REPORT TITLE:
Emergency Admission


DESCRIPTION:
Amends procedures relating to court orders for emergency
examination and hospitalization.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        
THE SENATE                              S.B. NO.           893
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO MENTAL HEALTH.
 


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  Section 334-59, Hawaii Revised Statutes, is
 
 2 amended to read as follows:
 
 3      "§334-59  Emergency examination and hospitalization.(a)
 
 4 Initiation of proceedings.  An emergency admission may be
 
 5 initiated as follows:
 
 6      (1)  If a police officer, a licensed physician,
 
 7           psychologist, health or social service professional, or
 
 8           any state or county employee in the course of
 
 9           employment, has reason to believe that a person is
 
10           [imminently]:
 
11           (A)  Mentally ill or suffering from substance abuse;
 
12           (B)  Imminently dangerous to self or others, [or is]
 
13                gravely disabled, or [is] obviously ill[, the
 
14                officer shall]; and
 
15           (C)  In need of care or treatment;
 
16           that person may call for assistance from the mental
 
17           health emergency workers designated by the director.
 
18           Upon determination by the mental health emergency
 
19           workers that the person is [imminently]:
 
20           (A)  Mentally ill or suffering from substance abuse;
 

 
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 1           (B)  Imminently dangerous to self or others, [or is]
 
 2                gravely disabled, or [is] obviously ill[,]; and
 
 3           (C)  In need of care or treatment; the [person shall
 
 4                be] mental health emergency worker shall have the
 
 5                person transported by police, ambulance, or other
 
 6                suitable means, to a licensed psychiatric facility
 
 7                for further evaluation and possible emergency
 
 8                hospitalization.  A police officer may also take
 
 9                into custody and transport to any facility
 
10                designated by the director any person threatening
 
11                or attempting suicide.  The officer shall make
 
12                application for the examination, observation, and
 
13                diagnosis of the person in custody.  The
 
14                application shall state or shall be accompanied by
 
15                a statement of the circumstances under which the
 
16                person was taken into custody and the reasons
 
17                therefor which shall be transmitted with the
 
18                person to a physician or psychologist at the
 
19                facility.
 
20      (2)  [Upon written or oral application of any licensed
 
21           physician, psychologist, attorney, member of the
 
22           clergy, health or social service professional, or any
 
23           state or county employee in the course of employment, a
 

 
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 1           judge may issue an ex parte order orally, but shall
 
 2           reduce the order to writing by the close of the next
 
 3           court day following the application, stating] If a
 
 4           judge finds that there is probable cause to believe
 
 5           [the] a person is [mentally]:
 
 6           (A)  Mentally ill or suffering from substance abuse[,
 
 7                is imminently];
 
 8           (B)  Imminently dangerous to self or others, [or is]
 
 9                gravely disabled, or [is] obviously ill[,] ; and
 
10                [in] 
 
11           (C)  In need of care or treatment, or both[,];
 
12 the judge may issue an ex parte order orally, but shall reduce
 
13 the order to writing, giving the findings on which the conclusion
 
14 is based, and directing that a police officer or other suitable
 
15 individual take the person into custody and deliver the person to
 
16 the nearest facility designated by the director for emergency
 
17 examination and treatment.  The ex parte order shall be made a
 
18 part of the patient's clinical record.  [If the application is
 
19 oral, the person making the application shall reduce the
 
20 application to writing and shall submit the same by noon of the
 
21 next court day to the judge who issued the oral ex parte order.
 
22 The written application shall be executed subject to the
 
23 penalties of perjury but need not be sworn to before a notary
 

 
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 1 public.]
 
 2      (3)  Any licensed physician or psychologist who has examined
 
 3           a person and has reason to believe the person is:
 
 4           (A)  Mentally ill or suffering from substance abuse;
 
 5           (B)  Imminently dangerous to self or others, [or is]
 
 6                gravely disabled, or [is] obviously ill; and
 
 7           (C)  In need of care or treatment;
 
 8           may direct transportation, by ambulance or other
 
 9           suitable means, to a licensed psychiatric facility for
 
10           further evaluation and possible emergency
 
11           hospitalization.  A licensed physician may administer
 
12           such treatment as is medically necessary, for the
 
13           person's safe transportation.  A licensed psychologist
 
14           may administer [such] all treatment [as] that is
 
15           psychologically necessary.
 
