HB1503

SECTION 1. The legislature finds that the State has several key tools and programs to assist individuals with untreated severe mental illness. These include court-ordered plans of treatment, known in Hawaii as "assisted community treatment" or "ACT" orders; involuntary commitments to the state hospital or similar facility; court-ordered medication; and department of health crises programs, among others. The legislature further finds that there are areas for improvement, especially as available resources and needs change over time.

Accordingly, the purpose of this Act is to improve the State's mental health resources by requiring:

(1) The department of health to respond to reports about persons with severe mental illness who need assistance and assess whether those persons may fulfill the criteria for assisted community treatment and, if a person meets that criteria, initiate the process for an assisted community treatment order;

(2) The department of health to track and publicly report data relating to crises reports, emergency mental health transports, and court-ordered treatments, and appropriating moneys to support technology needs for data collection and reporting;

(3) The court, when dismissing an involuntary hospitalization petition for a person, to assess whether the person meets the criteria for assisted community treatment and authorizing the court to order the person to obtain assisted community treatment, which may include medication; and

(4) The department of the attorney general to assist with the preparation and filing of assisted community treatment petitions and related court proceedings for private petitioners unless the petitioner declines the assistance.

SECTION 2. Chapter 334, Hawaii Revised Statutes, is amended as follows:

1. By adding a new section to part I to be appropriately designated and to read:

"§334- Data concerning persons experiencing a mental health crisis. The department shall track and publish data regarding reports of and responses to mental health crises. Reports required under this section shall be updated at least monthly, shall be reported on the department's website, and shall include:

(1) The number of reports, by county, made to a department hotline, crisis line, or other means for the public to contact the department, including through department‑contracted services and providers, and the disposition of those reports;

(2) The number of persons transported for emergency examination pursuant to section 334-59 by type of transport, length of time in the emergency room, disposition of the matter, and county in which the facility where the person was transported is located;

(3) The number of assisted community treatment evaluations performed prior to discharge pursuant to section 334‑121.5 and the disposition of the evaluations;

(4) The number of assisted community treatment petitions filed pursuant to section 334-123, category of the petitioner, whether the attorney general assisted with the petition, disposition of the petition, length of time to disposition, and number of persons currently under an assisted community treatment order;

(5) The number of:

(A) Court orders for treatment over the patient's objection sought pursuant to section 334-161, disposition of those orders sought, and number of patients currently under a court order for treatment; and

(B) Administrative orders for treatment over the patient's objection sought pursuant to section 334-162, disposition of those orders sought, and number of patients currently under an administrative order for treatment; and

(6) The number of involuntary hospitalization petitions filed pursuant to section 334-60.3, disposition of those petitions, length of time to disposition, and the number of patients currently under an involuntary hospitalization petition."

2. By adding a new section to part VIII to be appropriately designated and to read:

"§334- Department response to crisis reports. (a) When the department receives credible information that a person who has severe mental illness requires assistance, the department shall dispatch staff or a service provider to assist the person and may coordinate the response with other agencies as necessary. This requirement shall apply to communications received by any means by which the public may contact the department, including through a department hotline, crisis line, or other means, and shall apply to communications received through department-contracted services and providers.

(b) While assisting a person pursuant to section (a), the department staff or service provider shall assess whether the person meets the criteria for assisted community treatment pursuant to section 334-121.

(c) If, upon assessment of a person pursuant to subsection (b), the department reasonably believes that the person meets the criteria for assisted community treatment, the department, with assistance from the department of the attorney general, shall file a petition for an assisted community treatment order."

