SB 630 — Revise IVC Laws to Improve Behavioral Health.

Page 4 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 "§ 122C-55.

(a) Any facility may share confidential information regarding any client of that facility with any other facility when necessary to coordinate appropriate and effective care, treatment or Page 4 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 habilitation of the client.

(3) "Secretary" includes anythe Community Care of North Carolina Program, or other primary care case management programs that contract with the Department to provide a primary care case management program for recipients of publicly funded health and related services.

For purposes of this subsection, subsection (a6), and subsection (a7) of this section, the purposes or activities for which confidential information may be disclosed include, but are not limited to, case management and care coordination, disease management, outcomes evaluation, the development of clinical guidelines and protocols, the development of care management plans and systems, population-based activities relatingtorelating improvingorto reducinghealthimproving or reducing health care costs, and the provision, coordination, or management of mental health, developmental disabilities, and substance abuse services and other health or related services.

(a2) AnyareaorStatefacilityorthepsychiatricserviceoftheUniversityofNorth Carolina Hospitals at Chapel Hill may share confidential information regarding any client of that facility with any other area facility or State facility or the psychiatric service of the University of North Carolina Hospitals at Chapel Hill when necessary to conduct payment activities relating to an individual served by the facility.

Payment activities are activities undertaken by a facility to obtain payment or provide receive reimbursement for the provision of services and may include, but are not limited to, determinations of eligibility or coverage, coordination of benefits, determinations of cost-sharing amounts, claims management, claims processing, claims adjudication, claims appeals, billing and collection activities, medical necessity reviews, utilization management and review, precertification and preauthorization of services, concurrent and retrospective review of services, and appeals related to utilization management and review.

(a3) Whenever there is reason to believe that a client is eligible for benefits through a Department program, any State or area facility or the psychiatric service of the University of North Carolina Hospitals at Chapel Hill may share confidential information regarding any client ofthat facilitywith theSecretary, andtheSecretarymayshare confidential information regarding any client with an area facility or State facility or the psychiatric services of the University of North Carolina Hospitals at Chapel Hill.

Disclosure is limited to that information necessary to establish initial eligibility for benefits, determine continued eligibility over time, and obtain reimbursement for the costs of services provided to the client.

… (c1) A facility may furnish confidential information in its possession to the sheriff of any county when requested by the sheriff regarding any client of that facility who is confined in the county's jail or jail annex when the inmate has been determined by the county jail medical unit to be in need of treatment for mental illness, developmental disabilities, or substance abuse.

The sheriff may furnish to a facility confidential information in its possession about treatment for mental illness, developmental disabilities, or substance abuse that the county jail medical unit has provided to any present or former inmate if the inmate is presently seeking treatment from Senate Bill 630*-Second Edition Page 5 General Assembly Of North Carolina Session 2017 the requesting facilityor if the inmate has been involuntarily committed to the requesting facility for inpatient or outpatient treatment.

Under the circumstances described in this subsection, the consent of the client or inmate shall not be required in order for this information to be furnished and the information shall be furnished despite objection by the client or inmate.

Confidential information disclosed pursuant to this subsection is restricted from further disclosure.

122C-115.4122C-115.4(b) readsis asamended rewritten:by adding a new subdivision to read:

"§"(7a) 122C-115.4.Community crisis services planning in accordance with G.S.

Functions122C-202.2." ofSECTION local7. management entities.

… (b) The primary functions of an LME are designated in this subsection and shall not be conducted by any other entity unless an LME voluntarily enters into a contract with that entity under subsection (c) of this section.

The primary functions include all of the following:

… (7a) Community crisis services planning in accordance with G.S.

122C-202.2.

…." SECTION 7.

122C-117122C-117(a)(14) reads as rewritten:

"§"(14) 122C-117.Maintain a 24-hour a day, seven day a week crisis response service.service and adopt a community crisis services plan in accordance with G.S.

Powers122C-202.2. and duties of the area authority.

(a)Crisis Theresponse area authority shall doinclude alltelephone ofand theface-to-face following:capabilities.

…Crisis (18)phone Developresponse shall include triage and adoptreferral communityto appropriate face-to-face crisis servicesproviders plansand inshall accordancebe withinitiated G.S.within one hour of notification.

122C-202.2Crisis …."services SECTIONdo 8.not require prior authorization but shall be delivered in compliance with appropriate policies and procedures.

Crisis services shall be designed for prevention, intervention, and resolution, not merely triage and transfer, and shall be provided in the least restrictive setting possible, consistent with individual and family need and community safety." SECTION 8.

(a) Every LME/MCO shall adopt a community crisis services plan developed in accordance with this section to facilitate first examination in conjunction with a health screening at the sameimplementation locationof required pursuant to Parts 7 and 8 of this Article within its catchment area.

The community crisis services plan for the LME/MCO's catchment Senate Bill 630*-First Edition Page 5 General Assembly Of North Carolina Session 2017 area shall be comprised of separate plans, known as "local area crisis services plans" or "local plans," for each of the local areas or regions within the catchment area that the LME/MCO identifies as an appropriate local planning area, taking into consideration the available resources and interested stakeholders within a particular geographic area or region of the catchment area.

(1) IncorporateIdentify theone involuntaryor commitmentmore transportationarea agreementfacilities adoptedwhere pursuanta respondent subject to a transportation and custody order must be taken for a first examination by a commitment examiner as required by G.S.

122C-251(g) for the cities and counties within the local planning areas which identifies the law enforcement officers, designees under G.S.

122C-251(g), or individuals or entities otherwise required to provide custody and transportation of a respondent for a first examination in conjunction with a health screening at the same location required by G.S.

122C-283.122C-283(a).

NotwithstandingIf thean foregoing,area countiesfacility andis citiesidentified shallin retain the responsibilitiesplan foras custodyan andappropriate transportationfacility setfor forthconducting inthe thisfirst Article,examination exceptfor ascommitment, otherwiselaw setenforcement forthofficers, in a plan developed, agreed upon, and adoptedany inpersons compliancedesignated withto thisprovide sectiontransportation and custody under G.S.

122C-251(g), shall transport the commitment respondent to the area facility in accordance with, and under circumstances addressed in, the local area crisis services plan.

If no area facility is available in the local planning area to conduct the first examination for commitment, the local plan shall identify an acute care hospital or hospitals or other location for first examination.

This subdivision applies when a magistrate or clerk of court orders a respondent to be taken into custody for examination by a commitment examiner.

This subdivision does not apply when the respondent is already present on the premises of a location and the first examiner at that location is the affiant who is petitioning to initiate the commitment process.

(2) Identify any persons that the LME/MCO has designated under G.S.

122C-251(g) to be responsible for all or part of the transportation and custody of respondents in involuntary commitment proceedings under this Article, to the extent that the LME/MCO has exercised its authority under G.S.

(2)Any Identifyplan oneadopted orby morean areaLME/MCO facilitiesunder or other locations in accordance with G.S.

122C-263122C-251(g) andshall G.S.be included as a part of the local area crisis services plan for the area to which it pertains.

122C-283.Counties and cities shall retain the responsibilities for custody and transportation set forth in this Article except as otherwise set forth in a plan developed and adopted pursuant G.S.

Each122C-251(g). LME/MCO shall contract with one or more facilities or other locations described in G.S.

122C-263(3) andIdentify Pageappropriate 6and Senateavailable Billtraining 630*-Secondfor Editionlaw Generalenforcement Assemblypersonnel, Ofand Northany Carolinapersons Sessiondesignated 2017under G.S.

122C-283122C-251(g), forwho theprovide provisiontransportation of health screenings and firstcustody examinationsof requiredinvoluntary bycommitment G.S.respondents.

122C-263To andthe G.S.extent feasible, law enforcement officers shall participate in the training program identified by the LME/MCO.

122C-283Persons forwho theare provisiondesignated ofunder first examination in conjunction with a health screening required by G.S.

122C-263 and G.S.

122C-283, to meet the needs of its local planning area.

(3) Identify available training for law enforcement personnel and other persons designated or required under G.S.

122C-251(g) to provide transportation and custody of involuntary commitment respondents.

Law enforcement officers may request to participate in the training program identified by the LME/MCO.

Persons who are designated in compliance with G.S.

To the extent feasible, theidentifiedthe trainingshallidentified training shall address the useofuse of de-escalation strategies and techniques, the safe use of force and restraint, respondent rights relevant to custody and transportation, the location of any area facilities identified by the LME/MCO pursuant to subdivision (1) of this subsection, and the completion and return of the custody order to the clerk of superior court.

The training identified by the LME/MCO may be comprised of one or more programsandmayincludeaCrisisprograms, InterventionTeamprogramorothermentaland may include a crisis intervention team program or other mental health training program or a combination of these programs.

(b)To Lawthe enforcementextent agencies,feasible, acutethe careLME/MCO hospitals,shall magistrates,identify areatraining facilitiesthat withPage identified6 commitmentSenate examiners,Bill and630*-First otherEdition affectedGeneral agenciesAssembly shallOf participateNorth withCarolina theSession LME/MCO2017 inincludes thea developmentcomponent offor thedialogue localwith areaconsumers crisisof servicesmental planshealth, describeddevelopmental indisabilities, thisand section.substance abuse services.

Other(b) stakeholdersLaw andenforcement communityagencies, partnersacute care hospitals, magistrates or clerks of court, area facilities with identified bycommitment examiners, the LME/MCOLME/MCO, mayand beother invitedrelevant tocommunity partners or stakeholders shall participate in the planning.development of the local area crisis services plans described in this section.

No(c) localThe areaplans crisisadopted services plan developed under this section shallmay beaddress adoptedany ormatters thereafternecessary beto effectivefacilitate orthe implementedcustody, unlesstransportation, suchexamination, planand firsttreatment hasof beenrespondents mutuallyto agreedcommitment uponproceedings inunder writingParts by7 alland entities8 identified in the plan pursuant to subsection (a) of this section.Article." SECTION 9.

If any member of the Crisis Planning Committee fails to agree to the plan in writing, the Secretaryshall develop a procedure to attempt to resolve the conflict in order to achieve approval of the Plan.

(c) The plans adopted under this section may, by mutual agreement of all entities identified in theplan, address anyothermatters necessaryto facilitatethecustody, transportation, examination, and treatment of respondents to commitment proceedings under Parts 7 and 8 of this Article." SECTION 9.

and (iii) if consent to share information is granted bytheby client,the client,client or if the disclosure of the information is permitted under G.S.

The preceding requirements of this paragraph may be waived if the client has been admitted under emergency procedures to a State facilitynotfacility not serving the client's region of the State.

Senate Bill 630*-Second Edition Page 7 General Assembly Of North Carolina Session 2017 (1) Obtain authorization from the receiving facility that the facility will admit the respondent;

No later that than 24 hours after the transfer, the responsible professional at the original facility shall notify the petitioner, the clerk of court, the respondent's counsel, and, if consent is grantedbytherespondent,granted orifthedisclosureoftheinformationby the respondent, respondent or disclosure of the information is permittedunderpermitted under G.S.

122C-53122C-53(b), or other applicable law, the next of kin, that the transfer is completed.complete.

If the respondent is a minor, an incompetent adult, or an individual with a health care power of attorney who is deemed incapable, then the responsible professional at the original facility shall, not later than 24 hours after the transfer, notify the respondent'sclient's legally responsible person of the location of the transfer and that the transfer is complete.

(c1) If a client described in subsections (b) or (c) of this section is to be transferred from one 24-hour facility to another another, or to an acute care hospital pursuant to subsection (e) of this section, and transportation is needed, the responsible professional at the original facilityshallfacility shall notify the clerk of court or magistrate, and the clerk of court or magistrate shall issue a custody order for transportation of the client as provided by G.S.

