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THE SENATE |
S.B. NO. |
1322 |
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THIRTY-THIRD LEGISLATURE, 2025 |
S.D. 2 |
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STATE OF HAWAII |
H.D. 2 |
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A BILL FOR AN ACT
RELATING TO MENTAL HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
Accordingly, the purpose of this Act is to clarify, update, and revise Hawaii's mental health laws by:
(2) Clarifying emergency transportation, examination, and hospitalization procedures for individuals who may be mentally ill or suffering from substance abuse and are imminently dangerous to self or others;
(3) Requiring treatment providers to provide relevant treatment information to the department of the attorney general, upon the department's request, for purposes of preparing a petition for assisted community treatment;
(4) Amending the procedures for involuntary hospitalizations and assisted community treatment petitions; and
(5) Clarifying the circumstances under which a subject of an order for assisted community treatment can be administered medication over the subject's objection.
SECTION 2. Chapter 334, Hawaii Revised Statutes, is amended by adding a new section to part I to be appropriately designated and to read as follows:
"§334-A Annual report; emergency transportations;
assisted community treatment. Each
provider of services involved in an emergency transportation initiated by a law
enforcement officer, court order, or health care provider; assisted community
treatment petition; or assisted community treatment order pursuant to part IV or
VIII, and the department of the attorney general, shall provide the necessary data
to the department to complete the report under this section. Based on this data, the department shall submit
an annual report to the legislature no later than thirty days prior to the
convening of each regular session.
The
report shall include, at a minimum, an evaluation of the effectiveness of the
strategies employed by each provider operating pursuant to parts IV and VIII in
reducing homelessness and hospitalization of persons subject to emergency transportation
or assisted community treatment and in reducing involvement with local law
enforcement by persons subject to assisted community treatment orders. The evaluation and report shall also include
any other measures identified by the department regarding persons subject to assisted
community treatment petitions and orders and all of the following, based on
information that is available:
(1) The number of persons brought to
each of the facilities operated by service providers through emergency
transportation;
(2) The number of persons involuntarily
hospitalized through emergency transportation;
(3) The number of persons subject to assisted
community treatment petitions and orders;
(4) The identity of the petitioner for
an assisted community treatment order or, if applicable, the petitioner's
relationship to the person subject to the assisted community treatment petition;
(5) The number of persons who are
represented by legal counsel at all stages of assisted community treatment
proceedings;
(6) The number of persons under assisted
community treatment petitions or orders in contact with local law enforcement,
and the extent to which local and state incarceration of persons subject to an assisted
community treatment order has been reduced or avoided;
(7) The number of persons subject to an assisted
community treatment order participating in employment services programs,
including competitive employment;
(8) The number of days of
hospitalization reduced or avoided for persons subject to an assisted community
treatment order;
(9) The diagnosis and prescribed
treatment for persons subject to an assisted community treatment order,
including the type, intensity, and frequency of treatment of persons subject to
an assisted community treatment order;
(10) Adherence to prescribed treatment by
persons subject to an assisted community treatment order;
(11) Other indicators of successful
engagement, if any, by persons subject to an assisted community treatment order;
(12) Victimization of persons subject to
an assisted community treatment order;
(13) Violent behavior of persons subject
to an assisted community treatment order;
(14) Substance abuse by persons subject
to an assisted community treatment order;
(15) Extent to which enforcement
mechanisms are used pursuant to an assisted community treatment order, when
applicable;
(16) Social functioning of persons
subject to an assisted community treatment order;
(17) Skills in independent living of
persons subject to an assisted community treatment order; and
(18) Satisfaction with services provided
pursuant to an assisted community treatment order, both by the persons receiving
the services and, when relevant, by their families."
SECTION 3. Chapter 334, Hawaii
Revised Statutes, is amended as follows:
1. By adding a new subpart to part IV to be
designated as subpart A and to read:
"A. Emergency Procedures
§334-B Emergency procedures. The emergency procedures in this subpart shall
consist of emergency transportation, emergency examination, and emergency hospitalization
for individuals who may be mentally ill or suffering from substance abuse and imminently
dangerous to self or others.
§334-C Emergency transportation initiated by a law enforcement
officer. (a) When a law enforcement officer has a reasonable
suspicion that an individual is imminently dangerous to self or others and needs
to be detained for emergency examination, the law enforcement officer shall contact
a mental health emergency worker; provided that the law enforcement officer may
temporarily detain the individual at law enforcement facilities if the law enforcement
officer:
(1) Is unable to reach a mental health emergency worker
telephonically after three attempts;
(2) Has reason to believe that the situation requires
immediate intervention to prevent harm to the individual
or others;
(3) Contacts a mental health emergency worker at the
earliest time possible; and
(4) Documents the reasons why the situation necessitated
that the individual be detained.
If
the mental health emergency worker determines that the individual is mentally ill
or suffering from substance abuse and is imminently dangerous to self or others,
the law enforcement officer shall detain the individual for transportation to a
facility for an emergency examination.
(b) When a crisis intervention officer has probable
cause to believe that an individual is mentally ill or suffering from substance
abuse and is imminently dangerous to self or others, the crisis intervention officer
shall detain the individual for transportation to a facility for an emergency examination. The crisis intervention officer shall contact
a mental health emergency worker to determine the type of facility where the
individual shall be transported.
(c) Any individual detained under this section shall
be transported directly to a psychiatric facility or other facility designated by
the director, as determined by a mental health emergency worker; provided that if
a medical emergency occurs during transport, the individual shall be transported to the nearest emergency department. A law enforcement officer shall make an application
for the emergency examination of the individual. The application shall state in detail the circumstances
under which and reasons why the individual was taken into custody. The application shall be transmitted with the
individual to the psychiatric facility or other facility designated by the director
and be made a part of the individual's clinical record.
(d) For the purposes of this section, "crisis
intervention officer" has the same meaning as defined in section 353C-1.
§334-D Emergency transportation initiated by a court
order.
(a) Upon
written or oral application of any licensed physician, advanced practice registered
nurse, psychologist, attorney, member of the clergy, health or social service professional,
or any state or county employee in the course of employment, a judge may issue a
written or oral ex parte order:
(1) Stating that there is probable
cause that the individual is:
(A) Mentally ill or suffering from substance abuse; and
(B) Imminently dangerous to self or others;
(2) Stating the findings upon
which the conclusion is based; and
(3) Directing that a law enforcement officer take the
individual into custody and transport the individual directly to a psychiatric facility
or other facility designated by the director for an emergency examination.
The
person who made the application shall notify a mental health emergency worker
of the written or oral ex parte order and, when possible, shall coordinate the
transport of the individual with the emergency worker.
(b) If an application under subsection (a) was made
orally, the person who made the application shall reduce the application to writing
and submit it to the judge who issued the ex parte order by noon of the next court
day after the order was issued. The written
application shall be made under penalty of law but need not be sworn to before a
notary public. If the judge issued an ex
parte order orally, the judge shall reduce the oral order to writing by the close
of the next court day after the order was issued. The written ex parte order shall be transmitted
with the individual to the psychiatric facility or other facility designated by
the director and be made a part of the individual's clinical record.
§334-E Emergency transportation initiated by a
health care provider.
