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REPORT TITLE:
Involuntary Medication


DESCRIPTION:
Authorizes DOH to adopt administrative rules to establish an
administrative process allowing involuntary medication of
psychiatric patients institutionalized at the Hawaii State
Hospital in order to alleviate mental illness and restore
competency while protecting the rights of patients.  (SB1032 HD1)

 
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THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                H.D. 1
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO INVOLUNTARY PSYCHIATRIC TREATMENT.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The purpose of this Act is to authorize the
 
 2 Department of Health to adopt administrative rules to establish
 
 3 an administrative process allowing involuntary medication of
 
 4 psychiatric patients institutionalized at the Hawaii State
 
 5 Hospital in order to alleviate mental illness and restore
 
 6 competency while protecting the rights of patients.
 
 7      SECTION 2.  Chapter 334, Hawaii Revised Statutes, is amended
 
 8 by adding a new section to be appropriately designated and to
 
 9 read as follows:
 
10      "334-    Involuntary treatment with psychiatric medication.
 
11 (a)  The department shall adopt rules in accordance with chapter
 
12 91 to enable interdisciplinary clinical review panels to
 
13 authorize the involuntary administration of psychiatric
 
14 medication for appropriate patients committed to:
 
15      (1)  The state hospital established pursuant to section 334-
 
16           31 for involuntary hospitalization pursuant to this
 
17           chapter;
 
18      (2)  The state hospital for examination with respect to
 
19           physical or mental disease, disorder, or defect
 
20           pursuant to section 704-404;
 

 
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 1      (3)  The custody of the director and placed in the state
 
 2           hospital for detention, care, and treatment pursuant to
 
 3           section 704-406;
 
 4      (4)  The custody of the director and placed in the state
 
 5           hospital for custody, care, and treatment pursuant to
 
 6           section 704-411; or
 
 7      (5)  The custody of the director and placed in the state
 
 8           hospital pursuant to section 704-413(3).
 
 9      (b)  The rules shall:
 
10      (1)  Permit involuntary administration of psychiatric
 
11           medication only when medically appropriate; and
 
12           (A)  Considering less intrusive alternatives, essential
 
13                for the safety of the individual or the safety of
 
14                others; and
 
15           (B)  In the case of individuals placed in the state
 
16                hospital pursuant to section 704-404 or 704-406,
 
17                when treatment is necessary to obtain an
 
18                adjudication of the individual's guilt or
 
19                innocence;
 
20           and
 
21      (2)  Include an appeals process to a second body, appointed
 
22           by the director, whose decision shall be deemed the
 
23           final administrative decision.
 

 
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 1      (c)  The final decision in the administrative process may be
 
 2 appealed to the circuit courts within fourteen days.
 
 3      (d)  The administrative process established under the rules
 
 4 adopted under subsection (a) shall not be construed as a
 
 5 contested case under chapter 91."
 
 6      SECTION 3.  Section 334E-2, Hawaii Revised Statues, is
 
 7 amended by amending subsection (a) to read as follows:
 
 8      "(a)   Any patient in a psychiatric facility shall be
 
 9 afforded rights; and any psychiatric facility shall provide the
 
10 rights to all patients; provided that when a patient is not able
 
11 to exercise the patient's rights, the patient's legal guardian or
 
12 legal representative shall have the authority to exercise the
 
13 same on behalf of the patient.  The rights shall include, but not
 
14 be limited to, the following:
 
15      (1)  Access to written rules and regulations with which the
 
16           patient is expected to comply;
 
17      (2)  Access to the facility's grievance procedure or to the
 
18           department of health as provided in section 334-3;
 
19      (3)  Freedom from reprisal;
 
20      (4)  Privacy, respect, and personal dignity;
 
21      (5)  A humane environment;
 
22      (6)  Freedom from discriminatory treatment based on race,
 
23           color, creed, national origin, age, and sex;
 

 
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 1      (7)  A written treatment plan based on the individual
 
 2           patient;
 
 3      (8)  Participation in the planning of the patient's
 
 4           treatment plan;
 
 5      (9)  Refusal of treatment except in emergency situations or
 
 6           where a court order or administrative authorization
 
 7           pursuant to section 334-   exists;
 
 8     (10)  Refusal to participate in experimentation;
 
 9     (11)  The choice of physician if the physician chosen agrees;
 
10     (12)  A qualified, competent staff;
 
11     (13)  A medical examination before initiation of non-
 
12           emergency treatment;
 
13     (14)  Confidentiality of the patient's records;
 
14     (15)  Access to the patient's records;
 
15     (16)  Knowledge of rights withheld or removed by a court or
 
16           by law;
 
17     (17)  Physical exercise and recreation;
 
18     (18)  Adequate diet;
 
19     (19)  Knowledge of the names and titles of staff members with
 
20           whom the patient has frequent contact;
 
21     (20)  The right to work at the facility and fair compensation
 
22           for work done; provided that work is available and is
 
23           part of the patient's treatment plan;
 

 
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 1     (21)  Visitation rights, unless the patient poses a danger to
 
 2           self or others; provided that where visitation is
 
 3           prohibited, the legal guardian or legal representative
 
 4           shall be allowed to visit the patient upon request;
 
 5     (22)  Uncensored communication;
 
 6     (23)  Notice of and reasons for an impending transfer;
 
 7     (24)  Freedom from seclusion or restraint, except:
 
 8           (A)  When necessary to prevent injury to self of
 
 9                others; or
 
10           (B)  When part of the treatment plan; or
 
11           (C)  When necessary to preserve the rights of other
 
12                patients or staff;
 
13     (25)  Disclosure to a court, at an involuntary civil
 
14           commitment hearing, of all treatment procedures which
 
15           have been administered prior to the hearing; and
 
16     (26)  Receipt by the patient and the patient's guardian or
 
17           legal guardian, if the patient has one, of this
 
18           enunciation of rights at the time of admission."
 
19      SECTION 4.  New statutory material is underscored.
 
20      SECTION 5.  This Act shall take effect upon its approval.
 

 
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