Senate Bill 630*-First Edition Page 7 General Assembly Of North Carolina Session 2017 (d) Minors and incompetent adults, admitted pursuant to Part 5 of this Article and incapable adults admitted pursuant to Part 2A of this Article, may be transferred from one 24-hour facility to another provided that prior to transfer the responsible professional at the original facility shall:

(e) Theresponsibleprofessionalmaytransferaclientfromone24-hourfacilitytoanotherThe responsible professional may transfer a client from one 24-hour facility to another or to an acute care hospital for emergency medical treatment, emergency medical evaluation, or emergency surgery without notice to or consent from the client.

Within a reasonable period of time the responsible professional shall notify the next of kin or the legally responsible person of the client of the time and location of the transfer.

(f1) When a client is transferred from a 24-hour facility to an acute care hospital solely for medical reasons, the hospital shall return the client to the original facility as soon as the next client space becomes available at the original facility after completion of the client's medical Pagecare, 8and Senatethe Billoriginal 630*-Secondfacility Editionmust Generalaccept Assemblythe Ofreturn Northof Carolinathe Sessionclient; 2017 care.

Withprovided, thehowever, exceptionthat ofif facility-based crisis centers, the originalresponsible facilityprofessionals must allow at least 12 hours for the client's return before assigning the client's room or bed to another patient, unless both facilities agreeconcur that returndischarge of thea client inwho this time period is not feasible.subject to G.S.

The122C-266(b) originalis facilityappropriate, must accept the return of the client inshall prioritybe overreleased. other clients seeking admission, except in the cases of patients designated incapable to proceed to trial by court order.

IfIf, at the responsibletime professionalsof atthe bothtransfer, facilitiesa concurclient thatis dischargebeing ofheld under a clientcustody whoorder ispending nota subjectsecond commitment examination or a district court hearing under involuntary commitment proceedings, the custody order shall remain valid throughout the period of time necessary to G.S.complete the client's medical care and transport the client between the 24-hour facility and the acute care hospital;

122C-266(b) is appropriate, the client may be discharged.

If, at the time of the transfer, a client is being held under a custodyorder pending a second commitment examination or a district court hearing under involuntary commitment proceedings, the custody order shall remain valid throughout the period of time necessary to complete the client's medical care and transport the client between the 24-hour facility and the acute care hospital;

No facility facility, person, or entity, including an area facility, a facility licensed under this Chapter, an acute care hospital, a general hospital, or an area authority, aLME, lawor enforcementLME/MCO, officer,or anany LME,of orits anofficials, LME/MCO,staff, oranyofitsor theirofficials,employees, staff,oror employees,any oranyotherphysicianphysician or other individual who is responsible for the custody, transportation, examination, admission, management, supervision, treatment, or release of a respondent or client and who follows accepted professional judgment, practice, and standards takes reasonable measures in good faith under the authority of this Article and is not grossly negligent,negligent is civilly or criminallyliable,criminally personallyorliable, otherwise,personally for that person's or entity'sotherwise, for actions or omissions arising from these responsibilities or for the actions or omissions of the a respondent or client.

This immunity is in addition to any other legal immunity from liability to which these facilities persons, entities, facilities, agencies, or individuals may be entitled and applies to actions performed in connection with, or arising out of, the admission or commitment custody, transportation, examination, commitment, admission, management, supervision, treatment, or releasecommitment of any individual pursuant to or under the authority of this Article.ArticleArticle." or otherwise." SECTION 11.

Page 8 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 "§ 122C-210.3.

A custody order entered by the clerk or magistrate pursuant to this Chapter may be delivered to the law enforcement officer or other person designated orunder required to provide transportation and custody pursuant to G.S.

122C-251122C-251(g) by electronic or facsimile transmission." SECTION 12.

(a) Except as provided in subsections (b) through (f1) (f) of this section, any individual, including a parent in a familyunit,family unit, in need of treatment for mental illness or substance abuse may seek voluntary admission at any facility by presenting himself or herself for evaluation to the facility.

No physician's statement is necessary, but a written application for evaluation or admission, signed by the individual seeking admission, admission or the individual's legally responsible person, is required.

However, no oneshallone shall be denied admission becauseapplicationformsbecause arenotapplication forms are not available.

AnevaluationAn evaluation shall determine whether the individual is in need of care, treatment, habilitation or rehabilitation for mental illness or substance abuse or further evaluation by the facility.

Information provided by familymembersfamily regardingthemembers regarding the individual's need for treatment shall be reviewed in the evaluation.

An individual may not be accepted as a client if the facility determines that the individual does not need or Senate Bill 630*-Second Edition Page 9 General Assembly Of North Carolina Session 2017 cannot benefit from the care, treatment, habilitation, or rehabilitation available and that the individual is not in need of further evaluation by the facility.

…(b) (e)In When24-hour anfacilities individualthe fromapplication ashall singleacknowledge portalthat areathe seeksapplicant admissionmay tobe anheld areaby orthe Statefacility 24-hourfor facility,a period of 72 hours after any written request for release that the admissionapplicant may make, and shall followacknowledge that the procedures24-hour asfacility prescribedmay inhave the arealegal plan.right to petition for involuntary commitment of the applicant during that period.

At the time of application, the facility shall tell the applicant about procedures for discharge.

(c) Any individual who voluntarily seeks admission to a 24-hour facility in which medical care is an integral component of the treatment shall be examined and evaluated by a physician of the facility within 24 hours of admission.

The evaluation shall determine whether the individual is in need of treatment for mental illness or substance abuse or further evaluation by the facility.

If the evaluating physician determines that the individual will not benefit from the treatment available, the individual shall not be accepted as a client.

(d) Any individual who voluntarily seeks admission to any 24-hour facility, other than one in which medical care is an integral component of the treatment, shall have a medical examination within 30 days before or after admission if it is reasonably expected that the individual will receive treatment for more than 30 days or shall produce a current, valid physical examination report, signed by a physician, completed within 12 months prior to the current admission.

When applicable, this examination may be included in an examination conducted to meet the requirements of G.S.

122C-223 or G.S.

122C-232.

(e) When an individual from a single portal area seeks admission to an area or State 24-hour facility, the admission shall follow the procedures as prescribed in the area plan.

The facility shall notifythenotify the area authoritywithinauthority within 24 hours of the admission.

…(f) (f1)A Anfamily individualunit inmay needvoluntarily ofseek treatmentadmission forto mentala illness24-hour maysubstance beabuse admittedfacility tothat ais facilityable pursuant to anprovide, advancedirectly instructionor forby mentalcontract, healthtreatment, treatmenthabilitation, or pursuantrehabilitation toservices theSenate authorityBill of630*-First aEdition healthPage care9 agentGeneral namedAssembly inOf aNorth validCarolina healthSession care2017 powerthat ofwill attorney,specifically providedaddress that the individualfamily isunit's incapable,needs. as defined in G.S.

These services shall include gender-specific substance abuse treatment, habilitation, or rehabilitation for the parent as well as assessment, well-child care, and, as needed, early intervention services for the child.

A family unit that voluntarily seeks admission to a 24-hour substance abuse facility shall be evaluated by the facility to determine whether the family unit would benefit from the services of the facility.

A facility shall not accept a family unit as a client if the facility determines that the family unit does not need or cannot benefit from the care, habilitation, or rehabilitation available at the facility.

The facility shall give to a family unit that is denied admission a referral to another facility or facilities that may be able to provide treatment needed by the family unit.

Except as otherwise provided, this section applies to a parent in a family unit seeking admission under this section.

(f1) An individual in need of treatment for mental illness may be admitted to a facility pursuant to an advance instruction for mental health treatment or pursuant to the authority of a health care agent named in a valid health care power of attorney, provided that the individual is incapable, as defined in G.S.

When a health care power of attorneyauthorizesattorney authorizes a health care agent to seek the admission of an incapable individual, the health care agent shall act for the individual in applying for admission to a facility and in consenting to medical treatment at the facility when consent is required, provided that the individual is incapable.

…."(g) As used in this Part, the term "family unit" means a parent and the parent's dependent children under the age of three years." SECTION 13.

(a) Except as provided in subsections subsection (b) and (c) of this section, an individual who has been voluntarily admitted to a facility shall be discharged upon his theor individual'sher own request.

(b) An individual who has been voluntarilyadmittedvoluntarily admitted to a 24-hour facility maybemay be held for 72 hours after his theor individual'sher written application for discharge is submitted.

(c) An individual making an advance instruction for mental health treatment shallmay begrant governedor bywithhold Partconsent 2for ofmental Articlehealth 3treatment, including the use of thispsychotropic Chapter.medication, electroconvulsive treatment, and admission to and retention in a 24-hour facility for mental illness.

An attending physician or other mental health treatment provider shall act in accordance with an advance instruction for mental health treatment upon a determination that the Page 10 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 individual making the advance instruction is incapable, in which case, the provisions of Part 2 of Article 3 of this Chapter apply.

32A-19 to make mental health treatment decisions for an incapable individual, the health care agent shall act for the individual in applying for admission and consenting to treatment at a Page 10 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 facility, consistent with the extent and limitations of authority granted in the health care power of attorney for as long as the individual remains incapable.

(e) A 24-hour facility may not hold an individual under a voluntary admission who is determined to be incapable at the time of admission and who is admitted pursuant to an advance instruction for mental health treatment for more than 15 days, except as provided in G.S.

A 24-hour facility may file a petition for involuntary commitment pursuant to Article 5 of this Chapter if an individual meets applicable criteria at the conclusion of this 15-day period.

(a) The responsible professional shall unconditionally discharge an individual admitted to a facility pursuant to this Part at any time it is determined that the individual is no longer mentally ill or in need of treatment at the facility.

(b) An individual who has been voluntarilyadmittedvoluntarily admitted to a facilitypursuantfacility pursuant to this Part and who is no longer deemed incapable shall be discharged upon his or her own request.

A facility may hold an individual who has been voluntarily admitted to a 24-hour facility pursuant to this Part for up to 72 hours after the individual submits a written request for discharge, but the facility shall releasetheindividualrelease the individual upon theexpirationof72the hoursfollowingexpiration of 72 hours following submission ofthewrittenrequestof the written request for discharge unless the responsible professional obtains an order under Part 7 or 8 of this Article to hold the client.

(c) A health care agent named in a valid health care power of attorney or the legally responsible person may submit on behalf of an individual admitted to a facility under this Part a written request to have the individual discharged from the facility, provided (i) the individual remains incapable at the time of the request and (ii) the request is notconsistent inconsistent with the authority expressed in the health care power of attorneyorattorney. other controlling document.

(e) In any case in which an order is issued authorizing the involuntary commitment of an individual admitted to a facility under this Part, the facility's further treatment and holding of the individual shall be in accordance with Part 7 or 8 of this Article, whichever is applicable."applicable. SECTION 15.

"§§ 122C-215 through 122C-220:

Reserved for future codification purposes." SECTION 15.

122C-221122C-221(a) reads as rewritten:

"§"(a) 122C-221.Except as otherwise provided in this Part, a minor may be admitted to a facility if the minor is mentally ill or a substance abuser and in need of treatment.

Admissions.Except as otherwise provided in this Part, the provisions of G.S.

(a) Except as otherwise provided in this Part, a minor may be admitted to a facility if the minoris mentallyill ora substanceabuserand in needoftreatment.

Except as otherwiseprovided in this Part, the provisions of G.S.