(a) Any licensed physician,
advanced practice registered nurse, physician assistant, licensed clinical
social worker, or psychologist who has examined an individual and determines
that the individual is mentally ill or suffering from substance abuse and is imminently
dangerous to self or others shall contact a mental health emergency worker. Upon confirmation by the mental health
emergency worker that the individual is imminently dangerous to self or others,
the individual shall be transported by ambulance, law enforcement, or other
suitable means as identified by the examining health care provider, to a
licensed psychiatric facility or other facility designated by the director for an
emergency examination. The licensed
physician, advance practice registered nurse, physician assistant, licensed
clinical social worker, or psychologist shall provide a written statement of
circumstances and reasons necessitating the emergency examination. The written statement shall be transmitted
with the individual to the psychiatric facility or other facility designated by
the director and be made a part of the individual's clinical record.
(b) Any individual who is subject to an order for
assisted community treatment and fails to comply with the order for assisted
community treatment, despite reasonable efforts made by a designated assisted
community treatment provider, as defined in section 334-122, to solicit
compliance, may be transported to a psychiatric facility or other facility
designated by the director for an emergency examination if it is in the
clinical judgment of a licensed physician, advanced practice registered nurse,
physician assistant, licensed clinical social worker, or psychologist that the
individual may be in need of emergency hospitalization pursuant to section 334-G.
At the direction of the examining health
care provider, a law enforcement officer may detain and transport the
individual by ambulance or other suitable means to a psychiatric facility or
other facility designated by the director. The examining health care provider shall
provide a written statement of circumstances and reasons explaining why the
individual may be in need of emergency hospitalization. The written statement shall be transmitted
with the individual to the psychiatric facility or other facility designated by
the director and be made a part of the individual's clinical record.
(c)
The health care provider, when possible,
shall coordinate the transport of the individual with the mental health
emergency worker.
(d) The examining health care provider shall also
provide a copy of the written statement required under this section to the
department within five business days.
§334-F Emergency examination. (a) A licensed
physician, medical resident under the supervision of a licensed physician, or advanced
practice registered nurse may conduct an initial examination and screening of the
patient, and administer treatment as indicated by good medical practice; provided
that the patient is further examined by a qualified psychiatric examiner. A qualified psychiatric examiner shall conduct
an emergency examination of a patient transported under section 334-C, 334-D,
or 334-E without unnecessary delay and provide the patient with treatment as indicated
by good medical practice; provided that the emergency examination shall include
a screening to determine whether the patient meets the criteria for involuntary
hospitalization as provided in section 334-60.2.
(b) If, following an emergency examination of a patient
under subsection (a), a qualified psychiatric examiner determines that the criteria
for involuntary hospitalization do not exist, the patient shall be discharged
expeditiously; provided that if the patient is not under an order for assisted community
treatment, a qualified psychiatric examiner shall conduct an examination pursuant
to section 334-121.5 before the discharge.
A patient under criminal charges shall be returned to the custody of a law
enforcement officer.
§334-G Emergency hospitalization. (a) If,
following an emergency examination pursuant to section 334-F(a), a qualified psychiatric
examiner determines that the criteria for involuntary hospitalization exist, the
patient shall be hospitalized on an emergency basis or transferred to another psychiatric
facility or other facility designated by the director for emergency hospitalization.
(b) The patient admitted under subsection (a) shall
be released within seventy-two hours of the patient's admission to a psychiatric
facility or other facility designated by the director, unless:
(1) The patient voluntarily agrees to further hospitalization;
or
(2) A proceeding for court-ordered evaluation or hospitalization is initiated as provided in section 334-60.3.
If the seventy-two-hour time period expires on a Saturday, Sunday, or holiday, the time for initiation shall be extended to the close of the next court day. Upon initiation of the proceeding, the facility may detain the patient until further order of the court.
(c) If at any time during the period of emergency
hospitalization a qualified psychiatric examiner determines that a patient no longer
meets the criteria for emergency hospitalization, the patient shall be discharged
expeditiously; provided that if the patient is not under an order for assisted community
treatment, a qualified psychiatric examiner shall conduct an examination pursuant
to section 334-121.5 before the discharge.
A patient under criminal charges shall be returned to the custody of a law
enforcement officer.
(d) The patient shall have
the right, immediately upon emergency hospitalization, to telephone an attorney
and the patient's surrogate, guardian, family member including a reciprocal beneficiary,
or adult friend. The patient shall be allowed
to confer with an attorney in private.
§334-H Notice of emergency transportation, examination,
and hospitalization.
Notice of an individual's emergency transportation, examination, and hospitalization
under this subpart may be given to at least one of the following persons in the
following order of priority: the individual's
spouse or reciprocal beneficiary, legal parents, adult children, surrogate, legal
guardian, or if none can be found, the closest adult relative, as long as the individual:
(1) Has capacity to make health care decisions and
consents that notice may be given to at least
one of the persons listed in this section;
(2) Is given the opportunity to object and does not
object, or the health care provider can reasonably infer from the circumstances
based on the exercise of professional judgment that the individual does not object;
or
(3) Is incapacitated
or an emergency circumstance exists, and the health care provider determines, based
on the exercise of professional judgment, that giving notification is in the best
interest of the individual.
The staff of the facility shall make
reasonable efforts to ensure that the patient's family, including a reciprocal beneficiary,
is notified of the emergency hospitalization, unless the patient is an adult and
waives notification."
2. By designating section 334-60.1 as subpart B and inserting a title before section
334-60.1 to read:
"B. Voluntary
Admission"
3. By designating sections 334-60.2 to 334-60.7 as subpart C and inserting a title
before section 334-60.2 to read:
"C.
Involuntary Hospitalization"
4. By designating sections 334-61 and 334-62 as subpart D and inserting a title
before section 334-61 to read:
"D. General
Provisions"
SECTION 4.
Chapter 334, Hawaii Revised Statutes, is amended by adding a new section
to part VIII to be appropriately designated and to read as follows:
"§334-I Records and disclosure of information. (a)
A treatment provider who provided or is providing medical, psychiatric, therapeutic,
or social services treatment to an individual shall provide relevant treatment information,
if available, to the department of the attorney general upon the department's request
for the purpose of preparing a petition for assisted community treatment. The treatment information may include a certificate
issued pursuant to section 334-123(c), a treatment plan prepared pursuant to section
334-126(g), records related to actions or proceedings pursuant to part IV, records
relating to the individual's treatment history, and other records deemed relevant
by the individual's treatment provider.
(b)
The petitioner of an assisted community treatment order, department of the
attorney general, and family court shall disclose an assisted community treatment
order to state and county law enforcement agencies, an assisted community treatment
provider, or any other entity necessary to carry out the terms of the assisted community
treatment order."
SECTION
5. Section 334-1, Hawaii Revised Statutes,
is amended as follows:
1. By adding two new definitions to be appropriately
inserted and to read:
""Qualified psychiatric examiner" means a licensed psychiatrist or advanced practice registered nurse with prescriptive authority who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization.
"Surrogate"
means a person appointed under:
(1) A power of attorney for health care to
make a health care decision for the individual who made the appointment; or
(2) Law or court order to make health care decisions for an individual."
2. By amending the definition of "patient"
to read:
""Patient"
means [a person] an individual under observation, care, or treatment
at a psychiatric facility[.] or other facility designated by the director."
3. By amending the definition of "treatment"
to read:
""Treatment"
means the broad range of emergency, out-patient, intermediate, domiciliary, and
inpatient services and care, including diagnostic evaluation, medical, psychiatric,
psychological, and social service care, vocational rehabilitation, psychosocial
rehabilitation, career counseling, and other special services [which]
that may be extended to [handicapped persons.] an individual with
a disability."
