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H0734......................................................by STATE AFFAIRS
MENTAL ILLNESS - Amends existing law relating to mental illness to remove
language referencing medical attendance upon the mentally ill; to revise
the definition for "voluntary patient"; to revise provisions applicable to
the authority to admit voluntary patients and to receive involuntary
patients; to revise provisions applicable to a detention with a hearing;
and to revise exemptions from liability.
02/24 House intro - 1st rdg - to printing
02/27 Rpt prt - to Health/Wel
03/07 Rpt out - rec d/p - to 2nd rdg
03/08 2nd rdg - to 3rd rdg
03/10 3rd rdg - PASSED - 61-0-9
AYES -- Anderson, Andrus, Barraclough, Barrett, Bastian, Bayer,
Bedke, Bell, Bilbao, Block, Boe, Bolz, Brackett, Bradford, Cannon,
Chadderdon, Collins, Denney, Edmunson, Ellsworth, Eskridge,
Field(18), Field(23), Garrett, Hart, Harwood, Henbest, Henderson,
Jaquet, Kemp, Lake, LeFavour, Loertscher, Martinez, Mathews,
McGeachin, McKague, Miller, Mitchell, Moyle, Nielsen, Pasley-Stuart,
Pence, Raybould, Ring, Ringo, Roberts, Rusche, Rydalch, Sali, Sayler,
Shepherd(2), Shirley, Skippen, Smith(30), Smylie, Snodgrass,
Stevenson, Trail, Wills, Mr. Speaker
NAYS -- None
Absent and excused -- Black, Clark, Crow, Deal, Nonini, Schaefer,
Shepherd(8), Smith(24), Wood
Floor Sponsor - Garrett
Title apvd - to Senate
03/13 Senate intro - 1st rdg - to Health/Wel
03/15 Rpt out - rec d/p - to 2nd rdg
03/16 2nd rdg - to 3rd rdg
03/20 3rd rdg - PASSED - 33-0-2
AYES -- Andreason, Brandt, Broadsword, Bunderson, Burkett,
Burtenshaw, Cameron, Coiner, Compton, Corder, Darrington, Davis,
Fulcher, Gannon, Geddes, Goedde, Hill, Jorgenson, Kelly, Keough,
Langhorst, Little, Lodge, Malepeai, McGee, McKenzie, Pearce,
Richardson, Schroeder, Stegner, Stennett, Werk, Williams
NAYS -- None
Absent and excused -- Marley, Sweet
Floor Sponsor - Broadsword
Title apvd - to House
03/21 To enrol
03/22 Rpt enrol - Sp signed
03/23 Pres signed - To Governor
03/24 Governor signed
Session Law Chapter 214
Effective: 07/01/06
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature Second Regular Session - 2006