The application for admission of the minor shall be in writing and signed by the legally responsible person.

If a minor reaches the age of 18 while in Senate Bill 630*-Second630*-First Edition Page 11 General Assembly Of North Carolina Session 2017 minor reaches the age of 18 while in treatment under this Part, further treatment is authorized only on the written authorization of the client or under the provisions of Part 7 or Part 8 of Article 5 of this Chapter.Chapter." SECTION 16.

…." SECTION 16.

"§"(c) 122C-224.Within 24 hours after admission, the facility shall notify the clerk of court in the county where the facility is located that the minor has been admitted and that a hearing for concurrence in the admission must be scheduled.

JudicialAt reviewthe time notice is given to schedule a hearing, the facility shall (i) notify the clerk of voluntarythe admission.names and addresses of the legally responsible person and the responsible professional.professional and (ii) provide the clerk with a copy of the legally responsible person's written application for admission of the minor and the facility's written evaluation of the minor, both of which are required under G.S.

…122C-211(a)." (c)SECTION Within17. 24 hours after admission, the facility shall notify the clerk of court in the county where the facility is located that the minor has been admitted and that a hearing for concurrenceintheadmissionmustbescheduled.Atthetimenoticeisgiventoscheduleahearing, the facility shall (i) notify the clerk of the names and addresses of the legally responsible person and the responsible professional.professional and (ii) provide the clerk with a copy of the legally responsible person's written application for admission of the minor and the facility's written evaluation of the minor, both of which are required under G.S.

122C-211(a)."Part SECTION17.4 of Article 5 of Chapter 122C of the General Statutes is amended by adding a new section to read:

Part4ofArticle5ofChapter122C oftheGeneralStatutesis amended by adding a new section to read:

At the time the facility provides notice to the court to schedule a hearing for concurrence, the facility shall notify the clerk of the names and addresses of the legally responsible person and the responsible professional and provide a copyofcopy of the legally responsible person's written application for evaluation or admission of the incompetent adult and the facility's evaluation of the incompetent adult.

(b) In anycaserequiringthehearingdescribedinsubsection(a)ofthissection,nopetitionany case requiring the hearing described in subsection (a) of this section, no petition is necessary;

If the court finds by clear, cogent, and convincing evidence that these requirements have been met, the court shall concur with the voluntary admission of the incompetent adult.adultadult and set the length of the Page 12 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 authorized admission for a period not to exceed 90 days.

A finding Page 12 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 of dangerousnesstoselforothersisnotnecessarytosupportthedeterminationthatfurthertreatmentdangerousness to self or others is not necessary to support the determination that further treatment should be undertaken.

…(c) (d)Unless Inotherwise additionprovided toin this Part, the noticehearing ofspecified hearingsin andsubsection rehearings(a) toof thethis incompetentsection, adultincluding andthe hisprovisions orhercounselfor requiredrepresentation underPart7ofthisof Article,indigent noticeshallincompetent begivenbytheclerkadults, toall thelegallysubsequent responsibleproceedings, person,personand orconditional hisrelease successor.aare successorgoverned toby the legallyinvoluntary responsiblecommitment person.procedures of Part 7 of this Article.

The(d) legallyIn responsibleaddition person,to orthe hispersonnotice orof ahearings successorand rehearings to the legallyincompetent responsibleadult personand mayhis alsoor fileher withcounsel required under Part 7 of this Article, notice shall be given by the clerk ofto courtthe alegally writtenresponsible waiverperson,person ofor his thesuccessor.a rightsuccessor to receivethe notice."legally SECTIONresponsible 19.person.

The legally responsible person,person or his a successor to the legally responsible person may also file with the clerk of court a written waiver of his the right to receive notice." SECTION 19.

(a) Except as provided in subsections (f) (c), (f), and (g), transportation of a respondent within a county under the involuntary commitment proceedings of this Article, including admission and discharge, shall be provided bytheby cityorthe city or county.

The cityhascity has the dutytoduty to provide transportation of a respondent whoiswho aresidentis a resident of thecityorthe whoiscity physicallytakenintoor who is can be taken into custody in the city limits.

The county has the duty to provide transportation for a respondent who resides in the county outside city limits or who is physicallycan be taken into custody outside of city limits.

(b) Except as provided in subsections (f)(c),(f) (f), and (g) or in G.S.

122C-408(b), transportation between counties under the involuntary commitment proceedings of this Article forafirstfor examinationadmission asto describeda in24-hour G.S.facility shall be provided by the county where the respondent is taken into custody.

122C-263(a)andTransportation G.S.between counties under the involuntary commitment proceedings of this Article for respondents held in 24-hour facilities who have requested a change of venue for the district court hearing shall be provided by the county where the petition for involuntary commitment was initiated.

122C-283(a)andTransportation between counties under the involuntary commitment proceedings of this Article for admissiondischarge toof a respondent from a 24-hour facility shall be provided by the county whereof theresidence respondentof isthe takenrespondent. into custody.

Transportation between counties under the involuntary commitment proceedings of this Article for respondents held in 24-hour facilities who have requested a change of venue for the district court hearing shall be provided bythe countywhere the petition for involuntarycommitment was initiated.Transportation between counties under theinvoluntarycommitmentproceedings ofthis Article for discharge of a respondent from a 24-hour facility shall be provided by the county of residence of the respondent.

(c) Transportation ofbetween acounties respondentunder may be (i) by city- or county-owned vehicles or vehicles, (ii) by private vehicle by contract with the cityinvoluntary orcommitment county.county,proceedings orof (iii)this asArticle providedfor ina anfirst agreementexamination developedat anda adoptedlocation underdescribed subsectionin (g) of this section and G.S.

122C-202.2.122C-263(a) and G.S.

122C-238(a) shall be provided by the county where the respondent is taken into custody.

(c) Transportation of a respondent may be (i) by city- or county-owned vehicles orvehicles, (ii) by private vehicle by contract with the city or county.county, or (iii) as provided in a plan adopted under subsection (g) of this section.

Further, law enforcement officers, to the extent possible,possible,feasible, shall advise respondents when taking them into custody that they are not under arrest and have not committed a crime, but are being taken into custody and transported to receive treatment and for their own safety and that of others.

(e) In taking custody and providing transportation as required by this section, the law-enforcementlaw-enforcementlaw law enforcement officer may not use reasonable force to restrain the respondent if unless it appears necessary to protect himself,the law enforcement officer, the respondent, or others.

AnyThe uselaw ofenforcement restraintsofficer shall beuse asthe reasonablyleast determinedrestrictive byand themost officerreasonable torestraint be necessary under the circumstances forand afford the safetyrespondent ofas much dignity as the respondent,circumstances permit, taking into consideration the lawage, enforcementmedical officer,condition, special needs, and otherSenate persons.Bill 630*-First Edition Page 13 General Assembly Of North Carolina Session 2017 behavior of the respondent.

EveryTo effortthe toextent avoidfeasible, restraintthe oflaw aenforcement childofficer's underapplication theof ageforce ofor 10restraint shall beavoid madeaggravating byor theworsening transporting officer unless the child'srespondent's behaviorpreexisting injuries or othermedical circumstancesconditions. dictate that restraint is necessary.

TheTo law enforcement officer shall respond to all inquiries from the facilityextent concerningfeasible, the respondent'slaw behaviorenforcement andofficer theshall useconsult ofa anyparent, restraintscaretaker, relatedor toother thelegally custodyresponsible andperson transportationprior ofto Senaterestraining Bill 630*-Second Edition Page 13 General Assembly Of North Carolina Session 2017 the respondent, except in circumstances where providing that information is confidential or would otherwise compromise a lawminor. enforcement investigation.

NoThe law-enforcement law enforcement officer orshall otherrecord personon designatedthe orreturn requiredof toservice provideportion of the custody ororder transportthe type of mechanical restraint used on a clientrespondent, underif G.S.any, when taking the respondent into custody or transporting the respondent.

122C-251No law-enforcementlaw enforcement officer may be held criminally or civilly liable for assault, false imprisonment, or other torts or crimes on account of reasonable measures taken under the authority of this Article.

The limitations and conditions in this subsection on the use of force and restraint do not apply to acute care hospitals or general hospitals and their employees or contractors when the use of force and restraint by these entities and persons is governed by rules for accreditation adopted by accrediting bodies that review these entities and persons for compliance with the accreditation rules.

(g) The governing body of a city or county maycity, shallcounty, adoptor aLME/MCO planmay knownadopt asa anplan "involuntary commitment transportation agreement" or "transportation agreement" for the custody and transportation of respondents in involuntary commitment proceedings in under this Article.

Law-enforcement personnel, ArticleThe plan may designate law enforcement officers, volunteers, or other public or private agency personnel may be designated to provide all or parts of the custody and transportation required by involuntary commitment proceedings.proceedings, including taking a respondent into custody as follows:ordered by a clerk of superior court or magistrate.

(1)Persons Lawso enforcementdesignated and other affected agencies, including local acute care hospitals and other mental health providers, shall participatebe trained in developingtheaccordance transportationwith agreement.G.S.

The122C-202.2(a)(3) areaand authoritythe mayplan participateshall inassure developingadequate safety and protections for both the transportationpublic agreement.and the respondent.

(2)Law Theenforcement, transportationAffected agreement may designate law enforcement officers,agencies, volunteers,orotherpublicorprivateagencypersonnelmaybedesignatedwhoacute havecare agreedhospitals, pursuantmagistrates, toclerks subsection (g) of thissuperior sectioncourt, toarea providefacilities, allother oraffected partsagencies, ofand the custodyarea andauthority transportationshall requiredparticipate byin involuntarythe commitmentplanning. proceedings.

PersonsIf any person other than a law-enforcement agency is designated by a city or county, the person so designated Any person or otherwiseagency requireddesignated by a city, county, or LME/MCO to provide all or parts of the custody and transportation required by involuntary commitment proceedingsshallbetrainedassetforthinG.S.proceedings shall provide the custody and transportation and follow the procedures in this Article.

122C-202.2(a)(3),andtheplanReferences shallin assurethis adequateArticle safetyto anda protectionslaw-enforcement forlaw bothenforcement theofficer publicapply andto thethis respondent.person.designated person or agency.

LawA enforcement,person othershall affectednot agencies,be anddesignated without the areaconsent authorityof shall(i) participatethe inperson or (ii) the planning.agency that employs the person or contracts for the person's services.

IfCounties anyand personcities other than a law-enforcement agency is designated by a city or county, the person so designated shall provideretain the transportationresponsibilities andset Anyforth personin orthis agencyArticle, designatedexcept oras requiredotherwise todescribed providein alla orplan partsdeveloped of the custody and transportationadopted requiredpursuant by involuntary commitment proceedings shall follow the procedures in this Article.subsection.

References(h) inThe thiscost Articleand expenses for custody and transportation of transporting a respondent to or from a law-enforcement24-hour lawfacilityas enforcementrequired officerby applytothe involuntary commitment procedures of this person.anyArticle personis orthe entitydesignatedresponsibility toof providethe custodycounty orof transportation.residence of the respondent.respondent unless otherwise provided in a plan adopted under subsection (g) of this section.

The transportation agreement may provide that private personnel or agencies may contract for transportation services to transport respondents under involuntary commitment from one entity to another.

(3) A person shall not be designated under subsection (g) of this section without that person's written consent and the written consent of his or her employer, if applicable.

An agency, corporation, or entity shall not be designated without the written consent of that agency, corporation, or entity.

