SB 1479 — mental health treatment; patient transport.

SB1479 - 531R - IS Ver       REFERENCESenate TITLE:Engrossed         State of Arizona Senate Fifty-third Legislature First Regular Session     SENATE BILL 1479       AN ACT   Amending sections 36‑520 and 36‑524, Arizona Revised Statutes;

relating to court‑ordered mental health treatment;evaluations.

patient transport.

        State of Arizona Senate Fifty-third Legislature First Regular Session     SB 1479   Introduced by Senator Smith     AN ACT   Amending sections 36‑540, 36‑540.01 and 36‑544, Arizona Revised Statutes;

relating to mental health services.

Section 1.  Section 36-540,36-520, Arizona Revised Statutes, is amended to read:

START_STATUTE36-540.  CourtSTART_STATUTE36-520.  Application optionsfor A.  Ifevaluation; the court finds by clear and convincing evidence that the proposed patient, as a result of mental disorder, is a danger to self, is a danger to others, has a persistent or acute disability or a grave disability and is in need of treatment, and is either unwilling or unable to accept voluntary treatment, the court shall order the patient to undergo one of the following:

1.  Treatmentdefinition inA.  Any responsible individual may apply for a programcourt‑ordered evaluation of outpatienta treatment.person who is alleged to be, as a result of a mental disorder, a danger to self or to others or a person with a persistent or acute disability or a grave disability and who is unwilling or unable to undergo a voluntary evaluation.  The application shall be made in the prescribed form and manner as adopted by the director.

2.  TreatmentB.  The inapplication afor programevaluation consistingshall ofinclude combinedthe inpatientfollowing anddata: outpatient treatment.

3.  Inpatient1.  The treatmentname, inand aaddress mentalif healthknown, treatment agency, in a hospital operated by or under contract with the United States department of veterans affairs to provide treatment to eligible veterans pursuant to article 9 of this chapter, in the stateproposed hospitalpatient orfor inwhom aevaluation privateis hospital,applied. if the private hospital agrees, subject to the limitations of section 36‑541.

B.  The2.  The courtage, shalldate considerof allbirth, availablesex, race, marital status, occupation, social security number, present location, dates and appropriateplaces alternativesof forprevious thehospitalizations, treatmentnames and careaddresses of the patient.  Theguardian, courtspouse, shallnext orderof kin and significant other persons and other data that the leastdirector restrictivemay treatmentrequire alternativeon available.the form to whatever extent that this data is known and is applicable to the proposed patient.

C.  The3.  The courtname, mayaddress order the proposed patient to undergo outpatient or combined inpatient and outpatientrelationship treatmentof pursuantthe toperson subsectionwho A,is paragraphapplying 1for or 2 of this section if the court:evaluation.

1.  Determines4.  A statement that allthe proposed patient is believed to be, as a result of a mental disorder, a danger to self or to others or a patient with a persistent or acute disability or a grave disability and the followingfacts apply:on which this statement is based.

(a)  The5.  A statement that the applicant believes the proposed patient doesis notin requireneed continuousof inpatientsupervision, hospitalization.care and treatment and the facts on which this statement is based.

(b)  TheC.  The patientapplication willshall be moresigned appropriatelyand treatednotarized, inexcept that for an outpatientapplication treatmentmade programby ora inpeace officer a combinedcopy inpatientof the application that contains the applicant's original signature is acceptable and outpatientdoes treatmentnot program.need to be notarized.

(c)  TheD.  The patientscreening willagency followshall aoffer assistance to the applicant in preparation of the application.  On receipt of the application, the screening agency shall act as prescribed outpatientin treatmentsection plan.36‑521 within forty‑eight hours of after the filing of the application, excluding weekends and holidays.  If the application is not acted upon on within forty‑eight hours, the reasons for not acting promptly shall be reviewed by the director of the screening agency or the director's designee.

