealed by 84 Acts, ch 1323, § 7.
§ 229.21 Judicial
hospitalization referee -- appeals to district court.
1. The
chief judge of each judicial district may appoint at least one judicial
hospitalization referee for each county within the district. The judicial
hospitalization referee shall be an attorney, licensed to practice law in this
state, who shall be chosen with consideration to any training, experience,
interest, or combination of those factors, which are pertinent to the duties of
the office. The referee shall hold office at the pleasure of the chief judge of
the judicial district and receive compensation at a rate fixed by the supreme
court. If the referee expects to be absent for any significant length of time,
the referee shall inform the chief judge who may appoint a temporary substitute
judicial hospitalization referee having the qualifications set forth in this
subsection.
2. When
an application for involuntary hospitalization under this chapter or an
application for involuntary commitment or treatment of chronic substance
abusers under sections 125.75 to 125.94 is filed with the clerk of the district
court in any county for which a judicial hospitalization referee has been
appointed, and no district judge, district associate judge, or magistrate who
is admitted to the practice of law in this state is accessible, the clerk shall
immediately notify the referee in the manner required by section 229.7 or
section 125.77. The referee shall discharge all of the duties imposed upon the
court by sections 229.7 to 229.22 or sections 125.75 to 125.94 in the
proceeding so initiated. Subject to the provisions of subsection 4, orders
issued by a referee, in discharge of duties imposed under this section, shall
have the same force and effect as if ordered by a district judge. However, any
commitment to a facility regulated and operated under chapter 135C, shall be in
accordance with section 135C.23.
3.
a. Any respondent
with respect to whom the magistrate or judicial hospitalization referee has
found the contention that the respondent is seriously mentally impaired or a
chronic substance abuser sustained by clear and convincing evidence presented
at a hearing held under section 229.12 or section 125.82, may appeal from the
magistrate's or referee's finding to a judge of the district court by giving
the clerk notice in writing, within ten days after the magistrate's or
referee's finding is made, that an appeal is taken. The appeal may be signed by
the respondent or by the respondent's next friend, guardian, or attorney.
b. An order of a
magistrate or judicial hospitalization referee with a finding that the
respondent is seriously mentally impaired or a chronic substance abuser shall
include the following notice, located conspicuously on the face of the
order:
"NOTE: The
respondent may appeal from this order to a judge of the district court by
giving written notice of the appeal to the clerk of the district court within
ten days after the date of this order. The appeal may be signed by the
respondent or by the respondent's next friend, guardian, or attorney. For a
more complete description of the respondent's appeal rights, consult section
229.21 of the Code of Iowa or an attorney."
c. When appealed,
the matter shall stand for trial de novo. Upon appeal, the court shall schedule
a hospitalization or commitment hearing before a district judge at the earliest
practicable time.
d. Any respondent with respect to whom the
magistrate or judicial hospitalization referee has held a placement hearing and
has entered a placement order may appeal the order to a judge of the district
court. The request for appeal must be given to the clerk in writing within ten
days of the entry of the magistrate's or referee's order. The request for
appeal shall be signed by the respondent, or the respondent's next friend,
guardian, or attorney.
4. If
the appellant is in custody under the jurisdiction of the district court at the
time of service of the notice of appeal, the appellant shall be discharged from
custody unless an order that the appellant be taken into immediate custody has
previously been issued under section 229.11 or section 125.81, in which case
the appellant shall be detained as provided in that section until the
hospitalization or commitment hearing before the district judge. If the
appellant is in the custody of a hospital or facility at the time of service of
the notice of appeal, the appellant shall be discharged from custody pending
disposition of the appeal unless the chief medical officer, not later than the
end of the next secular day on which the office of the clerk is open and which
follows service of the notice of appeal, files with the clerk a certification
that in the chief medical officer's opinion the appellant is seriously mentally
ill or a substance abuser. In that case, the appellant shall remain in custody
of the hospital or facility until the hospitalization or commitment hearing
before the district court.