Anyperson, agency, corporation, or other entity shall be designated to provide only the services which the person, agency, corporation, or other entity has previously consented in writing to provide and shall be permitted to withdraw from or discontinue providing services, in whole or in part, upon written notice to the designating governing body.

The transportation agreement shall be submitted to the magistrates in the city or county's judicial district, to the county clerks of court, to the LME/MCO that serves the city or county, and to the Division Page 14 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 of Mental Health, Developmental Disabilities, and Substance Abuse Services on or before January 1, 2019.

If the city or county modifies the transportation agreement, it will submit the modified agreement to their magistrates in their judicial district, county clerks of court, the LME/MCO that serves the city or county, and the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services at least 10 days prior to the effective date of the new plan.

(4) Counties and cities shall retain and be required to perform the responsibilities set forth in this Article, except as set forth in a plan developed, agreed upon, and adopted in compliance with this subsection.

(h) The cost and expenses of transporting of custody and transportation of a respondent to or from a 24-hour facility is as required by the involuntary commitment procedures of this Article, to the extent they are not reimbursed bya third-party insurer, are the responsibilityof the county of residence of the respondent.respondent, to the extent they are not reimbursed by a third-party insurer.

Provided that the county of residence provides the respondent or other Page 14 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 individual liable for the respondent's support a reasonable notice and opportunity to object to the reimbursement, the county of residence of the respondent may recover that cost from:

Treatment at a private facility or by a private physician ororphysician, private psychologist physician, psychologist, or commitment examiner is at the expense of the respondent to the extent that the charges are not disposed of by contract between the area authorityandauthority and the private facility.

Beginning January 1, 2012, eacheachEach Each 24-hour residential facility that (i) falls under the category of nonhospital medical detoxification, facility-based crisis service, or inpatient hospital treatment, (ii) is not a State facility under the jurisdiction of the Secretary of Health and Human Services, and (iii) is designated by the Secretary of Health and Human Services as a facility for the custody and treatment of individuals under a petition of involuntary commitment pursuant to G.S.

Senate Bill 630*-Second Edition Page 15 General Assembly Of North Carolina Session 2017 (1) The number and primary presenting conditions of individuals receiving treatment from the facility under a petition of involuntary commitment.

(3) The reason for referring the individuals described in subdivision (2) of this section to adifferenta facilityorprogram,different facility or program, including theneedformoreintensivethe need for more intensive medical supervision." SECTION 22.

Senate Bill 630*-First Edition Page 15 General Assembly Of North Carolina Session 2017 (b) If the clerk or magistrate finds reasonable grounds to believe that the facts alleged in the affidavit are true and that the respondent is probably mentally ill and either (i) dangerous to self, as defined in G.S.

122C-3(11)b., or (ii) in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness, the clerk or magistrate shall issue an order to a law enforcement officer or any other designated person authorized under G.S.

122C-251 G.S.to take the respondent into custody for examination by a physician or eligible psychologist.commitment examiner.

122C-251(g)If the clerk or magistrate finds that, in addition to takeprobably being mentally ill, the respondent intois also probably mentally retarded, the clerk or magistrate shall contact the area authority before issuing a custody order and the area authority shall designate the facility to which the respondent is to be taken for examination by a physician or eligible psychologist.commitment examiner.

If the clerk or magistrate finds that, in addition to probably being mentallyill, the respondent is also probablymentallyretarded, the clerk or magistrate shall contact the area authority before issuing a custody order and the area authority shall designate the facility to which the respondent is to be taken for examination by a physician or eligible psychologist.commitment examiner.

If the affidavit is filed through electronic or facsimile transmission, the affiant shall mail the original affidavit no later than five days Page 16 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 after the facsimile transmission of the affidavit to the clerk or magistrate to be filed by the clerk or magistrate with the facsimile copy of the affidavit.

The affiant shall document in writing and file the examination findings with the affidavit delivered to the clerk or magistrate in accordance with subdivision (1)(d)(1) of subsection (d) of this section.

(3) If the physician or eligible psychologistpsychologistcommitment commitment examiner recommends outpatient commitment according to the criteria for outpatient commitment set forth in G.S.

The physician or eligible psychologistpsychologistThe The commitment examiner shall contact the local management entityentityLME/MCO LME/MCO that serves the county where the respondent resides or the local management entityentityLME/MCO LME/MCO that coordinated services for the respondent to inform the local management entityentityLME/MCO LME/MCO that the respondent hasis beenbeing scheduledrecommended for an appointment with an outpatient treatmentcommitment. physician or center.

The LME/MCO shall determine whether the respondent is a client of the LME/MCO or eligible for services through the LME/MCO and, if so, shall identify and schedule an Page 16 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 appointment with a proposed outpatient treatment physician or center and provide the commitment examiner with the name, address, and telephone number of the proposed outpatient treatment physician or center and the date and time that the respondent has been scheduled for an appointment with an the outpatient treatment physician or center.

(4) If the physician or eligible psychologistpsychologistcommitment commitment examiner recommends inpatient commitment based on the criteria for inpatient commitment set forth in G.S.

122C-263(d)(2) and the clerk or magistrate finds probable cause to believe that the respondent meets the criteria for inpatient commitment, the clerk or magistrate shall issue an order to a law enforcement officer to take the respondent into custody for transportation to or custodyany atother aperson 24-hourauthorized facilityunder described in G.S.

122C-252,122C-251(g) provided that if a 24-hour facility is not immediately available or appropriate to thetake respondent's medical condition, the respondent mayinto becustody temporarilyfor detainedtransportation underto appropriateor supervisioncustody and,at upona further24-hour examination,facility releaseddescribed in accordance with G.S.

122C-252, providedG.S.

122C-252;

provided, however, that if a 24-hour facility is not immediately available or appropriate to the respondent's medical condition, the respondent may be temporarily detained under appropriate supervision and, upon further examination, released in accordance with G.S.

…(5) (7) If the affiant is a physician or eligible psychologist commitmentat examiner executes an affidavit for inpatient commitment of a respondent,24-hour afacility seconddescribed physicianin who is not the commitment examiner who performed the examination under this section shall be required to perform the examination required by G.S.

122C-252 who recommends inpatient commitment;

the respondent is physically present on the premises of the same 24-hour facility;

and the clerk or magistrate finds probable cause to believe that the respondent meets the criteria for inpatient commitment, then the clerk or magistrate may issue an order by facsimile transmission or may issue an electronically scanned order by electronic transmission to the physician or eligible psychologist at the 24-hour facility, or a designee, to take the respondent into custody at the 24-hour facility and proceed according to G.S.

(8)Upon Noreceipt commitmentof examiner,the areacustody facility,order, acutethe carephysician hospital,or generaleligible hospital,psychologist at the 24-hour facility, or othera sitedesignee, ofshall firstimmediately examination,(i) ornotify itsthe officials,respondent staff,that employees,the orrespondent otheris individualsnot responsibleunder forarrest theand custody,has examination,not detention,committed management,a supervision,crime treatment,but oris releasebeing oftaken aninto individualcustody examinedto receive treatment and for commitment,the whorespondent's isown notsafety grosslynegligent,and shallthe besafety heldof liableothers, in(ii) anytake civilthe orrespondent criminalinto actioncustody, forand taking(iii) measurescomplete priorand tosign the inpatientappropriate admissionportion of the individualcustody order and return the order to athe 24-hourclerk facility.or magistrate either by facsimile transmission or by scanning it and sending it by electronic transmission.

(e)The Exceptphysician asor providedeligible inpsychologist, subdivisionor (5)a ofdesignee, subsectionshall (d)mail of this section, upon receipt of the original custody order ofno thelater clerkthan orfive magistratedays orafter areturning custodyit order issued by themeans courtof pursuantfacsimile toor Senateelectronic Billtransmission 630*-Secondto Editionthe Pageclerk 17or Generalmagistrate. Assembly Of North Carolina Session 2017 G.S.

15A-1003,The aclerk lawor enforcementmagistrate officershall orfile otherthe officer,original personcustody designatedorder underwith G.S.the copy of the custody order that was electronically returned.

122C-251(g),Notwithstanding the provisions of this subdivision, a clerk or othermagistrate personshall identifiednot inissue thea custody order shallto takea thephysician respondentor intoeligible custodypsychologist withinat 24a hours24-hour afterfacility, or a designee, if the orderphysician isor signed,eligible andpsychologist, proceedor accordinga todesignee, G.S.has not completed training in proper service and return of service.

As used in this subdivision, the term "designee" includes the 24-hour facility's on-site police security personnel.

The Department of Health and Human Services shall cooperate and collaborate with the Administrative Office of the Courts and the UNC School of Government to develop protocols to implement this section, Senate Bill 630*-First Edition Page 17 General Assembly Of North Carolina Session 2017 including a procedure for notifying clerks and magistrates of the names of the physicians, psychologists, and designees who have completed the training.

The Secretary of the Department shall oversee implementation of these protocols.

(6) If the clerk or magistrate finds probable cause to believe that the respondent, in addition to being mentally ill, is also mentally retarded, the clerk or magistrate shall contact the area authority before issuing the order and the area authority shall designate the facility to which the respondent is to be transported.

(7) If a physician or eligible psychologistcommitment examiner executes an affidavit for inpatient commitment of a respondent, a second physician who is not the commitment examiner who performed the examination under this section shall be required to perform the examination required by G.S.

122C-266.

(8) No commitment examiner, area facility, acute care hospital, general hospital, or other site of first examination, or its officials, staff, employees, or other individuals responsible for the custody, examination, detention, management, supervision, treatment, or release of an individual examined for commitment and who follows accepted professional judgment, standards, and practice, shall be held liable in any civil or criminal action for taking reasonable measures to temporarily detain an individual for the period of time necessary to complete a commitment examination, submit an affidavit to the magistrate or clerk of court, and await the issuance of a custody order as authorized by subsection (d) of this section, as long as the commitment examiner has a reasonable and good-faith belief that detention pending the examination and issuance of a custody order is necessary to protect the individual or others from bodily harm or life endangerment.

If the individual is temporarily detained under the circumstances described in this subdivision, the examiner shall certify in the affidavit delivered to the clerk or magistrate in accordance with subdivision (d)(1) of this section the reason the individual requires temporary detention pending the issuance of a custody order.

(e) Except as provided in subdivision (5) of subsection (d) of this section, upon receipt of the custody order of the clerk or magistrate or a custody order issued by the court pursuant to G.S.

15A-1003, a law enforcement officer or other person designated in the order shall take the respondent into custody within 24 hours after the order is signed, and proceed according to G.S.

If the area authority agrees to the admission, further planning of treatment Page 18 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 for the client is the joint responsibility of the area authority and the facility as prescribed in the area plan.

(3) Respondents who are so extremelydangerousextremely dangerous as to pose a serious threat to the community and to other patients committed to non-State hospital psychiatric inpatient units, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee;

and (4) Respondents who are so gravely disabled by both multiple disorders and medical fragility or multiple disorders and deafness that alternative care is inappropriate, as determined bytheby the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee.

Individuals transported to a State facility for the mentally ill who are not admitted by the facility may be transported by appropriate law enforcement officers or designated staff of the State facility in State-owned vehicles to an appropriate 24-hour facility that provides psychiatric inpatient care.

No later than 24 hours after the transfer, the responsible professional at the original facility shall notifythenotify the petitioner, the clerk of court, and, if consent is granted bytheby the respondent, the next of kin, that the transfer has been completed." SECTION 23.

122C-261(a)122C-261(a)G.S. G.S.

