2003 Legislation
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SENATE BILL NO. 1128 – Child, mental health serv, examiner


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Daily Data Tracking History

S1128................................................by JUDICIARY AND RULES
CHILDREN - MENTAL HEALTH SERVICES - Amends existing law to further define
the qualifications of a designated examiner for purposes of children's
mental health services.
02/24    Senate intro - 1st rdg - to printing
02/25    Rpt prt - to Health/Wel
03/05    Rpt out - rec d/p - to 2nd rdg
03/06    2nd rdg - to 3rd rdg
03/10    3rd rdg - PASSED - 30-2-3
      AYES -- Andreason, Brandt, Burkett, Burtenshaw, Cameron, Compton,
      Darrington, Davis, Gannon, Geddes, Goedde, Hill, Ingram, Kennedy,
      Keough, Little, Lodge, Malepeai, Marley, McKenzie, McWilliams, Noh,
      Pearce, Richardson, Schroeder, Stegner, Stennett, Sweet, Werk,
      NAYS -- Bailey, Calabretta
      Absent and excused -- Bunderson, Noble, Sorensen
    Floor Sponsor - Compton
    Title apvd - to House
03/11    House intro - 1st rdg - to Health/Wel
03/25    Rpt out - rec d/p - to 2nd rdg
03/26    2nd rdg - to 3rd rdg
03/28    3rd rdg - PASSED - 64-0-6
      AYES -- Andersen, Barraclough, Barrett, Bauer, Bedke, Bell, Bieter,
      Black, Block, Boe, Bolz, Campbell, Cannon, Clark, Collins, Deal,
      Denney, Douglas, Eberle, Edmunson, Eskridge, Field(18), Field(23),
      Gagner, Garrett, Harwood, Henbest(Bray), Jaquet, Jones, Kellogg,
      Kulczyk, Lake, Langford, Langhorst, Martinez, McGeachin, McKague,
      Meyer, Miller, Mitchell, Moyle, Nacarrato, Nielsen, Raybould,
      Ridinger, Ring, Ringo, Robison, Rydalch, Sali, Sayler, Schaefer,
      Shepherd, Shirley, Skippen, Smith(30), Smylie, Snodgrass, Stevenson,
      Tilman, Trail, Wills, Wood, Mr. Speaker
      NAYS -- None
      Absent and excused -- Bradford, Crow, Cuddy, Ellsworth, Roberts,
    Floor Sponsor - Garrett
    Title apvd - to Senate
03/31    To enrol
04/01    Rpt enrol - Pres signed
04/02    Sp signed
04/03    To Governor
04/08    Governor signed
         Session Law Chapter 249
         Effective: 07/01/03