SECTION 6. Section 334-60.2, Hawaii Revised Statutes, is
amended to read as follows:
"§334-60.2 Involuntary hospitalization criteria. [A person] An individual may be
committed
to a psychiatric facility for involuntary hospitalization[,] if the court
finds:
(1) That the [person]
individual is mentally ill or suffering from substance abuse;
(2) That the [person] individual is imminently
dangerous to self or others; and
(3) That the [person]
individual is in need of care or treatment, or both, and there is no suitable
alternative available through existing facilities and programs [which] that
would be less restrictive than hospitalization."
SECTION 7.
Section
334-60.3, Hawaii Revised Statutes, is amended to read as follows:
"§334-60.3 Initiation of proceeding for involuntary hospitalization. (a) Any
person may file a petition alleging that [a person located in the county]
an individual meets the criteria for commitment to a psychiatric facility[.]
as provided in section 334-60.2. The
petition shall be filed in the county where the individual resides and executed
subject to [the] penalties [of perjury] provided by law but
need not be sworn to before a notary public.
The [attorney general, the attorney general's deputy, special deputy,
or appointee designated to present the case] department of the attorney general
shall assist the petitioner [to state] in stating the substance of
the petition in plain and simple language.
The petition may be accompanied by a certificate of the [licensed physician,
advanced practice registered nurse,] qualified psychiatric examiner or
psychologist who has examined the [person] individual within two days
before [submission of] the petition[,] is filed, unless the
[person] individual whose commitment is sought has refused to submit
to medical or psychological examination, in which case the fact of refusal shall
be alleged in the petition. The certificate
shall set forth the signs and symptoms relied upon by the [physician, advanced
practice registered nurse,] qualified psychiatric examiner or psychologist
to determine the [person] individual is in need of [care or]
treatment[, or both,] and whether the [person] individual is
capable of realizing and making a rational decision with respect to the [person's]
individual's need for treatment. If
the petitioner believes that further [evaluation] examination is necessary
before commitment, the petitioner may request [such] further [evaluation.]
examination.
(b) In the event the subject of the petition has been
given an examination, evaluation, or treatment in a psychiatric facility within
five days before submission of the petition, and hospitalization is recommended
by the staff of the facility, the petition may be accompanied by the administrator's
certificate in lieu of a [physician's] qualified psychiatric examiner's
or psychologist's certificate.
(c) The petition shall include the name, address,
and telephone number of at least one of the following persons in the following order
of priority: the subject of the petition's
spouse or reciprocal beneficiary, legal parents, adult children, surrogate,
and legal guardian [, if one has been appointed]. If the subject of the petition has no living spouse
or reciprocal beneficiary, legal parent, adult [children,] child, surrogate,
or legal guardian, or if none can be found, notice shall be served on at least one
of the subject's closest adult relatives, if any can be found."
SECTION 8.
Section 334-60.4, Hawaii Revised Statutes, is amended by amending subsections
(a) to (c) to read as follows:
"(a) The court shall set a hearing on the petition
and notice of the time and place of the hearing shall be served in accordance
with, and to those persons specified in, a current order of commitment. If there is no current order of commitment, notice
of the hearing shall be served personally on the subject of the petition and served
personally or by certified or registered mail, return receipt requested, deliverable
to the addressee only, on the subject's spouse or reciprocal beneficiary, legal
parents, adult children, surrogate, and legal guardian[, if one has been
appointed]. If the subject of the petition
has no living spouse or reciprocal beneficiary, legal parent, adult [children,]
child, surrogate, or legal guardian, or if none can be found, notice of the
hearing shall be served on at least one of the subject's closest adult relatives,
if any can be found. Notice of the
hearing to the subject of the petition's spouse or reciprocal beneficiary, legal
parents, adult children, or closest adult relative may be waived if the subject
of the petition is an adult and requests that these persons not be notified. Notice of the hearing shall also
be served on the public defender, attorney for the subject of the petition, or other
court-appointed attorney [as the case may be]. If the subject of the petition is a minor, notice
of the hearing shall also be served upon the person who has had the principal care
and custody of the minor during the sixty days preceding the date of the petition,
if that person can be found within the State.
Notice shall also be given to other persons as the court may designate.
(b) The notice shall include the following:
(1) The date, time, and place of the
hearing[,]; a clear statement of the purpose of the proceedings and
of possible consequences to the subject[;] of the petition; and a
statement of the legal standard upon which commitment
is authorized;
(2) A copy of the petition;
(3) A [written notice,] statement, in
plain and simple language, that the subject may waive the hearing by voluntarily
agreeing to hospitalization[,] or, with the approval of the court,
to some other form of treatment;
(4) A filled-out form indicating [such] the
waiver;
(5) A [written notice,] statement, in
plain and simple language, that the subject or the subject's surrogate, guardian,
or representative may apply at any time for a hearing on the issue of the subject's
need for hospitalization, if the subject has previously waived such a hearing;
(6) [Notice] A statement that the subject
is entitled to the assistance of an attorney and that the public defender has been
notified of these proceedings; and
(7) [Notice] A statement that if the
subject does not want to be represented by the public defender, the subject may
contact the subject's own attorney[; and
(8) If applicable, notice that the petitioner intends
to adduce evidence to show that the subject of the petition is an incapacitated
or protected person, or both, under article V of chapter 560, and whether appointment
of a guardian is sought at the hearing. If
appointment of a guardian is to be recommended, and a nominee is known at the time
the petition is filed, the identity of the nominee shall be disclosed].
(c) If the subject of the petition executes
and files a waiver of the hearing, upon acceptance by the court following
a court determination that the [person] subject understands the [person's]
subject's rights and is competent to waive them, the court shall order the
subject to be committed to a facility that has agreed to admit the subject as an
involuntary patient or, if the subject is at such a facility, that the subject be
retained there."
SECTION
9. Section 334-60.5, Hawaii Revised Statutes, is
amended to read as follows:
"§334-60.5 Hearing on petition. (a) The
court shall adjourn or continue a hearing for failure to
timely notify the subject of the petition's spouse or reciprocal beneficiary, legal
[parents,] parent, adult [children,] child, surrogate,
guardian, or relative, or other person determined by the court to be entitled to
notice, or for failure by the subject to contact an attorney as provided in section
334-60.4(b)(7) unless the subject waived notice pursuant to section 334-60.4(a)
or the court determines that the interests of justice require that the hearing
continue without adjournment or continuance.
(b) The time and form of
the procedure incident to hearing the issues in the petition shall be provided by
court rule. Unless the hearing is waived,
the judge shall hear the petition as soon as possible and no later than ten days
after the date the petition is filed unless a reasonable delay is sought for good
cause shown by the subject of the petition, the subject's attorney, or those persons
entitled to receive notice of the hearing under section 334-60.4.
(c) The subject of the petition shall be present at
all hearings unless the subject waives the right to be present,
is unable to attend, or creates conditions that make it impossible to conduct [the]
a hearing in a reasonable manner as determined by the judge. A waiver is valid only upon acceptance by the
court following a judicial determination that the subject understands the subject's
rights and is competent to waive them, or is unable to participate. If the subject is unable to participate, the judge
shall appoint a guardian ad litem or a temporary guardian as provided in article
V of chapter 560, to represent the subject throughout the proceedings.
(d) Hearings may be held at
any convenient place within the circuit.
Hearings may be conducted by video conferencing unless the court determines
personal appearance is necessary. The
subject of the petition, any interested party, or the court on its own motion may
request a hearing in another circuit because of convenience to the parties, witnesses,
or the court or because of the [individual's] subject's mental or
physical condition.
(e) The [attorney general, the attorney general's
deputy, special deputy, or appointee] department of the attorney general
shall present the case for a petitioner for hearings convened under this
chapter, [except that the attorney general, the attorney general's deputy, special
deputy, or appointee need not participate in or be present at a hearing whenever]
unless a petitioner [or some other appropriate person] has retained
private counsel who will be present in court and will present to the court the case
for involuntary hospitalization.
