WEST virginia legislature
2022 regular session
Committee Substitute
for
House Bill 4377
By Delegates Rohrbach, D. Jeffries, Pack, Reed, Worrell, Bates, Rowan, G. Ward, Miller, Criss and Pinson
[Originating in the Committee on the Judiciary; reported on February 23, 2022]
A BILL to amend and reenact §27-5-1, §27-5-2, §27-5-3, §27-5-4, and §27-5-10 of the Code of West Virginia, 1931, as amended, all relating to involuntary hospitalization; modifying the time for the completion of proceedings; requiring applicants to disclose contact information of persons to receive notice of involuntary commitment proceedings; transportation of individuals who are ordered for involuntary hospitalization to a diversion facility; updating outdated language in the code; authorizing the West Virginia Department of Health and Human Resources to propose legislative rules to implement the provisions of these articles; authorizing the Supreme Court of Appeals and the West Virginia Department of Health and Human Resources to conduct retrospective reviews of involuntary commitment applications and orders; and making technical amendments.
Be it enacted by the Legislature of West Virginia:
ARTICLE 5. INVOLUNTARY HOSPITALIZATION.
§27-5-1. Appointment of mental hygiene officials.
(a) Appointment of mental hygiene commissioners. —
The chief judge in each judicial circuit of this state shall appoint a
competent attorney and may, if necessary, appoint additional attorneys to serve
as mental hygiene commissioners to preside over involuntary hospitalization
hearings. Mental hygiene commissioners shall be persons of good moral
character and of standing in their profession and they shall, before
assuming the duties of a commissioner, take the oath required of other special
commissioners as provided in §6-1-1 et seq. of this code.
Prior to presiding over an involuntary hospitalization
hearing, each newly appointed person to serve as a mental hygiene commissioner
and all magistrates shall attend and complete an orientation course that
consists of training provided annually by the Supreme Court of Appeals and
complete an orientation program to be developed by the Secretary of the Department
of Health and Human Resources. In addition, existing mental hygiene
commissioners and all magistrates trained to hold probable cause and emergency
detention hearings involving involuntary hospitalization shall attend and
complete a course provided by the Supreme Court of Appeals and complete an
orientation program to be developed by the Secretary of the Department of
Health and Human Resources. Persons attending the courses outside the
county of their residence shall be reimbursed out of the budget of the Supreme
Court—General Judicial for reasonable expenses incurred. The Supreme Court of
Appeals shall establish curricula and rules for the courses, including rules
providing for the reimbursement of reasonable expenses as authorized in this
section. The Secretary of the Department of Health and Human Resources shall
consult with the Supreme Court of Appeals regarding the development of the
orientation program.
(b) Duties of mental hygiene commissioners. —
(1) Mental hygiene commissioners may sign and issue summonses for the attendance, at any hearing held pursuant to §27-5-4 of this code, of the individual sought to be committed; may sign and issue subpoenas for witnesses, including subpoenas duces tecum; may place any witness under oath; may elicit testimony from applicants, respondents, and witnesses regarding factual issues raised in the petition; and may make findings of fact on evidence and may make conclusions of law, but the findings and conclusions are not binding on the circuit court. All mental hygiene commissioners shall be reasonably compensated at a uniform rate determined by the Supreme Court of Appeals. Mental hygiene commissioners shall submit all requests for compensation to the administrative director of the courts for payment. Mental hygiene commissioners shall discharge their duties and hold their offices at the pleasure of the chief judge of the judicial circuit in which he or she is appointed and may be removed at any time by the chief judge. A mental hygiene commissioner shall conduct orderly inquiries into the mental health of the individual sought to be committed concerning the advisability of committing the individual to a mental health facility. The mental hygiene commissioner shall safeguard, at all times, the rights, and interests of the individual as well as the interests of the state. The mental hygiene commissioner shall make a written report of his or her findings to the circuit court. In any proceedings before any court of record as set forth in this article, the court of record shall appoint an interpreter for any individual who is deaf or cannot speak, or who speaks a foreign language, and who may be subject to involuntary commitment to a mental health facility. A mental hygiene commissioner shall be available when necessary to hold hearings reasonably promptly in accordance with §27-5-1 et seq. of this code, not to exceed 48 hours.
(2) A mental hygiene commissioner appointed by the circuit court of one county or multiple county circuits may serve in that capacity in a jurisdiction other than that of his or her original appointment if it is agreed upon by the terms of a cooperative agreement between the circuit courts and county commissions of two or more counties entered into to provide prompt resolution of mental hygiene matters during hours when the courthouse is closed or on nonjudicial days.
(c) Duties of prosecuting attorney. —The prosecuting attorney or one of his or her assistants shall represent the applicants in all final commitment proceedings filed pursuant to the provisions of this article. The prosecuting attorney may appear in any proceeding held pursuant to the provisions of this article if he or she determines it to be in the public interest.
(d) Duties of sheriff, law-enforcement
officer. —
(1) Upon written order of the circuit court, mental hygiene commissioner, or magistrate in the county where the individual formally accused of being mentally ill or having a substance use disorder is a resident or is found, the circuit court, mental hygiene commissioner, or magistrate issuing an emergency custody order shall specify the primary law-enforcement agency and jurisdiction to execute the emergency custody order and provide transportation. However, the circuit court, mental hygiene commissioner, or magistrate shall consider any request to authorize transportation by an alternative transportation provider in accordance with this section, whenever an alternative transportation provider is identified to the mental hygiene commissioner or court, which may be a facility, agency, a representative of the community mental health services provider, or other transportation provider with personnel trained to provide transportation in a safe manner. To determine if an alternative transportation manner is appropriate the commissioner shall consider information provided by the petitioner; the community mental health services provider; the law-enforcement agency; the person’s treating physician; or other persons who are available and have knowledge of the person. If the mental hygiene commissioner or court deems appropriate, the proposed alternative transportation provider shall confirm availability to provide transportation in a safe manner.
(2) When transportation is ordered to be provided by an alternative transportation provider, the mental hygiene commissioner or court shall order the specified primary law-enforcement agency to execute the order, to take the person into custody, and to transfer custody of the person to the alternative transportation provider identified in the order. In such cases, a copy of the emergency custody order shall accompany the person being transported pursuant to this section at all times and shall be delivered by the alternative transportation provider to the community mental health services provider or its designee responsible for conducting the evaluation.
