House Bill #7725 (2018)

AN ACT RELATING TO HEALTH AND SAFETY -- EMERGENCY COMMITMENT FOR DRUG INTOXICATION

Authorizes a seventy-two (72) hour hold to be ordered by a physician in certain instances of substance abuse disorders.

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Changes since original draft

  • 2018 – H 7725
  • 2018 – H 7725 SUBSTITUTE A AS AMENDED
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  • LC004964
  • LC004964/SUB A/2
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  • S T A T E O F R H O D E I S L A N D
  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2018
  • ____________
  • A N A C T
  • RELATING TO HEALTH AND SAFETY – EMERGENCY COMMITMENT FOR DRUG
  • INTOXICATION
  • INTOXICATION
  • Introduced By: Representatives Casey, Morin, Canario, Hull, and Jacquard
  • Date Introduced: February 28, 2018
  • Referred To: House Judiciary
  • It is enacted by the General Assembly as follows:
  • SECTION 1. Sections 23-10.1-2, 23-10.1-3 and 23-10.1-4 of the General Laws in Chapter 23-10.1 entitled "Emergency Commitment for Drug Intoxication" are hereby amended to read as follows:
  • 23-10.1-2. Definitions.
  • Whenever used in this chapter, or in any order, rule, or regulation made or promulgated pursuant to this chapter, or in any printed forms prepared by the department or the director, unless otherwise expressly stated, or unless the context or subject matter otherwise requires:
  • (1) "Approved private treatment facility" means a private agency meeting the standards prescribed in § 23-10.1-7.
  • (1)(2) "Approved public treatment facility" means a treatment agency operating under the direction and control of the department or providing treatment under this chapter through a contract with the department.
  • (2)(3) "Department" means the state department of behavioral healthcare, developmental disabilities and hospitals.
  • (3)(4) "Director" means the director of the state department of behavioral healthcare, developmental disabilities and hospitals.
  • (5) "Drugs and intoxicating substance" shall include all substances listed in the schedules of controlled substances act, 21 U.S.C. § 812, chapter 28 of title 21, and all their intoxicating substances and inhalants.
  • (4)(6) "Drug intoxication" means an altered physiological substance or psychoactive substances, in which normal functioning is seriously impeded.
  • (7) "Incapacitated by" means a person, who as a result of the use of a controlled substance or alcohol as defined in this section, is intoxicated to such an extent that they are unconscious or have their judgment otherwise so impaired that they are incapable of realizing and making a rational decision with respect to their need for treatment.
  • (5)(8) "Likely to injure him or herself or others" means:
  • (i) A substantial risk of physical harm to himself or herself as manifested by behavior evidencing serious threats of, or attempts at, suicide or by behavior which will result in serious bodily harm; or
  • (ii) A substantial risk of physical harm to other persons as manifested by behavior or threats evidencing homicidal or other violent behavior.
  • (6)(9) "Physician" means a person duly licensed to practice medicine or osteopathy in this state.
  • (7)(10) "Psychoactive substance" means a drug that affects the central nervous system and alters mood, perception, and/or consciousness.
  • (11) "Substance abuser, drug abuser or intoxicating substance abuser" means a person who habitually lacks self-control as to the use of any substance as defined or listed in the schedules of the controlled substances act, 21 U.S.C. § 812, or chapter 28 of title 21 and any other intoxicating substance including alcohol.
  • (12) "Treatment" means the broad range of emergency, outpatient, intermediate, and inpatient services and care, including diagnostic evaluation, medical, psychiatric, psychological, and social service care, vocational rehabilitation and career counseling, which may be extended to substance abusers.
  • 23-10.1-3. General powers and duties.
  • (a) The department is charged with the execution of the laws relating to the emergency admission and custody of drug intoxicated individuals and/or those individuals who are substance abusers, drug abusers or intoxicating substance abusers.
  • (b) The department may adopt rules and regulations that it may deem necessary to carry out the provisions of this chapter to insure the safety and promote the welfare of individuals committed to its custody pursuant to this chapter.
  • 23-10.1-4. Emergency commitment. Emergency and /or involuntary commitment.
  • (a) Any police officer may take an individual into protective custody and transport him or her to the emergency room of any hospital if the officer has reason to believe that:
  • (1) The individual is intoxicated by drugs or other controlled substance, other than alcohol and as a result is likely to injure him or herself or others if allowed to be at liberty pending examination by a licensed physician; or
  • (2) The individual is in need of immediate assistance due to the use of drugs or controlled substance and requests the assistance.
