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Office of the Revisor of Statutes

Key: (1) language to be deleted (2) new language

                             CHAPTER 189-S.F.No. 16 
                  An act relating to health; modifying provisions 
                  relating to the administration and prescription of 
                  neuroleptic medications; changing the name of a court 
                  in certain circumstances; amending Minnesota Statutes 
                  1994, sections 13.42, subdivision 3; 253B.03, 
                  subdivisions 6b and 6c; 253B.05, subdivisions 2 and 3; 
                  253B.12, subdivision 1; and 253B.17, subdivision 1. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 1994, section 13.42, 
        subdivision 3, is amended to read: 
           Subd. 3.  [CLASSIFICATION OF MEDICAL DATA.] Unless the data 
        is summary data or a statute specifically provides a different 
        classification, medical data are private but are available only 
        to the subject of the data as provided in section 144.335, and 
        shall not be disclosed to others except: 
           (a) Pursuant to section 13.05; 
           (b) Pursuant to section 253B.03, subdivision 6c; 
           (b) (c) Pursuant to a valid court order; 
           (c) (d) To administer federal funds or programs; 
           (d) (e) To the surviving spouse, parents, children, and 
        siblings of a deceased patient or client or, if there are no 
        surviving spouse, parents, children, or siblings, to the 
        surviving heirs of the nearest degree of kindred; 
           (e) (f) To communicate a patient's or client's condition to 
        a family member or other appropriate person in accordance with 
        acceptable medical practice, unless the patient or client 
        directs otherwise; or 
           (f) (g) As otherwise required by law. 
           Sec. 2.  Minnesota Statutes 1994, section 253B.03, 
        subdivision 6b, is amended to read: 
           Subd. 6b.  [CONSENT FOR MENTAL HEALTH TREATMENT.] A 
        competent person admitted or committed without commitment to a 
        treatment facility may be subjected to intrusive mental health 
        treatment only with the person's written informed consent.  For 
        purposes of this section, "intrusive mental health treatment" 
        means electroshock therapy and neuroleptic medication and does 
        not include treatment for mental retardation.  An incompetent 
        person who has prepared a directive under subdivision 6d 
        regarding treatment with intrusive therapies must be treated in 
        accordance with this section, except in cases of emergencies. 
           Sec. 3.  Minnesota Statutes 1994, section 253B.03, 
        subdivision 6c, is amended to read: 
           Subd. 6c.  [RECORDS; ADMINISTRATION OF NEUROLEPTIC 
        MEDICATIONS.] (a) A treating physician who makes medical 
        decisions under this subdivision regarding the prescription and 
        administration of neuroleptic medication may have access to the 
        physician's order section of a patient's records on past 
        administration of neuroleptic medication at any treatment 
        facility, if the patient lacks the capacity to authorize the 
        release of records.  Upon request of a treating physician under 
        this subdivision, a treatment facility shall supply complete 
        information relating to the past records on administration of 
        neuroleptic medication of a patient subject to this 
        subdivision.  A patient who has the capacity to authorize the 
        release of data retains the right to make decisions regarding 
        access to medical records as provided by section 144.335. 
           (b) Neuroleptic medications may be administered to persons 
        committed as mentally ill or mentally ill and dangerous only as 
        described in this subdivision.  For purposes of this section, 
        "patient" also includes a proposed patient who is the subject of 
        a petition for commitment. 
           (b) (c) A neuroleptic medication may be administered 
        treatment provider may prescribe and administer neuroleptic 
        medication without judicial review to a patient who: 
           (1) is competent to consent to neuroleptic medications if 
        the patient has given written, informed consent to 
        administration of the neuroleptic medication. the treatment and 
        has signed a written, informed consent; 
           (c) A neuroleptic medication may be administered to a 
        patient who (2) is not competent to consent to neuroleptic 
        medications if the patient, when competent, prepared a 
        declaration under subdivision 6d requesting the treatment or 
        authorizing a proxy to request the treatment or if a court 
        approves the administration of the neuroleptic medication. and 
        the proxy has requested the neuroleptic medication; 
           (d) A neuroleptic medication may be administered without 
        court review to a patient who (3) has not prepared a declaration 
        under subdivision 6d and who is not competent to consent to 
        neuroleptic medications if:  
           (1) (i) the patient does not object to or refuse the 
        medication; 
           (2) (ii) a guardian ad litem appointed by the court with 
        authority to consent to neuroleptic medications gives written, 
        informed consent to the administration of the neuroleptic 
        medication; and 
           (3) (iii) a multidisciplinary treatment review panel 
        composed of persons who are not engaged in providing direct care 
        to the patient gives written approval to administration of the 
        neuroleptic medication.; or 
           (e) A neuroleptic medication may be administered without 
        judicial review and without consent (4) refuses prescribed 
        neuroleptic medication and is in an emergency situation.  
