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-operated or funded psychiatric facility in order to alleviate mental illness and restore competency while protecting the rights of patients. Sunsets after five years. Requires report after three years. (SD1)

 

THE SENATE

S.B. NO.

2091

TWENTY-SECOND LEGISLATURE, 2004

S.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:

SECTION 1. The legislature finds that mental health patients deserve the same degree of personal autonomy as other citizens when they receive services. This includes participating in the decision-making process regarding their own treatment. However, there are very limited circumstances when involuntary treatment is appropriate only for a very small subset of people with mental illness, and then only if the person is at imminent risk of danger to themselves or others.

The purpose of this Act is to authorize the department of health to adopt administrative rules to establish an administrative process allowing involuntary medication of certain psychiatric patients institutionalized at the Hawaii state hospital in order to alleviate mental illness and restore competency while protecting the rights of patients.

SECTION 2. Chapter 334, Hawaii Revised Statutes, is amended by adding a new section to part IV to be appropriately designated and to read as follows:

"ß334-   Involuntary treatment with psychiatric medication. (a) The department shall adopt rules in accordance with chapter 91 to enable interdisciplinary clinical review panels to authorize the involuntary administration of psychiatric medication for appropriate patients committed to:

(1) The state-operated or funded psychiatric facility for involuntary hospitalization pursuant to this chapter;

(2) The state-operated or funded psychiatric facility for examination with respect to physical or mental disease, disorder, or defect pursuant to section 704-404;

(3) The custody of the director and placed in the state-operated or funded psychiatric facility for detention, care, and treatment pursuant to section 704-406;

(4) The custody of the director and placed in the state-operated or funded psychiatric facility for custody, care, and treatment pursuant to section 704-411; or

(5) The custody of the director and placed in the state-operated or funded psychiatric facility pursuant to section 704-413(3).

(b) The rules shall:

(1) Permit involuntary administration of psychiatric medication only when medically appropriate;

(A) Considering less intrusive alternatives, essential for the safety of the individual or the safety of others; or

(B) In the case of individuals placed in the state-operated or funded psychiatric facility pursuant to sections 704-404 or 704-406, when treatment is necessary to restore fitness to proceed with prosecution; and

(2) Include an appeals process to a second body, appointed by the director, whose decision shall be deemed the final administrative decision.

(c) The final decision in the administrative process may be appealed to the circuit court within fourteen days.

(d) The administrative process established under the rules adopted under subsection (a) shall not be construed as a contested case under chapter 91."

SECTION 3. Section 334E-2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) Any patient in a psychiatric facility shall be afforded rights; and any psychiatric facility shall provide the rights to all patients; provided that when a patient is not able to exercise the patientís rights, the patientís legal guardian or legal representative shall have the authority to exercise the same on behalf of the patient. The rights shall include, but not be limited to, the following:

(1) Access to written rules and regulations with which the patient is expected to comply;

(2) Access to the facilityís grievance procedure or to the department of health as provided in section 334-3;

(3) Freedom from reprisal;

(4) Privacy, respect, and personal dignity;

(5) A humane environment;

(6) Freedom from discriminatory treatment based on race, color, creed, national origin, age, and sex;

(7) A written treatment plan based on the individual patient;

(8) Participation in the planning of the patientís treatment plan;

(9) Refusal of treatment except in emergency situations or where a court order or administrative authorization pursuant to section 334-   exists;

(10) Refusal to participate in experimentation;

(11) The choice of physician if the physician chosen agrees;

(12) A qualified, competent staff;

(13) A medical examination before initiation of non-emergency treatment;

(14) Confidentiality of the patientís records;

(15) Access to the patientís records;

(16) Knowledge of rights withheld or removed by a court or by law;

(17) Physical exercise and recreation;

(18) Adequate diet;

(19) Knowledge of the names and titles of staff members with whom the patient has frequent contact;

(20) The right to work at the facility and fair compensation for work done; provided that work is available and is part of the patientís treatment plan;

(21) Visitation rights, unless the patient poses a danger to self or others; provided that where visitation is prohibited, the legal guardian or legal representative shall be allowed to visit the patient upon request;

(22) Uncensored communication;

(23) Notice of and reasons for an impending transfer;

(24) Freedom from seclusion or restraint, except:

(A) When necessary to prevent injury to self or others; or

(B) When part of the treatment plan; or

(C) When necessary to preserve the rights of other patients or staff;

(25) Disclosure to a court, at an involuntary civil commitment hearing, of all treatment procedures which have been administered prior to the hearing;

(26) Receipt by the patient and the patientís guardian or legal guardian, if the patient has one, of this enunciation of rights at the time of admission."

SECTION 4. The department of health shall submit a report on the operation and effect of this Act to the legislature at least twenty days prior to the convening of the 2007 legislative session.

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval and shall be repealed on June 30, 2009; provided that section 334E-2(a), Hawaii Revised Statutes, shall be reenacted in the form in which it read on the day before the approval of this Act.