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SPONSOR: |
Rep. Barbieri & Rep. Heffernan & Sen.
Hall-Long |
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HOUSE OF REPRESENTATIVES 147th GENERAL ASSEMBLY |
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HOUSE BILL NO. 346 |
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AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO THE COMMITMENT OF THE MENTALLY ILL. |
Section 1. Amend Chapter 50, Title 16 of the Delaware
Code by making deletions as shown by strike through and insertions as shown by
underline as follows and redesignating accordingly:
§ 5001 Definitions.
Except where the context indicates
otherwise, as used in this chapter:
(1)
"Credentialed mental health screener" means an individual who is:
a. A
psychiatrist; or
b. A
licensed mental health professional who is credentialed by the Department to
provide emergency screening services and evaluation of the need for involuntary
observation and treatment for a mental condition; or
c. An
unlicensed mental health professional who works under the direct supervision of
a psychiatrist and who is credentialed by the Department to provide emergency
screening services and evaluation of the need for involuntary observation and
treatment for a mental condition; or
d. A
physician with a valid State of Delaware license to practice medicine and who
is credentialed by the Department to provide emergency screening services and
evaluation of the need for involuntary observation and treatment for a mental
condition.
(1)(2)
"Court" means the Superior Court or the Family Court of the State,
both of which courts shall have jurisdiction and responsibility for the
implementation of this chapter
(3) "Dangerous to others"
means that by reason of mental condition there is a substantial likelihood that
the person will inflict serious bodily harm upon another person within the
immediate future. This determination shall take into account a person's
history, recent behavior and any recent act or threat.
(4) “Dangerous to self" means that
by reason of mental condition there is a substantial likelihood that the person
will imminently sustain serious bodily harm to oneself. This determination shall take into account a
person’s history, recent behavior, and any recent act or threat.
(5) "Department" means the
State of Delaware Department of Health and Social Services. “Department” shall
also mean the Department of Services to Children, Youth, and their Families for
individuals under the age of 18 or otherwise are in custody of the Department
of Services to Children, Youth, and their Families or receiving financial
assistance from the Department of Services to Children, Youth, and their
Families.
(6) "Designated psychiatric
treatment facilities" means all facilities designated by the Secretary to
provide psychiatric emergency care for individuals believed to have a mental
condition and whose behavior is believed to be dangerous to self or dangerous
to others; such facilities include psychiatric hospitals operated by the State
of Delaware, privately operated psychiatric hospitals, any psychiatric
emergency receiving facilities that provide mental health screenings,
evaluations, treatment, and referral services, or other facilities as may be
designated by the Department by regulation.
(2)(7) "Designated transport personnel'' means such personnel
as designated by the Secretary of the Department of Health and Social
Services to transport persons with mental conditions to and from the
hospital and public treatment facilities needed healthcare services
provided in hospitals and designated psychiatric treatment facilities, pursuant
to this Chapter; these personnel include peace officers, private ambulance
staff, state employees and contracted transportation staff as approved by the
Department. Any peace officer involved may mandate the manner and method of
transportation of persons who require such transport when required to ensure
public safety.
(3) "Him,'' "his'' and
all other terms used in the masculine gender shall also include and be equally
applicable to the corresponding terms used in the feminine gender.
(8) "Emergency detention" and
“emergently detained” means the process whereby an adult who appears to have a
mental condition, and whose mental condition causes the person to be dangerous
to self or dangerous to others, and who is unwilling to be admitted to a
facility voluntarily for assessment or care, is involuntarily detained for such
evaluation and treatment for 24 hours in a designated psychiatric facility
because other less restrictive, more community integrated services are not
appropriate or available to meet the person's current mental health care needs.
Emergency detention shall also mean the process whereby a minor who appears to
have a mental condition, and whose mental condition causes the person to be
dangerous to self or dangerous to others, and who is unwilling to be admitted
to a facility voluntarily for assessment or care, is involuntarily detained for
such evaluation and treatment for 24 hours unless the parent or legal guardian
is unavailable to the Department during that 24 hour period; in such instances
the time period may be extended to 72 hours.
(4)(9) "Hospital'' and "mental hospital'' means the
Delaware Psychiatric Center, and any hospital in this State which
is certified by the Secretary of the Department of Health and Social Services
as being an appropriate facility for the diagnosis, care and treatment of
persons with mental conditions 18 years of age or older. "Hospital'' and
"mental hospital'' shall also mean any hospital in this State which is
certified by the Secretary of the Department of Services for Children, Youth
and Their Families as being an appropriate facility for the diagnosis, care and
treatment of persons with mental conditions under 18 years of age.
(5)(10) "Involuntary patient'' means a person admitted involuntarily
to the custody of the hospital for observation, diagnosis, care and treatment. pursuant
to emergency detention, provisional admission, a probable cause hearing or an
involuntary inpatient commitment hearing to the custody of a designated
psychiatric treatment facility or hospital for observation, diagnosis, care and
treatment.
(11) “Juvenile mental health screener”
means a person authorized by the Department of Services for Children, Youth and
Their Families to assess individuals under the age of 18 for emergency
detention. Juvenile mental health
screeners shall have the same duties, authority, rights, and protections,
including the immunity provisions of this chapter, as “credentialed mental
health screeners” when the term “credentialed mental health screeners” is utilized
throughout this chapter. The Department
of Services for Children, Youth and Their Families is authorized to establish
regulations concerning the credentialing process and criteria for juvenile
mental health screeners.
(12) "Licensed independent
practitioner" means to employees of designated psychiatric treatment
facilities, in addition to psychiatrists, who hold credentials and privileges
to admit persons into care and write orders to treat said persons in that
facility. Licensed independent practitioners can include but are not limited to
staff that hold licenses as psychologists, advanced practices nurses, and
physician assistants or such other healthcare providers as may be designated to
work independently pursuant to the regulations of the Department.
(13) "Mental condition" means
a current, substantial disturbance of thought, mood, perception or orientation
which significantly impairs judgment, capacity to control behavior, or capacity
to recognize reality. Unless it results in the severity of impairment described
herein, "mental condition" does not mean simple alcohol intoxication,
transitory reaction to drug ingestion, dementia due to various nontraumatic
etiologies or other general medical conditions, Alzheimer's disease, or
intellectual disability. The term "mental condition" is not limited
to "psychosis" or "active psychosis," but shall include all
conditions that result in the severity of impairment described herein.
(6)(14) "Peace officer'' means any public officer authorized by
law to make arrests in a criminal case.
(7) "Person with a mental
condition'' means a person suffering from a mental disease or condition which requires
such person to be observed and treated at a mental hospital for the person's
own welfare and which both (i) renders such person unable to make responsible
decisions with respect to the person's hospitalization, and (ii) poses a real
and present threat, based upon manifest indications, that such person is likely
to commit or suffer serious harm to that person's own self or others or to
property if not given immediate hospital care and treatment.
(8) "Psychiatrist'' means:
a. A
physician licensed to practice medicine in this State specializing in the field
of psychiatry, or a physician employed by the Delaware Psychiatric Center,
registered with the Medical Council of Delaware and certified by the Delaware
Psychiatric Center Medical Director to the Medical Council of Delaware as being
qualified in the diagnosis and treatment of persons with mental conditions; or
b. Any
physician employed by the United States government within the State in the
capacity of psychiatrist and certified by the Delaware Psychiatric Center
Medical Director to the Medical Council of Delaware as qualified in the
diagnosis and treatment of persons with mental conditions.
(15)
“Psychiatrist” means an individual who possesses a valid State of Delaware
license to practice medicine and has completed a residency training program
approved by the Accreditation Council for Graduate Medical Education in
psychiatry.
(16) "Secretary" means the
Secretary of the State of Delaware Department of Health and Social Services.
“Secretary” shall also mean the Secretary of the Department of Services to
Children, Youth, and their Families for individuals under the age of 18 or
otherwise are in custody of the Department of Services to Children, Youth, and
their Families or receiving financial assistance from the Department of
Services to Children, Youth, and their Families.
(17) “Serious bodily harm” means
physical injury which creates a substantial risk of death, significant and
prolonged disfigurement, significant impairment of health, or significant impairment
of the function of any bodily organ.
(18) “Voluntary patient” means a person
who voluntarily seeks treatment at, and is admitted to, a designated
psychiatric treatment facility or hospital for inpatient treatment of a mental
condition.
(9)(19) "Working day'' means all days any day other
than a Saturday, Sunday and legal holidays; and "day'' means
a calendar day.
§ 5002 Determination of mental
condition and of procedural compliance as prerequisites to involuntary
hospitalization.
Subject to §§ 5121-5123 of this title,
no No person
shall be involuntarily admitted to or confined as a an involuntary
patient at a designated psychiatric treatment or the hospital,
and no designated psychiatric treatment facility or the hospital
shall not involuntarily admit or confine as an involuntary
patient any person, unless such person is determined to be a person with a
mental condition and found to be dangerous to self or dangerous to others
in accordance with the procedures prescribed by this chapter, and unless the
procedural requirements of this chapter are complied with. A person may
not be admitted to or confined as an involuntary patient at a designated
psychiatric treatment facility or hospital unless it is determined that such
placement is the least restrictive intervention reasonably available and the
person has declined voluntary treatment. No person shall be deemed
“involuntarily committed” for any legal purpose until the court deems the
person an “involuntarily committed” person at the conclusion of a probable
cause hearing held pursuant to this chapter.
§ 5003. Voluntary admission procedure.
