HF 1139

1st Engrossment - 90th Legislature (2017 - 2018) Posted on 03/08/2018 05:34pm

A bill for an act
relating to human services; requiring mandatory assisted outpatient treatment for
persons who are mentally ill; amending Minnesota Statutes 2016, sections 144.293,
subdivision 5; 253B.05, subdivision 2; 253B.065, subdivision 5; 253B.07,
subdivision 2b; 253B.09, subdivision 5, by adding a subdivision; 253B.13,
subdivision 1.

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

Section 1.

Minnesota Statutes 2016, section 144.293, subdivision 5, is amended to read:

Subd. 5.

Exceptions to consent requirement.

(a) This section does not prohibit the
release of health records:

(1) for a medical emergency when the provider is unable to obtain the patient's consent
due to the patient's condition or the nature of the medical emergency;

(2) to other providers within related health care entities when necessary for the current
treatment of the patient; deleted text begin or
deleted text end

(3) to a health care facility licensed by this chapter, chapter 144A, or to the same types
of health care facilities licensed by this chapter and chapter 144A that are licensed in another
state when a patient:

(i) is returning to the health care facility and unable to provide consent; or

(ii) who resides in the health care facility, has services provided by an outside resource
under Code of Federal Regulations, title 42, section 483.75(h), and is unable to provide
consent new text begin ; or
new text end

new text begin (4) to a committing court or law enforcement agency for purposes of providing notice
of the failure of a patient to appear for an assisted outpatient treatment appointment or failure
to substantially comply with a court-approved treatment plan under section 253B.09,
subdivision 6 new text end .

(b) A provider may release a deceased patient's health care records to another provider
for the purposes of diagnosing or treating the deceased patient's surviving adult child.

Sec. 2.

Minnesota Statutes 2016, section 253B.05, subdivision 2, is amended to read:

Subd. 2.

Peace or health officer authority.

(a) A peace or health officer may take a
person into custody and transport the person to a licensed physician or treatment facility if
the officer has reason to believe, either through direct observation of the person's behavior,
or upon reliable information of the person's recent behavior and knowledge of the person's
past behavior or psychiatric treatment, that the person is mentally ill or developmentally
disabled and in danger of injuring self or others if not immediately detained. A peace or
health officer or a person working under such officer's supervision, may take a person who
is believed to be chemically dependent or is intoxicated in public into custody and transport
the person to a treatment facility. If the person is intoxicated in public or is believed to be
chemically dependent and is not in danger of causing self-harm or harm to any person or
property, the peace or health officer may transport the person home. The peace or health
officer shall make written application for admission of the person to the treatment facility.
The application shall contain the peace or health officer's statement specifying the reasons
for and circumstances under which the person was taken into custody. If danger to specific
individuals is a basis for the emergency hold, the statement must include identifying
information on those individuals, to the extent practicable. A copy of the statement shall be
made available to the person taken into custody. The peace or health officer who makes the
application shall provide the officer's name, the agency that employs the officer, and the
telephone number or other contact information for purposes of receiving notice under
subdivision 3, paragraph (d).

(b) As far as is practicable, a peace officer who provides transportation for a person
placed in a facility under this subdivision may not be in uniform and may not use a vehicle
visibly marked as a law enforcement vehicle.

(c) A person may be admitted to a treatment facility for emergency care and treatment
under this subdivision with the consent of the head of the facility under the following
circumstances: (1) a written statement shall only be made by the following individuals who
are knowledgeable, trained, and practicing in the diagnosis and treatment of mental illness
or developmental disability; the medical officer, or the officer's designee on duty at the
facility, including a licensed physician, a licensed physician assistant, or an advanced practice
registered nurse who after preliminary examination has determined that the person has
symptoms of mental illness or developmental disability and appears to be in danger of
harming self or others if not immediately detained; or (2) a written statement is made by
the institution program director or the director's designee on duty at the facility after
preliminary examination that the person has symptoms of chemical dependency and appears
to be in danger of harming self or others if not immediately detained or is intoxicated in
public.

new text begin (d) A peace officer shall take a person into custody and transport the person to a treatment
facility if the law enforcement agency that employs the officer has received notice of the
failure of a patient to appear for an assisted outpatient treatment appointment or failure to
substantially comply with a court-approved treatment plan under section 253B.09, subdivision
6. The person must be admitted to a treatment facility in order to ensure that the person
takes prescribed medications and to stabilize the person, if necessary.
new text end

Sec. 3.

