1.1                          A bill for an act 
  1.2             relating to health; providing for civil commitment for 
  1.3             prenatal alcohol abuse; requiring reporting; amending 
  1.4             Minnesota Statutes 1997 Supplement, sections 253B.02, 
  1.5             subdivision 2; 253B.07, subdivision 1; and 626.556, 
  1.6             subdivision 2; proposing coding for new law in 
  1.7             Minnesota Statutes, chapter 626. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1997 Supplement, section 
  1.10  253B.02, subdivision 2, is amended to read: 
  1.11     Subd. 2.  [CHEMICALLY DEPENDENT PERSON.] (a) "Chemically 
  1.12  dependent person" means any person (a): 
  1.13     (1) determined as being incapable of self-management or 
  1.14  management of personal affairs by reason of the habitual and 
  1.15  excessive use of alcohol, drugs, or other mind-altering 
  1.16  substances; and (b) 
  1.17     (2) whose recent conduct as a result of habitual and 
  1.18  excessive use of alcohol, drugs, or other mind-altering 
  1.19  substances poses a substantial likelihood of physical harm to 
  1.20  self or others as demonstrated by: 
  1.21     (i) a recent attempt or threat to physically harm self or 
  1.22  others,; 
  1.23     (ii) evidence of recent serious physical problems,; or 
  1.24     (iii) a failure to obtain necessary food, clothing, 
  1.25  shelter, or medical care.  
  1.26     (b) "Chemically dependent person" also means a pregnant 
  2.1   woman who: 
  2.2      (1) has engaged during the pregnancy in habitual or 
  2.3   excessive use, for a nonmedical purpose, of any of the following 
  2.4   controlled substances or their derivatives:  
  2.5      (i) cocaine,; 
  2.6      (ii) heroin,; 
  2.7      (iii) phencyclidine,; 
  2.8      (iv) methamphetamine,; or 
  2.9      (v) amphetamine; or 
  2.10     (2) has engaged in abuse of alcohol, as defined in section 
  2.11  626.5563, subdivision 1. 
  2.12     Sec. 2.  Minnesota Statutes 1997 Supplement, section 
  2.13  253B.07, subdivision 1, is amended to read: 
  2.14     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
  2.15  filing a petition for commitment of or early intervention for a 
  2.16  proposed patient, an interested person shall apply to the 
  2.17  designated agency in the county of the proposed patient's 
  2.18  residence or presence for conduct of a preliminary 
  2.19  investigation, except when the proposed patient has been 
  2.20  acquitted of a crime under section 611.026 and the county 
  2.21  attorney is required to file a petition for commitment.  The 
  2.22  designated agency shall appoint a screening team to conduct an 
  2.23  investigation which shall include:  
  2.24     (i) a personal interview with the proposed patient and 
  2.25  other individuals who appear to have knowledge of the condition 
  2.26  of the proposed patient.  If the proposed patient is not 
  2.27  interviewed, reasons must be documented; 
  2.28     (ii) identification and investigation of specific alleged 
  2.29  conduct which is the basis for application; 
  2.30     (iii) identification, exploration, and listing of the 
  2.31  reasons for rejecting or recommending alternatives to 
  2.32  involuntary placement; and 
  2.33     (iv) in the case of a commitment based on mental illness, 
  2.34  the following information, if it is known or available:  
  2.35  information that may be relevant to the administration of 
  2.36  neuroleptic medications, if necessary, including the existence 
  3.1   of a declaration under section 253B.03, subdivision 6d, or a 
  3.2   durable power of attorney for health care under chapter 145C or 
  3.3   a guardian, conservator, proxy, or attorney-in-fact with 
  3.4   authority to make health care decisions for the proposed 
  3.5   patient; information regarding the capacity of the proposed 
  3.6   patient to make decisions regarding administration of 
  3.7   neuroleptic medication; and whether the proposed patient is 
  3.8   likely to consent or refuse consent to administration of the 
  3.9   medication.  