  • (b) A physician in charge of an emergency room of a hospital shall determine if any individual brought into the emergency room by a police officer, family member, or other interested person, requires emergency medical treatment for his or her condition or if the individual is appropriate for emergency commitment to an approved public treatment facility by reason of the grounds stated in this section.
  • (c) If a physician determines, upon examination, that an individual is medically stable and appropriate for emergency commitment to an approved public treatment facility, he or she shall make application for the individual's admission to the approved public treatment facility.
  • (d) The application for admission shall state the circumstances under which an individual was taken into custody, brought to the emergency room, or brought to an approved public treatment facility and the reason for the physician's determination that the individual needs emergency commitment for drug intoxication or substance abuse.
  • (e) Upon the request of any physician making application in writing under this section, it shall be the duty of any police department of this state or any governmental subdivision of this state to whom the request is made, to take into custody and transport the individual to the designated approved public treatment facility.
  • (f) Any police officer, emergency medical technician, rescue personnel, fire department personnel or any other person acting pursuant to this section shall be immune from liability for exercising their discretion in securing and transporting the substance abuser or intoxicated individual to a facility against their will; provided that such person is acting in good faith and with the reasonable belief that the person is a substance abuser or under the influence of a controlled substance to such a degree that they are a danger to themselves or to others; and provided that, excessive force is not utilized by such person.
  • SECTION 2. Chapter 23-10.1 of the General Laws entitled "Emergency Commitment for Drug Intoxication" is hereby amended by adding thereto the following sections:
  • 23-10.1-4.1. Involuntary commitment of substance abusers.
  • (a) A person may be committed to the custody of the department by the district court upon the petition of their spouse or guardian, a relative, the certifying physician, or the administrator in charge of any approved public treatment facility. The petition shall allege that the person is a drug or intoxicating substance abuser who habitually lacks self-control as to the use of intoxicating substances, or that they are incapacitated by the use of a controlled substance, and that they:
  • (1) Have threatened, attempted, or inflicted physical harm on themselves or another and that unless committed are likely to inflict physical harm on themselves or another; or
  • (2) Will continue to suffer abnormal mental, emotional, or physical distress, will continue to deteriorate in ability to function independently if not treated, and are unable to make a rational and informed choice as to whether or not to submit to treatment, and as a result, poses a danger to themselves. Evidence that the person has had numerous short-term, involuntary admissions to a treatment facility shall be considered by the court in making a decision pursuant to this chapter. The petition shall be accompanied by a certificate of a licensed physician who has examined the person within three (3) days before submission of the petition, unless the person whose commitment is sought has refused to submit to a medical examination, in which case the fact of refusal shall be alleged in the petition. The certificate shall set forth the physician's findings in support of the allegations of the petition.
  • (b) Upon filing the petition, the court shall fix a date for a hearing no later than ten (10) days after the date the petition was filed. A copy of the petition and of the notice of the hearing, including the date fixed by the court, shall be served on the petitioner, the person whose commitment is sought, their next-of-kin other than the petitioner, a parent or their legal guardian if they are a minor, the administrator in charge of the approved public treatment facility to which they have been committed for emergency care, and any other person the court believes advisable. A copy of the petition and certificate shall be delivered to each person notified.
  • (c) At the hearing the court shall hear all relevant testimony, including, if possible, the testimony of at least one licensed physician who has examined the person whose commitment is sought. The person shall be present unless the court believes that their presence is likely to be injurious to them; in this event the court shall appoint a guardian ad litem to represent them throughout the proceeding. The court shall examine the person in open court, or if advisable shall examine the person out of court. If the person has refused to be examined by a licensed physician, they shall be given an opportunity to be examined by a court-appointed licensed physician. If they refuse and there is sufficient evidence to believe that the allegations of the petition are true, or if the court believes that more medical evidence is necessary, the court may make a temporary order committing them to the department for a period of not more than five (5) days for purposes of a diagnostic examination.
  • (d) If after hearing all relevant evidence, including the results of any diagnostic examination by the department, the court finds that grounds for involuntary commitment have been established by clear and convincing proof, it shall make an order of commitment to the department. It may not order commitment of a person unless it determines that the department is able to provide adequate and appropriate treatment for them and the treatment is likely to be beneficial.
