1.1                          A bill for an act 
  1.2             relating to civil commitment; modifying the definition 
  1.3             of a mentally ill person; modifying and expanding 
  1.4             provisions to facilitate voluntary treatment and 
  1.5             services; specifying certain patient rights and 
  1.6             examination requirements; providing for treatment 
  1.7             coverage and cost of care; allowing proposed patients 
  1.8             to bring claims for voluntary treatment and services; 
  1.9             expanding voluntary consent procedures; requiring 
  1.10            sealing of court records; appropriating money; 
  1.11            amending Minnesota Statutes 2000, sections 246.23, by 
  1.12            adding a subdivision; 253B.02, subdivision 13; 
  1.13            253B.03, subdivisions 5, 10, and by adding a 
  1.14            subdivision; 253B.04, subdivisions 1, 1a, and by 
  1.15            adding a subdivision; 253B.045, subdivisions 2, 3, and 
  1.16            6; 253B.05, subdivision 1; 253B.06, subdivision 1; 
  1.17            253B.07, subdivisions 1 and 2; 253B.09, subdivision 1; 
  1.18            253B.10, subdivision 4; and 253B.23, subdivision 9; 
  1.19            proposing coding for new law in Minnesota Statutes, 
  1.20            chapter 253B. 
  1.21  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.22     Section 1.  Minnesota Statutes 2000, section 246.23, is 
  1.23  amended by adding a subdivision to read: 
  1.24     Subd. 3.  [BEDS FOR VOLUNTARY MENTAL ILLNESS 
  1.25  TREATMENT.] The commissioner of human services shall make at 
  1.26  least 20 percent of beds in each regional treatment center 
  1.27  available to patients with a mental illness who are admitted on 
  1.28  a voluntary basis under chapter 253B. 
  1.29     Sec. 2.  Minnesota Statutes 2000, section 253B.02, 
  1.30  subdivision 13, is amended to read: 
  1.31     Subd. 13.  [MENTALLY ILL PERSON.] (a) "Mentally ill person" 
  1.32  means any person who has an organic disorder of the brain or a 
  1.33  substantial psychiatric disorder of thought, mood, perception, 
  2.1   orientation, or memory which grossly impairs judgment, behavior, 
  2.2   capacity to recognize reality, or to reason or understand, which 
  2.3   is manifested by instances of grossly disturbed behavior or 
  2.4   faulty perceptions and poses a substantial likelihood of 
  2.5   physical harm to self or others as demonstrated by: 
  2.6      (1) ~~a~~ an inability or failure to obtain necessary food, 
  2.7   clothing, shelter, or medical care as a result of the mental 
  2.8   impairment~~; or~~ for reasons other than indigence, provided that: 
  2.9      (i) the designated agency or other responsible entity is 
  2.10  offering to provide treatment, assistance, supervision, and 
  2.11  services appropriate to address the impairment and the person is 
  2.12  refusing the offer; and 
  2.13     (ii) the person will suffer substantial harm, significant 
  2.14  psychiatric deterioration or debilitation, or serious illness 
  2.15  unless appropriate treatment and services are provided; 
  2.16     (2) a recent attempt or threat to physically harm self or 
  2.17  others; or 
  2.18     (3) a recent and intentional act, resulting from the mental 
  2.19  impairment, that causes significant damage to substantial 
  2.20  property, and which has placed other persons in reasonable fear 
  2.21  of physical harm to themselves. 
  2.22     (b) A person is not mentally ill under this section if the 
  2.23  impairment is solely due to: 
  2.24     (1) epilepsy; 
  2.25     (2) mental retardation; 
  2.26     (3) brief periods of intoxication caused by alcohol, drugs, 
  2.27  or other mind-altering substances; or 
  2.28     (4) dependence upon or addiction to any alcohol, drugs, or 
  2.29  other mind-altering substances. 
  2.30     Sec. 3.  [253B.025] [RIGHT TO VOLUNTARY TREATMENT AND 
  2.31  SERVICES.] 
  2.32     Subdivision 1.  [PATIENT RIGHT.] Persons to whom this 
  2.33  chapter applies have the right to control their own lives as 
  2.34  fully as possible, including the right to treatment and services 
  2.35  that will enable them to live independently according to their 
  2.36  own choices.  Service providers and treating personnel shall 
  3.1   encourage a voluntary therapeutic relationship with their 
  3.2   clients.  A court may not commit a person who is seeking or 
  3.3   willing to accept treatment or services on a voluntary basis and 
  3.4   who is not dangerous to other persons.  Services available on a 
  3.5   voluntary basis include private and public health care; mental 
  3.6   health services provided under sections 245.461 to 245.490; 
  3.7   state contracted inpatient beds under section 256.969, 
  3.8   subdivision 3a; services provided by the mental health pilot 
  3.9   projects under section 245.4661; and treatment provided in state 
  3.10  regional treatment centers.  
  3.11     Subd. 2.  [COURT RELIEF.] A proposed patient may 
  3.12  affirmatively seek relief from the court to obtain voluntary 
  3.13  treatment and services from public or private entities with an 
  3.14  existing obligation to provide the treatment or services, 
  3.15  including, but not limited to, a designated agency, treatment 
  3.16  facility, health plan company, mental health pilot project, or 
  3.17  other provider.  A proposed patient may seek this relief through 
  3.18  a counterclaim or third-party claim under section 253B.075. 