(d)  TheE.  If patientthe willapplicant notfor likelythe becomecourt‑ordered dangerousevaluation orpresents sufferthe moreperson seriousto physicalbe harmevaluated orat seriousthe illnessscreening oragency, furtherthe deteriorationagency ifshall conduct a prepetition screening examination.  Except in the patientcase followsof aan prescribedemergency outpatientevaluation, treatmentthe plan.person to be evaluated shall not be detained or forced to undergo prepetition screening against the person's will.

2.  IsF.  If presentedthe withapplicant andfor approves a written treatment plan that conforms with the requirementscourt‑ordered ofevaluation sectiondoes 36‑540.01,not subsectionpresent B.  If the treatmentperson plan presented to thebe courtevaluated pursuantat tothe thisscreening subsectionagency, paragraph provides for supervision of the patient under court order by a mental health agency thatshall isconduct other than the mentalprepetition healthscreening agencyat thatthe petitionedhome orof requested the countyperson attorney to petitionbe theevaluated courtor forany treatmentother pursuantplace to section 36‑531, the treatmentperson planto must be approvedevaluated byis thefound.  If medicalprepetition directorscreening ofis thenot mentalpossible, healththe screening agency thatshall willproceed superviseas theprescribed treatmentin pursuantsection to36‑521, subsection EB. of this section.

D.  AnG.  If ordera toperson receiveis treatmentbeing pursuanttreated toby subsectionprayer A,or paragraphspiritual 1means oralone 2in accordance with the tenets and practices of thisa sectionrecognized shallchurch notor exceedreligious threedenomination hundredby sixty‑fivea days.  Theduly periodaccredited practitioner of inpatientthat treatmentchurch underor adenomination, combinedsuch treatmentthat orderperson pursuantmay tonot subsectionbe A,ordered paragraphevaluated, 2detained ofor thisinvoluntarily sectiontreated shallunless notthe exceedcourt has determined that the maximumperson periodis, allowedas fora anresult orderof formental inpatientdisorder, treatmenta pursuantdanger to subsectionothers For ofto thisself. section.

E.  IfH.  Court‑ordered theevaluation courtor enters an order for treatment pursuant to subsectionthis A,chapter paragraphdoes 1not oroperate 2to ofchange thisthe section,legal allresidence of thea followingpatient. apply:

1.  TheI.  If courtthe shallapplication designateis thenot medicalacted directoron ofbecause it has been determined that the mentalproposed healthpatient treatmentdoes not need an evaluation, the agency thatafter willa superviseperiod andof administersix months shall destroy the patient'sapplication treatmentand program.any other evidence of the application.

2.  TheJ.  For medical director shall not use the servicespurposes of anythis person,section, agency"person" orincludes organization to supervise a patient'sperson outpatientwho: treatment program unless the person, agency or organization has agreed to provide these services in the individual patient's case and unless the department has determined that the person, agency or organization is capable and competent to do so.

3.  The1.  Is person,under agencyeighteen oryears organization assigned to supervise an outpatient treatment program or the outpatient portion of aage. combined treatment program shall be notified at least three days before a referral.

The2.  Has medicalbeen directortransferred makingto the referralcriminal anddivision of the person,superior agencycourt orpursuant organization assigned to supervisesection the8‑327 treatmentor programwho shallhas sharebeen relevantcharged informationwith aboutan theoffense patientpursuant to providesection continuity13‑501. of treatment.

4.  During3.  Is any period of outpatient treatment under subsection A, paragraph 2 of this section, if the court,supervision on motion by the medical director of the patient's outpatient mental health treatment facility, determines that the patient is not complying with the terms of the order or that the outpatient treatment plan is no longer appropriate and the patient needs inpatient treatment, the court, without a hearing and based on the court record, the patient's medical record, the affidavits and recommendations of the medical director, and the advice of staff and physicians or the psychiatric and mental health nurse practitioner familiar with the treatment of the patient, may enter an orderadult amendingprobation itsdepartment. original order.  The amended order may alter the outpatient treatment plan or order the patient to inpatient treatment pursuant to subsection A, paragraph 3 of this section.  The amended order shall not increase the total period of commitment originally ordered by the court or, when added to the period of inpatient treatment provided by the original order and any other amended orders, exceed the maximum period allowed for an order for inpatient treatment pursuant to subsection F of this section.  If the patient refuses to comply with an amended order for inpatient treatment, the court may authorize and direct a peace officer, on the request of the medical director, to take the patient into protective custody and transport the patient to the agency for inpatient treatment.  If a peace officer is directed to take the patient into protective custody and transport the patient to the agency for inpatient treatment, a mental health provider shall accompany the peace officer.  When reporting to or being returned to a treatment agency for inpatient treatment pursuant to an amended order, the patient shall be informed of the patient's right to judicial review and the patient's right to consult with counsel pursuant to section 36‑546.