  • (e) A person committed under this section shall remain in the custody of the department for treatment for a period of thirty (30) days unless sooner discharged. At the end of the thirty (30) day period, they shall be discharged automatically unless the department, before the expiration of the period, obtains a court order for their recommitment upon the grounds set forth in subsection (a) of this section for a further period of ninety (90) days unless sooner discharged. If a person has been committed because they are a drug or intoxicating substance abuser likely to inflict physical harm on themselves or another, the department shall apply for recommitment if after examination it is determined that the likelihood still exists.
  • (f) A person recommitted under subsection (a) of this section who has not been discharged by the department before the end of the ninety (90) day period shall be discharged at the expiration of that period unless the department, before the expiration of the period, obtains a court order on the grounds set forth in subsection (a) of this section for recommitment for a further period not to exceed ninety (90) days. If a person has been committed because they are a drug or intoxicating substance abuser likely to inflict physical harm on themselves or another, the department shall apply for recommitment if after examination it is determined that the likelihood still exists. Only two (2) recommitment orders under subsections (e) and (f) of this section shall be permitted.
  • (g) Upon the filing of a petition for recommitment under subsections (e) or (f) of this section, the court shall fix a date for a hearing no later than ten (10) days after the date the petition was filed. A copy of the petition and of the notice of the hearing, including the date fixed by the court, shall be served on the petitioner, the person whose commitment is sought, their next- of-kin other than the petitioner, the original petitioner under subsection (a) of this section if different from the petitioner for recommitment, one of their parents or their legal guardian if they are a minor, and any other person the court believes advisable. At the hearing the court shall proceed as provided in subsection (c) of this section.
  • (h) The department shall provide for adequate and appropriate treatment of a person committed to its custody. The department may transfer any person committed to its custody from one approved public treatment facility to another if transfer is medically advisable.
  • (i) A person committed to the custody of the department for treatment shall be discharged at any time before the end of the period for which they have been committed if either of the following conditions is met:
  • (1) In case of a drug or intoxicating substance abuser committed on the grounds of likelihood of infliction of physical harm upon themselves or another, that they are no longer a drug or intoxicating substance abuser or the likelihood no longer exists; or
  • (2) In case of a drug or intoxicating substance abuser committed on the grounds of the need of treatment, deterioration, inability to function, or the fact that they are a danger to themselves, that the deterioration no longer exists, that they are no longer a danger to themselves, that they are able to function, that further treatment will not be likely to bring about significant improvement in the person's condition, or treatment is no longer adequate or appropriate.
  • (j) The court shall inform the person whose commitment or recommitment is sought of their right to contest the application, be represented by counsel at every stage of any proceedings relating to their commitment and recommitment, and have counsel appointed by the court or provided by the court if they want the assistance of counsel and are unable to obtain counsel. If the court believes that the person needs the assistance of counsel, the court shall require, by appointment if necessary, counsel for them regardless of their wishes. The person whose commitment or recommitment is sought shall be informed of their right to be examined by a licensed physician of their choice. If the person is unable to obtain a licensed physician and requests examination by a physician, the court shall employ a licensed physician.
  • (k) If a private treatment facility agrees with the request of a competent patient or their parent, sibling, adult child, or guardian to accept the patient for treatment, the administrator of the public treatment facility shall transfer them to the private treatment facility.
  • (l) A person committed under this chapter may at any time seek to be discharged from commitment by writ of habeas corpus.
  • (m)(1) Any aggrieved party may appeal to the superior court from a judgment of the district court by claiming the appeal in writing filed with the clerk within forty-eight (48) hours, exclusive of Sundays and legal holidays, after the judgment is entered.
  • (2) All court actions shall be heard within fourteen (14) days after the appeal and shall have precedence on the calendar and shall continue to have precedence on the calendar on a day- to-day basis until the matter is heard.
  • 23-10.1-7. Standards for treatment facilities – Inspections – Furnishing information to department – Noncompliance with standards.
  • (a) The department shall establish standards for approved treatment facilities that must be met for a treatment facility to be approved as a public or private treatment facility, and fix the fees to be charged by the department for the required inspections. The standards may concern only the health standards to be met and standards of treatment to be afforded patients.
  • (b) The department shall periodically inspect approved public and private treatment facilities at reasonable times and in a reasonable manner.
  • (c) The department shall maintain a list of approved public and private treatment facilities.
  • (d) Each approved public and private treatment facility shall file with the department on request: data, statistics, schedules, and any other information that the department reasonably requires. An approved public or private treatment facility that without good cause fails to furnish any data, statistics, schedules, and any other information as requested, or files fraudulent returns, shall be removed from the list of approved treatment facilities.