  3.19     Sec. 4.  Minnesota Statutes 2000, section 253B.03, 
  3.20  subdivision 5, is amended to read: 
  3.21     Subd. 5.  [PERIODIC ASSESSMENT.] A patient has the right to 
  3.22  periodic medical assessment, including assessment of the medical 
  3.23  necessity of continuing care and, if the treatment facility 
  3.24  declines to provide continuing care, the right to receive 
  3.25  specific written reasons why continuing care is declined at the 
  3.26  time of the assessment.  The treatment facility shall assess the 
  3.27  physical and mental condition of every patient as frequently as 
  3.28  necessary, but not less often than annually.  If the patient 
  3.29  refuses to be examined, the facility shall document in the 
  3.30  patient's chart its attempts to examine the patient.  If a 
  3.31  person is committed as mentally retarded for an indeterminate 
  3.32  period of time, the three-year judicial review must include the 
  3.33  annual reviews for each year as outlined in Minnesota Rules, 
  3.34  part 9525.0075, subpart 6.  
  3.35     Sec. 5.  Minnesota Statutes 2000, section 253B.03, 
  3.36  subdivision 10, is amended to read: 
  4.1      Subd. 10.  [NOTIFICATION.] All persons admitted or 
  4.2   committed to a treatment facility shall be notified in writing 
  4.3   of their rights ~~under this chapter~~ regarding hospitalization and 
  4.4   other treatment at the time of admission.  This notification 
  4.5   must include: 
  4.6      (1) patient rights specified in this section and section 
  4.7   144.651, including nursing home discharge rights; 
  4.8      (2) the right to obtain treatment and services voluntarily 
  4.9   under this chapter; 
  4.10     (3) the right to voluntary admission and release under 
  4.11  section 253B.04; 
  4.12     (4) rights in case of an emergency admission under section 
  4.13  253B.05, including the right to documentation in support of an 
  4.14  emergency hold and the right to a summary hearing before a judge 
  4.15  if the patient believes an emergency hold is improper; 
  4.16     (5) the right to request expedited review under section 
  4.17  62M.05 if additional days of inpatient stay are denied; 
  4.18     (6) the right to continuing benefits pending appeal and to 
  4.19  an expedited administrative hearing under section 256.045 if the 
  4.20  patient is a recipient of medical assistance, general assistance 
  4.21  medical care, or MinnesotaCare; and 
  4.22     (7) the right to an external appeal process under section 
  4.23  62Q.73, including the right to a second opinion.  
  4.24     Sec. 6.  Minnesota Statutes 2000, section 253B.03, is 
  4.25  amended by adding a subdivision to read: 
  4.26     Subd. 11.  [PROXY.] A legally authorized health care proxy, 
  4.27  agent, guardian, or conservator may exercise the patient's 
  4.28  rights on the patient's behalf.  
  4.29     Sec. 7.  Minnesota Statutes 2000, section 253B.04, 
  4.30  subdivision 1, is amended to read: 
  4.31     Subdivision 1.  [VOLUNTARY ADMISSION AND TREATMENT.] (a) 
  4.32  Voluntary admission is preferred over involuntary commitment and 
  4.33  treatment.  Any person 16 years of age or older may request to 
  4.34  be admitted to a treatment facility as a voluntary patient for 
  4.35  observation, evaluation, diagnosis, care and treatment without 
  4.36  making formal written application.  Any person under the age of 
  5.1   16 years may be admitted as a patient with the consent of a 
  5.2   parent or legal guardian if it is determined by independent 
  5.3   examination that there is reasonable evidence that (1) the 
  5.4   proposed patient has a mental illness, or is mentally retarded 
  5.5   or chemically dependent; and (2) the proposed patient is 
  5.6   suitable for treatment.  The head of the treatment facility 
  5.7   shall not arbitrarily refuse any person seeking admission as a 
  5.8   voluntary patient.  In making decisions regarding admissions, 
  5.9   the facility shall use clinical admission criteria consistent 
  5.10  with the current applicable inpatient admission standards 
  5.11  established by the American Psychiatric Association or the 
  5.12  American Academy of Child and Adolescent Psychiatry.  These 
  5.13  criteria must be no more restrictive than, and must be 
  5.14  consistent with, the requirements of section 62Q.53.  The 
  5.15  facility may not refuse to admit a person voluntarily because 
  5.16  the person does not meet the criteria for involuntary holds 
  5.17  under section 253B.05 or the definition of mental illness under 
  5.18  section 253B.02, subdivision 13.  
  5.19     (b) In addition to the consent provisions of paragraph (a), 
  5.20  a person who is 16 or 17 years of age who refuses to consent 
  5.21  personally to admission may be admitted as a patient for mental 
  5.22  illness or chemical dependency treatment with the consent of a 
  5.23  parent or legal guardian if it is determined by an independent 
  5.24  examination that there is reasonable evidence that the proposed 
  5.25  patient is chemically dependent or has a mental illness and is 
  5.26  suitable for treatment.  The person conducting the examination 
  5.27  shall notify the proposed patient and the parent or legal 
  5.28  guardian of this determination. 