5. The
hospitalization or commitment hearing before the district judge shall be held,
and the judge's finding shall be made and an appropriate order entered, as
prescribed by sections 229.12 and 229.13 or sections 125.82 and 125.83. If the
judge orders the appellant hospitalized or committed for a complete psychiatric
or substance abuse evaluation, jurisdiction of the matter shall revert to the
judicial hospitalization referee.
§ 229.22 Hospitalization
-- emergency procedure.
1. The
procedure prescribed by this section shall not be used unless it appears that a
person should be immediately detained due to serious mental impairment, but
that person cannot be immediately detained by the procedure prescribed in
sections 229.6 and 229.11 because there is no means of immediate access to the
district court.
2. In
the circumstances described in subsection 1, any peace officer who has
reasonable grounds to believe that a person is mentally ill, and because of
that illness is likely to physically injure the person's self or others if not
immediately detained, may without a warrant take or cause that person to be
taken to the nearest available facility as defined in section 229.11,
subsections 2 and 3. A person believed mentally ill, and likely to injure the person's
self or others if not immediately detained, may be delivered to a hospital by
someone other than a peace officer. Upon delivery of the person believed
mentally ill to the hospital, the chief medical officer 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. The peace officer who took the person into custody, or
other party who brought the person to the hospital, shall describe the
circumstances of the matter to the chief medical officer. If the chief medical
officer 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 chief medical officer
shall at once communicate with the nearest available magistrate as defined in
section 801.4, subsection 10. The magistrate shall, based upon the
circumstances described by the chief medical officer, give the chief medical
officer verbal instructions either directing that the person be released
forthwith or authorizing the person's continued detention at that facility. In
the latter case, the magistrate shall:
a. By the close of
business on the next working day, file with the clerk a written report stating
the substance of the information on the basis of which the person's continued
detention was ordered; and
b. Proceed to the
facility where the person is being detained within twenty-four hours of giving
instructions that the person be detained.
3. Upon
arrival at the hospital, the magistrate shall at once review the matter. Unless
convinced upon initial inquiry that there are no grounds for further detention
of the person, the magistrate shall in the manner prescribed by section 229.8,
subsection 1 insure that the person has or is provided legal counsel at the
earliest practicable time, and shall arrange for the counsel to be present, if
practicable, before proceeding further under this section. If the magistrate
finds upon review of the report prepared by the chief medical officer under
subsection 2 of this section, and of such other information or evidence as the
magistrate deems pertinent, that there is probable cause 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 detained, the
magistrate shall enter a written order for the person to be detained in custody
and, if the facility where the person is at that time is not an appropriate
hospital, transported to an appropriate hospital. The magistrate's order shall
state the circumstances under which the person was taken into custody or
otherwise brought to a hospital and the grounds supporting the finding of
probable cause to believe that the person is seriously mentally impaired and
likely to physically injure the person's self or others if not immediately
detained. The order shall be filed with the clerk of the district court in the
county where it is anticipated that an application will be filed under section
229.6, and a certified copy of the order shall be delivered to the chief
medical officer of the hospital where the person is detained, at the earliest
practicable time.
4. The
chief medical officer of the 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 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 hospital and released
from custody not later than the expiration of that period, unless an
application for the person's involuntary hospitalization is sooner filed with
the clerk pursuant to section 229.6. The detention of any person by the
procedure and not in excess of the period of time prescribed by this section
shall not render the peace officer, physician or hospital so detaining that
person liable in a criminal or civil action for false arrest or false
imprisonment if the peace officer, physician 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.
5. The
cost of hospitalization at a public hospital of a person detained temporarily by
the procedure prescribed in this section shall be paid in the same way as if
the person had been admitted to the hospital by the procedure prescribed in
sections 229.6 to 229.13.
§ 229.23 Rights
and privileges of hospitalized persons.