(a) The Department may establish, under
the direction and supervision of the Delaware Psychiatric Center, criteria for
voluntary admissions to designated psychiatric treatment facilities and
hospitals that differ from the criteria for involuntary admissions to
designated psychiatric treatment facilities and hospitals.
(b)
A psychiatrist or licensed independent practitioner who is credentialed
and authorized by the Division of Substance Abuse and Mental Health may admit
to a designated psychiatric treatment facility or hospital for observation,
diagnosis, care and treatment any individual who is a person with an apparent
mental condition or who has symptoms of a mental condition and who requests
admission subject to the payment of charges for care, maintenance and support
as provided in § 5020 of this chapter.
(c) Prior to admitting a person on a
voluntary basis, the designated psychiatric treatment facility or hospital must
notify the person verbally and in writing of the legal consequences of
voluntary admission in language that is understandable to the person, and
reasonably believe that the person comprehends such consequences, including but
not limited to:
(1) The person will not
to be allowed to leave the hospital grounds without permission of the treating
psychiatrist;
(2) If the person seeks
discharge prior to the discharge recommended by the person’s treatment team
pursuant to § 5004(f), the person’s treating psychiatrist may initiate the
involuntary inpatient commitment process if the psychiatrist believes the
individual presents a danger to self or danger to others; and
(3) Unless the
involuntary commitment process is initiated, the person will not have the hospitalization
reviewed by the Superior Court.
(d) The attending psychiatrist shall discharge
a voluntary patient when in-patient treatment is no longer clinically
indicated.
(e) A voluntary patient may make a
written request to the attending psychiatrist to be discharged at any
time. Upon the receipt of such request,
the attending psychiatrist shall discharge the person within 72 hours from the
receipt of the request, except if a psychiatrist or licensed independent
practitioner certifies that the voluntary patient is currently demonstrating
behaviors believed to be dangerous to self or dangerous to others and these
behaviors are documented in the medical record, an emergency detention may be
initiated for the person. No person may be involuntarily hospitalized unless in
compliance with the emergency detention procedures set forth in § 5004.
(f) If any applicant is under the age
of 18 years old, the following provisions shall apply:
(1) In the case of
voluntary admission to a designated psychiatric treatment facility or hospital,
consent to treatment shall be given only by a parent or legal guardian. The
request for admission to the designated psychiatric treatment facility or
hospital shall be signed by either the applicant's parent or legal guardian.
(2) A voluntary patient
or the voluntary patient’s parent or legal guardian may make a written request
to the attending psychiatrist to be discharged at any time.
(A) The provisions of §
5003(e) shall apply in such instances,
except that the voluntary patient's discharge may be conditioned upon the
consent of the voluntary patient's parent or legal guardian.
(B) If the parent or
legal guardian of a voluntary patient requests the patient’s discharge from a
treatment facility against the advice of the treatment team and administrator
of the facility, the facility may initiate involuntary treatment procedures as
provided for under this chapter. The provisions of this paragraph shall apply
as if the patient had made the request.
(3) Voluntary Outpatient
Treatment. A person between 14 and 18 years of age, who is in need of mental
health treatment, may request voluntary outpatient treatment from a [licensed
treatment facility or community provider]. If the individual in need of
treatment is a minor under 14 years of age, a parent, legal custodian, or legal
guardian shall make the request for voluntary outpatient mental health
treatment and give written consent for treatment.
(A) If a minor is 14
years of age or over, then either the minor, or a parent, legal custodian, or
legal guardian may give written consent to a [treatment facility or community
provider] for voluntary, outpatient treatment.
(B) Consent so given by
a minor 14 years of age or over shall, notwithstanding the minor's minority, be
valid and fully effective for all purposes and shall be binding upon such
minor, the minor's parents, custodian, and legal guardian as effectively as if
the minor were of full legal age at the time of giving such written consent.
The consent of no other person or court shall be necessary for the treatment
rendered such minor.
(C) A minor’s consent is
not necessary when a parent, legal custodian, or legal guardian of an
individual less than 18 years of age provides consent to voluntary outpatient
mental health treatment on behalf of the minor.
(D) A minor, including
those age 14 and older, may not abrogate consent provided by a parent, legal
custodian, or legal guardian on the minor’s behalf. Nor may a parent, legal custodian, or legal
guardian abrogate consent given by a minor age 14 and older on his or her own
behalf.
(E) This section does
not authorize a minor to receive psychotropic drugs without the consent of the
minor's parent, legal custodian, or legal guardian. Only a parent, legal
guardian, or legal custodian may provide consent for the administration of such
medication.
(4) A psychiatrist
designated by the Secretary of the Department of Services for Children, Youth
and Their Families may conduct an independent review to determine whether an
applicant who receives financial assistance from such Department or who is in
the custody of such Department is appropriate for voluntary hospitalization.
(g) Notwithstanding any other section
of the Delaware Code, the Medical Director of the Department's Division of Substance
Abuse and Mental Health shall have the independent authority to discharge
persons at the Delaware Psychiatric Center.
(h) The Department will pay for a
voluntary admission of a patient to a designated psychiatric treatment facility
or hospital pursuant to the same Departmental criteria as an involuntary
admission or community placement.
§5004. Emergency detention of a person
with a mental condition; justification; procedure.
(a) Any person who believes that
another person's behavior is both the product of a mental condition and is
dangerous to self or dangerous to others may notify a peace officer or a
credentialed mental health screener or juvenile mental health screener and
request assistance for said person. Upon the observation by a peace officer or
a credentialed mental health screener or juvenile mental health screener that
such individual with an apparent mental condition likely constitutes a danger
to self or danger to others, such person with an apparent mental condition
shall be promptly taken into custody for the purpose of an emergency detention
by any peace officer in the State without the necessity of a warrant. Any such
observation shall be described in writing and shall include a description of
the behavior and symptoms which led the peace officer or credentialed mental
health screener or juvenile mental health screener to such conclusion. The
documentation required herein shall set forth any known relationship between
the person making the complaint and any other connection to the person with an
apparent mental condition and, if known, the name of the nearest known
relative.
(b) An emergency detention may only be
initiated by a credentialed mental health screener or, if the individual is
under the age of 18, by a juvenile mental health screener. An individual may be held on an emergency
detention if it reasonably appears to a credentialed mental health screener or
juvenile mental health screener that the person is acting in a manner that
appears to be dangerous to self or dangerous to others. The credentialed mental
health screener or juvenile mental health screener shall verify this finding in
writing and complete the Department-approved emergency detention form; this
documentation shall include the credentialed mental health screener or juvenile
mental health screener's rationale for the detention, including specific
information regarding the alleged mental condition and dangerous behaviors
observed. Once the emergency detention form is completed, designated
transportation personnel shall be directed by the Department to transport the
person to a designated psychiatric treatment facility to for an evaluation. The
emergency detention does not start until the person is presented to a
designated psychiatric treatment facility.
(c) An emergency detention will result in
admission to a designated psychiatric treatment facility for psychiatric
observation, assessment, acute treatment, and any recommendations for referral
for other services. Any referral for an emergency detention shall include a
review of any advance health care directive as set forth in this title or any
other similar agreement relating to the person's wishes regarding potential
hospitalization, care, treatment, and notifications to others if known to the
credentialed mental health screener and available for review at the time of
such referral.
(d) Individuals under the age of 18 may
be emergently detained when the minor's parent or legal guardian is unwilling
to consent to the individual being admitted to a facility voluntarily for
assessment or care, or whose parent or legal guardian cannot be identified and
located. A psychiatrist designated by the Secretary of the Department of
Services for Children, Youth and Their Families may conduct an independent
review of a determination that a person under 18 years of age admitted to a
designated psychiatric treatment facility or hospital pursuant to an emergency
detention is dangerous to self or dangerous to others.
(e) Once an individual is emergently
detained in a designated psychiatric treatment facility pursuant to subsection
(c) of this section, a psychiatrist shall review all documentation, conduct an
examination of the individual, and document the findings of examination within
the emergency detention time period both in the person's medical record and the
emergency detention findings form. If the examining psychiatrist finds that the
individual with an apparent mental condition is not dangerous to self and is
not dangerous to others the psychiatrist shall certify these specific findings
in writing and the individual who has been emergently detained shall be
discharged from custody forthwith. All documentation required by this section
will be recorded and retained in the medical record of that individual and
reported to the Delaware Division of Substance Abuse and Mental Health, or if
the individual is a minor to the Division of Prevention and Behavioral Health
Services, upon the discharge of the individual.
(f) If, at any time, an individual who
is emergently detained agrees to go to a designated psychiatric treatment
facility for further observation, a voluntary admission will be sought to
fulfill the needed evaluation and the emergency detention order will become
void. If a physician affiliated with an emergency department has completed an
emergency medicine health assessment, as determined solely by such physician,
and refers the patient to a credentialed mental health screener or juvenile
mental health screener, with or without consultation with a psychiatrist, such
a referral constitutes an appropriate discharge plan and after such discharge
the physician affiliated with an emergency department will have no further
responsibility for the evaluation and disposition of the patient.
(g) In the event that the psychiatrist
at a designated psychiatric treatment facility determines that the person who
has been emergently detained meets the
criteria for further care and treatment and that such required care cannot be
provided in an available, less restrictive, more community-integrated setting,
such psychiatrist shall immediately initiate the provisional admission process
as set forth in § 5005 of this chapter. Any such determination must be based
upon observed and evaluated behavior and, if available, reliable information
provided by other sources regarding the person’s mental condition. Any
involuntary commitment of said person shall be only to a hospital designated by
the Secretary to provide such care and treatment.