  5.29     Sec. 8.  Minnesota Statutes 2000, section 253B.04, 
  5.30  subdivision 1a, is amended to read: 
  5.31     Subd. 1a.  [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 
  5.32  WITH MENTAL ILLNESS.] (a) A person with a mental illness may 
  5.33  seek or voluntarily agree to accept treatment or admission to a 
  5.34  facility.  If the mental health provider determines that the 
  5.35  person lacks the capacity to give informed consent for the 
  5.36  treatment or admission, and in the absence of a health care 
  6.1   power of attorney that authorizes consent, the designated agency 
  6.2   or its designee may give informed consent for mental health 
  6.3   treatment or admission to a treatment facility on behalf of the 
  6.4   person. 
  6.5      (b) The designated agency shall apply the following 
  6.6   criteria in determining the person's ability to give informed 
  6.7   consent: 
  6.8      (1) whether the person demonstrates an awareness of the 
  6.9   person's illness, and the reasons for treatment, its risks, 
  6.10  benefits and alternatives, and the possible consequences of 
  6.11  refusing treatment; and 
  6.12     (2) whether the person communicates verbally or nonverbally 
  6.13  a clear choice concerning treatment that is a reasoned one, not 
  6.14  based on delusion, even though it may not be in the person's 
  6.15  best interests. 
  6.16     (c) The basis for the designated agency's decision that the 
  6.17  person lacks the capacity to give informed consent for treatment 
  6.18  or admission, and that the patient has voluntarily accepted 
  6.19  treatment or admission, must be documented in writing. 
  6.20     (d) A mental health provider that provides treatment in 
  6.21  reliance on the written consent given by the designated agency 
  6.22  under this subdivision or by a substitute decision maker 
  6.23  appointed by the court is not civilly or criminally liable for 
  6.24  performing treatment without consent.  This paragraph does not 
  6.25  affect any other liability that may result from the manner in 
  6.26  which the treatment is performed. 
  6.27     (e) A person who receives treatment or is admitted to a 
  6.28  facility under this subdivision or subdivision 1b has the right 
  6.29  to refuse treatment at any time or to be released from a 
  6.30  facility as provided under subdivision 2.  The person or any 
  6.31  interested person acting on the person's behalf may seek court 
  6.32  review within five days for a determination of whether the 
  6.33  person's agreement to accept treatment or admission is 
  6.34  voluntary.  At the time a person agrees to treatment or 
  6.35  admission to a facility under this subdivision, the designated 
  6.36  agency or its designee shall inform the person in writing of the 
  7.1   person's rights under this paragraph. 
  7.2      (f) This subdivision does not authorize the administration 
  7.3   of neuroleptic medications.  Neuroleptic medications may be 
  7.4   administered only as provided in section 253B.092. 
  7.5      Sec. 9.  Minnesota Statutes 2000, section 253B.04, is 
  7.6   amended by adding a subdivision to read: 
  7.7      Subd. 1b.  [COURT APPOINTMENT OF SUBSTITUTE DECISION 
  7.8   MAKER.] If the designated agency or its designee declines or 
  7.9   refuses to give informed consent under subdivision 1a, the 
  7.10  person who is seeking treatment or admission, or an interested 
  7.11  person acting on behalf of the person, may petition the court 
  7.12  for appointment of a substitute decision maker who may give 
  7.13  informed consent for voluntary treatment and services.  In 
  7.14  making this determination, the court shall apply the criteria in 
  7.15  subdivision 1a, paragraph (b). 
  7.16     Sec. 10.  Minnesota Statutes 2000, section 253B.045, 
  7.17  subdivision 2, is amended to read: 
  7.18     Subd. 2.  [FACILITIES.] Each county or a group of counties 
  7.19  shall maintain or provide by contract a facility for confinement 
  7.20  of persons held temporarily for observation, evaluation, 
  7.21  diagnosis, treatment, and care.  When the temporary confinement 
  7.22  is provided at a regional treatment center, the commissioner 
  7.23  shall charge the county of financial responsibility for the 
  7.24  costs of confinement of persons hospitalized under section 
  7.25  253B.05, subdivisions 1 and 2, and section 253B.07, subdivision 
  7.26  2b, except that the commissioner shall bill the responsible 
  7.27  prepaid plan for medically necessary hospitalizations for 
  7.28  individuals enrolled in a prepaid plan under contract to provide 
  7.29  medical assistance, general assistance medical care, or 
  7.30  MinnesotaCare services.  ~~If the prepaid plan determines under~~ 
  7.31  ~~the terms of the medical assistance, general assistance medical~~ 
  7.32  ~~care, or MinnesotaCare contract that a hospitalization was not~~ 
  7.33  ~~medically necessary, the county is responsible.~~  A recipient of 
  7.34  medical assistance, general assistance medical care, 
  7.35  MinnesotaCare, or Medicare confined in a state regional 
  7.36  treatment center under this provision may not be billed for the 
  8.1   cost of care except to the extent that person would have been 
  8.2   financially responsible for the care if held temporarily in a 
  8.3   community hospital or other treatment facility.  "County of 
  8.4   financial responsibility" means the county in which the person 
  8.5   resides at the time of confinement or, if the person has no 
  8.6   residence in this state, the county which initiated the 
  8.7   confinement.  The charge shall be based on the commissioner's 
  8.8   determination of the cost of care pursuant to section 246.50, 
  8.9   subdivision 5.  When there is a dispute as to which county is 
  8.10  the county of financial responsibility, the county charged for 
  8.11  the costs of confinement shall pay for them pending final 
  8.12  determination of the dispute over financial responsibility.  