Every person who is
hospitalized or detained under this chapter shall have the right to:
1. Prompt
evaluation, necessary psychiatric services, and additional care and treatment
as indicated by the patient's condition. A comprehensive, individualized
treatment plan shall be timely developed following issuance of the court order
requiring involuntary hospitalization. The plan shall be consistent with
current standards appropriate to the facility to which the person has been
committed and with currently accepted standards for psychiatric treatment of
the patient's condition, including chemotherapy, psychotherapy, counseling and
other modalities as may be appropriate.
2. The
right to refuse treatment by shock therapy or chemotherapy, unless the use of
these treatment modalities is specifically consented to by the patient's next
of kin or guardian. The patient's right to refuse treatment by chemotherapy
shall not apply during any period of custody authorized by section 229.4,
subsection 3, section 229.11 or section 229.22, but this exception shall extend
only to chemotherapy treatment which is, in the chief medical officer's
judgment, necessary to preserve the patient'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. The patient's right to refuse treatment by
chemotherapy shall also not apply during any period of custody authorized by
the court pursuant to section 229.13 or 229.14. In any other situation in
which, in the chief medical officer's judgment, chemotherapy is appropriate for
the patient but the patient refuses to consent thereto and there is no next of
kin or guardian to give consent, the chief medical officer may request an order
authorizing treatment of the patient by chemotherapy from the district court
which ordered the patient's hospitalization.
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 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.
§ 229.24 Records
of involuntary hospitalization proceeding to be confidential.
1. All
papers and records pertaining to any involuntary hospitalization or application
for involuntary hospitalization of any person under this chapter, whether part
of the permanent record of the court or of a file in the department of human
services, are subject to inspection only upon an order of the court for good
cause shown. Nothing in this section shall prohibit a hospital from complying
with the requirements of this chapter and of chapter 230 relative to financial
responsibility for the cost of care and treatment provided a patient in that
hospital, nor from properly billing any responsible relative or third-party
payer for such care and treatment.
2. If
authorized in writing by a person who has been the subject of any proceeding or
report under sections 229.6 to 229.13 or section 229.22, or by the parent or
guardian of that person, information regarding that person which is
confidential under subsection 1 may be released to any designated person.
3. If
all or part of the costs associated with hospitalization of an individual under
this chapter are chargeable to a county of legal settlement, the clerk of the
district court shall provide to the county of legal settlement and to the
county in which the hospitalization order is entered, in a form prescribed by
the mental health and developmental disabilities commission, the following
information pertaining to the individual which would be confidential under
subsection 1:
a. Administrative
information, as defined in section 228.1.
b. An evaluation
order under this chapter and the location of the individual's placement under
the order.
c. A
hospitalization or placement order under this chapter and the location of the
individual's placement under the order.
d. The date,
location, and disposition of any hearing concerning the individual held under
this chapter.
e. Any payment source available for the
costs of the individual's care.
§ 229.25 Medical
records to be confidential -- exceptions.
The records
maintained by a hospital or other facility relating to the examination,
custody, care and treatment of any person in that hospital or facility pursuant
to this chapter shall be confidential, except that the chief medical officer
shall release appropriate information under any of the following circumstances:
1. The
information is requested by a licensed physician, attorney or advocate who provides
the chief medical officer with a written waiver signed by the person about whom
the information is sought.
2. The
information is sought by a court order.
3. The
person who is hospitalized or that person's guardian, if the person is a minor
or is not legally competent to do so, signs an informed consent to release
information. Each signed consent shall designate specifically the person or
agency to whom the information is to be sent, and the information may be sent
only to that person or agency.
Such records may
be released by the chief medical officer when requested for the purpose of
research into the causes, incidence, nature and treatment of mental illness,
however information shall not be provided in a way that discloses patients'
names or which otherwise discloses any patient's identity.