(h) A designated psychiatric treatment
facility that receives a minor on an emergency detention shall promptly make a
reasonable and good-faith effort to contact that person’s parent or legal
guardian.
(i) All professional personnel employed
by the State or private providers are mandated to disclose any potential or
apparent conflicts of interest regarding their participation in the emergency
detention of any individual with an apparent mental condition to any
psychiatric facility. Such conflicts of interest shall be disclosed on the
emergency detention form and may include, but are not limited to, employment by
a privately operated psychiatric facility, a personal relationship with the
individual being detained or committed involuntarily, a relationship with
family or significant others of the individual being detained or committed
involuntarily, or being the victim of a crime by the person being detained or
committed involuntarily.
(j) No person will be detained or
otherwise involuntarily committed to a designated psychiatric treatment
facility unless a credentialed mental health screener or juvenile mental health
screener determines that such detention or commitment is the least restrictive
and most community-integrated means to adequately treat the person that is
immediately available.
(k) The Department is authorized to
establish regulations consistent with this subchapter. These regulations shall
include rules regarding the disclosure by credentialed mental health screeners
and juvenile mental health screeners of potential conflicts of interest.
§ 5003 5005 Provisional
hospitalization by psychiatrist's certification.
(a) No person shall will be involuntarily admitted to the
a hospital as a patient until the person is detained for
observation pursuant to the procedure set forth in § 5004 of this chapter. At the completion of the emergency detention
period, the person shall not be admitted to a hospital except pursuant to
the written certification of a psychiatrist that based upon the psychiatrist's
examination of such person:, such person suffers from a disease or
condition which requires the person to be observed and treated at a mental
hospital for the person's own welfare and which either renders such person
unable to make responsible decisions with respect to the person's
hospitalization, or poses a present threat, based upon manifest indications,
that such person is likely to commit or suffer serious harm to that person's
own self or others or to property, if not given immediate hospital care and
treatment.
(1) Appears
to be a person with a mental condition;
(2) The person has been
offered voluntary inpatient treatment and has declined such care and treatment
or lacks the capacity to knowingly and voluntarily consent to such care and
treatment;
(3) As a result of the
person’s apparent mental condition, the person poses a present threat, based
upon manifest indications, of being dangerous to self or dangerous to others;
and
(4) Less restrictive
alternatives have been considered and determined to be clinically inappropriate
at the present time.
(b) The psychiatrist’s certificate shall state with particularity
the behavior and symptoms upon which the psychiatrist's opinion is based, shall
include (where available) the name and address of the spouse or other nearest
relative or person of close relationship to the alleged person with a mental
condition, and shall state that such person is not willing to accept hospital
care and treatment on a voluntary basis or that the person is incapable of
voluntarily consenting to such care and treatment. The certificate shall also set forth the date
of the psychiatrist’s determination. The
hospital shall thereupon advise the involuntary patient of the patient’s rights
under this Chapter in language that is understandable to the individual. Upon completion of the psychiatrist’s
certificate, the individual shall be detained for an additional 48 hour period.
(c) If the examining psychiatrist at the hospital determines that the
involuntary patient no longer meets the criteria for provisional admission, the
psychiatrist shall so certify in writing and the hospital shall immediately
discharge the person. Prior to such
discharge, the hospital shall provide the person with a copy of the certificate
stating that the person was not involuntarily committed for any legal
purpose.
(d) If the person seeks voluntary care
and treatment after being provisionally admitted under this subsection, the
provisional admission will terminate and the person shall be voluntarily
admitted to a hospital without delay.
(e) The 48 hour observation period
prescribed in this section shall be referred to as “provisional admission.” An
individual who is provisionally admitted pursuant to this chapter shall not be
considered “involuntarily committed” for any legal purpose.
§ 5004 Legal effect of psychiatrist's
certificate.
Where the psychiatric examination
occurs at a place other than the hospital, the certificate of the examining
psychiatrist shall constitute legal authorization for the alleged person with a
mental condition to be transported (together with the examining psychiatrist's
certificate) to the hospital by a peace officer or, in the sole discretion of
the examining physician, by designated transport personnel. Receipt by the
hospital of the certificate of the examining psychiatrist shall authorize the
hospital provisionally to admit the alleged person with a mental condition as a
patient. No peace officer or medical doctor shall be subject to civil damages
or criminal penalties for any harm to the person with a mental condition
resulting from the performance of the officer's or doctor's own functions under
this section or under § 5003 of this title unless such harm was the result of
negligent, reckless, wilful, wanton and/or intentional misconduct on the
officer's or doctor's own part.
§ 50055006 Duties of
hospital upon provisional admission.
Upon the provisional admission of the
alleged person with a mental condition as an involuntary patient: During the 48 hour period of
provisional admission:
(1) The hospital shall cause the
involuntary patient to be physically and mentally examined, and may treat the
involuntary patient if the examining psychiatrist certifies that treatment is
necessary pending judicial proceedings under this chapter;
(2) Where the certification of
the involuntary patient as a person with a mental condition was by a
psychiatrist other than an employee or agent of the hospital, the hospital
shall, within 2 working days from the date of admission, independently
determine whether or not the involuntary patient is a person with a mental
condition. If the hospital examining psychiatrist determines that the
involuntary patient is not a person with a mental condition, such psychiatrist
shall so certify in writing and the hospital shall discharge the involuntary
patient forthwith. If the hospital examining psychiatrist independently
determines that the involuntary patient is a person with a mental condition,
such psychiatrist shall so certify in writing. The certificate shall contain
the information required by § 5003 of this title and shall also set forth the
date of the hospital's determination. The hospital shall thereupon advise the
involuntary patient of the patient's rights under this chapter;
(1) The hospital shall try to evaluate
the involuntary patient to assess the person’s psychological and physical
needs, and may provide treatment to the involuntary patient as clinically
appropriate and consistent with the State’s Mental Health Patients’ Bill of
Rights pending the involuntary patient’s probable cause hearing;
(3) (2) A psychiatrist designated by the Secretary of the Department of
Services for Children, Youth and Their Families may, at any time prior to the
commencement of judicial proceedings to determine the mental condition of a
person under 18 years of agea minor or an individual over the age of 18
who is receiving financial assistance or is in the custody of the Department,
conduct an independent review of a determination that such a person is a person
with a mental condition. If the psychiatrist determines that such person is not
a person with a mental condition, the Department may withhold financial
assistance for the diagnosis, care or treatment of such person;
(4) A psychiatrist designated by
the Secretary of the Department of Health and Social Services may, at any time
prior to the commencement of judicial proceedings to determine the mental
condition of a person 18 years of age or older, conduct an independent review
of a determination that such person is a person with a mental condition. If the
psychiatrist determines that such person is not a person with a mental
condition, the Department may withhold financial assistance for the diagnosis,
care or treatment of such person;
(5)(3) The hospital shall investigate document in the
patient’s medical record whether or not the involuntary patient can afford
counsel and to engage an independent psychiatrist or other qualified
medical expert at patient's own expense licensed mental health
professional to serve as an expert witness on the individual’s behalf.
§ 50065007 Procedural
rights of involuntary patients.
A person whom the hospital has
determined to be a person with a mental condition shall be entitled When a designated treatment
facility, hospital or outpatient treatment provider seeks to require an
individual to be involuntarily hospitalized pursuant to a probable cause
hearing or an involuntary inpatient commitment hearing, or seeks to have the
individual placed on involuntary outpatient treatment over objection, or engage
in a specific mode of treatment without the individual’s consent, the
individual shall be entitled:
(1) To notice, including a
written statement, of the factual grounds upon which the proposed
hospitalization, outpatient treatment over objection, or treatment without consent
is predicated and the reasons for the necessity of confinement such
course of action.
(2) To hearings before the court
and to judicial determinations of (i) whether the involuntary patient's
confinement is based upon probable cause and (ii) whether or not the
involuntary patient is a person with a mental conditionwhether or not
the individual satisfies the requirements for a probable cause hearing,
involuntary inpatient commitment, outpatient treatment over objection, or treatment
without consent pursuant to the criteria set out in the relevant sections of
this chapter. Such hearings shall be without jury and not open to the
public, shall be preceded by adequate written notice to the
involuntary patientindividual, and the involuntary patient individual
shall be entitled to be present at all such hearings.
(3) To be represented by counsel
at all judicial proceedings, such counsel to be court appointed if the involuntary
patient individual cannot afford to retain counsel; and to be
examined by an independent psychiatrist or other qualified medical expert and
to have such psychiatrist or other expert testify as a witness in on
the patient's individual’s behalf, such witness to be court
appointed if the involuntary patient cannot afford to retain such witness.
(4) To conduct discovery, to
summon and cross-examine witnesses, to present evidence on the person's own
behalf and to avail the person's individual’s own self of all
other procedural rights afforded litigants in civil causes. The privilege
against self-incrimination shall be applicable to all proceedings under this
chapter.
(5) To have a full record made of
the proceedings, including findings adequate for review. All records and
pleadings shall remain confidential unless the court for good cause orders
otherwise.
(6)
To be notified in writing of the right to appeal a decision made by the court
pursuant to § 5015 of this chapter.
