HOUSE OF REPRESENTATIVES
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO MENTAL HEALTH.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
Mental health EXAMINATION
SECTION 1. The legislature finds that law enforcement officers are sometimes restricted in discharging their sworn duties due to constraints imposed by the federal courts and the judiciary over constitutional concerns.
The legislature also finds that psychiatric facilities licensed by the director of health lack a sufficient number of licensed physicians practicing psychiatry and clinical psychologists. This shortage is a barrier to addressing the increasing number of people in the state that pose an imminent danger to themselves or others or are obviously mentally ill and behaving in a manner deemed disorderly.
The purpose of this Act is to allow law enforcement officers to take into custody persons who are apparently mentally ill and behaving in a manner which in a mentally well person would be disorderly and remove unnecessary procedures established by the director of health which are used to determine if a person is an imminent danger to self or to others.
SECTION 2. Section 334-59, Hawaii Revised Statutes, is amended to read as follows:
"§334-59 Emergency examination and hospitalization. (a) Initiation of proceedings. An emergency admission may be initiated as follows:
a law enforcement officer has reason to believe that a person is imminently
dangerous to self or others[
, the officer shall call for assistance from the
mental health emergency workers designated by the director. Upon determination by the mental health
emergency workers that the person is imminently dangerous to self or others,]
or if the person is apparently mentally ill and conducting oneself in a
manner which in a mentally well person would be disorderly, the person
shall be transported by ambulance or other suitable means, to a licensed
psychiatric facility for further evaluation and possible emergency
hospitalization. A law enforcement
officer may also take into custody and transport to any facility designated by
the director any person threatening or attempting suicide. The officer shall make application for the
examination, observation, and diagnosis of the person in custody. The application shall state or shall be
accompanied by a statement of the circumstances under which the person was
taken into custody and the reasons therefor which shall be transmitted with the
person to a physician practicing
practice registered nurse, or
(2) Upon written or oral application of any licensed physician, advanced practice registered nurse, psychologist, attorney, member of the clergy, health or social service professional, or any state or county employee in the course of employment, a judge may issue an ex parte order orally, but shall reduce the order to writing by the close of the next court day following the application, stating that there is probable cause to believe the person is mentally ill or suffering from substance abuse, is imminently dangerous to self or others and in need of care or treatment, or both, giving the findings upon which the conclusion is based. The order shall direct that a law enforcement officer or other suitable individual take the person into custody and deliver the person to a designated mental health program, if subject to an assisted community treatment order issued pursuant to part VIII of this chapter, or to the nearest facility designated by the director for emergency examination and treatment, or both. The ex parte order shall be made a part of the patient's clinical record. If the application is oral, the person making the application shall reduce the application to writing and shall submit the same by noon of the next court day to the judge who issued the oral ex parte order. The written application shall be executed subject to the penalties of perjury but need not be sworn to before a notary public.
(3) Any licensed physician, advanced practice registered nurse, physician assistant, or psychologist who has examined a person and has reason to believe the person is:
(A) Mentally ill or suffering from substance abuse;
(B) Imminently dangerous to self or others; and
(C) In need of care or treatment;
may direct transportation, by ambulance or other suitable means, to a licensed psychiatric facility for further evaluation and possible emergency hospitalization. A licensed physician, an advanced practice registered nurse, or physician assistant may administer treatment as is medically necessary, for the person's safe transportation. A licensed psychologist may administer treatment as is psychologically necessary.
(b) Emergency examination. A patient who is delivered for emergency examination and treatment to a facility designated by the director shall be examined by a licensed physician practicing psychiatry, advanced practice registered nurse or clinical psychologist without unnecessary delay and may be given such treatment as is indicated by good medical practice. A psychiatrist, advanced practice registered nurse or clinical psychologist may further examine the patient to diagnose the presence or absence of a mental disorder, assess the risk that the patient may be dangerous to self or others, and assess whether or not the patient needs to be hospitalized.
Release from emergency examination.
If the physician practicing psychiatry, advanced practice
registered nurse or clinical psychologist who performs the emergency
in consultation with a psychologist if applicable,]
concludes that the patient need not be hospitalized, the patient shall be
discharged immediately unless the patient is under criminal charges, in which
case the patient shall be returned to the custody of a law enforcement officer.
