SF 406 –Involuntary Commitments and Mental Health Advocates
FLOOR ACTION:
SF 406: Background: Chapter 229 of the Iowa Code provides for the commitment of persons with mental illness. Those who are involuntarily committed are assigned an “advocate,” who is to follow them through the mental health system and advocate for them. There are problems with the existing system. Currently, counties hire and pay the advocates. Under this system, there is little consistency in qualifications, training and compensation for the advocates. In addition, although many of the advocates are dedicated and hardworking, under the present system they are really not accountable to anyone. As part of the mental health redesign, a Judicial Branch and Department of Human Services work group was established to look at issues related to the current involuntary commitment process. That workgroup met for several years, and this bill is a result of the recommendations that came out of those meetings. The Senate previously passed SF 406 and sent it to the House. The House amended the bill and sent it back to the Senate, which concurred with the House amendment.
As amended, the bill establishes an Office of Mental Health Advocate in the Department of Inspections and Appeals and specifies the duties of the director of the Division of Mental Health Advocate. The director’s duties will include appointing persons to serve as mental health advocates, training and supervising advocates and other staff, and implementing procedures for appointing, dismissing and supervising advocates. The minimum qualifications for mental health advocates include a bachelor’s degree from an accredited school, college or university in social work, counseling, human services, health, psychology or nursing, and one year of experience in the provision of mental health services. Licensed registered nurses who are current with applicable continuing education will meet the minimum qualifications. In addition, anyone serving as a mental health advocate at the county level as of June 30, 2013, is deemed to be automatically qualified to serve as an advocate in the new Division of Mental Health Advocate. The bill, as amended, also specifies that when there is a vacancy open for a mental health advocate position, the person appointed to fill that position must reside in the assigned geographic area.
The bill provides for a transition period of one year in order for the Department of Inspections and Appeals to organize and create the Division of Mental Health Advocate. In order to be the Division Director, a person must meet the qualifications for being an advocate.
The bill sunsets the involuntary commitment process set out in Chapter 222 for persons with an intellectual disability per the work group recommendation. These commitments are not used anymore; people pursue guardianships instead. If an involuntary commitment of a person with an intellectual disability is necessary, the process in Chapter 229 can be used.
The last division of the bill:
• Consolidates the application process for Chapters 125 (substance abuse) and 229 so that there will be one application when an interested person goes to a clerk of court office to pursue involuntary commitment. (Stakeholders said that many persons do not know whether the respondent has a substance abuse disorder or is mentally ill and thus don’t know which application to fill out.)
• Provides for a pre-application screening process for all applications pursuant to Chapters 125 and 229. This could divert persons from the involuntary commitment process while helping them connect with resources that are available for whatever issues they might be having.
• Requires the Department of Human Services to study the development of a hospital bed tracking system that will identify available beds for persons suffering from mental illness. [5/16: 47-0 (Behn, Houser, Kapucian excused)]