ARIZONA
HOUSE OF REPRESENTATIVES
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SB 1195: application; emergency admission; nonevaluating hospitals |
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PRIME SPONSOR: Senator Barto, LD 15 BILL STATUS: Health
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Relating to court-ordered evaluations.
Provisions
1. Requires an application for a court-ordered evaluation to be presented to a screening agency. (Sec. 2)
2. Requires an application for evaluation to include:
a. The name and address of an agent under a health care or mental health care power of attorney;
b. A history of the patient's mental health treatment and treatment compliance to the extent known by the applicant;
c. Copies of all available documents relating to guardianship or powers of attorney that permit consent to treatment;
d. A statement which states that a patient needs prepetition screening and evaluation;
e. The facts and information that are the basis of an applicant's belief that a proposed patient is likely to endure or cause harm or injury during the time it would take for a prepetition screening report to be completed; and
f. The names and contact information of witnesses to a proposed patient's behavior.
i. Prohibits a screening agency from denying or refusing to process an application due to a lack of witnesses. (Sec. 2)
4. Requires a screening agency to:
a. Assist an applicant, if they are not a medical professional, to develop mental health history and background necessary to complete an application;
b. Do things necessary to allow completion of an application within three days after initial contact by an applicant, excluding weekends and holidays; and
c. Note specified information on the front of an application and log the information in a record of applications received by the screening agency. (Sec. 2)
5. Permits a screening agency to screen and examine an individual at a hospital in person by a mental health provider or by way of telemedicine if the hospital and screening agency can do so. (Sec. 2)
a. The screener is not affiliated with the hospital or providing medical services; and
b. The screening is not protected by doctor-patient confidentiality. (Sec. 2)
7. Requires a screening agency to provide written information to an applicant and proposed patient regarding:
a. The involuntary screening, evaluation and treatment process;
b. Where needed mental health treatment can be obtained in the community; and
c. Legal decision making and where to obtain such information. (Sec. 3)
8. Requires a screening agency to issue a written notice if no reasonable cause exists indicating that a person needs evaluation. (Sec. 3)
9. Specifies that if an applicant is a non-evaluating hospital or health care provider, a written notice must:
a. Give the reasons for not moving forward with a petition for court-ordered evaluation; and
b. Be given immediately to the non-evaluating hospital or health care provider and the proposed patient, if requested. (Sec. 3)
10. Stipulates that if an application is not from a non-evaluating hospital or health care provider, the reasons for not moving forward with a petition for court-ordered evaluation must be provided to the applicant barring any conflict with state or federal patient privacy laws. (Sec. 3)
11. Stipulates that a screening agency must recommend specific evaluation or treatment services and make a direct referral to specified entities in the proposed patient's area if both of the following occur:
a. There is no reasonable cause to believe an applicant's allegations; and
b. There is reasonable cause to believe that a proposed patient has a mental disorder and would benefit from further evaluation or treatment and is willing and able to utilize further private or public evaluation or treatment services in the community. (Sec. 3)
12. Allows a proposed patient to voluntarily choose to receive specified services on an inpatient or outpatient basis. (Sec. 3)
13. Allows a voluntary evaluation to be performed if a proposed patient is:
a. In need of an evaluation;
b. Capable of consenting to and willing to undergo the evaluation; and
c. Unlikely to be a danger to themselves or others pending the evaluation. (Sec. 3)
14. Permits a screening agency to seek immediate admission in an evaluating agency if there is reasonable cause indicating that a proposed patient will be a danger to themselves or others and are unwilling or unable to be voluntarily evaluated. (Sec. 3)
15. Allows an evaluation agency to:
a. Contact the county attorney for assistance in preparing a court-ordered evaluation petition; and
b. Request advice and judgement of the county attorney when determining whether court-ordered evaluation is justified. (Sec. 3)
o Currently, only screening agencies may utilize the county attorney regarding a petition (A.R.S. § 36-521).
