2017 -- H 5945

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LC002160

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2017

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A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS - MENTAL HEALTH LAW

     Introduced By: Representatives Ruggiero, Almeida, McKiernan, Canario, and Jacquard

     Date Introduced: March 17, 2017

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 40.1-5-7 of the General Laws in Chapter 40.1-5 entitled "Mental

Health Law" is hereby amended to read as follows:

     40.1-5-7. Emergency certification.

     (a) Applicants. (1) Any physician, who after examining a person, has reason to believe

that the person is in need of immediate care and treatment, and is one whose continued

unsupervised presence in the community would create an imminent likelihood of serious harm by

reason of mental disability, may apply at a facility for the emergency certification of the person

thereto. The medical director, or any other physician employed by the proposed facility for

certification may apply under this subsection if no other physician is available and he or she

certifies this fact. If an examination is not possible because of the emergency nature of the case

and because of the refusal of the person to consent to the examination, the applicant on the basis

of his or her observation may determine, in accordance with the above, that emergency

certification is necessary and may apply therefor. In the event that no physician is available, a

qualified mental health professional or police officer who believes the person to be in need of

immediate care and treatment, and one whose continued unsupervised presence in the community

would create an imminent likelihood of serious harm by reason of mental disability, may make

the application for emergency certification to a facility. Application shall in all cases be made to

the facility which in the judgment of the applicant at the time of application would impose the

least restraint on the liberty of the person consistent with affording him or her the care and

treatment necessary and appropriate to his or her condition.

     (2) Whenever an applicant, not employed by a community mental health center

established pursuant to chapter 8.5 of this title, has reason to believe that the institute of mental

health is the appropriate facility for the person, the application shall be directed to the community

mental health center that serves the area in which the person resides, if the person is a Rhode

Island resident, or the area in which the person is physically present, if a nonresident, and the

qualified mental health professional(s) at the center shall make the final decision on the

application to the institute of mental health or may determine whether some other disposition

should be made.

     (b) Applications. An application for certification hereunder shall be in writing and filed

with the facility to which admission is sought. The application shall be executed within five (5)

days prior to the date of filing and shall state that it is based upon a personal observation of the

prospective patient by the applicant within the five (5) day period. It shall include a description of

the applicant's credentials and the behavior which constitutes the basis for his or her judgment

that the prospective patient is in need of immediate care and treatment and that a likelihood of

serious harm by reason of mental disability exists, and shall include, as well, any other relevant

information which may assist the admitting physician at the facility to which application is made.

Whenever practicable, prior to transporting or arranging for the transporting of a prospective

patient to a facility, the applicant shall telephone or otherwise communicate with the facility to

describe the circumstances and known clinical history to determine whether it is the proper

facility to receive the person, and to give notice of any restraint to be used or to determine

whether restraint is necessary.

     (c) Confirmation; discharge; transfer. Within one hour after reception at a facility, the

person regarding whom an application has been filed under this section shall be seen by a

physician. As soon as possible, but in no event later than twenty-four (24) hours after reception, a

preliminary examination and evaluation of the person by a psychiatrist or a physician under his or

her supervision shall begin. The psychiatrist shall not be an applicant hereunder. The preliminary

examination and evaluation shall be completed within seventy-two (72) hours from its inception

by the psychiatrist. If the psychiatrist determines that the patient is not a candidate for emergency

certification, he or she shall be discharged. If the psychiatrist(s) determines that the person who is

the subject of the application is in need of immediate care and treatment and is one whose

continued unsupervised presence in the community would create an imminent likelihood of

serious harm by reason of mental disability, he or she shall confirm the admission for care and

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treatment under this section of the person to the facility, provided the facility is one which would

impose the least restraint on the liberty of the person consistent with affording him or her the care

and treatment necessary and appropriate to his or her condition and that no suitable alternatives to

certification are available. If at any time the official in charge of a facility or his or her designee

determines that the person is not in need of immediate care and treatment, or is not one whose

continued unsupervised presence in the community would create an imminent likelihood of

serious harm by reason of mental disability, or suitable alternatives to certification are available,

he or she shall immediately discharge the person. In addition, the official may arrange to transfer

the person to an appropriate facility, if the facility to which he or she has been certified is not one

which imposes the least restraint on the liberty of the person consistent with affording him or her

the care and treatment necessary and appropriate to his or her condition.

     (d) Custody. Upon the request of an applicant under this section, to be confirmed in

writing, it shall be the duty of any peace officer of this state or of any governmental subdivision

thereof to whom request has been made, to take into custody and transport the person to the

facility designated, the person to be expeditiously presented for admission thereto.

     (e) Ex parte court order. An applicant under this section may present a petition to any

judge of the district court or any justice of the family court in the case of a person who is the

subject of an application, who has not yet attained his or her eighteenth birthday, for a warrant

directed to any peace officer of the state or any governmental subdivision thereof to take into

custody the person who is the subject of the application and immediately transport the person to a

designated facility. The application shall set forth that the person who is to be certified is in need

of immediate care and treatment and his or her continued unsupervised presence in the

community would create an imminent likelihood of serious harm by reason of mental disability,

and the reasons why an order directing a peace officer to transport the person to a designated

facility if necessary.

     (f) Notification of rights. No person shall be certified to a facility under the provisions of

this section unless appropriate opportunity is given to apply for voluntary admission under the

provisions of § 40.1-5-6 and unless he or she, or a parent, guardian or next of kin, has been

informed, in writing, on a form provided by the department, by the official in charge of the

facility: (1) that he or she has a right to the voluntary admission; (2) that a person cannot be

certified until all available alternatives to certification have been investigated and determined to

be unsuitable; and (3) that the period of hospitalization or treatment in a facility cannot exceed ten

(10) days under this section, except as provided in subsection (g) of this section.

     (g) Period of treatment. A person shall be discharged no later than ten (10) days measured

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from the date of his or her admission under this section, unless an application for a civil court

certification has been filed and set down for a hearing under the provisions of § 40.1-5-8, or the

person remains as a voluntary patient pursuant to § 40.1-5-6.

     SECTION 2. Chapter 40.1-5 of the General Laws entitled "Mental Health Law" is hereby

amended by adding thereto the following section:

     40.1-5-7.1. Emergency certification by police.

     (a) Any police officer may take an individual into protective custody and take or cause

such person to be taken to an emergency room of any hospital, by way of emergency vehicle, if

the officer has reason to believe that:

     (1) The individual is in need of immediate care and treatment, and is one whose

continued unsupervised presence in the community would create an imminent likelihood of

serious harm by reason of mental disability if allowed to be at liberty pending examination by a

licensed physician; or

     (2) The individual is in need of immediate assistance due to mental disability and

requests the assistance.

     (b) A physician in charge of an emergency room of a hospital shall determine if any

individual brought into the emergency room by a police officer requires emergency medical

treatment for their condition or if the individual is appropriate for emergency certification to an

approved treatment facility by reason of the grounds stated in this section.

     (c) If a physician determines, upon examination, that an individual is appropriate for

emergency certification, the physician shall make application for the individual's certification in

accordance with §40.1-5-7.

     (d) City, town and state police authorities shall develop and execute a memorandum of

agreement between public safety fire/emergency medical services and police departments

outlining the protocols for transporting persons under this statute.

     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS - MENTAL HEALTH LAW

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     This act would articulate the role of police officers in obtaining treatment for those

showing symptoms of mental illness.

     This act would take effect upon passage.

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