(3) The community mental health services provider or its designee conducting the evaluation shall return a copy of the emergency custody order as soon as is practicable. Delivery of an order to a law-enforcement officer or alternative transportation provider and return of an order to the court may be accomplished electronically. If a person is held in a regional jail, as authorized in §27-5-2, the Department of Corrections and Rehabilitation is responsible for execution of such orders and transport with the same duties as a primary law enforcement agency, without the ability to utilize alternative transport.
(4) If an alternative transportation provider is
not used, the sheriff of that county, law-enforcement officer
shall take the individual into custody and transport him or her to and from the
place of hearing and the mental health facility. The sheriff, law-enforcement
officer shall also maintain custody and control of the accused individual
during the period of time in which the individual is waiting for the
involuntary commitment hearing to be convened and while the hearing is being
conducted. The law-enforcement officer has no duty to maintain custody and
control of the individual as provided in §27-5-2(e) of this code.
(5) The circuit court, mental hygiene commissioner, or magistrate may change the transportation provider specified in a temporary detention order at any time prior to the initiation of transportation of a person who is the subject of a temporary detention order pursuant to this section. If the designated transportation provider is changed by the circuit court, mental hygiene commissioner, or magistrate at any time after the temporary detention order has been executed but prior to the initiation of transportation, the transportation provider having custody of the person shall transfer custody of the person to the transportation provider subsequently specified to provide transportation. For the purposes of this subsection, “transportation provider” includes both a law-enforcement agency and an alternative transportation provider.
(6) That An individual who is a resident of
a state other than West Virginia shall, upon a finding of probable cause, be
transferred to his or her state of residence for treatment pursuant to
§27-5-4(p) of this code: Provided, however, That where an
individual is a resident of West Virginia but not a resident of the county in
which he or she is found and there is a finding of probable cause, the county
in which the hearing is held may seek reimbursement from the county of
residence for reasonable costs incurred by the county attendant to the mental
hygiene proceeding.
(7) Notwithstanding any provision of this code to
the contrary, sheriffs law-enforcement
agencies may enter into cooperative agreements with sheriffs law-enforcement
agencies of one or more other counties, with the concurrence of their
respective circuit courts and county commissions, by which transportation and
security responsibilities for hearings held pursuant to the provisions of
this article during hours when the courthouse is closed or on nonjudicial
days may be shared in order to facilitate prompt hearings and to effectuate
transportation of persons found in need of treatment. In
the event an individual requires transportation to a state hospital as defined
by §27-1-6 of this code, the sheriff shall contact the state hospital in
advance of the transportation to determine if the state hospital has available
suitable bed capacity to place the individual.
(e) Duty of sheriff,
law-enforcement agency or alternative
transportation provider upon presentment to mental health care facility. — (1) When a person is brought to a mental
health care facility for purposes of evaluation for commitment under this
article, if he or she is violent or combative, the sheriff, or his or her
designee law-enforcement
agency or alternative transportation provider
shall maintain custody of the person in
the facility until the evaluation is completed., or the county commission
shall reimburse the mental health care facility at a reasonable rate for
security services provided by the mental health care facility for the period of
time the person is at the hospital prior to the determination of mental
competence or incompetence.
(2) When a law-enforcement officer takes custody of a person pursuant to this article, the officer may request assistance from emergency medical personnel if such assistance is needed for the safety of the officer or the person in custody.
(f) Duties of Supreme Court of Appeals. — The Supreme Court of Appeals shall provide uniform petition, procedure, and order forms which shall be used in all involuntary hospitalization proceedings brought in this state.
(g) Duties of the Department of Health and Human Resources. — The secretary shall develop an orientation program as provided in subsection (a) of this section. The orientation program shall include, but not be limited to, instruction regarding the nature and treatment of mental illness and substance use disorder; the goal and purpose of commitment; community-based treatment options; and less restrictive alternatives to inpatient commitment. The secretary shall provide to the Supreme Court of Appeals, the mental health centers and each law enforcement agency current information that identifies contact information for employees and staff at the state psychiatric hospitals who are responsible for facilitating the admission of persons who are involuntarily committed to state hospitals.
(h) Civil Involuntary Commitment Audits. – The Supreme Court of Appeals and the secretary shall establish a process to conduct retrospective quarterly audits of applications and licensed examiner forms prepared by certifiers for the involuntary civil commitment of persons as provided in §27-5-1 et seq. of this code. The process shall determine whether the licensed examiner forms prepared by certifiers are clinically justified and consistent with the requirements of this code and, if not, develop corrective actions to redress identified issues. The process and the findings thereof shall be confidential and not subject to the provisions of §6-9A-1 et seq. and §29B-1-1 et seq. of this code.
(i) Duties of the Mental Health Center for Purposes of Evaluation for Commitment. – Each mental health center shall make available as reasonably necessary a qualified and competent licensed person to conduct prompt evaluations of persons for commitment in accordance with §27-5-1 et seq. of this code. Evaluations shall be conducted in person, and only if such an in person evaluation is not possible, than an evaluation may be conducted electronically. Each mental health center that performs these evaluations shall exercise reasonable diligence in performing the evaluations and communicating with the state hospital to provide all reasonable and necessary information to facilitate a prompt and orderly admission to the state hospital of any person who is or is likely to be involuntarily committed to such hospital. Each mental health center that performs these evaluations shall explain the involuntary commitment process to the applicant and the person proposed to be committed and further identify appropriate alternative forms of potential treatment, loss of liberty if committed, and the likely risks and benefits of commitment.
(j) All paperwork shall be communicated through electronic
transmission.
This includes referrals to diversion hospitals from state hospitals.
(k) Notwithstanding any provision of this code, the Supreme Court, mental health facilities, Cabell County, law enforcement, and the Department of Health and Human Resources may participate in a pilot project to implement an involuntary commitment process.
§27-5-2. Institution of proceedings for involuntary custody for examination; custody; probable cause hearing; examination of individual.
(a) Any adult person may make an application for
involuntary hospitalization for examination of an individual when the person
making the application has reason to believe direct and specific
knowledge that the individual to be examined has a
substance use disorder as defined by the most recent edition of the American
Psychiatric Association in the Diagnostic and Statistical Manual of Mental
Disorders, inclusive of substance use withdrawal, or is mentally ill and that
as a direct and specific result of , because of his or her substance
use disorder or mental illness, the individual is likely to cause serious harm
to himself, herself, or to others if allowed to remain at liberty while
awaiting an examination and certification by a physician, psychologist,
licensed professional counselor, licensed independent social worker, an
advanced nurse practitioner, or physician assistant as provided in subsection
(e) of this section: Provided,
That a diagnosis of
dementia, epilepsy, or intellectual or developmental disability alone may
not serve as may not be a basis for involuntary commitment to a
state hospital.