16. Includes evaluation agencies in statute regarding interaction with a county attorney during the petition for court-ordered evaluation process. (Sec. 3)
17. Permits voluntary evaluations to be performed if a petition is not filed because a proposed patient is capable of and consenting to voluntary evaluation. (Sec. 4)
18. Allows voluntary evaluations to be conducted by an evaluation agency provided by the county or a private mental health provider or treatment agency if the provider or agency accepts the proposed patient's insurance or the proposed patient can pay privately. (Sec. 4)
19. Requires a screening agency to supply a time and place to the patient for evaluation. (Sec. 4)
20. Requires a screening agency to inform the proposed patient that if they do submit to an evaluation and the agency has reasonable cause to believe that the patient is a danger to self or others, has a persistent, acute or grave disability and is likely to deteriorate without an evaluation, that a peace officer may take the patient into custody and deliver them to an agency for screening or evaluation. (Sec. 4)
21. Requires a screening agency to contact the evaluation agency where the proposed patient was directed to:
a. Determine the patient's participation in the evaluation; and
b. Discuss evaluation results. (Sec. 4)
22. Stipulates that a screening agency may submit a petition for court-ordered treatment if the proposed patient fails to participate in the scheduled evaluation or the evaluation confirms that court-ordered treatment is needed. (Sec. 4)
23. Permits specified individuals to give and grant informed consent for inpatient evaluation that includes authority to consent to inpatient evaluation or treatment. (Sec. 4)
24. Requires a petition for court-ordered evaluation to include the known names and contact information of anyone acquainted with the proposed patient and who witnessed behavior for which the petition is based. (Sec. 5)
25. Specifies that a court-ordered petition and other forms required by the court may be filed by an evaluation agency or the county attorney. (Sec. 5)
26. Stipulates that if an applicant for emergency admission for evaluation is not a medical professional, the screening agency must assist to develop relevant mental health history and factual background to complete the application. (Sec. 6)
27. Requires an application for emergency admission to include:
a. A statement that there is reasonable cause, rather than a belief based on personal observation, to believe the person is a danger to themselves and is unable or unwilling to undergo voluntary evaluation; and
b. A summary of facts and data that support the assertions of the application. (Sec. 6)
28. Stipulates that an application for emergency admission made by a peace officer or specified health care provider does not need to be notarized and is allowed to be submitted as the written application if the original signature of the applicant is on the copy of the application. (Sec. 6)
29. Requires an evaluation agency, on receipt of an application for emergency admission, to:
a. Log the time and date of the application's receipt in the evaluation agency's records; and
b. Notate the date and time of receipt on the front of the application. (Sec. 6)
30. Permits an application for emergency admission to be granted if the admitting officer determines there is reasonable cause indicating that the person is a danger to themselves and others and is unwilling or unable to proceed with voluntary evaluation and that during the time to complete statutory screening procedures, the person is likely to suffer serious harm or illness or is likely to inflict harm on another person without immediate admission to an evaluation agency. (Sec. 6)
31. Requires the medical director or designee of an evaluation agency to review and approve the denial of an application for emergency admission if no reasonable cause exists for the emergency admission.
a. Specifies that an evaluation agency must issue a written denial to the applicant and the proposed patient stating the reasons for the denial. (Sec. 6)
32. Directs a non-evaluating hospital to provide a patient written notice that an application for emergency admission will be filed if the admitting officer of the hospital finds reasonable cause to believe the patient needs admission to an evaluation agency and is a danger to self or others because of a mental disorder.
a. Requires the notice to:
i. Be included in the patient's chart;
ii. Include the time and date of issuance; and
iii. Include a written statement outlining the grounds for the notice. (Sec. 7)
33. Permits a non-evaluating hospital to hold a person for two hours after issuing a notice to prepare and submit an application to an evaluating agency. (Sec. 7)
34. Stipulates that an application for emergency admission for a patient at a non-evaluating hospital must be reviewed by the admitting officer within four hours of receiving the application in order to deny or grant the application based on certain criteria, including an interview with the applicant, hospital staff and proposed patient. (Sec. 7)
35. Permits an interview with a proposed patient to be conducted by a mental health professional:
a. At the non-evaluating hospital in person; or
b. By telemedicine if feasible. (Sec. 7)
36. Requires all interviews conducted at a non-evaluating hospital, to provide an individual with a written and oral statement which states that:
a. The screener is not affiliated with the hospital or providing medical services; and
b. The screening is not protected by doctor-patient confidentiality. (Sec. 7)
37. Allows a patient to be involuntarily detained at a non-evaluating hospital or emergency room long enough for a determination to be made on the emergency admission application and to transport the patient for evaluation. (Sec. 7)
38. Prohibits a patient from being transported to an evaluation agency once an application is granted if the patient is not medically ready for discharge from a non-evaluating hospital.
a. Permits a patient to be detained until they are medically ready for discharge.
b. Requires a non-evaluating hospital to notify the evaluating agency in writing once the patient is medically ready for discharge.
c. Permits a patient to be held involuntarily only for the time necessary to transport the patient to an evaluating agency. (Sec. 7)
39. Stipulates that if an admitting officer determines, after consulting with specified non-evaluating hospital staff, that the proposed patient is not in need of psychiatric hospitalization, the admitting officer or designee must advise the non-evaluating hospital of the application's denial.
a. Requires a written statement to be issued outlining the basis for the denial.
