HF 2482

as introduced - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to civil commitment; allowing the local 
  1.3             mental health authority to consent to voluntary 
  1.4             treatment for certain incompetent persons; creating a 
  1.5             new standard for court-ordered early intervention to 
  1.6             provide less intrusive treatment; modifying standards 
  1.7             and procedures for the administration of neuroleptic 
  1.8             medications; modifying persons who receive certain 
  1.9             reports; providing for access to records; amending the 
  1.10            provisional discharge procedures; clarifying the time 
  1.11            a civil commitment commences; amending Minnesota 
  1.12            Statutes 1994, sections 253B.02, subdivision 15, and 
  1.13            by adding a subdivision; 253B.04; 253B.07, 
  1.14            subdivisions 1, 2, 4, and 7; 253B.09, subdivision 1, 
  1.15            and by adding a subdivision; 253B.10, subdivision 1; 
  1.16            253B.14; 253B.15, subdivisions 1, 1a, 2, 3, 5, and by 
  1.17            adding subdivisions; and 525.56, subdivision 3; 
  1.18            Minnesota Statutes 1995 Supplement, sections 13.42, 
  1.19            subdivision 3; and 253B.12, subdivision 1; proposing 
  1.20            coding for new law in Minnesota Statutes, chapter 
  1.21            253B; repealing Minnesota Statutes 1994, section 
  1.22            253B.15, subdivisions 4 and 6; Minnesota Statutes 1995 
  1.23            Supplement, section 253B.03, subdivision 6c. 
  1.24  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.25     Section 1.  Minnesota Statutes 1995 Supplement, section 
  1.26  13.42, subdivision 3, is amended to read: 
  1.27     Subd. 3.  [CLASSIFICATION OF MEDICAL DATA.] Unless the data 
  1.28  is summary data or a statute specifically provides a different 
  1.29  classification, medical data are private but are available only 
  1.30  to the subject of the data as provided in section 144.335, and 
  1.31  shall not be disclosed to others except: 
  1.32     (a) Pursuant to section 13.05; 
  1.33     (b) Pursuant to section 253B.03, subdivision 6c 253B.092 or 
  1.34  253B.14; 
  2.1      (c) Pursuant to a valid court order; 
  2.2      (d) To administer federal funds or programs; 
  2.3      (e) To the surviving spouse, parents, children, and 
  2.4   siblings of a deceased patient or client or, if there are no 
  2.5   surviving spouse, parents, children, or siblings, to the 
  2.6   surviving heirs of the nearest degree of kindred; 
  2.7      (f) To communicate a patient's or client's condition to a 
  2.8   family member or other appropriate person in accordance with 
  2.9   acceptable medical practice, unless the patient or client 
  2.10  directs otherwise; or 
  2.11     (g) As otherwise required by law. 
  2.12     Sec. 2.  Minnesota Statutes 1994, section 253B.02, is 
  2.13  amended by adding a subdivision to read: 
  2.14     Subd. 12a.  [MENTAL ILLNESS.] "Mental illness" means an 
  2.15  organic disorder of the brain or a clinically significant 
  2.16  disorder of thought, mood, perception, orientation, memory, or 
  2.17  behavior that is listed in the clinical manual of the 
  2.18  International Classification of Diseases (ICD-9-CM), current 
  2.19  edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the 
  2.20  corresponding code in the American Psychiatric Association's 
  2.21  Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), 
  2.22  current edition, Axes I, II, or III, and that seriously limits a 
  2.23  person's capacity to function in primary aspects of daily living 
  2.24  such as personal relations, living arrangements, work, and 
  2.25  recreation. 
  2.26     Sec. 3.  Minnesota Statutes 1994, section 253B.02, 
  2.27  subdivision 15, is amended to read: 
  2.28     Subd. 15.  [PATIENT.] "Patient" means any person who is 
  2.29  institutionalized or, committed, or determined to be in need of 
  2.30  other court-ordered intervention under this chapter.  
  2.31     Sec. 4.  Minnesota Statutes 1994, section 253B.04, is 
  2.32  amended to read: 
  2.33     253B.04 [INFORMAL VOLUNTARY TREATMENT AND ADMISSION 
  2.34  PROCEDURES.] 
  2.35     Subdivision 1.  [ADMISSION BY CONSENT.] Informal Voluntary 
  2.36  admission by consent is preferred over involuntary commitment.  
  3.1   Any person 16 years of age or older may request to be admitted 
  3.2   to a treatment facility as an informal a voluntary patient for 
  3.3   observation, evaluation, diagnosis, care and treatment without 
  3.4   making formal written application.  Any person under the age of 
  3.5   16 years may be admitted as an informal a voluntary patient with 
  3.6   the consent of a parent or legal guardian if it is determined by 
  3.7   independent examination that there is reasonable evidence that 
  3.8   (a) the proposed patient is mentally ill, mentally retarded, or 
  3.9   chemically dependent; and (b) the proposed patient is suitable 
  3.10  for treatment.  The head of the treatment facility shall not 
  3.11  arbitrarily refuse any person seeking admission as an informal a 
  3.12  voluntary patient.  
  3.13     Subd. 1a.  [VOLUNTARY TREATMENT OR ADMISSION FOR 
  3.14  INCOMPETENT PERSONS.] (a) The local mental health authority or 
  3.15  its designee may give informed consent for mental health 
  3.16  treatment or admission to a treatment facility on behalf of a 
  3.17  person who voluntarily agrees to accept treatment or admission 
  3.18  but is not capable of giving informed consent.  If a guardian or 
  3.19  conservator with power to consent to treatment under section 
  3.20  525.56, subdivision 3, clause (1), has been appointed on behalf 
  3.21  of the person, the consent of the guardian or conservator is 
  3.22  also required before treatment or admission is permitted under 
  3.23  this subdivision. 
  3.24     (b) A person who receives treatment or is admitted to a 
  3.25  facility under this subdivision has the right to refuse 
  3.26  treatment at any time or to be released from a facility as 
  3.27  provided under subdivision 2.  The person or an interested 
  3.28  person acting on the person's behalf may seek expedited court 
  3.29  review for a determination of whether the person's agreement to 
  3.30  accept treatment or admission is voluntary.  At the time a 
  3.31  person agrees to treatment or admission to a facility under this 
  3.32  subdivision, the local mental health authority shall inform the 
  3.33  person in writing of the person's rights under this paragraph. 
  3.34     (c) This subdivision does not apply to consent to the 
  3.35  administration of neuroleptic medications.  Neuroleptic 
  3.36  medications may be administered only as provided in section 
  4.1   253B.092. 
  4.2      Subd. 2.  [RELEASE.] Every patient admitted for mental 
  4.3   illness or mental retardation under this section shall be 
  4.4   informed in writing at the time of admission that the patient 
  4.5   has a right to leave the facility within 12 hours of making a 
  4.6   request, unless held under another provision of this chapter.  
  4.7   Every patient admitted for chemical dependency under this 
  4.8   section shall be informed in writing at the time of admission 
  4.9   that the patient has a right to leave the facility within 72 
  4.10  hours, exclusive of Saturdays, Sundays and holidays, of making a 
  4.11  request, unless held under another provision of this chapter.  
  4.12  The request shall be submitted in writing to the head of the 
  4.13  treatment facility.  On deeming it to be in the best interest of 
  4.14  the person, the person's family, or the public, the head of the 
  4.15  treatment facility shall petition for the commitment of the 
  4.16  person pursuant to section 253B.07. 
  4.17     Sec. 5.  [253B.064] [COURT-ORDERED EARLY INTERVENTION; 
  4.18  CRITERIA.] 
  4.19     Subdivision 1.  [EARLY INTERVENTION.] Upon a hearing on a 
  4.20  petition for early intervention filed under section 253B.065, 
  4.21  subdivision 2, a court shall order early intervention on behalf 
  4.22  of a proposed patient to provide treatment which is less 
  4.23  intrusive than long-term involuntary commitment if the patient 
  4.24  meets the criteria for early intervention under subdivision 2.  