Minnesota Statutes 2016, section 253B.065, subdivision 5, is amended to read:

Subd. 5.

Early intervention criteria.

(a) A court shall order early intervention treatment
of a proposed patient who meets the criteria under paragraph (b) or (c). The early intervention
treatment must be less intrusive than long-term inpatient commitment and must be the least
restrictive treatment program available that can meet the patient's treatment needs.

(b) The court shall order early intervention treatment if the court finds all of the elements
of the following factors by clear and convincing evidence:

(1) the proposed patient is mentally ill;

(2) the proposed patient refuses to accept appropriate mental health treatment new text begin or has
previously received court-ordered treatment and would benefit from a continuum of care new text end ;
and

(3) the proposed patient's mental illness is manifested by instances of grossly disturbed
behavior or faulty perceptions and either:

(i) the grossly disturbed behavior or faulty perceptions significantly interfere with the
proposed patient's ability to care for self and the proposed patient, when competent, would
have chosen substantially similar treatment under the same circumstances; or

(ii) due to the mental illness, the proposed patient received court-ordered inpatient
treatment under section 253B.09 at least two times in the previous three years; the patient
is exhibiting symptoms or behavior substantially similar to those that precipitated one or
more of the court-ordered treatments; and the patient is reasonably expected to physically
or mentally deteriorate to the point of meeting the criteria for commitment under section
253B.09 unless treated.

For purposes of this paragraph, a proposed patient who was released under section
253B.095 and whose release was not revoked is not considered to have received court-ordered
inpatient treatment under section 253B.09.

(c) The court may order early intervention treatment if the court finds by clear and
convincing evidence that a pregnant woman is a chemically dependent person. A chemically
dependent person for purposes of this section is a woman who has during pregnancy engaged
in excessive use, for a nonmedical purpose, of controlled substances or their derivatives,
alcohol, or inhalants that will pose a substantial risk of damage to the brain or physical
development of the fetus.

(d) For purposes of paragraphs (b) and (c), none of the following constitute a refusal to
accept appropriate mental health treatment:

(1) a willingness to take medication but a reasonable disagreement about type or dosage;

(2) a good faith effort to follow a reasonable alternative treatment plan, including
treatment as specified in a valid advance directive under chapter 145C or section 253B.03,
subdivision 6d;

(3) an inability to obtain access to appropriate treatment because of inadequate health
care coverage or an insurer's refusal or delay in providing coverage for the treatment; or

(4) an inability to obtain access to needed mental health services because the provider
will only accept patients who are under a court order or because the provider gives persons
under a court order a priority over voluntary patients in obtaining treatment and services.

Sec. 4.

Minnesota Statutes 2016, section 253B.07, subdivision 2b, is amended to read:

Subd. 2b.

Apprehend and hold orders.

(a) The court may order the treatment facility
to hold the person in a treatment facility or direct a health officer, peace officer, or other
person to take the proposed patient into custody and transport the proposed patient to a
treatment facility for observation, evaluation, diagnosis, care, treatment, and, if necessary,
confinement, when:

(1) there has been a particularized showing by the petitioner that serious physical harm
to the proposed patient or others is likely unless the proposed patient is immediately
apprehended;

(2) the proposed patient has not voluntarily appeared for the examination or the
commitment hearing pursuant to the summons; or

(3) a person is held pursuant to section 253B.05 and a request for a petition for
commitment has been filed new text begin or an evaluation is ordered for a patient who has failed to
substantially comply with an order for assisted outpatient treatment under section 253B.09,
subdivision 6 new text end .