5.  DuringEND_STATUTE anySec. 2.  Section period36-524, ofArizona outpatientRevised treatmentStatutes, under subsection A, paragraph 2 of this section, if the medical director of the outpatient treatment facility in charge of the patient's care determines, in concert with the medical director of an inpatient mental health treatment facility who has agreed to accept the patient, that the patient is in need of immediate acute inpatient psychiatric care because of behavior that is dangerous to self or to others, the medical director of the outpatient treatment facility may order a peace officer to apprehend and transport the patient to the inpatient treatment facility pending a court determination on an amended order under paragraph 4 of this subsection.  If a peace officer is ordered to apprehendread: and transport the patient to the inpatient treatment facility, a mental health provider shall accompany the peace officer.  The patient may be detained and treated at the inpatient treatment facility for a period of no more than forty‑eight hours, exclusive of weekends and holidays, from the time that the patient is taken to the inpatient treatment facility.  The medical director of the outpatient treatment facility shall file the motion for an amended court order requesting inpatient treatment no later than the next working day following the patient being taken to the inpatient treatment facility.  Any period of detention within the inpatient treatment facility pending issuance of an amended order shall not increase the total period of commitment originally ordered by the court or, when added to the period of inpatient treatment provided by the original order and any other amended orders, exceed the maximum period allowed for an order for inpatient treatment pursuant to subsection F of this section.  If a patient is ordered to undergo inpatient treatment pursuant to an amended order, the medical director of the outpatient treatment facility shall inform the patient of the patient's right to judicial review and to consult with an attorney pursuant to section 36‑546.

F.  TheSTART_STATUTE36-524.  Application maximumfor periodsemergency ofadmission inpatientfor treatmentevaluation; that the court may order, subject to the limitations of section 36‑541, are as follows:

1.  Ninetyrequirements; days for a person found to be a danger to self.

2.  Oneimmunity hundredA.  A eightywritten daysapplication for aemergency personadmission foundshall be made to bean evaluation agency before a dangerperson tomay others.be hospitalized in the agency.

3.  OneB.  The hundredapplication eightyfor daysemergency foradmission shall be made by a person foundwith toknowledge haveof the facts requiring emergency admission.  The applicant may be a persistentrelative or acutefriend disability.of the person, a peace officer, the admitting officer or another responsible person.

4.  ThreeC.  The hundredapplication sixty‑fiveshall daysbe forupon on a personprescribed foundform toand haveshall ainclude gravethe disability.following:

G.  If,1.  A onstatement findingby that the patientapplicant meetsthat thehe criteriabelieves foron court‑orderedthe treatmentbasis pursuant to subsection A of thispersonal section,observation the court also finds that there is reasonable cause to believe that the patient is an incapacitated person is, as defined in section 14‑5101 or is a personresult in need of protection pursuant to section 14‑5401 and that the patient is or may be in need of guardianship or conservatorship, or both, the court may order an investigation concerning the need for a guardianmental ordisorder, conservator, or both, and may appoint a suitabledanger person or agency to conductself the investigation.  The appointee may include a court appointed court‑appointed guardian ad litem, an investigator appointed pursuant to section 14‑5308 or theothers, public fiduciary if there is no person willing and qualified to act in that capacity. during The court shall give notice of the appointmenttime necessary to thecomplete appointee within three days of the appointment.  Theprepetition appointeescreening shallprocedures submitset theforth reportin ofsections the36‑520 investigationand to36‑521 the courtperson withinis twenty‑onelikely days.  Thewithout reportimmediate shallhospitalization include recommendations as to whosuffer shouldserious bephysical guardianharm or whoserious shouldillness be conservator, or both,is andlikely a report of the findings and reasons for the recommendation.  If the investigation and report so indicate, the court shall order the appropriate person to submitinflict aserious petitionphysical toharm becomeupon theon guardiananother orperson. conservator, or both, of the patient.

