Bill Text: MS HB121 | 2010 | Regular Session | Introduced

Mississippi House Bill 121 (Prior Session Legislation)

Introduced

Bill Title: Mental health commitment laws; authorize certain trained law enforcement officers to hold mentally ill persons for treatment.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Failed) 2010-02-02 - Died In Committee [HB121 Detail]

Download: Mississippi-2010-HB121-Introduced.html

MISSISSIPPI LEGISLATURE

2010 Regular Session

To: Public Health and Human Services

By: Representative Clarke

House Bill 121

AN ACT TO AMEND SECTION 41-21-61, MISSISSIPPI CODE OF 1972, TO DEFINE CERTAIN TERMS RELATING TO PERSONS IN NEED OF MENTAL TREATMENT; TO AMEND SECTION 41-21-67, MISSISSIPPI CODE OF 1972, TO AUTHORIZE CERTAIN TRAINED LAW ENFORCEMENT OFFICERS TO HOLD MENTALLY ILL PERSONS FOR PURPOSE OF EMERGENCY TREATMENT IN A LICENSED MEDICAL FACILITY; TO EXEMPT LAW ENFORCEMENT OFFICERS FROM CIVIL AND CRIMINAL LIABILITY FOR DETAINING A MENTALLY ILL PERSON IN GOOD FAITH; TO CREATE NEW SECTION 41-4-10, MISSISSIPPI CODE OF 1972, TO PROVIDE FOR OPERATION OF COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAMS BY HOSPITALS THAT ARE OPERATED BY STATE OR LOCAL GOVERNMENTS OR VOLUNTARY AGENCIES; TO PROVIDE FOR THE IMPLEMENTATION OF CRISIS INTERVENTION TEAMS; TO ESTABLISH A CRISIS INTERVENTION TEAM PILOT PROGRAM IN HINDS COUNTY IN WHICH THERE WILL BE A SINGLE POINT OF ENTRY FOR THE ASSESSMENT, TRIAGE AND STABILIZATION OF PERSONS IN NEED OF MENTAL HEALTH SERVICES WHO ARE DETAINED BY LAW ENFORCEMENT OFFICERS; TO PROVIDE THAT THE STATE BOARD OF MENTAL HEALTH SHALL ADOPT RULES AND REGULATIONS ESTABLISHING MINIMUM STANDARDS AND REQUIREMENTS FOR THE OPERATION OF THE PILOT PROGRAM AND FOR THE TRAINING OF CRISIS INTERVENTION TEAMS; TO PROVIDE THAT THE REGION 9 MENTAL HEALTH/MENTAL RETARDATION CENTER SHALL CONTRACT WITH THE UNIVERSITY OF MISSISSIPPI MEDICAL CENTER, ST. DOMINIC HOSPITAL AND CENTRAL MISSISSIPPI MEDICAL CENTER UNDER WHICH ONE OF THE FACILITIES WILL BE DESIGNATED AS THE SINGLE POINT OF ENTRY FOR LAW ENFORCEMENT OFFICERS TO BRING PERSONS WHO ARE IN NEED OF MENTAL HEALTH SERVICES; TO PROVIDE THAT THE OTHER TWO FACILITIES WILL ASSIST THE SINGLE POINT OF ENTRY FACILITY IN PROVIDING TEMPORARY TREATMENT SERVICES AS NECESSARY UNTIL THE PERSON RECEIVES MEDICAL CLEARANCE FOR TRANSFER; AND FOR RELATED PURPOSES.

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

SECTION 1. Section 41-21-61, Mississippi Code of 1972, is amended as follows:

41-21-61. As used in Sections 41-21-61 through 41-21-107, unless the context otherwise requires, the following terms defined have the meanings ascribed to them:

(a) "Chancellor" means a chancellor or a special master in chancery.

(b) "Clerk" means the clerk of the chancery court.

(c) "Director" means the chief administrative officer of a treatment facility or other employee designated by him as his deputy.

(d) "Interested person" means an adult, including but not limited to, a public official, and the legal guardian, spouse, parent, legal counsel, adult, child next of kin, or other person designated by a proposed patient.

