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art.011/6/011/5/011/4 | ||
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1 | ARTICLE 11 | |
2 | RELATING TO COURTS AND STATE HOSPITALS | |
3 | SECTION 1. Section 8-8-1 of the General Laws in Chapter 8-8 entitled "District Court" is | |
4 | hereby amended to read as follows: | |
5 | 8-8-1. District Court established -- Chief and associate justices. | |
6 | There is established a district court for the state of Rhode Island which shall consist of a | |
7 | chief judge and thirteen (13) fourteen (14) associate judges. The district court shall be a court of | |
8 | record and shall have a seal with such words and devices as it shall adopt. | |
9 | SECTION 2. Chapter 8-8 of the General Laws entitled "District Court" is hereby amended | |
10 | by adding thereto the following section: | |
11 | 8-8-1.2. Mental health treatment calendar. | |
12 | (a) Findings and declarations. The general assembly finds and declares as follows: | |
13 | (1) Mental illness is a prevalent and persistent issue in Rhode Island within the criminal | |
14 | population in general and the incarcerated population in particular. Approximately one-fifth (1/5) | |
15 | of all inmates at the adult correctional institutions have a diagnosed mental illness, while nearly | |
16 | eighty percent (80%) have a history of substance abuse. Many suffer from both maladies. | |
17 | (2) Mental illness can often go unrecognized and untreated, leaving some individuals to | |
18 | suffer and spiral downward until they are caught in the criminal justice system. These individuals | |
19 | often become trapped in a cycle of repeated prosecution and incarceration. | |
20 | (3) Individuals with mental illness who are charged with crimes can benefit from | |
21 | alternatives to incarceration when feasible, and when permitted to obtain proper treatment for | |
22 | persistent mental health and substance abuse disorders through a jail diversion treatment program | |
23 | that recognizes their special set of circumstances while at the same time providing accountability | |
24 | for their wrong-doing and providing for the safety of the public. | |
25 | (b) The district court shall create a voluntary mental health treatment calendar to better | |
26 | address individuals who suffer from mental illness and are charged with a misdemeanor. The | |
27 | district court will provide the tools and skills necessary to address these individuals’ unique | |
28 | challenges thus helping them develop the insight needed to reintegrate successfully into society and | |
29 | maintain a productive and law-abiding lifestyle within the community. | |
30 | (c) There shall be established, funded and staffed a mental health alternative sentencing | |
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1 | and treatment calendar within the jurisdiction of the district court for hearing, addressing and | |
2 | disposing of certain misdemeanor offenses in an effort to direct eligible defendants into a court | |
3 | program that integrates support and treatment plans with the judicial process, potentially resulting | |
4 | in alternatives to traditional prosecution, sentencing and incarceration; reducing the risk of | |
5 | recidivism; realizing cost savings for the state and increasing public safety. Successful completion | |
6 | may result in a full dismissal of charges or in reduced charges and alternative sentencing. The | |
7 | mental health treatment calendar shall be overseen by a district court judge to be appointed pursuant | |
8 | to chapter 16.1 of title 8, subject to an appropriation made by the general assembly. | |
9 | (d) The chief judge of the district court shall create a mental health treatment calendar in | |
10 | the district court and shall assign a district court judge and associated personnel to the extent | |
11 | necessary to hear and decide all criminal actions involving offenses committed by defendants | |
12 | accepted into the program. [The calendar shall be called the mental health treatment calendar.] | |
13 | (e) An eligible defendant is any person who stands charged in a district court complaint | |
14 | with one or more misdemeanors, and: | |
15 | (1) Suffers from a mental, behavioral or emotional disorder resulting in serious functional | |
16 | impairment which substantially interferes with or limits one or more major life activities; and | |
17 | (2) Is determined by the court to be appropriate for participation in the mental health | |
18 | treatment calendar. | |
19 | (3) An individual’s history of substance and alcohol abuse may also be considered to the | |
20 | extent necessary to make a proper diagnosis of a co-occurring disorder. | |
21 | SECTION 3. Section 9-5-9 of the General Laws in Chapter 9-5 entitled "Writs, Summons | |
22 | and Process" is hereby amended to read as follows: | |
23 | 9-5-9. Warrants for commitment to institutions Warrants for commitment to state- | |
24 | operated facilities. | |
25 | Any warrant or mittimus issued from any superior or district court committing any person | |
26 | to the institute of mental health Eleanor Slater Hospital or Rhode Island State Psychiatric Hospital | |
27 | shall be directed to and executed by duly authorized agents of the department of human services | |
28 | behavioral healthcare, developmental disabilities and hospitals, who shall make return thereon, the | |
29 | provisions of any other law to the contrary notwithstanding. | |
30 | SECTION 4. Sections 40.1-3-7 and 40.1-3-9 of the General Laws in Chapter 40.1-3 entitled | |
31 | "Curative Services" are hereby amended to read as follows: | |
32 | 40.1-3-7. Rules and regulations for Eleanor Slater hospital. | |
33 | The director of the department shall establish, in his or her discretion, rules for the | |
34 | government of the hospital Eleanor Slater Hospital, regulations for the admission of patients, and | |
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1 | shall generally be vested with all the powers necessary for the proper carrying on of the work | |
2 | entrusted to him or her. | |
3 | 40.1-3-9. Staff and employees of the state of Rhode Island medical center Staff and | |
4 | employees of the Eleanor Slater Hospital and of the Rhode Island State Psychiatric Hospital. | |
5 | The director of behavioral healthcare, developmental disabilities and hospitals shall | |
6 | appoint, or delegate to another employee of the department the authority to appoint, employees, as | |
7 | he or she may deem necessary for the proper management of the institutions facilities of either or | |
8 | both the Eleanor Slater Hospital or the Rhode Island State Psychiatric Hospital. | |
9 | SECTION 5. Chapter 40.1-3 of the General Laws entitled "Curative Services" 1s hereby | |
10 | amended by adding thereto the following section: | |
11 | 40.1-3-7.1. Rules and regulations for the Rhode Island State Psychiatric Hospital. | |
12 | The director of the department shall establish, in his or her discretion, rules for the | |
13 | governance of the Rhode Island State Psychiatric Hospital, regulations for the admission of | |
14 | patients, and shall generally be vested with all the powers necessary for the proper carrying on of | |
15 | the work entrusted to him or her. | |
16 | SECTION 6. Section 40.1-3-8 of the General Laws m Chapter 40.1-3 entitled "Curative | |
17 | Services" is hereby repealed: | |
18 | 40.1-3-8. Change of names of hospital for mental diseases and state infirmary. | |
19 | The name of the state institution at Cranston formerly known as the state asylum for the | |
20 | insane or the state hospital for the insane or the state hospital for mental diseases, and the name of | |
21 | the state institution at Cranston formerly known as tile state almshouse or the state infirmary, or | |
22 | the general hospital, shall hereafter be known as the "Eleanor Slater Hospital." In any general law, | |
23 | other public law, or resolution of the general assembly, and in any document, record, instrument, | |
24 | or proceeding authorized by any such law or resolution, unless the context or subject matter | |
25 | otherwise requires, the words "state asylum for the insane" and the words "state hospital for the | |
26 | insane" or "state hospital for mental disease" shall be construed to mean the "Eleanor Slater | |
27 | Hospital." | |
28 | SECTION 7. Sections 40.1-5-2, 40.1-5-5, 40.1-5-6, 40.1-5-7, 40.1-5-7.1, 40.1-5-8, 40.1-5- | |
29 | 11, 40.1-5-27.1, 40.1-5-31, 40.1-5-32, 40.1-5-33 and 40.1-5-34 of the General Laws in Chapter | |
30 | 40.1-5 entitled "Mental Health Law" are hereby amended to read as follows: | |
31 | 40.1-5-2. Definitions. | |
32 | Whenever used in this chapter, or in any order, rule, or regulation made or promulgated | |
33 | pursuant to this chapter, or in any printed forms prepared by the department or the director, unless | |
34 | otherwise expressly stated, or unless the context or subject matter otherwise requires: | |
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1 | (1) "Alternatives to admission or certification" means alternatives to a particular facility or | |
2 | treatment program, and shall include, but not be limited to, voluntary or court-ordered outpatient | |
3 | treatment, day treatment in a hospital, night treatment in a hospital, placement in the custody of a | |
4 | friend or relative, placement in a nursing home, referral to a community mental health clinic and | |
5 | home health aide services, or any other services that may be deemed appropriate. | |
6 | (2) "Care and treatment" means psychiatric care, together with such medical, nursing, | |
7 | psychological, social, rehabilitative, and maintenance services as may be required by a patient in | |
8 | association with the psychiatric care provided pursuant to an individualized treatment plan recorded | |
9 | in the patient's medical record. | |
10 | (3) "Department" means the state department of behavioral healthcare, developmental | |
11 | disabilities and hospitals. | |
12 | (4) "Director" means the director of the state department of behavioral healthcare, | |
13 | developmental disabilities and hospitals. | |
14 | (5)(i) "Facility" means a state hospital or psychiatric inpatient facility in the department | |
15 | any public or private hospital licensed by the Rhode Island department of health that maintains staff | |
16 | and facilities, including inpatient units, for the care and treatment of persons with psychiatric | |
17 | illness, psychiatric disorders, and/or psychiatric disabilities; and in order to operate pursuant to | |
18 | Mental Health Act as codified in this chapter, such facility and/or inpatient unit must be approved | |
19 | by the director of the department of behavioral healthcare, developmental disabilities and hospitals | |
20 | upon application of such facility and/or inpatient unit, a psychiatric inpatient facility maintained by | |
21 | a political subdivision of the state for the care and/or treatment of the mentally disabled; a general | |
22 | or specialized hospital maintaining staff and facilities for this purpose; and any of the several | |
23 | community mental health services established pursuant to chapter 8.5 of this title; and any other | |
24 | facility within the state providing inpatient psychiatric care and/or treatment and approved by the | |
25 | director upon application of this facility. Included within this definition shall be all hospitals, | |