§ 5007 Judicial proceedings
5006 Probable cause complaint.
(a) Forthwith, but not more
than 2 working days from the date of provisional admission If an
involuntary patient has not been discharged by the hospital by the end of the
48 hour provisional admission period, the hospital shall file a verified
complaint for involuntary civil commitment in the Superior Court or in
the Family Court if the involuntary patient would otherwise be amenable to
Family Court jurisdiction under other provisions of law. The complaint shall aver
set forth in detail facts to show that the hospital, as petitioner,
reasonably and in good faith believes that the involuntary patient (who shall
be named as respondent) is a person with a mental condition who meets
the standard for involuntary inpatient commitment set forth in § 5011 of this chapter, and who should be
continued as a patient at the hospital pursuant to this chapter until the
patient is determined no longer to be a person with a mental condition
meet the criteria for involuntary inpatient hospitalization. The complaint
shall also aver that the involuntary patient has been advised of the patient's
rights under this chapter. Copies of all certificates by examining
psychiatrists the Emergency Detention Certificate and the Provisional
Admission Certificate shall be attached to the complaint. A notarized affidavit indicating that a
hospital official has reviewed each complaint shall be filed electronically,
with the original copy sent to the court to be maintained in the patient’s
file.
(b) Nothing in this section shall
preclude the involuntary patient or another person acting on the involuntary
patient's behalf from filing a complaint with the court for a judicial
determination of the involuntary patient's mental status, in which complaint
the hospital shall be named as respondent. In such event, the hospital shall
appear as respondent and shall attach to its answer copies of certificates by
the examining psychiatrist, and the hospital shall be excused from compliance
with subsection (a) of this section.
(c) (b) The hospital's investigation affidavit filed with the
complaint shall indicate whether the involuntary patient is able to afford
counsel and an independent psychiatric witness within 4 working days of
provisional admission whether the patient requested an independent
psychiatric witness.
§ 5008 Appointment of counsel;
determination of probable cause. § 5009 Probable cause hearing.
Upon the filing of the probable
cause complaint the court shall forthwith:
(1) Schedule a probable cause hearing
to determine whether probable cause exists for the involuntary patient's
confinement, and, where necessary, appoint counsel to represent the involuntary
patient. Such probable cause hearing shall be held as soon as practicable, but
no later than 8 working days from the filing of the complaint. Hearings may be conducted using electronic
means, such as videoconferencing.
(2) Direct that notice of the
probable cause hearing and copies of the pleadings be supplied to the
involuntary patient, the patient's counsel and to the involuntary patient's
spouse, nearest relative or person of close relationship to the patient as
in the court's opinion would best represent the involuntary patient's interest
other relative, close personal friend of the patient or any other person
identified by the patient, provided that the patient is given the opportunity
to agree, prohibit, or restrict the disclosure.
(3) Enter such other orders as
may be appropriate, including an order authorizing the continued provisional
confinement of the involuntary patient until further order of the court.
(4) If, pursuant to the probable
cause hearing, the court determines that probable cause does not exist for
involuntary inpatient commitment, the involuntary patient shall be
immediately discharged. If the court determines that probable cause does exist
for involuntary inpatient commitment, it shall schedule an involuntary
inpatient commitment hearing, pursuant to § 5011, for the earliest
practicable date, and no later than eight working days after the probable
cause hearing a hearing to determine whether or not the involuntary
patient is a person with a mental condition; and where necessary, it shall
appoint an independent psychiatrist or other qualified medical expert to
examine the involuntary patient and act as an expert witness on the involuntary
patient's behalf. Notice of the hearing shall be given to the involuntary
patient and the patient's counsel.
(5) If the court determines that
probable cause does not exist for involuntary inpatient commitment, but finds
that an individual meets the criteria for outpatient treatment over objection,
the court may order that an individual be placed on outpatient treatment over
objection, pursuant to § 5013 of this chapter, and the next hearing shall be
scheduled for 3 months after the probable cause hearing. The court may only place an individual on
outpatient treatment over objection at a probable cause hearing if the issue
has been appropriately noticed.
(5) (6) For good cause shown, the court may order that judicial proceedings
under this chapter take place in the Superior Court in and for a county other
than the county in which the action was initiated.
(7) For purposes of this chapter and
for any other legal purpose, no person shall be considered “involuntarily
committed” until the court so orders following a probable cause hearing held
pursuant to the requirements of this chapter.
§ 50095010 Discharge by
the hospital.
Notwithstanding the pendency of the
action or any order previously entered by the court, if at any time after the
complaint is filed the hospital determines that the involuntary patient is
no longer a person with a mental condition no longer meets the criteria
for provisional admission or involuntary inpatient commitment, the hospital
shall so certify in writing and immediately discharge the patient
forthwith,person and shall immediately advise the court of
its determination and the discharge., and Upon receipt of such certification, the
court shall thereupon dismiss the action. A person involuntarily hospitalized pursuant
to the emergency detention, provisional admission or involuntary commitment
sections of this chapter may be discharged pursuant to this subsection without
further order of the court.
§ 5010 Hearing to determine mental
condition.
As a result of the hearing to determine
mental condition, the court shall make specific findings:
(1) That the involuntary patient
is not a person with a mental condition, in which case the court shall order
that the involuntary patient be discharged and released forthwith; or
(2) That based upon clear and
convincing evidence, the involuntary patient is a person with a mental
condition in which case the court shall enter an order of disposition, which
disposition shall be effective for a period not to exceed 3 months. In
determining the disposition of the involuntary patient the court shall consider
all available alternatives, including inpatient confinement at the hospital,
and shall order such disposition as imposes the least restraint upon the
involuntary patient's liberty and dignity consistent both with affording mental
health treatment and care with protecting the safety of the involuntary patient
and the public.
§5011
Involuntary inpatient commitment hearing and procedure.
(a) An individual shall be
involuntarily committed for inpatient treatment only if all of the following
criteria are met by clear and convincing evidence:
(1) The
individual is a person with a mental condition;
(2) Based
upon manifest indications, the individual is: (i) dangerous to self; or (ii)
dangerous to others;
(3) All less restrictive
alternatives have been considered and determined to be clinically inappropriate
at the time of the hearing; and
(4) The individual has
declined voluntarily inpatient treatment, or lacks the capacity to knowingly
and voluntarily consent to inpatient treatment. When evaluating capacity, the
court shall consider an individual’s ability to understand the significant
consequences, benefits, risks, and alternatives that result from the
individual’s decision to voluntarily request or decline inpatient treatment.
(b) The court shall set out specific
findings of facts and conclusions of law which address each of the required
criteria for involuntary commitment and which support its decision to
involuntarily commit or discharge the individual.
(c) If the court determines that an
individual meets the criteria for involuntary commitment, the court shall enter
an order of disposition which shall not exceed 3 months based upon the court’s
individualized assessment of the facts and circumstances at the time of the
hearing.
(d) Upon the expiration of the court
order pursuant to § 5011(c), if the individual has not been discharged by the
hospital, and the hospital believes that the individual continues to require
involuntary commitment, the court shall schedule a subsequent hearing which
will be held in compliance with § 5007 and this section. The individual shall be entitled to at least
14 working days’ notice of any subsequent hearings. As long as an individual
receives involuntary inpatient treatment, the court must convene a hearing in
compliance with § 5007 and this section at least once every 3 months to review
whether continued involuntary inpatient treatment is necessary.
(e) An individual, if represented by
counsel, may waive, orally or in writing, any hearing under this section. The
waiver must be submitted in writing to the court or be orally presented in open
court.
§ 5012 Hospitalization.
(a) Duties of hospital upon
involuntary patient's admission. — Upon the involuntary patient's admission to
the hospital pursuant to court order, the hospital shall for a period not to
exceed 3 months render treatment to the involuntary patient in accordance with
professional standards. If by the expiration of 3 months the involuntary
patient has not been discharged by the hospital, and if in the opinion of the
hospital the involuntary patient is still a person with a mental condition, the
hospital shall so notify the court; and the court shall order a hearing to be
held within 14 working days of such notice. If the court continues the
involuntary confinement upon the expiration of an additional 6 months, and the
involuntary patient has not been discharged by the hospital, and if in the
opinion of the hospital the patient is still a person with a mental condition,
the hospital shall so notify the court; and the court shall order a hearing to
be held within 14 working days of such notice.
(b) Further hearing. — In any
further hearing the procedural requirements of § 5006 of this title shall
govern, and the court may make such findings and orders as are permitted by §
5010 of this title; provided, that the court may order that the involuntary
patient's admission to the hospital shall be continued for an indefinite
period, in which case the hospital shall report to the court at intervals not
more than 6 months as to the continued need for involuntary hospitalization,
and the court shall review the involuntary patient's status at such 6-month
intervals and be required to hold hearings, at such intervals, until such time
as the involuntary patient is discharged.
(c) Waiver of hearing. — An
involuntary patient, if represented by counsel, may waive, orally or in
writing, any hearing under this section. The waiver must be submitted in
writing to the court or be orally presented in open court.
§ 5011 5012 Waiver of
rights; voluntary hospitalization.
(a) An involuntary patient may
waive any of the rights provided by this chapter if (i) the court determines
that such waiver is voluntary and with the involuntary patient's knowing and
intelligent consent, or if (ii) where the involuntary patient is incapable of
knowingly and intelligently consenting, the court, upon application by counsel
and after appropriate inquiry and finding of facts, approves such waiver for
good cause shown. If the hearing provided for in § 5010 5011 of
this title is waived, the court shall enter an order of disposition in
accordance with subdivision (2) of § 5010 § 5011(c) of this
title.
(b) If prior to any hearing the
court determines that the involuntary patient has knowingly and voluntarily
applied for, and has been accepted for hospitalization pursuant to § 51235003
of this title, the action shall be dismissed, and § 51235003
shall govern.
(c) A legal guardian may not waive any
right of an adult, including any right related to admission and judicial
review, under this chapter.
§ 5013 Involuntary outpatient treatment
over objection.