(f) Counsel for the subject
of the petition shall be allowed adequate time for investigation of the matters
at issue and for preparation[,] and shall be permitted to present the evidence
that the counsel believes necessary to a proper disposition of the proceedings,
including evidence as to alternatives to inpatient hospitalization.
(g) No individual may be found to require treatment
in a psychiatric facility unless at least one [physician, advanced practice registered
nurse,] qualified psychiatric examiner or psychologist who has personally
examined the individual testifies in person at the hearing. This testimony may be waived by the subject of
the petition. If the subject of the petition
[has refused] refuses to be examined by a [licensed physician,
advanced practice registered nurse,] qualified psychiatric examiner or
psychologist, the subject may be examined by a court-appointed [licensed physician,
advanced practice registered nurse,] qualified psychiatric examiner or
psychologist. If the subject refuses to
be examined and there is sufficient evidence to believe that the allegations
of the petition are true, the court may make a temporary order committing the subject
to a psychiatric facility for a period of no more than five days for the purpose
of a diagnostic examination [and evaluation]. The subject's refusal to be examined shall
be treated as a denial that the subject is mentally ill or suffering from substance
abuse. Nothing in this section shall limit
the [individual's] subject's privilege against self-incrimination.
(h) The subject of the petition in a hearing under
this section has the right to secure an independent [medical or psychological
evaluation] examination and present evidence thereon.
(i) If after hearing all relevant evidence, including
the result of any diagnostic examination ordered by the court, the court finds that
[an individual] a subject of a petition is not a person requiring
medical, psychiatric, psychological, or other rehabilitative treatment or supervision,
the court shall order that the [individual] subject be discharged
if the [individual] subject has been hospitalized [prior to]
before the hearing.
(j) If the court finds that the criteria for involuntary
hospitalization under section 334-60.2(1) has been met beyond a reasonable doubt
and that the criteria under [sections] section 334-60.2(2) and [334-60.2(3)]
(3) have been met by clear and convincing evidence, the court may issue an
order to any law enforcement officer to [deliver] transport the subject
of the order to a facility that has agreed to admit the subject as an involuntary
patient, or if the subject is already a patient in a psychiatric facility, authorize
the facility to retain the patient for treatment for a period of ninety days unless
sooner discharged. The court may also authorize
the involuntary administration of medication, where the subject has an existing
order for assisted community treatment[,] issued pursuant to part VIII of
this chapter[, relating to assisted community treatment,] and in accordance
with the treatment prescribed by that [prior] existing order. Notice of the subject's commitment and the facility
name and location where the subject will be committed shall be provided to those
persons entitled to notice pursuant to section 334-60.4. An order of commitment shall specify which of
those persons served with notice pursuant to section 334-60.4, together with such
other persons as the court may designate, shall be entitled to receive any subsequent
notice of intent to discharge, transfer, or recommit. The court shall forward to the Hawaii criminal
justice data center all orders of involuntary civil commitment or information from
all orders of involuntary civil commitment, as requested by the Hawaii criminal
justice data center, which in turn shall forward the information to the Federal
Bureau of Investigation, or its successor agency, for inclusion in the National
Instant Criminal Background Check System database. The
orders or information shall also be maintained by the Hawaii criminal justice data
center for disclosure to and use by law enforcement officials for the purpose of
firearms permitting, licensing, or registration pursuant to chapter 134. This subsection shall apply to all involuntary
civil commitments without regard to the date of the involuntary civil commitment.
[(k) The court may find that the subject of the petition
is an incapacitated or protected person, or both, under article V of chapter 560,
and may appoint a guardian or conservator, or both, for the subject under the terms
and conditions as the court shall determine.
(l)]
(k) Persons entitled to notice [are]
pursuant to this section shall also be entitled to be present in the
courtroom for the hearing and to receive a copy of the hearing transcript or recording,
unless the court determines that the interests of justice require otherwise."
SECTION 10.
Section 334-60.7, Hawaii Revised Statutes, is amended to read as follows:
"§334-60.7 Notice of intent to discharge. (a) When
the administrator, the administrator's deputy, or the attending physician
of a psychiatric facility contemplates discharge of an involuntary patient because
of expiration of the court order for commitment or because the patient is no longer
a proper subject for commitment, as determined by the criteria for involuntary hospitalization
in section 334-60.2, the administrator, the administrator's deputy, or the
attending physician shall provide notice of intent to discharge, or if the patient
voluntarily agrees to further hospitalization, the administrator, the administrator's
deputy, or the attending physician shall provide notice of the patient's admission
to voluntary inpatient treatment. The following
requirements and procedures shall apply:
(1) The notice and a certificate of service shall be
filed with the family court and served on those persons whom the order of commitment
specifies as entitled to receive notice, by mail at the person's last known address. [Notice] If the commitment resulted
directly from legal proceedings under chapter 704 or 706, notice shall also
be sent to the prosecuting attorney of the county from which the person was originally
committed, by facsimile or electronically, for the sole purpose of victim notification; and
(2) Any person specified
as entitled to receive notice may waive this right in writing with the psychiatric
facility[;
(3) If no objection is filed within five calendar
days of mailing the notice, the administrator or attending physician of the psychiatric
facility shall discharge the patient or accept the patient for voluntary inpatient
treatment;
(4) If any person specified as entitled to receive
notice files a written objection, with a certificate of service, to the discharge
or to the patient's admission to voluntary inpatient treatment on the grounds that
the patient is a proper subject for commitment, the family court shall conduct a
hearing as soon as possible, prior to the termination of the current commitment
order, to determine if the patient still meets the criteria for involuntary hospitalization
in section 334-60.2. The person filing the
objection shall also notify the psychiatric facility by telephone on the date the
objection is filed;
(5) If the family court finds that the patient does
not meet the criteria for involuntary hospitalization in section 334-60.2, the court
shall issue an order of discharge from the commitment; and
(6) If the family court finds that the patient does
meet the criteria for involuntary hospitalization in section 334-60.2, the court
shall issue an order denying discharge from the commitment].
(b) For civil commitments that do not result directly
from legal proceedings under [chapters] chapter 704 [and] or
706, when the administrator, the administrator's deputy, or the attending
physician of a psychiatric facility contemplates discharge of an involuntary patient,
the administrator, the administrator's deputy, or the attending physician
[may] shall assess whether an assisted community treatment plan is
indicated pursuant to section 334-123 and, if so indicated, may communicate with
an aftercare provider as part of discharge planning, as appropriate."
SECTION 11. Section 334-76, Hawaii Revised Statutes, is amended
to read as follows:
"§334-76 Discharge from custody. (a) Subject
to any special requirements of law as provided in sections 704-406,
704-411, and 706-607 or elsewhere, with respect to patients committed on court order
from a criminal proceeding, the administrator of a psychiatric facility, the
administrator's deputy, or the attending physician, pursuant to section 334‑60.7,
shall:
(1) Send a notice of intent to discharge or notice of the patient's admission to voluntary inpatient treatment to those persons specified in the order of commitment as entitled to receive notice of intent to discharge, by mail at their last known address; and
(2) [Send] In cases where the
commitment directly resulted from legal proceedings under chapter 704 or
706, send a notice of intent to discharge or notice
of the patient's admission to voluntary inpatient treatment to the prosecuting attorney
of the county from which the person was originally committed, by facsimile or electronically.