122C-263(d)(2) and who requires immediate hospitalization to prevent harm to self or others, may transport the individual directly to an area facility or other place, including a State facility for the mentally ill, for examination by a physician or eligible psychologistpsychologistcommitment commitment examiner in accordance with G.S.

122C-261(a), Page 18 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 the physician or eligible psychologist G.S.

If the physician or eligible psychologistpsychologistcommitment commitment examiner knowsorhasknows or has reason to believethattheindividualbelieve that the individual is mentally retarded, the certificate shall so state.

(c) If the physician or eligible psychologistpsychologistcommitment commitment examiner executes the oath, appearance before a magistrate shall be waived.

The physician or eligible psychologistpsychologistcommitment commitment examiner shall send a copy of the certificate to the clerk of superior court by the most reliable and expeditious means.

If it cannot be reasonably anticipated that the clerk will receive the copy within 24 hours, excluding Saturday, Sunday, and holidays, of the time that it was signed, the physician or eligible psychologistpsychologistcommitment examiner shall also communicate the findings to the clerk by telephone.

If there is no area 24-hour facility and if the respondent is Senate Bill 630*-First Edition Page 19 General Assembly Of North Carolina Session 2017 indigent and unable to pay for care at a private 24-hour facility, the law enforcement officer or other designated person providing transportation shall take the respondent to a State facility for the mentally ill designated by the Commission in accordance with G.S.

The physician's or eligible psychologist'spsychologist'scommitment commitment examiner's certificate shall serve as the custody order and the law enforcement officer or other designated person shall provide transportation in accordance with the provisions of G.S.

If a 24-hour facilityisfacility is not immediatelyavailableimmediately available or appropriate to the respondent's medical condition, the respondent may be temporarily detained under appropriate supervision in accordance with G.S.

In theeventthe event an individual knownorreasonablybelievedtoknown bementallyretardedisor reasonably believed to be mentally retarded is transported to a State facility for the mentally ill, in no event shall that individual be admitted to that facility except as follows:

(3) Respondents who are so extremelydangerousextremely dangerous as to pose a serious threat to the community and to other patients committed to non-State hospital psychiatric inpatient units, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee;

and (4) Respondents who are so gravely disabled by both multiple disorders and medical fragility or multiple disorders and deafness that alternative care is inappropriate, as determined bytheby the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee.

Individuals transported to a State facility for the mentally ill who are not admitted by the facility may be transported by law enforcement officers or designated staff of the State facility inState-ownedvehiclesin toanState-owned appropriate24-hourfacilitythatprovidespsychiatricinpatientcare.vehicles to an appropriate 24-hour facility that provides psychiatric inpatient care.

No later than 24 hours after the transfer, the responsible professional at the original facility shall notifythenotify the petitioner, the clerk of court, and, if consent is granted bytheby the respondent, the next of kin, that the transfer has been completed.

…(e) (f)Respondents If,received uponat examination of a respondent24-hour presentedfacility inunder accordancethe withprovisions subsection (a) of this section,section theshall commitmentbe examinerexamined findsby thata thesecond individualphysician meetsin theaccordance criteriawith for inpatient commitment specified in G.S.

122C-263(d)(2)122C-266. but does not require immediate hospitalization to prevent harm to self or others, the commitment examiner may petition the clerk or magistrate in Senate Bill 630*-Second Edition Page 19 General Assembly Of North Carolina Session 2017 accordance with G.S.

After receipt of notification that the district court has determined reasonable grounds for the commitment, further proceedings shall be carried out in the same way as for all other respondents under this Part.

(f) If, upon examination of a respondent presented in accordance with subsection (a) of this section, the commitment examiner finds that the individual meets the criteria for inpatient commitment specified in G.S.

122C-263(d)(2) but does not require immediate hospitalization to prevent harm to self or others, the commitment examiner may petition the clerk or magistrate in accordance with G.S.

Page 20 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 (g) This section applies exclusively to an individual who is transported to an area facility or other place for an examination by a commitment examiner in accordance with subsection (a) of this section." SECTION 24.

Duties of law-enforcementlaw-enforcementlaw law enforcement officer;

122C-251(g) required to provide transportation shall take the respondent to an area facility identified by the LME/MCO in the community crisis services plan adopted pursuant to G.S.

122C-251(g)122C-202.2 shall take the respondent to an area a facility for examination by a physician or eligible psychologist;

if a physician or eligible psychologist.psychologist commitment examiner.

orIf otheran locationarea facility identified byin the LME/MCOplan or one of its commitment examiners is not available in the communityarea crisisfacility,available, servicesor planif adoptedthere pursuantis no area facility identified in the plan, the person designated to G.S.provide transportation shall take the respondent to any physician or eligible psychologist locally available.

122C-202.2If thata hasphysician anor availableeligible commitmentpsychologist examineracute andcare ishospital capableidentified ofby performingthe aLME/MCO first examination in conjunction with a health screening at the samecommunity location,crisis unlessservices exigentplan circumstancesadopted requirepursuant the respondent be transported to anG.S. emergency department.

If122C-202.2. a commitment examiner is not available in the area facility,available, whether on-site, on-call, or via telemedicine, at any facility or location, or if a plan has not been adopted, the person designated to provide transportation shall take the respondent to an alternative non-hospital provider or facility-based crisis center for a first examination in conjunction with a health screening at the same location.

If noa non-hospitalcommitment providerexaminer oris facility-basednot crisisimmediately centeravailable, foravailable a first examination in conjunctionsuch witharea afacility healthor screeningacute atcare thehospital, same location for health screening and first examination exists, the person designated to provide transportation shall take the respondent tomay anybe physiciantemporarily ordetained eligiblein psychologist locally available.a private hospital or clinic, a general hospital, an acutearea carefacility, hospital,if orone ais Stateavailable; facility for the mentally ill.

Ifif an area facility is not available, the respondent may be detained under appropriate supervision in the respondent's home, in a physicianprivate hospital or eligiblea psychologistclinic, commitmentin examinera isgeneral nothospital, immediatelyor availablein available,a State facility for the respondentmentally mayill, beunder temporarilyappropriate detainedsupervision in ansuch area facility,facility ifor oneacute iscare available;hospital but not in a jail or other penal facility.

ifIf anno areaidentified facility or acute care hospital is notavailable, available,therespondentthe maybedetainedunderlaw appropriatesupervisionenforcement inofficer therespondent'sor home,other designated individual shall transport the respondent to any commitment examiner available in a private hospital or a clinic, in a general hospital, or in a State facility for the mentally ill,ill. but not in ajail orotherpenal facility.

Forthepurposes(a1) ofthisAn section,area "non-hospitalprovider"facility meansthat anis outpatientidentified providerby thatthe providesLME/MCO eitherin behavioralaccordance healthwith orG.S. medical services.

(a1)122C A202.2 facilityas ora othersite locationfor toconducting whichfirst aexaminations respondent is transported under subsection (a) of this section shall providebe capable of performing a healthmedical screening examination of the respondent.respondent that consists of a history and physical appropriate to the respondent's complaint or condition, with ancillary testing as necessary.

The healthmedical screening examination shall be conducted by a commitmentphysician examiner or other individual who is determined by the area facility,facility contracted facility, or other location to be qualified to perform the healthmedical screening.screening and is practicing within the scope of his or her licensure.

The Departmentrespondent willmay workeither withbe commitmentin examinerthe professionalsphysical face to developface apresence of the medical screening toolexaminer foror thismay purpose.be examined utilizing telemedicine equipment and procedures.

TheIf respondentthe mayarea eitherfacility be in subsection (a) of this section determines that an individual qualified to perform a medical screening examination appropriate to the physicalrespondent's face-to-facecomplaint presenceor condition is not available on-site or via telemedicine, the area facility shall identify and contact another area facility that is capable of performing the personmedical conductingscreening, or an acute care hospital, and the screenlaw enforcement officer or mayother bedesignated examinedperson utilizingshall telemedicinetransport equipmentthe andrespondent procedures.to the identified facility or hospital.

Documentation(a2) ofThe theresponsible healthprofessional screeningat requiredan underarea thisfacility subsectionor thatother issite completedof priorfirst toexamination transportingmay thetransfer patienta respondent to anyan general hospital, acute care hospital,hospital orfor designatedemergency facilitymedical shalltreatment, accompanyemergency themedical patientevaluation, oremergency otherwisesurgery, beor madeother availablemedical attreatment that the timesite of transportationfirst examination is unable to provide by directing the receivinglaw facility.enforcement officer or other person designated under G.S.

(b)122C The251(g) examinationto settransport forththe inrespondent subsectionto (a)an ofidentified thisacute sectioncare ishospital. not required if:under any of the following circumstances:

PageWhen 20the Senaterespondent Billis 630*-Secondtransferred Editionsolely Generalfor Assemblymedical Ofreasons, Norththe Carolinaoriginal Sessionfacility 2017shall (1)accept Thethe affiantreturn whoof obtainedthe respondent and the custodyrespondent ordershall be returned to the original facility after the medical care is acompleted physicianunless orthe eligibleresponsible psychologistprofessionals at both facilities concur that the respondent no longer meets the criteria for commitment examinerand whorecommend recommendsthat inpatientthe commitment;commitment.commitment proceedings be terminated.

(2)Any Thedecision custodyorderto statesterminate that the respondentproceedings wasshall chargedbe withdocumented aand violentreported crime,to includingthe aclerk crimeof involvingsuperior assaultcourt within aaccordance deadlywith weapon,subsection and(e) he the respondent was found incapable of proceeding;this section.

Senate Bill 630*-First Edition Page 21 General Assembly Of North Carolina Session 2017 (b) The examination set forth in subsection (a) of this section is not required if:under any of the following circumstances:

(1) The affiant who obtained the custody order is a physician or eligible psychologist commitment examiner who recommends inpatient commitment;commitment.

(2) The custody order states that the respondent was charged with a violent crime, including a crime involving assault with a deadly weapon, and he the respondent was found incapable of proceeding;

In any of these cases, the law-enforcementlaw-enforcementlaw law enforcement officer orshall persontake designatedthe underrespondent directly to a 24-hour facility described in G.S.

122C-251(g) shall take the respondent directly to a 24-hour facility described in G.S.

(c) The physician or eligible psychologistpsychologistcommitment commitment examiner described in subsection (a) of this section shall examine the respondent as soon as possible, and in any event within 24 hours,hours after the respondent is presented for examination.

When the examination set forth in subsection (a) of this section is performed by a physician or eligible psychologispsychologistcommitment tcommitment examiner, the respondent may either be in the physical face-to-face presence of the physician or eligible psychologistpsychologistcommitment commitment examiner or may be examined utilizing telemedicine equipment and procedures.

A physician or eligible psychologistpsychologistcommitment commitment examiner who examines a respondent by means of telemedicine must be satisfied to a reasonable medical certainty that the determinations made in accordance with subsection (d) of this section would not be different if the examination had been done in the physical presence of the physician or eligible psychologist.

A physician or eligible psychologistpsychologistcommitment commitment examiner.

The examination shall include but is not limited to an assessment of the respondent's:at least all of the following with respect to the respondent.respondent:

(d) After the conclusion of the examination the physician or eligible psychologistpsychologistcommitment commitment examiner shall make the following determinations:

(1) If the physician or eligible psychologistpsychologistcommitment commitment examiner finds that:all of the following:

Basedontherespondent'spsychiatrichistory,therespondentisinneedBased on the respondent's psychiatric history, the respondent is in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness as defined by G.S.

Page 22 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 d.

Therespondent'sThe respondent's current mental status orthenatureoftherespondent'sor the nature of the respondent's illness limits or negates the respondent's ability to make an informed decision to seek voluntarily or comply with recommended treatment.

