16 | 18 | | Relating to the Alabama Department of Mental Health; to |
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17 | 19 | | amend Sections 22-52-1.1, 22-52-1.2, 22-52-3, 22-52-7, |
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18 | 20 | | 22-52-10.1, as last amended by Act 2023-472 of the 2023 |
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19 | 21 | | Regular Session, 22-52-10.2, 22-52-10.4, 22-52-10.11, and |
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20 | 22 | | 22-52-11 of the Code of Alabama 1975; to authorize a judge of |
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21 | 23 | | probate to involuntarily commit an individual who suffers from |
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22 | 24 | | a substance use disorder that occurs secondarily to a primary |
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23 | 25 | | diagnosis of one or more mental illnesses; to provide for a |
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24 | 26 | | change in jurisdiction of the sheriff who is required to serve |
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25 | 27 | | the commitment petition on the respondent; to authorize the |
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26 | 28 | | judge of probate to establish a procedure for placing |
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27 | 29 | | limitations on the respondent's liberty, if any, pending a |
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28 | 30 | | final hearing; to allow the judge of probate to determine the |
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29 | 31 | | appropriate medical evaluation process, if any, for the |
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30 | 32 | | respondent prior to final hearing; and to add Section 15-16-26 |
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31 | 33 | | to the Code of Alabama 1975, to provide a process for the |
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32 | 34 | | committing judge of probate to seek relief for the respondent |
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33 | 35 | | from temporary criminal confinement, under certain |
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34 | 36 | | circumstances, to fulfill a pending commitment order; and to |
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35 | 37 | | provide that mental health providers are not required to |
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70 | 72 | | 22-52-7, 22-52-10.1, as last amended by Act 2023-472, of the |
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71 | 73 | | 2023 Regular Session, 22-52-10.2, 22-52-10.4, 22-52-10.11 and |
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72 | 74 | | 22-52-11, Code of Alabama 1975, are amended to read as |
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73 | 75 | | follows: |
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74 | 76 | | "§22-52-1.1 |
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75 | 77 | | (a) When used in this article, the following terms |
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76 | 78 | | shall have the following meanings, respectively, unless the |
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77 | 79 | | context clearly indicates otherwise: |
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78 | 80 | | (1) COMMISSIONER. The Commissioner of the Alabama State |
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79 | 81 | | Department of Mental Health. |
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80 | 82 | | (2) CO-OCCURRING SUBSTANCE USE DISORDER. A substance |
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81 | 83 | | use disorder that occurs secondarily to a primary diagnosis of |
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82 | 84 | | one or more mental illnesses. |
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83 | 85 | | (2)(3) DEPARTMENT. The Alabama State Department of |
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84 | 86 | | Mental Health. |
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85 | 87 | | (3)(4) DESIGNATED MENTAL HEALTH FACILITY. A mental |
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86 | 88 | | health facility, other than a state mental health facility, |
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87 | 89 | | which is designated by the State Department of Mental Health |
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88 | 90 | | to receive individuals for evaluation, examination, admission, |
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89 | 91 | | detention, or treatment pursuant to this article. |
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90 | 92 | | (4)(5) INPATIENT TREATMENT. Treatment being provided to |
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91 | 93 | | an individual at a state mental health facility or a |
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92 | 94 | | designated mental health facility which has been specifically |
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93 | 95 | | designated by the department for inpatient treatment. |
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128 | 130 | | behavior, capacity to recognize reality, or ability to cope |
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129 | 131 | | with the ordinary demands of life ., or a diagnosis designated |
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130 | 132 | | as a Serious Mental Illness (SMI), as defined in the then |
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131 | 133 | | current edition of the Diagnostic and Statistical Manual of |
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132 | 134 | | Mental Disorders. The term specifically excludes the primary |
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133 | 135 | | diagnosis of epilepsy , a substance use disorder , an |
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134 | 136 | | intellectual disability, substance abuse, including |
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135 | 137 | | alcoholism, or a developmental disability. |
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136 | 138 | | (7)(8) OUTPATIENT TREATMENT. Treatment being provided |
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137 | 139 | | to an individual in a nonresidential setting who is not |
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138 | 140 | | admitted for 24-hour-a-day care. |
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139 | 141 | | (8)(9) REAL AND PRESENT THREAT OF SUBSTANTIAL HARM TO |
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140 | 142 | | SELF OR OTHERS. A significant risk that an individual who is |
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141 | 143 | | exhibiting behavior consistent with a mental illness, as a |
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142 | 144 | | result of the mental illness, will do either of the following: |
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143 | 145 | | a. By action or inaction, cause, allow, or inflict |
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144 | 146 | | serious bodily harm upon himself, herself, or another |
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145 | 147 | | individual. |
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146 | 148 | | b. Be unable to satisfy his or her need for |
