§ 221.1 — Mental health compact enacted

Iowa § 221.1

• Jurisdiction: Iowa
• Title VI: HUMAN SERVICES
• Ch. 221: INTERSTATE MENTAL HEALTH COMPACT

Text

The interstate compact on mental health is hereby enacted into law and entered into by this
state with all other states legally joining therein in the form substantially as follows, and the
contracting states solemnly agree that:
1. Article I. The party states find that the proper and expeditious treatment of the
mentally ill and mentally deficient can be facilitated by cooperative action, to the benefit
of the patients, their families, and society as a whole. Further, the party states find that the
necessity of and desirability for furnishing such care and treatment bears no primary relation
to the residence or citizenship of the patient but that, on the contrary, the controlling factors
of community safety and humanitarianism require that facilities and services be made
available for all who are in need of them. Consequently, it is the purpose of this compact and
of the party states to provide the necessary legal basis for the institutionalization or other
appropriate care and treatment of the mentally ill and mentally deficient under a system that
recognizes the paramount importance of patient welfare and to establish the responsibilities
of the party states in terms of such welfare.
2. Article II. As used in this compact:
a. “Sending state” shall mean a party state from which a patient is transported pursuant
to the provisions of the compact or from which it is contemplated that a patient may be so
sent.
b. “Receiving state” shall mean a party state to which a patient is transported pursuant to
the provisions of the compact or to which it is contemplated that a patient may be so sent.
c. “Institution” shall mean any hospital or other facility maintained by a party state or
political subdivision thereof for the care and treatment of mental illness or mental deficiency.
d. “Patient” shall mean any person subject to or eligible as determined by the laws of the
sending state, for institutionalization or other care, treatment, or supervision pursuant to the
provisions of this compact.
e. “After-care” shall mean care, treatment and services provided a patient, as defined
herein, on convalescent status or conditional release.
f. “Mental illness” shall mean mental disease to such extent that a person so afflicted
requires care and treatment for the person’s own welfare, or the welfare of others, or of the
community.
g. “Mental deficiency” shall mean mental deficiency as defined by appropriate clinical
authorities to such extent that a person so afflicted is incapable of managing the person and
the person’s affairs, but shall not include mental illness as defined herein.
h. “State” shall mean any state, territory or possession of the United States, the District
of Columbia, and the Commonwealth of Puerto Rico.
3. Article III.
a. Whenever a person physically present in any party state shall be in need of
institutionalization by reason of mental illness or mental deficiency, the person shall be
eligible for care and treatment in an institution in that state irrespective of the person’s
residence, settlement or citizenship qualifications.
b. The provisions of paragraph “a” of this article to the contrary notwithstanding, any
patient may be transferred to an institution in another state whenever there are factors
based upon clinical determinations indicating that the care and treatment of said patient
would be facilitated or improved thereby. Any such institutionalization may be for the entire
period of care and treatment or for any portion or portions thereof. The factors referred to
in this paragraph shall include the patient’s full record with due regard for the location of
the patient’s family, character of the illness and probable duration thereof, and such other
factors as shall be considered appropriate.

c. No state shall be obliged to receive any patient pursuant to the provisions of paragraph
“b” of this article unless the sending state has given advance notice of its intention to send the
patient; furnished all available medical and other pertinent records concerning the patient;
given the qualified medical or other appropriate clinical authorities of the receiving state an
opportunity to examine the patient if said authorities so wish; and unless the receiving state
shall agree to accept the patient.
d. In the event that the laws of the receiving state establish a system of priorities for the
admission of patients, an interstate patient under this compact shall receive the same priority
as a local patient and shall be taken in the same order and at the same time that the interstate
patient would be taken if the interstate patient were a local patient.
e. Pursuant to this compact, the determination as to the suitable place of
institutionalization for a patient may be reviewed at any time and such further transfer of
the patient may be made as seems likely to be in the best interest of the patient.
4. Article IV.
a. Whenever, pursuant to the laws of the state in which a patient is physically present,
it shall be determined that the patient should receive after-care or supervision, such care
or supervision may be provided in a receiving state. If the medical or other appropriate
clinical authorities having responsibility for the care and treatment of the patient in the
sending state shall have reason to believe that after-care in another state would be in the
best interest of the patient and would not jeopardize the public safety, they shall request
the appropriate authorities in the receiving state to investigate the desirability of affording
the patient such after-care in said receiving state, and such investigation shall be made
with all reasonable speed. The request for investigation shall be accompanied by complete
information concerning the patient’s intended place of residence and the identity of the
person in whose charge it is proposed to place the patient, the complete medical history of
the patient, and such other documents as may be pertinent.
b. If the medical or other appropriate clinical authorities having responsibility for the
care and treatment of the patient in the sending state and the appropriate authorities in
the receiving state find that the best interest of the patient would be served thereby, and if
the public safety would not be jeopardized thereby, the patient may receive after-care or
supervision in the receiving state.
c. In supervising, treating, or caring for a patient on after-care pursuant to the terms of
this article, a receiving state shall employ the same standards of visitation, examination, care,
and treatment that it employs for similar local patients.
5. Article V. Whenever a dangerous or potentially dangerous patient escapes from an
institutioninanypartystate, thatstateshallpromptlynotifyallappropriateauthoritieswithin
and without the jurisdiction of the escape in a manner reasonably calculated to facilitate the
speedy apprehension of the escapee. Immediately upon the apprehension and identification
of any such dangerous or potentially dangerous patient, the patient shall be detained in the
state where found pending disposition in accordance with law.
6. Article VI. The duly accredited officers of any state party to this compact, upon the
establishment of their authority and the identity of the patient, shall be permitted to transport
any patient being moved pursuant to this compact through any and all states party to this
compact, without interference.
7. Article VII.
a. No person shall be deemed a patient of more than one institution at any given time.
Completion of transfer of any patient to an institution in a receiving state shall have the effect
of making the person a patient of the institution in the receiving state.
b. The sending state shall pay all costs of and incidental to the transportation of any
patient pursuant to this compact, but any two or more party states may, by making a specific
agreement for that purpose, arrange for a different allocation of costs as among themselves.
c. No provision of this compact shall be construed to alter or affect any internal
relationships among the departments, agencies and officers of and in the government of
a party state, or between a party state and its subdivisions, as to the payment of costs, or
responsibilities therefor.
d. Nothing in this compact shall be construed to prevent any party state or subdivision

