1.1                          A bill for an act
  1.2             relating to civil law; civil commitment; providing for 
  1.3             notice to certain relatives of patients receiving or 
  1.4             hospitalized for psychiatric or mental health care; 
  1.5             modifying consent provisions for voluntary mental 
  1.6             health treatment for certain minors; modifying 
  1.7             provisions related to early intervention mental health 
  1.8             treatment and civil commitment; amending Minnesota 
  1.9             Statutes 1998, sections 253B.065, by adding a 
  1.10            subdivision; 253B.066, subdivision 1; and 253B.15, 
  1.11            subdivision 8; Minnesota Statutes 1999 Supplement, 
  1.12            sections 253B.04, subdivision 1; and 253B.065, 
  1.13            subdivision 5; proposing coding for new law in 
  1.14            Minnesota Statutes, chapter 144. 
  1.15  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.16     Section 1.  [144.334] [RIGHT TO REQUEST PATIENT 
  1.17  INFORMATION.] 
  1.18     Upon an oral or written request by a spouse, parent, child, 
  1.19  or sibling for information about a patient who is being 
  1.20  evaluated for or diagnosed with mental illness, a provider must 
  1.21  notify the requesting individual of the right under section 
  1.22  144.335, subdivision 3a, paragraph (f), to have the provider 
  1.23  request the patient's authorization to release information about 
  1.24  the patient to a designated individual. 
  1.25     Sec. 2.  Minnesota Statutes 1999 Supplement, section 
  1.26  253B.04, subdivision 1, is amended to read: 
  1.27     Subdivision 1.  [VOLUNTARY ADMISSION AND TREATMENT.] (a) 
  1.28  Voluntary admission is preferred over involuntary commitment and 
  1.29  treatment.  Any person 16 years of age or older may request to 
  1.30  be admitted to a treatment facility as a voluntary patient for 
  2.1   observation, evaluation, diagnosis, care and treatment without 
  2.2   making formal written application.  Any person under the age of 
  2.3   16 years may be admitted as a patient with the consent of a 
  2.4   parent or legal guardian if it is determined by independent 
  2.5   examination that there is reasonable evidence that (1) the 
  2.6   proposed patient is mentally ill, mentally retarded, or 
  2.7   chemically dependent; and (2) the proposed patient is suitable 
  2.8   for treatment.  The head of the treatment facility shall not 
  2.9   arbitrarily refuse any person seeking admission as a voluntary 
  2.10  patient. 
  2.11     (b) In addition to the consent provisions of paragraph (a), 
  2.12  a person who is 16 or 17 years of age who refuses to consent 
  2.13  personally to admission may be admitted as a patient for mental 
  2.14  illness or chemical dependency treatment with the consent of a 
  2.15  parent or legal guardian if it is determined by an independent 
  2.16  examination that there is reasonable evidence that the proposed 
  2.17  patient is chemically dependent or mentally ill and suitable for 
  2.18  treatment.  The person conducting the examination shall notify 
  2.19  the proposed patient and the parent or legal guardian of this 
  2.20  determination. 
  2.21     Sec. 3.  Minnesota Statutes 1999 Supplement, section 
  2.22  253B.065, subdivision 5, is amended to read: 
  2.23     Subd. 5.  [EARLY INTERVENTION CRITERIA.] (a) A court shall 
  2.24  order early intervention treatment of a proposed patient who 
  2.25  meets the criteria under paragraph (b).  The early intervention 
  2.26  treatment must be less intrusive than long-term inpatient 
  2.27  commitment and must be the least restrictive treatment program 
  2.28  available that can meet the patient's treatment needs. 
  2.29     (b) The court shall order early intervention treatment if 
  2.30  the court finds all of the elements of the following factors by 
  2.31  clear and convincing evidence: 
  2.32     (1) the proposed patient is mentally ill; 
  2.33     (2) the proposed patient refuses to accept appropriate 
  2.34  mental health treatment; and 
  2.35     (3) the proposed patient's mental illness is manifested by 
  2.36  instances of grossly disturbed behavior or faulty perceptions 
  3.1   and either one of the following apply: 
  3.2      (i) the proposed patient is in need of treatment to prevent 
  3.3   progression of the illness; 
  3.4      (ii) the grossly disturbed behavior or faulty perceptions 
  3.5   significantly interfere with the proposed patient's ability to 
  3.6   care for self and the proposed patient, when competent, would 
  3.7   have chosen substantially similar treatment under the same 
  3.8   circumstances; or 
  3.9      (ii) (iii) due to the mental illness, the proposed patient 
  3.10  received court-ordered inpatient treatment under section 253B.09 
  3.11  at least two times in the previous three years; the patient is 
  3.12  exhibiting symptoms or behavior substantially similar to those 
  3.13  that precipitated one or more of the court-ordered treatments; 
  3.14  and the patient is reasonably expected to physically or mentally 
  3.15  deteriorate to the point of meeting the criteria for commitment 
  3.16  under section 253B.09 unless treated. 
