Connecticut 2019 Regular Session

Connecticut Senate Bill SB00967 Compare Versions

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	7	+	General Assembly Substitute Bill No. 967
	8	+	January Session, 2019
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4		-	Substitute Senate Bill No. 967
5		-
6		-	Public Act No. 19-99
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9	14		AN ACT CONCERNING TH E RECOMMENDATIONS OF THE
10	15		DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES
11	16		REGARDING EMERGENCY MEDICATION.
12	17		Be it enacted by the Senate and House of Representatives in General
13	18		Assembly convened:
14	19
15		-	Section 1. Section 17a-543a of the general statutes is repealed and
16		-	the following is substituted in lieu thereof (Effective from passage):
17		-	(a) (1) (A) If it is determined by the head of the hospital and two
18		-	qualified physicians that a patient who is a defendant placed in the
19		-	custody of the Commissioner of Mental Health and Addiction Services
20		-	pursuant to section 54-56d is incapable of giving informed consent to
21		-	medication for the treatment of the patient's psychiatric disabilities and
22		-	such medication is deemed to be necessary for the patient's treatment,
23		-	the facility in which the patient is placed may petition the probate
24		-	court for the district in which such facility is located for appointment
25		-	of a special limited conservator with specific authority to consent to
26		-	the administration of medication, provided an employee of such
27		-	facility shall not be appointed or serve as the special limited
28		-	conservator. The provisions of section 45a-649 concerning issuance of a
29		-	citation and notice, personal service and representation by,
30		-	appointment of, and compensation of an attorney shall apply to any
31		-	petition filed under this subsection as if such patient were a Substitute Senate Bill No. 967
	20	+	Section 1. Section 17a-543a of the general statutes is repealed and 1
	21	+	the following is substituted in lieu thereof (Effective from passage): 2
	22	+	(a) (1) (A) If it is determined by the head of the hospital and two 3
	23	+	qualified physicians that a patient who is a defendant placed in the 4
	24	+	custody of the Commissioner of Mental Health and Addiction Services 5
	25	+	pursuant to section 54-56d is incapable of giving informed consent to 6
	26	+	medication for the treatment of the patient's psychiatric disabilities and 7
	27	+	such medication is deemed to be necessary for the patient's treatment, 8
	28	+	the facility in which the patient is placed may petition the probate 9
	29	+	court for the district in which such facility is located for appointment 10
	30	+	of a special limited conservator with specific authority to consent to 11
	31	+	the administration of medication, provided an employee of such 12
	32	+	facility shall not be appointed or serve as the special limited 13
	33	+	conservator. The provisions of section 45a-649 concerning issuance of a 14
	34	+	citation and notice, personal service and representation by, 15
	35	+	appointment of, and compensation of an attorney shall apply to any 16
	36	+	petition filed under this subsection as if such patient were a 17
	37	+	respondent under section 45a-649, except that (i) the court shall only be 18 Substitute Bill No. 967
32	38
33		-	Public Act No. 19-99 2 of 5
34	39
35		-	respondent under section 45a-649, except that (i) the court shall only be
36		-	required to issue such citation and notice to the patient, the patient's
37		-	attorney and any conservator appointed for the patient, and (ii) the
38		-	court, in its discretion, may order notice as it directs to other persons
39		-	having an interest in the patient and to such persons the patient
40		-	requests to be notified. The Probate Court may appoint a special
41		-	limited conservator with such specific authority pursuant to this
42		-	subparagraph if the court finds by clear and convincing evidence that
43		-	the patient is incapable of giving informed consent to medication for
44		-	the treatment of the patient's psychiatric disabilities and such
45		-	medication is necessary for the patient's treatment. The Probate Court
46		-	may grant the special limited conservator specific authority to consent
47		-	to the release of the patient's medical records to such facility if the
48		-	court finds by clear and convincing evidence that the patient is
49		-	unwilling or unable to release such records and such records are
50		-	necessary to make decisions concerning the patient's treatment.
51		-	(B) The special limited conservator shall meet with the patient and
52		-	the physician, review the patient's written record and consider the
53		-	risks and benefits from the medication, the likelihood and seriousness
54		-	of adverse side effects, the preferences of the patient, the patient's
55		-	religious views, and the prognosis with and without medication. After
56		-	consideration of such information, the special limited conservator shall
57		-	either consent to the patient receiving medication for the treatment of
58		-	the patient's psychiatric disabilities or refuse to consent to the patient
59		-	receiving such medication.