(b) Notwithstanding any language in this subsection
to the contrary, if the individual to be examined under the provisions of this
section is incarcerated in a jail, prison, or other correctional facility, then
only the chief administrative officer of the facility holding the individual
may file the application, and the application must include the additional
statement that the correctional facility itself cannot reasonably provide
treatment and other services directly necessary to treat for the
individual’s mental illness or substance use.
(b) The person making the application shall make the
application under oath.
(c) Application for involuntary custody for examination may be made to the circuit court, magistrate court, or a mental hygiene commissioner of the county in which the individual resides or of the county in which he or she may be found. A magistrate before whom an application or matter is pending may, upon the availability of a mental hygiene commissioner or circuit court judge for immediate presentation of an application or pending matter, transfer the pending matter or application to the mental hygiene commissioner or circuit court judge for further proceedings unless otherwise ordered by the chief judge of the judicial circuit.
(d) The person making the application shall give information and state facts to which the person has direct and specific knowledge in the application required by the form provided for this purpose by the Supreme Court of Appeals.
(e) The circuit court, mental hygiene commissioner, or
magistrate may enter an order for the individual named in the application to be
detained and taken into custody as provided in §27-5-1(d) and §27-5-10 of
this code for the purpose of holding a probable cause hearing as provided
in §27-5-2(g) of this code. for the purpose of An examination of the
individual to determine whether the individual meets involuntary
hospitalization criteria shall be conducted in person.
Evaluations may be conducted electronically if they are available, if they are
not clinically contraindicated, and if an in-person evaluation would create a
substantial delay to the resolution of the matter, and shall be
performed by a physician, psychologist, a licensed professional counselor
practicing in compliance with §30-31-1 et seq. of this code, a licensed
independent clinical social worker practicing in compliance with §30-30-1 et
seq. of this code, an advanced nurse practitioner with psychiatric
certification practicing in compliance with §30-7-1 et seq. of this
code, a physician’s assistant practicing in compliance
with §30-3-1 et seq. of this code, or a physician’s assistant practicing
in compliance with §30-3E-1 et seq. of this code: Provided,
That a licensed professional counselor, a licensed independent clinical social
worker, a physician’s assistant, or an advanced nurse practitioner with
psychiatric certification may only perform the examination if he or she has
previously been authorized by an order of the circuit court to do so, the order
having found that the licensed professional counselor, the licensed independent
clinical social worker, physician’s assistant, or advanced nurse practitioner
with psychiatric certification has particularized expertise in the areas of
mental health and mental hygiene or substance use disorder sufficient to make
the determinations required by the provisions of this section. The examination is
to shall be provided or arranged by a community mental health center
designated by the Secretary of the Department of Health and Human Resources to
serve the county in which the action takes place. The
order is to specify that the hearing evaluation be held immediately
within a reasonable period of time not to exceed two hours is to shall
provide for the appointment of counsel for the individual: Provided,
however, That the order may allow the hearing to be held up to 24 hours
after the person to be examined is taken into custody rather than immediately
if the circuit court of the county in which the person is found has previously
entered a standing order which establishes within that jurisdiction a program
for placement of persons awaiting a hearing which assures the safety and humane
treatment of persons: Provided further That the time
requirements set forth in this subsection only apply to persons who are not in
need of medical care for a physical condition or disease for which the need for
treatment precludes the ability to comply with the time requirements. During
periods of holding and detention authorized by this subsection, upon consent of
the individual or in the event of if there is a medical or
psychiatric emergency, the individual may receive treatment. The medical
provider shall exercise due diligence in determining the individual’s existing
medical needs and provide treatment the individual requires, including
previously prescribed medications. As used in this section, “psychiatric
emergency” means an incident during which an individual loses control and
behaves in a manner that poses substantial likelihood of physical harm to
himself, herself, or others. Where a physician, psychologist, licensed
professional counselor, licensed independent clinical social worker, physician’s
assistant, or advanced nurse practitioner with psychiatric certification has,
within the preceding 72 hours, performed the examination required by the
provisions of this subsection the community mental health center may waive
the duty to perform or arrange another examination upon approving the
previously performed examination. Notwithstanding the provisions of this
subsection, §27-5-4(r) of this code applies regarding payment by the county
commission for examinations at hearings. If the examination reveals that the
individual is not mentally ill or has no substance use disorder, or is
determined to be mentally ill or has a substance use disorder but not likely to
cause harm to himself, herself, or others, the individual shall be immediately
released without the need for a probable cause hearing and the examiner is not
civilly liable for the rendering of the opinion absent a finding of
professional negligence. The examiner shall immediately but no later than 60
minutes after completion of the examination provide the mental hygiene
commissioner, circuit court, or magistrate before whom the matter is pending and
the state hospital to which the individual may be involuntarily hospitalized
the results of the examination on the form provided for this purpose by the
Supreme Court of Appeals for entry of an order reflecting the lack of probable
cause.
(f) A probable cause hearing is to shall be
held promptly before a magistrate, the mental hygiene commissioner, or
circuit judge of the county of which the individual is a resident or where he
or she was found. If requested by the individual or his or her counsel, the
hearing may be postponed for a period not to exceed 48 hours. Hearings shall
be conducted via videoconferencing unless the individual or his or her counsel
objects, or the magistrate, mental hygiene commissioner, or circuit judge
orders otherwise. The Supreme Court of Appeals is encouraged to develop
regional mental hygiene collaboratives where mental hygiene commissioners can
share on-call responsibilities, thereby reducing the burden on individual
circuits and commissioners.
The individual must shall be present at the
hearing and has the right to present evidence, confront all witnesses and other
evidence against him or her, and examine testimony offered, including testimony
by representatives of the community mental health center serving the area.
Expert testimony at the hearing may be taken telephonically or via
videoconferencing. The individual has the right to remain silent and to be
proceeded against in accordance with the Rules of Evidence of the Supreme Court
of Appeals, except as provided in §27-1-12 of this code. At the conclusion of
the hearing, the magistrate, mental hygiene commissioner, or circuit court
judge shall find and enter an order stating whether or not it is likely that
deterioration will occur without clinically necessary treatment, or there is
probable cause to believe that the individual, as a result of mental illness or
substance use disorder, is likely to cause serious harm to himself or herself
or to others. Any such order entered shall be provided to the state hospital
to which the individual may or will be involuntarily hospitalized within 60
minutes of filing absent good cause.