Bill Text

  ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
 Fifty-seventh Legislature                 First Regular Session - 2003
                                       IN THE SENATE
                                    SENATE BILL NO. 1128
                              BY JUDICIARY AND RULES COMMITTEE
  1                                        AN ACT
  8    Be It Enacted by the Legislature of the State of Idaho:
  9        SECTION  1.  That  Section 16-2403, Idaho Code, be, and the same is hereby
 10    amended to read as follows:
 11        16-2403.  DEFINITIONS. As used in this chapter:
 12        (1)  "Child" means an individual less than eighteen (18) years of age  and
 13    not emancipated by either marriage or legal proceeding.
 14        (2)  "Consistent  with  the least restrictive alternative principle" means
 15    that services are delivered in the setting which places  the  fewest  restric-
 16    tions on the personal liberty of the child, and provides the greatest integra-
 17    tion  with individuals who do not have disabilities, in typical and age appro-
 18    priate, school, community and family environments, which  is  consistent  with
 19    safe, effective and cost-effective treatment for the child and family.
 20        (3)  "Department" means the department of health and welfare.
 21        (4)  "Designated examiner" means a psychiatrist, psychologist, psychiatric
 22    nurse,  or  social worker and such other mental health professionals as may be
 23    designated in accordance with rules promulgated pursuant to the provisions  of
 24    chapter 52, title 67, Idaho Code, by the department of health and welfare. Any
 25    person  designated  by  the department director will be specially qualified by
 26    training and experience in the diagnosis and treatment of mental  or  mentally
 27    related illnesses or conditions.
 28        (5)  "Director"  means  the director of the state department of health and
 29    welfare.
 30        (6)  "Emergency" means a situation in which the child's condition, as evi-
 31    denced by recent behavior, poses a significant threat to the health or  safety
 32    of  the  child,  his  family or others, or poses a serious risk of substantial
 33    deterioration in the child's condition which cannot be eliminated by  the  use
 34    of  supportive  services  or  intervention  by  the child's parents, or mental
 35    health professionals, and treatment in the community while the  child  remains
 36    in his family home.
 37        (7)  "Informed  consent  to treatment" means a knowing and voluntary deci-
 38    sion to undergo a specific course of treatment, evidenced in writing, and made
 39    by an emancipated child, or a child's parent, or guardian, who has the  capac-
 40    ity  to  make  an  informed decision, after the staff of the facility or other
 41    provider of treatment have explained the nature and effects  of  the  proposed
 42    treatment.
 43        (8)  "Involuntary  treatment"  means  treatment, services and placement of
  1    children provided without consent of the parent of a child, under the  author-
  2    ity  of  a  court  order  obtained pursuant to this chapter, as directed by an
  3    order of disposition issued by a designated  employee  of  the  department  of
  4    health and welfare under section 16-2415, Idaho Code.
  5        (9)  "Lacks  capacity  to  make an informed decision concerning treatment"
  6    means that the parent is unable to understand the nature and effects of hospi-
  7    talization or treatment, or is unable to engage in a rational  decision-making
  8    process  regarding  such  hospitalization  or  treatment,  as  evidenced by an
  9    inability to weigh the risks and benefits, despite  conscientious  efforts  to
 10    explain them in terms that the parent can understand.
 11        (10) "Likely  to  cause harm to himself or to suffer substantial mental or
 12    physical deterioration" means that,  as  evidenced  by  recent  behavior,  the
 13    child:
 14        (a)  Is  likely  in the near future to inflict substantial physical injury
 15        upon himself; or
 16        (b)  Is likely to suffer significant deprivation of basic  needs  such  as
 17        food, clothing, shelter, health or safety; or
 18        (c)  Will suffer a substantial increase or persistence of symptoms of men-
 19        tal  illness or serious emotional disturbance which is likely to result in
 20        an inability to function in the community without risk to  his  safety  or
 21        well-being  or  the  safety  or  well-being of others, and which cannot be
 22        treated adequately with available home and community-based outpatient ser-
 23        vices.
 24        (11) "Likely to cause harm to others" means that, as evidenced  by  recent
 25    behavior causing, attempting, or threatening such harm with the apparent abil-