b. Requires the denial to be:
i. Transmitted to the non-evaluating hospital;
ii. Logged into the hospital's records; and
iii. Placed in the patient's medical chart. (Sec. 7)
40. Requires the evaluation agency to provide transportation within nine hours for a patient whose application has been approved and is medically ready for discharge. (Sec. 7)
41. Stipulates that once a written denial has been received from the evaluating agency, a patient may no longer be detained in the non-evaluating hospital and must be discharged unless there is a medically necessary reason. (Sec. 7)
42. Requires an admitting officer to make a determination based on specified information and prohibits the denial of an application based certain criteria. (Sec. 7)
43. Allows a patient, court-appointed guardian or agent under a power of attorney to give consent to continue treatment. (Sec. 10)
44. Grants immunity from civil liability to a non-evaluating hospital and its personnel, unless compliance was not done in good faith, for any:
a. Period of involuntary detention or the discharge of any person; and
b. Act committed by a person discharged from a non-evaluating hospital. (Sec. 10)
45. Provides immunity from civil liability for an admitting officer of an evaluation agency acting in good faith for any act committed by a person that the admitting officer did not advise to be taken into custody. (Sec. 10)
46. Requires each evaluating agency to compile and maintain a list of medical treatments and conditions that cannot be properly provided for.
a. Requires the list to be:
i. Publicly accessible; and
ii. Annually updated. (Sec. 11)
47. Stipulates that a patient may be held at a non-evaluating hospital until a hearing is held and an order is issued, if the patient requires treatment that cannot be properly provided. (Sec. 11)
48. Requires a physician at the evaluating hospital to consult with the treating physician at the non-evaluating hospital to determine whether a proposed patient is allowed to be transferred to and treated in the evaluation agency during the court-ordered evaluation process, if the admitting officer believes the patient requires services or treatment that is not on the list, but cannot be properly provided for by the agency. (Sec. 11)
49. Requires a receiving agency and non-evaluating hospital to consult with each other if a transport or treatment plan cannot be agreed on.
a. Specifies that if a treatment or transport plan continues to be disagreed upon, the receiving agency must provide the non-evaluating hospital with documentation containing the reasons the agency cannot receive and care for a patient.
b. Requires consultations to occur within 24 hours of receipt of an application for emergency admission. (Sec. 11)
50. Specifies that if a proposed patient must remain in a non-evaluating hospital due to specified reasons, the evaluation agency must file a request for an emergency status conference with the court.
a. Requires the court to hold the conference on the same or next court day.
b. Permits the conference to be held by electronic means. (Sec. 11)
51. Stipulates that if the court determines that statutory timeframes are impracticable, the court must issue orders regarding evaluation procedures and timeframes to complete the evaluation process. (Sec. 11)
52. Allows a person detained under emergency detention to receive treatment if a consent is signed by the patient's court-appointed guardian or agent under power of attorney. (Sec. 12)
53. Permits pharmacotherapy to be used as an emergency measure for safety purposes. (Sec. 11)
54. Excludes weekends and holidays from the 72-hour time frame in which a patient must be evaluated in an inpatient basis. (Sec. 14)
55. Allows a patient in certain instances to get further treatment if the patient's court-ordered guardian or power of attorney provides consent. (Sec. 15)
56. Defines and modifies relevant terms. (Sec. 1)
57. Makes technical and conforming changes. (Sec. 1, 2, 4-6, 8-10, 12-15)
Current Law
A responsible person is permitted to apply for a court-ordered evaluation for an individual that is unable or unwilling to undergo voluntary evaluation and who is alleged to be, due to a mental disorder, a danger to themselves or to others. A court-ordered evaluation may also be sought for a person who has a persistent or acute disability or a grave disability. An application for evaluation must contain statutorily specified information and be signed and notarized. A screening agency is required to help a person complete the application. The screening agency must be act within 48 hours, excluding weekends and holidays, of a submitted application. A prepetition screening must be completed to determine the validity of the allegations as described in the application. If allegations are found to have merit, the screening agency must file a petition seeking court-ordered evaluation.
Subjects of a court-ordered evaluation application may voluntarily submit to treatment. If treatment is received voluntarily, an evaluating agency can provide treatment and services on an inpatient or outpatient basis.
Additionally, an individual may apply to an evaluation agency for an emergency admission. The emergency admission application must contain specified information. In some instances, an individual may be involuntarily detained for evaluation purposes. An individual that has been taken into custody for emergency admission cannot he held for longer than 24 hours unless a petition for court-ordered evaluation is filed. A detained person may be released if the medical director of an evaluation agency deems the release appropriate.
The court may direct an individual to undergo an evaluation at a specified time and place. The individual has a right to refuse treatment and receive a hearing to determine if treatment is needed (Title 32, Chapter 5, Article 4).
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Fifty-third Legislature SB 1195
Second Regular Session Version 1: Health
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