2023 -- H 5427

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LC001338

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS -- MENTAL HEALTH LAW

     Introduced By: Representatives Bennett, Casimiro, Noret, Caldwell, Serpa, Ackerman,
Casey, Speakman, Carson, and Hull

     Date Introduced: February 08, 2023

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 40.1-5-5, 40.1-5-7, 40.1-5-8, 40.1-5-9 and 40.1-5-10 of the General

Laws in Chapter 40.1-5 entitled "Mental Health Law" are hereby amended to read as follows:

     40.1-5-5. Admission of patients generally — Rights of patients — Patients’ records —

Competence of patients.

     (a) Admissions. Any person who is in need of care and treatment in a facility, as herein

defined, may be admitted or certified, received, and retained as a patient in a facility by complying

with any one of the following admission procedures applicable to the case:

     (1) Voluntary admission.

     (2) Emergency certification.

     (3) Civil court certification.

     (b) Forms. The director shall prescribe and furnish forms for use in admissions and patient

notification procedures under this chapter.

     (c) Exclusions. No person with a psychiatric disability, or person under the influence of

alcohol or drugs shall be certified to a facility, as herein defined, solely by reason of that condition,

unless the person also qualified for admission or certification under the provisions of this chapter.

     (d) Examining physician or licensed advanced practice registered nurse (APRN). For

purposes of certification, no examining physician or licensed advanced practice registered nurse

(APRN), certified in psychiatric/mental health shall be related by blood or marriage to the person

who is applying for the admission of another, or to the person who is the subject of the application;

nor shall he or she have any interest, contractually, testamentary, or otherwise (other than

reasonable and proper charges for professional services rendered), in or against the estate or assets

of the person who is the subject of the application; nor shall he or she be a manager, trustee, visitor,

proprietor, officer, stockholder, or have any pecuniary interest, directly or indirectly, or, except as

otherwise herein expressly provided, be a director, resident physician, or salaried physician,

licensed advanced practice registered nurse (APRN), certified in psychiatric/mental health, or

employee in any facility to which it is proposed to admit the person.

     (e) Certificates. Certificates, as required by this chapter, must provide a factual

description of the person’s behavior that indicates that the person concerned is psychiatrically

disabled, creates a likelihood of serious harm, and is in need of care and treatment in a facility as

defined in this chapter. They shall further set forth such other findings as may be required by the

particular certification procedure used. Certificates shall also show that an examination of the

person concerned was made within five (5) days prior to the date of admission or certification,

unless otherwise herein provided. The date of the certificate shall be the date of the commencement

of the examination, and in the event examinations are conducted separately or over a period of

days, then the five-day (5) period above referred to (unless otherwise expressly provided) shall be

measured from the date of the commencement of the first examination. All certificates shall contain

the observations upon which judgments are based, and shall contain other information as the

director may by rule or regulation require.

     (f) Rights of patients. No patient admitted or certified to any facility under any provision

of this chapter shall be deprived of any constitutional, civil, or legal right, solely by reason of such

admission or certification nor shall the certification or admission modify or vary any constitutional

or civil right, including, but not limited to, the right or rights:

     (1) To privacy and dignity;

     (2) To civil service or merit rating or ranking and appointment;

     (3) Relating to the granting, forfeiture or denial of a license, permit, privilege, or benefit

pursuant to any law;

     (4) To religious freedom;

     (5) To be visited privately at all reasonable times by his or her personal physician, attorney,

and clergyperson, and by other persons at all reasonable times unless the official in charge of the

facility determines either that a visit by any of the other persons or a particular visitation time would

not be in the best interests of the patient and he or she incorporates a statement for any denial of

visiting rights in the individualized treatment record of the patient;

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     (6) To be provided with stationery, writing materials, and postage in reasonable amounts

and to have free unrestricted, unopened, and uncensored use of the mails for letters;

     (7) To wear one’s own clothes, keep and use personal possessions, including toilet articles;

to keep and be allowed to spend a reasonable sum of money for canteen expenses and small

purchases; to have access to individual storage space for the person’s private use; and reasonable

access to telephones to make and receive confidential calls; provided, however, that any of these

rights may be denied for good cause by the official in charge of a facility or a physician designated

by him or her. A statement of the reasons for any denial shall be entered in the individualized

treatment record of the patient;

     (8) To seek independent psychiatric examination and opinion from a psychiatrist or mental

health professional of the patient’s choice to include, but not limited to, a licensed advanced

practice registered nurse (APRN), certified in psychiatric/mental health;

     (9) To be employed at a gainful occupation insofar as the patient’s condition permits,

provided however, that no patient shall be required to perform labor;

     (10) To vote and participate in political activity;

     (11) To receive and read literature;

     (12) To have the least possible restraint imposed upon the person consistent with affording

him or her the care and treatment necessary and appropriate to the patient’s condition;

     (13) To have access to the mental health advocate upon request;

     (14) To prevent release of his or her name to the advocate or next of kin by signing a form

provided to all patients for that purpose at the time of admission.