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147 | 149 | | nourishment, medical care, shelter, or self-protection so that |
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148 | 150 | | there is a substantial likelihood of death, serious bodily |
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149 | 151 | | harm, serious physical debilitation, serious mental |
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150 | 152 | | debilitation, or life-threatening disease. |
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151 | 153 | | (9)(10) RESPONDENT. An individual for whom a petition |
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186 | 188 | | (12) SUBSTANCE USE DISORDER. A cluster of cognitive, |
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187 | 189 | | behavioral, and physiological symptoms indicating that the |
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188 | 190 | | individual continues using a substance despite significant |
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189 | 191 | | substance-related problems, such as impaired control, social |
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190 | 192 | | impairment, risky behaviors, and pharmacological tolerance and |
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191 | 193 | | withdrawal. |
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192 | 194 | | (b) The Legislature finds for purposes of this article |
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193 | 195 | | substance use disorder is commonly associated with mental |
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194 | 196 | | illness and providers who provide these services serve a |
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195 | 197 | | public purpose." |
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196 | 198 | | "§22-52-1.2 |
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197 | 199 | | (a) Any person individual may file a petition seeking |
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198 | 200 | | the involuntary commitment of another personindividual. The |
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199 | 201 | | petition shall be filed in the probate court of the county in |
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200 | 202 | | which the respondent is located. The petition shall be in |
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201 | 203 | | writing, executed under oath, and shall include the following |
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202 | 204 | | information: |
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203 | 205 | | (1) The name and address, if known, of the respondent. |
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204 | 206 | | (2) The name and address, if known, of the respondent's |
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205 | 207 | | spouse, legal counsel, or next-of-kin. |
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206 | 208 | | (3) That the petitioner has reason to believe the |
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207 | 209 | | respondent is mentally ill or is mentally ill with a secondary |
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208 | 210 | | diagnosis of co-occurring substance use disorder . |
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209 | 211 | | (4) That the beliefs of the petitioner are based on |
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244 | 246 | | or mental illness with a secondary diagnosis of co-occurring |
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245 | 247 | | substance use disorder who may be called as witnesses. |
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246 | 248 | | The petition may be accompanied by any other relevant |
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247 | 249 | | information. |
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248 | 250 | | (b) The home address and the telephone number of the |
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249 | 251 | | petitioner shall be excluded from the copy of the petition |
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250 | 252 | | seeking the involuntary commitment provided to the respondent, |
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251 | 253 | | however, if there is no other available address to contact the |
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252 | 254 | | petitioner, then the home address of the petitioner shall be |
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253 | 255 | | provided." |
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254 | 256 | | "§22-52-3 |
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255 | 257 | | When any petition has been filed seeking the |
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256 | 258 | | involuntary commitment of a respondent and such the petition |
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257 | 259 | | has been reviewed by the probate judgejudge of probate , the |
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258 | 260 | | probate judgejudge of probate shall order the sheriff of the |
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259 | 261 | | county in which the respondent iswas located at the time of |
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260 | 262 | | the filing to serve a copy of the petition, together with a |
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261 | 263 | | copy of the order setting the petition for a hearing, upon the |
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262 | 264 | | respondent. SaidThe notice shall include the date, time and |
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263 | 265 | | place of the hearing; a clear statement of the purpose of the |
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264 | 266 | | proceeding and the possible consequences to the subject |
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265 | 267 | | thereof; the alleged factual basis for the proposed |
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266 | 268 | | commitment; a statement of the legal standards upon which |
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267 | 269 | | commitment is authorized; and a list of the names and |
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302 | 304 | | (a)(1) When a petition has been filed seeking to have |
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303 | 305 | | limitations placed upon the liberty of a respondent pending |
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304 | 306 | | the outcome of a final hearing on the merits, the probate |
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305 | 307 | | judge judge of probate shall order the sheriff of the county |
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306 | 308 | | in which the respondent iswas located at the time of the |
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307 | 309 | | filing to serve a copy of the petition upon the respondent and |
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308 | 310 | | to either bring the respondent before the judge of probate |
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309 | 311 | | probate judge instanter or be evaluated as provided in |
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310 | 312 | | subsection (2). |