(b) The administrator [or], the administrator's
deputy, or the physician assuming medical responsibility for the patient
shall discharge an involuntary patient when the patient is no longer a proper subject
for commitment, as determined by the criteria for involuntary hospitalization in
section 334-60.2.
(c) Nothing in this section shall preclude a psychiatric
facility from accepting for voluntary inpatient treatment, in accordance with the
procedures in section 334-60.1, a patient for whom the facility contemplates discharge
pursuant to section 334-60.7 and who voluntarily agrees to further hospitalization
after the period of commitment has expired or where the
patient is no longer a proper subject for commitment."
SECTION 12.
Section 334-121, Hawaii Revised Statutes, is amended to read as follows:
"§334-121 Criteria for assisted community treatment. [A person] An individual may be
ordered to obtain assisted community treatment if the family court finds, based on the professional opinion of a [psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization,] qualified psychiatric examiner, that:
(1) The [person] individual is mentally
ill or suffering from substance abuse;
(2) The [person] individual is unlikely
to live safely in the community without available supervision, is now in need of
treatment in order to prevent a relapse or deterioration that would predictably
result in the [person] individual becoming imminently dangerous to
self or others, and the [person's] individual's current mental status
or the nature of the [person's] individual's disorder limits or negates
the [person's] individual's ability to make an informed decision to
voluntarily seek or comply with recommended treatment;
(3) The [person] individual
has a:
(A) Mental illness that has caused that [person]
individual to refuse needed and appropriate mental health services in the
community; or
(B) History of lack of adherence to treatment for mental
illness or substance abuse that resulted in the [person] individual
becoming dangerous to self or others and that now would predictably result in the
[person] individual becoming imminently
dangerous to self or others; and
(4) Considering less intrusive alternatives, assisted
community treatment is essential to prevent the danger posed by the [person,]
individual, is medically appropriate, and is in the [person's] individual's
medical interests."
SECTION 13.
Section 334-121.5, Hawaii Revised Statutes, is amended to read as follows:
"§334-121.5 Examination for assisted community treatment indication. A [licensed psychiatrist or advanced practice
registered nurse with prescriptive authority and who holds an accredited national
certification in an advanced practice registered nurse psychiatric specialization]
qualified psychiatric examiner associated with the [licensed] psychiatric
facility where a [person] patient is located who was committed to
involuntary hospitalization, delivered for emergency examination or emergency hospitalization,
or voluntarily admitted to inpatient treatment at a psychiatric facility pursuant
to part IV shall, before the [person's] patient's discharge, examine
the [person] patient to determine whether an assisted community treatment
plan is indicated pursuant to this part.
If a plan is indicated, the [psychiatrist or advanced practice registered
nurse] qualified psychiatric examiner shall prepare the certificate specified
by section 334-123. The department of the
attorney general shall assist with the preparation and filing of any petition brought
pursuant to section 334-123 and with the presentation of the case at any related
court proceedings; provided that, if the petitioner is a private provider or other
private individual, the petitioner may decline the assistance. The psychiatric facility may notify another mental
health program for assistance with the coordination of care in the community for
the person. Nothing in this section shall
delay the appropriate discharge of a [person] patient from the psychiatric
facility after the examination for assisted community treatment indication has been
completed."
SECTION 14.
Section 334-122, Hawaii Revised Statutes, is amended as follows:
1. By
adding two new definitions to be appropriately inserted and to read:
""Assisted
community treatment provider" means a mental health provider, which may
include a qualified psychiatric examiner or a mental health program, that is or
will be responsible, in accordance with an assisted community treatment order, for
the coordination, management, or administration of a subject of the order's treatment.
"Mental
health program" means a hospital, psychiatric facility, clinic, or other facility
providing mental health treatment to individuals suffering from mental illness or
substance abuse."
2. By amending the
definition of "assisted community treatment" to read:
""Assisted
community treatment" includes medication specifically authorized by court order;
individual or group therapy; day or partial day programming activities; services
and training, including educational and vocational activities; supervision of living
arrangements; and any other services prescribed to either alleviate the [person's]
subject of the order's disorder or disability, maintain or maximize semi‑independent
functioning, or prevent further deterioration that may reasonably be predicted to
result in the need for hospitalization or more intensive or restrictive levels of
care in the community or incarceration for criminal behavior."
3. By amending the definitions of "subject of
the order" and "subject of the petition" to read:
""Subject
of the order" means [a person] an individual who has been ordered
by the court to obtain assisted community treatment.
"Subject
of the petition" means the [person] individual who, under a petition
filed under section 334-123, is alleged to meet the criteria for assisted community
treatment."
4. By deleting the definition of "advanced practice
registered nurse".
[""Advanced
practice registered nurse" means a registered nurse licensed to practice in
this State who:
(1) Has met the qualifications set forth
in chapter 457 and this part;
(2) Because of advanced education and specialized
clinical training, is authorized to assess, screen, diagnose, order, utilize, or
perform medical, therapeutic, preventive, or corrective measures;
(3) Holds an accredited national certification in
an advanced practice registered nurse psychiatric specialization; and
(4) Holds prescriptive authority pursuant to section
457-8.6."]
5. By deleting the definition of "treating psychiatrist".
[""Treating
psychiatrist" means the psychiatrist who is responsible for the management
and supervision of a person's treatment under order of the court."]
SECTION 15. Section 334-123, Hawaii Revised Statutes, is amended
by amending subsections (c) and (d) to read as follows:
"(c) The petition may be accompanied by a certificate
of a [licensed psychiatrist or advanced practice registered nurse with
prescriptive authority and who holds an accredited national certification in an
advanced practice registered nurse psychiatric specialization] qualified
psychiatric examiner who has examined the subject of the petition in
person within twenty calendar days before the filing of the petition. For purposes of the petition, an examination shall
be considered valid so long as the [licensed psychiatrist or advanced
practice registered nurse with prescriptive authority and who holds an
accredited national certification in an advanced practice registered nurse
psychiatric specialization] qualified psychiatric examiner has obtained
enough information from the subject of the petition and has had face-to-face
contact to reach a diagnosis of the subject of the petition, and to express
a professional opinion concerning the same, even if the subject of the petition
is not fully cooperative. If the petitioner
believes that further [evaluation] examination is necessary before
treatment, the petitioner may request further [evaluation.] examination.
(d) The petition shall include the name of a
proposed assisted community treatment provider and the name, address, and telephone
number of at least one of the following persons in the following order of priority: the subject of the petition's spouse or reciprocal
beneficiary, legal parents, adult children, [and] surrogate, or legal
guardian[, if one has been appointed].
If the subject of the petition has no living spouse or reciprocal beneficiary,
legal parent, adult [children,] child, surrogate, or legal guardian,
or if none can be found, the petition shall include the name, address, and telephone
number of at least one of the subject's closest adult relatives, if any can be found."
SECTION
16. Section 334-124, Hawaii Revised Statutes,
is amended to read as follows:
"§334-124 Hearing date. The family court shall set a hearing date on a
petition, and any subsequent hearing dates for the petition, as soon as possible[.]
but no later than ten days after the filing of the
petition. A hearing on the petition may be
continued pending further examination of the subject of the petition, for the appointment
of a guardian ad litem, or for good cause."