  8.13  Disputes about the county of financial responsibility shall be 
  8.14  submitted to the commissioner to be settled in the manner 
  8.15  prescribed in section 256G.09. 
  8.16     Sec. 11.  Minnesota Statutes 2000, section 253B.045, 
  8.17  subdivision 3, is amended to read: 
  8.18     Subd. 3.  [COST OF CARE.] Notwithstanding subdivision 2, a 
  8.19  county shall be responsible for the cost of care as specified 
  8.20  under section 246.54 for persons hospitalized at a regional 
  8.21  treatment center in accordance with section 253B.09 and the 
  8.22  person's legal status has been changed to a court hold under 
  8.23  section 253B.07, subdivision 2b, pending a judicial 
  8.24  determination regarding continued commitment pursuant to 
  8.25  sections 253B.12 and 253B.13.  A recipient of medical 
  8.26  assistance, general assistance medical care, MinnesotaCare, or 
  8.27  Medicare confined in a state regional treatment center under 
  8.28  this provision may not be billed for the cost of care except to 
  8.29  the extent that person would have been financially responsible 
  8.30  for the care if held temporarily in a community hospital or 
  8.31  other treatment facility.  
  8.32     Sec. 12.  Minnesota Statutes 2000, section 253B.045, 
  8.33  subdivision 6, is amended to read: 
  8.34     Subd. 6.  [COVERAGE.] A health plan company must provide 
  8.35  coverage, according to the terms of the policy, contract, or 
  8.36  certificate of coverage, for all ~~medically necessary covered~~ 
  9.1   ~~services as determined by section 62Q.53~~ treatment and services 
  9.2   provided to an enrollee that are ordered by the court under this 
  9.3   chapter.  If the treatment and services are ordered by the 
  9.4   court, the health plan company may not deny coverage based on a 
  9.5   determination that the treatment and services are not medically 
  9.6   necessary if the treatment and services are otherwise covered 
  9.7   under the policy, contract, or certificate of coverage.  
  9.8      Sec. 13.  Minnesota Statutes 2000, section 253B.05, 
  9.9   subdivision 1, is amended to read: 
  9.10     Subdivision 1.  [EMERGENCY HOLD.] (a) Any person may be 
  9.11  admitted or held for emergency care and treatment in a treatment 
  9.12  facility with the consent of the head of the treatment facility 
  9.13  upon a written statement by an examiner that: 
  9.14     (1) the examiner has examined the person not more than 15 
  9.15  days prior to admission~~,~~; 
  9.16     (2) the examiner is of the opinion, for stated reasons, 
  9.17  that the person is mentally ill, mentally retarded or chemically 
  9.18  dependent, and is in ~~imminent~~ danger of causing injury to self 
  9.19  or others if not immediately ~~restrained,~~ detained; and 
  9.20     (3) an order of the court cannot be obtained in time to 
  9.21  prevent the anticipated injury.  
  9.22     (b) If the proposed patient has been brought to the 
  9.23  treatment facility by another person, the examiner shall obtain 
  9.24  a statement of information that is available from that person, 
  9.25  which must be taken into consideration in deciding whether to 
  9.26  place the proposed patient on an emergency hold.  The statement 
  9.27  of information must include direct observations of the proposed 
  9.28  patient's behaviors, reliable knowledge of recent and past 
  9.29  behavior, and information regarding psychiatric history, past 
  9.30  treatment, and current mental health providers.  The examiner 
  9.31  shall also inquire into the existence of health care directives 
  9.32  under chapter 145, and advance psychiatric directives under 
  9.33  section 253B.03, subdivision 6d. 
  9.34     (c) The examiner's statement shall be:  (1) sufficient 
  9.35  authority for a peace or health officer to transport a patient 
  9.36  to a treatment facility, (2) stated in behavioral terms and not 
 10.1   in conclusory language, and (3) of sufficient specificity to 
 10.2   provide an adequate record for review.  If ~~imminent~~ danger to 
 10.3   specific individuals is a basis for the emergency hold, the 
 10.4   statement must identify those individuals, to the extent 
 10.5   practicable.  A copy of the examiner's statement shall be 
 10.6   personally served on the person immediately upon admission and a 
 10.7   copy shall be maintained by the treatment facility.  
 10.8      Sec. 14.  Minnesota Statutes 2000, section 253B.06, 
 10.9   subdivision 1, is amended to read: 
 10.10     Subdivision 1.  [MENTALLY ILL AND MENTALLY RETARDED 
 10.11  PERSONS.] Every patient hospitalized as mentally ill or mentally 
 10.12  retarded pursuant to section 253B.04 or 253B.05 must be examined 
 10.13  by a physician as soon as possible but no more than 48 hours 
 10.14  following admission.  The physician shall be knowledgeable and 
 10.15  trained in the diagnosis of the alleged disability related to 
 10.16  the need for admission as a mentally ill or mentally retarded 
 10.17  person.  The examination must include an assessment of the 
 10.18  necessity for further inpatient care.  If the treatment facility 
 10.19  declines to provide continuing care, the facility must give the 
 10.20  patient specific written reasons why continuing care is declined 
 10.21  at the time of the assessment.  If the examining physician 
 10.22  recommends that a petition for involuntary treatment be filed, 
 10.23  the patient and any other person designated by the patient must 
 10.24  be immediately informed in writing of the reasons. 
