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 crisis 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 mental health crisis response 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 established by 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 and working group 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 who are
experiencing a mental illness or substance use disorder crisis shall be [ examined]
provided an examination, which shall include a screening to determine
whether the criteria for involuntary hospitalization listed in section 334-60.2
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, a psychologist, 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 illness 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 examination pursuant to section 334-121.5 shall be completed.
Release from emergency examination.
If, after examination, the licensed physician [
psychiatrist, or advanced practice registered nurse [ who performs the
emergency examination, in consultation with a psychologist if applicable,
concludes] with prescriptive authority and who holds an accredited
national certification in an advanced practice registered nurse psychiatric
specialization determines that [ the patient need not be hospitalized,]
the involuntary hospitalization criteria set forth in section 334-60.2 are
not met or do not persist and the examination 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, psychologist, or advanced practice
registered nurse[ , or psychologist] with 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;
(2) Imminently dangerous to self or others; and
(3) In need of care or treatment, or both;
psychologist, or advanced practice registered nurse[ , or psychologist
may] with 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 examination 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.
Emergency Examinations; Emergency Hospitalizations; 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. Effective 7/1/2050. (HD3)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.