     (g) Records. A facility shall maintain for each patient admitted pursuant to this chapter, a

comprehensive medical record. The record shall contain a recorded, individualized treatment plan,

which shall at least monthly be reviewed by the physician of the facility who is chiefly responsible

for the patient’s care, notations of the reviews to be entered in the record. The records shall also

contain information indicating at the time of admission or certification what alternatives to

admission or certification are available to the patient; what alternatives have been investigated; and

why the investigated alternatives were not deemed suitable. The medical record shall further

contain other information as the director may by rule or regulation require.

     (h) Competence. A person shall not, solely by reason of the person’s admission or

certification to a facility for examination or care and treatment under the provisions of this chapter,

thereby be deemed incompetent to manage the person’s affairs; to contract; to hold or seek a

professional, occupational, or vehicle operator’s license; to make a will; or for any other purpose.

Neither shall any requirement be made, by rule, regulation, or otherwise, as a condition to

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admission and retention, that any person applying for admission shall have the legal capacity to

contract, it being sufficient for the purpose, that the person understand the nature and consequence

of making the application.

     40.1-5-7. Emergency certification.

     (a) Applicants.

     (1) Any physician who or licensed advanced practice registered nurse (APRN), certified in

psychiatric/mental health, 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 psychiatric 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 or licensed advanced practice registered nurse (APRN), certified

in psychiatric/mental health, is available and the medical director or physician 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 or licensed advanced practice registered

nurse (APRN), certified in psychiatric/mental health, is available, a qualified mental health

professional 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 psychiatric disability, may make the application for emergency certification to a

facility. Application shall in all cases be made to the facility that, 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 the person the care and treatment necessary and appropriate to the person’s

condition.

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

established pursuant to chapter 8.5 of this title, has reason to believe that either the Rhode Island

state psychiatric hospital or the Eleanor Slater hospital 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 either the Rhode Island state psychiatric hospital

or the Eleanor Slater hospital or may determine whether some other disposition should be made.

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

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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-day (5) period. It shall include a description of

the applicant’s credentials and the behavior that 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 psychiatric disability exists, and shall include, as well, any other relevant

information that may assist the admitting physician or licensed advanced practice registered nurse

(APRN), certified in psychiatric/mental health at the facility to which application is made. The

application shall state whether the facility, 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. 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

or licensed advanced practice registered nurse (APRN), certified in psychiatric/mental health. 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, or licensed advanced

practice registered nurse (APRN), certified in psychiatric/mental health, under the psychiatrist’s

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, the patient 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 psychiatric disability, the psychiatrist shall confirm the admission for care and

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

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

and treatment necessary and appropriate to the person’s condition and that no suitable alternatives

to certification are available. If at any time the official in charge of a facility, or the official’s

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

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

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

available, the official 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 that 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 immediately transport the person

to the designated facility 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 the person’s continued unsupervised presence in the community would

create an imminent likelihood of serious harm by reason of psychiatric disability, and the reasons

why an order directing a peace officer to transport the person to a designated facility is 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 the person, 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

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.

     40.1-5-8. Civil court certification.

     (a) Petitions. A verified petition may be filed in the district court, or family court in the

case of a person who has not reached his or her eighteenth (18th) birthday, for the certification to a

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facility of any person who is alleged to be in need of care and treatment in a facility, and whose

continued unsupervised presence in the community would create a likelihood of serious harm by

reason of psychiatric disability. The petition may be filed by any person with whom the subject of

the petition may reside; or at whose house the person may be; or the father or mother, husband or

wife, brother or sister, or the adult child of the person; the nearest relative if none of the above are

available; or the person’s guardian; or the attorney general; or a local director of public welfare; or

the director of the department of behavioral healthcare, developmental disabilities and hospitals;

the director of the department of human services; or the director of the department of corrections;

the director of the department of health; the warden of the adult correctional institutions; the

superintendent of the boys training school for youth, or his or her designated agent; or the director

of any facility, or the facility director’s designated agent, whether or not the person shall have been

admitted and is a patient at the time of the petition. A petition under this section shall be filed only

after the petitioner has investigated what alternatives to certification are available and determined

why the alternatives are not deemed suitable.