  • (e) The department, after holding a hearing, may suspend, revoke, limit, or restrict an approval, or refuse to grant an approval, for failure to meet its standards.
  • SECTION 3. This act shall take effect upon passage.
  • SECTION 1. Chapter 23-10.1 of the General Laws entitled "Emergency Commitment for Drug Intoxication" is hereby amended by adding thereto the following sections:
  • 23-10.1-7. Substance abuse disorder.
  • As used in §§ 23-10.1-7 through 23-10.1-8, the term "substance abuse disorder'' means the chronic or habitual consumption or ingestion of drugs and intoxicating substance by a person to the extent that:
  • (1) Substantially injures the person's health or substantially interferes with the person's social or economic functioning; or
  • (2) The person has lost the power of self-control over the use of such drugs and intoxicating substance.
  • 23-10.1-8. Seventy-two (72) hour hold for substance abuse disorder.
  • (a) A physician who concentrates in diagnosing and/or treating persons with substance abuse disorders and who while treating a person (hereinafter, the "respondent ) for substance abuse, has reason to believe that the respondent is suffering from a substance abuse disorder and presents a danger or threat of danger to themself, family, or others, if not treated for substance abuse disorder, may issue a seventy-two (72) hour hold on the respondent for in-patient treatment at a facility designed to provide in-patient treatment to persons with substance abuse disorders. An order issued under this section shall be in writing and shall include the factual basis for the finding that the respondent requires a seventy-two (72) hour hold pursuant to this section. To issue an order for a seventy-two hour (72) hold, the physician must find that a respondent:
  • (1) As a result of the use of a controlled substance, as defined or listed in the schedules of the controlled substances act, 12 U.S.C. § 812 or in chapter 28 of title 21, is intoxicated to such an extent that they are unconscious or have their judgment otherwise so impaired that they are incapable of realizing and making a rational decision with respect to their need for treatment;
  • (2) Is likely to injure himself or herself or others, which for purposes of this section means the respondent:
  • (i) Presents a substantial risk of physical harm to himself or herself as manifested by behavior evidencing serious threats of, or attempts at, suicide, or by behavior that will result in serious bodily harm; or
  • (ii) Presents a substantial risk of physical harm to other persons as manifested by behavior or threats evidencing homicidal or other violent behavior.
  • (b) A family member of the respondent, or a first responder to the respondent, including a member of the police, fire, or rescue unit (hereinafter a "first responder") who assisted in bringing the respondent to the physician or the facility where the physician is treating the respondent, may request the physician to issue such a hold, but no hold may be implemented without an express written order from a physician as set forth in subsection (a) of this section.
  • (c) Any police officer, emergency medical technician, rescue personnel, fire department personnel, or any other person acting pursuant to §§ 23-10.1 -7 through 23-10.1-10 shall be immune from liability for exercising their discretion in securing and transporting the substance abuser or intoxicated individual to a facility against their will, provided that such person is acting in good faith and with the reasonable belief that the respondent is a substance abuser or under the influence of a controlled substance to such a degree that the respondent is a danger to the respondent's self or to others: and provided further, that excessive force shall not be utilized by such person.
  • 23-10.1-9. Hearing to extend seventy-two (72) hour hold.
  • (a) The physician issuing the order, a family member of the respondent, or a first responder who is familiar with the respondent may petition the district court for the district wherein the seventy-two (72) hour hold is being enforced for an extension of the hold of the respondent. The petition shall state the petitioner's belief, including the factual basis therefor, that the respondent is suffering from a substance abuse disorder and presents a danger or threat of danger to themself, family, or others if the respondent does not continue to be treated for the substance abuse disorder. These matters shall be given priority status on the district court's calendar and shall be heard no later than seventy-two (72) hours after the commencement of the hold on the respondent.
  • (b) A respondent subject to a seventy-two (72) hour hold pursuant to § 23-10.1-8 shall be informed both verbally and in writing if a petition has been filed to extend the hold. The respondent shall be entitled to legal counsel. At the preliminary hearing in the district court, the court shall serve a copy of the petition upon the respondent and advise the respondent of the nature of the proceedings and of the respondent's right to counsel. If the respondent is unable to afford counsel, the court forthwith shall appoint the mental health advocate for the respondent.
  • (c) The burden of proof on whether to extend a seventy-two (72) hour hold shall be on the petitioning party. The standard of determining whether or not to impose the hold shall be clear and convincing evidence. No extension shall be granted without medical testimony from a treating physician as to the elements set forth in § 23-10.1-8(a).