When the chief
medical officer deems it to be in the best interest of the patient and the
patient's next of kin to do so, the chief medical officer may release
appropriate information during a consultation which the hospital or facility
shall arrange with the next of kin of a voluntary or involuntary patient, if
requested by the patient's next of kin.
§ 229.26 Exclusive
procedure for involuntary hospitalization.
Sections 229.6
through 229.19 constitute the exclusive procedure for involuntary
hospitalization of persons by reason of serious mental impairment in this
state, except that this chapter does not negate the provisions of section
904.503 relating to transfer of prisoners with mental illness to state
hospitals for persons with mental illness and does not apply to commitments of
persons under chapter 812 or the rules of criminal procedure, Iowa court rules,
or negate the provisions of section 232.51 relating to disposition of children
with mental illness or mental retardation.
§ 229.27 Hospitalization
not to equate with incompetency -- procedure for finding incompetency due to
mental illness.
1. Hospitalization
of a person under this chapter, either voluntarily or involuntarily, does not
constitute a finding of nor equate with nor raise a presumption of
incompetency, nor cause the person so hospitalized to be deemed a person of
unsound mind nor a person under legal disability for any purpose, including but
not limited to any circumstances to which sections 6B.15, 447.7, 487.402,
subsection 5, paragraph "b", sections 487.705, 597.6, 600B.21,
614.8, 614.19, 614.22, 614.24, 614.27, and 633.244 are applicable.
2. The
applicant may, in initiating a petition for involuntary hospitalization of a
person under section 229.6 or at any subsequent time prior to conclusion of the
involuntary hospitalization proceeding, also petition the court for a finding
that the person is incompetent by reason of mental illness. The test of
competence for the purpose of this section shall be whether the person
possesses sufficient mind to understand in a reasonable manner the nature and
effect of the act in which the person is engaged; the fact that a person is
mentally ill and in need of treatment for that illness but because of the
illness lacks sufficient judgment to make responsible decisions with respect to
the person's hospitalization or treatment does not necessarily mean that that
person is incapable of transacting business on any subject.
3. A
hearing limited to the question of the person's competence and conducted in
substantially the manner prescribed in sections 633.552 to 633.556 shall be
held when:
a. The court is
petitioned or proposes upon its own motion to find incompetent by reason of
mental illness a person whose involuntary hospitalization has been ordered
under section 229.13 or 229.14, and who contends that the person is not
incompetent; or
b. A person
previously found incompetent by reason of mental illness under subsection 2
petitions the court for a finding that the person is no longer incompetent and,
after notice to the applicant who initiated the petition for hospitalization of
the person and to any other party as directed by the court, an objection is
filed with the court. The court may order a hearing on its own motion before
acting on a petition filed under this paragraph. A petition by a person for a
finding that the person is no longer incompetent may be filed at any time
without regard to whether the person is at that time hospitalized for treatment
of mental illness.
4. Nothing
in this chapter shall preclude use of any other procedure authorized by law for
declaring any person legally incompetent for reasons which may include mental
illness, without regard to whether that person is or has been hospitalized for
treatment of mental illness.
§ 229.28 Hospitalization
in certain federal facilities.
When a court
finds that the contention that a respondent is seriously mentally impaired has
been sustained or proposes to order continued hospitalization of any person, or
an alternative placement, as described under section 229.14, subsection 1,
paragraph "b" or "d", and the court is
furnished evidence that the respondent or patient is eligible for care and
treatment in a facility operated by the veterans administration or another
agency of the United States government and that the facility is willing to
receive the respondent or patient, the court may so order. The respondent or
patient, when so hospitalized or placed in a facility operated by the veterans
administration or another agency of the United States government within or
outside of this state, shall be subject to the rules of the veterans
administration or other agency, but shall not thereby lose any procedural
rights afforded the respondent or patient by this chapter. The chief officer of
the facility shall have, with respect to the person so hospitalized or placed,
the same powers and duties as the chief medical officer of a hospital in this
state would have in regard to submission of reports to the court, retention of
custody, transfer, convalescent leave or discharge. Jurisdiction is retained in
the court to maintain surveillance of the person's treatment and care, and at
any time to inquire into that person's mental condition and the need for
continued hospitalization or care and custody.
