Institutions for the Mentally Ill; Mental Health Generally

Passed

P HB2011

Emergency custody orders for adult persons who are mentally disabled as a result of physical injury or illness. Provides that, based upon the opinion of a licensed physician that an adult person is incapable of making an informed decision regarding treatment as a result of a physical injury or illness and that the medical standard of care indicates that testing, observation and treatment are necessary to prevent imminent and irreversible harm, a magistrate may issue, for good cause shown, an emergency custody order for such adult person to be taken into custody and transported to a hospital emergency room. This bill requires that, prior to issuance of an emergency custody order the magistrate must ascertain that there is no legally authorized person available to give consent to necessary treatment for the adult person, and that the adult person (i) is incapable of making an informed decision regarding obtaining necessary treatment, (ii) has refused transport to obtain such necessary treatment, (iii) has indicated an intention to resist such transport, and (iv) is unlikely to become capable of making an informed decision regarding obtaining necessary treatment within the time required for such decision. An opinion by the licensed physician that an adult person is incapable of making an informed decision as a result of physical injury or illness can only be rendered after such licensed physician has communicated electronically or personally with the adult person and the emergency medical services personnel on the scene to obtain information and medical data concerning the cause of the adult person's incapacity, has attempted to obtain consent from the adult person personally and has failed to obtain such consent. If there is a change in the person's condition, the emergency medical services personnel shall contact the licensed physician. If at any time the licensed physician determines that the person has become capable of making and communicating an informed decision, such physician shall rely on the person's decision on whether to consent to further observation, testing or treatment. The person must remain in custody until an evaluation by a licensed physician is performed or the person is otherwise admitted or detained, but in no event can the period of custody exceed four hours. The law-enforcement officer may lawfully go to or be sent beyond the territorial limits of the county, city or town in which he serves to any point in the Commonwealth for the purpose of executing an order for emergency custody. Nothing precludes a law-enforcement officer from obtaining emergency medical treatment or further medical evaluation at any time for a person in his custody. If an order of emergency custody is not executed within four hours of its issuance, the order will be void and will be returned unexecuted to the office of the clerk of the issuing court or, if such office is not open, to any judge or magistrate thereof.
Patron - Bell

P HB2309

State-responsible clients; forms of identification. Requires the Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services (DMHMRSAS) and the Director of the Department of Corrections to work with appropriate state and federal entities to assist any person who has been committed to the custody of any facility operated by the Department of Mental Health, Mental Retardation and Substance Abuse Services or Department of Corrections, prior to release, has certain pieces of identification. DMHMRSAS consumers who have been a patient for more than one year shall have possession of the following documents, if required by their discharge plan: a DMV approved ID card, a copy of their birth certificate and a social security card. Department of Corrections will make application for similar pieces of identification.
Patron - Alexander

P HB2346

Duties of the Inspector General for Mental Health, Mental Retardation and Substance Abuse Services. Clarifies the authority of the Inspector General for Mental Health, Mental Retardation and Substance Abuse Services to provide inspections of and make policy and operational recommendations for licensed mental health treatment services operated by state correctional facilities. The Department of Mental Health, Mental Retardation and Substance Abuse Services currently licenses inpatient and residential mental health treatment services provided in state correctional facilities at Powhatan, Marion, Brunswick, Greensville and Fluvanna and outpatient treatment services at Marion. This bill is identical to SB 947.
Patron - Weatherholtz

P HB2445

Sexually violent predators. Moves the effective date of the sexually violent predator legislation from 2004 to "effective from its passage." The bill redefines sexually violent offense to include a forcible sexual offense committed prior to July 1, 1981, involving sodomy, object sexual penetration and aggravated sexual battery. A sexually violent predator is defined as a person with a qualifying offense who, because of a mental abnormality or personality disorder, has difficulty controlling his predatory behavior and receives a certain minimum score on a sex offender risk assessment instrument. The bill limits the person's ability to raise challenges to the validity of his prior criminal convictions and restricts his right to use evidence in his defense if he refuses to cooperate with his mental examination. Time limits for actions required on behalf of the Commonwealth are extended and primary responsibility for control, care and treatment is placed with the Department of Mental Health, Mental Retardation and Substance Abuse Services or with a private entity with which the Department contracts. The bill changes the standard of proof for finding a person a sexual predator from "beyond a reasonable doubt" to "clear and convincing." This bill is identical to SB 1149.
Patron - Griffith

P HB2670

Transportation of person in civil commitment process. Requires magistrates to direct the transportation of persons who are the subject of an emergency custody or temporary detention order by a law-enforcement officer from a specified agency and jurisdiction to such medical facilities as may be necessary to obtain emergency medical evaluation or treatment prior to the placement of the individual in the temporary detention facility.
Patron - Hamilton