Senate Bill 630*-Second Edition Page 21 General Assembly Of North Carolina Session 2017 The physician or eligible psychologistpsychologistcommitment commitment examiner shall so show on the examination report and shall recommend outpatient commitment.

In addition the examining physician or eligible psychologistpsychologistcommitment commitment examiner shall showthename,address,show andtelephonenumberoftheproposedthe name, address, and telephone number of the proposed outpatient treatment physician or center.center in accordance with subsection (f) of this section.

(2) If the physician or eligible psychologistpsychologistcommitment commitment examiner finds that the respondent is mentally ill and is dangerous to self, as defined in G.S.

122C-3(11)b., the physician or eligible psychologistpsychologistcommitment commitment examiner shall recommend inpatient commitment, and shall so show on the examination report.

If, in addition to mental illness and dangerousness, the physician or eligible psychologistpsychologistcommitment commitment examiner also finds that the respondent is known or reasonably believed to be mentally retarded, this finding shall be shown on the report.

The UponWithout notification,unnecessary delay, and in any event within six hours after the comment examiner's finding and recommendation, the law enforcement officer or other designated person shall take the respondent to a 24-hour facility described in G.S.

ToIf thethere extentis feasible,no inarea providing24-hour thefacility transportationand ofif the respondent,respondent is indigent and unable to pay for care at a private 24-hour facility, the law enforcement officer shallor actother withindesignated sixperson hoursofnotification.Theotherdesignatedpersonshalltaketherespondentshall take the respondent to a 24-hourState facility describedfor the mentally ill designated by the Commission in accordance with G.S.

122C-252 pending a district court hearing within six hours of notification.

If there is no area 24-hour facilityand if the respondent is indigent and unable to pay for care at a private 24-hour facility, the law enforcement officer or other designated person shall take the respondent to a State facility for the mentally ill designated by the Commission in accordance with G.S.

If a 24-hour facility is not immediately available or appropriate to the respondent's medical condition, the respondent may be temporarily detained under appropriate supervision at the site of the first examination,providedexamination, provided that at anytime that a physician or eligible psychologistpsychologistexamination. examination.

Upon the commitment examiner's determination that a 24-hour facility is available and medically appropriate, the law enforcement officer or otherdesignatedpersonother designated person shall transporttherespondentcommence afterreceivingarequesttransporting forthe transportationrespondent bywithout theunnecessary facilitydelay ofand, in any event, within six hours after receiving a request for transportation by the commitment examiner.

To the extent feasible, in providing the transportation of the respondent, the law enforcement officer shall act within six hours of notification.

The other designated person shall transport the respondent without unnecessary delay and within six hours after receiving a request for transportation by the facility of the commitment examiner.

However, if the physician or eligible psychologistpsychologistcommitment commitment examiner determines that the respondent meets the criteria for outpatient commitment, as defined in subdivision (1) of this subsection, the physician or eligible psychologistpsychologistcommitment commitment examiner may recommend outpatient commitment, and the respondent shall be transported and released in accordance with subdivision Page 22 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 (1) of this subsection.

Any Senate Bill 630*-First Edition Page 23 General Assembly Of North Carolina Session 2017 decision to terminate the proceedings or to recommend outpatient commitment after an initial recommendation of inpatient commitment shall be documented and reported to the clerk of superior court in accordance with subsection (e) of this section.

If the respondent is temporarily detained and a 24-hour facility is not available or medically appropriate seven days after the issuance of the custody order, a physician or psychologistpsychologistcommitment commitment examiner shall report this fact to the clerk of superior court and the proceedings shall be terminated.

Affidavits filed in support of proceedings terminated pursuant to this subdivision may not be submitted in support of anysubsequentany subsequent petitions for involuntary commitment.

If the affiant initiating new commitment proceedings is a physician or eligible psychologist,commitmentpsychologistcommitment examiner, the affiant shall conduct a new examination and may not rely upon examinations conducted as part of proceedings terminated pursuant to this subdivision.

(3) If the physician or eligible psychologistpsychologistcommitment commitment examiner finds that neither condition described in subdivisions (1) or (2) of this subsection exists, the proceedings shall be terminated.

(e) The findings of the physician or eligible psychologistpsychologistcommitment commitment examiner and the facts on which they are based shall be in writing in all cases.

The physician or eligible Page 24 Senate Bill 630*-Second630*-First Edition Page 23 General Assembly Of North Carolina Session 2017 psychologistpsychologistcommitment commitment examiner shall sendacopyofthefindingssend a copy of the findings to theclerkthe ofsuperiorcourtclerk of superior court by the most reliable and expeditious means.

If it cannot be reasonably anticipated that the clerk will receive the copy within 48 hours of the time that it was signed, the physician or eligible psychologistpsychologistcommitment examiner shall also communicate his findings to the clerk by telephone.

The commitmentLME/MCO examiner shall givedetermine whether the respondent is a writtenclient noticeof listingthe LME/MCO or eligible for services through the LME/MCO and, if so, shall identify and schedule an appointment with a proposed outpatient treatment physician or center and provide the commitment examiner with the name, address, and telephone number of the proposed outpatient treatment physician or center and the date and time the respondent has been scheduled for an appointment with the outpatient treatment physician or center.

(g) The physiciancommitment orexaminer eligibleshall psychologist,commitmentgive examiner,the atrespondent a written notice listing the completionname, address, and telephone number of the examination,proposed shalloutpatient providetreatment physician or center and directing the respondent withto specificappear informationat regarding the nextaddress stepsat thata willspecified occur."date SECTIONand 25.time.

Prior to the appointment, the commitment examiner shall notify by telephone the designated outpatient treatment physician or center and shall send a copy of the notice and the commitment examiner's examination report to the physician or center.

(g) The physician or eligible psychologist, commitment examiner, at the completion of the examination, shall provide the respondent with specific information regarding the next steps that will occur." SECTION 25.

122C-283122C-283, other health, mental health, and substance abuse professionals whose scope of practice includes diagnosing and documenting psychiatric or substance use disorders and conducting mental status examinations to determine capacity to give informed consent to treatment as follows:

(1) TheSecretaryhasThe receivedarequestfromanLMEtosubstituteforaphysicianSecretary orhas eligiblereceived psychologist, a licensedrequest clinicalfrom socialan worker,LME ato master'ssubstitute levelfor psychiatrica nurse,physician or aeligible master'spsychologist, levelrequest: certified clinical addictions specialist in accordance with subdivision (8) of this subsection to conduct the initial (first-level) examinations of individuals meeting the criteria of G.S.

122C-261(a) or G.S.

122C-281(a).

In making this type of request, the LME shall specifically describe all of the following:request:

HowTo thecertify purposea oflicensed theclinical statutorysocial requirementworker, woulda bemaster's betterlevel servedpsychiatric bynurse, waiving the requirement and substituting the proposed change underthewaiver.Tocertifyalicensedclinical socialworker,amaster's or higher level degree nurse practitioner, a licensed professional counsellor,counselor, or a physician's assistant to conduct the first examinations described in G.S.

Senate Bill 630*-First Edition Page 25 General Assembly Of North Carolina Session 2017 b.

HowTo the waiver will enable the LME to improve the delivery or management of mental health, developmental disabilities, and substance abuse services.To certify a master's level certified licensed clinical Pageaddictions 24specialist Senatein Billaccordance 630*-Secondwith Editionsubdivision General(8) Assemblyof Ofthis Northsubsection Carolinato Sessionconduct 2017the addictionsinitial specialist(first-level) toexaminations conductof theindividuals firstmeeting examinationthe describedcriteria inof G.S.

122C-261(a) or G.S.

122C-281(a).

In making this type of request, the LME shall specifically describe all of the following:to conduct the first examination described in G.S.

a.

How the purpose of the statutory requirement would be better served by waiving the requirement and substituting the proposed change under the waiver.

b.

How the waiver will enable the LME to improve the delivery or management of mental health, developmental disabilities, and substance abuse services.

(4) A waiver certification granted by the Secretary under this section shall be in effect for a period of up to three years and maybemay be rescinded at anytimeany time within this period if the Secretary finds the LME certified individual has failed to meet the requirements of this section.

(5) In no event shall the substitution certification of a licensed clinical social worker, master's or higher level psychiatric nurse,nurse,nurse degreepractitioner, nurselicensed practitioner,professional licensedprofessionalcounsellor,physicianassistant,ormaster'slevelcertifiedcounselor, physician assistant, or master's level certified clinical addictions specialist under a waiver granted under this section be construed as authorization to expand the scope of practice of the licensed clinical social worker, the master's level psychiatric nurse,nurse,nurse nurse practitioner, licensed Page 26 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 professional counsellor,counselor, physician assistant, or the master's level certified clinical addictions specialist.

(6) The Department shall require that individuals performing certified to perform initial examinations under thewaiverthisthe waiver havethis section havesuccessfullycompletedhave successfully completed the Department's standardized involuntary commitment training program and examination.

(7a) No less than annually, the Department shall submit a list of certified first commitment examiners to the Chief District Court Judge of each judicial Senate Bill 630*-Second Edition Page 25 General Assembly Of North Carolina Session 2017 district in North Carolina and maintain a current list of certified first commitment examiners on its Internet Web site.

(a) Upon receipt of a physician's or eligible psychologist'spsychologist'scommitment commitment examiner's finding that the respondent meets the criteria of G.S.

122C-266(c) of a physician's or eligible psychologist's commitment examiner's finding that a respondent meets the criteria of G.S.

The petitioner or respondent, directly or through counsel, may file a written waiver of his the right to notice under this subsection with the clerk of court.

(b1) Upon receipt of a physician's or eligible psychologist'spsychologist'scommitment commitment examiner's certificate that a respondent meets the criteria of G.S.

The court shall review the certificate within 24 hours, excluding Saturday, Sunday, and holidays, for a finding of reasonable grounds in accordance with [G.S.] 122C-261(b).

(a) If a respondent, who has been recommended for outpatient commitment by an examining physician or eligible psychologist a commitment examiner different from the proposed outpatient treatment physician or center, fails to appear for examination by the Senate Bill 630*-First Edition Page 27 General Assembly Of North Carolina Session 2017 proposed outpatienttreatmentphysicianorcenteratthedesignatedtime,thephysicianorcentershallnotifyoutpatient treatment physician or center at the designated time, the physician or center shall notify the clerk of superior court who shall issue an order to a law-enforcement law enforcement officer or other person authorized under G.S.

Page 26 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 (c) In no event may a respondent released on a recommendation that he or she meets the outpatient commitment criteria be physically forced to take medication or forceably forcibly detained for treatment pending a district court hearing.

(e) If a respondent becomes dangerous to himself, selfself, as defined in G.S.

(f) If an inpatient commitment proceeding is initiated pending the hearing for outpatient commitment and the respondent is admitted to a 24-hour facility to be held for an inpatient commitment hearing, notice shall be sent bytheby the clerk of court in the countywherecounty where the respondent is being held to the clerk of court of the county where the outpatient commitment was initiated and the outpatient commitment proceeding shall be terminated." SECTION 28.

122C-267122C-266(a)(2) reads as rewritten:

"§"(2) 122C-267.If the physician finds that the respondent meets the criteria for outpatient commitment under G.S.

Outpatient122C-263(d)(1), commitment;the physician shall show these findings on the physician's examination report, release the respondent pending the district court hearing, and notify the clerk of superior court of the county where the petition was initiated of these findings.

districtIn courtaddition, hearing.the examining physician shall show on the examination report the name, address, and telephone number of the proposed outpatient treatment physician or center.