  4.25     Subd. 2.  [CRITERIA.] A court shall order early 
  4.26  intervention to provide treatment if the court finds by clear 
  4.27  and convincing evidence that a proposed patient: 
  4.28     (a) has a mental illness which is manifested by instances 
  4.29  of grossly disturbed behavior or faulty perceptions that: 
  4.30     (1) significantly interfere with the person's ability to 
  4.31  care for self; or 
  4.32     (2) have caused the proposed patient to receive involuntary 
  4.33  inpatient treatment twice within the previous three years, and 
  4.34  the proposed patient is: 
  4.35     (i) exhibiting symptoms or behavior similar to symptoms or 
  4.36  behavior that precipitated involuntary inpatient treatment; and 
  5.1      (ii) reasonably expected to physically or mentally 
  5.2   deteriorate to the point of meeting the criteria for civil 
  5.3   commitment unless treated; and 
  5.4      (b) refuses to accept mental health treatment or 
  5.5   hospitalization.  
  5.6   The court may not order early intervention under paragraph (a), 
  5.7   clause (1), unless clear and convincing evidence shows what the 
  5.8   proposed patient, when competent, would have chosen to do 
  5.9   concerning treatment under the same circumstances. 
  5.10     Sec. 6.  [253B.065] [COURT-ORDERED EARLY INTERVENTION; 
  5.11  PRELIMINARY PROCEDURES.] 
  5.12     Subdivision 1.  [PREPETITION SCREENING.] Prior to filing a 
  5.13  petition for early intervention for a proposed patient, an 
  5.14  interested person shall apply to the designated agency in the 
  5.15  county of the proposed patient's residence or presence for 
  5.16  conduct of a preliminary investigation under section 253B.07, 
  5.17  subdivision 1.  
  5.18     Subd. 2.  [PETITION.] A county attorney may file a petition 
  5.19  for early intervention in the probate court of the county of the 
  5.20  proposed patient's residence or presence.  The petition shall 
  5.21  set forth the name and address of the proposed patient, the name 
  5.22  and address of the patient's nearest relatives, and the reasons 
  5.23  for the petition.  The petition must contain factual 
  5.24  descriptions of the proposed patient's recent behavior, 
  5.25  including a description of the behavior, where it occurred, and 
  5.26  over what period of time it occurred.  Each factual allegation 
  5.27  must be supported by observations of witnesses named in the 
  5.28  petition.  Petitions shall be stated in behavioral terms and 
  5.29  shall not contain judgmental or conclusory statements.  The 
  5.30  petition shall be accompanied by a written statement by an 
  5.31  examiner stating that the examiner has examined the proposed 
  5.32  patient within the 15 days preceding the filing of the petition 
  5.33  and is of the opinion that the proposed patient is suffering a 
  5.34  designated disability and is in need of early intervention.  The 
  5.35  statement shall include the reasons for the opinion.  The 
  5.36  petition and the examiner's statement must include a statement 
  6.1   and opinion regarding the proposed patient's capacity to make 
  6.2   decisions regarding the administration of neuroleptic 
  6.3   medications and the reasons for the opinion.  If a petitioner 
  6.4   has been unable to secure a statement from the examiner, the 
  6.5   petition shall include documentation that a reasonable effort 
  6.6   has been made to secure the supporting statement. 
  6.7      Subd. 3.  [EXAMINERS.] After a petition has been filed, the 
  6.8   probate court or other court in which the petition was filed 
  6.9   shall appoint an examiner.  Prior to the early intervention 
  6.10  hearing, the court shall inform the proposed patient of the 
  6.11  right to an independent second examination.  At the proposed 
  6.12  patient's request, the court shall appoint a second examiner of 
  6.13  the patient's choosing to be paid for by the county at the rate 
  6.14  of compensation fixed by the court. 
  6.15     Subd. 4.  [PREHEARING EXAMINATION; NOTICE AND SUMMONS 
  6.16  PROCEDURE.] A summons to appear for a prehearing examination and 
  6.17  the early intervention hearing shall be served upon the proposed 
  6.18  patient.  A plain language notice of the proceedings and notice 
  6.19  of the filing of the petition, a copy of the petition, a copy of 
  6.20  the examiner's supporting statement, and the order for 
  6.21  examination and a copy of the prepetition screening report shall 
  6.22  be given to the proposed patient, patient's counsel, the 
  6.23  petitioner, the court, the patient's treatment facility, if 
  6.24  applicable, the examiner, and other persons designated by the 
  6.25  proposed patient.  The notice of the proceedings and notice of 
  6.26  the filing of the petition must be given to other interested 
  6.27  persons.  All papers shall be served personally on the proposed 
  6.28  patient.  Unless otherwise ordered by the court, the notice 
  6.29  shall be served on the proposed patient by a nonuniformed person.
  6.30     Subd. 5.  [PREHEARING EXAMINATION; REPORT.] The examination 
  6.31  shall be held at a treatment facility or other suitable place 
  6.32  the court determines is not likely to have a harmful effect on 
  6.33  the health of the proposed patient.  The county attorney and the 
  6.34  patient's attorney may be present during the examination.  
  6.35  Either party may waive this right.  Unless otherwise agreed by 
  6.36  the counsel for the proposed patient, a court appointed examiner 
  7.1   shall file three copies of the report with the court not less 
  7.2   than 48 hours prior to the hearing.  Copies of the examiner's 
  7.3   report shall be sent to the proposed patient and the patient's 
  7.4   counsel.  
  7.5      Subd. 6.  [PREHEARING EXAMINATION; FAILURE TO APPEAR.] If a 
  7.6   proposed patient fails to appear for the examination the court 
  7.7   may: 
  7.8      (1) reschedule the examination; or 
  7.9      (2) deem the failure to appear as a waiver of the proposed 
  7.10  patient's right to an examination and consider the failure to 
  7.11  appear when deciding the merits of the petition for early 
  7.12  intervention. 
  7.13     Sec. 7.  [253B.066] [COURT-ORDERED EARLY INTERVENTION; 
  7.14  HEARING PROCEDURES.] 
  7.15     Subdivision 1.  [TIME FOR EARLY INTERVENTION HEARING.] The 
  7.16  hearing on the petition for early intervention shall be held 
  7.17  within 14 days from the date of the filing of the petition.  For 
  7.18  good cause shown, the court may extend the time of hearing up to 
  7.19  an additional 30 days.  When any proposed patient has not had a 
  7.20  hearing on a petition filed for early intervention within the 
  7.21  allowed time, the proceedings shall be dismissed.  
  7.22     Subd. 2.  [NOTICE OF HEARING.] The proposed patient, 
  7.23  patient's counsel, the petitioner, and any other persons as the 
  7.24  court directs shall be given at least five days' notice that a 
  7.25  hearing will be held and at least two days' notice of the time 
  7.26  and date of the hearing, except that any person may waive 
  7.27  notice.  Notice to the proposed patient may be waived by 
  7.28  patient's counsel.  If the proposed patient has no residence in 
  7.29  this state, the commissioner shall be notified of the 
  7.30  proceedings by the court.  
  7.31     Subd. 3.  [FAILURE TO APPEAR.] If a proposed patient fails 
  7.32  to appear at the hearing, the court may reschedule the hearing 
  7.33  within five days and direct a health officer, peace officer, or 
  7.34  other person to take the proposed patient into custody and 
  7.35  transport the person to the hearing. 
  7.36     Subd. 4.  [RIGHT TO ATTEND AND TESTIFY.] All persons to 
  8.1   whom notice has been given may attend the hearing and, except 
  8.2   for the proposed patient's counsel, may testify.  The court 
  8.3   shall notify them of their right to attend the hearing and to 
  8.4   testify.  The court may exclude any person not necessary for the 
  8.5   conduct of the proceedings from the hearings except any person 
  8.6   requested to be present by the proposed patient.  Nothing in 
  8.7   this section shall prevent the court from ordering the 
  8.8   sequestration of any witness or witnesses other than the 
  8.9   petitioner or proposed patient.  
  8.10     Subd. 5.  [WITNESSES.] The proposed patient or patient's 
  8.11  counsel and the petitioner may present and cross-examine 
  8.12  witnesses, including examiners, at the hearing.  The court may 
  8.13  in its discretion receive the testimony of any other person.  
  8.14  Opinions of court-appointed examiners shall not be admitted into 
  8.15  evidence unless the examiner is present to testify, except by 
  8.16  agreement of the parties.  