(e) "Mentally ill person" means any person who has a substantial psychiatric disorder of thought, mood, perception, orientation, or memory which grossly impairs judgment, behavior, capacity to recognize reality, or to reason or understand, which (i) is manifested by instances of grossly disturbed behavior or faulty perceptions; and (ii) poses a substantial likelihood of physical harm to himself or others as demonstrated by (A) a recent attempt or threat to physically harm himself or others, or (B) a failure to provide necessary food, clothing, shelter or medical care for himself, as a result of the impairment. "Mentally ill person" includes a person who, based on treatment history and other applicable psychiatric indicia, is in need of treatment in order to prevent further disability or deterioration which would predictably result in dangerousness to himself or others when his current mental illness limits or negates his ability to make an informed decision to seek or comply with recommended treatment. "Mentally ill person" does not include a person having only one or more of the following conditions: (1) epilepsy, (2) mental retardation, (3) brief periods of intoxication caused by alcohol or drugs, (4) dependence upon or addiction to any alcohol or drugs, or (5) senile dementia.

(f) "Mentally retarded person" means any person (i) who has been diagnosed as having substantial limitations in present functioning, manifested before age eighteen (18), characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure and work, and (ii) whose recent conduct is a result of mental retardation and poses a substantial likelihood of physical harm to himself or others in that there has been (A) a recent attempt or threat to physically harm himself or others, or (B) a failure and inability to provide necessary food, clothing, shelter, safety, or medical care for himself.

(g) "Physician" means any person licensed by the State of Mississippi to practice medicine in any of its branches.

(h) "Psychologist" when used in Sections 41-21-61 through 41-21-107, means a licensed psychologist who has been certified by the State Board of Psychological Examiners as qualified to perform examinations for the purpose of civil commitment.

(i) "Treatment facility" means a hospital, community mental health center, or other institution qualified to provide care and treatment for mentally ill, mentally retarded, or chemically dependent persons.

(j) "Law enforcement officer" means an officer who is authorized to make arrests under Section 99-3-1 and who is trained and certified as a member of a crisis intervention team and working within the catchment area of a comprehensive psychiatric emergency program, as provided in Section 41-4-10, but does not include private persons.

(k) "Substantial likelihood of bodily harm" means that:

(i) The person has threatened or attempted suicide or to inflict serious bodily harm to himself; or

(ii) The person has threatened or attempted homicide or other violent behavior; or

(iii) The person has placed others in reasonable fear of violent behavior and serious physical harm to them; or

(iv) The person is unable to avoid severe impairment or injury from specific risks; and

(v) There is substantial likelihood that serious harm will occur unless the person is placed under emergency treatment.

SECTION 2. Section 41-21-67, Mississippi Code of 1972, is amended as follows:

41-21-67. (1) Whenever the affidavit provided for in Section 41-21-65 is filed with the chancery clerk, the clerk, upon direction of the chancellor of the court, shall issue a writ directed to the sheriff of the proper county to take into his or her custody the person alleged to be in need of treatment and to bring the person before the clerk or chancellor, who shall order pre-evaluation screening and treatment by the appropriate community mental health center established under Section 41-19-31 and for examination as set forth in Section 41-21-69. However, when the affidavit fails to set forth factual allegations and witnesses sufficient to support the need for treatment, the chancellor shall refuse to direct issuance of the writ. Reapplication may be made to the chancellor. If a pauper's affidavit is filed by a guardian for commitment of the ward of the guardian, the court shall determine if the ward is a pauper and if the ward is determined to be a pauper, the county of the residence of the respondent shall bear the costs of commitment, unless funds for those purposes are made available by the state.

(2) Upon issuance of the writ, the chancellor shall immediately appoint and summon two (2) reputable, licensed physicians or one (1) reputable, licensed physician and either one (1) psychologist, nurse practitioner or physician assistant to conduct a physical and mental examination of the person at a place to be designated by the clerk or chancellor and to report their findings to the clerk or chancellor. * * * However, * * * any nurse practitioner or physician assistant conducting the examination shall be independent from, and not under the supervision of, the other physician conducting the examination. In all counties in which there is a county health officer, the county health officer, if available, may be one (1) of the physicians so appointed. Neither of the physicians nor the psychologist, nurse practitioner or physician assistant selected shall be related to that person in any way, nor have any direct or indirect interest in the estate of that person nor shall any full-time staff of residential treatment facilities operated directly by the Department of Mental Health serve as examiner.