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311 | 313 | | (2) When any respondent against whom a petition has |
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312 | 314 | | been filed seeking to have limitations placed upon the |
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313 | 315 | | respondent's liberty pending the outcome of a full and final |
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314 | 316 | | hearing on the merits is initially brought before the probate |
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315 | 317 | | judgejudge of probate , the probate judgejudge of probate shall |
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316 | 318 | | determine from an interview with the respondent and with other |
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317 | 319 | | available persons what limitations, if any, shall be imposed |
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318 | 320 | | upon the respondent's liberty and what temporary treatment, if |
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319 | 321 | | any, shall be imposed upon the respondent pending further |
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320 | 322 | | hearings. In making these determinations, the judge of probate |
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321 | 323 | | may also interview any other available individuals or officers |
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322 | 324 | | and may consult with or seek an evaluation by a licensed |
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323 | 325 | | medical physician or qualified mental health professional. If |
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324 | 326 | | limitations on the respondent's liberty are ordered, the |
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325 | 327 | | probate judgejudge of probate may order the respondent |
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360 | 362 | | unless such limitations are determined necessary by the judge |
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361 | 363 | | of probate to prevent the respondent from doing substantial |
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362 | 364 | | and immediate harm to himself or to others posing a real and |
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363 | 365 | | present threat of substantial harm to self or others or to |
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364 | 366 | | prevent the respondent from leaving the jurisdiction of the |
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365 | 367 | | court. No respondent shall be placed in a jail or other |
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366 | 368 | | facility for persons individuals accused of or convicted of |
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367 | 369 | | committing crimes. |
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368 | 370 | | (c) The probate judgejudge of probate shall order the |
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369 | 371 | | respondent to appear at the times and places set for hearing |
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370 | 372 | | the petition and may order the respondent to appear at |
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371 | 373 | | designated times and places to be examined by licensed medical |
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372 | 374 | | doctors or qualified mental health professionals. If the |
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373 | 375 | | respondent does not appear as ordered by the probate judge |
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374 | 376 | | judge of probate , or if the judge of probate determines it is |
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375 | 377 | | likely the respondent will not appear, the probate judgejudge |
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376 | 378 | | of probate may order the sheriff of the county in which the |
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377 | 379 | | respondent iswas located at the time of the filing to take the |
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378 | 380 | | respondent into custody and compel the respondent's attendance |
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379 | 381 | | as ordered by the probate judgejudge of probate . If temporary |
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380 | 382 | | treatment or admittance to a hospital is ordered for the |
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381 | 383 | | respondent, such the treatment shall be supervised by a |
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382 | 384 | | licensed medical doctor physician or qualified mental health |
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383 | 385 | | professional who has willingly consented to treat the |
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418 | 420 | | (a) If at the final hearing on a petition seeking to |
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419 | 421 | | involuntarily commit a respondent, the judge of probate finds, |
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420 | 422 | | based on clear and convincing evidence, that the respondent |
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421 | 423 | | meets the criteria for involuntary commitment, an order shall |
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422 | 424 | | be entered for either of the following: |
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423 | 425 | | (1) Outpatient treatment. |
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424 | 426 | | (2) Inpatient treatment. |
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425 | 427 | | (b) The least restrictive alternative necessary and |
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426 | 428 | | available for the treatment of the respondent's mental illness |
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427 | 429 | | or mental illness with a secondary diagnosis of co-occurring |
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428 | 430 | | substance use disorder shall be ordered. |
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429 | 431 | | (c) The petition for involuntary commitment shall be |
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430 | 432 | | dismissed if the criteria for commitment is not proved. |
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431 | 433 | | (d)(1) The judge of probate shall immediately report an |
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432 | 434 | | order for involuntary commitment to the Alabama State Law |
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433 | 435 | | Enforcement Agency, in a manner prescribed by the Alabama |
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434 | 436 | | Justice Information Commission, for entry into the state |
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435 | 437 | | firearms prohibited person database and the National Instant |
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436 | 438 | | Criminal Background Check (NICS) system. |
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437 | 439 | | (2) The judge of probate shall report to the Alabama |