(g) Probable cause hearings may occur in the county where a person is hospitalized. The judicial hearing officer may: Use videoconferencing and telephonic technology; permit persons hospitalized for substance use disorder to be involuntarily hospitalized only until detoxification is accomplished; and specify other alternative or modified procedures that are consistent with the purposes and provisions of this article to promote a reasonably prompt, orderly, and efficient hearing. The alternative or modified procedures shall fully and effectively guarantee to the person who is the subject of the involuntary commitment proceeding and other interested parties due process of the law and access to the least restrictive available treatment needed to prevent serious harm to self or others.
(h) If the magistrate, mental hygiene commissioner, or
circuit court judge at a probable cause hearing or a mental hygiene
commissioner or circuit judge at a final commitment hearing held pursuant to
the provisions of §27-5-4 of this code finds that the individual, as a direct
result of mental illness or substance use disorder except as otherwise
provided in §27-5-2(a) of this code, is likely to cause serious harm
to himself, herself, or others and because of mental illness or a substance use
disorder requires treatment, the magistrate, mental hygiene commissioner, or
circuit court judge may consider evidence on the question of whether the
individual’s circumstances make him or her amenable to outpatient treatment in
a nonresidential or nonhospital setting pursuant to a voluntary treatment
agreement. At the conclusion of the hearing, the magistrate, mental hygiene
commissioner, or circuit court judge shall find and enter an order stating
whether or not it is likely that deterioration will occur without clinically
necessary treatment, or there is probable cause to believe that the individual,
as a result of mental illness or substance use disorder, is likely to cause
serious harm to himself or herself or others. The agreement is to be in writing
and approved by the individual, his or her counsel, and the magistrate, mental
hygiene commissioner, or circuit court judge. If the magistrate, mental hygiene
commissioner, or circuit court judge determines that appropriate outpatient
treatment is available in a nonresidential or nonhospital setting, the
individual may be released to outpatient treatment upon the terms and
conditions of the voluntary treatment agreement. The failure of an individual
released to outpatient treatment pursuant to a voluntary treatment agreement to
comply with the terms of the voluntary treatment agreement constitutes evidence
that outpatient treatment is insufficient and, after a hearing before a
magistrate, mental hygiene commissioner, or circuit judge on the issue of
whether or not the individual failed or refused to comply with the terms and
conditions of the voluntary treatment agreement and whether the individual as a
result of mental illness or substance use disorder remains likely to cause serious
harm to himself, herself, or others, the entry of an order requiring admission
under involuntary hospitalization pursuant to the provisions of §27-5-3
of this code may be entered except as otherwise provided in §27-5-2(a) of
this code. Nothing in the provisions of this article regarding release
pursuant to a voluntary treatment agreement or convalescent status may be
construed as creating a right to receive outpatient mental health services or
treatment, or as obligating any person or agency to provide outpatient services
or treatment. Time limitations set forth in this article relating to periods of
involuntary commitment to a mental health facility for hospitalization do not
apply to release pursuant to the terms of a voluntary treatment agreement: Provided,
That release pursuant to a voluntary treatment agreement may not be for a
period of more than six months if the individual has not been found to be
involuntarily committed during the previous two years and for a period of no
more than two years if the individual has been involuntarily committed during
the preceding two years. If in any proceeding held pursuant to this article the
individual objects to the issuance or conditions and terms of an order adopting
a voluntary treatment agreement, then the circuit judge, magistrate, or mental
hygiene commissioner may not enter an order directing treatment pursuant to a
voluntary treatment agreement. If involuntary commitment with release pursuant
to a voluntary treatment agreement is ordered, the individual subject to the
order may, upon request during the period the order is in effect, have a
hearing before a mental hygiene commissioner or circuit judge where the
individual may seek to have the order canceled or modified. Nothing in this
section affects the appellate and habeas corpus rights of any individual
subject to any commitment order.
Notwithstanding anything in this article to the
contrary, The commitment of any individual as provided in this article
shall be in the least
restrictive setting and in an outpatient
community-based treatment program to the extent resources and programs are
available, unless the clear and convincing evidence of the certifying
professional under subsection (e) of this section, who is acting in a manner
consistent with the standard of care and after explaining the risks and
benefits of potential commitment or treatment as required by §27-5-1(i)
of this code, establishes that the commitment or treatment of that
individual requires an inpatient hospital placement. Outpatient treatment will
be based upon a plan jointly prepared by the department and the comprehensive
community mental health center or licensed behavioral health provider.
(i) If the certifying professional determines that an individual requires involuntary hospitalization for a substance use disorder as permitted by §27-5-2(a) of this code which, due to the degree of the disorder, creates a reasonable likelihood that withdrawal or detoxification will cause significant medical complications, the person certifying the individual shall recommend that the individual be closely monitored for possible medical complications. If the magistrate, mental hygiene commissioner, or circuit court judge presiding orders involuntary hospitalization, he or she shall include a recommendation that the individual be closely monitored in the order of commitment.
(j) The Supreme Court of Appeals and the Secretary of the Department of Health and Human Resources shall specifically develop and propose a statewide system for evaluation and adjudication of mental hygiene petitions which shall include payment schedules and recommendations regarding funding sources. Additionally, the Secretary of the Department of Health and Human Resources shall also immediately seek reciprocal agreements with officials in contiguous states to develop interstate/intergovernmental agreements to provide efficient and efficacious services to out-of-state residents found in West Virginia and who are in need of mental hygiene services.
§27-5-3. Admission under involuntary hospitalization for examination; hearing; release.