26 | institutions, facilities, and services under the control and direction of the director and the | |
27 | department, as provided in this chapter. Nothing contained herein shall be construed to amend or | |
28 | repeal any of the provisions of chapter 16 of title 23. | |
29 | (ii) The Eleanor Slater Hospital shall be required to apply to the department for approval | |
30 | from the director to operate pursuant to this chapter. | |
31 | (iii) The Rhode Island State Psychiatric Hospital shall be required to apply to the | |
32 | department for approval from the director to operate pursuant to this chapter. | |
33 | (6) "Indigent person" means a person who has not sufficient property or income to support | |
34 | himself or herself, and to support the members of his or her family dependent upon him or her for | |
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1 | support, and/or is unable to pay the fees and costs incurred pursuant to any legal proceedings | |
2 | conducted under the provisions of this chapter. | |
3 | (7) "Likelihood of serious harm" means: | |
4 | (i) A substantial risk of physical harm to the person himself or herself as manifested by | |
5 | behavior evidencing serious threats of, or attempts at, suicide; | |
6 | (ii) A substantial risk of physical harm to other persons as manifested by behavior or threats | |
7 | evidencing homicidal or other violent behavior; or | |
8 | (iii) A substantial risk of physical harm to the mentally disabled person as manifested by | |
9 | behavior that has created a grave, clear, and present risk to his or her physical health and safety. | |
10 | (iv) In determining whether there exists a likelihood of serious harm, the physician and the | |
11 | court may consider previous acts, diagnosis, words, or thoughts of the patient. If a patient has been | |
12 | incarcerated, or institutionalized, or in a controlled environment of any kind, the court may give | |
13 | great weight to such prior acts, diagnosis, words, or thoughts. | |
14 | (9)(8) "Mental health professional" means a psychiatrist, psychologist, or social worker | |
15 | and such other persons, including psychiatric nurse clinicians, as may be defined by rules and | |
16 | regulations promulgated by the director. | |
17 | (10)(9) "NICS database" means the National Instant Criminal Background Check System | |
18 | as created pursuant to section 103(b) of the Brady Handgun Violence Prevention Act (Brady Act), | |
19 | Pub. L. No. 103-159, 107 Stat. 1536 as established by 28 C.F.R. 25.1. | |
20 | (11)(10)"Patient" means a person admitted voluntarily, certified or re-certified admitted to | |
21 | a facility according to the provisions of this chapter. | |
22 | (12)(11) "Physician" means a person duly licensed by the Rhode Island department of | |
23 | health to practice medicine or osteopathy in this state pursuant to chapter 37 of title 5. | |
24 | (8)(12) "Mental disability" "Psychiatric disability" means a mental disorder in which the | |
25 | capacity of a person to exercise self-control or judgment in the conduct of his or her affairs and | |
26 | social relations, or to care for his or her own personal needs, is significantly impaired. | |
27 | (13) "Psychiatric nurse clinician" means a licensed, professional registered nurse with a | |
28 | master's degree in psychiatric nursing or related field who is licensed by the Rhode Island | |
29 | department of health pursuant to chapter 34 of title 5 and who is currently working in the mental | |
30 | health field as defined by the American Nurses Association, and/or a licensed advanced practice | |
31 | registered nurse with a population focus of psychiatric/mental health population focus as defined | |
32 | in paragraphs (2) and (12)(vi) of § 5-34-3. | |
33 | (14) "Psychiatrist" means a person duly licensed by the Rhode Island department of health | |
34 | to practice medicine or osteopathy in this state pursuant to chapter 37 of title 5 who has, in addition, | |
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1 | completed three (3) years of graduate psychiatric training in a program approved by the American | |
2 | Medical Association or American Osteopathic Association. | |
3 | (15) "Psychologist" means a person certified licensed by the Rhode Island department of | |
4 | health pursuant to chapter 44 of title 5. | |
5 | (16) "Social worker" means a person with who has a masters or further advanced degree | |
6 | from a school of social work, that is accredited by the council of social work education and who is | |
7 | licensed by the Rhode Island department of health pursuant to chapter 39.1 of title 5. | |
8 | 40.1-5-5. Admission of patients generally -- Rights of patients -- Patients' records -- | |
9 | Competence of patients. | |
10 | (a) Admissions. Any person who is in need of care and treatment in a facility, as herein | |
11 | defined, may be admitted or certified, received, and retained as a patient in a facility by complying | |
12 | with any one of the following admission procedures applicable to the case: | |
13 | (1) Voluntary admission. | |
14 | (2) Emergency certification. | |
15 | (3) Civil court certification. | |
16 | (b) Forms. The director shall prescribe and furnish forms for use in admissions and patient | |
17 | notification procedures under this chapter. | |
18 | (c) Exclusions. No defective delinquent, person with a mental psychiatric disability, or | |
19 | person under the influence of alcohol or drugs shall be certified to a facility, as herein defined, | |
20 | solely by reason of that condition, unless the person also qualified for admission or certification | |
21 | under the provisions of this chapter. | |
22 | (d) Examining physician. For purposes of certification, no examining physician shall be | |
23 | related by blood or marriage to the person who is applying for the admission of another, or to the | |
24 | person who is the subject of the application; nor shall he or she have any interest, contractually, | |
25 | testamentary, or otherwise (other than reasonable and proper charges for professional services | |
26 | rendered), in or against the estate or assets of the person who is the subject of the application; nor | |
27 | shall he or she be a manager, trustee, visitor, proprietor, officer, stockholder, or have any pecuniary | |
28 | interest, directly or indirectly, or, except as otherwise herein expressly provided, be a director, | |
29 | resident physician, or salaried physician, or employee in any facility to which it is proposed to | |
30 | admit the person. | |
31 | (e) Certificates. Certificates, as required by this chapter, must provide a factual description | |
32 | of the person's behavior that indicates that the person concerned is mentally psychiatrically | |
33 | disabled, creates a likelihood of serious harm, and is in need of care and treatment in a facility as | |
34 | defined in this chapter. They shall further set forth such other findings as may be required by the | |
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1 | particular certification procedure used. Certificates shall also show that an examination of the | |
2 | person concerned was made within five (5) days prior to the date of admission or certification, | |
3 | unless otherwise herein provided. The date of the certificate shall be the date of the commencement | |
4 | of the examination, and in the event examinations are conducted separately or over a period of | |
5 | days, then the five-day (5) period above referred to (unless otherwise expressly provided) shall be | |
6 | measured from the date of the commencement of the first examination. All certificates shall contain | |
7 | the observations upon which judgments are based, and shall contain other information as the | |
8 | director may by rule or regulation require. | |
9 | (f) Rights of patients. No patient admitted or certified to any facility under any provision | |
10 | of this chapter shall be deprived of any constitutional, civil, or legal right, solely by reason of such | |
11 | admission or certification nor shall the certification or admission modify or vary any constitutional | |
12 | or civil right, including, but not limited to, the right or rights: | |
13 | (1) To privacy and dignity; | |
14 | (2) To civil service or merit rating or ranking and appointment; | |
15 | (3) Relating to the granting, forfeiture or denial of a license, permit, privilege, or benefit | |
16 | pursuant to any law; | |
17 | (4) To religious freedom; | |
18 | (5) To be visited privately at all reasonable times by his or her personal physician, attorney, | |
19 | and clergyperson, and by other persons at all reasonable times unless the official in charge of the | |
20 | facility determines either that a visit by any of the other persons or a particular visitation time would | |
21 | not be in the best interests of the patient and he or she incorporates a statement for any denial of | |
22 | visiting rights in the individualized treatment record of the patient; | |
23 | (6) To be provided with stationery, writing materials, and postage in reasonable amounts | |
24 | and to have free unrestricted, unopened, and uncensored use of the mails for letters; | |
25 | (7) To wear one's own clothes, keep and use personal possessions, including toilet articles; | |
26 | to keep and be allowed to spend a reasonable sum of money for canteen expenses and small | |
27 | purchases; to have access to individual storage space for his or her private use; and reasonable | |
28 | access to telephones to make and receive confidential calls; provided, however, that any of these | |
29 | rights may be denied for good cause by the official in charge of a facility or a physician designated | |
30 | by him or her. A statement of the reasons for any denial shall be entered in the individualized | |
31 | treatment record of the patient; | |
32 | (8) To seek independent psychiatric examination and opinion from a psychiatrist or mental | |
33 | health professional of his or her choice; | |
34 | (9) To be employed at a gainful occupation insofar as the patient's condition permits, | |
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1 | provided however, that no patient shall be required to perform labor; | |
2 | (10) To vote and participate in political activity; | |
3 | (11) To receive and read literature; | |
4 | (12) To have the least possible restraint imposed upon the person consistent with affording | |
5 | him or her the care and treatment necessary and appropriate to his or her condition; | |
6 | (13) To have access to the mental health advocate upon request; | |
7 | (14) To prevent release of his or her name to the advocate or next of kin by signing a form | |
8 | provided to all patients for that purpose at the time of admission. | |
9 | (g) Records. A facility shall maintain for each patient admitted pursuant to this chapter, a | |
10 | comprehensive medical record. The record shall contain a recorded, individualized treatment plan, | |
11 | which shall at least monthly be reviewed by the physician of the facility who is chiefly responsible | |
12 | for the patient's care, notations of the reviews to be entered in the record. The records shall also | |
13 | contain information indicating at the time of admission or certification what alternatives to | |
14 | admission or certification are available to the patient; what alternatives have been investigated; and | |