SECTION
17. Section 334-125, Hawaii Revised
Statutes, is amended as follows:
1. By amending subsection (a) to read:
"(a) Notice of the hearing under this part shall be:
(1) Served personally on the subject of the petition pursuant to family court rules;
(2) Served
personally or by certified or registered mail, return receipt requested,
deliverable to the addressee only, to as many as are known to the petitioner of
the subject's spouse or reciprocal beneficiary, legal [parents,] parent,
adult [children,] child, surrogate, and legal guardian[, if
one has been appointed]. If the
subject of the petition has no living spouse or reciprocal beneficiary, legal
parent, adult [children,] child, surrogate, or legal guardian, or
if none can be found, notice of the hearing shall be served on at least one of
the subject's closest adult relatives, if any can be found;
(3) Served
on the guardian ad litem appointed for the subject of the petition [or the
subject's existing guardian, if the court determines the existence of one;]
as provided in section 334-123.5;
(4) Served
on the attorney for the subject of the petition, if applicable; [and]
(5) Served
on the assisted community treatment provider proposed in the petition, unless
the petitioner is also the proposed assisted community treatment provider; and
[(5)] (6) Given to other persons as the court may
designate."
2. By amending subsection (c) to read:
"(c) Notice [of all subsequent hearings shall
be served in accordance with subsections (a) and (b), and in accordance with
all applicable family court rules relating to service of notice, including that
service need not be made on parties in default for failure to appear.] to
the subject of the petition's spouse or reciprocal beneficiary, legal parent,
adult child, or closest adult relative may be waived if the subject is an adult
and requests that these persons not be notified."
SECTION
18. Section 334-126, Hawaii Revised Statutes,
is amended by amending subsection (g) to read as follows:
"(g)
No
subject of the petition shall be ordered to receive assisted community treatment
unless at least one [psychiatrist or advanced practice registered nurse with
prescriptive authority and who holds an accredited national certification in an
advanced practice registered nurse psychiatric specialization testifies in person
at the hearing] qualified psychiatric examiner who has personally [assessed]
examined the subject[,] within a reasonable time before the filing
of the petition [up to the time when the psychiatrist or advanced practice registered
nurse with prescriptive authority and who holds an accredited national certification
in an advanced practice registered nurse psychiatric specialization] provides
oral testimony at [court.] the hearing. The [testimony of the psychiatrist or advanced
practice registered nurse with prescriptive authority and who holds an accredited
national certification in an advanced practice registered nurse psychiatric specialization]
qualified psychiatric examiner shall [state] provide the facts
[which] that support the allegation that the subject meets all the
criteria for assisted community treatment, provide a written treatment plan, which
shall include non-mental health treatment if appropriate, provide the rationale
for the recommended treatment, and identify the [designated mental health program
responsible for the coordination of care.] assisted community treatment provider.
If the recommended assisted community treatment
includes medication, the testimony [of] provided by the [psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization] qualified psychiatric examiner shall describe the types
or classes of medication [which] that should be authorized, and describe
the physical and mental beneficial and detrimental effects of [such] the
medication."
SECTION 19. Section
334-127, Hawaii Revised Statutes, is amended to read as follows:
"§334-127 Disposition. (a) If,
after [hearing] considering all relevant evidence, including the results
of any diagnostic examination ordered by the family court, the family court finds
that the subject of the petition does not meet the criteria for assisted community
treatment, the family court shall dismiss the petition. Notice of the dismissal shall be provided to those
persons entitled to notice pursuant to section 334-125.
(b) If,
after hearing all relevant evidence, including the results of any diagnostic examination
ordered by the family court, the family court finds that the criteria for assisted
community treatment under section 334-121(1) have been met beyond a reasonable doubt
and that the criteria under section 334-121(2) to (4) have been met by clear and
convincing evidence, the family court shall order the subject to obtain assisted
community treatment for a period of no more than two years. The written treatment plan submitted pursuant
to section 334-126(g) shall be attached to the order and made a part of the
order.
If the family court finds by clear and convincing
evidence that the beneficial mental and physical effects of recommended medication
outweigh the detrimental mental and physical effects, if any, the order may authorize
types or classes of medication to be included in treatment at the discretion of
the [treating psychiatrist or advanced practice registered nurse with prescriptive
authority and who holds an accredited national certification in an advanced practice
registered nurse psychiatric specialization.] assisted community treatment
provider.
The court order shall [also] state who should receive
notice of intent to discharge early in the event that the [treating psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization] assisted community treatment provider determines, before
the end of the court ordered period of treatment, that the subject should be discharged
early from assisted community treatment.
Notice of the order shall be provided to the
director, the [interested party who filed the petition,] petitioner,
and those persons entitled to notice pursuant to section 334-125.
(c) The
family court shall also designate on the order the [treating psychiatrist or
advanced practice registered nurse with prescriptive authority and who holds an
accredited national certification in an advanced practice registered nurse psychiatric
specialization who is to be responsible for the management and supervision of the
subject's treatment, or shall assign an administrator of a designated mental health
program to, in turn, designate the treating psychiatrist or advanced practice registered
nurse with prescriptive authority and who holds an accredited national certification
in an advanced practice registered nurse psychiatric specialization during the treatment
period without court approval, and may designate either a publicly employed psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization, or a private psychiatrist or advanced practice registered nurse
with prescriptive authority and who holds an accredited national certification in
an advanced practice registered nurse psychiatric specialization; provided that
the private psychiatrist or advanced practice registered nurse with prescriptive
authority and who holds an accredited national certification in an advanced practice
registered nurse psychiatric specialization shall agree to the designation. The order for assisted community treatment shall
be subject to the Health Care Privacy Harmonization Act, chapter 323B.] assisted
community treatment provider.
(d) Nothing
in this section shall preclude the subject's stipulation to the continuance [[]of[]]
an existing court order."
SECTION 20.
Section 334-129, Hawaii Revised Statutes, is amended to read as follows:
"§334-129 Failure to comply with assisted community treatment. (a) A [treating
psychiatrist or advanced practice registered nurse with prescriptive authority and
who holds an accredited national certification in an advanced practice registered
nurse psychiatric specialization] qualified psychiatric examiner may
prescribe or administer to the subject of the order reasonable and appropriate medication
or medications, if specifically authorized by [the] a court order,
and treatment that is consistent with accepted medical standards and the [family]
court order, including the written treatment plan submitted pursuant to section
334-126(g)[.], and in accordance with the procedures described in subsection
(b).
(b) [No
subject of the order shall be physically forced to take medication under a family
court order for assisted community treatment unless the subject is within an emergency
department or admitted to a hospital, subsequent to the date of the current assisted community treatment
order.] A qualified psychiatric examiner may administer
medication or medications specifically authorized by a court order to a subject
of the order over objection of the subject during emergency examination or hospitalization
under part IV, subpart A or while committed for involuntary
hospitalization under part IV, subpart C.
(c) A subject of the order may be transported
to [a designated mental
health program, or a hospital emergency department,] a psychiatric facility or other
facility designated by the director for failure to comply with an order for
assisted community treatment via the following methods:
(1) By
an
interested party with the consent of the subject of the order; or
(2) In accordance with
section [334-59.] 334-E(b).
(d) The
[designated mental health program's treating psychiatrist or advanced practice
registered nurse with prescriptive authority and who holds an accredited national
certification in an advanced practice registered nurse psychiatric specialization
or designee of the psychiatrist or advanced practice registered nurse with prescriptive
authority and who holds an accredited national certification in an advanced practice
registered nurse psychiatric specialization] assisted community treatment
provider shall make [all] reasonable efforts to solicit the subject's
compliance with the prescribed treatment.
If the subject fails or refuses to comply after the efforts to solicit compliance,
the [treating psychiatrist or advanced practice registered nurse with prescriptive
authority and who holds an accredited national certification in an advanced practice
registered nurse psychiatric specialization] assisted community treatment
provider shall [assess whether the subject of the order meets criteria
for involuntary hospitalization under part IV of this chapter, and] proceed
[with the admission pursuant to section [334-59(a)(2) or (3);] pursuant
to section 334-D or 334-E; provided that the refusal of treatment shall
not, by itself, constitute a basis for involuntary hospitalization.