60		-	(2) The authority of a special limited conservator to consent to the
61		-	administration of medication under subdivision (1) of this subsection
62		-	shall be effective for not more than one hundred twenty days. In the
63		-	case of continuous hospitalization of the patient beyond such one
64		-	hundred twenty days, if the head of the hospital and two qualified
65		-	physicians determine that the patient continues to be incapable of Substitute Senate Bill No. 967
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67		-	Public Act No. 19-99 3 of 5
	44	+	required to issue such citation and notice to the patient, the patient's 19
	45	+	attorney and any conservator appointed for the patient, and (ii) the 20
	46	+	court, in its discretion, may order notice as it directs to other persons 21
	47	+	having an interest in the patient and to such persons the patient 22
	48	+	requests to be notified. The Probate Court may appoint a special 23
	49	+	limited conservator with such specific authority pursuant to this 24
	50	+	subparagraph if the court finds by clear and convincing evidence that 25
	51	+	the patient is incapable of giving informed consent to medication for 26
	52	+	the treatment of the patient's psychiatric disabilities and such 27
	53	+	medication is necessary for the patient's treatment. The Probate Court 28
	54	+	may grant the special limited conservator specific authority to consent 29
	55	+	to the release of the patient's medical records to such facility if the 30
	56	+	court finds by clear and convincing evidence that the patient is 31
	57	+	unwilling or unable to release such records and such records are 32
	58	+	necessary to make decisions concerning the patient's treatment. 33
	59	+	(B) The special limited conservator shall meet with the patient and 34
	60	+	the physician, review the patient's written record and consider the 35
	61	+	risks and benefits from the medication, the likelihood and seriousness 36
	62	+	of adverse side effects, the preferences of the patient, the patient's 37
	63	+	religious views, and the prognosis with and without medication. After 38
	64	+	consideration of such information, the special limited conservator shall 39
	65	+	either consent to the patient receiving medication for the treatment of 40
	66	+	the patient's psychiatric disabilities or refuse to consent to the patient 41
	67	+	receiving such medication. 42
	68	+	(2) The authority of a special limited conservator to consent to the 43
	69	+	administration of medication under subdivision (1) of this subsection 44
	70	+	shall be effective for not more than one hundred twenty days. In the 45
	71	+	case of continuous hospitalization of the patient beyond such one 46
	72	+	hundred twenty days, if the head of the hospital and two qualified 47
	73	+	physicians determine that the patient continues to be incapable of 48
	74	+	giving informed consent to medication for the treatment of the 49
	75	+	patient's psychiatric disabilities and such medication is deemed to be 50
	76	+	necessary for the patient's treatment, the authority of the special 51 Substitute Bill No. 967
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69		-	giving informed consent to medication for the treatment of the
70		-	patient's psychiatric disabilities and such medication is deemed to be
71		-	necessary for the patient's treatment, the authority of the special
72		-	limited conservator to consent to the administration of medication may
73		-	be extended for a period not to exceed one hundred twenty days by
74		-	order of the Probate Court without a hearing upon application by the
75		-	head of the hospital. Prompt notice of the order shall be given to the
76		-	patient, special limited conservator and facility.
77		-	(3) The reasonable compensation of a special limited conservator
78		-	appointed under this subsection shall be established by the Probate
79		-	Court Administrator and paid from the Probate Court Administration
80		-	Fund.
