LCO \\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-00967-R01- SB.docx 1 of 5 General Assembly Substitute Bill No. 967 January Session, 2019 AN ACT CONCERNING TH E RECOMMENDATIONS OF THE DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES REGARDING EMERGENCY MEDICATION. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 17a-543a of the general statutes is repealed and 1 the following is substituted in lieu thereof (Effective from passage): 2 (a) (1) (A) If it is determined by the head of the hospital and two 3 qualified physicians that a patient who is a defendant placed in the 4 custody of the Commissioner of Mental Health and Addiction Services 5 pursuant to section 54-56d is incapable of giving informed consent to 6 medication for the treatment of the patient's psychiatric disabilities and 7 such medication is deemed to be necessary for the patient's treatment, 8 the facility in which the patient is placed may petition the probate 9 court for the district in which such facility is located for appointment 10 of a special limited conservator with specific authority to consent to 11 the administration of medication, provided an employee of such 12 facility shall not be appointed or serve as the special limited 13 conservator. The provisions of section 45a-649 concerning issuance of a 14 citation and notice, personal service and representation by, 15 appointment of, and compensation of an attorney shall apply to any 16 petition filed under this subsection as if such patient were a 17 respondent under section 45a-649, except that (i) the court shall only be 18 Substitute Bill No. 967 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-00967- R01-SB.docx } 2 of 5 required to issue such citation and notice to the patient, the patient's 19 attorney and any conservator appointed for the patient, and (ii) the 20 court, in its discretion, may order notice as it directs to other persons 21 having an interest in the patient and to such persons the patient 22 requests to be notified. The Probate Court may appoint a special 23 limited conservator with such specific authority pursuant to this 24 subparagraph if the court finds by clear and convincing evidence that 25 the patient is incapable of giving informed consent to medication for 26 the treatment of the patient's psychiatric disabilities and such 27 medication is necessary for the patient's treatment. The Probate Court 28 may grant the special limited conservator specific authority to consent 29 to the release of the patient's medical records to such facility if the 30 court finds by clear and convincing evidence that the patient is 31 unwilling or unable to release such records and such records are 32 necessary to make decisions concerning the patient's treatment. 33 (B) The special limited conservator shall meet with the patient and 34 the physician, review the patient's written record and consider the 35 risks and benefits from the medication, the likelihood and seriousness 36 of adverse side effects, the preferences of the patient, the patient's 37 religious views, and the prognosis with and without medication. After 38 consideration of such information, the special limited conservator shall 39 either consent to the patient receiving medication for the treatment of 40 the patient's psychiatric disabilities or refuse to consent to the patient 41 receiving such medication. 42 (2) The authority of a special limited conservator to consent to the 43 administration of medication under subdivision (1) of this subsection 44 shall be effective for not more than one hundred twenty days. In the 45 case of continuous hospitalization of the patient beyond such one 46 hundred twenty days, if the head of the hospital and two qualified 47 physicians determine that the patient continues to be incapable of 48 giving informed consent to medication for the treatment of the 49 patient's psychiatric disabilities and such medication is deemed to be 50 necessary for the patient's treatment, the authority of the special 51 Substitute Bill No. 967 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-00967- R01-SB.docx } 3 of 5 limited conservator to consent to the administration of medication may 52 be extended for a period not to exceed one hundred twenty days by 53 order of the Probate Court without a hearing upon application by the 54 head of the hospital. Prompt notice of the order shall be given to the 55 patient, special limited conservator and facility. 56 (3) The reasonable compensation of a special limited conservator 57 appointed under this subsection shall be established by the Probate 58 Court Administrator and paid from the Probate Court Administration 59 Fund. 60 (b) (1) If it is determined by the head of the hospital and two 61 qualified physicians that (A) a patient who is a defendant placed in the 62 custody of the Commissioner of Mental Health and Addiction Services 63 pursuant to section 54-56d is capable of giving informed consent but 64 refuses to consent to medication for treatment of the patient's 65 psychiatric disabilities, (B) there is no less intrusive beneficial 66 treatment, and (C) without medication, the psychiatric disabilities with 67 which the patient has been diagnosed will continue unabated and 68 place the patient or others in direct threat of harm, the facility in which 69 the patient is placed may petition the probate court for the district in 70 which such facility is located to authorize the administration to the 71 patient of medication for the treatment of the patient's psychiatric 72 disabilities, despite the refusal of the patient to consent to such 73 medication. The provisions of section 45a-649 concerning issuance of a 74 citation and notice, personal service and representation by, 75 appointment of, and compensation of an attorney shall apply to any 76 petition filed under this subsection as if such patient were a 77 respondent under section 45a-649, except that (i) the court shall only be 78 required to issue such citation and notice to the patient, the patient's 79 attorney and any conservator appointed for the patient, and (ii) the 80 court, in its discretion, may order notice as it directs to other persons 81 having an interest in the patient and to such persons the patient 82 requests to be notified. The Probate Court may authorize the 83 administration of medication to the patient if the court finds by clear 84 Substitute Bill No. 967 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-00967- R01-SB.docx } 4 of 5 and convincing evidence that (I) the patient is capable of giving 85 informed consent but refuses to consent to medication for treatment of 86 the patient's psychiatric disabilities, (II) there is no less intrusive 87 beneficial treatment, and (III) without medication, the psychiatric 88 disabilities with which the patient has been diagnosed will continue 89 unabated and place the patient or others in direct threat of harm. 90 (2) An order authorizing the administration of medication under 91 subdivision (1) of this subsection shall be effective for not more than 92 one hundred twenty days. In the case of continuous hospitalization of 93 the patient beyond such one hundred twenty days, if the head of the 94 hospital and two qualified physicians determine that (A) the patient 95 continues to be capable of giving informed consent but refuses to 96 consent to medication for treatment of the patient's psychiatric 97 disabilities, (B) there is no less intrusive beneficial treatment, and (C) 98 without medication, the psychiatric disabilities with which the patient 99 has been diagnosed will continue unabated and place the patient or 100 others in direct threat of harm, the order may be extended for a period 101 not to exceed one hundred twenty days by order of the Probate Court 102 without a hearing. Prompt notice of the order shall be given to the 103 patient and facility. 104 (c) Notwithstanding the provisions of subsections (a) and (b) of this 105 section, if obtaining consent under this section would cause a 106 medically harmful delay to a patient whose condition is of an 107 extremely critical nature, as determined by the personal observation of 108 a physician or the senior clinician on duty in the facility in which the 109 patient is placed, the physician or senior clinician may order 110 medication for treatment of the patient's psychiatric disabilities 111 without consent. 112 [(c)] (d) Unless there is a serious risk of harm to the patient or 113 others, based upon the patient's past history or current condition, 114 nothing in this section authorizes any form of involuntary medical, 115 psychological or psychiatric treatment of any patient who in the 116 sincere practice of his or her religious beliefs is being treated by prayer 117 Substitute Bill No. 967 LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2019SB-00967- R01-SB.docx } 5 of 5 alone in accordance with the principles and practices of a church or 118 religious denomination by a duly accredited practitioner or ordained 119 minister, priest or rabbi thereof. 120 [(d)] (e) Nothing in this section shall be construed to limit the 121 application of sections 45a-644 to 45a-663, inclusive, except as 122 specifically provided in this section. 123 This act shall take effect as follows and shall amend the following sections: Section 1 from passage 17a-543a PH Joint Favorable Subst.