§ 229.29 Transfer
to certain federal facilities.
Upon receipt of a
certificate stating that any person involuntarily hospitalized under this
chapter is eligible for care and treatment in a facility operated by the
veterans administration or another agency of the United States government which
is willing to receive the person without charge to the state of Iowa or any
county in the state, the chief medical officer may transfer the person to that
facility. Upon so doing, the chief medical officer shall notify the court which
ordered the person's hospitalization in the same manner as would be required in
the case of a transfer under section 229.15, subsection 4, and the person
transferred shall be entitled to the same rights as the person would have under
that subsection. No person shall be transferred under this section who is
confined pursuant to conviction of a public offense or whose hospitalization
was ordered upon contention of incompetence to stand trial by reason of mental
illness, without prior approval of the court which ordered that person's
hospitalization.
§ 229.30 Orders
of courts in other states.
A judgment or
order of hospitalization or commitment by a court of competent jurisdiction of
another state or the District of Columbia, under which any person is
hospitalized or placed in a facility operated by the veterans administration or
another agency of the United States government, shall have the same force and
effect with respect to that person while the person is in this state as the
judgment or order would have if the person were in the jurisdiction of the
court which issued it. That court shall be deemed to have retained jurisdiction
of the person so hospitalized or placed for the purpose of inquiring into that
person's mental condition and the need for continued hospitalization or care
and custody, as do courts in this state under section 229.28. Consent is hereby
given to the application of the law of the state or district in which is
situated the court which issued the judgment or order as regards authority of
the chief officer of any facility, operated in this state by the veterans
administration or another agency of the United States government, to retain
custody, transfer, place on convalescent leave or discharge th e person so
hospitalized or committed.
§ 229.31 Commission
of inquiry.
A sworn
complaint, alleging that a named person is not seriously mentally impaired and
is unjustly deprived of liberty in any hospital in the state, may be filed by
any person with the clerk of the district court of the county in which such
named person is so confined, or of the county in which such named person has a
legal settlement, and thereupon a judge of said court shall appoint a
commission of not more than three persons to inquire into the truth of said
allegations. One of said commissioners shall be a physician and if additional
commissioners are appointed, one of such commissioners shall be a lawyer.
§ 229.32 Duty
of commission.
Said commission
shall at once proceed to the place where said person is confined and make a
thorough and discreet examination for the purpose of determining the truth of
said allegations and shall promptly report its findings to said judge in
writing. Said report shall be accompanied by a written statement of the case
signed by the chief medical officer of the hospital in which the person is
confined.
§ 229.33 Hearing.
If, on such
report and statement, and the hearing of testimony if any is offered, the judge
shall find that such person is not seriously mentally impaired, the judge shall
order the person's discharge; if the contrary, the judge shall so state, and
authorize the continued detention of the person, subject to all applicable
requirements of this chapter.
§ 229.34 Finding
and order filed.
The finding and
order of the judge, with the report and other papers, shall be filed in the
office of the clerk of the court where the complaint was filed. Said clerk
shall enter a memorandum thereof on the appropriate record, and forthwith
notify the chief medical officer of the hospital of the finding and order of
the judge, and the chief medical officer shall carry out the order.
§ 229.35 Compensation
-- payment.
Said
commissioners shall be entitled to their necessary expenses and a reasonable
compensation, to be allowed by the judge, who shall certify the same to the
director of revenue and finance who shall thereupon draw the proper warrants on
any funds in the state treasury not otherwise appropriated. The applicant shall
pay said costs and expenses if the judge shall so order on a finding that the
complaint was filed without probable cause.
§ 229.36 Limitation
on proceedings.