(3) The clerk shall ascertain whether the respondent is represented by an attorney, and if it is determined that respondent does not have an attorney, the clerk shall immediately notify the chancellor of that fact. If the chancellor determines that respondent for any reason does not have the services of an attorney, the chancellor shall immediately appoint an attorney for the respondent at the time the examiners are appointed.

(4) If the chancellor determines that there is probable cause to believe that the respondent is mentally ill and that there is no reasonable alternative to detention, the chancellor may order that the respondent be retained as an emergency patient at any available regional mental health facility or any other available suitable location as the court may so designate pending an admission hearing and may, if necessary, order a peace officer or other person to transport the respondent to that mental health facility or suitable location. Any respondent so retained may be given such treatment by a licensed physician as is indicated by standard medical practice. However, the respondent shall not be held in a hospital operated directly by the Department of Mental Health, and shall not be held in jail unless the court finds that there is no reasonable alternative.

(5) Whenever a licensed physician or psychologist certified to complete examinations for the purpose of commitment, or a law enforcement officer, has reason to believe that a person poses an immediate substantial likelihood of physical harm to himself or others or is gravely disabled and unable to care for himself by virtue of mental illness, as defined in Section 41-21-61(e), then the physician, psychologist or law enforcement officer may hold the person or the physician may admit the person to and treat the person in a licensed medical facility, without a civil order or warrant for a period not to exceed seventy-two (72) hours or the end of the next business day of the chancery clerk's office. The person may be held and treated as an emergency patient at any licensed medical facility, available regional mental health facility, or crisis intervention center. The physician, psychologist or law enforcement officer who holds the person shall certify in writing the reasons for the need for holding. Any respondent so held may be given any treatment by a licensed physician as indicated by standard medical practice. Persons acting in good faith in connection with the detention of a person believed to be mentally ill shall incur no liability, civil or criminal, for those acts.

SECTION 3. The following shall be codified as Section 41-4-10, Mississippi Code of 1972:

41-4-10. (1) As used in this section:

(a) "Crisis intervention team" means an authorized community partnership of law enforcement officers, mental health providers and mental health consumers and family members.

(b) "Comprehensive psychiatric emergency program" means a specialized psychiatric program to provide psychiatric emergency services, triage and referral services, and extended observation beds needed to provide these services while also providing acute, short-term stabilization of patients in crisis.

(c) "Extended observation bed" means a bed that is in or near to an emergency department or designated catchment area, designed to provide a safe environment for an individual who, in the opinion of the examining physician, requires extensive evaluation, assessment, or stabilization of the person's acute psychiatric symptoms, except that, if the Executive Director of the State Department of Health determines that the program can provide for the privacy and safety of all patients receiving services in a hospital, he or she may approve the location of one or more of those beds within another unit of the hospital.

(d) "Psychiatric emergency services" means services designed to stabilize and, when possible, reduce acute psychiatric symptoms of an individual who appears to be mentally ill and in crisis.

(e) "Triage and referral services" means services designed to provide preliminary diagnosis, assessment and evaluation of individuals served by a comprehensive psychiatric emergency program in order to direct that person to those services that appropriately address their needs.

(2) At the request of the executive director of the department, the Executive Director of the State Department of Health may license the operation of comprehensive psychiatric emergency programs by hospitals that are operated by state or local governments or voluntary agencies.

(3) The board shall develop standards for comprehensive psychiatric emergency programs, and the executive directors of the State Department of Mental Health and the State Department of Health shall enter into a cooperative agreement to govern the operation of comprehensive psychiatric emergency programs, including visitation, inspection and supervision of those programs and the protection of the confidentiality of clinical information regarding patients at those programs. The executive director of the department shall establish a uniform system by which hospitals that operate comprehensive psychiatric emergency programs will report the cost of operation to the department.

(4) The intent of the Legislature in establishing comprehensive psychiatric emergency programs is to provide for the implementation of crisis intervention teams. The board shall adopt rules and regulations establishing minimum standards and requirements for the operation of crisis intervention teams, and for the training of crisis intervention teams and for certification by the department of persons who have completed the training. The board, working with law enforcement agencies, shall establish training guidelines and qualifications for the certification of law enforcement officers as crisis intervention team members.