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 734
BY STATE AFFAIRS COMMITTEE
1 AN ACT
2 RELATING TO MENTAL ILLNESS; AMENDING SECTION 39-4501, IDAHO CODE, TO REMOVE
3 LANGUAGE REFERENCING MEDICAL ATTENDANCE UPON THE MENTALLY ILL; AMENDING
4 SECTION 66-317, IDAHO CODE, TO REVISE THE DEFINITION FOR "VOLUNTARY
5 PATIENT" AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 66-318, IDAHO
6 CODE, TO REVISE PROVISIONS APPLICABLE TO THE AUTHORITY TO ADMIT VOLUNTARY
7 PATIENTS AND TO MAKE TECHNICAL CORRECTIONS; AMENDING SECTION 66-324, IDAHO
8 CODE, TO REVISE PROVISIONS APPLICABLE TO THE AUTHORITY TO RECEIVE INVOLUN-
9 TARY PATIENTS; AMENDING SECTION 66-326, IDAHO CODE, TO REVISE PROVISIONS
10 APPLICABLE TO A DETENTION WITHOUT A HEARING AND TO MAKE TECHNICAL CORREC-
11 TIONS; AMENDING SECTION 66-341, IDAHO CODE, TO REVISE EXEMPTIONS FROM LIA-
12 BILITY; AND AMENDING SECTION 66-601, IDAHO CODE, TO REVISE A CODE REFER-
13 ENCE.
14 Be It Enacted by the Legislature of the State of Idaho:
15 SECTION 1. That Section 39-4501, Idaho Code, be, and the same is hereby
16 amended to read as follows:
17 39-4501. PURPOSES -- APPLICATION. (1) The primary purposes of this chap-
18 ter are:
19 (a) To provide and codify Idaho law concerning consent for the furnishing
20 of hospital, medical, dental or surgical care, treatment or procedures,
21 and concerning what constitutes an informed consent for such care, treat-
22 ment or procedures; and
23 (b) To provide certainty and clarity in the law of medical consent in the
24 furtherance of high standards of health care and its ready availability in
25 proper cases.
26 (2) Nothing in this chapter shall be deemed to amend or repeal the provi-
27 sions of chapter 3, title 66, Idaho Code, as those provisions pertain to medi-
28 cal attendance upon or hospitalization of the mentally ill, nor the provisions
29 of chapter 6, title 18, Idaho Code, pertaining to the provision of examina-
30 tions, prescriptions, devices and informational materials regarding prevention
31 of pregnancy or pertaining to therapeutic abortions and consent to the perfor-
32 mance thereof.
33 (3) Nothing in this chapter shall be construed to permit or require the
34 provision of health care for a patient in contravention of the patient's
35 stated or implied objection thereto upon religious grounds nor shall anything
36 in this chapter be construed to require the granting of permission for or on
37 behalf of any patient who is not able to act for himself by his parent, spouse
38 or guardian in violation of the religious beliefs of the patient or the
39 patient's parent or spouse.
40 SECTION 2. That Section 66-317, Idaho Code, be, and the same is hereby
41 amended to read as follows:
2
1 66-317. DEFINITIONS. As used in this chapter, terms shall have the fol-
2 lowing meanings:
3 (a1) "Department director" means the director of the state department of
4 health and welfare.
5 (b2) "Voluntary patient" means an individual admitted to a facility for
6 evaluation pursuant to section 18-211 or 20-520, Idaho Code, or admitted to a
7 facility for observation, diagnosis, evaluation, care or treatment pursuant to
8 section 66-318, Idaho Code.
9 (c3) "Involuntary patient" means an individual committed pursuant to sec-
10 tion 18-212, 66-329 or 66-1201, Idaho Code, or committed pursuant to section
11 16-1619 or 20-520, Idaho Code, and admitted to a facility for the treatment
12 of minors.
13 (d4) "Licensed physician" means an individual licensed under the laws of
14 this state to practice medicine or a medical officer of the government of the
15 United States while in this state in the performance of his official duties.
16 (e5) "Designated examiner" means a psychiatrist, psychologist, psychiat-
17 ric nurse, or social worker and such other mental health professionals as may
18 be designated in accordance with rules promulgated pursuant to the provisions
19 of chapter 52, title 67, Idaho Code, by the department of health and welfare.
20 Any person designated by the department director will be specially qualified
21 by training and experience in the diagnosis and treatment of mental or men-
22 tally related illnesses or conditions.
23 (f6) "Dispositioner" means a designated examiner employed by or under
24 contract with the department of health and welfare and designated by the
25 department director to determine the appropriate location for care and treat-
26 ment of involuntary patients.
27 (g7) "Facility" means any public or private hospital, sanatorium, insti-
28 tution, mental health center or other organization designated in accordance
29 with rules adopted by the board of health and welfare as equipped to initially
30 hold, evaluate, rehabilitate or to provide care or treatment, or both, for the
31 mentally ill.
32 (h8) "Lacks capacity to make informed decisions about treatment" means
33 the inability, by reason of mental illness, to achieve a rudimentary under-
34 standing after conscientious efforts at explanation of the purpose, nature,
35 and possible significant risks and benefits of treatment.