 26    ity  to complete the act, a child is likely to cause physical injury or physi-
 27    cal abuse to another person.
 28        (12) "Protection and advocacy system" means the agency designated  by  the
 29    governor  as  the  state  protection and advocacy system pursuant to 42 U.S.C.
 30    6042 and 42 U.S.C. 10801 et seq.
 31        (13) "Serious emotional disturbance" means an emotional or behavioral dis-
 32    order, or a neuropsychiatric condition  which results in a serious disability,
 33    and which requires sustained treatment interventions, and causes  the  child's
 34    functioning  to be impaired in thought, perception, affect or behavior. A dis-
 35    order shall be considered to "result in a serious  disability"  if  it  causes
 36    substantial  impairment  of functioning in family, school or community. A sub-
 37    stance abuse disorder does not, by itself, constitute a serious emotional dis-
 38    turbance, although it may coexist with serious emotional disturbance.
 39        (14) "Special therapy" means any treatment modality used to treat children
 40    with serious emotional disturbances which is subject to restrictions  or  spe-
 41    cial conditions imposed by the department of health and welfare rules.
 42        (15) "Surrogate  parent" means any person appointed to act in the place of
 43    the parent of a child for purposes of developing an individual education  pro-
 44    gram  under  the authority of the individuals with disabilities education act,
 45    20 U.S.C. 1400 et seq., as amended.
 46        (16) "Treatment facility" means a facility or program  meeting  applicable
 47    licensing  standards,  that  has  been approved for the provisions of services
 48    under this chapter by the department of health and welfare.
 49        SECTION 2.  That Section 66-317, Idaho Code, be, and the  same  is  hereby
 50    amended to read as follows:
 51        66-317.  DEFINITIONS.  As  used in this chapter, terms shall have the fol-
 52    lowing meanings:
 53        (a)  "Department director" means the director of the state  department  of
  1    health and welfare.
  2        (b)  "Voluntary  patient"  means  an individual admitted to a facility for
  3    evaluation pursuant to section 18-211 or 20-520, Idaho Code, or admitted to  a
  4    facility for treatment pursuant to section 66-318, Idaho Code.
  5        (c)  "Involuntary  patient" means an individual committed pursuant to sec-
  6    tion 18-212, 18-214, 66-329 or 66-1201, Idaho Code, or committed  pursuant  to
  7    section  16-1608  or  20-520,  Idaho  Code, and admitted to a facility for the
  8    treatment of minors.
  9        (d)  "Licensed physician" means an individual licensed under the  laws  of
 10    this  state to practice medicine or a medical officer of the government of the
 11    United States while in this state in the performance of his official duties.
 12        (e)  "Designated examiner" means a psychiatrist, psychologist, psychiatric
 13    nurse, or social worker and such other mental health professionals as  may  be
 14    designated  in accordance with rules promulgated pursuant to the provisions of
 15    chapter 52, title 67, Idaho Code, by the department  of  health  and  welfare.
 16    Aany  person designated by the department director as will be specially quali-
 17    fied by training and experience in the diagnosis and treatment  of  mental  or
 18    mentally related illnesses or conditions. Such persons shall be psychiatrists,
 19    licensed  psychologists,  licensed  physicians, a holder of an earned master's
 20    level or higher degree in social work from an accredited program, a registered
 21    nurse with an earned master's level or higher degree  in  psychiatric  nursing
 22    from  an accredited program, or a holder of an earned master's level or higher
 23    degree in psychology from an accredited program.
 24        (f)  "Dispositioner" means a designated examiner employed by or under con-
 25    tract with the department of health and welfare and designated by the  depart-
 26    ment  director to determine the appropriate location for care and treatment of
 27    involuntary patients.
 28        (g)  "Facility" means any public or private hospital, sanatorium, institu-
 29    tion, mental health center or other organization designated in accordance with
 30    rules adopted by the board of health and  welfare  as  equipped  to  initially
 31    hold, evaluate, rehabilitate or to provide care or treatment, or both, for the
 32    mentally ill.
 33        (h)  "Lacks capacity to make informed decisions about treatment" means the
 34    inability, by reason of mental illness, to achieve a rudimentary understanding
 35    after  conscientious efforts at explanation of the purpose, nature, and possi-