15 | why the investigated alternatives were not deemed suitable. The medical record shall further | |
16 | contain other information as the director may by rule or regulation require. | |
17 | (h) Competence. A person shall not, solely by reason of his or her admission or certification | |
18 | to a facility for examination or care and treatment under the provisions of this chapter, thereby be | |
19 | deemed incompetent to manage his or her affairs; to contract; to hold, or seek a professional, | |
20 | occupational, or vehicle operator's license; to make a will; or for any other purpose. Neither shall | |
21 | any requirement be made, by rule, regulation, or otherwise, as a condition to admission and | |
22 | retention, that any person applying for admission shall have the legal capacity to contract, it being | |
23 | sufficient for the purpose, that the person understand the nature and consequence of making the | |
24 | application. | |
25 | 40.1-5-6. Voluntary admission. | |
26 | (a)(1) General. Any individual of lawful age may apply for voluntary admission to any | |
27 | facility provided for by this law seeking care and treatment for alleged mental psychiatric disability. | |
28 | The application shall be in writing, signed by the applicant in the presence of at least one witness, | |
29 | who shall attest to the application by placing his or her name and address thereon. If the applicant | |
30 | has not yet attained his or her eighteenth (18th) birthday, the application shall be signed by him or | |
31 | her and his or her parent, guardian, or next of kin. | |
32 | (2) Admission of children. Any person who is under the age of eighteen (18) and who | |
33 | receives medical benefits funded in whole or in part by either the department of children, youth and | |
34 | families or by the department of human services may be admitted to any facility provided for by | |
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1 | this chapter seeking care and treatment for alleged mental psychiatric disability only after an initial | |
2 | mental health crisis intervention is completed by a provider who is licensed by the department of | |
3 | children, youth and families for emergency services, has proper credentials, and is contracted with | |
4 | the RIte Care health plan or the state and the provider, after considering alternative services to | |
5 | hospitalization with the child, family and other providers, requests prior authorization for the | |
6 | admission from a representative of the child and family's insurance company or utilization review | |
7 | organization representing the insurance company. If the inpatient hospital admits a child without | |
8 | the crisis intervention and prior authorization from the insurance company or utilization review | |
9 | organization, the hospital will be paid a rate equivalent to an Administratively Necessary Day | |
10 | (AND) for each day that the insurance company or utilization review organization representing the | |
11 | insurance company determines that the child did not meet the inpatient level-of-care criteria. The | |
12 | state shall ensure that this provision is included in all publicly financed contracts and agreements | |
13 | for behavioral health services. Activities conducted pursuant to this section shall be exempt from | |
14 | the provisions of § 23-17.12 [repealed], but shall be subject to the provisions of subsection (b) of | |
15 | this section. | |
16 | (3) The department of human services shall develop regulations for emergency admissions | |
17 | that would allow the admitting hospital to maintain its compliance with the provisions of the act | |
18 | while meeting the need of the child. | |
19 | (b) Period of treatment. If it is determined that the applicant is in need of care and treatment | |
20 | for mental psychiatric disability and no suitable alternatives to admission are available, he or she | |
21 | shall be admitted for a period not to exceed thirty (30) days. Successive applications for continued | |
22 | voluntary status may be made for successive periods not to exceed ninety (90) days each, so long | |
23 | as care and treatment is deemed necessary and documented in accordance with the requirements of | |
24 | this chapter and no suitable alternatives to admission are available. | |
25 | (c) Discharge. | |
26 | (1) A voluntary patient shall be discharged no later than the end of the business day | |
27 | following of his or her presenting a written notice of his or her intent to leave the facility to the | |
28 | medical official in charge or the medical official designated by him or her, unless that official or | |
29 | another qualified person from the facility files an application for the patient's civil court | |
30 | certification pursuant to § 40.1-5-8. The notice shall be on a form prescribed by the director and | |
31 | made available to all patients at all times. If a decision to file an application for civil court | |
32 | certification is made, the patient concerned and his or her legal guardian(s), if any, shall receive | |
33 | immediately, but in no event later than twelve (12) hours from the making of the decision, notice | |
34 | of the intention from the official in charge of the facility, or his or her designee, and the patient | |
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1 | may, in the discretion of the official, be detained for an additional period not to exceed two (2) | |
2 | business days, pending the filing and setting down for hearing of the application under § 40.1-5-8. | |
3 | (2) A voluntary patient who gives notice of his or her intention or desire to leave the facility | |
4 | may at any time during the period of his or her hospitalization prior to any certification pursuant to | |
5 | § 40.1-5-8, following the giving of the notice, submit a written communication withdrawing the | |
6 | notice, whereby his or her voluntary status shall be considered to continue unchanged until the | |
7 | expiration of thirty (30) or ninety (90) days as provided in subsection (b). In the case of an | |
8 | individual under eighteen (18) years of age, the notice or withdrawal of notice may be given by | |
9 | either of the persons who made the application for his or her admission, or by a person of equal or | |
10 | closer relationship to the patient, who shall, as well, receive notice from the official in charge | |
11 | indicating a decision to present an application for civil court certification. The official may in his | |
12 | or her discretion refuse to discharge the patient upon notice given by any person other than the | |
13 | person who made the application, and in the event of such a refusal, the person giving notice may | |
14 | apply to a justice of the family court for release of the patient. | |
15 | (d) Examination at facility. The medical official in charge of a facility shall ensure that all | |
16 | voluntary patients receive preliminary physical and psychiatric examinations within twenty-four | |
17 | (24) hours of admission. Furthermore, a complete psychiatric examination shall be conducted to | |
18 | determine whether the person qualifies for care and treatment under the provisions of this chapter. | |
19 | The examination shall begin within forty-eight (48) hours of admission and shall be concluded as | |
20 | soon as practicable, but in no case shall extend beyond five (5) days. The examination shall include | |
21 | an investigation with the prospective patient of (1) What alternatives for admission are available | |
22 | and (2) Why those alternatives are not suitable. The alternatives for admission investigated and | |
23 | reasons for unsuitability, if any, shall be recorded on the patient's record. If it is determined that the | |
24 | patient does not belong to the voluntary class in that a suitable alternative to admission is available, | |
25 | or is otherwise ineligible for care and treatment, he or she shall be discharged. | |
26 | (e) Rights of voluntary patients. A voluntary patient shall be informed, in writing, of his or | |
27 | her status and rights as a voluntary patient immediately upon his or her admission, and again at the | |
28 | time of his or her periodic review(s) as provided in § 40.1-5-10, including his or her rights pursuant | |
29 | to § 40.1-5-5(f). Blank forms for purposes of indicating an intention or desire to leave a facility | |
30 | shall be available at all times and on and in all wards and segments of a facility wherein voluntary | |
31 | patients may reside. | |
32 | 40.1-5-7. Emergency certification. | |
33 | (a) Applicants. | |
34 | (1) Any physician who, after examining a person, has reason to believe that the person is | |
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1 | in need of immediate care and treatment, and is one whose continued unsupervised presence in the | |
2 | community would create an imminent likelihood of serious harm by reason of mental psychiatric | |
3 | disability, may apply at a facility for the emergency certification of the person thereto. The medical | |
4 | director, or any other physician employed by the proposed facility for certification, may apply | |
5 | under this subsection if no other physician is available and he or she certifies this fact. If an | |
6 | examination is not possible because of the emergency nature of the case and because of the refusal | |
7 | of the person to consent to the examination, the applicant on the basis of his or her observation may | |
8 | determine, in accordance with the above, that emergency certification is necessary and may apply | |
9 | therefor. In the event that no physician is available, a qualified mental health professional who | |
10 | believes the person to be in need of immediate care and treatment, and one whose continued | |
11 | unsupervised presence in the community would create an imminent likelihood of serious harm by | |
12 | reason of mental psychiatric disability, may make the application for emergency certification to a | |
13 | facility. Application shall in all cases be made to the facility that, in the judgment of the applicant | |
14 | at the time of application, would impose the least restraint on the liberty of the person consistent | |
15 | with affording him or her the care and treatment necessary and appropriate to his or her condition. | |
16 | (2) Whenever an applicant, who is not employed by a community mental health center | |
17 | established pursuant to chapter 8.5 of this title, has reason to believe that either the institute of | |
18 | mental health Rhode Island State Psychiatric Hospital or the Eleanor Slater Hospital is the | |
19 | appropriate facility for the person, the application shall be directed to the community mental health | |
20 | center that serves the area in which the person resides, if the person is a Rhode Island resident, or | |
21 | the area in which the person is physically present, if a nonresident, and the qualified mental health | |
22 | professional(s) at the center shall make the final decision on the application to either the institute | |
23 | of mental health Rhode Island State Psychiatric Hospital or the Eleanor Slater Hospital or may | |
24 | determine whether some other disposition should be made. | |
25 | (b) Applications. An application for certification hereunder shall be in writing and filed | |