(a) A person shall be involuntarily
committed by the court for outpatient treatment over objection only if all of
the following criteria are satisfied by clear and convincing evidence:
(1) The person is 18 years of age or older.
(2) The
person has a documented mental condition.
(3) The person is
reasonably expected to become dangerous to self or dangerous to others or otherwise
unlikely to survive safely in the community without treatment for the person’s
mental condition.
(4) The person is
currently refusing to voluntarily participate in the treatment plan recommended
by the person’s mental health treatment provider or lacks the capacity to
determine whether such treatment is necessary.
(5) The person has a
documented history of lack of adherence with recommended treatment for the
mental condition, or poses an extreme threat of danger to self or danger to
others based upon recent actions, that has either:
(i) Resulted in a
deterioration of functioning that was observed to be dangerous to the
individual’s personal health and safety; or
(ii) Resulted in a
deterioration of functioning that was observed to be imminently dangerous to
self or dangerous to others, including but not limited to suicidal ideation,
violent threats, or violence towards others.
(6) All less restrictive
treatment options have been considered and have either been determined to be
clinically inappropriate at this time or evidence is offered to show that the
person is not likely to adhere to such options.
(b) The court shall set out specific
findings of facts and conclusions of law which address each of the required
criteria for involuntary outpatient treatment over objection and which support
its decision to involuntarily commit or discharge the individual.
(c) If the court determines that an
individual meets the criteria for involuntary outpatient treatment over
objection, the court shall enter an order of disposition which shall not exceed
3 months based upon the court’s individualized assessment of the facts and
circumstances at the time of the hearing.
(d) The Department is responsible for
ensuring the provision of all necessary services and supports to fully
implement the court order, or for informing the court as quickly as possible if
such services are not available and providing the Court with an explanation of
why such services are not available and when they are anticipated to become
available.
(e) Notwithstanding an order entered by
the court pursuant to this section, an individual may be discharged by the
individual’s treating psychiatrist at any time if the treating psychiatrist
determines that the individual no longer meets the clinical criteria for
involuntary outpatient commitment. Upon
such determination the psychiatrist shall so certify in writing and advise the
court of its determination and the discharge.
Upon the receipt of such certification, the court shall dismiss the
action.
(f) An individual or the individual’s
counsel may waive, orally or in writing, any hearing under this section. The
waiver must be submitted in writing to the court or be orally presented in open
court.
(g) Should an individual committed by
the court to involuntary outpatient treatment over objection engage in behavior
in the community that is dangerous to self or dangerous to others, an emergency
detention, consistent with § 5004, may be initiated. No individual may be
involuntarily hospitalized unless the individual is initially emergently
detained and is given the due process protections provided for in this chapter.
§ 5013 5014 Appeal;
habeas corpus; rules of procedure.
(a) Appeal of order of
disposition. — Any party to the proceedings may appeal an order of disposition
issued by a Commissioner to a Superior Court Judge within 10 days of the entry
of such order. The appeal shall not
operate as a stay of the order of disposition unless the Commissioner or Judge
so directs. A decision by a Superior
Court Judge may be appealed Any party to the proceedings may appeal an
order of disposition to the Supreme Court within 30 days of the entry of
such order. The appeal shall not operate as a stay of the order of disposition
unless the courtSuperior Court or the Supreme Court so directs.
(b) Habeas corpus. — After
any order of disposition becomes final, the involuntary patient shall be
entitled to petition the court for a writ of habeas corpus for release on the
grounds:
(1) That the
proceeding which led to the patient's commitment was illegal; provided, that
that issue has not been previously determined; or
(2) That
although the original confinement was legal, continued confinement is not
warranted.
(c) Court rules. — The
Superior Court and the Family Court shall adopt such rules of procedure as may
be required to implement the procedural requirements of this chapter.
§ 5014 5015 Enlargement
of time.
Notwithstanding §§ 5001-5013 of this
title, the The court may enlarge the time for the
performance of acts by the hospital or respondent's attorney pursuant to
this chapter, and of scheduling hearings thereunder, for good cause shown,
for a reasonable period, consistent with the rights of the respondent.
§ 5015 Costs of transportation and
medical services 5016 Payment of transportation and medical costs.
(a) The State Treasurer shall pay police officers, constables,
sheriffs and deputy sheriffs for service as peace officers under this section
at the rate of $0.31 for each mile necessarily traveled as well as a custody
fee of $100 when transporting a person with a mental condition from 1 county to
another county peace officers or other transportation providers under
contract with the Department of Health and Social Services for transportation
services under this subchapter at an agreed upon rate, including a custody fee
and mileage traveled.
(b) The State Treasurer shall pay
third-party medical and dental providers at a contractually agreed upon rate
for services rendered for the medically necessary treatment of persons
receiving mental health treatment and services pursuant to this chapter.
§ 5017 Immunity.
(a) Initial Assessment - No peace
officer, medical doctor, credentialed mental health screener, juvenile mental
health screener, or facility in which a medical doctor or credentialed mental
health screener or juvenile mental health screener practices shall be subject
to civil damages or criminal penalties for any harm resulting from the
performance of their functions under this section unless such harm was
intentional or the result of willful or wanton misconduct on their part. This
immunity is limited to the mental health assessment, resulting clinical
decision, and involuntary hold necessary until the person is presented to a
designated psychiatric treatment facility that is able to provide such
psychiatric healthcare services for the emergency detention described in
paragraph § 5001(8) of this chapter.
(b) Emergency Detention - After the
person presents to the designated psychiatric treatment facility and during the
emergency detention period described in paragraph § 5001(8) of this chapter, no
medical doctor or designated psychiatric treatment facility shall be subject to
civil damages or criminal penalties for any harm to the person with a mental
condition resulting from the performance of functions under § 5004(e) of this chapter
unless such harm was the result of negligent, reckless, willful, wanton and/or
intentional misconduct.
(c) Subsequent Care - After the person
is voluntarily admitted, provisionally admitted or involuntarily committed, no
peace officer or medical doctor shall be subject to civil damages or criminal
penalties for any harm to the person with a mental condition resulting from the
performance of the officer's or doctor's own functions of this title unless
such harm was the result of negligent, reckless, willful, wanton and/or
intentional misconduct on the officer's or doctor's own part.
(d) Nothing in this section is intended
to waive the State's sovereign immunity or the privileges and immunities set
forth at Chapter 40 of Title 10.
§ 5018 Discharge of patients from
hospitals.
(a) Hospitals shall examine every
involuntary patient and voluntary patient present in its facility as frequently
as practicable, but not less often than every 3 months. If pursuant to such examination a person’s
treating psychiatrist determines that a person no longer satisfies the criteria
for involuntary hospitalization pursuant to the emergency detention, provisional
admission or involuntary court commitment sections of this chapter, or as
established for voluntary treatment under § 5003(a), the patient shall be
discharged. A person involuntarily hospitalized pursuant to the emergency
detention, provisional admission or involuntary court commitment sections of
this chapter may be discharged pursuant to this subsection without further
order of the court.
(b) The certificate of discharge shall
state the basis for the discharge. Prior to discharge, the hospital shall prepare
a written continuing care plan developed in consultation with interdisciplinary
staff, identified post-discharge community mental health providers and the
patient, and, if the patient is a minor, with the patient's parent or legal
guardian. At a minimum, community-based services staff shall be consulted prior
to the discharge of patients in hospitals. The continuing care plan shall be
consistent with the discharge planning requirements set out in 16 Del. C. §
5161, the Mental Health Patients’ Bill of Rights. The continuing care plan
shall include: a realistic assessment of the patient's post-discharge social,
financial, vocational, housing and treatment needs; identification of available
support services and provider linkages necessary to meet the assessed needs;
and identification and a timetable of discrete, predischarge activities
necessary to promote the patient's successful transition to the community-based
services system or to another appropriate post-discharge setting.
§ 5019 Liability for maintenance of
patient; collection remedies.
(a) Any adult committed to or placed in
a designated psychiatric treatment facility or hospital shall be liable for the
cost of care, treatment, or both to the extent authorized by § 7940 of Title
29. If a minor is committed to or placed in a designated psychiatric treatment
facility or hospital, liability for costs of care, treatment, or both shall
conform to § 9019 of Title 29.
(b) The Department of Health and Social
Services and Department of Services for Children, Youth and Their Families
shall keep an account of the cost of care, treatment, or both and credit
against the account all moneys received from the patient or other persons on
the patient's behalf.
(c) In the event of nonpayment, the
Department of Health and Social Services and Department of Services for
Children, Youth and Their Families may pursue collection remedies authorized by
§§ 7940 and 9019, respectively, of Title 29.
§ 5020 Expenses of examination and
removal of indigent patients.
The expenses of the examination of an
indigent person alleged to be suffering from a mental condition and the
transportation of such person, by a peace officer or credentialed mental health
screener or juvenile mental health screener to a designated psychiatric treatment
facility or hospital able to provide further evaluation or care and treatment,
shall be paid by the State Treasurer.
§ 5021 Veterans Administration
hospitals.
The provisions in the Delaware Code
pertaining to the admission, commitment, care and discharge of persons
diagnosed with a mental condition at state institutions shall apply with the
same force and effect to persons entitled to the services of hospitals for
people with a mental condition operated by the Veterans Administration. Persons
so entitled may be transferred from state institutions to such Veterans
Administration hospitals subject to the statutory provisions affording
interested parties the right to have the status of the person with a mental
condition determined as provided by law.
§ 5022 Return of patients; order;
notice; custody.