 10.25     Sec. 15.  Minnesota Statutes 2000, section 253B.07, 
 10.26  subdivision 1, is amended to read: 
 10.27     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
 10.28  filing a petition for commitment of or early intervention for a 
 10.29  proposed patient, an interested person shall apply to the 
 10.30  designated agency in the county of the proposed patient's 
 10.31  residence or presence for conduct of a preliminary 
 10.32  investigation, except when the proposed patient has been 
 10.33  acquitted of a crime under section 611.026 and the county 
 10.34  attorney is required to file a petition for commitment.  The 
 10.35  designated agency shall appoint a screening team to conduct an 
 10.36  investigation ~~which shall include~~.  The petitioner may not be a 
 11.1   member of the screening team.  The investigation must include: 
 11.2      (i) a personal interview with the proposed patient and 
 11.3   other individuals who appear to have knowledge of the condition 
 11.4   of the proposed patient.  If the proposed patient is not 
 11.5   interviewed, specific reasons must be documented; 
 11.6      (ii) identification and investigation of specific alleged 
 11.7   conduct which is the basis for application; 
 11.8      (iii) identification, exploration, and listing of 
 11.9   the specific reasons for rejecting or recommending alternatives 
 11.10  to involuntary placement; 
 11.11     (iv) a written statement from the patient's health plan 
 11.12  specifying the services the plan will or will not pay for and 
 11.13  its reasons for this determination, to the extent a statement is 
 11.14  available in a timely manner.  If a statement is not available, 
 11.15  any written report recommending commitment must indicate that a 
 11.16  statement could not be obtained and the petitioner shall notify 
 11.17  the court of this issue; 
 11.18     (v) in the case of a commitment based on mental illness, 
 11.19  the following information, if it is known or available~~:~~  
 11.20  ~~information~~, that may be relevant to the administration of 
 11.21  neuroleptic medications, ~~if necessary,~~ including the existence 
 11.22  of a declaration under section 253B.03, subdivision 6d, or a 
 11.23  health care directive under chapter 145C or a guardian, 
 11.24  conservator, proxy, or agent with authority to make health care 
 11.25  decisions for the proposed patient; information regarding the 
 11.26  capacity of the proposed patient to make decisions regarding 
 11.27  administration of neuroleptic medication; and whether the 
 11.28  proposed patient is likely to consent or refuse consent to 
 11.29  administration of the medication; and 
 11.30     ~~(v) seeking input from the proposed patient's health plan~~ 
 11.31  ~~company to provide the court with information about services the~~ 
 11.32  ~~enrollee needs and the least restrictive alternatives.~~ 
 11.33     (vi) in the case of a commitment based on mental illness, 
 11.34  information listed in clause (v) for other purposes relevant to 
 11.35  treatment. 
 11.36     (b) In conducting the investigation required by this 
 12.1   subdivision, the screening team shall have access to all 
 12.2   relevant medical records of proposed patients currently in 
 12.3   treatment facilities.  Data collected pursuant to this clause 
 12.4   shall be considered private data on individuals.  The 
 12.5   prepetition screening report is not admissible as evidence in 
 12.6   any court proceedings ~~unrelated to the commitment proceedings~~. 
 12.7      (c) The prepetition screening team shall provide a notice, 
 12.8   written in easily understood language, to the proposed patient, 
 12.9   the petitioner, persons named in a declaration under chapter 
 12.10  145C or section 253B.03, subdivision 6d, and, with the proposed 
 12.11  patient's consent, other interested parties.  The team shall ask 
 12.12  the patient if the patient wants the notice read and shall read 
 12.13  the notice to the patient upon request.  The notice must contain 
 12.14  information regarding the process, purpose, and legal effects of 
 12.15  civil commitment and early intervention.  The notice must inform 
 12.16  the proposed patient that: 
 12.17     (1) if a petition is filed, the patient has certain rights, 
 12.18  including the right to a court-appointed attorney, the right to 
 12.19  request a second examiner, the right to attend hearings, and the 
 12.20  right to oppose the proceeding and to present and contest 
 12.21  evidence; 
 12.22     (2) the patient or other interested person acting on behalf 
 12.23  of the patient has a right to petition the court for an order to 
 12.24  obtain voluntary treatment and services under section 253B.075; 
 12.25  and 
 12.26     (3) if the proposed patient is committed to a state 
 12.27  regional treatment center or group home, the patient will be 
 12.28  billed for the cost of care and the state has the right to make 
 12.29  a claim against the patient's estate for this cost. 
 12.30     The ombudsman for mental health and mental retardation 
 12.31  shall develop a form for the notice, which includes the 
 12.32  requirements of this paragraph.  