H.  In2.  The any proceeding for court‑ordered treatment in which the petition alleges that the patient is in need of a guardian or conservator and states the grounds for that allegation, the court may appoint an emergency temporary guardian or conservator, or both, for a specific purposenature or purposes identified in its order and for a specific period of time not to exceed thirty days if the courtdanger. finds that all of the following are true:

1.  The3.  A patientsummary meetsof the criteriaobservations forupon court-orderedon treatmentwhich pursuantthe tostatement subsection A of thisdanger section.is based.

2.  There4.  The issignature reasonableof cause to believe that the patientapplicant. is an incapacitated person as defined in section 14‑5101 or is in need of protection pursuant to section 14‑5401, paragraph 2.

3.  TheD.  A patienttelephonic doesapplication notmay havebe made no more than twenty‑four hours prior to before a guardianwritten orapplication.  A conservatortelephonic andapplication shall be made by or in the welfarepresence of a peace officer unless the patientapplication requiresis immediatemade actionby a health care provider who is licensed pursuant to protecttitle 32, chapter 13, 15, 17 or 19.1 and who is directly involved with the care of a patient who is in a health care facility licensed in this state.  For an application made by a doctor, or a nurse, the ward'soriginal property.signature of the applicant on or a peace officer, a facsimile copy of the application that contains the applicant's original signature is acceptable, does not have to be notarized and may be submitted as the written application.

4.  TheE.  If conditionsthe prescribedperson pursuant to sectionbe 14‑5310,admitted subsectionis Bnot already present at the evaluation agency and if the admitting officer, based upon on a review of the written or sectiontelephonic 14‑5401.01,application subsectionand Bconversation havewith beenthe met.applicant and peace officer, has reasonable cause to believe that an emergency examination is necessary, the admitting officer may advise the peace officer,  that sufficient grounds exist to take the person into custody and to transport the person to the evaluation agency.  The admitting officer shall not be held civilly liable for any acts committed by a person whom the admitting officer did not advise be taken into custody if the admitting officer has in good faith followed the requirements of this section.

I.  The court may appoint as a temporary guardian or conservator pursuant to subsection H of this section a suitable person or the public fiduciary if there is no person qualified and willing to act in that capacity.  The court shall issue an order for an investigation as prescribed pursuant to subsection G of this section and, unless the patient is represented by independent counsel, the court shall appoint an attorney to represent the patient in further proceedings regarding the appointment of a guardian or conservator.  The court shall schedule a further hearing within fourteen days on the appropriate court calendar of a court that has authority over guardianship or conservatorship matters pursuant to this title to consider the continued need for an emergency temporary guardian or conservator and the appropriateness of the temporary guardian or conservator appointed, and shall order the appointed guardian or conservator to give notice to persons entitled to notice pursuant to section 14‑5309, subsection A or section 14‑5405, subsection A.  The court shall authorize certified letters of temporary emergency guardianship or conservatorship to be issued on presentation of a copy of the court's order.  If a temporary emergency conservator other than the public fiduciary is appointed pursuant to this subsection, the court shall order that the use of the money and property of the patient by the conservator is restricted and not to be sold, used, transferred or encumbered, except that the court may authorize the conservator to use money or property of the patient specifically identified as needed to pay an expense to provide for the care, treatment or welfare of the patient pending further hearing.  This subsection and subsection H of this section do not:

1.  Prevent the evaluation or treatment agency from seeking guardianship and conservatorship in any other manner allowed by law at any time during the period of court‑ordered evaluation and treatment.

2.  Relieve the evaluation or treatment agency from its obligations concerning the suspected abuse of a vulnerable adult pursuant to title 46, chapter 4.