16      (b)  Emergency examination.  A patient who is delivered for
 
17 emergency examination and treatment to a facility designated by
 
18 the director shall be examined by a licensed physician without
 
19 unnecessary delay, and may be given [such] all treatment [as]
 
20 that is indicated by good medical practice.  A psychiatrist or
 
21 psychologist may further examine the patient to diagnose the
 
22 presence or absence of a mental disorder, assess the risk that
 
23 the patient may be dangerous to self or others, [or is] gravely
 

 
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 1 disabled, or [is] obviously ill, and assess whether or not the
 
 2 patient needs to be hospitalized.
 
 3      (c)  Release from emergency examination.  If the physician
 
 4 who performs the emergency examination, in consultation with a
 
 5 psychologist if applicable, concludes that the patient need not
 
 6 be hospitalized, the patient shall be discharged immediately
 
 7 unless the patient is under criminal charges, in which case the
 
 8 patient shall be returned to the custody of a law enforcement
 
 9 officer.
 
10      (d)  Emergency hospitalization.  If the physician or the
 
11 psychologist who performs the emergency examination has reason to
 
12 believe that the patient is:
 
13      (1)  Mentally ill or suffering from substance abuse;
 
14      (2)  Imminently dangerous to self or others, [or is] gravely
 
15           disabled, or [is] obviously ill; and
 
16      (3)  In need of care or treatment, or both;
 
17 the physician or the psychologist may direct that the patient be
 
18 hospitalized on an emergency basis or cause the patient to be
 
19 transferred to another psychiatric facility for emergency
 
20 hospitalization, or both.  The patient shall have the right
 
21 immediately upon admission to telephone the patient's guardian or
 
22 a family member including a reciprocal beneficiary, or an adult
 
23 friend and an attorney.  If the patient declines to exercise that
 

 
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 1 right, the staff of the facility shall inform the adult patient
 
 2 of the right to waive notification to the family including a
 
 3 reciprocal beneficiary, and shall make reasonable efforts to
 
 4 ensure that the patient's guardian or family including a
 
 5 reciprocal beneficiary, is notified of the emergency admission
 
 6 but the patient's family including a reciprocal beneficiary, need
 
 7 not be notified if the patient is an adult and requests that
 
 8 there be no notification.  The patient shall be allowed to confer
 
 9 with an attorney in private.
 
10      (e)  Release from emergency hospitalization.  If at any time
 
11 during the period of emergency hospitalization the responsible
 
12 physician concludes that the patient no longer meets the criteria
 
13 for emergency hospitalization, the physician shall discharge the
 
14 patient.  If the patient is under criminal charges, the patient
 
15 shall be returned to the custody of a law enforcement officer.
 
16 In any event, the patient must be released within forty-eight
 
17 hours of the patient's admission, unless the patient voluntarily
 
18 agrees to further hospitalization, or a proceeding for court-
 
19 ordered evaluation or hospitalization, or both, is initiated as
 
20 provided in section 334-60.3.  If that time expires on a
 
21 Saturday, Sunday, or holiday, the time for initiation is extended
 
22 to the close of the next court day.  Upon initiation of the
 
23 proceedings the facility shall be authorized to detain the
 

 
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 1 patient until further order of the court.
 
 2      (f)  Immunity from liability.  No individual who assumes a
 
 3 duty or responsibility pursuant to this section shall be liable
 
 4 for acts or omissions performed within the scope of the
 
 5 individual's duty or responsibility."
 
 6      SECTION 2.  This Act does not affect rights and duties that
 
 7 matured, penalties that were incurred, and proceedings that were
 
 8 begun, before its effective date.
 
 9      SECTION 3.  Statutory material to be repealed is bracketed.
 
10 New statutory material is underscored.
 
11      SECTION 4.  This Act shall take effect on July 1, 2000.
 
12 
 
13                           INTRODUCED BY:  _______________________