  8.17     Subd. 6.  [ABSENCE PERMITTED.] (a) The court may permit the 
  8.18  proposed patient to waive the right to attend the hearing if it 
  8.19  determines that the waiver is freely given.  All waivers shall 
  8.20  be on the record.  At the time of the hearing, the patient shall 
  8.21  not be so under the influence or suffering from the effects of 
  8.22  drugs, medication, or other treatment so as to be hampered in 
  8.23  participating in the proceedings.  When in the opinion of the 
  8.24  licensed physician or licensed psychologist attending the 
  8.25  patient the discontinuance of drugs, medication, or other 
  8.26  treatment is not in the best interest of the patient, the court, 
  8.27  at the time of the hearing, shall be presented a record of all 
  8.28  drugs, medication, or other treatment which the patient has 
  8.29  received during the 48 hours immediately prior to the hearing.  
  8.30     (b) The court, on its own motion or on motion of any party, 
  8.31  may exclude or excuse a respondent who is seriously disruptive 
  8.32  or who is totally incapable of comprehending and participating 
  8.33  in the proceedings.  In such instances, the court shall, with 
  8.34  specificity on the record, state the behavior of respondent or 
  8.35  other circumstances justifying proceeding in the absence of the 
  8.36  respondent.  
  9.1      Subd. 7.  [PLACE OF HEARING.] The hearing shall be 
  9.2   conducted in a manner consistent with orderly procedure.  The 
  9.3   hearing shall be held at a courtroom meeting standards 
  9.4   prescribed by local court rule which may be at a treatment 
  9.5   facility.  
  9.6      Subd. 8.  [EVIDENCE.] The court shall admit all relevant 
  9.7   evidence at the hearing.  The court shall make its determination 
  9.8   upon the entire record pursuant to the rules of evidence. 
  9.9      Subd. 9.  [RECORD REQUIRED.] The court shall keep accurate 
  9.10  records containing, among other appropriate materials, notations 
  9.11  of appearances at the hearing, including witnesses, motions made 
  9.12  and their disposition, and all waivers of rights made by the 
  9.13  parties.  The court shall take and preserve an accurate 
  9.14  stenographic record or tape recording of the proceedings.  
  9.15     Sec. 8.  [253B.0667] [COURT-ORDERED EARLY INTERVENTION; 
  9.16  DECISION; TREATMENT ALTERNATIVES; DURATION.] 
  9.17     Subdivision 1.  [TREATMENT ALTERNATIVES.] If the court 
  9.18  orders early intervention under section 253B.064, subdivision 2, 
  9.19  the court may include in its order a variety of treatment 
  9.20  alternatives including, but not limited to, day treatment, 
  9.21  medication compliance monitoring, and short-term hospitalization 
  9.22  not to exceed ten days. 
  9.23     If the court orders short-term hospitalization, the court 
  9.24  shall determine whether the proposed patient has the capacity to 
  9.25  make an informed decision regarding the administration of 
  9.26  neuroleptic medication based on a preponderance of the 
  9.27  evidence.  If lack of capacity is found, the court shall appoint 
  9.28  a substitute decision-maker as provided in section 253B.092.  
  9.29  The proposed patient shall not be hospitalized until the policy 
  9.30  regarding the administration of neuroleptic medication is 
  9.31  complete.  If the court orders short-term hospitalization and 
  9.32  the proposed patient will not go voluntarily, the court may 
  9.33  direct a health officer, peace officer, or other person to take 
  9.34  the person into custody and transport the person to the hospital.
  9.35     Subd. 2.  [FINDINGS.] The court shall find the facts 
  9.36  specifically, separately state its conclusions of law, and 
 10.1   direct the entry of an appropriate judgment.  Where early 
 10.2   intervention is ordered, the findings of fact and conclusions of 
 10.3   law shall specifically state the proposed patient's conduct 
 10.4   which is a basis for determining that each of the requisites for 
 10.5   early intervention is met.  
 10.6      Subd. 3.  [FINANCIAL DETERMINATION.] The court shall 
 10.7   determine the nature and extent of the property of the patient 
 10.8   and of the persons who are liable for the patient's care.  
 10.9      Subd. 4.  [DURATION.] The order for early intervention 
 10.10  shall not exceed 90 days. 
 10.11     Sec. 9.  Minnesota Statutes 1994, section 253B.07, 
 10.12  subdivision 1, is amended to read: 
 10.13     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
 10.14  filing a petition for commitment of or early intervention for a 
 10.15  proposed patient, an interested person shall apply to the 
 10.16  designated agency in the county of the proposed patient's 
 10.17  residence or presence for conduct of a preliminary 
 10.18  investigation, except when the proposed patient has been 
 10.19  acquitted of a crime under section 611.026 and the county 
 10.20  attorney is required to file a petition for commitment pursuant 
 10.21  to subdivision 2.  In any case coming within this exception, the 
 10.22  county attorney shall apply to the designated county agency in 
 10.23  the county in which the acquittal took place for a preliminary 
 10.24  investigation unless substantially the same information relevant 
 10.25  to the proposed patient's current mental condition as could be 
 10.26  obtained by a preliminary investigation is part of the court 
 10.27  record in the criminal proceeding or is contained in the report 
 10.28  of a mental examination conducted in connection with the 
 10.29  criminal proceeding.  The designated agency shall appoint a 
 10.30  screening team to conduct an investigation which shall include:  
 10.31     (i) a personal interview with the proposed patient and 
 10.32  other individuals who appear to have knowledge of the condition 
 10.33  of the proposed patient.  If the proposed patient is not 
 10.34  interviewed, reasons must be documented; 
 10.35     (ii) identification and investigation of specific alleged 
 10.36  conduct which is the basis for application; and 
 11.1      (iii) identification, exploration, and listing of the 
 11.2   reasons for rejecting or recommending alternatives to 
 11.3   involuntary placement; and 
 11.4      (iv) in the case of a commitment based on mental illness, 
 11.5   identification of information that may be relevant to the 
 11.6   administration of neuroleptic medications, if necessary, 
 11.7   including the existence of a guardian, conservator, proxy, or 
 11.8   attorney-in-fact with authority to make health care decisions 
 11.9   for the proposed patient; the capacity of the proposed patient 
 11.10  to make decisions regarding administration of neuroleptic 
 11.11  medication; and whether the proposed patient is likely to 
 11.12  consent or refuse consent to administration of the medication.  
 11.13     (b) In conducting the investigation required by this 
 11.14  subdivision, the screening team shall have access to all 
 11.15  relevant medical records of proposed patients currently in 
 11.16  treatment facilities.  Data collected pursuant to this clause 
 11.17  shall be considered private data on individuals.  
 11.18     (c) When the prepetition screening team recommends 
 11.19  commitment, a written report shall be sent to the county 
 11.20  attorney for the county in which the petition is to be 
 11.21  filed.  If it appears that treatment with neuroleptic 
 11.22  medications may be considered, the report must include 
 11.23  recommendations based on the information described in paragraph 
 11.24  (a), clause (iv). 
 11.25     (d) The prepetition screening team shall refuse to support 
 11.26  a petition if the investigation does not disclose evidence 
 11.27  sufficient to support commitment.  Notice of the prepetition 
 11.28  screening team's decision shall be provided to the prospective 
 11.29  petitioner.  
 11.30     (e) If the interested person wishes to proceed with a 
 11.31  petition contrary to the recommendation of the prepetition 
 11.32  screening team, application may be made directly to the county 
 11.33  attorney, who may determine whether or not to proceed with the 
 11.34  petition.  Notice of the county attorney's determination shall 
 11.35  be provided to the interested party.  
 11.36     (f) If a court petitions for commitment pursuant to the 
 12.1   rules of criminal procedure or a county attorney petitions 
 12.2   pursuant to acquittal of a criminal charge under section 
 12.3   611.026, the prepetition investigation, if required by this 
 12.4   section, shall be completed within seven days after the filing 
 12.5   of the petition.  
 12.6      Sec. 10.  Minnesota Statutes 1994, section 253B.07, 
 12.7   subdivision 2, is amended to read: 
 12.8      Subd. 2.  [THE PETITION.] Any interested person may file a 
 12.9   petition for commitment in the probate court of the county of 
 12.10  the proposed patient's residence or presence.  Following an 
 12.11  acquittal of a person of a criminal charge under section 
 12.12  611.026, the petition shall be filed by the county attorney of 
 12.13  the county in which the acquittal took place and the petition 
 12.14  shall be filed with the court in which the acquittal took place, 
 12.15  and that court shall be the committing court for purposes of 
 12.16  this chapter.  The petition shall set forth the name and address 
 12.17  of the proposed patient, the name and address of the patient's 
 12.18  nearest relatives, and the reasons for the petition.  The 
 12.19  petition must contain factual descriptions of the proposed 
 12.20  patient's recent behavior, including a description of the 
 12.21  behavior, where it occurred, and over what period of time it 
 12.22  occurred.  Each factual allegation must be supported by 
 12.23  observations of witnesses named in the petition.  Petitions 
 12.24  shall be stated in behavioral terms and shall not contain 
 12.25  judgmental or conclusory statements.  The petition shall be 
 12.26  accompanied by a written statement by an examiner stating that 
 12.27  the examiner has examined the proposed patient within the 15 
 12.28  days preceding the filing of the petition and is of the opinion 
 12.29  that the proposed patient is suffering a designated disability 
 12.30  and should be committed to a treatment facility.  The statement 
 12.31  shall include the reasons for the opinion.  In the case of a 
 12.32  commitment based on mental illness, the petition and the 
 12.33  examiner's statement must include a statement and opinion 
 12.34  regarding the proposed patient's capacity to make decisions 
 12.35  regarding the administration of neuroleptic medications and the 
 12.36  reasons for the opinion.  If a petitioner has been unable to 
 13.1   secure a statement from an examiner, the petition shall include 
 13.2   documentation that a reasonable effort has been made to secure 
 13.3   the supporting statement. 
 13.4      Sec. 11.  Minnesota Statutes 1994, section 253B.07, 
 13.5   subdivision 4, is amended to read: 
 13.6      Subd. 4.  [PREHEARING EXAMINATION; NOTICE AND SUMMONS 
 13.7   PROCEDURE.] A summons to appear for a prehearing examination and 
 13.8   the commitment hearing shall be served upon the proposed 
 13.9   patient.  A plain language notice of the proceedings and notice 
 13.10  of the filing of the petition, a copy of the petition, a copy of 
 13.11  the examiner's supporting statement, and the order for 
 13.12  examination and a copy of the prepetition screening report shall 
 13.13  be given to the proposed patient, patient's counsel, the 
 13.14  petitioner, any interested person, and any other persons as the 
 13.15  court directs the court, the patient's treatment facility, if 
 13.16  applicable, the examiner, and other persons designated by the 
 13.17  proposed patient.  The notice of the proceedings and notice of 
 13.18  filing of the petition must be given to other interested 
 13.19  persons.  All papers shall be served personally on the proposed 
 13.20  patient.  Unless otherwise ordered by the court, the notice 
 13.21  shall be served on the proposed patient by a nonuniformed person.
 13.22     Sec. 12.  Minnesota Statutes 1994, section 253B.07, 
 13.23  subdivision 7, is amended to read: 
 13.24     Subd. 7.  [PRELIMINARY HEARING.] (a) No proposed patient 
 13.25  may be held pursuant to subdivision 6 for longer than 72 hours, 
 13.26  exclusive of Saturdays, Sundays, and legal holidays, unless the 
 13.27  court holds a preliminary hearing and determines that probable 
 13.28  cause exists to continue to hold the person.  
 13.29     (b) The proposed patient, patient's counsel, the 
 13.30  petitioner, the county attorney, and any other persons as the 
 13.31  court directs shall be given at least 24 hours written notice of 
 13.32  the preliminary hearing.  The notice shall include the alleged 
 13.33  grounds for confinement.  The proposed patient shall be 
 13.34  represented at the preliminary hearing by counsel.  If the court 
 13.35  finds it to be reliable, it may admit hearsay evidence, 
 13.36  including written reports.  
 14.1      (c) The court, on its motion or on motion of any party, may 
 14.2   exclude or excuse a respondent who is seriously disruptive or 
 14.3   who is totally incapable of comprehending and participating in 
 14.4   the proceedings.  In such instances, the court shall, with 
 14.5   specificity on the record, state the behavior of respondent or 
 14.6   other circumstances justifying proceeding in the absence of the 
 14.7   respondent.  
 14.8      (d) The court may order the continued holding of the 
 14.9   proposed patient if it finds, by a preponderance of the 
 14.10  evidence, that serious imminent physical harm to the patient or 
 14.11  others is likely if the proposed patient is not confined.  The 
 14.12  fact that a proposed patient was acquitted of a crime against 
 14.13  the person under section 611.026 immediately preceding the 
 14.14  filing of the petition constitutes evidence that serious 
 14.15  imminent physical harm to the patient or others is likely if the 
 14.16  proposed patient is not confined and shifts the burden of going 
 14.17  forward in the presentation of evidence to the proposed patient; 
 14.18  provided that the standard of proof remains as required by this 
 14.19  chapter.  
 14.20     (e) Upon request of the petitioner in the case of a 
 14.21  commitment based on mental illness, the court shall make a 
 14.22  preliminary finding based on a showing of probable cause as to 
 14.23  whether the proposed patient has the capacity to make an 
 14.24  informed decision regarding administration of neuroleptic 
 14.25  medication.  If lack of capacity is found, the court shall 
 14.26  appoint a substitute decision-maker as provided in section 
 14.27  253B.092.  With the consent of the substitute decision-maker and 
 14.28  the proposed patient, neuroleptic medication may be administered 
 14.29  pending the commitment hearing under section 253B.08.  If either 
 14.30  objects, the issue must be considered at the commitment hearing 
 14.31  and the medication may not be administered. 
 14.32     Sec. 13.  Minnesota Statutes 1994, section 253B.09, 
 14.33  subdivision 1, is amended to read: 
 14.34     Subdivision 1.  [STANDARD OF PROOF; DISPOSITIONS.] (a) If 
 14.35  the court finds by clear and convincing evidence that the 
 14.36  proposed patient is a mentally ill, mentally retarded, or 
 15.1   chemically dependent person and, that after careful 
 15.2   consideration of reasonable alternative dispositions, including 
 15.3   but not limited to, dismissal of petition, voluntary outpatient 
 15.4   care, informal admission to a treatment facility, appointment of 
 15.5   a guardian or conservator, or release before commitment as 
 15.6   provided for in subdivision 4, it finds that there is no 
 15.7   suitable alternative to judicial commitment, the court shall 
 15.8   commit the patient to the least restrictive treatment program 
 15.9   which can meet the patient's treatment needs consistent with 
 15.10  section 253B.03, subdivision 7.  In deciding on the least 
 15.11  restrictive program, the court shall consider a range of 
 15.12  treatment alternatives including, but not limited to, 
 15.13  community-based nonresidential treatment, community residential 
 15.14  treatment, partial hospitalization, acute care hospital, and 
 15.15  regional treatment center services.  The court shall also 
 15.16  consider the proposed patient's treatment preferences and 
 15.17  willingness to participate in the treatment ordered.  The court 
 15.18  may not commit a patient to a facility or program that is not 
 15.19  capable of meeting the patient's needs.  
 15.20     (b) If a preliminary finding as to capacity was made under 
 15.21  section 253B.07, subdivision 7, paragraph (e), the court shall 
 15.22  review that determination and make a finding of fact, based on a 
 15.23  preponderance of the evidence presented, that affirms or 
 15.24  reverses the preliminary finding.  If there was no preliminary 
 15.25  finding, the court may address the issue of capacity at the 
 15.26  hearing under this section.  If the court finds that the 
 15.27  proposed patient lacks capacity and a substitute decision-maker 
 15.28  was not appointed, the court shall appoint a substitute 
 15.29  decision-maker. 
 15.30     (c) If a substitute decision-maker was appointed, the court 
 15.31  shall either affirm or reverse any decision of the substitute 
 15.32  decision-maker regarding the administration of neuroleptic 
 15.33  medications.  If the substitute decision-maker consented to 
 15.34  administration of the medication and the proposed patient has 
 15.35  not refused to consent, the court shall make a finding that 
 15.36  consent has been given and the treatment is authorized. 
 16.1      Sec. 14.  Minnesota Statutes 1994, section 253B.09, is 
 16.2   amended by adding a subdivision to read: 
 16.3      Subd. 6.  [COMMENCEMENT OF COMMITMENT PERIOD.] The period 
 16.4   of initial commitment begins on the date the court issues the 
 16.5   warrant under section 253B.10, subdivision 1. 
 16.6      Sec. 15.  [253B.092] [STANDARDS AND CRITERIA FOR 
 16.7   ADMINISTRATION OF NEUROLEPTIC MEDICATION; PROCEDURES.] 
 16.8      Subdivision 1.  [GENERAL.] Neuroleptic medications may be 
 16.9   administered to patients subject to early intervention or civil 
 16.10  commitment as mentally ill or mentally ill and dangerous only as 
 16.11  provided in this section.  For purposes of this section, 
 16.12  "patient" includes a proposed patient who is the subject of a 
 16.13  petition for early intervention or commitment. 
 16.14     Subd. 2.  [PATIENTS WITH CAPACITY TO MAKE INFORMED 
 16.15  DECISION.] (a) A patient who has the capacity to make an 
 16.16  informed decision regarding the administration of neuroleptic 
 16.17  medication may consent or refuse consent to administration of 
 16.18  the medication.  The informed consent of a patient must be in 
 16.19  writing.  Unless a guardian or conservator with authority to 
 16.20  make medical treatment decisions has already been appointed on 
 16.21  behalf of a patient, a patient is presumed to have capacity to 
 16.22  make decisions regarding administration of neuroleptic 
 16.23  medication.  Except as provided in section 253B.07, subdivision 
 16.24  7, paragraph (e), the petitioner in a proceeding under this 
 16.25  chapter has the burden of proving incapacity by a preponderance 
 16.26  of the evidence. 
 16.27     (b) In determining a person's capacity to make decisions 
 16.28  regarding the administration of neuroleptic medication, the 
 16.29  court shall consider: 
 16.30     (1) whether the person demonstrates an awareness of the 
 16.31  nature of the person's situation, including the reasons for 
 16.32  hospitalization, and the possible consequences of refusing 
 16.33  treatment with neuroleptic medications; 
 16.34     (2) whether the person demonstrates a factual understanding 
 16.35  of treatment with neuroleptic medications and the risks, 
 16.36  benefits, and alternatives; and 
 17.1      (3) whether the person communicates a clear choice 
 17.2   regarding treatment with neuroleptic medications that is a 
 17.3   reasoned one not based on delusion, even though it may not be in 
 17.4   the person's best interests. 
 17.5      Factual understanding under clause (2) need not be 
 17.6   scientific.  Communication of choice under clause (3) may be 
 17.7   verbal or nonverbal.  Disagreement with the physician's 
 17.8   recommendation is not per se evidence of an unreasonable 
 17.9   decision. 
 17.10     Subd. 3.  [PATIENTS WITHOUT CAPACITY TO MAKE INFORMED 
 17.11  DECISION; SUBSTITUTE DECISION-MAKER.] (a) If a court finds that 
 17.12  a patient does not have capacity to make an informed decision 
 17.13  regarding the administration of neuroleptic medication, the 
 17.14  court shall appoint a substitute decision-maker with authority 
 17.15  to consent to the administration of neuroleptic medication as 
 17.16  provided in this section.  The substitute decision-maker must be 
 17.17  an individual or a community or institutional multidisciplinary 
 17.18  panel designated by the local mental health authority.  In 
 17.19  appointing a substitute decision-maker, the court shall give 
 17.20  preference to a guardian or conservator, proxy, or 
 17.21  attorney-in-fact with authority to make health care decisions 
 17.22  for the patient.  The court may provide for the payment of a 
 17.23  reasonable fee to the substitute decision-maker for services 
 17.24  under this section or may appoint a volunteer.  The authority of 
 17.25  the substitute decision-maker lasts for the duration of the 
 17.26  court's order appointing the decision-maker or until the patient 
 17.27  is found to have capacity to make an informed decision regarding 
 17.28  administration of neuroleptic medication. 
 17.29     (b) If a person's treating physician recommends treatment 
 17.30  with neuroleptic medication, the substitute decision-maker may 
 17.31  give or withhold consent to the administration of the 
 17.32  medication, based on the standards under subdivision 4.  If the 
 17.33  substitute decision-maker gives informed consent to the 
 17.34  treatment and the person does not refuse, the medication may be 
 17.35  administered and the court so notified.  The consent of the 
 17.36  substitute decision-maker must be in writing.  If the substitute 
 18.1   decision-maker refuses consent or the person refuses consent, 
 18.2   neuroleptic medication may not be administered to the person 
 18.3   without a court order. 
 18.4      (c) Upon request, the court shall review the reasonableness 
 18.5   of the substitute decision-makers decision based on the 
 18.6   standards under subdivision 4 and enter an order upholding or 
 18.7   reversing the decision within seven days.  The court may limit 
 18.8   the maximum dosage of neuroleptic medication that may be 
 18.9   administered. 
 18.10     Subd. 4.  [STANDARDS FOR MAKING DECISION REGARDING 
 18.11  ADMINISTRATION OF NEUROLEPTIC MEDICATION.] (a) When a person 
 18.12  lacks capacity to make decisions regarding the administration of 
 18.13  neuroleptic medication, the substitute decision-maker or the 
 18.14  court shall use the standards in this subdivision in making a 
 18.15  decision regarding administration of the medication. 
 18.16     (b) If the person clearly stated what the person would 
 18.17  choose to do in this situation when the person had the capacity 
 18.18  to make a reasoned decision, the person's wishes must be 
 18.19  followed using substituted judgment.  Evidence of the person's 
 18.20  wishes may include written instruments, including a health care 
 18.21  power of attorney or advance mental health directive. 
 18.22     (c) If evidence of the person's wishes regarding the 
 18.23  administration of neuroleptic medications is conflicting or 
 18.24  lacking, the decision must be based on what a reasonable person 
 18.25  would do, taking into consideration: 
 18.26     (1) the person's family, community, moral, religious, and 
 18.27  social values; 
 18.28     (2) the medical risks, benefits, and alternatives to the 
 18.29  proposed treatment; 
 18.30     (3) past efficacy and any extenuating circumstances of past 
 18.31  use of neuroleptic medications; and 
 18.32     (4) any other relevant factors. 
 18.33     Subd. 5.  [INITIATION OF PROCESS FOR ADMINISTRATION OF 
 18.34  MEDICATION.] If an order for civil commitment or early 
 18.35  intervention did not deal with authority to administer 
 18.36  neuroleptic medications, the treatment facility may file a 
 19.1   motion to initiate the process for administration of the 
 19.2   medication.  The court shall conduct a hearing within 72 hours 
 19.3   and, except as otherwise provided in this subdivision, proceed 
 19.4   in the same manner as if the request were made at the 
 19.5   preliminary hearing before civil commitment or early 
 19.6   intervention and the provisions of sections 253B.07, subdivision 
 19.7   7, paragraph (e), and 253B.09, subdivision 1, paragraphs (b) and 
 19.8   (c), apply.  If the court determines that the person does not 
 19.9   have the capacity to make an informed decision, the court shall 
 19.10  appoint a substitute decision-maker within 24 hours or less.  
 19.11  The final hearing addressing the issues under section 253B.09, 
 19.12  subdivision 1, paragraphs (b) and (c), must be held within seven 
 19.13  days of the preliminary hearing. 
 19.14     Subd. 6.  [WITHDRAWAL OF CONSENT.] (a) If the substitute 
 19.15  decision-maker withdraws consent, neuroleptic mediation may not 
 19.16  be administered without a court order. 
 19.17     (b) If the patient withdraws consent or refuses the 
 19.18  medication, a motion must be filed with the court and a hearing 
 19.19  held within seven days to review the substitute decision-maker's 
 19.20  decision.  Neuroleptic medication may continue to be 
 19.21  administered pending the outcome of the hearing. 
 19.22     Subd. 7.  [EMERGENCY ADMINISTRATION.] A treating physician 
 19.23  may administer neuroleptic medication to a patient who does not 
 19.24  have capacity to make a decision regarding administration of the 
 19.25  medication and for whom a substitute decision-maker has not been 
 19.26  appointed, if the patient is in an emergency situation.  
