Chapter 428
2017 -- H 5945 SUBSTITUTE A
Enacted 10/05/2017

A N   A C T
RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS - MENTAL HEALTH LAW

Introduced By: Representatives Ruggiero, Almeida, McKiernan, Canario, and Jacquard
Date Introduced: March 17, 2017

It is enacted by the General Assembly as follows:
     SECTION 1. Section 40.1-5-7 of the General Laws in Chapter 40.1-5 entitled "Mental
Health Law" is hereby amended to read as follows:
     40.1-5-7. Emergency certification.
     (a) Applicants. (1) Any physician, who, after examining a person, has reason to believe
that the person is in need of immediate care and treatment, and is one whose continued
unsupervised presence in the community would create an imminent likelihood of serious harm by
reason of mental disability, may apply at a facility for the emergency certification of the person
thereto. The medical director, or any other physician employed by the proposed facility for
certification, may apply under this subsection if no other physician is available and he or she
certifies this fact. If an examination is not possible because of the emergency nature of the case
and because of the refusal of the person to consent to the examination, the applicant on the basis
of his or her observation may determine, in accordance with the above, that emergency
certification is necessary and may apply therefor. In the event that no physician is available, a
qualified mental health professional or police officer who believes the person to be in need of
immediate care and treatment, and one whose continued unsupervised presence in the community
would create an imminent likelihood of serious harm by reason of mental disability, may make
the application for emergency certification to a facility. Application shall in all cases be made to
the facility which 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 him or her the care and
treatment necessary and appropriate to his or her condition.
     (2) Whenever an applicant, not employed by a community mental health center
established pursuant to chapter 8.5 of this title, has reason to believe that the institute of mental
health is the appropriate facility for the person, the application shall be directed to the community
mental health center that serves the area in which the person resides, if the person is a Rhode
Island resident, or the area in which the person is physically present, if a nonresident, and the
qualified mental health professional(s) at the center shall make the final decision on the
application to the institute of mental health or may determine whether some other disposition
should be made.
     (b) Applications. An application for certification hereunder shall be in writing and filed
with the facility to which admission is sought. The application shall be executed within five (5)
days prior to the date of filing and shall state that it is based upon a personal observation of the
prospective patient by the applicant within the five-(5) day (5) period. It shall include a
description of the applicant's credentials and the behavior which 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 mental disability exists, and shall include, as well, any
other relevant information which that may assist the admitting physician at the facility to which
application is made. Whenever practicable, prior to transporting or arranging for the transporting
of a prospective patient to a facility, the applicant shall telephone or otherwise communicate with
the facility to describe the circumstances and known clinical history to determine whether it is the
proper facility to receive the person, and to give notice of any restraint to be used or to determine
whether restraint is necessary.
     (c) Confirmation; discharge; transfer. Within one hour after reception at a facility, the
person regarding whom an application has been filed under this section shall be seen by a
physician. As soon as possible, but in no event later than twenty-four (24) hours after reception, a
preliminary examination and evaluation of the person by a psychiatrist or a physician under his or
her supervision shall begin. The psychiatrist shall not be an applicant hereunder. The preliminary
examination and evaluation shall be completed within seventy-two (72) hours from its inception
by the psychiatrist. If the psychiatrist determines that the patient is not a candidate for emergency
certification, he or she shall be discharged. If the psychiatrist(s) determines that the person who is
the subject of the application is in need of immediate care and treatment and is one whose
continued unsupervised presence in the community would create an imminent likelihood of
serious harm by reason of mental disability, he or she shall confirm the admission for care and
treatment under this section of the person to the facility, provided the facility is one which that
would impose the least restraint on the liberty of the person consistent with affording him or her
the care and treatment necessary and appropriate to his or her condition and that no suitable
alternatives to certification are available. If at any time the official in charge of a facility or his or
her designee determines that the person is not in need of immediate care and treatment, or is not
one whose continued unsupervised presence in the community would create an imminent
likelihood of serious harm by reason of mental disability, or suitable alternatives to certification
are available, he or she shall immediately discharge the person. In addition, the official may
arrange to transfer the person to an appropriate facility, if the facility to which he or she has been
certified is not one which 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 transport the person to the
facility designated, the person to be expeditiously presented for admission thereto.
     (e) Ex parte court order. An applicant under this section may present a petition to any
judge of the district court or any justice of the family court, in the case of a person who is the
subject of an application, who has not yet attained his or her eighteenth birthday, for a warrant
directed to any peace officer of the state or any governmental subdivision thereof to take into
custody the person who is the subject of the application and immediately transport the person to a
designated facility. The application shall set forth that the person who is to be certified is in need
of immediate care and treatment and his or her continued unsupervised presence in the
community would create an imminent likelihood of serious harm by reason of mental disability,
and the reasons why an order directing a peace officer to transport the person to a designated
facility if 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 he or she, or a parent, guardian, or next of kin, has been
informed, in writing, on a form provided by the department, by the official in charge of the
facility: (1) tThat he or she has a right to the voluntary admission; (2) tThat a person cannot be
certified until all available alternatives to certification have been investigated and determined to
be unsuitable; and (3) tThat 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.
     SECTION 2. Chapter 40.1-5 of the General Laws entitled "Mental Health Law" is hereby
amended by adding thereto the following section:
     40.1-5-7.1. Emergency transportation by police.
     (a) Any police officer may take an individual into protective custody and take or cause
such person to be taken to an emergency room of any hospital, by way of emergency vehicle, if
the officer has reason to believe that:
     (1) The individual is in need of immediate care and treatment, and is one whose
continued unsupervised presence in the community would create an imminent likelihood of
serious harm by reason of mental disability if allowed to be at liberty pending examination by a
licensed physician; or
     (2) The individual is in need of immediate assistance due to mental disability and
requests the assistance.
     (b) The officer making the determination to transport, will document the reason for the
decision in a police report and travel with the individual to the hospital to relay the reason for
transport to the attending medical staff.
     SECTION 3. This act shall take effect upon passage.
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LC002160/SUB A
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