…The (c)physician Certifiedshall copiescontact ofthe reportsLME/MCO andthat findingsserves ofthe physicianscounty andin psychologistswhich commitmentthe examinersrespondent andresides medicalor recordsthat ofcoordinated previousservices andfor currentthe treatmentrespondent areto admissibleinform inthe evidence.LME/MCO that the respondent is being recommended for outpatient commitment.

…."The SECTIONLME/MCO 29.shall determine whether the respondent is a client of the LME/MCO or eligible for services through the LME/MCO and, if so, shall identify and schedule an appointment with a proposed outpatient treatment physician or center and provide the commitment examiner with the name, address, and telephone number of the proposed outpatient treatment physician or center and the date and time that the respondent has been scheduled for an appointment with the outpatient treatment physician or center.

The physician shall give the respondent a written notice listing the name, address, and telephone number of the proposed outpatient treatment physician or center and directing the respondent to appear at that address at a specified date and time.

The examining physician before the appointment shall notify by telephone and shall send a copy of the notice and the examination report to the proposed outpatient treatment physician or center." SECTION 29.

122C-267(c) reads as rewritten:

Page 28 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 "(c) Certified copies of reports and findings of physicians and psychologistscommitment examiners and medical records of previous and current treatment are admissible in evidence." SECTION 30.

G.S.

… (f) Certified copies of reports and findings of physicians and psychologistspsychologistscommitment commitment examiners and previous and current medical records are admissible in evidence, but the respondent's right to confront and cross-examine witnesses may not be denied.

(g) Hearings may To the extent feasible, hearings shall be held in an appropriate room not used for treatment of clients at the facility in which the respondent is being treated if ititin in a manner approved by the chief district court judge if the facility is located within the presiding judge's district court district as defined in G.S.

7A-133, byaudioby andinteractive videovideoconferencing transmission between a treatment facility and a courtroomcourtroom, inorG.S. which the judge and the respondent can see and hear each other, or G.S.

Notwithstanding the provisions of this subsection, if the respondent, through counsel, objects to a hearing held by audio and video transmission, the Senate Bill 630*-Second Edition Page 27 General Assembly Of North Carolina Session 2017 hearing shall be held in the physical presence of the presiding district court judge.

Regardless of the manner and location for hearings, hearings shall be held in a manner that complies with any applicable federal and State laws governing the confidentiality and security of confidential information,includinganyinformationtransmittedfromthetreatmentfacilitybyaudioinformation, andvideoincluding any information transmitted from the treatment facility by audio and video transmission.

Iftherespondenthas…." counsel,therespondentshallbeallowedSECTION tocommunicatefully31. and confidentiallywith his attorneyduringthe proceeding.

Prior to the use of the audio and video transmission, the procedures and type of equipment for audio and video transmission shall be submitted to the Administrative Office of the Courts by the chief district court judge and approved by the Administrative Office of the Courts.

…." SECTION 30.

(a) If an examining physician or eligible psychologistpsychologista a commitment examiner has recommended outpatient commitment and the respondent has been released pending the district court hearing, the court may make one of the following dispositions:

(1) Ifthecourtfindsbyclear,cogent,andconvincingevidencethattherespondentIf the court finds by clear, cogent, and convincing evidence that the respondent is mentally ill;

and that the respondent's current mental status or the nature of his illness limits or negates his ability to make an informed decision to seek voluntarily or Senate Bill 630*-First Edition Page 29 General Assembly Of North Carolina Session 2017 comply with recommended treatment, it may order outpatient commitment for a period not in excess of 90 days.

(2) If the court does not find that the respondent meets the criteria of commitment set out in subdivision(1)subdivision ofthis(1) subsection,theof this subsection, the respondent shall bedischargedbe discharged and the facility at which he was last a clientclientproposed proposed outpatient physician or center so notified.

The court shall show on the order the outpatient treatment physician or center that is to be responsibleforthemanagementandsupervisionresponsible oftherespondent'sfor the management and supervision of the respondent's outpatient commitment.

TheIf the designated outpatient treatment physician or center will be monitoring and supervising the respondent's outpatient commitment pursuant to a contract for services with an LME/MCO, the clerk of court shall also send a copy of the order to that LME/MCO.

…(1) (4)If Before ordering any outpatient commitment, the court shallfinds makeby findingsclear, ofcogent, factand asconvincing toevidence the availability of outpatient treatment.treatment from an outpatient Page 28 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 treatment physician or center that has agreed to accept the respondent asis amentally clientill; of outpatient treatment services.

that the respondent is capable of surviving safely in the community with available supervision from family, friends, or others;

that based on respondent's psychiatric history, the respondent is in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness as defined by G.S.

122C-3(11);

and that the respondent's current mental status or the nature of the respondent's illness limits or negates the respondent's ability to make an informed decision voluntarily to seek or comply with recommended treatment, it may order outpatient commitment for a period not in excess of 90 days.

If the commitment proceedings were initiated as the result of the respondent's being charged with a violent crime, including a crime involving an assault with a deadly weapon, and the respondent was found incapable of proceeding, the commitment order shall so show.

(2) If the court finds by clear, cogent, and convincing evidence that the respondent is mentally ill and is dangerous to self, as defined in G.S.

122C-3(11)a., or others, as defined in G.S.

122C-3(11)b., it may order inpatient commitment at a 24-hour facility described in G.S.

122C-252 for a period not in excess of 90 days.

However, no respondent found to be both mentally retarded and mentally ill may be committed to a State, area or private facility for the mentally retarded.

An individual who is mentally ill and dangerous to self, as defined in G.S.

122C-3(11)a., or others, as defined in G.S.

122C-3(11)b., may also be committed to a combination of inpatient Page 30 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 and outpatient commitment at both a 24-hour facility and an outpatient treatment physician or center for a period not in excess of 90 days.

If the commitment proceedings were initiated as the result of the respondent's being charged with a violent crime, including a crime involving an assault with a deadly weapon, and the respondent was found incapable of proceeding, the commitment order shall so show.

If the court orders inpatient commitment for a respondent who is under an outpatient commitment order, the outpatient commitment is terminated;

and the clerk of the superior court of the county where the district court hearing is held shall send a notice of the inpatient commitment to the clerk of superior court where the outpatient commitment was being supervised.

(3) If the court does not find that the respondent meets either of the commitment criteria set out in subdivisions (1) and (2) of this subsection, the respondent shall be discharged, and the facility in which the respondent was last a client so notified.

(4) Before ordering any outpatient commitment, the court shall make findings of fact as to the availability of outpatient treatment.

When an outpatient commitment order is issued for a respondent held in a 24-hour facility, the court may order the respondent held at the facility for no more than 72 hours in order for the facility to notify the designated outpatient treatment physician or center of the treatment needs of the respondent.respondent.including any combination of inpatient and outpatient commitment, the 24-hour facility shall identify for the court an outpatient treatment physician or center that meets all of the following criteria:

a.

Has participated in discharge planning for the respondent.

b.

Has agreed to accept the respondent as a client of outpatient treatment services.

c.

Has scheduled the respondent for an outpatient appointment to take place no later than seven days after the respondent's discharge from the 24-hour facility.

The court shall make findings of fact as to the availability of an outpatient treatment physician or center that has met the conditions of this subsection.

If the respondent is a client of an LME/MCO or eligible for services through an LME/MCO, and before the court orders any outpatient commitment, the LME/MCO shall participate in the respondent's discharge planning and assist the 24-hour facility in identifying an outpatient treatment physician or center that is able to comply with the provisions of this subsection.

The court shall show on the order the outpatient treatment physician or center who is responsible for the management and supervision of the respondent's outpatient commitment.

If the treatment center or physician shall be providing outpatient treatment services to the respondent pursuant to a contract for services with an LME/MCO, the order shall also show the LME/MCO.

If the designated outpatient treatment physician or center shall be monitoring and supervising the respondent's outpatient commitment pursuant to a contract for services with an LME/MCO, the Senate Bill 630*-First Edition Page 31 General Assembly Of North Carolina Session 2017 clerk of court shall howalso onsend thea ordercopy of the identityorder ofto the LME/MCO.

The clerk of court shall send a copy of the order to the LME/MCO.

If the outpatient commitment will be supervised in a county other than the county where the commitment originated, the court shall order venue for further court proceedings to be transferred to the county where the outpatient commitmentwill besupervised.Upon anorder changingvenue,the clerk of superior court in the county where the commitment originatedwill shall transferthefileto theclerkofsuperiorcourtin thecountywheretheoutpatient commitment is to be supervised.

…."Upon SECTIONan 31.order changing venue, the clerk of superior court in the county where the commitment originated shall transfer the file to the clerk of superior court in the county where the outpatient commitment is to be supervised.

(c) If the respondent was found not guilty by reason of insanity and has been held in a 24-hour facility pending the court hearing held pursuant to G.S.

122C-268.1, the court may make one of the following dispositions:

(1) If the court finds that the respondent has not proved by a preponderance of the evidence that he no longer has a mental illness or that he is no longer dangerous to others, it shall order inpatient treatment at a 24-hour facility for a period not to exceed 90 days.

(2) If the court finds that the respondent has proven by a preponderance of the evidence that he no longer has a mental illness or that he is no longer dangerous to others, the court shall order the respondent discharged and released." SECTION 32.

122C-276122C-276(c) reads as rewritten:

"§"(c) 122C-276.Subject to the provisions of G.S.

Inpatient122C-269(c), commitment;rehearings shall be held at the facility in which the respondent is receiving treatment.

rehearingsas forauthorized respondentsin otherG.S. than insanity acquittees.

… (c) Subject to the provisions of G.S.

122C-269(c), rehearings shall be held at the facility in which the respondent is receiving treatment.as authorized in G.S.

7A-133 in which the facility is located or a district court judge temporarily assigned to that district.district." SECTION 33.

…." SECTION 32.

(a) AnyindividualAny individual who has knowledgeofknowledge asubstanceof abuserwhoa substance abuser who is dangeroustodangerous to himself self or others may appear before a clerk or assistant or deputy clerk of superior court or a magistrate, execute an affidavit to this effect, and petition the clerk or magistrate for issuance of an order to take the respondent into custody for examination by a physician or eligible psychologist.commitment examiner.

(b) If the clerk or magistrate finds reasonable grounds to believe that the facts alleged in the affidavit are true and that the respondent is probably a substance abuser and dangerous to himself self or others, he the clerk or magistrate shall issue an order to a law-enforcementlaw-enforcementlaw law enforcement officer or any other person authorized by G.S.

122C-251 designated under G.S.122C-251(g) to take the respondent into custody for examination by a physician or eligible psychologist.commitment examiner.

Senate Bill 630*-Second Edition Page 29 General Assembly Of North Carolina Session 2017 (c) If the clerk or magistrate issues a custody order, he the clerk or magistrate shall also make inquiry in any reliable way as to whether the respondent is indigent within the meaning of G.S.

TheSuch affiant shall file the affidavit and examination findings with the clerk of court in the manner described in Page 32 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 G.S.

If the physician or eligible psychologistpsychologistcommitment commitment examiner recommends commitment and the clerk or magistrate finds probable cause to believe that the respondent meets the criteria for commitment, he the clerk or magistrate shall issue an order to a law enforcement officer to take the respondent into custody for transportation to or custodyother atperson adesignated 24-hourunder facility or release the respondent,facility, or, if the respondent is released pending hearing, as described in G.S.

122C-251(g) to take the respondent into custody for transportation to or custody at a 24-hour facility or release the respondent,facility;

or if the respondent is released pending hearing, as described in G.S.