P HB2698

Civil commitment procedures. Requires the Secretary of Public Safety, in consultation with the Secretary of Health and Human Resources and the Executive Secretary of the Supreme Court, to appoint a committee on civil commitment procedures to establish statewide policies and guidelines that identify the party or parties responsible for the safety and security of individuals who are the subject of or who participate in involuntary detention and admission activities in order to assist the courts and other participating parties in the uniform and effective operation of the Commonwealth's civil commitment statutes. The policies and guidelines must include transportation, custody, medical evaluation, screening and treatment, and detention services and must recognize the varying resources of localities and conditions and needs of individuals under temporary detention orders and provide for protection of patients, staff, and employees of facilities as well as be consistent with the Emergency Medical Treatment and Active Labor Act, which requires hospitals to treat or stabilize and transport individuals presenting with an emergency or in active labor. The committee must report these policies and guidelines to the Council by October 1, 2003, and include recommendations for any legislative actions needed to implement the policies and guidelines. These policies and guidelines will be used by the applicable local representatives or counterparts of the agencies and organizations represented on the committee to develop local procedures. The representatives or counterparts are charged with reviewing the local procedures annually and revising them as necessary. This provision will, however, expire on July 1, 2004, pursuant to a second enactment clause.
Patron - Hamilton

P HB2775

Mental health; reports by guardians. Allows the jurisdiction where the incapacitated person resides to retain the filing fee of five dollars, which accompanies the annual report by the guardian, to be used for services for adults in need. Administrative costs to process and mail the fee exceed the amount of the fee and could fund resources for additional services.
Patron - Ingram

P HB2809

Mental health; power of conservator. Prohibits a conservator for an incapacitated person from revoking or amending a trust or withdrawing or demanding distribution of trust assets without the approval of the court for good cause shown, unless the trust instrument expressly provides otherwise.
Patron - Athey

P SB801

Office of Inspector General for Mental Health, Mental Retardation and Substance Abuse Services. Adds a requirement for the Inspector General to submit reports to the Joint Commission on Behavioral Health Care, or its successor in interest. The Inspector General is currently required to submit certain reports, information, documents and recommendations to the Governor, the General Assembly, the Secretary of Health and Human Resources and the Commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services.
Patron - Martin

P SB947

Duties of the Inspector General for Mental Health, Mental Retardation and Substance Abuse Services. Clarifies the authority of the Inspector General for Mental Health, Mental Retardation and Substance Abuse Services to provide inspections of and make policy and operational recommendations for licensed mental health treatment services operated by state correctional facilities. However, if a criminal offense has been committed, notification shall be given to the Inspector General for the Department of Corrections. The Department of Mental Health, Mental Retardation and Substance Abuse Services currently licenses inpatient and residential mental health treatment services provided in state correctional facilities at Powhatan, Marion, Brunswick, Greensville and Fluvanna and outpatient treatment services at Marion.
Patron - Houck

P SB1121

Criminal background checks; victims of domestic violence. Authorizes community services boards, behavioral health authorities and agencies licensed by the Department of Mental Health, Mental Retardation and Substance Abuse Services to hire persons who were convicted of one misdemeanor offense for assault and battery or assault and battery against a family or household member if 10 years have elapsed following the conviction, unless the person committed such offense in the scope of his employment in a direct consumer care position.
Patron - Lucas

P SB1149

Civil commitment; sexually violent predators. Moves the effective date of the civil commitment of sexually violent predator legislation from 2004 to "effective from its passage." The bill redefines sexually violent offense to include a forcible sexual offense committed prior to July 1, 1981, involving sodomy, object penetration or sexual battery. Sexually violent predator is defined as a person who, because of a mental abnormality or personality disorder, has serious difficulty controlling his predatory behavior. The bill limits the person's ability to raise challenges to the validity of his prior criminal convictions and restricts his right to use evidence in his defense if he refuses to cooperate with his mental examination. Time limits for actions required on behalf of the Commonwealth are extended and primary responsibility for control, care and treatment is placed with the Department of Mental Health, Mental Retardation and Substance Abuse Services or with a private entity with which the Department contracts. The bill changes the standard of proof for finding a person a sexual predator from "beyond a reasonable doubt" to "clear and convincing." This bill is identical to HB 2445.
Patron - Stolle

P SJ358

Effective treatment modalities and practices for children with mental health needs. Directs the Virginia Commission on Youth, or its successor in interest, to make empirically based information concerning effective treatment modalities and practices for children available through the Internet. The Commission shall seek the assistance of the SJR 99 Advisory Group, the Secretary of Health and Human Resources, the Secretary of Public Safety, and the Secretary of Education in posting, maintaining, and biennially updating this information. Such information shall include effective, empirically based, treatment modalities and practices for juvenile offenders with mental health treatment needs, symptoms, and disorders. The agencies of the Secretariat of Health and Human Resources that deliver services to children, the Department of Education, and the Department of Juvenile Justice must also post this information on their respective websites, provide for the dissemination of the information in as efficient and cost-effective manner as possible, and ensure access to the information by consumers, family members, advocates, mental health policy makers, and other interested persons. The Virginia Commission on Youth, or its successor in interest, must submit an executive summary and report of its progress in meeting the directives of this resolution no later than the first day of the 2004 Regular Session of the General Assembly.
Patron - Houck