 19.27  Medication may be administered for so long as the emergency 
 19.28  continues to exist, up to 14 days, if the treating physician 
 19.29  determines that the medication is necessary to prevent serious, 
 19.30  immediate physical harm to the patient or to others.  If a 
 19.31  petition for authorization to administer medication is filed 
 19.32  within the 14 days, the treating physician may continue the 
 19.33  medication through the date of the first court hearing, if the 
 19.34  emergency continues to exist.  If the petition for authorization 
 19.35  to administer medication is filed in conjunction with a petition 
 19.36  for commitment or early intervention and the court makes a 
 20.1   determination at the preliminary hearing under section 253B.07, 
 20.2   subdivision 7, that there is sufficient cause to continue the 
 20.3   physician's order until the hearing under section 253B.08, the 
 20.4   treating physician may continue the medication until that 
 20.5   hearing, if the emergency continues to exist.  The treatment 
 20.6   facility shall document the emergency in the patient's medical 
 20.7   record in specific behavioral terms. 
 20.8      Subd. 8.  [INDEPENDENT MEDICAL OPINION.] A second, 
 20.9   independent medical opinion may be obtained by the court or any 
 20.10  party objecting to the administration of neuroleptic 
 20.11  medication.  A request for a second examiner must be made at the 
 20.12  preliminary hearing.  The physician who makes the second opinion 
 20.13  must be a doctor who is knowledgeable, trained, and practicing 
 20.14  in the diagnoses and treatment of mental illness. 
 20.15     Subd. 9.  [ACCESS TO MEDICAL RECORDS.] (a) A treating 
 20.16  physician who makes medical decisions under this section 
 20.17  regarding the prescription and administration of neuroleptic 
 20.18  medication may have access to the physician's order section of a 
 20.19  patient's records on past administration of neuroleptic 
 20.20  medication at any treatment facility, if the patient lacks the 
 20.21  capacity to authorize the release of records.  Upon request of a 
 20.22  treating physician under this section, a treatment facility 
 20.23  shall supply complete information relating to the past records 
 20.24  on administration of neuroleptic medication of a patient subject 
 20.25  to this section.  A patient who has the capacity to authorize 
 20.26  the release of data retains the right to make decisions 
 20.27  regarding access to medical records as provided by section 
 20.28  144.335. 
 20.29     Subd. 10.  [DURATION OF CONSENT; REVIEW.] (a) The informed 
 20.30  consent of a substitute decision-maker or a court order for 
 20.31  authority to administer neuroleptic medication is enforceable 
 20.32  until the person is discharged from civil commitment or an early 
 20.33  intervention order, until the person is determined by the court 
 20.34  to have the capacity to give informed consent or until the 
 20.35  authority is otherwise modified by the court, whichever is 
 20.36  earlier. 
 21.1      (b) A hearing may be requested under section 253B.17 if the 
 21.2   patient or any interested person believes that circumstances 
 21.3   have changed and the court's order concerning capacity or 
 21.4   treatment with neuroleptic medications is no longer just or 
 21.5   equitable. 
 21.6      Subd. 11.  [FORCED ADMINISTRATION.] If physical force is 
 21.7   required to administer the neuroleptic medication, force may 
 21.8   only take place in a treatment facility or therapeutic setting 
 21.9   where the person's condition can be reassessed and appropriate 
 21.10  medical staff are available. 
 21.11     Subd. 12.  [IMMUNITY.] A substitute decision-maker who 
 21.12  consents to treatment is not civilly or criminally liable for 
 21.13  the performance of or the manner of performing the treatment.  A 
 21.14  person is not liable for performing treatment without consent if 
 21.15  the substitute decision-maker has given proper written, informed 
 21.16  consent.  This provision does not affect any other liability 
 21.17  that may result from the manner in which the treatment is 
 21.18  performed. 
 21.19     Sec. 16.  Minnesota Statutes 1994, section 253B.10, 
 21.20  subdivision 1, is amended to read: 
 21.21     Subdivision 1.  [ADMINISTRATIVE REQUIREMENTS.] When a 
 21.22  person is committed, the court shall issue a warrant in 
 21.23  duplicate, committing the patient to the custody of the head of 
 21.24  the treatment facility.  The warrant shall include a statement 
 21.25  that the patient meets the statutory criteria requiring civil 
 21.26  commitment.  Upon the arrival of a patient at the designated 
 21.27  treatment facility, the head of the facility shall retain the 
 21.28  duplicate of the warrant and endorse receipt upon the original 
 21.29  warrant, which shall be filed in the court of commitment.  After 
 21.30  arrival, the patient shall be under the control and custody of 
 21.31  the head of the treatment facility.  
 21.32     Copies of the petition for commitment, the court's findings 
 21.33  of fact and conclusions of law, the court order committing the 
 21.34  patient, the report of the examiners, and the prepetition report 
 21.35  shall be provided to the treatment facility at the time of 
 21.36  admission.  
 22.1      Sec. 17.  Minnesota Statutes 1995 Supplement, section 
 22.2   253B.12, subdivision 1, is amended to read: 
 22.3      Subdivision 1.  [REPORT.] Prior to the termination of the 
 22.4   initial commitment order or final discharge of the patient, the 
 22.5   head of the facility or, in the case of a patient on provisional 
 22.6   discharge, the case manager shall file a written report with the 
 22.7   committing court with a copy to the patient and patient's 
 22.8   counsel, setting forth in detailed narrative form at least the 
 22.9   following: 
 22.10     (1) the diagnosis of the patient with the supporting data; 
 22.11     (2) the anticipated discharge date; 
 22.12     (3) an individualized treatment plan; 
 22.13     (4) a detailed description of the discharge planning 
 22.14  process with suggested after care plan; 
 22.15     (5) whether the patient is in need of further care and 
 22.16  treatment with evidence to support the response; 
 22.17     (6) whether any further care and treatment must be provided 
 22.18  in a treatment facility with evidence to support the response; 
 22.19     (7) whether in the opinion of the head of the facility the 
 22.20  patient must continue to be committed to a treatment facility; 
 22.21     (8) whether in the opinion of the head of the facility the 
 22.22  patient satisfies the statutory requirement for continued 
 22.23  commitment, with documentation to support the opinion; and 
 22.24     (9) whether the administration of neuroleptic medication is 
 22.25  clinically indicated, whether the patient is able to give 
 22.26  informed consent to that medication, and the basis for these 
 22.27  opinions. 
 22.28     Sec. 18.  Minnesota Statutes 1994, section 253B.14, is 
 22.29  amended to read: 
 22.30     253B.14 [TRANSFER OF COMMITTED PERSONS PATIENTS.] 
 22.31     Subdivision 1.  [TRANSFER AUTHORIZED; NOTICE.] The 
 22.32  commissioner may transfer any committed person, other than a 
 22.33  person committed as mentally ill and dangerous to the public, 
 22.34  from one regional center to any other institution under the 
 22.35  commissioner's jurisdiction which is capable of providing proper 
 22.36  care and treatment.  When a committed person is transferred from 
 23.1   one treatment facility to another, written notice shall be given 
 23.2   to the committing court and to the person's parent or spouse or, 
 23.3   if none is known, to an interested person, and the designated 
 23.4   agency.  
 23.5      Subd. 2.  [ACCESS TO MEDICAL RECORDS.] (a) This subdivision 
 23.6   applies to a person who:  
 23.7      (1) is under a court order for mental health treatment 
 23.8   under this chapter; 
 23.9      (2) is transferred from one treatment facility or program 
 23.10  to another; and 
 23.11     (3) is unwilling or unable to consent to the release of 
 23.12  relevant medical records. 
 23.13     (b) A treating physician who is making decisions regarding 
 23.14  the prescription and administration of medications to treat the 
 23.15  person's mental illness has access to portions of the person's 
 23.16  prior medical records relevant to the administration of the 
 23.17  medications and the person's response to those medications, 
 23.18  without the person's consent. 
 23.19     Sec. 19.  Minnesota Statutes 1994, section 253B.15, 
 23.20  subdivision 1, is amended to read: 
 23.21     Subdivision 1.  [PROVISIONAL DISCHARGE.] The head of the 
 23.22  treatment facility may provisionally discharge any patient 
 23.23  without discharging the commitment, unless the patient was found 
 23.24  by the committing court to be mentally ill and dangerous to the 
 23.25  public. 
 23.26     Each patient released on provisional discharge shall have 
 23.27  an aftercare plan developed which specifies the services and 
 23.28  treatment to be provided as part of the aftercare plan, the 
 23.29  financial resources available to pay for the services specified, 
 23.30  the expected period of provisional discharge, the precise goals 
 23.31  for the granting of a final discharge, and conditions or 
 23.32  restrictions on the patient during the period of the provisional 
 23.33  discharge.  The aftercare plan shall be given to the patient's 
 23.34  attorney. 