 36    ble significant risks and benefits of treatment.
 37        (i)  "Inpatient treatment facility" means a facility in which an  individ-
 38    ual  receives  medical  and  mental  treatment  for not less than a continuous
 39    twenty-four (24) hour period.
 40        (j)  "Supervised residential facility" means a facility,  other  than  the
 41    individual's  home, in which the individual lives and in which there lives, or
 42    are otherwise on duty during the  times  that  the  individual's  presence  is
 43    expected,  persons who are employed to supervise, direct, treat or monitor the
 44    individual.
 45        (k)  "Likely to injure himself or others" means either:
 46        (1)  A substantial risk that physical harm will be inflicted by  the  pro-
 47        posed  patient upon his own person, as evidenced by threats or attempts to
 48        commit suicide or inflict physical harm on himself; or
 49        (2)  A substantial risk that physical harm will be inflicted by  the  pro-
 50        posed  patient upon another as evidenced by behavior which has caused such
 51        harm or which places another person or persons in reasonable fear of  sus-
 52        taining such harm.
 53        (l)  "Mentally  ill" means a person, who as a result of a substantial dis-
 54    order of thought, mood, perception,  orientation,  or  memory,  which  grossly
 55    impairs  judgment,  behavior,  capacity  to  recognize  and  adapt to reality,
  1    requires care and treatment at a facility.
  2        (m)  "Gravely disabled" means a person who, as the result of  mental  ill-
  3    ness,  is  in danger of serious physical harm due to the person's inability to
  4    provide for any of his basic needs for nourishment, or essential medical care,
  5    or shelter or safety.
  6        (n)  "Outpatient commitment" means a court order  directing  a  person  to
  7    comply  with specified mental health treatment requirements, not involving the
  8    continuous supervision of a person in an inpatient setting, that  are  reason-
  9    ably  designed  to alleviate or to reduce a person's illness or disability, or
 10    to maintain or prevent deterioration of the person's mental or emotional func-
 11    tioning. The specified requirements may include, but need not be  limited  to,
 12    taking  prescribed medication, reporting to a facility to permit monitoring of
 13    the person's condition, or participating in individual or group therapy or  in
 14    educational  or  vocational   programs. Outpatient commitment may be up to one
 15    (1) year.
 16        SECTION 3.  That Section 66-329, Idaho Code, be, and the  same  is  hereby
 17    amended to read as follows:
 19    PROCEDURE. (a) Proceedings for the involuntary care and treatment of  mentally
 20    ill  persons  by  the department of health and welfare may be commenced by the
 21    filing of a written application with a court of competent  jurisdiction  by  a
 22    friend, relative, spouse or guardian of the proposed patient, or by a licensed
 23    physician,  prosecuting  attorney, or other public official of a municipality,
 24    county or of the state of Idaho, or the director of any facility in which such
 25    patient may be.
 26        (b)  The application shall state the name and last known  address  of  the
 27    proposed patient; the name and address of either the spouse, guardian, next of
 28    kin  or  friend  of  the proposed patient; whether the proposed patient can be
 29    cared for privately in the event commitment is not ordered;  if  the  proposed
 30    patient  is,  at the time of the application, a voluntary patient; whether the
 31    proposed patient has applied for release pursuant  to  section  66-320,  Idaho
 32    Code;  and  a  simple and precise statement of the facts showing that the pro-
 33    posed patient is mentally ill and either likely to injure himself or others or
 34    is gravely disabled due to mental illness.
 35        (c)  Any such application shall be accompanied by a certificate of a  des-
 36    ignated  examiner stating that he has personally examined the proposed patient
 37    within the last fourteen (14) days and is of the  opinion  that  the  proposed
 38    patient  is:  (i)  mentally ill; (ii) likely to injure himself or others or is
 39    gravely disabled due to mental illness;  and  (iii)  lacks  capacity  to  make
 40    informed  decisions  about  treatment, or a written statement by the applicant
 41    that the proposed patient has refused to submit to examination by a designated
 42    examiner.
 43        (d)  Upon receipt of an  application  for  commitment,  the  court  shall,
 44    within  forty-eight  (48)  hours appoint another designated examiner to make a
 45    personal examination of the proposed patient or if the  proposed  patient  has
