Iowa lawmakers are working to require hospitals take better care of discharged mental health patients under a bill being considered in the Iowa legislature.
House File 385 would require hospitals to provide a 15-day supply of medication for discharged mental health patients who were committed involuntarily. The legislation would also require hospitals to provide the patients with dates and times for scheduled follow-up appointments as well as other resources.
Hospitals would also be required to notify the patient’s family and the courts about that individual’s release.
The bill passed the house unanimously on March 20 and now awaits consideration in the Iowa Senate.
The proposed bill is at a standstill as hospitals in the state evaluate how this legislation will impact not only the patients but the hospitals themselves.
The bill was first proposed over two years ago by retired physical therapist and Iowa Mental Health Advocacy member Leslie Carpenter.
Carpenter originally proposed the legislation to Iowa Rep. Ann Meyer, R-Fort Dodge, who had helped lead the charge since then.
“Care coordination needs to happen after someone comes out of the hospital, especially the first time,” Carpenter said. “If they don’t have care coordinated for them, it is not surprising that some are not staying consistent with their treatment. Intensive case management and support is what makes the difference.”
Carpenter has been advocating for the bill’s spot on the debate schedule and hopes to see movement soon.
As the proposed bill is still making its way through the system, more attention has been paid to what this would mean for hospitalized patients after their release.
Professor Emeritus of Psychiatry Micheal Flaum said although the health care system provides the best care possible, it still isn’t enough.
“This bill is meant to help those who have bad outcomes, even though they have been in in-patient treatment,” he said. “For most severe patients, hospitals bottleneck on what to do with them, and they often just send them off.”
Although House File 385 would likely be beneficial, Flaum said there are also downsides, and he has concerns about costs and privacy after reviewing the legislation.
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Flaun said it would be an unfunded mandate and could inform people of a patient’s release without their consent.
Flaum said he does consider this problem of repeat hospital visits worth addressing. He said he likes what the bill is trying to do and thinks it is worth pursuing if the correct measures are taken.
“The part I’m stressing is if this bill requires adequate funding and who determines whose tasks, who’s responsible for them,” he said. “If [House File 385] navigates confidentiality issues and isn’t completely unfunded, then it has a chance of doing good.”
Denise Rathman, executive director of the National Association of Social Workers Iowa Chapter and lobbyist in support of the legislation, said the bill will serve the greater good of both patients and professionals.
“The National Association of Social Workers Iowa Chapter’s take on this is anything we can do to get people better treatment and keep them out of inpatient is probably a good thing,” she said. “We’re always working towards making sure people have the medications that they need, the services they need, so they can spend as little time in an inpatient setting as possible.”
Carpenter said this bill will help reduce overall suicide and greatly help those struggling with mental health who are frequently in and out of hospitalization.
“This is a common-sense bill and can help manage those patients going in and out, stopping the revolving door at times when they are most at risk,” she said. “This bill is literally a suicide prevention bill and a bill to stop the revolving door.”