(a) If an inpatient of a state-operated
hospital escapes or is on unauthorized leave, its director may issue an order
for the patient's immediate rehospitalization. The director or the director's
designee may notify such patient of the existence of a rehospitalization order
by any reasonable means of communication open to the director. Such an order,
irrespective of the patient's actual receipt, shall authorize any peace officer
to take the patient into custody for rehospitalization.
(b) If an involuntarily committed
inpatient or a person detained involuntarily under this chapter from a
non-state-operated hospital certified under § 5026 or § 5027 of this title
escapes or is on unauthorized leave, that hospital's director shall immediately
notify the Director of the Division of Substance Abuse and Mental Health or the
Director's designee if the patient is 18 years of age or older or the Division
of Prevention and Behavioral Health Services if the patient is under 18 years
of age. Upon receipt of such notification, the Division Director or the
Director's designee may issue notice and a rehospitalization order in
conformity with subsection (a) of this section. Such an order, irrespective of
the patient's actual receipt, shall authorize any peace officer to take the
patient into custody for rehospitalization.
§ 5023 Unwarranted hospitalization in
Delaware Psychiatric Center or denial of rights; penalties.
(a) Any person who willfully causes, or
conspires with or assists another to cause:
(1) The unwarranted
hospitalization of any individual in the Delaware Psychiatric Center under this
chapter; or
(2) The denial to any
individual of any of the rights accorded to said individual under this chapter
shall be punished by a fine not exceeding $500 or imprisonment not exceeding 1
year, or both.
(b) The Superior Court shall have
jurisdiction of offenses under this section.
§ 5024 Examinations of persons relative
to parole, pardon or commutation of sentence in case of certain crimes.
Whenever the Director of the Division
of Substance Abuse and Mental Health or the Director of the Division of
Developmental Disabilities Services receives a request from the Commissioner of
the Department of Correction, relative to parole, pursuant to § 4353 of Title
11, or relative to pardon or commutation of sentence, pursuant to § 4362 of
Title 11, for psychiatric examination and psychological clinical studies, and a
report containing an opinion of the prisoner's condition and of the probability
of the prisoner's again committing crimes similar to the 1 for which the
prisoner was incarcerated, or other crimes, the Director shall cause such
examination and studies to be made at the correctional institution or the
Delaware Psychiatric Center, and copies of the report shall be delivered to
each member of the Parole Board or the Board of Pardons, as the case may be;
and in cases of pardons and commutations of sentence, a copy to the Governor.
§ 5025 Minors.
(a) Except as otherwise provided, the
provisions of this chapter pertaining to the care and release of persons age 18
and older shall apply with the same force and effect to persons under 18 years
of age admitted to a designated psychiatric treatment facility or hospital,
certified by the Secretary of the Department of Services for Children, Youth
and Their Families as being appropriate for the diagnosis, care, and treatment
of persons with mental illness under 18 years of age.
(b) All substantive and procedural
rights provided to individuals pursuant to this Chapter shall automatically
transfer to the individual’s parents or legal guardian if the individual is a
minor, unless specifically stated otherwise in this chapter. Even when such a transfer of rights occurs,
all reasonable efforts shall be made to ensure the relevant rights and
procedures are explained to the minor in language understandable to the minor.
(c) A psychiatrist or Emergency
Detention of Juveniles Review Board designated by the Secretary of the
Department of Services for Children, Youth and Their Families may conduct an
independent review of a determination that a person under 18 years of age
admitted to a designated psychiatric treatment facility or hospital pursuant to
an emergency detention on the basis of the appearance of a mental condition,
and whose mental condition causes the individual to be dangerous to self or
dangerous to others. Such review may
include an examination of the determinations made by juvenile mental health screeners
in individual cases or in aggregate. The
Department for Children, Youth and Their Families is authorized to establish
regulations concerning the process and criteria for such determinations.
§ 5026 Additional facilities for
adults.
The Secretary of the Department of
Health and Social Services, upon voluntary application of a private or public
hospital, may certify such hospital as an appropriate facility for the
detention, diagnosis, care and treatment of adults with a mental condition
under this chapter. If so certified, on a case-by-case basis, any such hospital
shall be authorized to serve in addition to the Delaware Psychiatric Center
under this chapter.
Section 2. Amend Chapter 51, Title 16 of the Delaware
Code by making deletions as shown by strike through and insertions as shown by
underline as follows:
§ 5122 Emergency detention of a person
with a mental condition; justification; procedure.
(a) As used in this subchapter,
unless the context clearly indicates otherwise, the following words or phrases
shall have the following meanings:
(1) "Credentialed
mental health screener'' is an individual who either:
a. Possesses
a valid State of Delaware license to practice as a psychiatrist; or
b. Is a licensed
mental health professional who is credentialed by the Department to provide
emergency screening services and evaluation of the need for involuntary
observation and treatment for a mental condition; or
c. Is an
unlicensed mental health professional who works under the direct supervision of
a psychiatrist and who is credentialed by the Department to provide emergency
screening services and evaluation of the need for involuntary observation and
treatment for a mental condition; or
d. Is a physician
with a valid State of Delaware license to practice medicine and who is
credentialed by the Department to provide emergency screening services and
evaluation of the need for involuntary observation and treatment for a mental
condition.
(2) "Dangerous
to others'' means that by reason of mental condition there is a substantial
likelihood that the person will inflict serious bodily harm upon another person
within the immediate future. This determination shall take into account a
person's history, recent behavior and any recent act or threat.
(3) "Dangerous
to self'' means that by reason of mental condition the person is likely to
cause injury to oneself and to require immediate care, treatment, or detention.
(4) "Department''
shall refer to the State of Delaware Department of Health and Social Services.
(5) "Designated
psychiatric treatment facilities'' includes all facilities designated by the
Secretary to provide psychiatric emergency care for individuals believed to
have a mental condition and whose behavior is believed to be dangerous to self
or others due to that mental condition; such facilities include psychiatric
hospitals operated by the State of Delaware, privately operated psychiatric
hospitals, any psychiatric emergency receiving facilities that provide mental
health screenings, evaluations, treatment, and referral services, or other
facilities as may be designated by the Department by regulation.
(6) "Designated
transport personnel'' means such personnel as designated by the Secretary to
transport persons who require 24-hour detention to or from needed healthcare
services provided in hospitals and public treatment facilities; these personnel
include police officers, peace officers and constables with arrest power as
well as private ambulance, state employees and contracted transportation staff
as approved by the Department. Any peace officer involved may mandate the
manner and method of transportation of persons who require 24-hour detention
when required to ensure public safety.
(7) "Involuntary
detention'' refers to the legally sanctioned use of this subchapter that allows
a qualified professional who meets criteria to be a credentialed mental health
screener to determine that an individual is behaving in a manner that is
dangerous to self or others due to a mental condition that requires keeping
that individual in a medical facility against the individual's will for up to
24 hours for an evaluation to determine what treatment needs are required to
keep the person or the public safe. Involuntary detention requires written
documentation reflecting the credentialed mental health screener's clinical
decision process and must be signed either by the licensed credentialed mental
health screener or by the supervising psychiatrist of an unlicensed
credentialed mental health screener, at the time of the determination that a
24-hour detention is warranted. The 24-hour timeframe does not start until the
person is presented to a designated facility that is able to provide such
psychiatric healthcare services.
(8) "Licensed
independent practitioner'' as set forth in this subchapter refers to employees
of designated psychiatric treatment facilities, in addition to psychiatrists,
who hold credentials and privileges to admit persons into care and write orders
to treat said persons in that facility. Licensed independent practitioners can
include but are not limited to staff that hold licenses as psychologists, nurse
practitioners, and physician assistants or such other healthcare providers as
may be designated to work independently pursuant to the regulations of the
Department.
(9) "Mental
condition'' means a current, substantial disturbance of thought, mood,
perception or orientation which significantly impairs judgment, capacity to
control behavior or capacity to recognize reality. Unless it results in the
severity of impairment described herein, "mental condition'' does not mean
simple alcohol intoxication, transitory reaction to drug ingestion, dementia
due to various nontraumatic etiologies or other general medical conditions,
Alzheimer's disease, or intellectual disability. The term "mental
condition'' is not limited to "psychosis'' or "active psychosis,''
but shall include all conditions that result in the severity of impairment
described herein.
(10) "Peace
officer'' means any public officer authorized by law to make arrests, including
police officers and constables.
(11) "Secretary''
shall refer to the Secretary of the State of Delaware Department of Health and
Social Services.
(12) "24-hour
detention'' refers to the process as set forth herein whereby an adult who
appears to have a mental condition, and whose mental condition causes the
person to be dangerous to self or dangerous to others, and who is unwilling to
be admitted to a facility voluntarily for assessment or care, is involuntarily
detained for such evaluation and treatment for 24 hours in a designated psychiatric
facility because other less restrictive, more community integrated services are
not appropriate or available to meet the person's mental health care needs.
(b) Any person who believes that
another person's behavior is both the product of a mental condition and may
result in danger to that person or others, may notify a peace officer, a
credentialed mental health screener, or Departmental crisis services and
request assistance for said person. Upon the observation by a peace officer, a
credentialed mental health screener, or Departmental crisis services that such
individual with an alleged mental condition likely constitutes a danger to self
or others and is in need of emergency psychiatric evaluation, such person with
an alleged mental condition shall be promptly taken into custody by any peace
officer, credentialed mental health screener, or Departmental crisis services
in the State without the necessity of a warrant. Any such observation shall be
described in writing and shall include a description of the behavior and
symptoms which led the peace officer, credentialed mental health screener or
Departmental crisis services to such conclusion. The documentation required
herein shall set forth any known relationship between the person making the
complaint and any other connection to the alleged person with a mental
condition and, if known, the name of the spouse or nearest known relative.