26 | with the facility to which admission is sought. The application shall be executed within five (5) | |
27 | days prior to the date of filing and shall state that it is based upon a personal observation of the | |
28 | prospective patient by the applicant within the five-day (5) period. It shall include a description of | |
29 | the applicant's credentials and the behavior that constitutes the basis for his or her judgment that | |
30 | the prospective patient is in need of immediate care and treatment and that a likelihood of serious | |
31 | harm by reason of mental psychiatric disability exists, and shall include, as well, any other relevant | |
32 | information that may assist the admitting physician at the facility to which application is made. | |
33 | Whenever practicable, prior to transporting or arranging for the transporting of a prospective patient | |
34 | to a facility, the applicant shall telephone or otherwise communicate with the facility to describe | |
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1 | the circumstances and known clinical history to determine whether it is the proper facility to receive | |
2 | the person, and to give notice of any restraint to be used or to determine whether restraint is | |
3 | necessary. The application shall state whether the facility, in the judgment of the applicant at the | |
4 | time of application, would impose the least restraint on the liberty of the person consistent with | |
5 | affording him or her the care and treatment necessary and appropriate to his or her condition. | |
6 | Whenever practicable, prior to transporting or arranging for the transporting of a prospective patient | |
7 | to a facility, the applicant shall telephone or otherwise communicate with the facility to describe | |
8 | the circumstances and known clinical history to determine whether it is the proper facility to receive | |
9 | the person, and to give notice of any restraint to be used or to determine whether restraint is | |
10 | necessary. | |
11 | (c) Confirmation; discharge; transfer. Within one hour after reception at a facility, the | |
12 | person regarding whom an application has been filed under this section shall be seen by a physician. | |
13 | As soon as possible, but in no event later than twenty-four (24) hours after reception, a preliminary | |
14 | examination and evaluation of the person by a psychiatrist or a physician under his or her | |
15 | supervision shall begin. The psychiatrist shall not be an applicant hereunder. The preliminary | |
16 | examination and evaluation shall be completed within seventy-two (72) hours from its inception | |
17 | by the psychiatrist. If the psychiatrist determines that the patient is not a candidate for emergency | |
18 | certification, he or she shall be discharged. If the psychiatrist(s) determines that the person who is | |
19 | the subject of the application is in need of immediate care and treatment and is one whose continued | |
20 | unsupervised presence in the community would create an imminent likelihood of serious harm by | |
21 | reason of mental psychiatric disability, he or she shall confirm the admission for care and treatment | |
22 | under this section of the person to the facility, provided the facility is one that would impose the | |
23 | least restraint on the liberty of the person consistent with affording him or her the care and treatment | |
24 | necessary and appropriate to his or her condition and that no suitable alternatives to certification | |
25 | are available. If at any time the official in charge of a facility, or his or her designee, determines | |
26 | that the person is not in need of immediate care and treatment, or is not one whose continued | |
27 | unsupervised presence in the community would create an imminent likelihood of serious harm by | |
28 | reason of mental psychiatric disability, or suitable alternatives to certification are available, he or | |
29 | she shall immediately discharge the person. In addition, the official may arrange to transfer the | |
30 | person to an appropriate facility if the facility to which he or she has been certified is not one that | |
31 | imposes the least restraint on the liberty of the person consistent with affording him or her the care | |
32 | and treatment necessary and appropriate to his or her condition. | |
33 | (d) Custody. Upon the request of an applicant under this section, to be confirmed in writing, | |
34 | it shall be the duty of any peace officer of this state or of any governmental subdivision thereof to | |
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1 | whom request has been made, to take into custody and transport the person to the facility | |
2 | designated, the person to be expeditiously presented for admission thereto to take into custody and | |
3 | immediately transport the person to the designated facility for admission thereto. | |
4 | (e) Ex parte court order. An applicant under this section may present a petition to any judge | |
5 | of the district court or any justice of the family court, in the case of a person who is the subject of | |
6 | an application who has not yet attained his or her eighteenth birthday, for a warrant directed to any | |
7 | peace officer of the state or any governmental subdivision thereof to take into custody the person | |
8 | who is the subject of the application and immediately transport the person to a designated facility. | |
9 | The application shall set forth that the person who is to be certified is in need of immediate care | |
10 | and treatment and his or her continued unsupervised presence in the community would create an | |
11 | imminent likelihood of serious harm by reason of mental psychiatric disability, and the reasons | |
12 | why an order directing a peace officer to transport the person to a designated facility is necessary. | |
13 | (f) Notification of rights. No person shall be certified to a facility under the provisions of | |
14 | this section unless appropriate opportunity is given to apply for voluntary admission under the | |
15 | provisions of § 40.1-5-6 and unless he or she, or a parent, guardian, or next of kin, has been | |
16 | informed, in writing, on a form provided by the department, by the official in charge of the facility: | |
17 | (1) That he or she has a right to the voluntary admission; (2) That a person cannot be certified until | |
18 | all available alternatives to certification have been investigated and determined to be unsuitable; | |
19 | and (3) That the period of hospitalization or treatment in a facility cannot exceed ten (10) days | |
20 | under this section, except as provided in subsection (g) of this section. | |
21 | (g) Period of treatment. A person shall be discharged no later than ten (10) days measured | |
22 | from the date of his or her admission under this section, unless an application for a civil court | |
23 | certification has been filed and set down for a hearing under the provisions of § 40.1-5-8, or the | |
24 | person remains as a voluntary patient pursuant to § 40.1-5-6. | |
25 | 40.1-5-7.1. Emergency transportation by police. | |
26 | (a) Any police officer may take an individual into protective custody and take or cause the | |
27 | person to be taken to an emergency room of any hospital, by way of emergency vehicle, if the | |
28 | officer has reason to believe that: | |
29 | (1) The individual is in need of immediate care and treatment, and is one whose continued | |
30 | unsupervised presence in the community would create an imminent likelihood of serious harm by | |
31 | reason of mental psychiatric disability if allowed to be at liberty pending examination by a licensed | |
32 | physician; or | |
33 | (2) The individual is in need of immediate assistance due to mental psychiatric disability | |
34 | and requests the assistance. | |
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1 | (b) The officer making the determination to transport will document the reason for the | |
2 | decision in a police report and travel with the individual to the hospital to relay the reason for | |
3 | transport to the attending medical staff. | |
4 | 40.1-5-8. Civil court certification. | |
5 | (a) Petitions. A verified petition may be filed in the district court, or family court in the | |
6 | case of a person who has not reached his or her eighteenth (18th) birthday, for the certification to a | |
7 | facility of any person who is alleged to be in need of care and treatment in a facility, and whose | |
8 | continued unsupervised presence in the community would create a likelihood of serious harm by | |
9 | reason of mental psychiatric disability. The petition may be filed by any person with whom the | |
10 | subject of the petition may reside; or at whose house he or she may be; or the father or mother, | |
11 | husband or wife, brother or sister, or the adult child of the person; the nearest relative if none of the | |
12 | above are available; or his or her guardian; or the attorney general; or a local director of public | |
13 | welfare; or the director of the department of behavioral healthcare, developmental disabilities and | |
14 | hospitals; the director of the department of human services; or the director of the department of | |
15 | corrections; the director of the department of health; the warden of the adult correctional | |
16 | institutions; the superintendent of the boys training school for youth, or his or her designated agent; | |
17 | or the director of any facility, or his or her designated agent, whether or not the person shall have | |
18 | been admitted and is a patient at the time of the petition. A petition under this section shall be filed | |
19 | only after the petitioner has investigated what alternatives to certification are available and | |
20 | determined why the alternatives are not deemed suitable. | |
21 | (b) Contents of petition. The petition shall state that it is based upon a personal observation | |
22 | of the person concerned by the petitioner within a ten-day (10) period prior to filing. It shall include | |
23 | a description of the behavior that constitutes the basis for the petitioner's judgment that the person | |
24 | concerned is in need of care and treatment and that a likelihood of serious harm by reason of mental | |
25 | psychiatric disability exists. In addition, the petitioner shall indicate what alternatives to | |
26 | certification are available; what alternatives have been investigated; and why the investigated | |
27 | alternatives are not deemed suitable. | |
28 | (c) Certificates and contents thereof. A petition hereunder shall be accompanied by the | |
29 | certificates of two (2) physicians unless the petitioner is unable to afford, or is otherwise unable to | |
30 | obtain, the services of a physician or physicians qualified to make the certifications. The certificates | |
31 | shall be rendered pursuant to the provisions of § 40.1-5-5, except when the patient is a resident in | |
32 | a facility, the attending physician and one other physician from the facility may sign the certificates, | |
33 | and shall set forth that the prospective patient is in need of care and treatment in a facility and | |
34 | would likely benefit therefrom, and is one whose continued unsupervised presence in the | |
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| |
1 | community would create a likelihood of serious harm by reason of mental psychiatric disability | |