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438 | 440 | | State Law Enforcement Agency, in a method determined by the |
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439 | 441 | | commission, updates to any order for involuntary commitment |
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440 | 442 | | that was previously forwarded to the Alabama State Law |
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441 | 443 | | Enforcement Agency under this section, including notice of any |
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476 | 478 | | convincing evidence, finds all of the following: |
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477 | 479 | | (1) The respondent has a mental illness or a mental |
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478 | 480 | | illness with a secondary diagnosis of co-occurring substance |
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479 | 481 | | use disorder. |
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480 | 482 | | (2) As a result of the mental illness , or mental |
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481 | 483 | | illness with secondary diagnosis of co-occurring substance use |
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482 | 484 | | disorder, the respondent, if not treated, will suffer mental |
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483 | 485 | | distress and experience deterioration of the ability to |
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484 | 486 | | function independently. |
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485 | 487 | | (3) The respondent is unable to maintain consistent |
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486 | 488 | | engagement with outpatient treatment on a voluntary basis, as |
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487 | 489 | | demonstrated by either of the following: |
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488 | 490 | | a. The respondent's actions occurring within the |
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489 | 491 | | two-year period immediately preceding the hearing. |
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490 | 492 | | b. Specific aspects of the respondent's clinical |
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491 | 493 | | condition that significantly impair the respondent's ability |
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492 | 494 | | to consistently make rational and informed decisions as to |
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493 | 495 | | whether to participate in treatment for mental illness. |
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494 | 496 | | (b) Upon a recommendation made by the designated mental |
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495 | 497 | | health facility currently providing outpatient treatment that |
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496 | 498 | | the respondent's outpatient commitment order should be |
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497 | 499 | | renewed, a probate court may enter an order to renew the |
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498 | 500 | | commitment order upon the expiration of time allotted for |
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499 | 501 | | treatment by the original outpatient treatment order if the |
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534 | 536 | | use disorder. |
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535 | 537 | | (2) As a result of the mental illness or mental illness |
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536 | 538 | | with a secondary diagnosis of co-occurring substance use |
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537 | 539 | | disorder, the respondent, if treatment is not continued, will |
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538 | 540 | | suffer mental distress and experience deterioration of the |
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539 | 541 | | ability to function independently. |
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540 | 542 | | (3) The respondent remains unable to maintain |
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541 | 543 | | consistent engagement with outpatient treatment on a voluntary |
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542 | 544 | | basis." |
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543 | 545 | | "§22-52-10.4 |
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544 | 546 | | (a) A respondent may be committed to inpatient |
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545 | 547 | | treatment if the judge of probate court, based upon clear and |
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546 | 548 | | convincing evidence, finds that all of the following are true: |
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547 | 549 | | (1) The respondent has a mental illness or a mental |
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548 | 550 | | illness with a secondary diagnosis of co-occurring substance |
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549 | 551 | | use disorder. |
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550 | 552 | | (2) As a result of the mental illness , or mental |
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551 | 553 | | illness with a secondary diagnosis of co-occurring substance |
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552 | 554 | | use disorder, the respondent poses a real and present threat |
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553 | 555 | | of substantial harm to self or others. |
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554 | 556 | | (3) The respondent, if not treated, will continue to |
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555 | 557 | | suffer mental distress and continue to experience |
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556 | 558 | | deterioration of the ability to function independently. |
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557 | 559 | | (4) The respondent is unable to make a rational and |
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592 | 594 | | treatment is presently available for the respondent's mental |
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593 | 595 | | illness or mental illness with a secondary diagnosis of |
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594 | 596 | | co-occurring substance use disorder , but that confinement is |
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595 | 597 | | necessary to prevent the respondent from causing substantial |
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596 | 598 | | harm to himself or herself or to others, the order committing |
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597 | 599 | | the respondent shall provide that, should treatment for the |
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598 | 600 | | respondent's mental illness or mental illness with a secondary |
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599 | 601 | | diagnosis of co-occurring substance use disorder become |
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600 | 602 | | available at any time during the period of the respondent's |
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601 | 603 | | confinement, the treatment shall be made available to him or |
