Chapter 06-597

Chapter 597

2006 -- H 8071

Enacted 07/14/06

A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- DEPARTMENT OF CHILDREN, YOUTH AND FAMILIES

Introduced By: Representatives Costantino, and Naughton

Date Introduced: May 04, 2006

It is enacted by the General Assembly as follows:

SECTION 1. Section 40.1-5-6 of the General Laws in Chapter 40.1-5 entitled "Mental

Health Law" is hereby amended to read as follows:

40.1-5-6. Voluntary admission. [Effective until January 1, 2007.] -- (a) ~~(1)~~ General. -

Any individual of lawful age may apply for voluntary admission to any facility provided for by

this law seeking care and treatment for alleged mental disability. The application shall be in

writing, signed by the applicant in the presence of at least one witness, who shall attest to the

application by placing his or her name and address thereon. If the applicant has not yet attained

his or her eighteenth birthday, the application shall be signed by him or her and his or her parent,

guardian, or next of kin.

~~(2) Admission of children. - Any person who is under the age of eighteen (18) and who~~

~~receives medical benefits funded in whole or in part by either the department of children, youth~~

~~and families or by the department of human services may be admitted to any facility provided for~~

~~by this chapter seeking care and treatment for alleged mental disability only after an initial mental~~

~~health crisis intervention is completed by a provider that is licensed by the department of~~

~~children, youth and families for emergency services, has proper credentials and is contracted with~~

~~the RIte Care health plan or the state and said provider, after considering alternative services to~~

~~hospitalization with the child, family and other providers, requests prior authorization for the~~

~~admission from a representative of the child and family's insurance company or utilization review~~

~~organization representing the insurance company. If the inpatient hospital admits a child without~~

~~the crisis intervention and prior authorization from the insurance company or utilization review~~

~~organization, the hospital will be paid a rate equivalent to an Administratively Necessary Day~~

~~(AND) for each day that the insurance company or utilization review organization representing~~

~~the insurance company determines that the child did not meet the inpatient level of care criteria.~~

~~The state shall ensure that this provision is included in all publicly financed contracts and~~

~~agreements for behavioral health services. Activities conducted pursuant to this section shall be~~

~~exempt from the provisions of section 23-17.12, but shall be subject to the provisions of~~

~~subsection (b) of this section.~~

~~(3) The department of human services shall develop regulations for emergency~~

~~admissions, that would allow the admitting hospital to maintain their compliance with the~~

~~provisions of the act, while meeting the need of the child.~~

(b) Period of treatment. - If it is determined that the applicant is in need of care and

treatment for mental disability and no suitable alternatives to admission are available, he or she

shall be admitted for a period not to exceed thirty (30) days. Successive applications for

continued voluntary status may be made for successive periods not to exceed ninety (90) days

each, so long as care and treatment is deemed necessary and documented in accordance with the

requirements of this chapter, and no suitable alternatives to admission are available.

(1) A voluntary patient shall be discharged no later than the end of the business day

following of his or her presenting a written notice of his or her intent to leave the facility to the

medical official in charge or the medical official designated by him or her, unless that official or

another qualified person from the facility files an application for the patient's civil court

certification pursuant to section 40.1-5-8. The notice shall be on a form prescribed by the director

and made available to all patients at all times. If a decision to file an application for civil court

certification is made, the patient concerned and his or her legal guardian(s), if any, shall receive

immediately, but in no event later than twelve (12) hours from the making of the decision, notice

of the intention from the official in charge of the facility, or his or her designee, and the patient

may, in the discretion of the official, be detained for an additional period not to exceed two (2)

business days, pending the filing and setting down for hearing of the application under section

40.1-5-8.

(2) A voluntary patient who gives notice of his or her intention or desire to leave the

facility may at any time during the period of his or her hospitalization prior to any certification

pursuant to section 40.1-5-8, following the giving of the notice, submit a written communication

withdrawing the notice, whereby his or her voluntary status shall be considered to continue

unchanged until the expiration of thirty (30) or ninety (90) days as provided in subsection (b). In

the case of an individual under eighteen (18) years of age, the notice or withdrawal of notice may

be given by either of the persons who made the application for his or her admission, or by a

person of equal or closer relationship to the patient, who shall, as well, receive notice from the

official in charge indicating a decision to present an application for civil court certification. The

official may in his or her discretion refuse to discharge the patient upon notice given by any

person other than the person who made the application, and in the event of such a refusal the

person giving notice may apply to a justice of the family court for release of the patient.

(d) Examination at facility. - The medical official in charge of a facility shall ensure that

all voluntary patients receive preliminary physical and psychiatric examinations within twenty-

four (24) hours of admission. Furthermore, a complete psychiatric examination shall be

conducted to determine whether the person qualifies for care and treatment under the provisions

of this chapter. The examination shall begin within forty-eight (48) hours of admission and shall

be concluded as soon as practicable, but in no case shall extend beyond five (5) days. The

examination shall include an investigation with the prospective patient of (1) what alternatives for

admission are available and (2) why those alternatives are not suitable. The alternatives for

admission investigated and reasons for unsuitability, if any, shall be recorded on the patient's

record. If it is determined that the patient does not belong to the voluntary class in that a suitable

alternative to admission is available, or is otherwise ineligible for care and treatment, he or she

shall be discharged.

(e) Rights of voluntary patients. - A voluntary patient shall be informed in writing of his

or her status and rights as a voluntary patient immediately upon his or her admission, and again at

the time of his or her periodic review(s) as provided in section 40.1-5-10, including his or her

rights pursuant to section 40.1-5-5(f). Blank forms for purposes of indicating an intention or

desire to leave a facility shall be available at all times and on and in all wards and segments of a

facility wherein voluntary patients may reside.

SECTION 2. Section 40.1-5-6 of the General Laws in Chapter 40.1-5 entitled "Mental

Health Law" is hereby amended to read as follows:

40.1-5-6. Voluntary admission. [Effective January 1, 2007.] -- (a) (1) General. - Any

individual of lawful age may apply for voluntary admission to any facility provided for by this

law seeking care and treatment for alleged mental disability. The application shall be in writing,

signed by the applicant in the presence of at least one witness, who shall attest to the application

by placing his or her name and address thereon. If the applicant has not yet attained his or her

eighteenth birthday, the application shall be signed by him or her and his or her parent, guardian,

or next of kin.

(2) Admission of children. - Any person who is under the age of eighteen (18) and who

receives medical benefits funded in whole or in part by either the department of children, youth

and families or by the department of human services may be admitted to any facility provided for

by this chapter seeking care and treatment for alleged mental disability only after an initial mental

health crisis intervention is completed by a provider that is licensed by the department of

children, youth and families for emergency services, has proper credentials and is contracted with

the RIte Care health plan or the state and said provider, after considering alternative services to

hospitalization with the child, family and other providers, requests prior authorization for the

admission from a representative of the child and family's insurance company or utilization review

organization representing the insurance company. If the inpatient hospital admits a child without

the crisis intervention and prior authorization from the insurance company or utilization review

organization, the hospital will be paid a rate equivalent to an Administratively Necessary Day

(AND) for each day that the insurance company or utilization review organization representing

the insurance company determines that the child did not meet the inpatient level of care criteria.

The state shall ensure that this provision is included in all publicly financed contracts and

agreements for behavioral health services. Activities conducted pursuant to this section shall be

exempt from the provisions of section 23-17.12, but shall be subject to the provisions of

subsection (b) of this section.

(3) The department of human services shall develop regulations for emergency

admissions, that would allow the admitting hospital to maintain their compliance with the

provisions of the act, while meeting the need of the child.