The proceeding
authorized in sections 229.31 to 229.35, inclusive, shall not be had oftener
than once in six months regarding the same person; nor regarding any patient
within six months after the patient's admission to the hospital.
§ 229.37 Habeas
corpus.
All persons
confined as seriously mentally impaired shall be entitled to the benefit of the
writ of habeas corpus, and the question of serious mental impairment shall be
decided at the hearing. If the judge shall decide that the person is seriously
mentally impaired, such decision shall be no bar to the issuing of the writ a
second time, whenever it shall be alleged that such person is no longer
seriously mentally impaired.
§ 229.38 Cruelty
or official misconduct.
If any person
having the care of a person with mental illness who has voluntarily entered a
hospital or other facility for treatment or care, or who is responsible for
psychiatric examination care, treatment, and maintenance of any person
involuntarily hospitalized under sections 229.6 to 229.15, whether in a
hospital or elsewhere, with or without proper authority, shall treat such patient
with unnecessary severity, harshness, or cruelty, or in any way abuse the
patient or if any person unlawfully detains or deprives of liberty any person
with mental illness or any person who is alleged to have mental illness, or if
any officer required by the provisions of this chapter and chapters 226 and
227, to perform any act shall willfully refuse or neglect to perform the same,
the offending person shall, unless otherwise provided, be guilty of a serious
misdemeanor.
§ 229.39 Status
of persons hospitalized under former law.
1. Each
person admitted or committed to a hospital for treatment of mental illness on
or before December 31, 1975 who remained so hospitalized, or was on
convalescent leave or was receiving care in another facility on transfer from
such hospitalization, on or after January 1, 1976 shall be considered to have
been hospitalized under this chapter, and its provisions shall apply to each
such person on and after the effective date of this section, except as
otherwise provided by subsection 3.
2. Hospitalization
of a person for treatment of mental illness, either voluntary or involuntary,
on or before December 31, 1975 does not constitute a finding nor equate with
nor raise a presumption of incompetency, nor cause the person hospitalized to
be deemed a person of unsound mind nor a person under legal disability for any
purpose, including but not limited to the circumstances enumerated in section
229.27, subsection 1. This subsection does not invalidate any specific
declaration of incompetence of a person hospitalized if the declaration was
made pursuant to a separate procedure authorized by law for that purpose, and
did not result automatically from the person's hospitalization.
3. Where
a person was hospitalized involuntarily for treatment of mental illness on or
before December 31, 1975 and remained so hospitalized, or was on convalescent
leave or was receiving care in another facility on transfer from such
hospitalization, on or after January 1, 1976, but was subsequently discharged
prior to July 1, 1978, this section shall not be construed to require:
a. The filing
after July 1, 1978 of any report relative to that person's status which would
have been required to be filed prior to said date if that person had initially
been hospitalized under this chapter as amended by Acts of the Sixty-sixth
General Assembly, 1975 Session, chapter 139, sections 1 to 30.
b. That legal
proceedings be taken under this chapter, as so amended, to clarify the status
of the person so hospitalized, unless that person or the district court
considers such proceedings necessary in a particular case to appropriately
conclude the matter.
§ 229.40 Rules
for proceedings.
Proceedings under
this chapter are subject to rules prescribed by the supreme court under section
602.4201.
§ 229.41 Voluntary
admission.
Persons making
application pursuant to section 229.2 on their own behalf or on behalf of
another person who is under eighteen years of age, if the person whose
admission is sought is received for observation and treatment on the
application, shall be required to pay the costs of hospitalization at rates
established by the administrator. The costs may be collected weekly in advance
and shall be payable at the business office of the hospital. The collections shall
be remitted to the department of human services monthly to be credited to the
general fund of the state.
§ 229.42 Costs
paid by county.