(d) Emergency hospitalization. If the physician[
psychiatry, advanced practice registered nurse or clinical
psychologist 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;
,] practicing psychiatry, advanced practice registered
nurse or clinical psychologist may 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 physician concludes that the patient no longer meets the criteria
for emergency hospitalization the physician shall 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 be released
forty-eight] seventy-two hours of the patient’s
admission, 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
TEMPORARY RESTRAINING ORDER DATABASE
SECTION 3. The legislature finds that law enforcement officers do not have sufficient access to a suspect's temporary restraining orders and past interactions with law enforcement. Providing law enforcement with the ability to access records regarding temporary restraining orders can provide insight into a subject's history, potential mental health issues, and propensity for violence. This lack of knowledge results in law enforcement officers being unable to properly assess the subject of a 911 call in order to properly prepare for an encounter with an alleged suspect.
The purpose of this Act is to establish a state wide temporary restraining order database within the judiciary that catalogs a person's temporary restraining orders which can be accessed by state and county law enforcement officers.
SECTION 4. Chapter 586-4, Hawaii Revised Statutes, is amended by adding a section to be appropriately designated to read as follows:
"§586-4— Temporary restraining order database. (a) There is established within the judiciary, the state wide temporary restraining order database, responsible for providing the department of attorney general access to all current and expired temporary restraining orders for individuals in the state."
PUBLIC PSYCHIATRIC BEDS
SECTION 5. The legislature finds that a minimum of 50 beds per 100,000 people is considered necessary to provide minimally adequate treatment for individuals with severe mental illness. Hawaii fails to meet this minimum standard. In order to better help those with severe mental illness and to better protect the citizens of Hawaii, we must restore a sufficient number of beds to create access to inpatient care for qualifying individuals in crisis and to stop eliminating public psychiatric beds.
The purpose of this Act is to appropriate funds to the department of health to:
(1) Plan, design, construct, and equip new licensed psychiatric facilities; and
(2) Expand current licensed psychiatric facilities.
SECTION 6. The director of finance is authorized to issue general obligation bonds in the sum of $50,000,000 or so much thereof as may be necessary and the same sum or so much thereof as may be necessary is appropriated for fiscal year 2020-2021 for the purpose of financing capital improvement projects for the planning, design, construction of, and equipment for new or existing licensed psychiatric facilities.
SECTION 7. The sum appropriated for the capital improvement projects set forth in section 6 of this Act shall be expended by the department of health for the purposes of this Act.
SECTION 8. The appropriation made for the capital improvement projects authorized by this Act shall not lapse at the end of the fiscal biennium for which the appropriation is made; provided that all moneys from the appropriation unencumbered as of June 30, 2022, shall lapse as of that date.
EMERGENCY EXAMINATION AND HOSPITALIZATION SUBSIDY PROGRAM
SECTION 9. The director of health shall establish an emergency examination and hospitalization subsidy program within the department of health for the purpose of recruiting, retaining, and subsidizing the salaries of licensed physicians practicing psychiatry and clinical psychologists employed by licensed psychiatric facilities.
SECTION 10. The director of health shall adopt rules, pursuant to chapter 91, necessary for the purposes of section 9.
SECTION 11. The director of health shall submit a report of the status of the emergency examination and hospitalization subsidy program, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2021.
SECTION 12. There is appropriated out of the general revenues of the State of Hawaii the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2020-2021 for the emergency examination and hospitalization subsidy program.
The sum appropriated shall be expended by the department of health for the purposes of this Act.
13. Statutory material to be repealed is
bracketed and stricken. New statutory
material is underscored.
SECTION 14. This Act shall take effect upon its approval, provided that section 2 shall take effect on January 1, 2021, and sections 6, 7, 8, and 12 shall take effect on July 1, 2020.
Mental Health Examinations; Facilities; Appropriations
Amends emergency mental health examination procedures, creates TRO database, appropriates funds for additional mental health care facilities, appropriates funds to licensed psychiatric facilities to recruit and retain personnel and subsidize salaries.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.