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602 | 604 | | her immediately. |
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603 | 605 | | (c) In determining whether an individual poses a real |
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604 | 606 | | and present threat of substantial harm to self or others, all |
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605 | 607 | | available relevant information shall be considered, including |
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606 | 608 | | any known relevant aspects of the individual's psychosocial, |
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607 | 609 | | medical, and psychiatric history, in addition to the |
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608 | 610 | | individual's current behavior. |
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609 | 611 | | (d) Nothing in this section shall be construed as |
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610 | 612 | | requiring a mental health provider to expand their current |
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611 | 613 | | services if necessary funding is not provided. " |
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612 | 614 | | "§22-52-10.11 |
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613 | 615 | | (a) The director of a state mental health facility or |
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614 | 616 | | designated mental health facility to which a respondent is |
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615 | 617 | | currently committed for inpatient treatment, not later than 30 |
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650 | 652 | | respondent's mental illness or mental illness with a secondary |
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651 | 653 | | diagnosis of co-occurring substance use disorder . The director |
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652 | 654 | | may recommend to the probate court in writing that the order |
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653 | 655 | | be modified to commit the respondent to outpatient treatment. |
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654 | 656 | | (b) A recommendation under subsection (a) shall do both |
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655 | 657 | | of the following: |
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656 | 658 | | (1) State the grounds for the director's determination |
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657 | 659 | | that outpatient treatment is the least restrictive alternative |
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658 | 660 | | necessary and available for the treatment of the respondent's |
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659 | 661 | | mental illness or mental illness with a secondary diagnosis of |
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660 | 662 | | co-occurring substance use disorder . |
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661 | 663 | | (2) Identify the designated mental health facility to |
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662 | 664 | | which the director recommends that the respondent be committed |
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663 | 665 | | for outpatient treatment. |
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664 | 666 | | (c) Notice of the recommendation under subsection (a) |
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665 | 667 | | shall be provided to both of the following: |
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666 | 668 | | (1) The respondent. |
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667 | 669 | | (2) The director of the designated mental health |
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668 | 670 | | facility identified under subsection (b), unless the director |
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669 | 671 | | is the individual making the recommendation. |
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670 | 672 | | (d) Upon request of the respondent or any other |
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671 | 673 | | interested party, the probate court shall hold a hearing on |
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672 | 674 | | the recommendation. The probate courtjudge of probate shall |
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673 | 675 | | appoint an attorney to represent the respondent at the |
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708 | 710 | | recommendation based upon both of the following: |
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709 | 711 | | (1) The grounds stated in the recommendation. |
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710 | 712 | | (2) Consultation with the director of the designated |
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711 | 713 | | mental health facility, or his or her designee, concerning the |
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712 | 714 | | availability of resources to treat the respondent as an |
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713 | 715 | | outpatient. |
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714 | 716 | | (f) If the probate court modifies the order, the |
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715 | 717 | | modified order shall conform to all requirements of an |
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716 | 718 | | original commitment to outpatient treatment under Section |
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717 | 719 | | 22-52-10.3, except that the modified order may not extend |
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718 | 720 | | beyond the term of the original order by more than 60 days." |
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719 | 721 | | Section 2. Section 15-16-26 is added to the Code of |
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720 | 722 | | Alabama 1975, to read as follows: |
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721 | 723 | | §15-16-26 |
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722 | 724 | | Notwithstanding Section 15-16-20, Code of Alabama 1975, |
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723 | 725 | | if a commitment order has been issued pursuant to Title 22, |
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724 | 726 | | Chapter 52, Code of Alabama 1975, but cannot be fulfilled |
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725 | 727 | | because the respondent is subsequently confined solely for |
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726 | 728 | | misdemeanor charges or municipal ordinance violations, the |
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727 | 729 | | judge of probate who issued the commitment order may |
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728 | 730 | | communicate with the judge of the district, municipal or |
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729 | 731 | | circuit court who ordered the respondent to be confined to |
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730 | 732 | | discuss whether he or she will issue an order to discharge the |
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731 | 733 | | respondent from confinement and suspend the criminal |
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