     (b) Contents of petition. The petition shall state that it is based upon a personal

observation of the person concerned by the petitioner within a ten-day (10) period prior to filing. It

shall include a description of the behavior that constitutes the basis for the petitioner’s judgment

that the person concerned is in need of care and treatment and that a likelihood of serious harm by

reason of psychiatric disability exists. In addition, the petitioner shall indicate what alternatives to

certification are available; what alternatives have been investigated; and why the investigated

alternatives are not deemed suitable.

     (c) Certificates and contents thereof. A petition hereunder shall be accompanied by the

two (2) certificates of two (2) by either a physicians physician(s)and/or licensed advanced practice

registered nurses (APRN), certified in psychiatric/mental health unless the petitioner is unable to

afford, or is otherwise unable to obtain, the services of a physician or physicians or a licensed

advanced practice registered nurse (APRN), certified in psychiatric/mental health qualified to make

the certifications. The certificates shall be rendered pursuant to the provisions of § 40.1-5-5, except

when the patient is a resident in a facility, the attending physician and one other physician or

licensed advanced practice registered nurse (APRN), certified in psychiatric/mental health from the

facility may sign the certificates, and shall set forth that the prospective patient is in need of care

and treatment in a facility and would likely benefit therefrom, and is one whose continued

unsupervised presence in the community would create a likelihood of serious harm by reason of

psychiatric disability together with the reasons therefor. The petitions and accompanying

certificates shall be executed under penalty of perjury, but shall not require the signature of a notary

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public thereon.

     (d) Preliminary hearing.

     (1) Upon a determination that the petition sets forth facts constituting reasonable grounds

to support certification, the court shall summon the person to appear before the court at a

preliminary hearing, scheduled no later than five (5) business days from the date of filing. This

hearing shall be treated as a priority on the court calendar and may be continued only for good

cause shown. In default of an appearance, the court may issue a warrant directing a police officer

to bring the person before the court.

     (2) At the preliminary hearing, the court shall serve a copy of the petition upon the person

and advise the person of the nature of the proceedings and of the person’s right to counsel. If the

person is unable to afford counsel, the court forthwith shall appoint the mental health advocate for

him or her. If the court finds that there is no probable cause to support certification, the petition

shall be dismissed, and the person shall be discharged unless the person applies for voluntary

admission. However, if the court is satisfied by the testimony that there is probable cause to support

certification, a final hearing shall be held not less than seven (7) days, nor more than twenty-one

(21) days, after the preliminary hearing, unless continued at the request of counsel for the person,

and notice of the date set down for the hearing shall be served on the person. Copies of the petition

and notice of the date set down for the hearing shall also be served immediately upon the person’s

nearest relatives or legal guardian, if known, and to any other person designated by the patient, in

writing, to receive copies of notices. The preliminary hearing can be waived by a motion of the

patient to the court if the patient is a resident of a facility.

     (e) Petition for examination.

     (1) Upon motion of either the petitioner or the person, or upon its own motion, the court

may order that the person be examined by a psychiatrist or licensed advanced practice registered

nurse (APRN), certified in psychiatric/mental health, appointed by the court. The examination may

be conducted on an outpatient basis and the person shall have the right to the presence of counsel

while it is being conducted. A report of the examination shall be furnished to the court, the

petitioner, and the person and his or her counsel at least forty-eight (48) hours prior to the hearing.

     (2) If the petition is submitted without two (2) physicians’ certificates as required under

subsection (c), the petition shall be accompanied by a motion for a psychiatric examination to be

ordered by the court. The motion shall be heard on the date of the preliminary hearing set by the

court pursuant to subsection (d), or as soon thereafter as counsel for the subject person is engaged,

appointed, and ready to proceed. The motion shall be verified or accompanied by affidavits and

shall set forth facts demonstrating the efforts made to secure examination and certification by a

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physician or physicians, or licensed advanced practice registered nurse (APRN), certified in

psychiatric/mental health, and shall indicate the reasons why the efforts failed.

     (3) After considering the motion and testimony as may be offered on the date of hearing

the motion, the court may deny the application and dismiss the petition, or upon finding: (i) That

there is a good cause for the failure to obtain one or more physician’s or licensed advanced practice

registered nurse (APRN), certified in psychiatric/mental health certificates in accordance with

subsection (c); and (ii) That there is probable cause to substantiate the allegations of the petition,

the court shall order an immediate examination by two (2) qualified psychiatrists or licensed

advanced practice registered nurses (APRN), certified in psychiatric/mental health, pursuant to

subsection (e)(1).