2 | together with the reasons therefor. The petitions and accompanying certificates shall be executed | |
3 | under penalty of perjury, but shall not require the signature of a notary public thereon. | |
4 | (d) Preliminary hearing. | |
5 | (1) Upon a determination that the petition sets forth facts constituting reasonable grounds | |
6 | to support certification, the court shall summon the person to appear before the court at a | |
7 | preliminary hearing, scheduled no later than five (5) business days from the date of filing. This | |
8 | hearing shall be treated as a priority on the court calendar and may be continued only for good | |
9 | cause shown. In default of an appearance, the court may issue a warrant directing a police officer | |
10 | to bring the person before the court. | |
11 | (2) At the preliminary hearing, the court shall serve a copy of the petition upon the person | |
12 | and advise him or her of the nature of the proceedings and of his or her right to counsel. If the | |
13 | person is unable to afford counsel, the court forthwith shall appoint the mental health advocate for | |
14 | him or her. If the court finds that there is no probable cause to support certification, the petition | |
15 | shall be dismissed, and the person shall be discharged unless the person applies for voluntary | |
16 | admission. However, if the court is satisfied by the testimony that there is probable cause to support | |
17 | certification, a final hearing shall be held not less than seven (7) days, nor more than twenty-one | |
18 | (21) days, after the preliminary hearing, unless continued at the request of counsel for the person, | |
19 | and notice of the date set down for the hearing shall be served on the person. Copies of the petition | |
20 | and notice of the date set down for the hearing shall also be served immediately upon the person's | |
21 | nearest relatives or legal guardian, if known, and to any other person designated by the patient, in | |
22 | writing, to receive copies of notices. The preliminary hearing can be waived by a motion of the | |
23 | patient to the court if the patient is a resident of a facility. | |
24 | (e) Petition for examination. | |
25 | (1) Upon motion of either the petitioner or the person, or upon its own motion, the court | |
26 | may order that the person be examined by a psychiatrist appointed by the court. The examination | |
27 | may be conducted on an outpatient basis and the person shall have the right to the presence of | |
28 | counsel while it is being conducted. A report of the examination shall be furnished to the court, the | |
29 | petitioner, and the person and his or her counsel at least forty-eight (48) hours prior to the hearing. | |
30 | (2) If the petition is submitted without two (2) physicians' certificates as required under | |
31 | subsection (c), the petition shall be accompanied by a motion for a psychiatric examination to be | |
32 | ordered by the court. The motion shall be heard on the date of the preliminary hearing set by the | |
33 | court pursuant to subsection (d), or as soon thereafter as counsel for the subject person is engaged, | |
34 | appointed, and ready to proceed. The motion shall be verified or accompanied by affidavits and | |
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| |
1 | shall set forth facts demonstrating the efforts made to secure examination and certification by a | |
2 | physician or physicians and shall indicate the reasons why the efforts failed. | |
3 | (3) After considering the motion and testimony as may be offered on the date of hearing | |
4 | the motion, the court may deny the application and dismiss the petition, or upon finding: (i) That | |
5 | there is a good cause for the failure to obtain one or more physician's certificates in accordance | |
6 | with subsection (c); and (ii) That there is probable cause to substantiate the allegations of the | |
7 | petition, the court shall order an immediate examination by two (2) qualified psychiatrists, pursuant | |
8 | to subsection (e)(1). | |
9 | (f) Professional assistance. A person with respect to whom a court hearing has been ordered | |
10 | under this section shall have, and be informed of, a right to employ a mental health professional of | |
11 | his or her choice to assist him or her in connection with the hearing and to testify on his or her | |
12 | behalf. If the person cannot afford to engage such a professional, the court shall, on application, | |
13 | allow a reasonable fee for the purpose. | |
14 | (g) Procedure. Upon receipt of the required certificates and/or psychiatric reports as | |
15 | applicable hereunder, the court shall schedule the petition for final hearing unless, upon review of | |
16 | the reports and certificates, the court concludes that the certificates and reports do not indicate, with | |
17 | supporting reasons, that the person who is the subject of the petition is in need of care and treatment; | |
18 | that his or her unsupervised presence in the community would create a likelihood of serious harm | |
19 | by reason of mental psychiatric disability; and that all alternatives to certification have been | |
20 | investigated and are unsuitable, in which event the court may dismiss the petition. | |
21 | (h) Venue. An application for certification under this section shall be made to, and all | |
22 | proceedings pursuant thereto shall be conducted in, the district court, or family court in the case of | |
23 | a person who has not yet reached his or her eighteenth (18th) birthday, of the division or county in | |
24 | which the subject of an application may reside or may be, or when the person is already a patient | |
25 | in a facility, in the district court or family court of the division or county in which the facility is | |
26 | located, subject, however, to application by any interested party for change of venue because of | |
27 | inconvenience of the parties or witnesses or the condition of the subject of the petition or other | |
28 | valid judicial reason for the change of venue. | |
29 | (i) Hearing. A hearing scheduled under this section shall be conducted pursuant to the | |
30 | following requirements: | |
31 | (1) All evidence shall be presented according to the usual rules of evidence that apply in | |
32 | civil, non-jury cases. The subject of the proceedings shall have the right to present evidence in his | |
33 | or her own behalf and to cross examine all witnesses against him or her, including any physician | |
34 | who has completed a certificate or filed a report as provided hereunder. The subject of the | |
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| |
1 | proceedings shall have the further right to subpoena witnesses and documents, the cost of such to | |
2 | be borne by the court where the court finds upon an application of the subject that the person cannot | |
3 | afford to pay for the cost of subpoenaing witnesses and documents. | |
4 | (2) A verbatim transcript or electronic recording shall be made of the hearing that shall be | |
5 | impounded and obtained or examined only with the consent of the subject thereof (or in the case of | |
6 | a person who has not yet attained his or her eighteenth (18th) birthday, his or her parent, guardian, | |
7 | or next of kin) or by order of the court. | |
8 | (3) The hearing may be held at a location other than a court, including any facility where | |
9 | the subject may currently be a patient, where it appears to the court that holding the hearing at | |
10 | another location would be in the best interests of the subject thereof. | |
11 | (4) The burden of proceeding and the burden of proof in a hearing held pursuant to this | |
12 | section shall be upon the petitioner. The petitioner has the burden of demonstrating that the subject | |
13 | of the hearing is in need of care and treatment in a facility; is one whose continued unsupervised | |
14 | presence in the community would create a likelihood of serious harm by reason of mental | |
15 | psychiatric disability; and what alternatives to certification are available, what alternatives to | |
16 | certification were investigated, and why these alternatives were not deemed suitable. | |
17 | (5) The court shall render a decision within forty-eight (48) hours after the hearing is | |
18 | concluded. | |
19 | (j) Order. If the court at a final hearing finds by clear and convincing evidence that the | |
20 | subject of the hearing is in need of care and treatment in a facility, and is one whose continued | |
21 | unsupervised presence in the community would, by reason of mental psychiatric disability, create | |
22 | a likelihood of serious harm, and that all alternatives to certification have been investigated and | |
23 | deemed unsuitable, it shall issue an order committing the person to the custody of the director for | |
24 | care and treatment or to an appropriate facility. In either event, and to the extent practicable, the | |
25 | person shall be cared for in a facility that imposes the least restraint upon the liberty of the person | |
26 | consistent with affording him or her the care and treatment necessary and appropriate to his or her | |
27 | condition. No certification shall be made under this section unless and until full consideration has | |
28 | been given by the certifying court to the alternatives to in-patient care, including, but not limited | |
29 | to, a determination of the person's relationship to the community and to his or her family; of his or | |
30 | her employment possibilities; and of all available community resources, alternate available living | |
31 | arrangements, foster care, community residential facilities, nursing homes, and other convalescent | |
32 | facilities. A certificate ordered pursuant to this section shall be valid for a period of six (6) months | |
33 | from the date of the order. At the end of that period the patient shall be discharged, unless he or she | |
34 | is discharged prior to that time, in which case the certification shall expire on the date of the | |
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1 | discharge. | |
2 | (k) Appeals. | |
3 | (1) A person certified under this section shall have a right to appeal from a final hearing to | |
4 | the supreme court of the state within thirty (30) days of the entry of an order of certification. The | |
5 | person shall have the right to be represented on appeal by counsel of his or her choice or by the | |
6 | mental health advocate if the supreme court finds that he or she cannot afford to retain counsel. | |
7 | Upon a showing of indigency, the supreme court shall permit an appeal to proceed without payment | |
8 | of costs, and a copy of the transcript of the proceedings below shall be furnished to the subject of | |
9 | the proceedings, or to his or her attorney, at the expense of the state. The certifying court shall | |
10 | advise the person of all his or her rights pursuant to this section immediately upon the entry of an | |
11 | order of certification. | |
12 | (2) Appeals under this section shall be given precedence, insofar as practicable, on the | |
13 | supreme court dockets. The district and family courts shall promulgate rules with the approval of | |
14 | the supreme court to insure the expeditious transmission of the record and transcript in all appeals | |
15 | pursuant to this chapter. | |