(e) Notice of any transport or [admission]
hospitalization under this section shall be provided pursuant to section [334‑59.5.]
334-H."
SECTION 21. Section 334-130,
Hawaii Revised Statutes, is amended to read as follows:
"§334-130 Period of assisted community treatment. (a) [The]
Unless a family court orders otherwise, the assisted community treatment
order shall continue to apply to the subject, for the duration specified in the
order, regardless of whether the treatment setting changes.
(b)
A subject of [assisted community treatment
is] the order shall be automatically and fully discharged at the end
of the family [court ordered] court-ordered period of treatment[,]
pursuant to an assisted community treatment order, a period of no more than
two years, unless a new family court order has been obtained [as provided hereinbelow].
(c) Nothing in this section shall preclude the subject's
stipulation to the continuance [[]of[]] an existing court order."
SECTION 22.
Section 334-131, Hawaii Revised Statutes, is amended by amending subsection
(a) to read as follows:
"(a) When the [treating psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization] assisted community treatment provider contemplates discharge
for a subject of the order because of the imminent expiration of the court
order or because the subject of the order is no longer a proper subject for assisted
community treatment, as determined by the criteria in section 334-121, the [treating
psychiatrist or advanced practice registered nurse with prescriptive authority and
who holds an accredited national certification in an advanced practice registered
nurse psychiatric specialization] assisted community treatment provider
shall provide notice of intent to discharge."
SECTION 23.
Section 334-162, Hawaii Revised Statutes, is amended by amending subsection
(a) to read as follows:
"(a)
A patient who is in the custody of the director and in a psychiatric facility
may be ordered to receive medical treatment over the patient's objection through
an administrative authorization process that includes the following due process
safeguards:
(1) The
facility shall give notice to the patient of the authorization process and the reasons for
initiating the process;
(2) The
administrative panel [shall consist], consisting of three members
with relevant clinical training and experience, and who are not involved with the
current treatment of the patient[;], shall, after considering all relevant
evidence, determine whether the criteria under section 334-161 are met;
(3) The
patient shall have the right to attend the hearing, receive assistance from an advisor,
cross examine
witnesses, and present testimony, exhibits, and witnesses; and
(4) The
patient shall have the right to appeal the decision of the administrative panel."
SECTION 24.
Section 334E-2, Hawaii Revised Statutes, is amended by amending subsection
(a) to read as follows:
"(a)
Any patient in a psychiatric facility shall be afforded rights, and any psychiatric
facility shall provide the rights to all patients; provided that when a patient
is not able to exercise the patient's rights, the patient's legal guardian or legal
representative shall have the authority to exercise the same on behalf of the patient. The rights shall include but not be limited to
the following:
(1) Access
to written rules and regulations with which the patient is expected to comply;
(2) Access
to the facility's grievance procedure or to the department of health as provided
in section 334-3;
(3) Freedom from reprisal;
(4) Privacy, respect, and personal dignity;
(5) A
humane environment;
(6) Freedom
from discriminatory treatment based on race, color, creed, national origin, age,
and sex;
(7) A written treatment plan based on the individual patient;
(8) Participation in the planning of the patient's treatment plan;
(9) Refusal
of treatment except in emergency situations or when a court order or an administrative
order pursuant to chapter 334, part VIII or X, has been issued;
(10) Refusal to participate in experimentation;
(11) The choice of physician if the
physician chosen agrees;
(12) A
qualified, competent staff;
(13) A
medical examination before initiation of non-emergency treatment;
(14) Confidentiality
of the patient's records;
(15) Access to the patient's records;
(16) Knowledge
of rights withheld or removed by a court or by law;
(17) Physical
exercise and recreation;
(18) Adequate
diet;
(19) Knowledge
of the names and titles of staff members with whom the patient has frequent contact;
(20) The
right to work at the facility and fair compensation for work done; provided that
work is available and is part of the patient's treatment plan;
(21) Visitation
rights, unless the patient poses a danger to self or others; provided that where
visitation is prohibited, the legal guardian or legal representative shall be allowed
to visit the patient upon request;
(22) Uncensored
communication;
(23) Notice
of and reasons for an impending transfer;
(24) Freedom
from seclusion or restraint, except:
(A) When necessary to prevent injury to self or others;
(B) When
part of the treatment plan; or
(C) When
necessary to preserve the rights of other patients or staff;
(25) Disclosure
to a court, at an involuntary civil commitment hearing, of all treatment procedures
[which] that have been administered [prior to] before
the hearing; and
(26) Receipt
by the patient and the patient's guardian or legal guardian, if the patient has
one, of this enunciation of rights at the time of admission."
SECTION 25.
Section 586-5.5, Hawaii Revised Statutes, is amended by amending subsection
(a) to read as follows:
"(a)
If, after hearing all relevant evidence, the court finds that the respondent
has failed to show cause why the order should not be continued and that a protective
order is necessary to prevent domestic abuse or a recurrence of abuse, the court
may order that a protective order be issued for a further fixed reasonable period
as the court deems appropriate, including, in the case where a protective order
restrains any party from contacting, threatening, or physically abusing a minor,
a fixed reasonable period extending to a date after the minor has reached eighteen
years of age.
The protective order may include all orders
stated in the temporary restraining order and may provide for further relief as
the court deems necessary to prevent domestic abuse or a recurrence of abuse, including
orders establishing temporary visitation and custody with regard to minor children
of the parties and orders to either or both parties to participate in domestic violence
intervention services. If the court finds
that the party meets the requirements under section [334‑59(a)(2),]
334-D, the court [further] may further order that the party
be taken to the nearest facility for emergency examination and treatment."
SECTION 26.
Section 334-59, Hawaii Revised Statutes, is repealed.
["§334-59 Emergency examination and hospitalization. (a) Initiation
of proceedings. An emergency admission may
be initiated as follows:
(1) If a law enforcement officer has reason
to believe that a person is imminently dangerous to self or others, the officer
shall call for assistance from a mental health emergency worker designated by the
director; provided that if a law enforcement officer is unable to reach a mental
health emergency worker telephonically or has reason to believe the situation to
be unstable to a degree that a delay of greater than two minutes would result in
serious harm to the individual, others, or property, the law enforcement officer
may act to gain control of the individual.
Once the law enforcement officer has gained control of the individual, the
law enforcement officer shall call for assistance from a mental health emergency
worker designated by the director; provided that the law enforcement officer shall
document why the situation necessitated that the law enforcement officer gain control
of the individual. Upon determination by
the mental health emergency worker that the person is imminently dangerous to self
or others, the person shall be transported by ambulance or other suitable means
to a licensed psychiatric facility or other facility designated by the director
for further evaluation and possible emergency hospitalization. If a crisis intervention officer has probable
cause to believe that a person is imminently dangerous to self or others, the crisis
intervention officer shall call a mental health emergency worker to determine if
the person shall be transported by ambulance or other suitable means to a behavioral
health crisis center designated by the director as determined by a mental health
emergency worker. A law enforcement officer
may also take into custody and transport to any facility designated by the director
any person threatening or attempting suicide.
The law enforcement officer shall make application for the examination, observation,
and diagnosis of the person in custody. The
application shall state or shall be accompanied by a statement of the circumstances
under which the person was taken into custody and the reasons therefor, which shall
be transmitted with the person to a physician, advanced practice registered nurse,
or psychologist at the facility.