Any(e) personUpon orreceipt entityof whothe custody order of the clerk or whichmagistrate, hasa beenlaw-enforcementlaw enforcement officer or other person designated in compliancethe withorder G.S.shall take the respondent into custody within 24 hours after the order is signed.

122C-251(g) shall be permitted to complete all or part of the duties of a law enforcement officer, in accord with the designation.

(e) Upon receipt of the custody order of the clerk or magistrate, a law-enforcement law enforcement officer or other person designated person identified in the order shall take the respondent into custody within 24 hours after the order is signed.

(e1) No commitment examiner, area facility, acute care hospital, general hospital, or other site of first examination, or their officials, staff, employees, or other individuals responsible for the custody, examination, detention, management, supervision, treatment, or release of an individual examined for commitment,commitment and who isfollows notaccepted grosslyprofessional negligent,judgment, standards, and practice, shall be held liable in any civil or criminal action for taking reasonable measures to temporarily detain an individual for the period of time necessary to complete a commitment examination, submit an affidavit to the magistrate or clerk of court, and await the issuance of a custody order as authorized by subsection (d) of this section.section, as long as the commitment examiner has a reasonable and good-faith belief that detention pending the examination and issuance of a custody order is necessary to protect the individual or others from bodily harm or life endangerment.

If the individual is temporarily detained under the circumstances described in this subsection, the commitment examiner shall certify in the affidavit delivered to the clerk or magistrate in accordance with subdivision (d)(1) of this section the reason the individual requires temporary detention pending the issuance of a custody order.

The facility shall notify the area authority within 24 hours of admission and further planning of treatment for the individual is the joint responsibility of the area authority and the facility as prescribed in the area plan." SECTION 33.34.

When an individual subject to commitment under the provisions of this Part is also violent and requires restraint and when delay in taking him the individual to a physician or eligible psychologistpsychologistcommitment commitment examiner for examination would likely endanger life or property, a law-enforcementlaw-enforcementlaw law enforcement officer may take the person into custody and take him or her immediately before a magistrate or clerk.

The law-enforcementlaw-enforcementlaw law enforcement officer shall execute the affidavit required by G.S.

122C-281 and in addition shall swear that the respondent is violent and requires restraint and that delay in taking the respondent to a physician or eligible psychologistpsychologistcommitment commitment examiner for an examination would endanger life or property.

If the clerk or magistrate finds by clear, cogent, and convincing evidence that the facts stated in the affidavit are true, that the respondent is in fact violent and requires restraint, and that delay Page 30 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 in taking the respondent to a physician or eligible psychologistpsychologistcommitment commitment examiner for an examination would endanger life or property, he the clerk or magistrate shall order the law-enforcementSenate lawBill 630*-First Edition Page 33 General Assembly Of North Carolina Session 2017 law-enforcementlaw enforcement officer to take the respondent directly to a 24-hour facility described in G.S.

Respondents received at a 24-hour facility under the provisions of this section shall be examined and processed thereafter in the same way as all other respondents under this Part." SECTION 34.35.

(a) Without unnecessary delay after assuming custody, the law-enforcement law enforcement officer or the individual designated by the clerk or magistrate or required to provide transportation under G.S.

122C-251(g) to provide transportation shall take the respondent to an area a facility foridentified examination by athe physicianLME/MCO or eligible psychologist if a physician or eligible psychologist is not available in the areacrisis facility,services heplan shalladopted takepursuant the respondent to anyG.S. physician or eligible psychologist locally available.

or122C-202.2 otherfor locationexamination identified by thea LME/MCOphysician inor theeligible communitypsychologist; crisis services plan adopted pursuant to G.S.

122C-202.2if that has an available commitment examiner and is capable of performing a firstphysician examinationor ineligible conjunctionpsychologistcommitment withexaminer. a health screening in the same location, unless exigent circumstances require the respondent be transported to an emergency department.

If athe commitmentarea examinerfacility isidentified notin available,the whetherplan on-site, on-call, or viaone telemedicine,of atthe anyfacility's facilitycommitment orexaminers location,is ornot ifavailable ain planthe hasarea notfacility, beenheavailable, adopted, the person designated to provide transportation shall take the respondent to anany alternativephysician non-hospital provider or facility-basedeligible crisispsychologist centerlocally foravailable. a first examination in conjunction with a health screening at the same location.

If noa non-hospitalphysician provider or facility-basedeligible crisispsychologist centeris fornot aimmediately firstavailable, examination in conjunction with a health screening at the same location, the person designated to provide transportations shall take the respondent tomay abe privatetemporarily hospitaldetained orin clinic, a general hospital, an acutearea care hospital, or a State facility forif theone mentallyis ill.available;

Ifif aan physicianarea orfacility eligible psychologist commitment examiner is not immediately available, thehe respondentmay maybebe temporarily detained under appropriate supervision, in anhis home,other area facility ifor onean isacute available;care hospital as identified and provided in the LME/MCO's community crisis services plan adopted pursuant to G.S.

if122C-202.2. an area facility is not available, he may be detained under appropriate supervision, in his home, in a private hospital or a clinic, or in a general hospital, but not in a jail or other penal facility.

ForIf no identified facility or hospital is available, the purposesrespondent ofshall thisbe section,transported "non-hospitalto provider"any meanscommitment anexaminer outpatientavailable providerin thata providesprivate eitherhospital behavioralor healtha clinic, or medicalin services.a general hospital,hospital.

(a1)If Aa facility,commitment orexaminer otheris locationnot toavailable whichin aan area facility or acute care hospital, the respondent ismay transportedbe temporarily detained under subsectionappropriate (a)supervision ofin thisthe section,area shallfacility provideor hospital but not in a healthjail screeningor ofother thepenal respondent.facility.

The(a1) healthAn screeningarea shallfacility bethat conducted by a physician or other individual who is determinedidentified by the areaLME/MCO facility,in contractedaccordance facility,with orG.S. other location to be qualified to perform the health screening.

The122C-202.2 respondentas maya eithersite befor inconducting thefirst physicalexaminations face-to-faceunder presencesubsection (a) of thethis healthsection shall be capable of performing a medical screening examinerexamination orof maythe berespondent examinedthat utilizingconsists telemedicineof equipmenta history and procedures.physical appropriate to the respondent's complaint or condition, with ancillary testing as necessary.

DocumentationThe ofmedical the health screening requiredexamination undershall thisbe subsectionconducted thatby isa completedphysician prioror toother transportingindividual thewho patientis todetermined anyby generalthe orarea acutefacility careto hospitalbe shallqualified accompanyto perform the patientmedical orscreening otherwiseand beis madepracticing availablewithin at the timescope of transportationhis toor theher receivinglicensure. facility.

(b) The examinationrespondent setmay fortheither be in subsectionthe (a)physical face-to-face presence of thisthe sectionmedical isscreening notexaminer requiredor if:undermay eitherbe ofexamined theutilizing followingtelemedicine circumstances:equipment and procedures.

If the area facility in subsection (a) of this section determines that an individual qualified to perform a medical screening examination appropriate to the respondent's complaint or condition is not available on-site or via telemedicine, the area facility shall identify and contact another area facility that is capable of performing the medical screening, or an acute care hospital, and the law enforcement officer or other designated person shall transport the respondent to the identified facility or hospital.

(a2) The responsible professional at an area facility or other site of first examination may transfer a respondent to an acute care hospital for emergency medical treatment, emergency medical evaluation, emergency surgery, or other medical treatment that the site of first examination is unable to provide by directing the law enforcement officer or other person designated under G.S.

122C-251(g) to transport the respondent to an identified acute care hospital.

When the respondent is transferred solely for medical reasons, the original facility shall accept the return of the respondent and the respondent shall be returned to the original facility after the medical care is completed unless the responsible professionals at both facilities concur that the respondent no longer meets the criteria for commitment and recommend that the commitment proceedings be terminated.

Any decision to terminate the proceedings shall be documented and reported to the clerk of superior court in accordance with subsection (e) of this section.

Page 34 Senate Bill 630*-First Edition General Assembly Of North Carolina Session 2017 (b) The examination set forth in subsection (a) of this section is not required if:under either of the following circumstances:

(2) TherespondentisincustodyunderthespecialemergencyproceduredescribedThe respondent is in custody under the special emergency procedure described in G.S.

In these cases when it is recommended that the respondent be detained in a 24-hour facility, the law-enforcement law enforcement officer shall take the respondent directly to a 24-hour facility described in G.S.

Senate Bill 630*-Second Edition Page 31 General Assembly Of North Carolina Session 2017 (c) The physician or eligible psychologistpsychologistcommitment commitment examiner described in subsection (a) of this section shall examine the respondent as soon as possible, and in any event within 24 hours, after the respondent is presented for examination.

(d) After the conclusion of the examinationexaminationexamination, examination, the physician or eligible psychologistpsychologistcommitment commitment examiner shall make the following determinations:

(1) If the physician or eligible psychologistpsychologistcommitment commitment examiner finds that the respondent is a substance abuser and is dangerous to himself self or others, he the commitment examiner shall recommend commitment and whether the respondent should be released or be held at a 24-hour facility pending hearing and shall so show on [the] his theexaminationreport.Basedexamination onreport. the physician's or eligible psychologist's recommendation commitment examiner's recommendation, the law-enforcement law enforcement officer or other designated individual shall take the respondent to a 24-hour facility described in G.S.

Based on the physician's or eligible psychologist'scommitment examiner's recommendationrecommendation, the law-enforcementlaw enforcement officer or other designated individual shall take the respondent to a 24-hour facility described in G.S.

(2) If the physician or eligible psychologistpsychologistcommitment commitment examiner finds that the condition described in subdivision (1) of this subsection does not exist, the respondent shall be released and the proceedings terminated.

(e) The findings of the physician or eligible psychologistpsychologistcommitment commitment examiner and the facts on which they are based shall be in writing in all cases.

If it cannot be reasonably anticipated that the clerk will receive the copy within 48 hours of after the time that it was signed, the physician or eligible psychologistpsychologistcommitment commitment examiner shall also communicate his the findings to the clerk by telephone." SECTION 35.36.

122C-285(c) that a respondent is a substance abuser and dangerous to himself self or others and that commitment is recommended, the clerk of superior court of the countywherecounty where the facility is located, if the respondent is held in a 24-hour facility, or the clerk of superior court where the petition was initiated shall upon direction of a district court judge assign counsel, calendar the matter for hearing, and notify the respondent, his the respondent's counsel, and the petitioner of the time and place of the hearing.

The petitioner or respondent, directly, or through counsel, may file a written waiver of his the right to notice under this subsection with the clerk of court.

Senate Bill 630*-First Edition Page 35 General Assembly Of North Carolina Session 2017 (b) Notice to the respondent required by subsection (a) of this section shall be given as provided in G.S.

…."(c) SECTIONUpon 36.receipt of notice that transportation is necessary to take a committed respondent to a 24-hour facility pursuant to G.S.

122C-290(b), the clerk shall issue a custody order for the respondent.

(d) The clerk of superior court shall upon the direction of a district court judge calendar all hearings, supplemental hearings, and rehearings and provide all notices required by this Part." SECTION 37.

This professional shall be a physician if the initial commitment evaluation was conducted by an eligible psychologist.a commitment Page 32 Senate Bill 630*-Second Edition General Assembly Of North Carolina Session 2017 examiner who is not a physician.

If the respondent is released, the law-enforcement law enforcement officer or other person designated orto requiredprovide undertransportation G.S.shall return the respondent to the originating county.