36 (i9) "Inpatient treatment facility" means a facility in which an individ-
37 ual receives medical and mental treatment for not less than a continuous
38 twenty-four (24) hour period.
39 (j10) "Supervised residential facility" means a facility, other than the
40 individual's home, in which the individual lives and in which there lives, or
41 are otherwise on duty during the times that the individual's presence is
42 expected, persons who are employed to supervise, direct, treat or monitor the
43 individual.
44 (k11) "Likely to injure himself or others" means either:
45 (1a) A substantial risk that physical harm will be inflicted by the pro-
46 posed patient upon his own person, as evidenced by threats or attempts to
47 commit suicide or inflict physical harm on himself; or
48 (2b) A substantial risk that physical harm will be inflicted by the pro-
49 posed patient upon another as evidenced by behavior which has caused such
50 harm or which places another person or persons in reasonable fear of sus-
51 taining such harm.
52 (l12) "Mentally ill" means a person, who as a result of a substantial dis-
53 order of thought, mood, perception, orientation, or memory, which grossly
54 impairs judgment, behavior, capacity to recognize and adapt to reality,
55 requires care and treatment at a facility.
3
1 (m13) "Gravely disabled" means a person who, as the result of mental ill-
2 ness, is in danger of serious physical harm due to the person's inability to
3 provide for any of his basic needs for nourishment, or essential medical care,
4 or shelter or safety.
5 (n14) "Outpatient commitment" means a court order directing a person to
6 comply with specified mental health treatment requirements, not involving the
7 continuous supervision of a person in an inpatient setting, that are reason-
8 ably designed to alleviate or to reduce a person's illness or disability, or
9 to maintain or prevent deterioration of the person's mental or emotional func-
10 tioning. The specified requirements may include, but need not be limited to,
11 taking prescribed medication, reporting to a facility to permit monitoring of
12 the person's condition, or participating in individual or group therapy or in
13 educational or vocational programs. Outpatient commitment may be up to one (1)
14 year.
15 (o15) "Protection and advocacy system" means the agency designated by the
16 governor as the state protection and advocacy system pursuant to 42 U.S.C.
17 section 15043 and 42 U.S.C. sections 10801 et seq.
18 SECTION 3. That Section 66-318, Idaho Code, be, and the same is hereby
19 amended to read as follows:
20 66-318. AUTHORITY TO ADMIT VOLUNTARY PATIENTS -- DENIAL OF ADMISSION.
21 (a1) The director of any facility may admit as a voluntary patient the follow-
22 ing persons for observation, diagnosis, evaluation, care or treatment of men-
23 tal illness:
24 (1a) Any person who is eighteen (18) years of age or older;
25 (2b) Any individual fourteen (14) to eighteen (18) years of age who may
26 apply to be admitted for observation, diagnosis, evaluation, and care or
27 treatment and the facility director will notify the parent, parents or
28 guardian of the individual of the admission; a parent or guardian may
29 apply for the individual's release and the facility director will release
30 the patient within three (3) days, excluding Saturdays, Sundays and legal
31 holidays, of the application for discharge, unless the time period for
32 diagnosis, evaluation, care or treatment is extended pursuant to section
33 66-320, Idaho Code;
34 (3c) Any emancipated minor;
35 (4d) Any individual under fourteen (14) years of age upon application of
36 the individual's parent or guardian, provided that admission to an inpa-
37 tient facility shall require a recommendation for admission by a desig-
38 nated examiner;
39 (5e) Any individual who lacks capacity to make informed decisions about
40 treatment upon application of the individual's guardian; provided that
41 admission to an inpatient facility shall require a recommendation for
42 admission by a designated examiner; or
43 (6f) Any individual confined for examination pursuant to section 18-211
44 or 20-520, Idaho Code.