(a) Admission to a mental health facility for
examination. — Any individual may be admitted to a mental health facility
for examination and treatment upon entry of an order finding probable cause as
provided in §27-5-2 of this code. Upon entry of such an order, the
individual shall be examined by a qualified health care practitioner to
determine whether the individual is medically stable. The results of any such
examinations, assessments, and treatments shall be provided to the state
hospital as soon as practicable but no later than 30 minutes after completion
absent good cause. If the individual is determined to be medically stable or,
if not medically stable and upon a resolution of the individual’s acute medical
issues as determined by the qualified health care practitioner. upon a
finding by a licensed physician that the individual is medically stable,
and certification by a physician, psychologist, licensed professional
counselor, licensed independent clinical social worker practicing in compliance
with the provisions of §30-30-1 et seq. of this code, an advanced nurse practitioner with psychiatric
certification practicing in compliance with §30-7-1 et seq. of this
code, or a physician’s assistant practicing in compliance with §30-3E-1 et
seq. of this code with advanced duties in psychiatric medicine that he
or she has examined the individual and is of the opinion that the individual is
mentally ill or has a substance use disorder and, because of the mental illness
or substance use disorder, is likely to cause serious harm to himself, herself,
or to others if not immediately restrained and treated: Provided,
That the opinions offered by an independent clinical social worker, an advanced
nurse practitioner with psychiatric certification, or a physician’s assistant
with advanced duties in psychiatric medicine must shall be within
his or her particular areas of expertise, as recognized by the order of the
authorizing court.
(b) Three-day time limitation on examination. — If the examination does not take place within three days from the date the individual is taken into custody, the individual shall be released. If the examination reveals that the individual is not mentally ill or has a substance use disorder, the individual shall be released.
(c) Three-day time limitation on certification. — The certification required in §27-5-3(a) of this code is valid for three days. Any individual with respect to whom the certification has been issued may not be admitted on the basis of the certification at any time after the expiration of three days from the date of the examination.
(d) Findings and conclusions required for certification.
— A certification under this section must shall include findings
and conclusions of the mental examination, the date, time, and place of the
examination, and the facts upon which the conclusion that involuntary
commitment is necessary is based, including facts
that less restrictive interventions and placements were considered but are not
appropriate and available and that the risks and benefits were explained as
required by §27-5-1(i) of this code.
(e) Notice requirements. — When an individual is admitted to a mental health facility or a state hospital pursuant to the provisions of this section, the chief medical officer of the facility shall immediately give notice of the individual’s admission to the individual’s spouse, if any, and one of the individual’s parents or guardians or if there is no spouse and are no parents or guardians, to one of the individual’s adult next of kin if the next of kin is not the applicant. Notice shall also be given to the community mental health facility, if any, having jurisdiction in the county of the individual’s residence. The notices other than to the community mental health facility shall be in writing and shall be transmitted to the person or persons at his, her, or their last known address by certified mail, return receipt requested.
(f) Three-day time limitation for examination and
certification at mental health facility or state hospital. — After the
individual’s admission to a mental health facility or state hospital, he or she
may not be detained more than three days, excluding Sundays and holidays,
unless, within the period, the individual is examined by a staff physician and
the physician certifies that in his or her opinion the patient is mentally ill
or has a substance use disorder and as a direct
result of such illness or disorder is likely to injure himself, herself,
or others and requires continued commitment and
treatment. if allowed to be at liberty. In the event If
the staff physician determines that the individual does not meet the criteria
for continued commitment, that the individual can be treated in an available outpatient community-based treatment program
and poses no present danger to himself, herself or others, or that the
individual has an underlying medical issue or issues that resulted in a
determination that the individual should not have been committed, the staff
physician shall release and discharge the individual as appropriate as soon as
practicable.
(g) Ten Twenty-day time limitation for
institution of final commitment proceedings. — If, in the opinion of the
examining physician, the patient is mentally ill or has a substance use
disorder and because of the mental illness or substance use disorder is likely
to injure himself, herself, or others if allowed to be at liberty, the chief
medical officer shall, within 10 20 calendar days from the date
of admission, institute final commitment proceedings as provided in §27-5-4 of
this code. If the proceedings are not instituted within the 10 20-day
period absent good cause, the individual shall be immediately released.
After the request for hearing is filed, the hearing may not be canceled on the
basis that the individual has become a voluntary patient unless the mental
hygiene commissioner concurs in the motion for cancellation of the hearing.
(h) Twenty Thirty-five day time
limitation for conclusion of all proceedings. — If all proceedings as
provided in §27-3-1 et seq. and §27-4-1 et seq. of this code are
not completed within 20 35 days from the date of institution
of the proceedings filing the Application for Involuntary Custody for
Mental Health Examination, the individual shall be immediately released. The
petition is valid in the community or petitioning institution for 15 days, and
20 days in the mental health facility.
§27-5-4. Institution of final commitment proceedings; hearing requirements; release.
(a) Involuntary commitment. — Except as provided in §27-5-2 and §27-5-3 of this code, no individual may be involuntarily committed to a mental health facility or state hospital except by order entered of record at any time by the circuit court of the county in which the person resides or was found, or if the individual is hospitalized in a mental health facility or state hospital located in a county other than where he or she resides or was found, in the county of the mental health facility and then only after a full hearing on issues relating to the necessity of committing an individual to a mental health facility or state hospital. If the individual objects to the hearing being held in the county where the mental health facility is located, the hearing shall be conducted in the county of the individual’s residence. Notwithstanding anything herein to the contrary, all hearings for the involuntary final civil commitment of a person who is committed in accordance with §27-6A-1 et al., of this code shall be held by the circuit court of the county that has jurisdiction over the person for the criminal charges and such circuit court shall have jurisdiction over the involuntary final civil commitment of such person.
(b) How final commitment proceedings are commenced.
— Final commitment proceedings for an individual may be commenced by the filing
of a written application under oath by an adult person having personal direct
and specific knowledge of the facts of the case. The certificate or
affidavit is filed with the clerk of the circuit court or mental hygiene
commissioner of the county where the individual is a resident or where he or
she may be found, or the county of a mental health facility if he or she is
hospitalized in a mental health facility or state hospital located in a county
other than where he or she resides or may be found. Notwithstanding
anything herein to the contrary, all hearings for the involuntary final civil
commitment of a person who is committed in accordance with §27-6A-1 et seq.,
of this code shall be commenced upon the filing only of the Certificate of the
Licensed Certifier at the mental health facility where the person is currently
committed.
(c) Oath; contents of application; who may inspect application; when application cannot be filed. —
(1) The person making the application shall do so under oath.
(2) The application shall contain statements by the
applicant that the individual is likely to cause serious harm to self or others
due to what the applicant believes are symptoms of mental illness or substance
use disorder. The Except for persons sought to be committed as
provided in §27-6A-1 et seq., of this code, the applicant
shall state in detail the recent overt acts within the prior 72 hours
upon which the belief clinical opinion is based.