16 | (l) Submission to NICS database. | |
17 | (1) The district court shall submit the name, date of birth, gender, race or ethnicity, and | |
18 | date of civil commitment to the National Instant Criminal Background Check System (NICS) | |
19 | database of all persons subject to a civil court certification order pursuant to this section within | |
20 | forty-eight (48) hours of certification. | |
21 | (2) Any person affected by the provisions of this section, after the lapse of a period of three | |
22 | (3) years from the date such civil certification is terminated, shall have the right to appear before | |
23 | the relief from disqualifiers board. | |
24 | (3) Upon notice of a successful appeal pursuant to subsection (k), the district court shall, | |
25 | as soon as practicable, cause the appellant's record to be updated, corrected, modified, or removed | |
26 | from any database maintained and made available to the NICS and reflect that the appellant is no | |
27 | longer subject to a firearms prohibition as it relates to 18 U.S.C. § 922(d)(4) and 18 U.S.C. § | |
28 | 922(g)(4). | |
29 | (m) Equitable authority. In addition to the powers heretofore exercised, the district and | |
30 | family courts are hereby empowered, in furtherance of their jurisdiction under this chapter, to grant | |
31 | petitions for instructions for the provision or withholding of treatment as justice and equity may | |
32 | require. | |
33 | 40.1-5-11. Discharge -- Recertification. | |
34 | (a) The official in charge of any facility, or his or her designated agent, on having his or | |
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| |
1 | her reasons noted on the patient's records, shall discharge any patient certified or admitted pursuant | |
2 | to the provisions of this chapter, when: | |
3 | (1) Suitable alternatives to certification or admission are available; | |
4 | (2) The patient is, in the judgment of the official, recovered; | |
5 | (3) The patient is not recovered, but discharge, in the judgment of the official, will not | |
6 | create a likelihood of serious harm by reason of mental psychiatric disability. | |
7 | (b) When a patient discharge is requested and if the discharge is denied, the reasons therefor | |
8 | shall be stated, in writing, and noted in the patient's record and a copy thereof shall be given to the | |
9 | person applying for the release. | |
10 | (c) At the expiration of the six-month (6) period set forth in § 40.1-5-8(j), or any subsequent | |
11 | six-month (6) period following recertification pursuant to this section, the patient shall be | |
12 | unconditionally released unless a recertification petition is filed by the official in charge of a | |
13 | facility, or his or her designated agent, within no less than fifteen (15) days and no more than thirty | |
14 | (30) days prior to the scheduled expiration date of a six-month (6) period. A hearing must be held | |
15 | pursuant to the petition and a decision rendered before the expiration of the six-month (6) period. | |
16 | A recertification hearing shall follow all of the procedures set forth in § 40.1-5-8 and recertification | |
17 | may be ordered only if the petitioner proves by clear and convincing evidence that the conduct and | |
18 | responses of the patient during the course of the previous six-month (6) period indicate that the | |
19 | patient is presently in need of care and treatment in a facility; is one whose continued unsupervised | |
20 | presence in the community would create a likelihood of serious harm by reason of mental | |
21 | psychiatric disability; and that all alternatives to recertification have been investigated and deemed | |
22 | unsuitable. | |
23 | 40.1-5-27.1. Disclosure by mental health professional. | |
24 | (a) Notwithstanding §§ 40.1-5-26 and 40.1-5-27, a mental health professional providing | |
25 | care and treatment to an adult person with a mental psychiatric disability as defined in § 40.1-5- | |
26 | 2(8) § 40.1-5-2(12) may provide certain information to a family member or other person if this | |
27 | family member or other person lives with and provides direct care to the mentally psychiatrically | |
28 | disabled person, and without such direct care there would be significant deterioration in the | |
29 | mentally psychiatrically disabled person's daily functioning, and such disclosure would directly | |
30 | assist in the care of the mentally psychiatrically disabled person. Disclosure can be made only at | |
31 | the written request of the family member or person living with the mentally psychiatrically disabled | |
32 | person. | |
33 | (b) Prior to the disclosure, the mentally psychiatrically disabled person shall be informed, | |
34 | in writing, of the request, the name of the person requesting the information, the reason for the | |
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| |
1 | request, and the specific information being provided. Prior to disclosure, the mentally | |
2 | psychiatrically disabled person shall be provided the opportunity to give or withhold consent. If the | |
3 | mentally psychiatrically disabled person withholds consent, the information shall not be disclosed | |
4 | and the family member or other person shall be provided the opportunity to appeal. Disclosures | |
5 | shall be limited to information regarding diagnosis, admission to or discharge from a treatment | |
6 | facility, the name of the medication prescribed, and side effects of prescribed medication. | |
7 | (c) On or before April 1, 1993, the department of behavioral healthcare, developmental | |
8 | disabilities and hospitals shall promulgate rules and regulations to further define and interpret the | |
9 | provisions of this section. In the development of these rules and regulations, the department shall | |
10 | work with an advisory committee composed, at a minimum, of proportionate representation from | |
11 | the following: the Coalition of Consumer Self Advocates, the Alliance for the Mentally Ill, the | |
12 | Mental Health Association of Rhode Island, the Council of Community Mental Health Centers, the | |
13 | mental health advocate, and Rhode Island Protection and Advocacy Services. Rules and regulations | |
14 | by the department shall include the provision of an appeals process, that would serve to protect the | |
15 | rights of mentally psychiatrically disabled persons under the law. | |
16 | 40.1-5-31. Maintenance of facilities. | |
17 | Facilities under the jurisdiction, supervision, and control of the department shall be | |
18 | maintained, and services shall be provided, for the care and treatment of the mentally | |
19 | psychiatrically disabled of the state and for other persons and related purposes as shall be provided | |
20 | and authorized by law. | |
21 | 40.1-5-32. Transfer of patients. | |
22 | (a) No transfer of a patient already in a facility shall be made to a facility, or section of a | |
23 | facility, maintained for patients certified upon an order of a court or judge having criminal | |
24 | jurisdiction in a proceeding arising out of a criminal offense. The official in charge of a facility, or | |
25 | his or her designated agent, shall have reasonable discretion to order or permit transfers within a | |
26 | facility for reason of finances, adequacy of personnel, and upon conditions set forth in rules or | |
27 | regulations promulgated by the director pursuant hereto. | |
28 | (b) A patient certified to any facility pursuant to the provisions of this chapter may be | |
29 | transferred, with his or her consent or that of his or her guardian, to any facility within or without | |
30 | the state or to an institution operated by the Veterans' Administration or to any agency of the United | |
31 | States government for the treatment of mental psychiatric disability at a facility under its | |
32 | jurisdiction, within or without the state, when deemed in the interest of the patient and approved | |
33 | by the transferring and receiving facilities. A transfer as above described may be accomplished | |
34 | without the consent of a patient, or his or her guardian, only upon prior application to, and a hearing | |
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| |
1 | in, the district court (or family court in the case of a patient under eighteen (18) years of age) and a | |
2 | specific finding by the court that the proposed transfer is in the best interests of the patient and is | |
3 | to a facility that will afford the patient the care and treatment necessary and appropriate to his or | |
4 | her condition. | |
5 | (c) A patient received on voluntary admission may be transferred as provided in subsection | |
6 | (b) with his or her consent; and if the patient shall not yet have attained his or her eighteenth | |
7 | birthday, with the consent of his or her parent, guardian, next of kin, or person who signed for his | |
8 | or her admission. A voluntary patient may be transferred to another facility without his or her | |
9 | consent only upon the filing of a petition for certification to the facility, and a finding of probable | |
10 | cause at a preliminary hearing in accordance with § 40.1-5-8. | |
11 | (d) Patients transferred to facilities without the state, or to the Veterans' Administration or | |
12 | the United States Public Health Service, or another agency operated by the United States | |
13 | government, shall be subject to the rules and regulations of the facility or institution to which they | |
14 | are transferred, and the person or official in charge thereof, in connection with the care and | |
15 | treatment of the patient, being vested with the same powers as persons in charge of similar facilities | |
16 | within the state, provided that no such transfer shall be made to a facility maintained for the purpose | |
17 | of patients committed upon an order of a court or judge having criminal jurisdiction in a proceeding | |
18 | arising out of a criminal offense. Transfers of patients between states that have entered into the | |
19 | interstate compact on mental health shall be pursuant to and in accordance with said compact | |
20 | whenever applicable. | |
21 | 40.1-5-33. Payment for care and treatment. | |
22 | For the purposes of this chapter, facilities shall be maintained by the state for the care, | |
23 | treatment, and maintenance of the mentally psychiatrically disabled, and the patients may be | |
24 | maintained and treated in the facilities or in foster family care, and may receive the services | |
25 | conditioned upon prompt and regular payments for the care, maintenance, and treatment or for the | |
26 | services in amounts as fixed by the director. In the discretion of the director, the rates so fixed may | |
27 | be the reimbursement rates or in excess thereof. A preference shall be given to persons whose | |
28 | estate, or the person or persons legally liable for their support, cannot sufficiently pay for the care | |
29 | and treatment, or for the services in licensed private facilities or from sources outside the | |
30 | department. The director, in his or her discretion, may accept payments for services at less than the | |
31 | reimbursement rates, but the acceptance of the lesser payments shall not release the patient, his or | |
32 | her estate, or relatives, if they have sufficient financial ability, from the obligation to make up the | |