 23.35     The aftercare plan shall be reviewed on a quarterly basis 
 23.36  by the patient, designated agency and other appropriate persons. 
 24.1   The aftercare plan shall contain the grounds upon which a 
 24.2   provisional discharge may be revoked.  The provisional discharge 
 24.3   shall terminate on the date specified in the plan unless 
 24.4   specific action is taken to revoke or extend it.  
 24.5      Sec. 20.  Minnesota Statutes 1994, section 253B.15, 
 24.6   subdivision 1a, is amended to read: 
 24.7      Subd. 1a.  [CASE MANAGER.] Before a provisional discharge 
 24.8   is granted, a representative of the designated agency must be 
 24.9   identified as the case manager.  The case manager shall ensure 
 24.10  continuity of care by being involved with the treatment facility 
 24.11  and the patient prior to the provisional discharge.  The case 
 24.12  manager shall coordinate plans for and monitor the patient's 
 24.13  aftercare program.  The case manager shall provide the treatment 
 24.14  report to the court required under section 253B.12, subdivision 
 24.15  1. 
 24.16     Sec. 21.  Minnesota Statutes 1994, section 253B.15, 
 24.17  subdivision 2, is amended to read: 
 24.18     Subd. 2.  [REVOCATION OF PROVISIONAL DISCHARGE.] The head 
 24.19  of the treatment facility designated agency may revoke a 
 24.20  provisional discharge if: 
 24.21     (i) The patient has violated material conditions of the 
 24.22  provisional discharge, and the violation creates the need to 
 24.23  return the patient to the facility a more restrictive setting; 
 24.24  or, 
 24.25     (ii) There exists a serious likelihood that the safety of 
 24.26  the patient or others will be jeopardized, in that either the 
 24.27  patient's need for food, clothing, shelter, or medical care are 
 24.28  not being met, or will not be met in the near future, or the 
 24.29  patient has attempted or threatened to seriously physically harm 
 24.30  self or others; and 
 24.31     (iii) revocation is the least restrictive alternative 
 24.32  available.  
 24.33     Any interested person, including the designated agency, may 
 24.34  request that the head of the treatment facility designated 
 24.35  agency revoke the patient's provisional discharge.  Any person 
 24.36  making a request shall provide the head of the treatment 
 25.1   facility designated agency with a written report setting forth 
 25.2   the specific facts, including witnesses, dates and locations, 
 25.3   supporting a revocation, demonstrating that every effort has 
 25.4   been made to avoid revocation and that revocation is the least 
 25.5   restrictive alternative available.  
 25.6      Sec. 22.  Minnesota Statutes 1994, section 253B.15, 
 25.7   subdivision 3, is amended to read: 
 25.8      Subd. 3.  [PROCEDURE; NOTICE.] When the possibility of 
 25.9   revocation becomes apparent, the designated agency shall notify 
 25.10  the patient, the patient's attorney, and all participants in the 
 25.11  plan, and every effort shall be made to prevent revocation.  
 25.12     Revocation shall be commenced by a the designated agency's 
 25.13  service of notice of intent to revoke provisional discharge, 
 25.14  which shall be served upon the patient, the patient's attorney, 
 25.15  and the designated agency treatment facility.  The notice shall 
 25.16  set forth the grounds upon which the intention to revoke is 
 25.17  based, and shall inform the patient of the rights of a patient 
 25.18  under this chapter.  
 25.19     Sec. 23.  Minnesota Statutes 1994, section 253B.15, is 
 25.20  amended by adding a subdivision to read: 
 25.21     Subd. 3a.  [REPORT TO THE COURT.] Within 48 hours of 
 25.22  service of notice upon the patient, the designated agency shall 
 25.23  file with the court a copy of the notice and a report setting 
 25.24  forth the specific facts, including witnesses, dates and 
 25.25  locations, which (1) support revocation, (2) demonstrate that 
 25.26  revocation is the least restrictive alternative available, and 
 25.27  (3) show that special efforts were made to avoid revocation.  
 25.28  The designated agency shall provide copies of the report to the 
 25.29  patient, the patient's attorney and the treatment facility 
 25.30  within 48 hours of the service of notice upon the patient under 
 25.31  subdivision 3. 
 25.32     Sec. 24.  Minnesota Statutes 1994, section 253B.15, is 
 25.33  amended by adding a subdivision to read: 
 25.34     Subd. 3b.  [REVIEW.] The patient may request review of the 
 25.35  intended revocation by filing a petition for review and an 
 25.36  affidavit with the committing court.  The affidavit shall state 
 26.1   specific grounds for denying the revocation.  If the patient 
 26.2   does not file a petition for review within five days of 
 26.3   receiving the notice under subdivision 3, revocation of the 
 26.4   provisional discharge is final and the court, without hearing, 
 26.5   may order the patient into a treatment facility.  If the patient 
 26.6   files a petition for review, the court shall review the petition 
 26.7   and determine whether a genuine issue exists as to the propriety 
 26.8   of the revocation.  The burden of proof is on the designated 
 26.9   agency to show that no genuine issue exists as to the propriety 
 26.10  of the revocation.  If the court finds that no genuine issue 
 26.11  exists as to the propriety of the revocation, the revocation of 
 26.12  the provisional discharge is final. 
 26.13     Sec. 25.  Minnesota Statutes 1994, section 253B.15, is 
 26.14  amended by adding a subdivision to read: 
 26.15     Subd. 3c.  [HEARING.] If the court finds under subdivision 
 26.16  3b that a genuine issue exists as to the propriety of the 
 26.17  revocation, the court shall hold a hearing on the petition 
 26.18  within three days after the patient files the petition.  The 
 26.19  court may continue the review hearing for an additional five 
 26.20  days upon any party's showing of good cause.  At the hearing, 
 26.21  the burden of proof is on the designated agency to show a 
 26.22  factual basis for the revocation.  At the conclusion of the 
 26.23  hearing, the court shall make specific findings of fact.  The 
 26.24  court shall affirm the revocation if it finds: 
 26.25     (1) a factual basis for revocation due to: 
 26.26     (i) a violation of the material conditions of the 
 26.27  provisional discharge that creates a need for a return to a more 
 26.28  restrictive setting; or 
 26.29     (ii) a probable danger of harm to the patient or others if 
 26.30  the provisional discharge is not revoked; and 
 26.31     (2) that revocation is the least restrictive alternative 
 26.32  available.  Otherwise the court shall order the patient returned 
 26.33  to provisional discharge status. 
 26.34     Sec. 26.  Minnesota Statutes 1994, section 253B.15, 
 26.35  subdivision 5, is amended to read: 
 26.36     Subd. 5.  [RETURN TO FACILITY.] The case manager may When 
 27.1   the designated agency serves notice of the intent to revoke a 
 27.2   patient's provisional discharge, it may also apply to the 
 27.3   committing court for an order directing that the patient be 
 27.4   returned to the a facility.  The court may order the patient 
 27.5   returned to the a facility prior to a review hearing only upon 
 27.6   finding that immediate return to the a facility is necessary to 
 27.7   avoid serious, imminent harm to the patient or others because 
 27.8   there is a serious likelihood that the safety of the patient or 
 27.9   others will be jeopardized, in that (1) the patient's need for 
 27.10  food, clothing, shelter or medical care is not being met, or 
 27.11  will not be met in the near future, or (2) the patient has 
 27.12  attempted or threatened to seriously harm self or others.  If a 
 27.13  voluntary return is not arranged, the head of the treatment 
 27.14  facility may request a health officer, a welfare officer, or a 
 27.15  peace officer to return the patient to the treatment facility 
 27.16  from which the patient was released or to any other treatment 
 27.17  facility which consents to receive the patient.  If necessary, 
 27.18  the head of the treatment facility may request the committing 
 27.19  court to direct a health or peace officer in the county where 
 27.20  the patient is located to return the patient to the treatment 
 27.21  facility or to another treatment facility which consents to 
 27.22  receive the patient.  The expense of returning the patient to a 
 27.23  treatment facility shall be paid by the commissioner unless paid 
 27.24  by the patient or the patient's relatives.  If the court orders 
 27.25  the patient to return to the treatment facility and the patient 
 27.26  wants review of the revocation, the patient must file the 
 27.27  petition for review and affidavit required under subdivision 3b 
 27.28  within 48 hours of receipt of the notice of the intent to 
 27.29  revoke.  The court must issue a final determination on the 
 27.30  revocation within five days after the designated agency files 
 27.31  the notice of intention to revoke.  