 12.33     (d) When the prepetition screening team recommends 
 12.34  commitment, a written report shall be sent to the county 
 12.35  attorney for the county in which the petition is to be 
 12.36  filed.  The statement of facts contained in the written report 
 13.1   must meet the requirements of subdivision 2, paragraph (b). 
 13.2      ~~(d)~~ (e) The prepetition screening team shall refuse to 
 13.3   support a petition if the investigation does not disclose 
 13.4   evidence sufficient to support commitment.  Notice of the 
 13.5   prepetition screening team's decision shall be provided to the 
 13.6   prospective petitioner and to the proposed patient.  
 13.7      ~~(e)~~ (f) If the interested person wishes to proceed with a 
 13.8   petition contrary to the recommendation of the prepetition 
 13.9   screening team, application may be made directly to the county 
 13.10  attorney, who ~~may~~ shall determine whether or not to proceed with 
 13.11  the petition.  Notice of the county attorney's determination 
 13.12  shall be provided to the interested party.  
 13.13     ~~(f)~~ (g) If the proposed patient has been acquitted of a 
 13.14  crime under section 611.026, the county attorney shall apply to 
 13.15  the designated county agency in the county in which the 
 13.16  acquittal took place for a preliminary investigation unless 
 13.17  substantially the same information relevant to the proposed 
 13.18  patient's current mental condition, as could be obtained by a 
 13.19  preliminary investigation, is part of the court record in the 
 13.20  criminal proceeding or is contained in the report of a mental 
 13.21  examination conducted in connection with the criminal 
 13.22  proceeding.  If a court petitions for commitment pursuant to the 
 13.23  rules of criminal or juvenile procedure or a county attorney 
 13.24  petitions pursuant to acquittal of a criminal charge under 
 13.25  section 611.026, the prepetition investigation, if required by 
 13.26  this section, shall be completed within seven days after the 
 13.27  filing of the petition.  
 13.28     Sec. 16.  Minnesota Statutes 2000, section 253B.07, 
 13.29  subdivision 2, is amended to read: 
 13.30     Subd. 2.  [THE PETITION.] (a) Any interested person, except 
 13.31  a member of the prepetition screening team, may file a petition 
 13.32  for commitment in the district court of the county of the 
 13.33  proposed patient's residence or presence.  If the head of the 
 13.34  treatment facility believes that commitment is required and no 
 13.35  petition has been filed, the head of the treatment facility 
 13.36  shall seek a petition for the commitment of the person. 
 14.1      (b) The petition shall set forth the name and address of 
 14.2   the proposed patient, the name and address of the patient's 
 14.3   nearest relatives, and the reasons for the petition.  The 
 14.4   caption of the case must refer to the proposed patient by 
 14.5   initials only.  The petition must contain factual descriptions 
 14.6   of the proposed patient's recent behavior, including a 
 14.7   description of the behavior, where it occurred, and the time 
 14.8   period over which it occurred.  Each factual allegation must be 
 14.9   supported by observations of witnesses named in the petition.  
 14.10  Petitions shall be stated in behavioral terms and shall not 
 14.11  contain judgmental or conclusory statements.  
 14.12     (c) The petition shall be accompanied by a written 
 14.13  statement by an examiner stating that the examiner has examined 
 14.14  the proposed patient within the 15 days preceding the filing of 
 14.15  the petition and is of the opinion that the proposed patient is 
 14.16  suffering a designated disability and should be committed to a 
 14.17  treatment facility.  The statement shall include the reasons for 
 14.18  the opinion.  In the case of a commitment based on mental 
 14.19  illness, the petition and the examiner's statement may include, 
 14.20  to the extent this information is available, a statement and 
 14.21  opinion regarding the proposed patient's need for treatment with 
 14.22  neuroleptic medication and the patient's capacity to make 
 14.23  decisions regarding the administration of neuroleptic 
 14.24  medications, and the reasons for the opinion.  If a petitioner 
 14.25  has been unable to secure a statement from an examiner, the 
 14.26  petition shall include documentation that a reasonable effort 
 14.27  has been made to secure the supporting statement.  
 14.28     Sec. 17.  [253B.075] [CLAIM FOR VOLUNTARY TREATMENT AND 
 14.29  SERVICES.] 
 14.30     Subdivision 1.  [COUNTERCLAIM OR THIRD-PARTY CLAIM.] A 
 14.31  patient against whom a petition under this chapter has been 
 14.32  filed may file a counterclaim or a third-party claim for 
 14.33  appropriate voluntary treatment and services.  A legally 
 14.34  authorized representative, including an agent or proxy appointed 
 14.35  under an advance health care directive or a guardian or 
 14.36  conservator, may seek this relief on the person's behalf.  A 
 15.1   counterclaim or third-party claim must be filed with the court 
 15.2   and served on the parties alleged to be respondents within 72 
 15.3   hours after the preliminary hearing under section 253B.07, 
 15.4   subdivision 7.  The patient is entitled to the assistance of 
 15.5   court-appointed counsel as provided in section 253B.07, 
 15.6   subdivision 2, paragraph (c), and has the right to present 
 15.7   evidence and witnesses, including an independent second 
 15.8   examination under section 253B.07, subdivision 3, that addresses 
 15.9   the issues raised by the patient.  A court examination under 
 15.10  section 253B.07, subdivision 3, must include the examiner's 
 15.11  recommendations on the issues raised by the patient.  