45 (b2) The director of any facility must refuse admission to any applicant
46 under this section whenever:
47 (1a) The applicant is determined not to be in need of observation, diag-
48 nosis, evaluation, care or treatment at the facility;
49 (2b) The applicant lacks is determined to lack capacity to make informed
50 decisions about treatment unless the application is made by a guardian
51 with authority to consent to treatment; or
52 (3c) The applicant's welfare or the welfare of society, or both, are bet-
53 ter protected by the provisions of section 66-329, Idaho Code.
4
1 SECTION 4. That Section 66-324, Idaho Code, be, and the same is hereby
2 amended to read as follows:
3 66-324. AUTHORITY TO RECEIVE INVOLUNTARY PATIENTS. The director of any
4 facility is authorized to receive therein for observation, diagnosis, evalua-
5 tion, care and or treatment any individual:
6 (1) Ccommitted to the department director pursuant to sections 16-1619,
7 20-520, 18-212, 18-214 or 66-329, or Idaho Code;
8 (2) Ttransferred pursuant to section 66-1201, Idaho Code; or
9 (3) Detained or transferred pursuant to section 66-326, Idaho Code.
10 SECTION 5. That Section 66-326, Idaho Code, be, and the same is hereby
11 amended to read as follows:
12 66-326. DETENTION WITHOUT HEARING. (a1) No person shall be taken into
13 custody or detained as an alleged emergency patient for observation, diagno-
14 sis, evaluation, care or treatment of mental illness unless and until the
15 court has ordered such apprehension and custody under the provisions outlined
16 in section 66-329, Idaho Code; provided, however, that a person may be taken
17 into custody by a peace officer and placed in a facility, or the person may be
18 detained at a hospital at which the person presented or was brought to receive
19 medical or mental health care, if the peace officer or a physician medical
20 staff member of such hospital has reason to believe that the person is gravely
21 disabled due to mental illness or the person's continued liberty poses an
22 imminent danger to that person or others, as evidenced by a threat of substan-
23 tial physical harm; provided, under no circumstances shall the proposed
24 patient be detained in a nonmedical unit used for the detention of individuals
25 charged with or convicted of penal offenses. Whenever a person is taken into
26 custody or detained under this section without court order, the evidence sup-
27 porting the claim of grave disability due to mental illness or imminent danger
28 must be presented to a duly authorized court within twenty-four (24) hours
29 from the time the individual was placed in custody or detained.
30 (b2) If the court finds the individual to be gravely disabled due to men-
31 tal illness or imminently dangerous under subsection (a1) of this section, the
32 court shall issue a temporary custody order requiring the person to be held in
33 a facility, and requiring an examination of the person by a designated exam-
34 iner within twenty-four (24) hours of the entry of the order of the court.
35 Under no circumstances shall the proposed patient be detained in a nonmedical
36 unit used for the detention of individuals charged with or convicted of penal
37 offenses.
38 (c3) Where an examination is required under subsection (b2) of this sec-
39 tion, the designated examiner shall make his findings and report to the court
40 within twenty-four (24) hours of the examination.
41 (d4) If the designated examiner finds, in his examination under this sec-
42 tion, that the person is mentally ill, and either is likely to injure himself
43 or others or is gravely disabled due to mental illness, the prosecuting attor-
44 ney shall file, within twenty-four (24) hours of the examination of the per-
45 son, a petition with the court requesting the patient's detention pending com-
46 mitment proceedings pursuant to the provisions of section 66-329, Idaho Code.
47 Upon the receipt of such a petition, the court shall order his detention to
48 await hearing which shall be within five (5) days (including Saturdays, Sun-
49 days and legal holidays) of the detention order. If no petition is filed
50 within twenty-four (24) hours of the designated examiner's examination of the
51 person, the person shall be released from the facility.
52 (e5) Any person held in custody under the provisions of this section
5
1 shall have the same protection and rights which are guaranteed to a person
2 already committed to the department director. Upon taking a person into cus-
3 tody, notice shall be given to the person's immediate relatives of the
4 person's physical whereabouts and the reasons for detaining or taking the per-
5 son into custody.