Failed

F HB2446

Civil commitment of sexually violent predators. Authorizes the civil commitment of persons convicted of two or more violent sex offenses on different occasions whose mental abnormalities render them so likely to commit sexually violent offenses that they constitute a threat to the health and safety of others. The bill establishes a procedure for determining whether a sex offender who is scheduled to be released from prisoner meets the criteria for civil commitment. A Commitment Review Committee will review eligible prisoners and make a recommendation to the Attorney General. The Attorney General determines whether to file a petition for the commitment of the prisoner. The prisoner is entitled to a jury trial. Persons who are committed are placed in the custody of the Department of Mental Health, Mental Retardation and Substance Abuse Services for an indeterminate period in a secure facility operated by the Department of Mental Health, Mental Retardation and Substance Abuse Services for treatment and confinement consistent with their needs or the Commonwealth may contract with a public or private facility, in or out of state, to provide comparable care, control and treatment.
Patron - Griffith

F HB2572

Mental health; procedures for implementation of temporary detention orders. Requires, in the interests of promoting public safety and efficient and effective use of resources, each community services board to convene a task force, with representation from law-enforcement agencies; facilities and practitioners providing emergency medical evaluations, treatment or temporary detention; courts; state hospitals; local governments; and other relevant entities, to develop procedures for implementing temporary detention orders. Such procedures shall be consistent with the requirements of the Emergency Medical Treatment and Active Labor Act (42 U.S.C. 1395dd) and shall include, but need not be limited to, provisions for transportation; medical evaluation, screening, and treatment; and detention services that recognize the many and varying conditions and needs of individuals subject to temporary detention orders and the need to protect their security and the security of other patients and facility staff and employees providing emergency medical evaluation, treatment or detention services. All relevant agencies and entities convened by the relevant community services board shall appoint representatives to the task force required by this subsection who shall develop and implement the required procedures and shall, at least annually, review and revise such procedures as necessary.
Patron - Scott

F SB1079

Mandatory outpatient treatment. Establishes a program of mandatory outpatient treatment in those jurisdictions served by a community services board that the Commissioner designates as having adequate and appropriate resources for the provision of mandatory outpatient treatment. The bill authorizes mandatory outpatient treatment only for persons previously hospitalized due to noncompliance with prescribed psychiatric treatment. The bill requires that a specific written treatment plan be prepared by the community services board that gives consideration to the treatment preferences of the individual and explicitly bars the forcible administration of medication. The bill also authorizes law-enforcement personnel to transport the individual to a treatment facility for persuasion and evaluation by a treatment provider only when the individual has substantially failed to comply with the treatment plan without good cause, and only for a three-hour period, including transportation time. The bill also limits the duration of the court order to 180 days or less, and provides the person with procedural protections, including the right to an adversary hearing, the right to counsel, the right to an appeal, and the right to a jury trial on appeal.
Patron - Marsh

F SB1119

Involuntary detention and commitment. Provides that persons in emergency custody or subject to the involuntary detention or commitment process shall not be handcuffed, shackled or otherwise restrained during their transport or hearings unless they present a clear, immediate and severe threat to the law-enforcement officer or others or to their own personal safety. The bill provides that a person subject to a temporary detention order shall be detained in a facility in or closest to the locality in which he resides unless not feasible. The bill also requires commitment hearings to be held in the locality in which the person whose involuntary admission is being sought resides and at the facility where the person has been involuntarily detained unless not feasible. Finally, the bill requires the chief judge of the general district court, with assistance from the local community services board serving his jurisdiction, to maintain a list of local examiners from which the judge conducting the commitment hearing shall obtain an examiner.
Patron - Lucas

F SB1326

Judicial authorization of treatment and detention. Removes the court's authority to order the withholding or withdrawal of a specific treatment or course of treatment for a mental or physical disorder when an adult patient is either incapable of making an informed decision on his own behalf or is incapable of communicating an informed decision due to a physical or mental disorder and the proposed action is in the best interest of the person. Authority to order a specific treatment or a course of treatment is retained for the allegedly incapable adult person. This provision also strikes the authority for "any person" to file a request for a court to order the withholding or withdrawal of treatment for an adult person who is incapable of making or communicating informed consent. For individuals incapable of making or communicating informed consent who are hospital patients at the time of the petition for treatment, this provision requires "complete accordance with the Health Care Decisions Act . . . and the delineated authorization of consent as set forth in § 54.1-2986, with all prudent effort made to obtain such informed consent from an individual or individuals in order of priority who are legally authorized to give consent."
Patron - Mims

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