thereof from asserting any right against any person, agency or other entity in regard to costs
forwhichsuchpartystateorsubdivisionthereofmayberesponsiblepursuanttoanyprovision
of this compact.
e. Nothing in this compact shall be construed to invalidate any reciprocal agreement
between a party state and a nonparty state relating to institutionalization, care or treatment
of the mentally ill or mentally deficient, or any statutory authority pursuant to which such
agreements may be made.
8. Article VIII.
a. Nothing in this compact shall be construed to abridge, diminish, or in any way impair
the rights, duties, and responsibilities of any patient’s guardian on the guardian’s own behalf
or in respect of any patient for whom the guardian may serve, except that where the transfer
of any patient to another jurisdiction makes advisable the appointment of a supplemental
or substitute guardian, any court of competent jurisdiction in the receiving state may make
such supplemental or substitute appointment and the court which appointed the previous
guardian shall upon being duly advised of the new appointment, and upon the satisfactory
completion of such accounting and other acts as such court may by law require, relieve the
previous guardian of power and responsibility to whatever extent shall be appropriate in
the circumstances; provided, however, that in the case of any patient having settlement in
the sending state, the court of competent jurisdiction in the sending state shall have the
sole discretion to relieve a guardian appointed by it or continue the guardian’s power and
responsibility, whichever it shall deem advisable. The court in the receiving state may, in its
discretion, confirm or reappoint the person or persons previously serving as guardian in the
sending state in lieu of making a supplemental or substitute appointment.
b. The term “guardian” as used in paragraph “a” of this article shall include any guardian,
trustee,legalcommittee,conservator,orotherpersonoragencyhoweverdenominatedwhois
charged by law with power to act for or responsibility for the person or property of a patient.
9. Article IX.
a. No provision of this compact except article V shall apply to any person institutionalized
while under sentence in a penal or correctional institution or while subject to trial on a
criminal charge, or whose institutionalization is due to the commission of an offense for
which, in the absence of mental illness or mental deficiency, said person would be subject to
incarceration in a penal or correctional institution.
b. To every extent possible, it shall be the policy of states party to this compact that no
patient shall be placed or detained in any prison, jail or lockup, but such patient shall, with all
expedition, be taken to a suitable institutional facility for mental illness or mental deficiency.
10. Article X.
a. Each party state shall appoint a “compact administrator” who, on behalf of the compact
administrator’s state, shall act as general coordinator of activities under the compact in
the administrator’s state and who shall receive copies of all reports, correspondence, and
other documents relating to any patient processed under the compact by the administrator’s
state either in the capacity of sending or receiving state. The compact administrator or the
administrator’s duly designated representative shall be the official with whom other party
states shall deal in any matter relating to the compact or any patient processed thereunder.
b. The compact administrators of the respective party states shall have power to
promulgate reasonable rules and regulations to carry out more effectively the terms and
provisions of this compact.
11. Article XI. The duly constituted administrative authorities of any two or more
party states may enter into supplementary agreements for the provision of any service or
facility or for the maintenance of any institution on a joint or cooperative basis whenever
the states concerned shall find that such agreements will improve services, facilities, or
institutional care and treatment in the fields of mental illness or mental deficiency. No
such supplementary agreement shall be construed so as to relieve any party state of any
obligation which it otherwise would have under other provisions of this compact.
12. Article XII. This compact shall enter into full force and effect as to any state when
enacted by it into law and such state shall thereafter be a party thereto with any and all states
legally joining therein.

13. Article XIII.
a. A state party to this compact may withdraw therefrom by enacting a statute repealing
the same. Such withdrawal shall take effect one year after notice thereof has been
communicated officially and in writing to the governors and compact administrators of all
other party states. However, the withdrawal of any state shall not change the status of any
patient who has been sent to said state or sent out of said state pursuant to the provisions
of the compact.
b. Withdrawal from any agreement permitted by article VII, paragraph “b”, as to costs or
from any supplementary agreement made pursuant to article XI shall be in accordance with
the terms of such agreement.
14. ArticleXIV. Thiscompactshallbeliberallyconstruedsoastoeffectuatethepurposes
thereof. The provisions of this compact shall be severable and if any phrase, clause, sentence
or provision of this compact is declared to be contrary to the Constitution of any party state
or of the United States or the applicability thereof to any government, agency, person or
circumstanceisheldinvalid,thevalidityoftheremainderofthiscompactandtheapplicability
thereof to any government, agency, person or circumstance shall not be affected thereby. If
this compact shall be held contrary to the Constitution of any state party thereto, the compact
shall remain in full force and effect as to the remaining states and in full force and effect as
to the state affected as to all severable matters.

Legislative History

[C66, 71, 73, 75, 77, 79, 81, §218A.1]