(5) Comprehensive psychiatric emergency programs shall provide psychiatric emergency services, triage and referral services, and extended observation beds needed to provide these services while also providing acute, short-term stabilization of patients in crisis. The medical director of the department must certify that all necessary services are available before the executive director makes the request for licensure of a service in a comprehensive psychiatric emergency program.

(6) Patients admitted to a comprehensive psychiatric emergency program must have a final disposition within a maximum of seventy-two (72) hours. If a patient cannot be stabilized within this seventy-two-hour period, the patient shall be transferred from an extended observation bed to a more appropriate inpatient unit.

(7) A comprehensive psychiatric emergency program shall serve as a primary psychiatric emergency service provider within a defined catchment area for persons in need of psychiatric emergency services, including persons who require immediate observation, care and treatment. Catchment areas shall be designated and approved by the executive director. Crisis intervention teams must be associated with and work within a particular catchment area.

(8) When requesting licensure of a comprehensive psychiatric emergency program, the executive director shall specify the number of extended observation beds that are required. This number of beds shall be determined by the medical director, with approval of the executive director, so as to adequately serve the designated catchment area.

(9) Each comprehensive psychiatric emergency program shall provide or contract to provide psychiatric emergency services twenty-four (24) hours per day, seven (7) days per week, including, but not limited to, evaluation and treatment, extended observation beds and triage and referral services. The comprehensive psychiatric emergency program shall have at least one (1) physician, who is a member of the psychiatric staff of the program, on duty and available at all times, however, the medical director, with the approval of the executive director, may promulgate regulations to permit the issuance of a waiver of this requirement when the volume of service of a program does not require that level of staff coverage.

(10) Law enforcement officers who have been trained and certified as members of a crisis intervention team and working within the catchment area of a comprehensive psychiatric emergency program are authorized to take persons in need of mental health services into custody and transport them directly to a comprehensive psychiatric emergency program facility instead of taking them to jail.

(11) Law enforcement officers and community mental health centers that are outside of a designated catchment area shall not be authorized to send persons in need of mental health services to established comprehensive psychiatric emergency programs.

(12) Notwithstanding any other provision of law, nothing in this section shall be interpreted to create an entitlement for any individual to receive psychiatric emergency services in a comprehensive psychiatric emergency program.

(13) For the purpose of addressing unique rural service delivery needs and conditions, the medical director, with approval of the executive director shall provide technical assistance to assist in the establishment of comprehensive psychiatric emergency programs otherwise approved under the provisions of this section, including technical assistance to promote and facilitate the establishment of those programs in rural areas in the state in single counties or combinations of rural counties.

SECTION 4. (1) There is established a crisis intervention team pilot program in Hinds County in which there will be a single point of entry for the assessment, triage and stabilization of persons in need of mental health services who are detained by law enforcement officers before the persons are transferred to an appropriate mental health facility.

(2) The State Board of Mental Health shall adopt rules and regulations establishing minimum standards and requirements for the operation of the crisis intervention team pilot program, and for the training of crisis intervention teams and for certification by the State Department of Mental Health of persons who have completed the training.

(3) The Region 9 Mental Health/Mental Retardation Center, known as Hinds Behavioral Health Services, shall contract with the University of Mississippi Medical Center, St. Dominic Hospital and Central Mississippi Medical Center under which one (1) of the facilities will be designated as the single point of entry for law enforcement officers to bring persons who are in need of mental health services. The terms of the contract must be in accordance with the minimum standards and requirements established by the State Board of Mental Health under subsection (2) of this section.

(4) Persons in need of mental health services who are brought to the single point of entry facility by law enforcement officers will receive initial assessment, triage and stabilization at that facility. The person then will be provided temporary treatment services at that facility or at either of the other two (2) facilities as necessary until the person receives medical clearance for transfer. After the person obtains medical clearance, the facility in which the person is located will transfer the person to an appropriate mental health facility for treatment.

(5) The Region 9 Mental Health/Mental Retardation Center shall provide the Legislature with progress reports on the operation of the pilot program on or before September 1, 2010, and January 1, 2011.

SECTION 5. This act shall take effect and be in force from and after its passage.