 27.32     Sec. 27.  Minnesota Statutes 1994, section 525.56, 
 27.33  subdivision 3, is amended to read: 
 27.34     Subd. 3.  The court may appoint a guardian of the person if 
 27.35  it determines that all the powers and duties listed in this 
 27.36  subdivision are needed to provide for the needs of the 
 28.1   incapacitated person.  The court may appoint a conservator of 
 28.2   the person if it determines that a conservator is needed to 
 28.3   provide for the needs of the incapacitated person through the 
 28.4   exercise of some, but not all, of the powers and duties listed 
 28.5   in this subdivision.  The duties and powers of a guardian or 
 28.6   those which the court may grant to a conservator of the person 
 28.7   include, but are not limited to: 
 28.8      (1) The power to have custody of the ward or conservatee 
 28.9   and the power to establish a place of abode within or without 
 28.10  the state, except as otherwise provided in this clause.  The 
 28.11  ward or conservatee or any person interested in the ward's or 
 28.12  conservatee's welfare may petition the court to prevent or to 
 28.13  initiate a change in abode.  A ward or conservatee may not be 
 28.14  admitted to a regional treatment center by the guardian or 
 28.15  conservator except (1) after a hearing pursuant to chapter 253B; 
 28.16  (2) for outpatient services; or (3) for the purpose of receiving 
 28.17  temporary care for a specific period of time not to exceed 90 
 28.18  days in any calendar year, unless additional care is provided 
 28.19  under section 253B.04. 
 28.20     (2) The duty to provide for the ward's or conservatee's 
 28.21  care, comfort and maintenance needs, including food, clothing, 
 28.22  shelter, health care, social and recreational requirements, and, 
 28.23  whenever appropriate, training, education, and habilitation or 
 28.24  rehabilitation.  The guardian or conservator has no duty to pay 
 28.25  for these requirements out of personal funds.  Whenever possible 
 28.26  and appropriate, the guardian or conservator should meet these 
 28.27  requirements through governmental benefits or services to which 
 28.28  the ward or conservatee is entitled, rather than from the ward's 
 28.29  or conservatee's estate.  Failure to satisfy the needs and 
 28.30  requirements of this clause shall be grounds for removal of a 
 28.31  private guardian or conservator, but the guardian or conservator 
 28.32  shall have no personal or monetary liability.  
 28.33     (3) The duty to take reasonable care of the ward's or 
 28.34  conservatee's clothing, furniture, vehicles, and other personal 
 28.35  effects, and, if other property requires protection, the power 
 28.36  to seek appointment of a guardian or conservator of the estate.  
 29.1   The guardian or conservator must give notice in the manner 
 29.2   required and to those persons specified in section 525.55 prior 
 29.3   to the disposition of the ward's or conservatee's clothing, 
 29.4   furniture, vehicles, or other personal effects.  The notice must 
 29.5   inform the person of the right to object to the disposition of 
 29.6   the property within ten days and to petition the court for a 
 29.7   review of the guardian's or conservator's proposed actions.  
 29.8   Notice of the objection must be served by mail or personal 
 29.9   service on the guardian or conservator and the ward or 
 29.10  conservatee unless the ward or conservatee be the objector.  The 
 29.11  guardian or conservator served with notice of an objection to 
 29.12  the disposition of the property may not dispose of the property 
 29.13  unless the court approves the disposition after a hearing. 
 29.14     (4)(a) The power to give any necessary consent to enable 
 29.15  the ward or conservatee to receive necessary medical or other 
 29.16  professional care, counsel, treatment or service, except that no 
 29.17  guardian or conservator may give consent for psychosurgery, 
 29.18  electroshock, sterilization, or experimental treatment of any 
 29.19  kind unless the procedure is first approved by order of the 
 29.20  court as provided in this clause.  The guardian or conservator 
 29.21  shall not consent to any medical care for the ward or 
 29.22  conservatee which violates the known conscientious, religious, 
 29.23  or moral belief of the ward or conservatee. 
 29.24     (b) A guardian or conservator who believes a procedure 
 29.25  described in clause (4)(a) requiring prior court approval to be 
 29.26  necessary for the proper care of the ward or conservatee shall 
 29.27  petition the court for an order and, in the case of a public 
 29.28  guardianship or conservatorship under chapter 252A, obtain the 
 29.29  written recommendation of the commissioner of human services.  
 29.30  The court shall fix the time and place for the hearing and shall 
 29.31  give notice to the ward or conservatee and to the other persons 
 29.32  specified in section 525.55, subdivision 1.  The notice shall 
 29.33  comply with the requirements of, and be served in the manner 
 29.34  provided in section 525.55, subdivision 2.  The court shall 
 29.35  appoint an attorney to represent the ward or conservatee who is 
 29.36  not represented by counsel.  In every case the court shall 
 30.1   determine if the procedure is in the best interests of the ward 
 30.2   or conservatee.  In making its determination, the court shall 
 30.3   consider a written medical report which specifically considers 
 30.4   the medical risks of the procedure, whether alternative, less 
 30.5   restrictive methods of treatment could be used to protect the 
 30.6   best interests of the ward or conservatee, and any 
 30.7   recommendation of the commissioner of human services for a 
 30.8   public ward or conservatee.  The standard of proof is that of 
 30.9   clear and convincing evidence.  
 30.10     (c) In the case of a petition for sterilization of a 
 30.11  mentally retarded ward or conservatee, the court shall appoint a 
 30.12  licensed physician, a psychologist who is qualified in the 
 30.13  diagnosis and treatment of mental retardation, and a social 
 30.14  worker who is familiar with the ward's or conservatee's social 
 30.15  history and adjustment or the case manager for the ward or 
 30.16  conservatee to examine or evaluate the ward or conservatee and 
 30.17  to provide written reports to the court.  The reports shall 
 30.18  indicate why sterilization is being proposed, whether 
 30.19  sterilization is necessary and is the least intrusive method for 
 30.20  alleviating the problem presented, and whether it is in the best 
 30.21  interests of the ward or conservatee.  The medical report shall 
 30.22  specifically consider the medical risks of sterilization, the 
 30.23  consequences of not performing the sterilization, and whether 
 30.24  alternative methods of contraception could be used to protect 
 30.25  the best interests of the ward or conservatee. 
 30.26     (d) Any conservatee whose right to consent to a 
 30.27  sterilization has not been restricted under this section or 
 30.28  section 252A.101, may be sterilized only if the conservatee 
 30.29  consents in writing or there is a sworn acknowledgment by an 
 30.30  interested person of a nonwritten consent by the conservatee.  
 30.31  The consent must certify that the conservatee has received a 
 30.32  full explanation from a physician or registered nurse of the 
 30.33  nature and irreversible consequences of the sterilization 
 30.34  operation.  
 30.35     (e) A guardian or conservator or the public guardian's 
 30.36  designee who acts within the scope of authority conferred by 
 31.1   letters of guardianship under section 252A.101, subdivision 7, 
 31.2   and according to the standards established in this chapter or in 
 31.3   chapter 252A shall not be civilly or criminally liable for the 
 31.4   provision of any necessary medical care, including but not 
 31.5   limited to, the administration of psychotropic medication or the 
 31.6   implementation of aversive and deprivation procedures to which 
 31.7   the guardian or conservator or the public guardian's designee 
 31.8   has consented. 
 31.9      (5) The power to approve or withhold approval of any 
 31.10  contract, except for necessities, which the ward or conservatee 
 31.11  may make or wish to make. 
 31.12     (6) The duty and power to exercise supervisory authority 
 31.13  over the ward or conservatee in a manner which limits civil 
 31.14  rights and restricts personal freedom only to the extent 
 31.15  necessary to provide needed care and services. 
 31.16     Sec. 28.  [REPEALER.] 
 31.17     Minnesota Statutes 1994, section 253B.15, subdivisions 4 
 31.18  and 6; Minnesota Statutes 1995 Supplement, section 253B.03, 
 31.19  subdivision 6c, are repealed.