  3.10     (b) In conducting the investigation required by this 
  3.11  subdivision, the screening team shall have access to all 
  3.12  relevant medical records of proposed patients who are currently 
  3.13  in treatment facilities or pregnant.  Data collected pursuant to 
  3.14  this clause shall be considered private data on individuals.  
  3.15  The prepetition screening report is not admissible in any court 
  3.16  proceedings unrelated to the commitment proceedings. 
  3.17     (c) When the prepetition screening team recommends 
  3.18  commitment, a written report shall be sent to the county 
  3.19  attorney for the county in which the petition is to be filed. 
  3.20     (d) The prepetition screening team shall refuse to support 
  3.21  a petition if the investigation does not disclose evidence 
  3.22  sufficient to support commitment.  Notice of the prepetition 
  3.23  screening team's decision shall be provided to the prospective 
  3.24  petitioner.  
  3.25     (e) If the interested person wishes to proceed with a 
  3.26  petition contrary to the recommendation of the prepetition 
  3.27  screening team, application may be made directly to the county 
  3.28  attorney, who may determine whether or not to proceed with the 
  3.29  petition.  Notice of the county attorney's determination shall 
  3.30  be provided to the interested party.  
  3.31     (f) If the proposed patient has been acquitted of a crime 
  3.32  under section 611.026, the county attorney shall apply to the 
  3.33  designated county agency in the county in which the acquittal 
  3.34  took place for a preliminary investigation unless substantially 
  3.35  the same information relevant to the proposed patient's current 
  3.36  mental condition, as could be obtained by a preliminary 
  4.1   investigation, is part of the court record in the criminal 
  4.2   proceeding or is contained in the report of a mental examination 
  4.3   conducted in connection with the criminal proceeding.  If a 
  4.4   court petitions for commitment pursuant to the rules of criminal 
  4.5   or juvenile procedure or a county attorney petitions pursuant to 
  4.6   acquittal of a criminal charge under section 611.026, the 
  4.7   prepetition investigation, if required by this section, shall be 
  4.8   completed within seven days after the filing of the petition.  
  4.9      Sec. 3.  Minnesota Statutes 1997 Supplement, section 
  4.10  626.556, subdivision 2, is amended to read: 
  4.11     Subd. 2.  [DEFINITIONS.] As used in this section, the 
  4.12  following terms have the meanings given them unless the specific 
  4.13  content indicates otherwise: 
  4.14     (a) "Sexual abuse" means the subjection of a child by a 
  4.15  person responsible for the child's care, by a person who has a 
  4.16  significant relationship to the child, as defined in section 
  4.17  609.341, or by a person in a position of authority, as defined 
  4.18  in section 609.341, subdivision 10, to any act which constitutes 
  4.19  a violation of section 609.342, 609.343, 609.344, or 609.345.  
  4.20  Sexual abuse also includes any act which involves a minor which 
  4.21  constitutes a violation of sections 609.321 to 609.324 or 
  4.22  617.246.  Sexual abuse includes threatened sexual abuse.  
  4.23     (b) "Person responsible for the child's care" means (1) an 
  4.24  individual functioning within the family unit and having 
  4.25  responsibilities for the care of the child such as a parent, 
  4.26  guardian, or other person having similar care responsibilities, 
  4.27  or (2) an individual functioning outside the family unit and 
  4.28  having responsibilities for the care of the child such as a 
  4.29  teacher, school administrator, or other lawful custodian of a 
  4.30  child having either full-time or short-term care 
  4.31  responsibilities including, but not limited to, day care, 
  4.32  babysitting whether paid or unpaid, counseling, teaching, and 
  4.33  coaching.  
  4.34     (c) "Neglect" means failure by a person responsible for a 
  4.35  child's care to supply a child with necessary food, clothing, 
  4.36  shelter or medical care when reasonably able to do so, failure 
  5.1   to protect a child from conditions or actions which imminently 
  5.2   and seriously endanger the child's physical or mental health 
  5.3   when reasonably able to do so, or failure to take steps to 
  5.4   ensure that a child is educated in accordance with state law. 