(b) The order of the court may be executed on any day and at any time by the use of all
necessary means including the imposition of necessary restraint upon the proposed patient.
Where possible, a peace officer taking the proposed patient into custody pursuant to this
subdivision shall not be in uniform and shall not use a motor vehicle visibly marked as a
police vehicle. Except as provided in section 253D.10, subdivision 2, in the case of an
individual on a judicial hold due to a petition for civil commitment under chapter 253D,
assignment of custody during the hold is to the commissioner of human services. The
commissioner is responsible for determining the appropriate placement within a secure
treatment facility under the authority of the commissioner.

(c) A proposed patient must not be allowed or required to consent to nor participate in
a clinical drug trial while an order is in effect under this subdivision. A consent given while
an order is in effect is void and unenforceable. This paragraph does not prohibit a patient
from continuing participation in a clinical drug trial if the patient was participating in the
drug trial at the time the order was issued under this subdivision.

Sec. 5.

Minnesota Statutes 2016, section 253B.09, subdivision 5, is amended to read:

Subd. 5.

Initial commitment period.

The initial commitment begins on the date that
the court issues its order or warrant under section 253B.10, subdivision 1. For persons
committed as mentally ill, developmentally disabled, or chemically dependent the initial
commitment shall not exceed six months new text begin , except to the extent the person is subject to a
mandatory assisted outpatient treatment order under subdivision 6 new text end .

Sec. 6.

Minnesota Statutes 2016, section 253B.09, is amended by adding a subdivision to
read:

new text begin Subd. 6. new text end

new text begin Mandatory assisted outpatient treatment. new text end

new text begin (a) In all cases where a person is
committed as a mentally ill person under this chapter, the commitment order must include
a requirement that the person participate in mandatory assisted outpatient treatment for one
year following the discharge or release of the person from a treatment facility. The head of
the treatment facility must arrange for the assignment of a case manager for the person
under section 245.462. The case manager must, in consultation with the mentally ill person
and the treating psychiatrist, psychologist, physician, or nurse practitioner, develop a written
individual treatment plan under section 245.462, subdivision 14, which must include
appropriate elements of case management services, community support services, and
outpatient services under that section, and treatment alternatives under section 253B.066,
subdivision 1, tailored to the needs of the mentally ill person. The treatment plan must
include:
new text end

new text begin (1) an appointment at least once every week with a case manager or a licensed
psychiatrist, psychologist, physician, or nurse practitioner who would qualify as an examiner
under section 253B.02, subdivision 7; and
new text end

new text begin (2) verification that the person is taking medication as prescribed for treatment of the
person's mental illness.
new text end

new text begin (b) The treatment plan must be presented to the committing court for review and approval
at a hearing designated for that purpose. If, after discharge or release, the person fails to
appear for a scheduled appointment or fails to substantially comply with the court-approved
treatment plan, the case manager, psychiatrist, psychologist, physician, or nurse practitioner
must notify the committing court and a law enforcement agency with jurisdiction in the
area where the person resides or where the person may be located for purposes of taking
the person into custody under section 253B.05, subdivision 2, paragraph (d).
new text end

Sec. 7.

Minnesota Statutes 2016, section 253B.13, subdivision 1, is amended to read:

Subdivision 1.

Mentally ill or chemically dependent persons.

If at the conclusion of
a review hearing the court finds that the person continues to be mentally ill or chemically
dependent and in need of treatment or supervision, the court shall determine the length of
continued commitment. No period of commitment shall exceed this length of time or 12
months, whichever is less. new text begin This time period does not apply to a person to the extent the
person is subject to a mandatory assisted outpatient treatment order under section 253B.09,
subdivision 6.
new text end

At the conclusion of the prescribed period, commitment may not be continued unless a
new petition is filed pursuant to section 253B.07 and hearing and determination made on
it. Notwithstanding the provisions of section 253B.09, subdivision 5, the initial commitment
period under the new petition shall be the probable length of commitment necessary or 12
months, whichever is less. The standard of proof at the hearing on the new petition shall be
the standard specified in section 253B.12, subdivision 4.