  3.17     For purposes of this paragraph, a proposed patient who was 
  3.18  released under section 253B.095 and whose release was not 
  3.19  revoked is not considered to have received court-ordered 
  3.20  inpatient treatment under section 253B.09. 
  3.21     Sec. 4.  Minnesota Statutes 1998, section 253B.065 is 
  3.22  amended by adding a subdivision to read: 
  3.23     Subd. 6. [STAY OF OUTPATIENT EARLY INTERVENTION.] (a) After 
  3.24  a hearing and before an order for outpatient early intervention 
  3.25  has been issued, the court may release a proposed patient to the 
  3.26  custody of an individual or agency upon conditions that 
  3.27  guarantee the care and treatment of the patient. 
  3.28     (b) A continuance for dismissal, with or without findings, 
  3.29  may be granted for up to 90 days. 
  3.30     (c) When the court stays an order for outpatient early 
  3.31  intervention for more than 14 days beyond the date of the 
  3.32  initially scheduled hearing, the court shall issue an order that 
  3.33  must include: 
  3.34     (1) a written plan for services to which the proposed 
  3.35  patient has agreed; 
  3.36     (2) a finding that the proposed treatment is available and 
  4.1   accessible to the patient and that public or private financial 
  4.2   resources are available to pay for the proposed treatment; and 
  4.3      (3) conditions the patient must meet to avoid revocation of 
  4.4   the stayed order and imposition of the order for outpatient 
  4.5   early intervention. 
  4.6      (d) A person receiving treatment under this subdivision has 
  4.7   all rights under this chapter. 
  4.8      (e) When a court releases a patient under this subdivision, 
  4.9   the court shall direct the case manager to report to the court 
  4.10  at least once every 90 days and shall immediately report a 
  4.11  substantial failure of a patient or provider to comply with the 
  4.12  conditions of the release. 
  4.13     (f) The maximum duration of a stayed order under this 
  4.14  subdivision is six months.  The court may continue the order for 
  4.15  a maximum of an additional 12 months if, after notice and 
  4.16  hearing, under sections 253B.08 and 253B.09, the court finds 
  4.17  that (1) the person continues to be mentally ill, and (2) an 
  4.18  order is needed to protect the patient or others. 
  4.19     (g) An order under this subdivision may be modified upon 
  4.20  agreement of the parties and approval of the court. 
  4.21     (h) The court, on its own motion or upon the motion of any 
  4.22  party that the patient has not complied with a material 
  4.23  condition of release, and after notice and a hearing unless 
  4.24  otherwise ordered by the court, may revoke any release and enter 
  4.25  an order for outpatient early intervention for the proposed 
  4.26  patient. 
  4.27     Sec. 5.  Minnesota Statutes 1998, section 253B.066, 
  4.28  subdivision 1, is amended to read: 
  4.29     Subdivision 1.  [TREATMENT ALTERNATIVES.] If the court 
  4.30  orders early intervention under section 253B.065, subdivision 5, 
  4.31  the court may include in its order a variety of treatment 
  4.32  alternatives including, but not limited to, day treatment, 
  4.33  medication compliance monitoring, and short-term hospitalization 
  4.34  not to exceed ten 30 days. 
  4.35     If the court orders short-term hospitalization and the 
  4.36  proposed patient will not go voluntarily, the court may direct a 
  5.1   health officer, peace officer, or other person to take the 
  5.2   person into custody and transport the person to the hospital.  
  5.3      Sec. 6.  Minnesota Statutes 1998, section 253B.15, 
  5.4   subdivision 8, is amended to read: 
  5.5      Subd. 8.  [EFFECT OF EXTENSION.] No provisional discharge, 
  5.6   revocation, or extension shall extend the term of the commitment 
  5.7   beyond the period provided for in the commitment order one year 
  5.8   after the date of the provisional discharge, revocation, or 
  5.9   extension.  
  5.10     Sec. 7.  [RECOMMENDATIONS TO THE LEGISLATURE.] 
  5.11     By January 15, 2001, the commissioner of human services in 
  5.12  consultation with the departments of health; corrections; and 
  5.13  children, families, and learning shall submit to the legislature 
  5.14  recommendations regarding mental health service system 
  5.15  improvements that would: 
  5.16     (1) reduce the need for involuntary treatment; 
  5.17     (2) result in more appropriate services that could be used 
  5.18  as part of outpatient commitment or early intervention; 
  5.19     (3) result in integrated services across state and local 
  5.20  agencies that would be more effective in meeting consumer needs; 
  5.21     (4) include a strategy to counteract the stigma of mental 
  5.22  illness; 
  5.23     (5) result in more culturally sensitive services; 
  5.24     (6) assess the cost of unmet needs for mental health care; 
  5.25     (7) include strong accountability provisions that would 
  5.26  focus on outcomes while supporting local flexibility and 
  5.27  control; and 
  5.28     (8) propose alternative methods of financing and payment 
  5.29  that would support the objectives in clauses (1) to (7).