HOUSE OF REPRESENTATIVES
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
Section 1. The legislature finds that a comprehensive mental health response system is needed to serve the dual purposes of supporting individuals suffering from a behavioral health crisis and maintaining public safety. The legislature further finds that the system has multiple steps for mental health crisis intervention, including initial contact by first responders, determining need and basis for involuntary transport for evaluation, and determination for disposition once an individual has been taken into custody under an MH-1.
The legislature further finds that the department of health, along with a wide range of stakeholder partners, including the legislature, has been actively evaluating and restructuring the mental health crisis response system through the task force and working group of Act 90 and Act 263, Session Laws of Hawaii 2019.
The purpose of this Act is to support the efforts of the mental health task force by amending chapter 334, Hawaii Revised Statutes, to further define and guide the process that occurs when an individual has been transported to an emergency room or behavioral health crisis center under an MH-1 order for evaluation and the disposition of the individual once the evaluation has been completed.
SECTION 2. Section 334-59, Hawaii Revised Statutes, is amended by amending subsections (b) to (e) to read as follows:
"(b) Emergency examination. A patient who is delivered for emergency
examination and treatment to a psychiatric facility [
the director] or a behavioral health crisis center specifically designed
and staffed to provide care, diagnosis, or treatment for persons in crisis who
are experiencing a mental illness or substance use disorder shall be [ examined]
provided an examination, which shall include a screening to determine
whether the criteria for involuntary hospitalization listed in section 334-602
persists, by a licensed physician, medical resident under the
supervision of a licensed physician, or advanced practice registered nurse without
unnecessary delay, and [ may] shall be [ given] provided
such treatment as is indicated by good [ medical] mental health
practice. [ A] If, after the
examination, screening, and treatment, the licensed physician, medical resident
under the supervision of a licensed physician, or advanced practice registered
nurse determines that the involuntary hospitalization criteria persist, then a
psychiatrist[ ,] or an advanced practice registered nurse[ , or
psychologist may] who has prescriptive authority and who holds an
accredited national certification in an advanced practice registered nurse
psychiatric specialization shall further examine the patient to
diagnose the presence or absence of a mental or substance use disorder, further
assess the risk that the patient may be dangerous to self or others, and assess
whether or not the patient needs to be hospitalized. If it is determined that hospitalization
is not needed, an evaluation pursuant to section 334-121.5 shall be completed.
Release from emergency examination.
If, after examination, the licensed physician [
psychiatrist, advanced practice registered nurse, or advanced practice
registered nurse who has prescriptive authority and who holds an accredited
national certification in an advanced practice registered nurse psychiatric
specialization [ who performs the emergency examination, in consultation
with a psychologist if applicable, concludes] determines that [ the
patient need not be hospitalized,] imminent danger to self or others
does not exist or persist and the evaluation pursuant to section 334-121.5,
where required, has been completed, the patient shall be discharged [ immediately]
expediently unless the patient is under criminal charges, in which case
the patient shall be returned to the custody of a law enforcement officer.
Emergency hospitalization. If the
physician,] psychiatrist or advanced practice registered nurse[ ,
or psychologist] who has prescriptive authority and who holds an
accredited national certification in an advanced practice registered nurse
psychiatric specialization who performs the emergency examination has
reason to believe that the patient is:
(1) Mentally ill or suffering from substance abuse;
dangerous to self or others; [
(3) In need of care or
, or both]; or
(4) All of the above,
physician,] psychiatrist or
advanced practice registered nurse[ , or psychologist may] who has
prescriptive authority and who holds an accredited national certification in an
advanced practice registered nurse psychiatric specialization shall direct
that the patient be hospitalized on an emergency basis or cause the patient to
be transferred to another psychiatric facility for emergency hospitalization,
or both. The patient shall have the
right immediately upon admission to telephone the patient's guardian or a family
member including a reciprocal beneficiary, or an adult friend and an
attorney. If the patient declines to
exercise that right, the staff of the facility shall inform the adult patient
of the right to waive notification to the family including a reciprocal
beneficiary, and shall make reasonable efforts to ensure that the patient's
guardian or family including a reciprocal beneficiary, is notified of the
emergency admission but the patient's family including a reciprocal
beneficiary, need not be notified if the patient is an adult and requests that
there be no notification. The patient
shall be allowed to confer with an attorney in private.
Release from emergency hospitalization. If at any time during the period of emergency
hospitalization the [
responsible] treating physician [ concludes]
determines that the patient no longer meets the criteria for emergency
hospitalization and the evaluation pursuant to section 334-121.5 has been
completed, the physician shall expediently discharge the
patient. If the patient is under
criminal charges, the patient shall be returned to the custody of a law
enforcement officer. In any event, the
patient [ must] shall be released within forty-eight hours of the
patient's admission to a licensed psychiatric facility, unless the
patient voluntarily agrees to further hospitalization, or a proceeding for
court-ordered evaluation or hospitalization, or both, is initiated as provided
in section 334-60.3. If that time
expires on a Saturday, Sunday, or holiday, the time for initiation is extended
to the close of the next court day. Upon
initiation of the proceedings, the facility shall be authorized to
detain the patient until further order of the court."
SECTION 3. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect on July 1, 2050.
Amends Criteria for Emergency Examination, Release from Emergency Examination, Emergency Hospitalization, Release from Emergency Hospitalization; Individuals with Behavioral Health Crisis
Amends criteria for emergency examination, release from emergency examination, emergency hospitalization, and release from emergency hospitalization for individuals suffering from a behavioral health crisis. Takes effect 7/1/2050. (HD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.