(3) The written application, certificate, affidavit, and any warrants issued pursuant thereto, including any related documents, filed with a circuit court, mental hygiene commissioner, or magistrate for the involuntary hospitalization of an individual are not open to inspection by any person other than the individual, unless authorized by the individual or his or her legal representative or by order of the circuit court. The records may not be published unless authorized by the individual or his or her legal representative. Disclosure of these records may, however, be made by the clerk, circuit court, mental hygiene commissioner, or magistrate to provide notice to the Federal National Instant Criminal Background Check System established pursuant to section 103(d) of the Brady Handgun Violence Prevention Act, 18 U.S.C. §922, and the central state mental health registry, in accordance with §61-7A-1 et seq. of this code, and the sheriff of a county performing background investigations pursuant to §61-7-1 et seq. of this code. Disclosure may also be made to the prosecuting attorney and reviewing court in an action brought by the individual pursuant to §61-7A-5 of this code to regain firearm and ammunition rights.
(4) Applications may not be accepted shall be
denied for individuals who only have epilepsy, dementia, or an
intellectual or developmental disability. as provided in §27-5-2(a)
of this code.
(d) Certificate filed with application; contents of certificate; affidavit by applicant in place of certificate. —
(1) The applicant shall file with his or her application
the certificate of a physician or a psychologist stating that in his or her
opinion the individual is mentally ill or has a substance use disorder and that
because of the as a direct result of such mental illness or
substance use disorder, the individual is likely to cause serious harm to self
or others if allowed to remain at liberty and, therefore and requires continued commitment and treatment,
and should be hospitalized. The certificate shall state in detail the
recent overt acts within the prior 72 hours on which the conclusion is
based, including facts that less restrictive interventions and placements
were considered but are not appropriate and available. The applicant shall
further file with his or her application the names and last known addresses of
the persons identified in §27-54(e)(3) of this code.
(2) A certificate is not necessary when an affidavit is filed by the applicant showing facts and the individual has refused to submit to examination by a physician or a psychologist.
(e) Notice requirements; eight days’ notice required. — Upon receipt of an application, the mental hygiene commissioner or circuit court shall review the application, and if it is determined that the facts alleged, if any, are sufficient to warrant involuntary hospitalization, immediately fix a date for and have the clerk of the circuit court give notice of the hearing:
(1) To the individual;
(2) To the applicant or applicants;
(3) To the individual’s spouse, one of the parents or guardians, or, if the individual does not have a spouse, parents or parent or guardian, to one of the individual’s adult next of kin if the next of kin is not the applicant;
(4) To the mental health authorities serving the area;
(5) To the circuit court in the county of the individual’s residence if the hearing is to be held in a county other than that of the individual’s residence; and
(6) To the prosecuting attorney of the county in which the hearing is to be held.
(f) The notice shall be served on the individual by personal service of process not less than eight days prior to the date of the hearing and shall specify:
(1) The nature of the charges against the individual;
(2) The facts underlying and supporting the application of involuntary commitment;
(3) The right to have counsel appointed;
(4) The right to consult with and be represented by counsel at every stage of the proceedings; and
(5) The time and place of the hearing.
The notice to the individual’s spouse, parents or parent or guardian, the individual’s adult next of kin or to the circuit court in the county of the individual’s residence may be by personal service of process or by certified or registered mail, return receipt requested, and shall state the time and place of the hearing.
(g) Examination of individual by court-appointed physician, psychologist, advanced nurse practitioner, or physician’s assistant; custody for examination; dismissal of proceedings. —
(1) Except as provided in subdivision (3) of this subsection, within a reasonable time after notice of the commencement of final commitment proceedings is given, the circuit court or mental hygiene commissioner shall appoint a physician, psychologist, an advanced nurse practitioner with psychiatric certification, or a physician’s assistant with advanced duties in psychiatric medicine to examine the individual and report to the circuit court or mental hygiene commissioner his or her findings as to the mental condition or substance use disorder of the individual and the likelihood of causing serious harm to self or others. Any such report shall include the names and last known addresses of the persons identified in §27-5-4-(e)(3) of this code.
(2) If the designated physician, psychologist, advanced nurse practitioner, or physician assistant reports to the circuit court or mental hygiene commissioner that the individual has refused to submit to an examination, the circuit court or mental hygiene commissioner shall order him or her to submit to the examination. The circuit court or mental hygiene commissioner may direct that the individual be detained or taken into custody for the purpose of an immediate examination by the designated physician, psychologist, nurse practitioner, or physician’s assistant. All orders shall be directed to the sheriff of the county or other appropriate law-enforcement officer. After the examination has been completed, the individual shall be released from custody unless proceedings are instituted pursuant to §27-5-3 of this code.
(3) If the reports of the appointed physician, psychologist, nurse practitioner, or physician’s assistant do not confirm that the individual is mentally ill or has a substance use disorder and might be harmful to self or others, then the proceedings for involuntary hospitalization shall be dismissed.
(h) Rights of the individual at the final commitment hearing; seven days’ notice to counsel required. —
(1) The individual shall be present at the final commitment hearing, and he or she, the applicant and all persons entitled to notice of the hearing shall be afforded an opportunity to testify and to present and cross-examine witnesses.
(2) In the event If the individual has not
retained counsel, the court or mental hygiene commissioner, at least six days
prior to hearing, shall appoint a competent attorney and shall inform the
individual of the name, address, and telephone number of his or her appointed
counsel.
(3) The individual has the right to have an examination by an independent expert of his or her choice and to present testimony from the expert as a medical witness on his or her behalf. The cost of the independent expert is paid by the individual unless he or she is indigent.
(4) The individual may not be compelled to be a witness against himself or herself.
(i) Duties of counsel representing individual; payment of counsel representing indigent. —
(1) Counsel representing an individual shall conduct a timely interview, make investigation, and secure appropriate witnesses, be present at the hearing, and protect the interests of the individual.
(2) Counsel representing an individual is entitled to copies of all medical reports, psychiatric or otherwise.
(3) The circuit court, by order of record, may allow the attorney a reasonable fee not to exceed the amount allowed for attorneys in defense of needy persons as provided in §29-21-1 et seq. of this code.
(j) Conduct of hearing; receipt of evidence; no evidentiary privilege; record of hearing. —
(1) The circuit court or mental hygiene commissioner shall hear evidence from all interested parties in chamber, including testimony from representatives of the community mental health facility.