        Medication may be administered for so long as the emergency 
        continues to exist, up to 14 days, if the treating physician 
        determines that the medication is necessary to prevent serious, 
        immediate physical harm to the patient or to others.  If a 
        petition for authorization to administer medication is filed 
        within the 14 days, the treating physician may continue the 
        medication through the date of the first court hearing, if the 
        emergency continues to exist.  If the petition for authorization 
        to administer medication is filed in conjunction with a petition 
        for commitment and the court makes a determination at the 
        preliminary hearing under section 253B.07, subdivision 7, that 
        there is sufficient cause to continue the physician's order 
        until the hearing under section 253B.08, the treating physician 
        may continue the medication until that hearing, if the emergency 
        continues to exist.  The treatment facility shall document the 
        emergency in the patient's medical record in specific behavioral 
        terms. 
           (f) A person who consents to treatment pursuant to this 
        subdivision is not civilly or criminally liable for the 
        performance of or the manner of performing the treatment.  A 
        person is not liable for performing treatment without consent if 
        written, informed consent was given pursuant to this 
        subdivision.  This provision does not affect any other liability 
        that may result from the manner in which the treatment is 
        performed. 
           (g) (d) The court may allow and order paid to a guardian ad 
        litem a reasonable fee for services provided under paragraph 
        (c), or the court may appoint a volunteer guardian ad litem. 
           (h) A medical director or patient may petition the 
        committing court, or the court to which venue has been 
        transferred, for a hearing concerning the administration of 
        neuroleptic medication.  A hearing may also be held pursuant to 
        section 253B.08, 253B.09, 253B.12, or 253B.18.  The hearing 
        concerning the administration of neuroleptic medication must be 
        held within 14 days from the date of the filing of the 
        petition.  The court may extend the time for hearing up to an 
        additional 15 days for good cause shown. 
           (e) A treatment facility must obtain judicial review to 
        administer neuroleptic medication to a patient who refuses to 
        take the medication, or when an independent medical review does 
        not support the prescribed treatment. 
           (f) A physician on behalf of a treatment facility may file 
        a petition requesting authorization to administer neuroleptic 
        medication to a patient who is not competent to consent to the 
        prescribed medication, as certified by a physician, and who 
        refuses to take the prescribed medication.  A patient may also 
        file a petition pursuant to section 253B.17 for a review of a 
        physician's order for neuroleptic medication.  
           (g) A petition may be filed with the district court in the 
        county of commitment or, with the consent of the committing 
        court, the county in which the patient is being held or treated. 
        The petition may be heard as part of any other district court 
        proceeding under this chapter.  The hearing must be held within 
        14 days from the date of the filing of the petition.  By 
        agreement of the parties, or for good cause shown, the court may 
        extend the time of hearing an additional 30 days.  
           (h) If the petitioning facility has a treatment review 
        panel, the panel shall review the appropriateness of the 
        proposed medication and submit its recommendations to the court, 
        to the county attorney, and to the patient's counsel at least 
        two days prior to the hearing. 
           (i) The patient must be examined by a court examiner prior 
        to the hearing.  If the patient refuses to participate in an 
        examination, the examiner may rely on the patient's medical 
        records to reach an opinion as to the appropriateness of 
        neuroleptic medication.  The patient is entitled to counsel and 
        a second examiner, if requested by the patient or patient's 
        counsel. 
           (j) At any time during the commitment proceedings, the 
        court may appoint a guardian ad litem upon the request of any 
        party, the recommendation of the prepetition screener, an 
        examining physician, the court's examiner, or upon the court's 
        own motion. 
           (k) The court may base its decision on relevant and 
        admissible evidence, including the testimony of a treating 
        physician or other qualified physician, a member of the 
        patient's treatment team, a court appointed examiner, witness 
        testimony, or the patient's medical records. 
           (l) If the patient is found to be competent to decide 
        whether to take neuroleptic medication, the treating facility 
        may not administer medication without the patient's informed 
        written consent or without the declaration of an emergency, or 
        until further review by the court. 
           (m) If the patient is found incompetent to decide whether 
        to take neuroleptic medication, the court may authorize the 
        treating facility, and any other community or treatment facility 
        to which the patient may be transferred or provisionally 
        discharged, to involuntarily administer the medication to the 
        patient.  A finding of incompetence under this section must not 
        be construed to determine the patient's competence for any other 
        purpose.  
           (n) The court may, but is not required to, limit the 
        maximum dosage of neuroleptic medication which may be 
        administered. 
           (o) The court may authorize the administration of 
        neuroleptic medication until the termination of a determinate 
        commitment.  If the patient is committed for an indeterminate 
        period, the court may authorize treatment of neuroleptic 
        medication for not more than two years, subject to the patient's 
        right to petition the court for review of the order.  The 
        treatment facility must submit annual reports to the court, 
        which shall provide copies to the patient and the respective 
        attorneys.  
           (p) If the patient is transferred from a facility which 
        does not have a treatment review panel to a facility which has a 
        treatment review panel, the receiving facility shall review the 
        appropriateness of the patient's medication within 30 days after 
        the patient begins treatment at the facility. 