  5.5   Nothing in this section shall be construed to mean that a child 
  5.6   is neglected solely because the child's parent, guardian, or 
  5.7   other person responsible for the child's care in good faith 
  5.8   selects and depends upon spiritual means or prayer for treatment 
  5.9   or care of disease or remedial care of the child in lieu of 
  5.10  medical care; except that a parent, guardian, or caretaker, or a 
  5.11  person mandated to report pursuant to subdivision 3, has a duty 
  5.12  to report if a lack of medical care may cause serious danger to 
  5.13  the child's health.  This section does not impose upon persons, 
  5.14  not otherwise legally responsible for providing a child with 
  5.15  necessary food, clothing, shelter, education, or medical care, a 
  5.16  duty to provide that care. Neglect includes prenatal exposure to 
  5.17  a controlled substance, as defined in section 253B.02, 
  5.18  subdivision 2, used by the mother for a nonmedical purpose, or 
  5.19  prenatal abuse of alcohol as defined in section 626.5563, 
  5.20  subdivision 1, as evidenced by withdrawal symptoms in the child 
  5.21  at birth, results of a toxicology test performed on the mother 
  5.22  at delivery or the child at birth, or medical effects or 
  5.23  developmental delays during the child's first year of life that 
  5.24  medically indicate prenatal exposure to a controlled 
  5.25  substance or excessive amounts of alcohol.  Neglect also means 
  5.26  "medical neglect" as defined in section 260.015, subdivision 2a, 
  5.27  clause (5). 
  5.28     (d) "Physical abuse" means any physical or mental injury, 
  5.29  or threatened injury, inflicted by a person responsible for the 
  5.30  child's care on a child other than by accidental means, or any 
  5.31  physical or mental injury that cannot reasonably be explained by 
  5.32  the child's history of injuries, or any aversive and deprivation 
  5.33  procedures that have not been authorized under section 245.825.  
  5.34     (e) "Report" means any report received by the local welfare 
  5.35  agency, police department, or county sheriff pursuant to this 
  5.36  section. 
  6.1      (f) "Facility" means a day care facility, residential 
  6.2   facility, agency, hospital, sanitarium, or other facility or 
  6.3   institution required to be licensed pursuant to sections 144.50 
  6.4   to 144.58, 241.021, or 245A.01 to 245A.16.  
  6.5      (g) "Operator" means an operator or agency as defined in 
  6.6   section 245A.02.  
  6.7      (h) "Commissioner" means the commissioner of human services.
  6.8      (i) "Assessment" includes authority to interview the child, 
  6.9   the person or persons responsible for the child's care, the 
  6.10  alleged perpetrator, and any other person with knowledge of the 
  6.11  abuse or neglect for the purpose of gathering the facts, 
  6.12  assessing the risk to the child, and formulating a plan.  
  6.13     (j) "Practice of social services," for the purposes of 
  6.14  subdivision 3, includes but is not limited to employee 
  6.15  assistance counseling and the provision of guardian ad litem and 
  6.16  visitation expeditor services.  
  6.17     (k) "Mental injury" means an injury to the psychological 
  6.18  capacity or emotional stability of a child as evidenced by an 
  6.19  observable or substantial impairment in the child's ability to 
  6.20  function within a normal range of performance and behavior with 
  6.21  due regard to the child's culture.  
  6.22     (l) "Threatened injury" means a statement, overt act, 
  6.23  condition, or status that represents a substantial risk of 
  6.24  physical or sexual abuse or mental injury. 
  6.25     Sec. 4.  [626.5563] [REPORTING PRENATAL EXPOSURE TO ALCOHOL 
  6.26  ABUSE.] 
  6.27     Subdivision 1.  [DEFINITION.] For purposes of this section, 
  6.28  "abuse of alcohol" means: 
  6.29     (1) the person has required detoxification during the 
  6.30  pregnancy; 
  6.31     (2) the person reports having been intoxicated due to 
  6.32  alcohol use on at least one occasion in the last month after 
  6.33  knowing of the pregnancy or is found to be an alcohol abuser 
  6.34  through use of a validated chemical use screening test; or 
  6.35     (3) the person appears intoxicated as indicated by two or 
  6.36  more of the following: 
  7.1      (i) the odor of alcohol; 
  7.2      (ii) slurred speech; 
  7.3      (iii) disconjugate gaze; 
  7.4      (iv) impaired balance; 
  7.5      (v) difficulty remaining awake; 
  7.6      (vi) consumption of alcohol; 
  7.7      (vii) responding to sights or sounds that are not actually 
  7.8   present; or 
  7.9      (viii) extreme restlessness, fast speech, or unusual 
  7.10  belligerence. 