(2) The circuit court or mental hygiene commissioner shall receive all relevant and material evidence which may be offered.
(3) The circuit court or mental hygiene commissioner is bound by the rules of evidence promulgated by the Supreme Court of Appeals except that statements made to health care professionals appointed under subsection (g) of this section by the individual may be admitted into evidence by the health care professional’s testimony, notwithstanding failure to inform the individual that this statement may be used against him or her. A health care professional testifying shall bring all records pertaining to the individual to the hearing. The medical evidence obtained pursuant to an examination under this section, or §27-5-2 or §27-5-3 of this code, is not privileged information for purposes of a hearing pursuant to this section.
(4) All final commitment proceedings shall be reported or recorded, whether before the circuit court or mental hygiene commissioner, and a transcript made available to the individual, his or her counsel or the prosecuting attorney within 30 days if requested for the purpose of further proceedings. In any case where an indigent person intends to pursue further proceedings, the circuit court shall, by order entered of record, authorize, and direct the court reporter to furnish a transcript of the hearings.
(k) Requisite findings by the court. —
(1) Upon completion of the final commitment hearing and the evidence presented in the hearing, the circuit court or mental hygiene commissioner shall make findings as to the following based upon clear and convincing evidence:
(A) Whether the individual is mentally ill or has a substance use disorder;
(B) Whether, because as a direct result of
illness or substance use disorder, the individual is likely to cause serious
harm to self or others if allowed to remain at liberty and requires
continued commitment and treatment;
(C) Whether the individual is a resident of the county in which the hearing is held or currently is a patient at a mental health facility in the county; and
(D) Whether there is a less restrictive alternative than commitment appropriate for the individual that is appropriate and available. The burden of proof of the lack of a less restrictive alternative than commitment is on the person or persons seeking the commitment of the individual: Provided, That for any commitment to a state hospital as defined by §27-1-6 of this code, a specific finding shall be made that the commitment of, or treatment for, the individual requires inpatient hospital placement and that no suitable outpatient community-based treatment program exists appropriate and available in the individual’s area.
(2) The findings of fact shall be incorporated into the order entered by the circuit court and must be based upon clear, cogent, and convincing proof.
(l) Orders issued pursuant to final commitment hearing; entry of order; change in order of court; expiration of order. —
(1) Upon the requisite findings, the circuit court may order the individual to a mental health facility or state hospital for a period not to exceed 90 days except as otherwise provided in this subdivision. During that period and solely for individuals who are committed under §27-6A-1 et seq. of this code, the chief medical officer of the mental health facility or state hospital shall conduct a clinical assessment of the individual at least every 30 days to determine if the individual requires continued placement and treatment at the mental health facility or state hospital and whether the individual is suitable to receive any necessary treatment at an outpatient community-based treatment program. If at any time the chief medical officer, acting in good faith and in a manner consistent with the standard of care, determines that: (i) The individual is suitable for receiving outpatient community-based treatment; (ii) necessary outpatient community-based treatment is available in the individual’s area as evidenced by a discharge and treatment plan jointly developed by the department and the comprehensive community mental health center or licensed behavioral health provider; and (iii) the individual’s clinical presentation no longer requires inpatient commitment, the chief medical officer shall provide written notice to the court of record and prosecuting attorney as provided in subdivision (2) of this section that the individual is suitable for discharge. The chief medical officer may discharge the patient 30 days after the notice unless the court of record stays the discharge of the individual. In the event the court stays the discharge of the individual, the court shall conduct a hearing within 45 days of the stay, and the individual shall be thereafter discharged unless the court finds by clear and convincing evidence that the individual is a significant and present danger to self or others, and that continued placement at the mental health facility or state hospital is required.
If the chief medical officer determines that the
individual requires commitment and treatment at the mental health
facility or state hospital at any time for a period longer than 90 days, then
the individual shall remain at the mental health facility or state hospital
until the chief medical officer of the mental health facility or state hospital
determines that the individual’s clinical presentation no longer requires
further commitment and treatment. The chief medical officer shall
provide notice to the court, and the prosecuting attorney, the
individual, and the individual’s guardian or attorney, or both, if applicable,
that the individual requires commitment and treatment for a period in
excess of 90 days and, in the notice, the chief medical officer shall describe the
reasons how the individual continues to meet commitment criteria and the
need for ongoing commitment and treatment. In its discretion, the
The court, or prosecuting attorney, the individual, or the
individual’s guardian or attorney, or both, if applicable, may request any
information from the chief medical officer that the court or prosecuting
attorney considers appropriate to justify the need for the individual’s ongoing
commitment and treatment. The court may hold any hearing that it considers
appropriate.
(2) Notice to the court of record and prosecuting attorney shall be provided by personal service or certified mail, return receipt requested. The chief medical officer shall make the following findings:
(A) Whether the individual has a mental illness or substance use disorder that does not require inpatient treatment, and the mental illness or serious emotional disturbance is in substantial remission;
(B) Whether the individual’s condition individual
has the independent ability to manage safely the risk factors resulting
from his or her mental illness or substance use disorder and is not
likely to deteriorate to the point that the individual will pose a likelihood
of serious harm to self or others unless without continued commitment
and treatment is continued;
(C) Whether the individual is likely to participate in outpatient treatment with a legal obligation to do so;
(D) Whether the individual is not likely to participate in outpatient treatment unless legally obligated to do so;
(E) Whether the individual is not a danger to self or
others is capable of surviving safely in freedom by himself or herself
or with the help of willing and responsible family members, guardian, or
friends; and
(F) Whether mandatory outpatient treatment is a suitable, less restrictive alternative to ongoing commitment.
(3) The individual may not be detained in a mental health facility or state hospital for a period in excess of 10 days after a final commitment hearing pursuant to this section unless an order has been entered and received by the facility.
(4) An individual committed pursuant to §27-6A-3 of this code may be committed for the period he or she is determined by the court to remain an imminent danger to self or others.
(5) In the event If the commitment of the
individual as provided under subdivision (1) of this subsection exceeds two years,
the individual or his or her counsel may request a hearing and a hearing shall
be held by the mental hygiene commissioner or by the circuit court of the
county as provided in subsection (a) of this section.
(m) Dismissal of proceedings. — In the event
If the individual is discharged as provided in subsection (l) of this
section, the circuit court or mental hygiene commissioner shall dismiss the
proceedings.