SECTION 3. Section 334-60.5, Hawaii Revised Statutes, is amended by amending subsection (i) to read as follows:

"(i) If, after hearing all relevant evidence, including the result of any diagnostic examination ordered by the court, the court finds that an individual is not a person requiring medical, psychiatric, psychological, or other rehabilitative treatment or supervision, the court shall order that the individual be discharged if the individual has been hospitalized prior to the hearing. Prior to the dismissal of the petition, the court shall first assess whether the person meets the criteria for assisted community treatment under section 334-121 and may order the person to obtain assisted community treatment, which may include medication; provided that a mental health facility or program is designated to take responsibility for coordination of the person's care and which has voluntarily accepted the designation; provided further that the designation includes a treating psychiatrist or an advanced practice registered nurse who has prescriptive authority and holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, who shall be responsible for the management and supervision of the treatment and who has voluntarily accepted the designation. Within ten days after the issuance of the order for assisted community treatment, the designated mental health facility or program shall submit to the court a treatment plan, which may include medication; provided that the plan describes the type or class of medication to be authorized and the physical, mental, beneficial, and detrimental effects of the medication. The treatment plan shall be attached to the order."

SECTION 4. Section 334-123, Hawaii Revised Statutes, is amended to read as follows:

"§334-123 Initiation of proceeding for assisted community treatment. (a) Any interested party may file a petition with the family court alleging that another person meets the criteria for assisted community treatment. The petition shall state:

(1) Each of the criteria under section 334-121 for assisted community treatment;

(2) Petitioner's good faith belief that the subject of the petition meets each of the criteria under section 334‑121;

(3) Facts that support the petitioner's good faith belief that the subject of the petition meets each of the criteria under section 334-121; and

(4) That the subject of the petition is present within the county where the petition is filed.

The hearing on the petition need not be limited to the facts stated in the petition. The petition shall be executed subject to the penalties of perjury but need not be sworn to before a notary public.

(b) The department of the attorney general shall assist with the preparation and filing of any petition brought pursuant to this section and any related court proceedings; provided that if the petitioner is a private provider or other private individual, the petitioner may decline the assistance.

[~~(b)~~] (c) The petition may be accompanied by a certificate of a licensed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who has examined the subject of the petition within twenty calendar days prior to the filing of the petition. For purposes of the petition, an examination shall be considered valid so long as the licensed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization has obtained enough information from the subject of the petition to reach a diagnosis of the subject of the petition, and to express a professional opinion concerning the same, even if the subject of the petition is not fully cooperative. If the petitioner believes that further evaluation is necessary before treatment, the petitioner may request further evaluation.

[~~(c)~~] (d) The petition shall include the name, address, and telephone number of at least one of the following persons in the following order of priority: the subject of the petition's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult children, or legal guardian, or if none can be found, the petition shall include the name, address, and telephone number of at least one of the subject's closest adult relatives, if any can be found."

SECTION 5. Act 221, Session Laws of Hawaii 2013, as amended by Act 114, Session Laws of Hawaii 2016, is amended by amending section 24 to read as follows:

"SECTION 24. This Act shall take effect on January 1, 2014; provided that:

(1) Petitions filed pursuant to section 334-123, Hawaii Revised Statutes, for assisted community treatment involving a designated mental health program that is a state-operated provider shall not be filed until after July 1, 2015;

(2) Any private provider wishing to file a petition pursuant to section 334-123, Hawaii Revised Statutes, for assisted community treatment may do so after January 1, 2014, [~~using its own resources,~~] if the petitioner is to be the designated mental health program; [~~and~~]

(3) Any interested party wishing to file a petition pursuant to section 334-123, Hawaii Revised Statutes, for assisted community treatment may do so after January 1, 2014, [~~using the party's own resources,~~] if the designated mental health program is a private provider[.]; and

(4) The department of the attorney general shall assist with the preparation and filing of any petition brought pursuant to section 334-123, Hawaii Revised Statutes, and the related court proceedings; provided that if the petitioner is a private provider or any other private individual, the interested party may decline the assistance."

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $100,000 or so much thereof as may be necessary for fiscal year 2023-2024 for the department of health to procure software and prepare the department's website for data collection and publication of data regarding reports of and responses to mental health crises.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 7. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 8. This Act shall take effect on July 1, 2023.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	1503
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII