SB 240 — Department of Mental Health; expand category for involuntary commitment to include individuals with co-occurring substance use disorder, authorize service of petition in county of respondent's location when original petition was filed, authorize judge to determine when to bring respondent before court for hearing on restriction of liberty pending final hearing, authorize judge of probate to petition district or municipal court for suspension of criminal confinement for commitment; bill does not require providers to expand services unless additional funding provided

SB240 ENGROSSEDENROLLED SB240 7LQ822E-27LQ822E-3 By Senator Barfoot RFD:

21-Mar-24 Page 0 SB240 EngrossedEnrolled 2Enrolled, 4An AAct, BILL3 TO BE ENTITLED AN ACT 9 Relating to the Alabama Department of Mental Health;

and to provide that mental health providers are not required to Page 1 SB240 Engrossed expand existing services unless its currently available funds support the expansion.

Sections 22-52-1.1, 22-52-1.2, 22-52-3, 22-52-7, 22-52-10.1, as last amended by Act 2023-472, of the Page 1 SB240 Enrolled 2023 Regular Session, 22-52-10.2, 22-52-10.4, 22-52-10.11 and 22-52-11, Code of Alabama 1975, are amended to read as follows:

Page 2 SB240 Engrossed (5)(6) INVOLUNTARY COMMITMENT.

A psychiatric disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope Page 2 SB240 Enrolled with the ordinary demands of life., or a diagnosis designated as a Serious Mental Illness (SMI), as defined in the then current edition of the Diagnostic and Statistical Manual of Mental Disorders.

An individual for whom a petition Page 3 SB240 Engrossed for commitment to mental health services has been filed.

A cluster of cognitive, Page 3 SB240 Enrolled behavioral, and physiological symptoms indicating that the individual continues using a substance despite significant substance-related problems, such as impaired control, social impairment, risky behaviors, and pharmacological tolerance and withdrawal.

95 (b) The Legislature finds for purposes of this article substance use disorder is commonly associated with mental illness and providers who provide these services serve a public purpose." "§22-52-1.2 95 (a) Any person individual may file a petition seeking the involuntary commitment of another personindividual.

(4) That the beliefs of the petitioner are based on Page 4 SB240 Engrossed specific behavior, acts, attempts, or threats, which shall be specified and described in detail.

(5) The names and addresses of other persons individuals with knowledge of the respondent's mental illness or mental illness with a secondary diagnosis of co-occurring Page 4 SB240 Enrolled substance use disorder who may be called as witnesses.

and a list of the names and Page 5 SB240 Engrossed addresses of the witnesses who may be called to testify in support of the petition.

The hearing shall be preceded by adequate notice to the respondent." "§22-52-7 (a)(1) When a petition has been filed seeking to have Page 5 SB240 Enrolled limitations placed upon the liberty of a respondent pending the outcome of a final hearing on the merits, the probate judge judge of probate shall order the sheriff of the county in which the respondent iswas located at the time of the filing to serve a copy of the petition upon the respondent and to either bring the respondent before the judge of probate probate judge instanteror be evaluated as provided in subsection (2).

If limitations on the respondent's liberty are ordered, the probate judgejudge of probate may order the respondent Page 6 SB240 Engrossed detained under the provisions of this section at a designated mental health facility or a hospital.

(b) No limitations shall be placed upon the respondent's liberty nor treatment imposed upon the respondent unless such limitations are determined necessary by the judge Page 6 SB240 Enrolled of probate to prevent the respondent from doing substantial and immediate harm to himself or to others posing a real and present threat of substantial harm to self or others or to prevent the respondent from leaving the jurisdiction of the court.

If temporary treatment or admittance to a hospital is ordered for the respondent, such the treatment shall be supervised by a licensed medical doctor physician or qualified mental health professional who has willingly consented to treat the Page 7 SB240 Engrossed respondent, and admission to a hospital shall be ordered by a licensed medical doctor who has willingly consented to admit and treat the respondent." "§22-52-10.1 (a) If at the final hearing on a petition seeking to Page 7 SB240 Enrolled involuntarily commit a respondent, the judge of probate finds, based on clear and convincing evidence, that the respondent meets the criteria for involuntary commitment, an order shall be entered for either of the following:

(2) The judge of probate shall report to the Alabama State Law Enforcement Agency, in a method determined by the commission, updates to any order for involuntary commitment that was previously forwarded to the Alabama State Law Enforcement Agency under this section, including notice of any Page 8 SB240 Engrossed reversal of petition or appeal." "§22-52-10.2 (a) A respondent may be committed to outpatient treatment if the probate court, based upon clear and convincing evidence, finds all of the following:

Page 8 SB240 Enrolled (1) The respondent has a mental illness or a mental illness with a secondary diagnosis of co-occurring substance use disorder.

(b) Upon a recommendation made by the designated mental health facility currently providing outpatient treatment that the respondent's outpatient commitment order should be renewed, a probate court may enter an order to renew the commitment order upon the expiration of time allotted for treatment by the original outpatient treatment order if the Page 9 SB240 Engrossed judge of probate court finds, based upon clear and convincing evidence, all of the following:

Page 9 SB240 Enrolled (2) As a result of the mental illness or mental illness with a secondary diagnosis of co-occurring substance use disorder, the respondent, if treatment is not continued, will suffer mental distress and experience deterioration of the ability to function independently.

(4) The respondent is unable to make a rational and Page 10 SB240 Engrossed informed decision as to whether or not treatment for mental illness or mental illness with a secondary diagnosis of co-occurring substance use disorder would be desirable.

(b) If the probate judge judge of probate finds that no treatment is presently available for the respondent's mental Page 10 SB240 Enrolled illness or mental illness with a secondary diagnosis of co-occurring substance use disorder, but that confinement is necessary to prevent the respondent from causing substantial harm to himself or herself or to others, the order committing the respondent shall provide that, should treatment for the respondent's mental illness or mental illness with a secondary diagnosis of co-occurring substance use disorder become available at any time during the period of the respondent's confinement, the treatment shall be made available to him or her immediately.

(d) Nothing in this section shall be construed as requiring a mental health provider to expand their current services if necessary funding is not provided." "§22-52-10.11 (a) The director of a state mental health facility or designated mental health facility to which a respondent is currently committed for inpatient treatment, not later than 30 Page 11 SB240 Engrossed days prior to the expiration of the current commitment order, shall assess the appropriateness of transferring the respondent to outpatient treatment as the least restrictive alternative necessary and available for the treatment of the respondent's mental illness or mental illness with a secondary Page 11 SB240 Enrolled diagnosis of co-occurring substance use disorder.

The probate courtjudge of probate shall appoint an attorney to represent the respondent at the Page 12 SB240 Engrossed hearing.

Page 12 SB240 Enrolled (1) The grounds stated in the recommendation.

§15-16-26 Notwithstanding Section 15-16-20, Code of Alabama 1975, if a commitment order has been issued pursuant to Title 22, Chapter 52, Code of Alabama 1975, but cannot be fulfilled because the respondent is subsequently confined solely for misdemeanor charges or municipal ordinance violations, the judge of probate who issued the commitment order may communicate with the judge of the district, municipal or circuit court who ordered the respondent to be confined to discuss whether he or she will issue an order to discharge the respondent from confinement and suspend the criminal Page 13 SB240 Engrossed proceedings temporarily so that the commitment order may be fulfilled.

Page 1413 SB240 EngrossedEnrolled Senate________________________________________________ ReadPresident forand thePresiding firstOfficer timeof andthe referredSenate ................21-Mar-24________________________________________________ toSpeaker of the House of Representatives SB240 Senate committee09-Apr-24 onI Judiciaryhereby Readcertify forthat the secondwithin timeAct andoriginated placedin ................03-Apr-24and onpassed the calendar:Senate, as amended.

1 amendment Read for the third time and passed ................09-Apr-24 as amended Yeas 34 Nays 0 Abstains 0 Patrick Harris, Secretary.

PageHouse 15of Representatives Passed:

25-Apr-24 By:

Senator Barfoot Page 14