Office of the Revisor of Statutes
Minnesota Session Laws - 1995, Regular Session
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.
Official Publication of the State of Minnesota
Revisor of Statutes