SB1492 HD2

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

Accordingly, the purpose of this Act is to:

(1) Require and appropriate funds for the department of health to track and publicly report data relating to crisis reports, emergency mental health transports, and court-ordered treatments;

(2) Require the department of health, or a contracted service provider, to review reports about persons having severe mental illnesses who need assistance; assess whether the person may fulfill the criteria for assisted community treatment; and, if the person meets the criteria, coordinate the process for an assisted community treatment order;

(3) Establish that a court's denial of a petition for involuntary commitment shall serve as notification to the department of health that the person should be evaluated for assisted community treatment;

(4) Require 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; and

(5) Appropriate funds to the department of health to develop and implement statewide media, education, and training activities for policies related to emergency examination and hospitalization and assisted community treatment for those in need of mental health intervention.

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-A Data concerning persons experiencing a mental health crisis; reports. (a) The department shall track data on reports of persons experiencing a mental health crisis and the response to these persons by the department, service providers contracted by the department pursuant to section 334-B(d), or another department or private provider coordinating with the department pursuant to section 334-B(a).

(b) The department shall publish a report on the department's website on the data collected pursuant to subsection (a). The reports shall be updated at least monthly and shall include the number of:

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

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

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

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

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

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

(c) Every licensed physician; psychiatrist; psychologist; advanced practice registered nurse with prescriptive authority who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization; hospital; psychiatric facility; or petitioner for an order for involuntary hospitalization, authorization for treatment over the patient's objection, or order for assisted community treatment shall provide the information tracked under this section to the department; provided that the persons or entities involved may coordinate among each other to provide a single report of the event to the department. The reports and information shall be submitted to the department in the manner, time, and form prescribed by the department."

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

"§334-B Department response to crisis reports. (a) When the department receives credible information that a person having a severe mental illness requires assistance, the department shall dispatch staff to assist the person. The department may coordinate the response with other departments or private providers 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 service providers.

(b) While assisting a person pursuant to subsection (a), the department staff or responder from another department or private provider coordinating with the department shall assess whether the person meets the criteria for assisted community treatment pursuant to section 334-121. If, upon assessment, the department reasonably believes that the person meets the criteria for assisted community treatment, the department shall coordinate:

(1) Completion of an examination pursuant to section 334-121.5;

(2) Preparation of a certificate specified by section 334-123; and

(3) Filing, with assistance from the department of the attorney general, a petition for an assisted community treatment order pursuant to section 334-123;

provided that the certificate and petition shall not be required if an assisted community treatment order is not indicated by the examination; provided further that the examination, certificate preparation, and filing of the petition may be completed by the department or by another department or private provider coordinating with the department pursuant to subsection (a), in which case the department shall not be required to be the petitioner.

(c) Notwithstanding subsection (b), if the department is unable to coordinate the process for an assisted community treatment order, the department may notify another mental health program for the coordination of care in the community for the person.

(d) The department may contract with a service provider to fulfill the requirements of this section."

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. Within twenty-four hours of the denial of a petition for involuntary commitment, the court shall provide notice to the department of the petition's denial, which shall serve as notification to the department that the individual should be assessed for assisted community treatment. If, upon assessment, the department reasonably believes the individual meets the criteria for assisted community treatment, the department shall coordinate the completion of an evaluation, preparation of a certificate, and filing of a petition pursuant to section 334-B(b)."

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) After July 1, 2023, 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 any related court proceedings; provided further that if the petitioner is a private provider or other private individual, the petitioner may decline the assistance."

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 for:

(1) Procurement of software;

(2) Preparation of the department's website for data collection and publication of data reports regarding responses to mental health crises;

(3) full-time equivalent ( FTE) coordinator position;

(4) full-time equivalent ( FTE) data position; and

(5) full-time equivalent ( FTE) epidemiologist position.

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

SECTION 7. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2023-2024 and the same sum or so much thereof as may be necessary for fiscal year 2024-2025 for the development and implementation of statewide media, education, and training activities for policies related to emergency examination and hospitalization and assisted community treatment for those in need of mental health intervention.

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

SECTION 8. In codifying the new sections added by section 2 of this Act, the revisor of statutes shall substitute appropriate section numbers for the letters used in designating the new sections in this Act.

SECTION 9. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 10. This Act shall take effect on June 30, 3000.

THE SENATE	S.B. NO.	1492
THIRTY-SECOND LEGISLATURE, 2023		S.D. 2
STATE OF HAWAII		H.D. 2