6 (6) Nothing in this section shall preclude a hospital from transferring a
7 person who has been detained under this section to another facility that is
8 willing to accept the transferred individual for purposes of observation,
9 diagnosis, evaluation, care or treatment.
10 SECTION 6. That Section 66-341, Idaho Code, be, and the same is hereby
11 amended to read as follows:
12 66-341. EXEMPTIONS FROM LIABILITY. No agency, public or private facility,
13 nor an employee of a public or private facility, nor the superintendent, pro-
14 fessional person in charge, or attending staff of any such facility, nor any
15 public official performing functions necessary to the administration of this
16 chapter, nor a peace officer responsible for detaining or transporting a per-
17 son pursuant to this chapter, shall be civilly or criminally liable for
18 detaining, failing to detain, diagnosing, transporting, treating or releasing
19 a person pursuant to this chapter; provided that such duties were performed
20 according to the procedures of this chapter in good faith and without gross
21 negligence.
22 SECTION 7. That Section 66-601, Idaho Code, be, and the same is hereby
23 amended to read as follows:
24 66-601. DEFINITIONS. For the purposes of this chapter, the following def-
25 initions shall apply:
26 (1) "Agent" means an adult properly appointed to make mental health
27 treatment decisions for a principal under a declaration for mental health
28 treatment and also means an alternative agent.
29 (2) "Attending physician" means the licensed physician who has primary
30 responsibility for the care and treatment of the declarant.
31 (3) "Facility" means:
32 (a) A designated treatment facility, as defined in section 66-317(g),
33 Idaho Code;
34 (b) A nursing home; or
35 (c) An assisted living home.
36 (4) "Incapable" means that, by order of a court in a guardianship pro-
37 ceeding under section 66-322, Idaho Code, or in the opinion of two (2) physi-
38 cians that include a psychiatrist, or in the opinion of a physician and a pro-
39 fessional mental health clinician, a person's ability to receive and evaluate
40 information effectively or communicate decisions is impaired to such an extent
41 that the person currently lacks the capacity to make mental health treatment
42 decisions.
43 (5) "Mental health treatment" means electroconvulsive treatment, treat-
44 ment with psychotropic medication or short-term admission to a treatment
45 facility for a period not to exceed seventeen (17) days.
46 (6) "Mental illness" means a substantial disorder of thought, mood, per-
47 ception, orientation or memory, which grossly impairs judgment, behavior, or
48 capacity to recognize and adapt to reality.
49 (7) "Professional mental health clinician" means an individual who holds
50 an earned master's level or higher degree in social work from an accredited
51 program; a registered nurse with an earned master's degree or higher degree in
6
1 nursing with a specialization in psychiatric or mental health nursing from an
2 accredited program; an individual who holds an earned master's level or higher
3 degree in psychology from an accredited program; or an individual who holds an
4 earned master's level or higher degree in counseling, marriage and family
5 therapy or other closely related degree. Additionally, professionals in each
6 category must have at least two (2) years experience in a clinical mental
7 health setting.
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STATEMENT OF PURPOSE
RS 16145
Idaho Code Section 66-301 et seq. concerns the hospitalization of
persons with mental illness. A problem arises under the current
statute when a gravely disabled patient (i.e., one who poses a
risk to themselves or others) refuses care or seeks to leave a
facility.
The purpose of this legislation is to clarify certain statutory
provisions and authorize hospitals to detain a gravely disabled
person for 24 hours. The same conditions and limits would apply
to hospitals as currently apply to law enforcement. Accordingly,
the proposed amendment would: (1) protect gravely disabled
persons, health care providers, and the public; (2) reduce the
demands on law enforcement; and(3) retain the substantive and
procedural protections currently afforded to individuals who
would otherwise be detained by law enforcement.
FISCAL NOTE
There is no fiscal impact on the general fund.
Contact
Name: Steven A. Millard
Phone: (208) 338-5100
Name: Representative Kathie Garrett
(208) 332-1000
STATEMENT OF PURPOSE/FISCAL NOTE H 734