 15.12     Subd. 2.  [NOTICE AND SUMMONS.] The court shall issue a 
 15.13  notice and summons to the third-party respondents named in the 
 15.14  patient's claim.  The court may order joined as additional 
 15.15  respondents in any proceeding under this chapter any state or 
 15.16  county agency, private service provider, third-party 
 15.17  administrator, health plan company, or other parties who are or 
 15.18  may be responsible for providing or paying for the provision or 
 15.19  development of services for any person who is the subject of a 
 15.20  petition under this chapter.  
 15.21     Subd. 3.  [HEARING.] The hearing shall be held concurrently 
 15.22  with the hearing required under section 253B.08.  If the court 
 15.23  finds that the counterclaim or third-party claim is supported by 
 15.24  a preponderance of the evidence, the court shall enter an order 
 15.25  granting relief.  The relief granted may include: 
 15.26     (1) an order requiring the provision of treatment and 
 15.27  services to the patient on a voluntary basis or under section 
 15.28  253B.065 or 253B.09; 
 15.29     (2) an order appointing a substitute decision maker under 
 15.30  subdivision 4 if a proposed patient lacks capacity to consent to 
 15.31  treatment and services and the designated agency or its designee 
 15.32  has not given consent under section 253B.04, subdivision 1a; 
 15.33     (3) dismissal of a petition for involuntary commitment; 
 15.34     (4) an order for reasonable attorney fees; or 
 15.35     (5) other relief as the court may deem just and appropriate.
 15.36     Subd. 4.  [SUBSTITUTE DECISION MAKER.] If the proposed 
 16.1   patient is requesting or acquiescing in the provision of 
 16.2   treatment and services but the court finds that the patient does 
 16.3   not have the capacity to give informed consent, the court may 
 16.4   appoint a substitute decision maker who may give informed 
 16.5   consent for mental health treatment or admission to a treatment 
 16.6   facility on behalf of the person.  In making this determination, 
 16.7   the court shall apply the criteria in section 253B.04, 
 16.8   subdivision 1a, paragraph (b).  The provisions of section 
 16.9   253B.04, subdivisions 1a, paragraphs (e) and (f), and 2, apply 
 16.10  to patients who receive treatment and services under this 
 16.11  subdivision.  
 16.12     Subd. 5.  [COMPENSATION FOR SERVICES.] If the court has 
 16.13  ordered a respondent to furnish or provide mental health 
 16.14  services for which the respondent is responsible and the 
 16.15  respondent does not fulfill its responsibilities to the patient, 
 16.16  the court may order the respondent to provide compensation to 
 16.17  any facility or program actually providing services to the 
 16.18  patient, may order payment in an amount adequate for the 
 16.19  delivery of needed services, or may order compensation to the 
 16.20  patient if the patient has become financially encumbered due to 
 16.21  the failure to provide treatment or services to which the 
 16.22  patient is entitled.  Compensation may include coinsurance, 
 16.23  co-payments, other treatment related expenses, lost wages, and 
 16.24  other damages suffered by the patient. 
 16.25     Subd. 6.  [ATTORNEY FEES.] Orders for attorney fees under 
 16.26  this section may include reimbursement to the public authority 
 16.27  and the patient for expenses incurred by the patient's attorney 
 16.28  and the county attorney in gaining compliance with the court's 
 16.29  order.  Orders for attorney fees may include payment to 
 16.30  attorneys under contract and their contractors, public defender 
 16.31  programs, other court-appointed attorneys or attorney programs, 
 16.32  and privately retained attorneys.  
 16.33     Sec. 18.  Minnesota Statutes 2000, section 253B.09, 
 16.34  subdivision 1, is amended to read: 
 16.35     Subdivision 1.  [STANDARD OF PROOF.] (a) If the court finds 
 16.36  by clear and convincing evidence that the proposed patient is a 
 17.1   mentally ill, mentally retarded, or chemically dependent person 
 17.2   and after careful consideration of reasonable alternative 
 17.3   dispositions, including but not limited to, dismissal of 
 17.4   petition, voluntary outpatient care, voluntary admission to a 
 17.5   treatment facility, appointment of a guardian or conservator, or 
 17.6   release before commitment as provided for in subdivision 4, it 
 17.7   finds that there is no suitable alternative to judicial 
 17.8   commitment, the court shall commit the patient to the least 
 17.9   restrictive treatment program or alternative programs which can 
 17.10  meet the patient's treatment needs consistent with section 
 17.11  253B.03, subdivision 7.  
 17.12     (b) In deciding on the least restrictive program, the court 
 17.13  shall consider a range of treatment alternatives including, but 
 17.14  not limited to, community-based nonresidential treatment, 
 17.15  community residential treatment, partial hospitalization, acute 
 17.16  care hospital, and regional treatment center services.  The 
 17.17  court shall also consider the proposed patient's treatment 
 17.18  preferences and willingness to participate voluntarily in the 
 17.19  treatment ordered.  The court may not commit a patient to a 
 17.20  facility or program that is not capable of meeting the patient's 
 17.21  needs.  