(n) Immediate notification of order of hospitalization. — The clerk of the circuit court in which an order directing hospitalization is entered, if not in the county of the individual’s residence, shall immediately upon entry of the order forward a certified copy of the order to the clerk of the circuit court of the county of which the individual is a resident.
(o) Consideration of transcript by circuit court of county of individual’s residence; order of hospitalization; execution of order. —
(1) If the circuit court or mental hygiene commissioner is satisfied that hospitalization should be ordered but finds that the individual is not a resident of the county in which the hearing is held and the individual is not currently a resident of a mental health facility or state hospital, a transcript of the evidence adduced at the final commitment hearing of the individual, certified by the clerk of the circuit court, shall immediately be forwarded to the clerk of the circuit court of the county of which the individual is a resident. The clerk shall immediately present the transcript to the circuit court or mental hygiene commissioner of the county.
(2) If the circuit court or mental hygiene commissioner of the county of the residence of the individual is satisfied from the evidence contained in the transcript that the individual should be hospitalized as determined by the standard set forth in subdivision one of this subsection, the circuit court shall order the appropriate hospitalization as though the individual had been brought before the circuit court or its mental hygiene commissioner in the first instance.
(3) This order shall be transmitted immediately to the clerk of the circuit court of the county in which the hearing was held who shall execute the order promptly.
(p) Order of custody to responsible person. — In lieu of ordering the individual to a mental health facility or state hospital, the circuit court may order the individual delivered to some responsible person who will agree to take care of the individual and the circuit court may take from the responsible person a bond in an amount to be determined by the circuit court with condition to restrain and take proper care of the individual until further order of the court.
(q) Individual not a resident of this state. — If the individual is found to be mentally ill or to have a substance use disorder by the circuit court or mental hygiene commissioner is a resident of another state, this information shall be immediately given to the Secretary of the Department of Health and Human Resources, or to his or her designee, who shall make appropriate arrangements for transfer of the individual to the state of his or her residence conditioned on the agreement of the individual, except as qualified by the interstate compact on mental health.
(r) Report to the Secretary of the Department of Health and Human Resources. —
(1) The chief medical officer of a mental health facility or state hospital admitting a patient pursuant to proceedings under this section shall immediately make a report of the admission to the Secretary of the Department of Health and Human Resources or to his or her designee.
(2) Whenever an individual is released from custody due to the failure of an employee of a mental health facility or state hospital to comply with the time requirements of this article, the chief medical officer of the mental health or state hospital facility shall immediately, after the release of the individual, make a report to the Secretary of the Department of Health and Human Resources or to his or her designee of the failure to comply.
(s) Payment of some expenses by the state; mental hygiene fund established; expenses paid by the county commission. —
(1) The state shall pay the commissioner’s fee and the court reporter fees that are not paid and reimbursed under §29-21-1 et seq. of this code out of a special fund to be established within the Supreme Court of Appeals to be known as the Mental Hygiene Fund.
(2) The county commission shall pay out of the county treasury all other expenses incurred in the hearings conducted under the provisions of this article whether or not hospitalization is ordered, including any fee allowed by the circuit court by order entered of record for any physician, psychologist, and witness called by the indigent individual. The copying and mailing costs associated with providing notice of the final commitment hearing and issuance of the final order shall be paid by the county where the involuntary commitment petition was initially filed.
(3) The Department of Health and Human Resources shall reimburse for alternative transportation provider expenses incurred under the provisions of this article upon submission of requests for reimbursement payment.
§27-5-10. Transportation for the mentally ill or persons with substance use disorder.
(a) Whenever transportation of an individual is
required under the provisions of §27-4-1 et seq. and §27-5-1 et seq. of this code, the sheriff law-enforcement
agency or alternative transportation provider
shall provide immediate transportation to or from the appropriate mental health
facility or state hospital as described in §27-5-19(d) of this code: Provided, That, where hospitalization occurs
pursuant to §27-4-1 et seq. of this code, the sheriff may permit, upon
the written request of a person having proper interest in the individual’s
hospitalization, for the interested person to arrange for the individual’s
transportation to the mental health facility or state hospital if the sheriff
determines that those means are suitable given the individual’s condition.
(b) Upon written agreement between the county commission on behalf of the sheriff and the directors of the local community mental health center and emergency medical services, an alternative transportation program may be arranged. The agreement shall clearly define the responsibilities of each of the parties, the requirements for program participation, and the persons bearing ultimate responsibility for the individual’s safety and well-being.
(c) Use of certified municipal law-enforcement
officers. — Sheriffs and municipal governments may enter into
written agreements by which certified municipal law-enforcement officers may
perform the duties of the sheriff as described in this article. The agreement
shall determine jurisdiction, responsibility of costs, and all other necessary
requirements, including training related to the performance of these duties,
and shall be approved by the county commission and circuit court of the county
in which the agreement is made. For purposes of this subsection, “certified
municipal law-enforcement officer” means any duly authorized member of a
municipal law-enforcement agency who is empowered to maintain public peace and
order, make arrests, and enforce the laws of this state or any political
subdivision thereof, other than parking ordinances, and who is currently
certified as a law-enforcement officer pursuant to §30-29-1 et seq. of
this code.
(d) In the event an individual requires
transportation to a state hospital as defined by §27-1-6
of this code, the sheriff, or
certified municipal law-enforcement officer shall contact the state hospital in
advance of the transportation to determine if the state hospital has suitable
bed capacity to place the individual.
If the sheriff, law-enforcement agency or alternative
transportation provider is informed by the state hospital as defined by §27-1-6
of this code as specified in the commitment or transportation order that it
lacks or is likely to lack suitable bed capacity to place such individual, the sheriff,
law-enforcement agency or alternative transportation provider shall
transport such individual to a diversion facility in the state as designated by
the chief medical officer of the state hospital: Provided, That the
state hospital shall identify a diversion facility within a reasonable period
of time not to exceed two hours, after the state hospital receives the
application, certification, and order issued by any
circuit court, mental hygiene commissioner, or magistrate.
(d) Any person executing any transportation or commitment order as provided in this chapter issued by any circuit court, mental hygiene commissioner, or magistrate shall not be declared as violating the provisions of §27-12-2 of this code.
(e) Nothing in this section is intended to alter
security responsibilities for the patient by the sheriff unless mutually agreed
upon as provided in subsection (c) of this section.
NOTE: The purpose of this bill is to update the involuntary commitment process.
Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.