As
used in this paragraph, "crisis intervention officer" has the same meaning
as defined in section 353C-1;
(2) Upon written or oral application of any
licensed physician, advanced practice registered nurse, psychologist, attorney,
member of the clergy, health or social service professional, or any state or county
employee in the course of employment, a judge may issue an ex parte order orally,
but shall reduce the order to writing by the close of the next court day following
the application, stating that there is probable cause to believe the person is mentally
ill or suffering from substance abuse, is imminently dangerous to self or others
and in need of care or treatment, or both, giving the findings upon which the conclusion
is based. The order shall direct that a law
enforcement officer or other suitable individual take the person into custody and
deliver the person to a designated mental health program, if subject to an assisted
community treatment order issued pursuant to part VIII, or to the nearest facility
designated by the director for emergency examination and treatment, or both. The ex parte order shall be made a part of the
patient's clinical record. If the application
is oral, the person making the application shall reduce the application to writing
and shall submit the same by noon of the next court day to the judge who issued
the oral ex parte order. The written application
shall be executed subject to the penalties of perjury but need not be sworn to before
a notary public; or
(3) Any licensed physician, advanced practice
registered nurse, physician assistant, or psychologist who has examined a person
and has reason to believe the person is:
(A) Mentally ill or suffering from substance
abuse;
(B) Imminently dangerous to self or others;
and
(C) In need of care or treatment,
may
direct transportation, by ambulance or other suitable means, to a licensed
psychiatric facility or other facility designated by the director for further
evaluation and possible emergency hospitalization. A licensed physician, an advanced practice
registered nurse, or a physician assistant may administer treatment as is
medically necessary, for the person's safe transportation. A licensed psychologist may administer
treatment as is psychologically necessary.
(b) Emergency examination. A patient who is delivered for emergency examination
and treatment to a psychiatric facility or a behavioral health crisis center shall
be provided an examination, which shall include a screening to determine whether
the criteria for involuntary hospitalization listed in section 334-60.2 persists,
by a licensed physician, medical resident under the supervision of a licensed physician,
or advanced practice registered nurse without unnecessary delay, and shall be provided
such treatment as is indicated by good medical practice. If, after the examination, screening, and treatment,
the licensed physician, medical resident under the supervision of a licensed physician,
or advanced practice registered nurse determines that the involuntary hospitalization
criteria persist, then a psychiatrist or advanced practice registered nurse who
has prescriptive authority and who holds an accredited national certification in
an advanced practice registered nurse psychiatric specialization shall further examine
the patient to diagnose the presence or absence of a mental illness or substance
use disorder, further assess the risk that the patient may be dangerous to self
or others, and assess whether or not the patient needs to be hospitalized. If it is determined that hospitalization is not
needed, an examination pursuant to section 334-121.5 shall be completed.
(c) Release from emergency examination. If, after examination, the licensed physician,
psychiatrist, or advanced practice registered nurse with prescriptive authority
and who holds an accredited national certification in an advanced practice registered
nurse psychiatric specialization determines that the involuntary hospitalization
criteria set forth in section 334-60.2 are not met or do not persist and the examination
pursuant to section 334-121.5, where required, has been completed, the patient shall
be discharged expediently, unless the patient is under criminal charges, in which
case the patient shall be returned to the custody of a law enforcement officer.
(d) Emergency hospitalization. If the psychiatrist or advanced practice registered
nurse with prescriptive authority and who holds an accredited national certification
in an advanced practice registered nurse psychiatric specialization who performs
the emergency examination has reason to believe that the patient is:
(1) Mentally ill or suffering from substance
abuse;
(2) Imminently dangerous to self or others;
and
(3) In need of care or treatment, or both,
the psychiatrist
or advanced practice registered nurse with prescriptive authority and who holds
an accredited national certification in an advanced practice registered nurse psychiatric
specialization shall direct that the patient be hospitalized on an emergency basis
or cause the patient to be transferred to another psychiatric facility or other
facility designated by the director for emergency hospitalization, or both. The patient shall have the right immediately upon
admission to telephone the patient's guardian or a family member including a reciprocal
beneficiary, or an adult friend and an attorney. If the patient declines to exercise that right,
the staff of the facility shall inform the adult patient of the right to waive notification
to the family, including a reciprocal beneficiary, and shall make reasonable efforts
to ensure that the patient's guardian or family, including a reciprocal beneficiary,
is notified of the emergency admission but the patient's family, including a reciprocal
beneficiary, need not be notified if the patient is an adult and requests that there
be no notification. The patient shall be
allowed to confer with an attorney in private.
(e) Release from emergency
hospitalization. If at any time during
the period of emergency hospitalization the treating physician determines that the
patient no longer meets the criteria for emergency hospitalization and the examination
pursuant to section 334-121.5 has been completed, the physician shall expediently
discharge the patient. If the patient is
under criminal charges, the patient shall be returned to the custody of a law enforcement
officer. In any event, the patient shall
be released within forty-eight hours of the patient's admission to a psychiatric
facility or other facility designated by the director, unless the patient voluntarily
agrees to further hospitalization, or a proceeding for court-ordered evaluation
or hospitalization, or both, is initiated as provided in section 334-60.3. If that time expires on a Saturday, Sunday, or
holiday, the time for initiation is extended to the close of the next court day. Upon initiation of the proceedings, the facility
shall be authorized to detain the patient until further order of the court."]
SECTION 27.
Section 334-59.5, Hawaii Revised Statutes, is repealed.
["[§334-59.5 Notice of emergency transportation, examinations,
and hospitalizations. Notice of
an individual's emergency admission, examination, and hospitalization under this
chapter may be given to at least one of the following persons in the following order
of priority: the individual's spouse or reciprocal
beneficiary, legal parents, adult children, legal guardian, if one has been appointed,
or if none can be found, the closest adult relative, as long as the individual:
(1) Has capacity to make health care decisions and
agrees;
(2) Is given the opportunity to object and does
not object, or the health care provider can reasonably infer from the circumstances
based on the exercise of professional judgment that the individual does not object;
or
(3) Is incapacitated or an emergency circumstance
exists and the health care provider determines based on the exercise of professional
judgment that doing so is in the best interest of the individual."]
SECTION 28. This Act does not affect rights and duties that
matured, penalties that were incurred, and proceedings that were begun before its
effective date.
SECTION 29.
If any provision of this Act or the application thereof to any person or
circumstance is held invalid, the invalidity does not affect other provisions or
applications of the Act that can be given effect without the invalid provision or
application, and to this end the provisions of this Act are severable.
SECTION 30. In codifying the new sections added by sections 2,
3, and 4 of this Act, the revisor of statutes shall substitute appropriate section
numbers for the letters used in designating the new sections in this Act.
SECTION 31. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 32. This Act shall take effect on December 31, 2050.
Report Title:
DOH; Mental Health; Admission to Psychiatric Facility; Emergency Procedures; Involuntary Hospitalization; Assisted Community Treatment; Administration of Treatment Over Objection
Description:
Requires the Department of Health to submit annual reports to the Legislature on emergency transportations and assisted community treatment petitions and orders, based on information provided by service providers. Clarifies the procedures for emergency transportation, examination, and hospitalization for individuals who may be mentally ill or suffering from substance abuse who are imminently dangerous to self or others. Requires treatment providers to provide relevant information to the Attorney General for purposes of preparing an assisted community treatment petition. Amends the procedures for involuntary hospitalizations and assisted community treatment petitions. Clarifies the circumstances under which a subject of an assisted community treatment order can be administered medication over objection. Effective 12/31/2050. (HD2)
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.