  7.11     Subd. 2.  [REPORT REQUIRED.] (a) If a person mandated to 
  7.12  report under section 626.556, subdivision 3, knows or has reason 
  7.13  to believe that a woman is pregnant and has knowingly abused 
  7.14  alcohol during the pregnancy, the person shall:  
  7.15     (1) arrange for a chemical use assessment conducted 
  7.16  according to rules adopted by the commissioner of human services 
  7.17  under section 254A.03, subdivision 3, and confirm that the 
  7.18  recommendations indicated by the assessment are followed; or 
  7.19     (2) immediately report to the local welfare agency or 
  7.20  maternal child substance abuse project.  
  7.21     (b) If the woman is referred for a chemical use assessment 
  7.22  under paragraph (a), clause (1), and fails to obtain one or 
  7.23  fails to follow the recommendations of the assessment, a report 
  7.24  must be made to the local welfare agency or maternal child 
  7.25  substance abuse project providing services to the area where the 
  7.26  woman resides.  
  7.27     (c) Any person may make a voluntary report if the person 
  7.28  knows or has reason to believe that a woman is pregnant and has 
  7.29  abused alcohol during the pregnancy.  
  7.30     (d) A report shall be of sufficient content to identify the 
  7.31  pregnant woman, the nature and extent of the abuse of alcohol, 
  7.32  any health risk associated with the abuse of alcohol, if known, 
  7.33  and the name and address of the reporter. 
  7.34     Subd. 3.  [LOCAL WELFARE AGENCY.] (a) A local welfare 
  7.35  agency receiving a report under subdivision 2 shall, within five 
  7.36  working days, conduct an appropriate assessment and offer 
  8.1   services indicated under the circumstances.  The local welfare 
  8.2   agency may meet this requirement by referral to a local maternal 
  8.3   child substance abuse project.  
  8.4      (b) Services offered must include a chemical use assessment 
  8.5   conducted according to rules adopted by the commissioner of 
  8.6   human services under section 254A.03, subdivision 3.  If the 
  8.7   chemical use assessment indicates that the woman is in need of 
  8.8   chemical dependency treatment, the local welfare agency must 
  8.9   arrange for provision of the indicated level of chemical 
  8.10  dependency care.  
  8.11     (c) If the woman fails to follow the recommendations of the 
  8.12  chemical use assessment or is found by a maternal child 
  8.13  substance abuse project to be continuing the abuse of alcohol, 
  8.14  the noncompliance must be reported to the local welfare agency.  
  8.15     (d) If the woman continues to abuse alcohol or does not 
  8.16  comply with treatment recommendations, the local welfare agency 
  8.17  shall take appropriate action under chapter 253B, including 
  8.18  seeking an emergency admission under section 253B.05. 
  8.19     Subd. 4.  [IMMUNITY.] A person making a mandatory or 
  8.20  voluntary report under subdivision 2 or assisting in an 
  8.21  assessment under subdivision 3 is immune from civil or criminal 
  8.22  liability if the person acted in good faith in making the report.
  8.23     Sec. 5.  [REPORT REQUIRED.] 
  8.24     The commissioner of human services shall evaluate the 
  8.25  impact of the changes in the reporting and commitment provisions 
  8.26  in sections 1 to 4 and submit a report to the legislature by 
  8.27  February 1, 2001.  Local and state agencies shall provide 
  8.28  information to the commissioner for purposes of the report. 
  8.29     Sec. 6.  [EFFECTIVE DATE.] 
  8.30     Sections 1 to 5 are effective August 1, 1999.