  • (d) The court may order the hold and treatment of the respondent to continue for a period of up to thirty (30) days, and may, upon a motion and after hearing thereon, extend the time of commitment for a period of up to another thirty (30) days. No involuntary commitment for substance abuse disorder shall be extended more than two (2) times.
  • (e) The provisions of § 23-10.1-5 shall not apply to a seventy-two (72) hour hold issued pursuant to §§ 23-10.1-7 through 23-10.1-10.
  • (f) If, at any time after the petition is filed, the court finds that there is no probable cause to continue treatment or if the petitioner withdraws the petition, then the proceedings against the respondent shall be dismissed.
  • 23-10.1-10. Seventy-two (72) hour holds to be in addition to other remedies.
  • The authorization of and proceedings for a seventy-two (72) hour hold pursuant to §§ 23- 10.1-8 through 23-10.1.-10 shall not preclude the concurrent or subsequent filing of other actions for involuntary commitment of substance abusers, including, but not limited to, actions brought pursuant to §§ 23-10.1-4.1 and 40.1-5-7.
  • 23-10.1-11. Rules and regulations.
  • The department of health shall promulgate rules and regulations to implement the provisions of §§ 23-10.1-7 through 23-10.1-10.
  • SECTION 2. This act shall take effect on January 1, 2019.
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  • LC004964
  • LC004964/SUB A/2
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  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • RELATING TO HEALTH AND SAFETY – EMERGENCY COMMITMENT FOR DRUG
  • INTOXICATION
  • ***
  • This act would provide for the involuntary commitment of drug and intoxicating substance abusers who are a danger to themselves or others.
  • This act would take effect upon passage. ======== LC004964 ========
  • INTOXICATION
  • ***
  • This act would authorize a seventy-two (72) hour hold to be ordered by a physician in certain instances of substance abuse disorders. The hold could be continued beyond the seventy- two (72) hour period if ordered by a district court judge.
  • This act would take effect on January 1, 2019. ======== LC004964/SUB A/2 ========

Votes

NOTE: Electronic voting records are unofficial and may not be accurate. For an official vote tally, check the House or Senate Journal from the day of the vote.

Floor vote for PASSAGE PASSAGE OF AMENDMENT

June 20, 2018 at 8:38pm
Yeas: 71 / Nays: 0 / Not voting: 4 / Recused: 0
Legislator Vote
Rep. Abney Y
Rep. Ackerman Y
Rep. Ajello Y
Rep. Almeida Y
Rep. Amore Y
Rep. Azzinaro Y
Rep. Barros NV
Rep. Bennett Y
Rep. Blazejewski Y
Rep. Canario Y
Rep. Carson Y
Rep. Casey Y
Rep. Casimiro Y
Rep. Chippendale Y
Rep. Corvese Y
Rep. Costantino Y
Rep. Coughlin Y
Rep. Craven Y
Rep. Cunha NV
Rep. Diaz Y
Rep. Donovan Y
Rep. Edwards Y
Rep. Fellela Y
Rep. Filippi Y
Rep. Fogarty Y
Rep. Giarrusso Y
Rep. Handy Y
Rep. Hearn Y
Rep. Hull Y
Rep. Jacquard Y
Rep. Johnston Y
Rep. Kazarian Y
Rep. Keable Y
Rep. Kennedy Y
Rep. Knight Y
Rep. Lancia Y
Rep. Lima Y
Rep. Lombardi Y
Rep. Maldonado Y
Rep. Marshall Y
Rep. Marszalkowski Y
Rep. Mattiello Y
Rep. McEntee Y
Rep. McKiernan Y
Rep. McLaughlin Y
Rep. McNamara Y
Rep. Mendonca Y
Rep. Messier Y
Rep. Morgan Y
Rep. Morin Y
Rep. Nardolillo Y
Rep. Newberry Y
Rep. Nunes Y
Rep. O'Brien Y
Rep. O'Grady Y
Rep. Perez NV
Rep. Phillips Y
Rep. Price Y
Rep. Quattrocchi NV
Rep. Ranglin-Vassell Y
Rep. Regunberg Y
Rep. Roberts Y
Rep. Ruggiero Y
Rep. Serpa Y
Rep. Shanley Y
Rep. Shekarchi Y
Rep. Slater Y
Rep. Solomon Y
Rep. Tanzi Y
Rep. Tobon Y
Rep. Ucci Y
Rep. Vella-Wilkinson Y
Rep. Walsh Y
Rep. Williams Y
Rep. Winfield Y