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Mental Health Advocates Bill Moves Forward

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The Senate Judiciary Committee made sure that an important piece of the ongoing redesign of the MH/DS system survived today's (April 5) funnel deadline.  Senate File 406 makes the changes recommended by Department of Human Services/Judicial Work Group, including streamlining the involuntary commitment process, moving oversight of the state's 43 Mental Health Advocates to the state, and directing DHS to develop recommendations for a real-time tracking system for inpatient psychiatric beds.

Mental Health Advocates.  Mental Health Advocates are currently hired and employed by the courts, but paid for by the counties.  The DHS/Judiciary Work Group felt it was very important for the Mental Health Advocates to be free of conflict, and, since counties, DHS, and the courts all are part of that hospitalization process, the Work Group suggested moving them to an independent state agency. Senate File 406 addresses this by making Mental Health Advocates employees of the Department of Human Rights, which already has advocacy as a part of its mission. However, the House decided to change this to the Department of Inspections and Appeals, as recommended by the work group. During committee debate this week, it was pointed out that currently, because of legal settlement, Mental Health Advocates travel all over the state because they are required to appear in the county of legal settlement (not necessarily the county where the person is being hospitalized).  With the end to legal settlement, the Work Group thought the timing was right to realign the Mental Health Advocates with the new region.

Psychiatric Hospital Bed Tracking.  It's no secret that Iowa has a shortage of psychiatric inpatient hospital beds.  Stories like the two that were told during the subcommittee meeting on Senate File 406 are all too common.  A sheriff's deputy reported driving a patient 720 miles in one day, driving city to city trying to find an open bed, all while the person in crisis was in the backseat of the car.  Another person told of two sheriff's deputies coming from two different areas of the state, both headed for Woodbury County where there was one hospital bed available.  Others told of the hours spent on the phone trying to find an available bed.  Senate File 406 directs the Department of Human Services to make recommendations on the development of a real-time psychiatric inpatient hospitalization bed tracking system that would show how many beds the state has, where those beds are at, what types of beds they are, and their availability in real time.  It would allow a sheriff to log into a system, find the nearest bed, call to have a hold placed on it, and deliver the person, saving time and allowing sheriffs to concentrate on other public safety matters.

While the bill has survived the funnel, there is still some uncertainty about the bill because it does create new state employees (which cost money) and funds for this have not yet been identified.  Rep. Chip Baltimore, Rep. Dave Heaton and Rep. Mark Smith are the key legislators on this issue.