     (f) Professional assistance. A person with respect to whom a court hearing has been

ordered under this section shall have, and be informed of, a right to employ a mental health

professional of the person’s choice to assist the person in connection with the hearing and to testify

on the person’s behalf. If the person cannot afford to engage such a professional, the court shall,

on application, allow a reasonable fee for the purpose.

     (g) Procedure. Upon receipt of the required certificates and/or psychiatric reports as

applicable hereunder, the court shall schedule the petition for final hearing unless, upon review of

the reports and certificates, the court concludes that the certificates and reports do not indicate, with

supporting reasons, that the person who is the subject of the petition is in need of care and treatment;

that his or her unsupervised presence in the community would create a likelihood of serious harm

by reason of psychiatric disability; and that all alternatives to certification have been investigated

and are unsuitable, in which event the court may dismiss the petition.

     (h) Venue. An application for certification under this section shall be made to, and all

proceedings pursuant thereto shall be conducted in, the district court, or family court in the case of

a person who has not yet reached his or her eighteenth (18th) birthday, of the division or county in

which the subject of an application may reside or may be, or when the person is already a patient

in a facility, in the district court or family court of the division or county in which the facility is

located, subject, however, to application by any interested party for change of venue because of

inconvenience of the parties or witnesses or the condition of the subject of the petition or other

valid judicial reason for the change of venue.

     (i) Hearing. A hearing scheduled under this section shall be conducted pursuant to the

following requirements:

     (1) All evidence shall be presented according to the usual rules of evidence that apply in

civil, non-jury cases. The subject of the proceedings shall have the right to present evidence in his

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or her own behalf and to cross examine all witnesses against him or her, including any physician

or licensed advanced practice registered nurse (APRN), certified in psychiatric/mental health who

has completed a certificate or filed a report as provided hereunder. The subject of the proceedings

shall have the further right to subpoena witnesses and documents, the cost of such to be borne by

the court where the court finds upon an application of the subject that the person cannot afford to

pay for the cost of subpoenaing witnesses and documents.

     (2) A verbatim transcript or electronic recording shall be made of the hearing that shall be

impounded and obtained or examined only with the consent of the subject thereof (or in the case of

a person who has not yet attained his or her eighteenth (18th) birthday, the person’s parent,

guardian, or next of kin) or by order of the court.

     (3) The hearing may be held at a location other than a court, including any facility where

the subject may currently be a patient, where it appears to the court that holding the hearing at

another location would be in the best interests of the subject thereof.

     (4) The burden of proceeding and the burden of proof in a hearing held pursuant to this

section shall be upon the petitioner. The petitioner has the burden of demonstrating that the subject

of the hearing is in need of care and treatment in a facility; is one whose continued unsupervised

presence in the community would create a likelihood of serious harm by reason of psychiatric

disability; and what alternatives to certification are available, what alternatives to certification were

investigated, and why these alternatives were not deemed suitable.

     (5) The court shall render a decision within forty-eight (48) hours after the hearing is

concluded.

     (j) Order. If the court at a final hearing finds by clear and convincing evidence that the

subject of the hearing is in need of care and treatment in a facility, and is one whose continued

unsupervised presence in the community would, by reason of psychiatric disability, create a

likelihood of serious harm, and that all alternatives to certification have been investigated and

deemed unsuitable, it shall issue an order committing the person to the custody of the director for

care and treatment or to an appropriate facility. In either event, and to the extent practicable, the

person shall be cared for in a facility that imposes the least restraint upon the liberty of the person

consistent with affording the person the care and treatment necessary and appropriate to the

person’s condition. No certification shall be made under this section unless and until full

consideration has been given by the certifying court to the alternatives to in-patient care, including,

but not limited to, a determination of the person’s relationship to the community and to the person’s

family; of his or her employment possibilities; and of all available community resources, alternate

available living arrangements, foster care, community residential facilities, nursing homes, and

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other convalescent facilities. A certificate ordered pursuant to this section shall be valid for a period

of six (6) months from the date of the order. At the end of that period the patient shall be discharged,

unless the patient is discharged prior to that time, in which case the certification shall expire on the

date of the discharge.

     (k) Appeals.

     (1) A person certified under this section shall have a right to appeal from a final hearing to

the supreme court of the state within thirty (30) days of the entry of an order of certification. The

person shall have the right to be represented on appeal by counsel of his or her choice or by the

mental health advocate if the supreme court finds that the person cannot afford to retain counsel.

Upon a showing of indigency, the supreme court shall permit an appeal to proceed without payment

of costs, and a copy of the transcript of the proceedings below shall be furnished to the subject of

the proceedings, or to the person’s attorney, at the expense of the state. The certifying court shall

advise the person of all the person’s rights pursuant to this section immediately upon the entry of

an order of certification.