(c) Such person with an alleged
mental condition, who is demonstrating behaviors believed dangerous to self or
others, shall be taken by a peace officer, a credentialed mental health
screener, or Departmental crisis services with all reasonable promptness to:
(1) A designated
psychiatric treatment facility for emergency screening services by a
credentialed mental health screener; or
(2) A
credentialed mental health screener; or
(3) Any hospital
as defined by § 5101 of this title so long as any resulting order for 24-hour
detention relating to said person is entered by a credentialed mental health
screener.
(d) If it reasonably appears to
the credentialed mental health screener that the person is acting in a manner
that appears to be dangerous to self or others and this behavior is the result
of a mental condition, the credentialed mental health screener shall verify
this finding in writing and complete the Departmentally approved 24-hour
detention form; this documentation shall include that screener's rationale for
the detention including specific information regarding the alleged mental
condition and dangerous behaviors observed. Once the 24-hour detention form is
completed, designated transportation personnel shall be directed by the
Department to transport the person under detention to a designated psychiatric
treatment facility to provide such a 24-hour evaluation. If, at any time, an
individual who has been determined to meet the standard in paragraph (a)(12) of
this section agrees to go to a facility for further observation, a voluntary
admission will be sought to fulfill the needed evaluation and the 24-hour
detention order will become void. The Department will pay for voluntary
admissions pursuant to the same criteria as involuntary admissions or community
placement. If a hospital-based physician has completed an emergency medicine
health assessment, as determined solely by such physician, and refers the
patient to a credentialed mental health screener, with or without consultation
with a psychiatrist, such a referral constitutes an appropriate discharge plan
and after such discharge the hospital-based physician will have no further
responsibility for the evaluation and disposition of the patient.
(e) A 24-hour detention will
result in admission to a designated psychiatric treatment facility for
psychiatric observation, assessment, acute treatment, and any recommendations
for referral for other services within the 24-hour period of time. Any referral
for a 24-hour detention shall include a review of any advance health care
directive as set forth in this chapter or any other similar agreement relating
to the person's wishes regarding potential hospitalization, care, treatment,
and notifications to others if known to the credentialed mental health screener
and available for review at the time of such referral.
(f) Once an individual is
detained in a designated psychiatric treatment facility pursuant to subsection
(d) of this section, a psychiatrist shall review all documentation, conduct an
examination of the individual, and document the findings of examination within
24 hours both in the person's medical record and the 24-hour detention findings
form. If the examining psychiatrist finds that the individual with an apparent
mental condition is not dangerous to self or others or is not in need of
involuntary inpatient commitment, the psychiatrist shall certify these specific
findings in writing and the individual who was detained shall be discharged
from custody forthwith. All documentation required by this section will be
recorded and retained in the medical record of that individual and reported to
the Delaware Division of Substance Abuse and Mental Health's Eligibility and
Enrollment Unit upon the release of the individual.
(g) In the event that the
psychiatrist at a designated psychiatric treatment facility determines that the
person who has been detained under the 24-hour detention law meets the criteria
for further care and treatment and that such required care cannot be provided
in an available, less restrictive, more community-integrated setting, such
psychiatrist shall immediately implement the involuntary commitment processes
as set forth in Chapter 50 of this title. Any such determination must be based
upon observed and evaluated behavior which is the result of a mental condition
that is reasonably believed to be dangerous to self or others. Any involuntary
commitment of said person shall be only to an inpatient psychiatric facility
designated by the Secretary to provide such care and treatment. If, at any
time, the person at risk of being involuntarily committed voluntarily seeks
care and treatment for his or her mental condition or behaviors, any pending
request for involuntary commitment pursuant to Chapter 50 of this title will
terminate and the person shall be voluntarily admitted to a designated
psychiatric treatment facility without delay.
(h) The 24-hour detention period
referred to herein shall be 72 hours for minors admitted in conformity with §
5135 of this title. If it appears that the nearest known relative of the minor
has not received prior notice of the proceedings, the facility administrator or
designee shall, if reasonably possible, promptly give such notice. A
psychiatrist designated by the Secretary of the Department of Services for
Children, Youth and Their Families may conduct an independent review of a
determination that a person under 18 years of age admitted to any mental health
facility pursuant to this chapter is a person deemed to be dangerous as a
result of a mental condition.
(i) The State Treasurer shall pay
peace officers, including police officers and constables, for transportation
services as peace officers under this subchapter at an agreed upon rate,
including a custody fee and mileage traveled.
(j)(1) No peace
officer, medical doctor, credentialed mental health screener, or facility in
which a medical doctor or credentialed mental health screener practices shall
be subject to civil damages or criminal penalties for any harm resulting from
the performance of their functions under this section unless such harm was
intentional or the result of wilful or wanton misconduct on their part. This immunity
is limited to the mental health assessment, resulting clinical decision, and
involuntary hold necessary until the person is presented to a designated
psychiatric treatment facility that is able to provide such psychiatric
healthcare services for the 24-hour detention described in paragraph (a)(7) of
this section.
(2) After the
person presents to the designated psychiatric treatment facility and during the
24-hour involuntary detention period described in paragraph (a)(12) of this
section, no medical doctor or designated psychiatric treatment facility shall
be subject to civil damages or criminal penalties for any harm to the person
with a mental condition resulting from the performance of functions under
subsection (f) of this section unless such harm was the result of negligent,
reckless, wilful, wanton and/or intentional misconduct.
(3) Nothing in
this section is intended to waive the State's sovereign immunity or the
privileges and immunities set forth at Chapter 40 of Title 10.
(k) All professional personnel
employed by the State or private providers are mandated to disclose any
conflicts of interest regarding their participation in the 24-hour detention of
any individual with an apparent mental condition to any psychiatric facility.
Such conflicts of interest shall be disclosed on the 24-hour detention form and
may include, but are not limited to, employment by a privately operated
psychiatric facility, a personal relationship with the individual being
detained or committed involuntarily, a relationship with family or significant
others of the individual being detained or committed involuntarily, or being
the victim of a crime by the person being detained or committed involuntarily.
(l) Notwithstanding any other
section of the Delaware Code, no person shall be detained or otherwise
involuntarily committed to a designated psychiatric treatment facility unless a
psychiatrist or credentialed mental health screener determines that such
detention or commitment is the least restrictive and most community-integrated
means to adequately treat the person that is immediately available.
(m) The Department is hereby
authorized to establish regulations consistent with this subchapter. These
regulations shall include rules regarding the disclosure by credentialed mental
health screeners of potential conflicts of interest.
(n) The Department shall form an
expert panel for the purposes of advising the Department on the content of the
regulations. The expert panel shall be chaired by the Director of the Division
of Substance Abuse and Mental Health or his or her designees, and shall
include, but not be limited to, representatives from the following: the
Director of the Division of Professional Regulations, or his or her designee; 2
representatives from the physician community, to be appointed by the Medical
Society of Delaware; 2 representatives from the Delaware Chapter of the
American College of Emergency Physicians, to be appointed by the chair of the
expert panel; 3 representatives from general hospitals, appointed by the
Delaware Healthcare Association; 3 representatives from the designated
psychiatric facilities, to be appointed by the chair of the expert panel; 1
psychiatrist appointed by the Psychiatric Society of Delaware; 2 community
providers, to be appointed by the chair of the expert panel; 1 representative
of the Mental Health Association in Delaware, to be appointed by the chair of
the expert panel; 1 representative of the National Alliance on Mental Illness
in Delaware, to be appointed by the chair of the expert panel; and 1 or more
members of the public, to be appointed by the chair of the expert panel, who
shall represent the interests of patients.
§ 5127 Liability for maintenance of
patient; collection remedies.
(a) Any adult committed to or
placed in a designated psychiatric treatment facility or mental hospital shall
be liable for the cost of care, treatment, or both to the extent authorized by
§ 7940 of Title 29. If a child is committed to or placed in a designated
psychiatric treatment facility or mental hospital, liability for costs of care,
treatment, or both shall conform to § 9019 of Title 29.
(b) The Department of Health and
Social Services and Department of Services for Children, Youth and Their
Families shall keep an account of the cost of care, treatment, or both and
credit against the account all moneys received from the patient or other
persons on the patient's behalf.
(c) In the event of nonpayment,
the Department of Health and Social Services and Department of Services for
Children, Youth and Their Families may pursue collection remedies authorized by
§§ 7940 and 9019, respectively, of Title 29.
§ 5128 Expenses of examination and
removal of indigent patients.
The expenses of the examination of an
indigent person alleged to be suffering from a mental condition and the
transportation of such person, if found to be suffering from a mental
condition, by a peace officer or credentialed mental health screener to a
designated psychiatric facility able to provide further evaluation or care and
treatment, shall be paid by the State Treasurer.
§ 5130 Veterans Administration
hospitals.
The provisions in the Delaware Code
pertaining to the admission, commitment, care and release of persons diagnosed
with a mental condition at state institutions shall apply with the same force
and effect to persons entitled to the services of hospitals for people with a
mental condition operated by the Veterans Administration. Persons so entitled
may be transferred from state institutions to such Veterans Administration hospitals
subject to the statutory provisions affording interested parties the right to
have the status of the person with a mental condition determined as provided by
law.
§ 5131 Discharge of patients at
Delaware Psychiatric Center; release on convalescent status; continued
responsibility; review of convalescent status.