 46    not  been  examined,  the  court shall appoint two (2) designated examiners to
 47    make individual personal examinations of the proposed patient  and  may  order
 48    the  proposed patient to submit to an immediate examination. If neither desig-
 49    nated examiner is a physician, the court shall order a physical examination of
 50    the proposed patient. At least one (1) designated examiner shall be a psychia-
 51    trist, licensed physician or licensed psychologist; no more than one (1)  des-
 52    ignated  examiner may be a physician not practicing psychiatry, a holder of an
 53    earned master's level or higher degree in social work from an accredited  pro-
  1    gram,  a  registered  nurse  with an earned master's level or higher degree in
  2    psychiatric nursing from an accredited program,  or  a  holder  of  an  earned
  3    master's  level or higher degree in psychology from an accredited program. The
  4    designated examiners shall report to the court their findings within the  fol-
  5    lowing  seventy-two  (72)  hours  as  to  the mental condition of the proposed
  6    patient and his need for custody,  care,  or  treatment  by  a  facility.  The
  7    reports shall be in the form of written certificates which shall be filed with
  8    the court. The court may terminate the proceedings and dismiss the application
  9    without  taking  any further action in the event the reports of the designated
 10    examiners are to the effect that the proposed patient is not mentally ill  or,
 11    although  mentally  ill,  is  not likely to injure himself or others or is not
 12    gravely disabled due to mental illness. If the proceedings are terminated, the
 13    proposed patient shall be released immediately.
 14        (e)  If the designated examiner's certificate states  a  belief  that  the
 15    proposed patient is mentally ill and either likely to injure himself or others
 16    or  is  gravely disabled  due to mental illness, the judge of such court shall
 17    issue an order authorizing any health officer, peace officer, or director of a
 18    facility to take the proposed patient to a facility in the community in  which
 19    the proposed patient is residing or to the nearest facility to await the hear-
 20    ing  and  for good cause may authorize treatment during such period subject to
 21    the provisions of section 66-346(a)(4), Idaho  Code.  Under  no  circumstances
 22    shall  the  proposed  patient  be  detained  in a nonmedical unit used for the
 23    detention of individuals charged with or convicted of penal offenses.
 24        (f)  Upon receipt of such application and  designated  examiners'  reports
 25    the  court  shall appoint a time and place for hearing not more than seven (7)
 26    days from the receipt of such designated examiners' reports and thereupon give
 27    written notice of such time and place of such hearing together with a copy  of
 28    the  application,  designated  examiner's certificates, and notice of the pro-
 29    posed patient's right to be represented by an attorney, or if indigent, to  be
 30    represented  by  a court-appointed attorney, to the applicant, to the proposed
 31    patient, to the proposed patient's spouse, guardian, next of  kin  or  friend.
 32    With  the consent of the proposed patient and his attorney, the hearing may be
 33    held immediately. Upon motion of the proposed patient  and  attorney  and  for
 34    good cause shown, the court may continue the hearing up to an additional four-
 35    teen  (14)  days during which time, for good cause shown, the court may autho-
 36    rize treatment.
 37        (g)  An opportunity to be represented by  counsel  shall  be  afforded  to
 38    every proposed patient, and if neither the proposed patient nor others provide
 39    counsel,  the  court shall appoint counsel in accordance with chapter 8, title
 40    19, Idaho Code, no later than the time the  application  is  received  by  the
 41    court.
 42        (h)  The  hearing shall be held at a facility, at the home of the proposed
 43    patient, or at any other suitable place not likely to have a harmful effect on
 44    the proposed patient's physical or mental health. Venue for the hearing  shall
 45    be  in  the  county  of  residence of the proposed patient, unless the patient
 46    waives the right to have venue fixed there.
 47        (i)  In all proceedings under this section, any existing provision of  the
 48    law prohibiting the disclosure of confidential communications between the des-
 49    ignated examiner and proposed patient shall not apply and any designated exam-
 50    iner who shall have examined the proposed patient shall be a competent witness
 51    to testify as to the proposed patient's condition.
 52        (j)  The  proposed  patient,  the applicant, and any other persons to whom