     (2) Appeals under this section shall be given precedence, insofar as practicable, on the

supreme court dockets. The district and family courts shall promulgate rules with the approval of

the supreme court to insure the expeditious transmission of the record and transcript in all appeals

pursuant to this chapter.

     (l) Submission to NICS database.

     (1) The district court shall submit the name, date of birth, gender, race or ethnicity, and

date of civil commitment to the National Instant Criminal Background Check System (NICS)

database of all persons subject to a civil court certification order pursuant to this section within

forty-eight (48) hours of certification.

     (2) Any person affected by the provisions of this section, after the lapse of a period of three

(3) years from the date such civil certification is terminated, shall have the right to appear before

the relief from disqualifiers board.

     (3) Upon notice of a successful appeal pursuant to subsection (k), the district court shall,

as soon as practicable, cause the appellant’s record to be updated, corrected, modified, or removed

from any database maintained and made available to the NICS and reflect that the appellant is no

longer subject to a firearms prohibition as it relates to 18 U.S.C. § 922(d)(4) and 18 U.S.C. §

922(g)(4).

     (m) Equitable authority. In addition to the powers heretofore exercised, the district and

family courts are hereby empowered, in furtherance of their jurisdiction under this chapter, to grant

petitions for instructions for the provision or withholding of treatment as justice and equity may

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require.

     40.1-5-9. Right to treatment — Treatment plan.

     (a) Any person who is a patient in a facility pursuant to this chapter shall have a right to

receive the care and treatment that is necessary for and appropriate to the condition for which he or

she was admitted or certified and from which he or she can reasonably be expected to benefit. Each

patient shall have an individualized treatment plan. This plan shall be developed by appropriate

mental health professionals, including a psychiatrist, or licensed advanced practice registered nurse

(APRN), certified in psychiatric/mental health, and implemented as soon as possible — in any

event no later than five (5) days after a patient’s voluntary admission or involuntary court

certification. Each individual treatment plan shall be made in accordance with the professional

regulations of each facility, and by way of illustration and, not limited to the following, shall

contain:

     (1) A statement of the nature of the specific problems and specific needs of the patient;

     (2) A statement of the least restrictive treatment conditions necessary to achieve the

purposes of certification or admission;

     (3) A description of intermediate and long-range treatment goals; and

     (4) A statement and rationale for the plan of treatment for achieving these intermediate and

long-range goals.

     (b) The individualized treatment plan shall become part of the patient’s record in

accordance with § 40.1-5-5(g), and the subject of periodic review in accordance with § 40.1-5-10.

In implementing a treatment plan on behalf of any patient, the official in charge of any facility, or

his or her designee(s), may, when it is warranted, authorize the release of the patient for such

periods of time and under such terms and conditions that he or she deems appropriate.

     40.1-5-10. Periodic institutional review proceedings.

     (a) In general. Each patient admitted or certified to a facility pursuant to the provisions of

this chapter shall be the subject of a periodic review of his or her condition and status to be

conducted by a review committee composed of at least one psychiatrist or licensed advanced

practice registered nurse (APRN), certified in psychiatric/mental health and other mental health

professionals involved in treating the patient. The committee shall be composed of no fewer than

three (3) persons and shall be appointed by the director of the facility or his or her designated agent.

The reviews shall minimally involve an evaluation of the quality of care the patient is receiving,

including an evaluation of the patient’s treatment plan, and the making of any recommendations

for the improvement of the care or for the revision of the treatment plan, including alternative

available living arrangements, foster care, community residential facilities, nursing homes, and

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other convalescent facilities. At every fourth review, one member of the committee shall be a

member of the hospital’s utilization review committee appointed by that committee’s chairperson.

     (b) Frequency. The review proceedings shall take place at least once within each ninety-

day (90) period during which a person is a patient in the facility.

     (c) Results of review. The results of each review shall be entered in the patient’s medical

record, presented orally to the patient within twenty-four (24) hours, and confirmed by written

notice to the patient and his or her guardian, or with the patient’s consent, to his or her next of kin,

within seventy-two (72) hours. In the event the director of the facility is not a member of the

committee, the notice shall be transmitted to him or her as well. Where the committee determines

that further care in the facility is required, the notice to the patient shall include an explanation of

the patient’s rights to pursue discharge as elsewhere provided in this chapter.

     SECTION 2. 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

***

     This act would include licensed advanced practice registered nurses (APRN), certified in

psychiatric/mental health, as qualified to certify the need for mental health treatment in certain

patients.

     This act would take effect upon passage.

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