S2760 Key Provisions and Issues
o Expands civil commitment to apply to treatment, including outpatient and inpatient. Determination of which would be “least restrictive” would be by a judge, based on the screening certificate within 72 hours and a hearing in 20 days, as currently applies to civil commitment.
o Treatment plan requirement. When the judge orders outpatient commitment, the designated outpatient program must develop a treatment plan to be approved by a judge. Family involvement is allowed but not required or expected.
o Uses existing standard for commitment. Adds language to strengthen a broader interpretation than currently applied by many screening centers, including in Mercer.
o “Single” standard was one of the minimum recommendations of the Task Force
o Language reinforces standard of danger “within the foreseeable future” (sometimes interpreted now as “imminent instead”); and use of the person’s history of treatment & illness course in assessing foreseeable danger)
o How many will be affected. Impact is unclear. Numbers could be very small if narrowly applies or much larger if broadly applied, particularly if used frequently for people discharged from state hospital as additional form of conditional release.
o Earlier Intervention. There was disagreement about the how wide are the circumstances in which earlier commitment would be allowed. John believed that it would be more broadly allowed. One of Jean’s concerns about the use of the same standard is that it will not affect people at an earlier point. My interpretation is that it would be allowed for individuals with a prior pattern of deterioration leading to commitment, which is being repeated in the present. I.e. if the course twice before was A>B>C>D>E>F, where F is great imminent danger, then commitment could be the option at D.
o Family
involvement. The bill does not include provisions for greater family
involvement. The Task Force and
o Medication. Administration of medication is included in involuntary outpatient treatment. However, if a person refuses medication, administering medication involuntarily would only be done on inpatient basis, in a STCF or state hospital.
o Decision to hospitalize. As written, the bill is still procedurally ambiguous. It allows a ten day period for a consumer to request a hearing on this, but it does not require a judicial review to approve the change from OP to hospital status. It also allows an outpatient provider to authorize admission independently. Jean believes that these elements would render it unconstitutional. All of us were in agreement that clearer procedural safeguards including judicial review were desirable, and that the evaluative role should be by the screening center, rather than the outpatient provider. With the exception of Jean, we did not see this provision bad enough to not support the bill.