 53    notice is required to be given shall be afforded an opportunity to  appear  at
 54    the  hearing, to testify, and to present and cross-examine witnesses. The pro-
 55    posed patient shall be required to be present at the hearing unless the  court
  1    determines  that  the mental or physical state of the proposed patient is such
  2    that his presence  at  the  hearing  would  be  detrimental  to  the  proposed
  3    patient's health or would unduly disrupt the proceedings. A record of the pro-
  4    ceedings  shall be made as for other civil hearings. The hearing shall be con-
  5    ducted in as informal a manner as may be consistent  with  orderly  procedure.
  6    The court shall receive all relevant and material evidence consistent with the
  7    rules of evidence.
  8        (k)  If,  upon  completion of the hearing and consideration of the record,
  9    the court finds by clear and convincing evidence that the proposed patient:
 10        (1)  is mentally ill; and
 11        (2)  is, because of such condition, likely to injure himself or others, or
 12        is gravely disabled due to mental illness;
 13    the court shall order the proposed patient committed to  the  custody  of  the
 14    department  director for an indeterminate period of time not to exceed one (1)
 15    year. The department director,  through  his  dispositioner,  shall  determine
 16    within  twenty-four  (24) hours the least restrictive  available facility con-
 17    sistent with the needs of each patient committed under this section for obser-
 18    vation, care, and treatment.
 19        (l)  Nothing in this chapter or in any rule adopted pursuant thereto shall
 20    be construed to authorize the detention or involuntary admission to a hospital
 21    or other facility of an individual who:
 22        (1)  has epilepsy, a developmental disability, a physical disability, men-
 23        tal retardation, is impaired by chronic alcoholism or drug abuse, or aged,
 24        unless in addition to such condition, such person is mentally ill;
 25        (2)  is a patient  under  treatment  by  spiritual  means  alone,  through
 26        prayer, in accordance with the tenets and practices of a recognized church
 27        or  religious  denomination  by a duly accredited practitioner thereof and
 28        who asserts to any authority attempting to detain him  that  he  is  under
 29        such treatment and who gives the name of a practitioner so treating him to
 30        such authority; or
 31        (3)  can be properly cared for privately with the help of willing and able
 32        family  or  friends,  and  provided,  that such persons may be detained or
 33        involuntarily admitted if such persons are is mentally ill and presents  a
 34        substantial  risk  of  injury to himself or others if allowed to remain at
 35        liberty.
 36        (m)  The order of commitment shall  state  whether  the  proposed  patient
 37    lacks  capacity  to  make  informed  decisions  about  treatment, the name and
 38    address of the patient's attorney and either the patient's  spouse,  guardian,
 39    adult next of kin, or friend.
 40        (n)  If the patient has no spouse or guardian and if the patient has prop-
 41    erty  which  may not be cared for pursuant to chapter 5, title 66, Idaho Code,
 42    or by the patient while confined at a facility,  the  court  shall  appoint  a
 43    guardian  ad litem for the purpose of preserving the patient's estate, pending
 44    further guardianship or conservatorship proceedings.
 45        (o)  The commitment shall continue until the commitment is terminated  and
 46    shall be unaffected by the patient's conditional release or change in disposi-
 47    tion.

Statement of Purpose / Fiscal Impact

                      STATEMENT OF PURPOSE

                            RS 13071

Relating to qualifications of a designated examiner for purposes of adult and children's mental
health services; amending section 16-2403, Idaho Code, to further define terms of becoming a
designated examiner, adding language to strengthen the qualifications to become an examiner
making it consistent with the designated examiner definition in 66-317, Idaho Code; amending
section 66-317, Idaho Code to define terms making it consistent with the designated examiner's
definition found in children's mental health services, 16-2403, Idaho Code; and amending section
66-329, Idaho Code, to make technical corrections.

This legislation will enable the Director of Health and Welfare to promulgate rules to appoint other
mental health professionals for adults as current Idaho Code allows for children.

                         Fiscal Impact

There is no fiscal impact to these changes.

Name: Ken Deibert
Agency: Health and Welfare
Phone: 334-0641

Statement of Purpose/Fiscal Impact                      S 1128