 17.22     (c) For purposes of findings under this chapter, none of 
 17.23  the following constitute a refusal to accept appropriate mental 
 17.24  health treatment: 
 17.25     (1) a willingness to take medication but a reasonable 
 17.26  disagreement about type or dosage; 
 17.27     (2) a good-faith effort to follow a reasonable alternative 
 17.28  treatment plan, including treatment as specified in a valid 
 17.29  advance directive under chapter 145C or section 253B.03, 
 17.30  subdivision 6d; 
 17.31     (3) an inability to obtain access to appropriate treatment 
 17.32  because of inadequate health care coverage or an insurer's 
 17.33  refusal or delay in providing coverage for the treatment; or 
 17.34     (4) an inability to obtain access to needed mental health 
 17.35  services because the provider will only accept patients who are 
 17.36  under a court order or because the provider gives persons under 
 18.1   a court order a priority over voluntary patients in obtaining 
 18.2   treatment and services.  
 18.3      Sec. 19.  Minnesota Statutes 2000, section 253B.10, 
 18.4   subdivision 4, is amended to read: 
 18.5      Subd. 4.  [PRIVATE TREATMENT.] ~~Patients or other~~ 
 18.6   ~~responsible persons are required to pay the necessary charges~~ 
 18.7   ~~for patients committed or transferred to private treatment~~ 
 18.8   ~~facilities.  Private treatment facilities may refuse to accept a~~ 
 18.9   ~~committed person.~~  Private treatment facilities may not refuse 
 18.10  to admit a committed person on the sole basis of that person's 
 18.11  court-ordered status.  Private treatment facilities may refuse 
 18.12  to accept a committed person who has no public or private source 
 18.13  of coverage or whose treatment needs are outside of the 
 18.14  facility's ability to treat.  Insurers must provide 
 18.15  court-ordered treatment and services as ordered by the court and 
 18.16  as required under chapter 62M.  If the committed person is 
 18.17  eligible for public or private coverage and that coverage has 
 18.18  been applied for, the county of financial responsibility shall 
 18.19  provide payment until coverage has been finalized.  
 18.20     Sec. 20.  Minnesota Statutes 2000, section 253B.23, 
 18.21  subdivision 9, is amended to read: 
 18.22     Subd. 9.  [SEALING OF RECORDS.] ~~Upon a motion by a person~~ 
 18.23  ~~who has been the subject of a judicial commitment proceeding,~~ 
 18.24  The court ~~may~~ shall seal all judicial records of ~~the~~ commitment 
 18.25  proceedings ~~if it finds that access to the records creates undue~~ 
 18.26  ~~hardship for the person~~ for a mentally ill, mentally ill and 
 18.27  dangerous, or chemically dependent person.  ~~The county attorney~~ 
 18.28  ~~shall be notified of the motion and may participate in the~~ 
 18.29  ~~hearings.  All hearings on the motion shall be in camera.~~  The 
 18.30  files and records of the court in proceedings ~~on the motion~~ 
 18.31  shall be sealed except to the ~~moving party~~ person, the person's 
 18.32  attorney, the county attorney, or other persons by court order.  
 18.33  The files and records must be made available as otherwise 
 18.34  required by law.  
 18.35     Sec. 21.  [APPROPRIATIONS.] 
 18.36     (a) $....... is appropriated from the general fund to the 
 19.1   attorney general for purposes of training county attorneys, 
 19.2   defense attorneys, mental health case managers, interested 
 19.3   members of the public, and others regarding the commitment act, 
 19.4   including, but not limited to, newly enacted amendments and 
 19.5   other legislation that affects the commitment process.  
 19.6      (b) $....... is appropriated from the general fund to the 
 19.7   commissioner of human services for the purpose of studying the 
 19.8   population of individuals against whom petitions for involuntary 
 19.9   treatment are filed, assessing the relationship between funding 
 19.10  sources and the use of civil commitment, and recommending 
 19.11  changes in the law to address funding and resource problems.  
 19.12  The study must address: 
 19.13     (1) how much each funding source pays for court and 
 19.14  treatment costs; 
 19.15     (2) how often individuals are committed because treatment 
 19.16  and services are not available on a voluntary basis; 
 19.17     (3) how often persons are unable to obtain access to 
 19.18  treatment and services voluntarily because of third-party 
 19.19  coverage problems; 
 19.20     (4) how much money committed persons are billed for 
 19.21  services and care while in regional treatment centers, compared 
 19.22  to persons served in community hospitals; 
 19.23     (5) how often persons are committed because they are not 
 19.24  capable of consenting to treatment and services, although they 
 19.25  are voluntarily acquiescing; 
 19.26     (6) how often persons willing to obtain access to treatment 
 19.27  voluntarily at the time an advance directive was executed are 
 19.28  committed because they are subsequently refusing treatment; 
 19.29     (7) how often persons are committed because they are in 
 19.30  need of treatment and services for their mental illnesses but 
 19.31  refuse to obtain access to treatment or services voluntarily; 
 19.32  and 
 19.33     (8) how often inadequate levels of residential treatment 
 19.34  facilities, adult foster care homes, subsidized and affordable 
 19.35  housing, case management, community support services, and 
 19.36  psychiatric services contribute to unnecessary prolonged stays 
 20.1   at a regional treatment center, and for persons already in the 
 20.2   community, to deterioration and eventual involuntary treatment.