33 | difference between the amount fixed, accepted, or paid and the full reimbursement rates. | |
34 | 40.1-5-34. Exclusiveness of this chapter. | |
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1 | Where under any provision of any existing law, except in the case of a person held under | |
2 | criminal process, or under process of the family court for an act that would be considered a crime | |
3 | if committed by an adult, any person with mental psychiatric disability, as defined in this chapter, | |
4 | shall have recourse to or be dealt with as provided in this chapter, exclusively. This section shall | |
5 | prevail notwithstanding the provisions of § 14-1-5(1)(v). | |
6 | SECTION 8. Sections 40.1-5.3-1, 40.1-5.3-2 and 40.1-5.3-3 of the General Laws in | |
7 | Chapter 40.1-5.3 entitled "Incompetency to Stand Trial and Persons Adjudged Not Guilty by | |
8 | Reason of Insanity" are hereby amended to read as follows: | |
9 | 40.1-5.3-1. Facility for incompetent persons and others. | |
10 | (a) The state director of behavioral healthcare, developmental disabilities and hospitals | |
11 | shall maintain, at the state institution of Cranston, an appropriate facility appropriate facilities, | |
12 | including the Rhode Island State Psychiatric Hospital and the Eleanor Slater Hospital, for the | |
13 | confinement of persons committed to his or her custody pursuant to this chapter and shall provide | |
14 | for the proper care, treatment, and restraint of all such persons. All persons now or hereafter | |
15 | committed, pursuant to the provisions of §§ 40.1-5.3-3, 40.1-5.3-4, 40.1-5.3-7, or the provisions of | |
16 | prior law, shall be removed or committed, as the case may be, to the facility to the facility into the | |
17 | custody of the director, or his or her designee, who in turn shall ensure the admission of the person | |
18 | to either the Rhode Island State Psychiatric Hospital or the Eleanor Slater Hospital in the discretion | |
19 | of the director or his or her designee. | |
20 | (b) The cost of care, maintenance, and treatment of persons committed to the custody of | |
21 | the director of behavioral healthcare, developmental disabilities and hospitals, as provided in §§ | |
22 | 40.1-5.3-3 and 40.1-5.3-4, unless otherwise provided for, shall be paid by the person, if he or she | |
23 | has any estate, or by the person liable for his or her support, if such there be; otherwise, the director | |
24 | may maintain without charge or defray the expense of care and treatment of the poor or indigent | |
25 | persons incompetent to stand trial or acquitted on the grounds of insanity. | |
26 | 40.1-5.3-2. Transfers to and from general wards Transfers between state-operated | |
27 | hospitals. | |
28 | Whenever any person committed, transferred, or removed to either the Rhode Island State | |
29 | Psychiatric Hospital or the Eleanor Slater Hospital to the facility provided for in § 40.1-5.3-1 shall | |
30 | have recovered his or her mental health sufficiently, or if any such person requires more intensive | |
31 | treatment or supervision to be cared for in the general wards of the institute of mental health, the | |
32 | director may, upon request of the superintendent chief executive officer or the chief medical officer | |
33 | of the state either state-operated hospital, transfer discharge the person to the general wards of the | |
34 | state hospital, and retransfer him or her to the facility provided for in § 40.1-5.3-1 upon a like | |
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1 | request from the first hospital and then admit the person to the general units of either the Rhode | |
2 | Island State Psychiatric Hospital or Eleanor Slater Hospital, as the case may be. | |
3 | 40.1-5.3-3. Competency to stand trial. | |
4 | (a) Definitions. As used in this section: | |
5 | (1) "Attorney for the state" means the attorney general, an authorized assistant attorney | |
6 | general, or other person as may be authorized by law to act as a representative of the state in a | |
7 | criminal proceeding; | |
8 | (2) "Competent" or "competency" means mental ability to stand trial. A person is mentally | |
9 | competent to stand trial if he or she is able to understand the character and consequences of the | |
10 | proceedings against him or her and is able properly to assist in his or her defense; | |
11 | (3) "Department" means the state department of behavioral healthcare, developmental | |
12 | disabilities and hospitals. | |
13 | (4) "Director" means the director of the state department of behavioral healthcare, | |
14 | developmental disabilities and hospitals; | |
15 | (5) "Incompetent" or "incompetency" means mentally incompetent to stand trial. A person | |
16 | is mentally incompetent to stand trial if he or she is unable to understand the character and | |
17 | consequences of the proceedings against him or her or is unable properly to assist in his or her | |
18 | defense. | |
19 | (b) Presumption of competency. A defendant is presumed competent. The burden of | |
20 | proving that the defendant is not competent shall be by a preponderance of the evidence, and the | |
21 | burden of going forward with the evidence shall be on the party raising the issue. The burden of | |
22 | going forward shall be on the state if the court raises the issue. | |
23 | (c) Request for examination. If at any time during a criminal proceeding, prior to the | |
24 | imposition of sentence, it appears that the defendant is not competent, counsel for the defendant or | |
25 | the state, or the court, on its own motion, may request an examination to determine the defendant's | |
26 | competency. | |
27 | (d) Examination of defendant. | |
28 | (1) If the court finds that the request for examination is justified, the court shall order an | |
29 | examination of the defendant. The scope of the examination shall be limited to the question of | |
30 | whether the defendant is competent. | |
31 | (2) The examination shall take place on an outpatient basis if the defendant is to be released | |
32 | on bail or recognizance. If the defendant is ordered confined at the adult correctional institutions, | |
33 | the examination shall take place at that facility. The department shall appoint or designate the | |
34 | physician(s) who will conduct the examinations. | |
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1 | (3) If the defendant is ordered confined to the adult correctional institutions, the physician | |
2 | shall complete the examination within five (5) days. If the physician determines that the defendant | |
3 | is incompetent to stand trial, the defendant shall be immediately transferred for admission to the | |
4 | institute of mental health's forensic unit Rhode Island State Psychiatric Hospital or the Eleanor | |
5 | Slater Hospital, pending the hearing provided for in subsection (g). At the discretion of the director, | |
6 | pending the hearing provided for in subsection (g), the defendant may be discharged from one state- | |
7 | operated hospital for the purpose of contemporaneously admitting the defendant to the other state- | |
8 | operated hospital pursuant to the procedures enumerated in§ 40.1-5.3-2. | |
9 | (e) Bail or recognizance during examination. | |
10 | (1) A defendant for whom a competency examination has been ordered shall be entitled to | |
11 | release on bail or recognizance to the same extent and on the same terms and conditions as if the | |
12 | issue of competency had not been raised. | |
13 | (2) The court may order the defendant to appear at a designated time and place for | |
14 | outpatient examination, and such an appearance may be made a condition of pretrial release. | |
15 | (f) Reports of examining physicians. Each examining physician shall prepare a report, in | |
16 | writing, in which he or she shall state his or her findings concerning the defendant's competency, | |
17 | together with the medical and other data upon which his or her findings are based. The report shall | |
18 | be filed with the court within ten (10) business days if the defendant was ordered confined at the | |
19 | adult correctional institutions, and as soon as practicable if the defendant was released on bail or | |
20 | recognizance, and copies given to the attorney for the state and to the defendant or his or her | |
21 | counsel. | |
22 | (g) Hearing. Upon receipt of the report and appropriate notice to the parties, the court shall | |
23 | hold a hearing unless the report concludes that the defendant is competent and the defendant and | |
24 | the attorney for the state in open court state their assent to the findings on the record. At the hearing, | |
25 | the report shall be introduced, other evidence bearing on the defendant's competence may be | |
26 | introduced by the parties, and the defendant may testify, confront witnesses, and present evidence | |
27 | on the issue of his or her competency. On the basis of the evidence introduced at the hearing, the | |
28 | court shall decide if the defendant is competent. | |
29 | (h) Commitment of the defendant. | |
30 | (1) If the court finds, after the hearing, that a defendant is competent, it shall proceed with | |
31 | the criminal case. | |
32 | (2) If the court finds that a defendant is incompetent, it shall commit him or her to the | |
33 | custody of the director for the purpose of determining whether or not the defendant is likely to | |
34 | imperil the peace and safety of the people of the state or the safety of himself or herself and whether | |
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1 | the defendant will regain competency within the maximum period of any placement under this | |
2 | chapter. | |
3 | (3) Not later than fifteen (15) days from the date of the order of commitment, the director | |
4 | shall prepare and file with the court a written report in which he or she shall state his or her opinion | |
5 | regarding the defendant's dangerousness; the likelihood of the defendant becoming competent to | |
6 | stand trial within the maximum period of any placement order; and the recommendations of the | |
7 | department regarding appropriate care and treatment of the defendant. | |
8 | (4) In the event the director is unable to complete the examination of the person in time to | |
9 | render his or her report within the fifteen-day (15) period, he or she shall report that fact, in writing, | |
10 | to the court with a statement of the reasons why the examination and report could not be completed | |
11 | within the prescribed period. A copy of the director's statement shall be given to the attorney general | |
12 | and to the defendant, or his or her counsel, any of whom may respond in writing, or if the court | |
13 | deems it appropriate, orally, to the director's statement. The court may thereupon enter an order | |
14 | extending for an additional twenty (20) days the time in which the director is to file his or her report. | |
15 | (i) Hearing. | |
16 | (1) Upon receipt of the report and appropriate notice to the director, the attorney general, | |
17 | and the defendant, or his or her counsel, the court shall hold a hearing at which the report shall be | |
18 | introduced, other evidence bearing on the question of the mental condition of the person may be | |
19 | introduced by the parties, and the person may testify, confront witnesses, and present evidence. | |