(a) The Hospital Director of the
Delaware Psychiatric Center shall as frequently as practicable, but not less
often than every 3 months, examine or cause to be examined every hospitalized
patient admitted under § 5003 of this title, and whenever the Hospital
Director, in consultation with a psychiatrist, determines that any patient is
not a person with a mental condition, as that term is defined in § 5001 of this
title, or whenever the Hospital Director, in consultation with a psychiatrist,
determines that otherwise, the care, treatment and supervision of the
Psychiatric Center are no longer necessary, the patient shall be discharged.
The certificate of discharge shall state the basis for the discharge. Prior to
discharge, the facility shall prepare a written continuing care plan developed
in consultation with interdisciplinary staff, anticipated post-discharge
providers and the patient, and, if the patient is a minor, with the patient's
parents or legal guardian. At a minimum, Departmental community-based services
staff shall be consulted for adult patients in Departmental facilities. The
continuing care plan shall include: a realistic assessment of the patient's
post-discharge social, financial, vocational, housing and treatment needs;
identification of available support services and provider linkages necessary to
meet the assessed needs; and identification and a timetable of discrete,
predischarge activities necessary to promote the patient's successful
transition to the community-based services system or to another appropriate
post-discharge setting.
(b) The Hospital Director of the
Delaware Psychiatric Center may release an improved patient who was admitted
under § 5003 of this title on convalescent status when the Hospital Director,
in consultation with a psychiatrist, believes that such release is in the best
interests of the patient.
(c) Release on convalescent
status shall include provisions for continuing responsibility to and by the
Psychiatric Center, including a plan of treatment on an outpatient or
nonhospital patient basis.
(d) Prior to the end of a year on
convalescent status, and not less frequently than annually thereafter, the
Hospital Director shall examine the facts relating to the condition of the
patient on convalescent status and whenever the Hospital Director, in
consultation with a psychiatrist, determines that the patient is not a person
with a mental condition, as that term is defined in § 5001 of this title, or
whenever the Hospital Director, in consultation with a psychiatrist, determines
that otherwise, the care, treatment and supervision of the Psychiatric Center
are no longer necessary, the patient shall be discharged. The certificate of
discharge shall state the basis for the discharge.
§ 5132 Return of patients; order;
notice; custody.
(a) If an inpatient of a
state-operated mental hospital escapes or is on unauthorized leave, its
director may issue an order for the patient's immediate rehospitalization. The
director or the director's designee may notify such patient of the existence of
a rehospitalization order by any reasonable means of communication open to the
director. Such an order, irrespective of the patient's actual receipt, shall
authorize any peace officer to take the patient into custody for
rehospitalization.
(b) If an involuntarily committed
inpatient or a person detained involuntarily under this chapter from a
non-state-operated hospital certified under § 5135 or § 5136 of this title
escapes or is on unauthorized leave, that hospital's director shall immediately
notify the Director of the Division of Substance Abuse and Mental Health or the
Director's designee if the patient is 18 years of age or older or the Division
of Prevention and Behavioral Health Services if the patient is under 18 years
of age. Upon receipt of such notification, the Division Director or the
Director's designee may issue notice and a rehospitalization order in
conformity with subsection (a) of this section. Such an order, irrespective of
the patient's actual receipt, shall authorize any peace officer to take the
patient into custody for rehospitalization.
§ 5133 Unwarranted hospitalization in
Delaware Psychiatric Center or denial of rights; penalties.
(a) Any person who wilfully
causes, or conspires with or assists another to cause:
(1) The
unwarranted hospitalization of any individual in the Delaware Psychiatric
Center under this chapter; or
(2) The denial to
any individual of any of the rights accorded to said individual under this
chapter shall be punished by a fine not exceeding $500 or imprisonment not
exceeding 1 year, or both.
(b) The Superior Court shall have
jurisdiction of offenses under this section.
§ 5134 Examinations of persons relative
to parole, pardon or commutation of sentence in case of certain crimes.
Whenever the Director of the Division
of Substance Abuse and Mental Health or the Director of the Division of
Developmental Disabilities Services receives a request from the Commissioner of
the Department of Correction, relative to parole, pursuant to § 4353 of Title
11, or relative to pardon or commutation of sentence, pursuant to § 4362 of
Title 11, for psychiatric examination and psychological clinical studies, and a
report containing an opinion of the prisoner's condition and of the probability
of the prisoner's again committing crimes similar to the 1 for which the
prisoner was incarcerated, or other crimes, the Director shall cause such
examination and studies to be made at the correctional institution or the Delaware
Psychiatric Center, and copies of the report shall be delivered to each member
of the Parole Board or the Board of Pardons, as the case may be; and in cases
of pardons and commutations of sentence, a copy to the Governor.
§ 5135 Minors.
(a) Any person under 18 years of
age admitted pursuant to this chapter shall not be admitted to the Delaware
Psychiatric Center but to a hospital certified by the Secretary of the
Department of Services for Children, Youth and Their Families as being
appropriate for the diagnosis, care and treatment of persons with a mental
condition under 18 years of age.
(b) The provisions of this
chapter pertaining to the care and release of persons with mental conditions at
the Delaware Psychiatric Center shall apply with the same force and effect to
persons admitted to a hospital or other location as defined in § 5101(2) of
this title.
§ 5136 Additional facilities for
adults.
The Secretary of the Department of
Health and Social Services, upon voluntary application of a private or public
hospital, may certify such hospital as an appropriate facility for the
detention, diagnosis, care and treatment of adults with a mental condition
under this chapter. If so certified, on a case-by-case basis, any such hospital
shall be authorized to serve in addition to the Delaware Psychiatric Center
under this chapter.
SYNOPSIS
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The 146th General Assembly passed House Joint Resolution
No. 17 establishing a Study Group to, inter alia, conduct a comprehensive
evaluation of Delaware's civil mental health laws. HJR 17 noted that it has been decades since
a comprehensive review was made of these laws. HJR 17 further noted that it is in the
interest of the State that “people be able to access the most appropriate
mental health treatment, in the most appropriate but least restrictive
setting, at the most appropriate time.” This bill is the result of
recommendations made by the HJR 17 Study Group. It is important to
note at the outset that the changes in this bill appear more comprehensive
than they actually are because one of the primary changes made by this Act is
the combination of Chapter 50 with those portions of Chapter 51 dealing with
civil commitment. Thus, much of the
stricken language of Chapter 51 appears as underlined “new” language in
Chapter 50, but has not actually been changed significantly. Combining the chapters creates consistent
definitions and a logical and structured process. The language and definitions of both
chapters have been updated to refelect modern usage, current terms and
promote consistency across the Delaware Code. Substantive changes were made to modernize procedures and
provide better civil rights protections to patients. Much attention was paid to making a
consistent process, so that people enter civil mental treatment in a
consistent manner with due process protections and that similar protections
and treatment philosophies are applied across the different levels of
treatment. The voluntary admission process was revised to require a
clearer showing of informed consent by the individual requesting to be
voluntarily admitted. The proposal
also reduces the timeframe to discharge a voluntary patient who requests
discharge in writing from the current 5 working days to 72 hours. The proposal broadly adds additional safeguards and
removes the ability to provisionally admit someone based on property
destruction; it removes the ability of psychiatrist to bypass emergency
detention through the use of provisional admission; it adds in explicit
language that an individual who is provisionally admitted shall not be
considered “involuntarily committed” for any legal purpose; but it allows for
48-hour admission following a 24-hour emergency detention. The following due process protection have been added after
an involuntary inpatient commitment has been ordered: the order may not exceed three months;
shall be based on the court’s individualized assessment of the facts and
circumstances; at the end of the three month period, an individual is
entitled to a hearing with at least a 14 day notice if continued inpatient
treatment is ordered, hearings are held every three months to review the
case. Other changes include appeal rules that better reflect
Superior Court rules. Discharge
requirements will explicitly extend to private psychiatric hospitals as well
as DPC. This will not functionally change services already being provided by
psychiatric hospitals because the majority of what is covered by provision is
already required elsewhere in Delaware Law.
Due process protections were added for youth. Parallel to
the adult system, the Study Group recommends that emergency detentions be
done only by psychiatrists and “Juvenile Mental Health Screeners.” However, because they are minors, consent
for voluntary admissions to designated psychiatric treatment facilities or
hospitals may only be given by a parent or legal guardian and such requests
must be signed by a parent or legal guardian. Once admitted, minors or their parents or legal guardians
may make a written request to the psychiatrist to be discharged at any
time. Discharge may be conditioned
upon the consent of the parent or legal guardian. If the parent or legal guardian of a voluntary
patient requests discharge against medical advice, the involuntary treatment
procedures may be initiated. At the recommendation of the HJR17 Study Group, consent
for voluntary outpatient mental health treatment for minors under the age of
14 requires the consent of a parent, legal custodian, or legal guardian. However, for minors age 14 to 18, the minor
or the parent / legal custodian / legal guardian may provide the
consent. A minor, including those
14-18, cannot overrule consent provided by a parent/legal guardian / legal
custodian. A parent/legal custodian /
legal guardian may not abrogate the consent provided by a minor age 14 or
older. Psychotropic medication
requires the consent of the parent, legal guardian, or legal custodian. A different time frame is proposed for minors than adults for emergency detentions. When minors are emergently detained, the evaluation and treatment shall occur within 24 hours unless the parent or legal guardian is unavailable during that initial 24 hour period. In such instances the time period may be extended to 72 hours. Finally, the proposed legislation establishes the ability for the Secretary of the Department of Services for Children, Youth and Their Families to designate a psychiatrist or Institutional Review Board to review the emergency detention decisions of Juvenile Mental Health Screeners on an individual case or aggregate basis. |
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