81		-	(b) (1) If it is determined by the head of the hospital and two
82		-	qualified physicians that (A) a patient who is a defendant placed in the
83		-	custody of the Commissioner of Mental Health and Addiction Services
84		-	pursuant to section 54-56d is capable of giving informed consent but
85		-	refuses to consent to medication for treatment of the patient's
86		-	psychiatric disabilities, (B) there is no less intrusive beneficial
87		-	treatment, and (C) without medication, the psychiatric disabilities with
88		-	which the patient has been diagnosed will continue unabated and
89		-	place the patient or others in direct threat of harm, the facility in which
90		-	the patient is placed may petition the probate court for the district in
91		-	which such facility is located to authorize the administration to the
92		-	patient of medication for the treatment of the patient's psychiatric
93		-	disabilities, despite the refusal of the patient to consent to such
94		-	medication. The provisions of section 45a-649 concerning issuance of a
95		-	citation and notice, personal service and representation by,
96		-	appointment of, and compensation of an attorney shall apply to any
97		-	petition filed under this subsection as if such patient were a
98		-	respondent under section 45a-649, except that (i) the court shall only be
99		-	required to issue such citation and notice to the patient, the patient's Substitute Senate Bill No. 967
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103		-	attorney and any conservator appointed for the patient, and (ii) the
104		-	court, in its discretion, may order notice as it directs to other persons
105		-	having an interest in the patient and to such persons the patient
106		-	requests to be notified. The Probate Court may authorize the
107		-	administration of medication to the patient if the court finds by clear
108		-	and convincing evidence that (I) the patient is capable of giving
109		-	informed consent but refuses to consent to medication for treatment of
110		-	the patient's psychiatric disabilities, (II) there is no less intrusive
111		-	beneficial treatment, and (III) without medication, the psychiatric
112		-	disabilities with which the patient has been diagnosed will continue
113		-	unabated and place the patient or others in direct threat of harm.
114		-	(2) An order authorizing the administration of medication under
115		-	subdivision (1) of this subsection shall be effective for not more than
116		-	one hundred twenty days. In the case of continuous hospitalization of
117		-	the patient beyond such one hundred twenty days, if the head of the
118		-	hospital and two qualified physicians determine that (A) the patient
119		-	continues to be capable of giving informed consent but refuses to
120		-	consent to medication for treatment of the patient's psychiatric
121		-	disabilities, (B) there is no less intrusive beneficial treatment, and (C)
122		-	without medication, the psychiatric disabilities with which the patient
123		-	has been diagnosed will continue unabated and place the patient or
124		-	others in direct threat of harm, the order may be extended for a period
125		-	not to exceed one hundred twenty days by order of the Probate Court
126		-	without a hearing. Prompt notice of the order shall be given to the
127		-	patient and facility.
128		-	(c) Notwithstanding the provisions of subsections (a) and (b) of this
129		-	section, if obtaining consent under this section would cause a
130		-	medically harmful delay to a patient whose condition is of an
131		-	extremely critical nature, as determined by the personal observation of
132		-	a physician or the senior clinician on duty in the facility in which the
133		-	patient is placed, the physician or senior clinician may order Substitute Senate Bill No. 967
	83	+	limited conservator to consent to the administration of medication may 52
	84	+	be extended for a period not to exceed one hundred twenty days by 53
	85	+	order of the Probate Court without a hearing upon application by the 54
	86	+	head of the hospital. Prompt notice of the order shall be given to the 55
	87	+	patient, special limited conservator and facility. 56
	88	+	(3) The reasonable compensation of a special limited conservator 57
	89	+	appointed under this subsection shall be established by the Probate 58
	90	+	Court Administrator and paid from the Probate Court Administration 59
	91	+	Fund. 60
	92	+	(b) (1) If it is determined by the head of the hospital and two 61
	93	+	qualified physicians that (A) a patient who is a defendant placed in the 62
	94	+	custody of the Commissioner of Mental Health and Addiction Services 63
	95	+	pursuant to section 54-56d is capable of giving informed consent but 64
	96	+	refuses to consent to medication for treatment of the patient's 65
	97	+	psychiatric disabilities, (B) there is no less intrusive beneficial 66
	98	+	treatment, and (C) without medication, the psychiatric disabilities with 67
	99	+	which the patient has been diagnosed will continue unabated and 68
	100	+	place the patient or others in direct threat of harm, the facility in which 69
	101	+	the patient is placed may petition the probate court for the district in 70
	102	+	which such facility is located to authorize the administration to the 71
	103	+	patient of medication for the treatment of the patient's psychiatric 72
	104	+	disabilities, despite the refusal of the patient to consent to such 73
	105	+	medication. The provisions of section 45a-649 concerning issuance of a 74
	106	+	citation and notice, personal service and representation by, 75
	107	+	appointment of, and compensation of an attorney shall apply to any 76
	108	+	petition filed under this subsection as if such patient were a 77
	109	+	respondent under section 45a-649, except that (i) the court shall only be 78
	110	+	required to issue such citation and notice to the patient, the patient's 79
	111	+	attorney and any conservator appointed for the patient, and (ii) the 80
	112	+	court, in its discretion, may order notice as it directs to other persons 81
	113	+	having an interest in the patient and to such persons the patient 82
	114	+	requests to be notified. The Probate Court may authorize the 83
	115	+	administration of medication to the patient if the court finds by clear 84 Substitute Bill No. 967
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135		-	Public Act No. 19-99 5 of 5
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137		-	medication for treatment of the patient's psychiatric disabilities
138		-	without consent.