20 | (2) If the court finds that a defendant who is incompetent may be placed on outpatient status | |
21 | without imperiling the peace or safety of the public or the safety of himself or herself, it may | |
22 | commit the defendant to an appropriate outpatient facility that agrees to provide treatment to the | |
23 | defendant and to adhere to the requirements of this section, in order that the defendant may receive | |
24 | treatment to restore or establish his or her competency. | |
25 | (3) If the court finds that a defendant who is incompetent is likely to imperil the peace or | |
26 | safety of the people of the state or the peace and safety of himself or herself, it may order the | |
27 | defendant to the facility established Rhode Island State Psychiatric Hospital or the Eleanor Slater | |
28 | Hospital, pursuant to § 40.1-5.3-1 or to the general wards of the institute of mental health, if the | |
29 | director agrees that the defendant should be placed on the general wards. A person who is ordered | |
30 | to be treated on inpatient status shall not be paroled, furloughed, placed on outpatient status or | |
31 | removed from a locked facility, or otherwise released from the institution where he or she is being | |
32 | treated except upon petition to the court by the director, on notice to the attorney general and the | |
33 | defendant, or his or her counsel, and after hearing thereon and entry of an order by a judge of the | |
34 | court authorizing release. The commitment ordered pursuant to this section shall terminate upon | |
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1 | the occurrence of any of the following: | |
2 | (i) The defendant is determined by the court to be competent; or | |
3 | (ii) The charges against the defendant are dismissed pursuant to subsection (j); or | |
4 | (iii) The charges against the defendant are dismissed or a nolle prosequi is entered; or | |
5 | (iv) The defendant is civilly committed pursuant to § 40.1-5-8; or | |
6 | (v) The court finds there is no reasonable likelihood that in the foreseeable future the | |
7 | defendant will become competent and his or her condition is such that he or she cannot properly be | |
8 | committed under § 40.1-5-8. | |
9 | (j) Period of commitment. When a court commits a defendant pursuant to subsection (i)(2) | |
10 | or (i)(3), it shall compute, counting from the date of entry to the order of commitment, the date of | |
11 | the expiration of the period of time equal to two thirds (⅔) of the maximum term of imprisonment | |
12 | for the most serious offense with which the defendant is charged. If the maximum term for the most | |
13 | serious offense charged is life imprisonment or death, the court shall, for the purpose of | |
14 | computation, deem the offense to be punishable by a maximum term of thirty (30) years. In the | |
15 | order of commitment, the court shall provide that if, on the date so computed, the defendant is still | |
16 | committed under the order, the charges against him or her shall be dismissed. | |
17 | (k) Periodic review. The director shall petition the court to review the state of competency | |
18 | of a defendant committed pursuant to subsection (i)(2) or (i)(3) not later than six (6) months from | |
19 | the date of the order of commitment and every six (6) months thereafter, or when the director | |
20 | believes the defendant is no longer incompetent, whichever occurs first. Outpatient facilities that | |
21 | are providing treatment to defendants in accordance with subsection (i)(2) shall prepare reports to | |
22 | be submitted to the director in accordance with the requirements of this section. The director shall | |
23 | attach to the petition a report on the condition of the defendant. If the report indicates that the | |
24 | defendant remains incompetent, it shall include a prognosis regarding the likelihood that he or she | |
25 | will become competent prior to the dismissal of the charges pursuant to subsection (j). Copies of | |
26 | the report shall be given to the attorney for the state and to the defendant or his or her counsel. | |
27 | (l) Defendant's right to petition. A defendant committed pursuant to subsection (i)(2) or | |
28 | (i)(3) may at any time petition the court to review the state of his or her competency. | |
29 | (m) Hearing on petition. Upon receipt of a petition pursuant to subsection (k) or (l) and | |
30 | appropriate notice to the defendant, the state, and the director, the court shall hold a hearing at | |
31 | which the parties may introduce evidence as to the defendant's competency, including any reports | |
32 | of the director, and the defendant may testify, confront witnesses, and present evidence as to his or | |
33 | her competency and prognosis. On the basis of the evidence, the court shall make a finding as to | |
34 | the defendant's competency and, if he or she is found to be incompetent, whether a reasonable | |
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1 | likelihood exists that he or she will become competent prior to the dismissal of the charges pursuant | |
2 | to subsection (j). If the court finds that the defendant is competent, it shall enter an order to that | |
3 | effect. If the court finds that the defendant is incompetent and that a reasonable likelihood exists | |
4 | that he or she will become competent prior to the dismissal of the charges pursuant to subsection | |
5 | (j), it shall order continuation of the commitment of the defendant. If the court finds that the | |
6 | defendant is incompetent and that a reasonable likelihood does not exist that he or she will become | |
7 | competent prior to the dismissal of the charges pursuant to subsection (j), it shall order that thirty | |
8 | (30) days thereafter the defendant be discharged from detention under the order of commitment. | |
9 | Upon entry of the order, the state may commence proceedings seeking to commit the defendant | |
10 | pursuant to § 40.1-5-8. | |
11 | (n) Statements inadmissible. No statements made by a defendant in the course of an | |
12 | examination conducted pursuant to subsection (d) or during a hearing conducted pursuant to | |
13 | subsection (i) or (m) shall be admissible in evidence against the defendant in any criminal action | |
14 | on any issue other than his or her mental condition. The statements shall be admissible on the issue | |
15 | of his or her mental condition even though they might otherwise be deemed to be privileged | |
16 | communications. | |
17 | (o) Disposition of charges. The court may, at any time, proceed to a disposition of the | |
18 | charges pending against a defendant who has been committed pursuant to subsection (i)(2) or (i)(3) | |
19 | if the factual and legal issues involved can be resolved without regard to the competency of the | |
20 | defendant. | |
21 | SECTION 9. Sections 42-12.1-4 and 42-12.1-9 of the General Laws in Chapter 42-12.1 | |
22 | entitled "Department of Behavioral Healthcare, Developmental Disabilities and Hospitals" are | |
23 | hereby amended to read as follows: | |
24 | 42-12.1-4. Management of institutions. | |
25 | The department of behavioral healthcare, developmental disabilities and hospitals shall | |
26 | have the management, supervision, and control of both the Eleanor Slater Hospital and the Rhode | |
27 | Island State Psychiatric Hospital, and such other functions as have been or may be assigned. The | |
28 | director of the department may delegate to another employee of the department any functions | |
29 | related to the separate management, supervision and control of the state-operated hospitals. The | |
30 | department also shall operate, maintain, and repair the buildings, grounds, and other physical | |
31 | property at those institutions, other than the roads and driveways, which shall be under the care and | |
32 | supervision of the department of transportation. | |
33 | 42-12.1-9. The Eleanor Slater Hospital. | |
34 | The facilities known as the general hospital, the institution of mental health and the Dr. U. | |
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1 | E. Zambarano within the state of Rhode Island shall hereafter be named the "Eleanor Slater | |
2 | Hospital." The hospital known as the Eleanor Slater Hospital shall consist of facilities in Cranston | |
3 | and/or Burrillville, or any units of such facilities, as licensed by the department of health. | |
4 | SECTION 10. Chapter 42-12.1 of the General Laws entitled "Department of Behavioral | |
5 | Healthcare, Developmental Disabilities and Hospitals" is hereby amended by adding thereto the | |
6 | following section: | |
7 | 42-12.1-10. The Rhode Island State Psychiatric Hospital. | |
8 | (a) A new hospital is hereby established to furnish care to any adult patient in Rhode Island | |
9 | requiring inpatient psychiatric care, and who meets at least one of the following criteria: | |
10 | (1) The individual has been determined to require specialized mental health care and | |
11 | psychiatric inpatient services that cannot be provided in a correctional facility as defined in § 40.1- | |
12 | 5.3-7: | |
13 | (2) The individual has been ordered to inpatient care by a court of competent jurisdiction | |
14 | for the purpose of competency evaluation, competency restoration, if indicated, and treatment; | |
15 | (3) The individual has been ordered to the forensic unit after a finding of not guilty by | |
16 | reason of insanity until such time, subject to a determination of the director or his/her designee, the | |
17 | individual may be safely managed in a civil unit of Eleanor Slater Hospital; | |
18 | (4) The individual has been transferred to the Rhode Island State Psychiatric Hospital from | |
19 | the department of corrections when specialized services are required that are better provided in a | |
20 | hospital setting and are provided until such time. in the discretion of the director, the patient's | |
21 | condition has improved to the point at which the patient may be returned to the adult correctional | |
22 | institutions and to receive sufficient treatment, as approved by a judge of the district court or a | |
23 | justice of the superior court pursuant the applicable procedures and requirements of sections 6, 7, | |
24 | 8, 9 and/or 9.1 of chapter 5.3 of title 40.1. | |
25 | (b) The new hospital shall be named the Rhode Island State Psychiatric Hospital and shall | |
26 | consist of facilities, or any units of such facilities, on the grounds of the John O. Pastore Center in | |
27 | Cranston. Rhode Island, as licensed by the department of health. | |
28 | (c) The Rhode Island State Psychiatric Hospital shall be operated by the department of | |
29 | behavioral healthcare, developmental disabilities and hospitals and shall be licensed by the | |
30 | department of health pursuant to chapter 17 of title 23; however, the Rhode Island State Psychiatric | |
31 | Hospital shall be a separate licensed entity from the Eleanor Slater Hospital; and | |
32 | (d) The director of the department of behavioral healthcare, developmental disabilities and | |
33 | hospitals is authorized to take such actions as may be necessary or prudent to establish the Rhode | |
34 | Island State Psychiatric Hospital consistent with this chapter. | |
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1 | SECTION 11. This article shall take effect upon passage. | |
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