If a person
wishing to make application for voluntary admission to a mental hospital
established by chapter 226 is unable to pay the costs of hospitalization or
those responsible for the person are unable to pay the costs, application for
authorization of voluntary admission must be made through a single entry point
process before application for admission is made to the hospital. The person's
county of legal settlement shall be determined through the single entry point
process and if the admission is approved through the single entry point
process, the person's admission to a mental health hospital shall be authorized
as a voluntary case. The authorization shall be issued on forms provided by the
administrator. The costs of the hospitalization shall be paid by the county of
legal settlement to the department of human services and credited to the
general fund of the state, provided that the mental health hospital rendering
the services has certified to the county auditor of the county of legal
settlement the amount chargeable to the county and has sent a duplicate
statement of the charges to the department of human services. A county shall
not be billed for the cost of a patient unless the patient's admission is
authorized through the single entry point process. The mental health institute
and the county shall work together to locate appropriate alternative placements
and services, and to educate patients and family members of patients regarding
such alternatives.
All the
provisions of chapter 230 shall apply to such voluntary patients so far as is
applicable.
The provisions of
this section and of section 229.41 shall apply to all voluntary inpatients or
outpatients receiving mental health services either away from or at the
institution.
If a county fails
to pay the billed charges within forty-five days from the date the county
auditor received the certification statement from the superintendent, the
department of human services shall charge the delinquent county the penalty of
one percent per month on and after forty-five days from the date the county
received the certification statement until paid. The penalties received shall
be credited to the general fund of the state.
§ 229.43 Nonresidents
or no-settlement patients.
The administrator
may place patients of mental health institutes who have no county of legal
settlement, who are nonresidents, or whose legal settlement is unknown on
convalescent leave to a private sponsor or in a health care facility licensed
under chapter 135C, when in the opinion of the administrator the placement is
in the best interests of the patient and the state of Iowa. If the patient was
involuntarily hospitalized, the district court which ordered hospitalization of
the patient must be informed when the patient is placed on convalescent leave,
as required by section 229.15, subsection 4.
§ 229.44 Venue.
1. Venue
for hospitalization proceedings shall be in the county where the respondent is
found, unless the matter is transferred pursuant to
2. After
an order is entered pursuant to section 229.13 or 229.14, the court may
transfer proceedings to the court of any county having venue at any further
stage in the proceeding as follows:
a. When it appears
that the best interests of the respondent or the convenience of the parties
will be served by a transfer, the court may transfer the case to the court of
the county of the respondent's residence.
b. When it appears
that the best interests of the respondent or the convenience of the parties
will be served by a transfer, the court may transfer the case to the court of
the county where the respondent is found.
3. If
a proceeding is transferred, the court shall contact the court in the county
which is to be the recipient of the transfer before entering the order to
transfer the case. The court shall then transfer the case by ordering a
transfer of the matter to the recipient county, by ordering a continuance of
the matter in the transferring county, and by forwarding to the clerk of the
receiving court a certified copy of all papers filed, together with the order
of transfer. The referee of the receiving court may accept the filings of the
transferring court or may direct the filing of a new application and may hear
the case anew.
§ 229.45 Provision
of summary of procedures to applicant in involuntary commitment.
The department of
human services, in consultation with the office of attorney general, shall
develop a summary of the procedures involved in an involuntary commitment and
information concerning the participation of an applicant in the proceedings.
The summary shall be provided by the department, at the department's expense,
to the clerks of the district court who shall make the summary available to all
applicants prior to the filing of a verified application, or to any other
person upon request, and who shall attach a copy of the summary to the notice
of hearing which is served upon the respondent under section 125.77 or 229.7.
The summary may include, but is not limited to, the following:
1. The
statutory criteria for ordering that a person be involuntarily committed under
chapter 125 or sections 229.11 and 229.13.
2. A
description of the hearing process.
3. An
explanation of the applicant's right to testify and examples of the kinds of
relevant information which may be introduced at the hearing.
4. An
explanation of the duties of the county attorney in civil commitment
proceedings.
§ 229.50 through
229.53
Repealed by 82
Acts, ch 1212, § 28.
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