2019 -- H 5167

========

LC000647

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

____________

A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS - MENTAL HEALTH LAW

     Introduced By: Representatives Bennett, Ucci, Hawkins, Millea, and Tanzi

     Date Introduced: January 23, 2019

     Referred To: House Health, Education & Welfare

     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 defective delinquent, mentally retarded person, 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 which indicates that the person concerned is mentally

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 (5) day 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 such

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,

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

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

LC000647 - Page 2 of 14

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;

     (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 his or her 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 his or her choice;

     (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 his or her 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 such other information as the director may by rule or regulation require.

     (h) Competence. A person shall not, solely by reason of his or her admission or

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

chapter thereby be deemed incompetent to manage his or her affairs, to contract, to hold, or seek a

LC000647 - Page 3 of 14

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

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

psychiatric/mental health, 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 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 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 mental 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 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

LC000647 - Page 4 of 14

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-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 mental 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.

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 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 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

LC000647 - Page 5 of 14

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

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 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) 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

LC000647 - Page 6 of 14

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

a 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 mental disability. The petition may be filed by any person with whom the subject of the

petition may reside; or at whose house he or she may be; or the father or mother, husband or wife,

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

available; or his or her 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 his or her 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 mental 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

certificates of two (2) physicians or licensed advanced practice registered nurse (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 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

mental disability together with the reasons therefor. The petitions and accompanying certificates

LC000647 - Page 7 of 14

shall be executed under penalty of perjury, but shall not require the signature of a notary 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 him or her of the nature of the proceedings and of his or her 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

LC000647 - Page 8 of 14

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 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 nurse (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 his or her choice to assist him or her in connection with the hearing and to testify

on his or her 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 mental 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:

LC000647 - Page 9 of 14

     (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

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, his or her 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

mental 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 mental 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 him or her the care and treatment necessary and appropriate to his or her

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 his or her family, of his

LC000647 - Page 10 of 14

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

living arrangements, foster care, community residential facilities, nursing homes, and 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 he or she 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 he or she 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 his or her attorney, at the expense of the state. The

certifying court shall advise the person of all his or her 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 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 National Instant Criminal Background

Check System (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

LC000647 - Page 11 of 14

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

may 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 they deem 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 which 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,

LC000647 - Page 12 of 14

including alternative available living arrangements, foster care, community residential facilities,

nursing homes, and 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

(90) day 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.

========

LC000647

========

LC000647 - Page 13 of 14

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.

========

LC000647

========

LC000647 - Page 14 of 14