139		-	[(c)] (d) Unless there is a serious risk of harm to the patient or
140		-	others, based upon the patient's past history or current condition,
141		-	nothing in this section authorizes any form of involuntary medical,
142		-	psychological or psychiatric treatment of any patient who in the
143		-	sincere practice of his or her religious beliefs is being treated by prayer
144		-	alone in accordance with the principles and practices of a church or
145		-	religious denomination by a duly accredited practitioner or ordained
146		-	minister, priest or rabbi thereof.
147		-	[(d)] (e) Nothing in this section shall be construed to limit the
148		-	application of sections 45a-644 to 45a-663, inclusive, except as
149		-	specifically provided in this section.
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	122	+	and convincing evidence that (I) the patient is capable of giving 85
	123	+	informed consent but refuses to consent to medication for treatment of 86
	124	+	the patient's psychiatric disabilities, (II) there is no less intrusive 87
	125	+	beneficial treatment, and (III) without medication, the psychiatric 88
	126	+	disabilities with which the patient has been diagnosed will continue 89
	127	+	unabated and place the patient or others in direct threat of harm. 90
	128	+	(2) An order authorizing the administration of medication under 91
	129	+	subdivision (1) of this subsection shall be effective for not more than 92
	130	+	one hundred twenty days. In the case of continuous hospitalization of 93
	131	+	the patient beyond such one hundred twenty days, if the head of the 94
	132	+	hospital and two qualified physicians determine that (A) the patient 95
	133	+	continues to be capable of giving informed consent but refuses to 96
	134	+	consent to medication for treatment of the patient's psychiatric 97
	135	+	disabilities, (B) there is no less intrusive beneficial treatment, and (C) 98
	136	+	without medication, the psychiatric disabilities with which the patient 99
	137	+	has been diagnosed will continue unabated and place the patient or 100
	138	+	others in direct threat of harm, the order may be extended for a period 101
	139	+	not to exceed one hundred twenty days by order of the Probate Court 102
	140	+	without a hearing. Prompt notice of the order shall be given to the 103
	141	+	patient and facility. 104
	142	+	(c) Notwithstanding the provisions of subsections (a) and (b) of this 105
	143	+	section, if obtaining consent under this section would cause a 106
	144	+	medically harmful delay to a patient whose condition is of an 107
	145	+	extremely critical nature, as determined by the personal observation of 108
	146	+	a physician or the senior clinician on duty in the facility in which the 109
	147	+	patient is placed, the physician or senior clinician may order 110
	148	+	medication for treatment of the patient's psychiatric disabilities 111
	149	+	without consent. 112
	150	+	[(c)] (d) Unless there is a serious risk of harm to the patient or 113
	151	+	others, based upon the patient's past history or current condition, 114
	152	+	nothing in this section authorizes any form of involuntary medical, 115
	153	+	psychological or psychiatric treatment of any patient who in the 116
	154	+	sincere practice of his or her religious beliefs is being treated by prayer 117 Substitute Bill No. 967
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	161	+	alone in accordance with the principles and practices of a church or 118
	162	+	religious denomination by a duly accredited practitioner or ordained 119
	163	+	minister, priest or rabbi thereof. 120
	164	+	[(d)] (e) Nothing in this section shall be construed to limit the 121
	165	+	application of sections 45a-644 to 45a-663, inclusive, except as 122
	166	+	specifically provided in this section. 123
	167	+	This act shall take effect as follows and shall amend the following
	168	+	sections:
	169	+
	170	+	Section 1 from passage 17a-543a
	171	+
	172	+	PH Joint Favorable Subst.
	173	+	JUD Joint Favorable
150	174