           Sec. 4.  Minnesota Statutes 1994, section 253B.05, 
        subdivision 2, is amended to read: 
           Subd. 2.  [PEACE OR HEALTH OFFICER HOLD.] (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 mentally retarded and in imminent danger of injuring self 
        or others if not immediately restrained.  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.  Written 
        application for admission of the person to a treatment facility 
        shall be made by the peace or health officer.  The application 
        shall contain a statement given by the peace or health officer 
        specifying the reasons for and circumstances under which the 
        person was taken into custody.  If imminent 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.  
           (b) 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:  a written statement is made by the medical 
        officer on duty at the facility that after preliminary 
        examination the person has symptoms of mental illness or mental 
        retardation and appears to be in imminent danger of harming self 
        or others; or, a written statement is made by the institution 
        program director or the director's designee on duty at the 
        facility that after preliminary examination the person has 
        symptoms of chemical dependency and appears to be in imminent 
        danger of harming self or others or is intoxicated in public. 
           Sec. 5.  Minnesota Statutes 1994, section 253B.05, 
        subdivision 3, is amended to read: 
           Subd. 3.  [DURATION OF HOLD.] (a) Any person held pursuant 
        to this section may be held up to 72 hours, exclusive of 
        Saturdays, Sundays, and legal holidays, after admission unless a 
        petition for the commitment of the person has been filed in the 
        probate court of the county of the person's residence or of the 
        county in which the treatment facility is located and the court 
        issues an order pursuant to section 253B.07, subdivision 6.  If 
        the head of the treatment facility believes that commitment is 
        required and no petition has been filed, the head of the 
        treatment facility shall file a petition for the commitment of 
        the person.  The hospitalized person may move to have the venue 
        of the petition changed to the probate court of the county of 
        the person's residence, if the person is a resident of Minnesota.
           (b) During the 72-hour hold period, a court may not release 
        a person held under this section unless the court has received a 
        written petition for release and held a summary hearing 
        regarding the release.  The petition must include the name of 
        the person being held, the basis for and location of the hold, 
        and a statement as to why the hold is improper.  The petition 
        also must include copies of any written documentation under 
        subdivision 1 or 2 in support of the hold, unless the person 
        holding the petitioner refuses to supply the documentation.  The 
        hearing must be held as soon as practicable and may be conducted 
        by means of a telephone conference call or similar method by 
        which the participants are able to simultaneously hear each 
        other.  If the court decides to release the person, the court 
        shall issue written findings supporting the decision, but may 
        not delay the release.  Before deciding to release the person, 
        the court shall make every reasonable effort to provide notice 
        of the proposed release to:  (1) any specific individuals 
        identified in a statement under subdivision 1 or 2 or in the 
        record as individuals who might be endangered if the person was 
        not held; and (2) the examiner whose written statement was a 
        basis for a hold under subdivision 1 or the peace or health 
        officer who applied for a hold under subdivision 2. 
           (c) If a treatment facility releases a person during the 
        72-hour hold period, the head of the treatment facility shall 
        immediately notify the agency which employs the peace or health 
        officer who transported the person to the treatment facility 
        under this section. 
           Sec. 6.  Minnesota Statutes 1994, section 253B.12, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [REPORT.] Prior to the termination of the 
        initial commitment order or final discharge of the patient, the 
        head of the facility shall file a written report with the 
        committing court with a copy to the patient and patient's 
        counsel, setting forth in detailed narrative form at least the 
        following: 
           (1) the diagnosis of the patient with the supporting data; 
           (2) the anticipated discharge date; 
           (3) an individualized treatment plan; 
           (4) a detailed description of the discharge planning 
        process with suggested after care plan; 
           (5) whether the patient is in need of further care and 
        treatment with evidence to support the response; 
           (6) whether any further care and treatment must be provided 
        in a treatment facility with evidence to support the response; 
           (7) whether in the opinion of the head of the facility the 
        patient must continue to be committed to a treatment facility; 
        and 
           (8) whether in the opinion of the head of the facility the 
        patient satisfies the statutory requirement for continued 
        commitment, with documentation to support the opinion; and 
           (9) whether the administration of neuroleptic medication is 
        clinically indicated, whether the patient is able to give 
        informed consent to that medication, and the basis for these 
        opinions. 
           Sec. 7.  Minnesota Statutes 1994, section 253B.17, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [PETITION.] Any patient, except one 
        committed as mentally ill and dangerous to the public, or any 
        interested person may petition the committing court or the court 
        to which venue has been transferred for an order that the 
        patient is not in need of continued institutionalization or for 
        an order that an individual is no longer mentally ill, mentally 
        retarded, or chemically dependent, or for any other relief as 
        the court deems just and equitable.  A patient committed as 
        mentally ill or mentally ill and dangerous may petition the 
        committing court or the court to which venue has been 
        transferred for a hearing concerning the administration of 
        neuroleptic medication.  A hearing may also be held pursuant to 
        sections 253B.08, 253B.09, 253B.12, and 253B.18. 
           Sec. 8.  [INSTRUCTION TO REVISOR.] 
           The revisor of statutes shall change the words "probate 
        court" to "district court," in Minnesota Statutes 1996 and 
        subsequent editions of the statutes. 
           Presented to the governor May 17, 1995 
           Signed by the governor May 19, 1995, 2:42 p.m.