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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 Section 17a-543a of the general statutes is repealed and 1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
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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
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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
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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
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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.
JUD Joint Favorable