25 LC 52 0784
Senate Bill 269
By: Senators Hatchett of the 50th, Watson of the 1st and Kirkpatrick of the 32nd
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 3 of Title 37 of the Official Code of Georgia Annotated, relating to
1
examination, treatment, etc., for mental illness, so as to provide certain procedures and2
notifications for involuntary outpatient commitments; to provide for a definition; to provide3
for a nurse examiner to determine and certify that a patient admitted to or examined at a4
facility is a mentally ill person requiring involuntary treatment; to provide for a nurse5
examiner to discharge a patient meeting outpatient care criteria; to provide for written6
notification of certain information; to provide for obligations of referring facilities and7
receiving facilities; to provide for a nurse examiner to update a patient's individualized8
service plan, prepare a report, and petition the hearing examiners; to provide for related9
matters; to provide for an effective date; to repeal conflicting laws; and for other purposes.10
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11
SECTION 1.12
Chapter 3 of Title 37 of the Official Code of Georgia Annotated, relating to examination,13
treatment, etc., for mental illness, is amended in Code Section 37-3-1, relating to definitions,14
by adding a new paragraph to read as follows:15
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"(12.05) 'Nurse examiner' means a clinical nurse specialist in psychiatric/mental health16
or nurse practitioner licensed or authorized to practice nursing in this state pursuant to17
Chapter 26 of Title 43 and approved by the department to conduct certain examinations,18
determinations, and certifications under Code Sections 37-3-90, 37-3-91, and 37-3-91.1."19
SECTION 2.20
Said chapter is further amended in Code Section 37-3-81.1, relating to disposition of patient21
upon hearing, by revising paragraph (2) of subsection (a) as follows:22
"(2) That the patient is an outpatient, the court shall further determine, based upon either23
the individualized service plan required to be prepared under subsection (c) of Code24
Section 37-3-64, or subsection (b) of Code Section 37-3-91, or subsection (b) of Code25
Section 37-3-91.1 or the individualized service plan proposed by the physician or26
psychologist chosen by the patient, whether there is available outpatient treatment for the27
patient which meets the requirements of the plan chosen by the court and whether the28
patient will likely obtain that such treatment so as to minimize the likelihood of the29
patient's becoming an inpatient. If the court determines that there is such available30
outpatient treatment which the patient will likely obtain so as to minimize the likelihood31
of the patient's becoming an inpatient, then the court shall order the patient to obtain that32
such treatment and shall discharge the patient subject to such order;"33
SECTION 3.34
Said chapter is further amended in Code Section 37-3-90, relating to physician's or35
psychologist's determination and certification as to necessity of involuntary care, treatment36
of patient as inpatient or outpatient, and minors, by revising subsections (a) and (b) as37
follows:38
"(a) When a physician, or psychologist at a, or nurse examiner at an emergency receiving39
facility, evaluating facility, or treatment facility or on behalf of a such facility determines40
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and certifies under this article that there is reason to believe a patient admitted to or
41
examined at the facility is a mentally ill person requiring involuntary treatment, that
such42
physician, or psychologist, or nurse examiner shall further determine and certify whether43
there is reason to believe the patient is:44
(1) An inpatient or outpatient; and45
(2) If an outpatient, whether there is available outpatient treatment.46
(b) Unless otherwise specifically provided, the determination and certification as to47
paragraphs (1) and (2) of pursuant to subsection (a) of this Code section shall be made48
within the time period required for determining whether a patient is a mentally ill person49
requiring involuntary treatment, except that if such determination is made by a physician50
or psychologist at or on behalf of a community mental health center, the determination and51
certification shall be made within four hours after the patient is examined by the physician52
or psychologist."53
SECTION 4.54
Said chapter is further amended by revising Code Section 37-3-91, relating to discharge of55
persons meeting outpatient care criteria, as follows:56
"37-3-91.57
(a) A person who is in the physical custody of a community mental health center,58
emergency receiving facility, or evaluating facility and who is determined by a physician,59
or a psychologist, or nurse examiner at or on behalf of that such facility, to meet all of the60
outpatient treatment requirements of paragraphs (1) and (2) of provided in subsection (c)61
of Code Section 37-3-90 shall be discharged from that such facility as provided in this62
Code section pending a full and fair hearing or waiver thereof under Code Section 37-3-92.63
That discharge from a community mental health center shall occur within four hours after64
the patient is examined by a physician or a psychologist at or on behalf of that center. That65
Such discharge from an emergency receiving facility shall occur within 48 hours after the66
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patient's admission thereto. That to such facility. Such discharge from an evaluating67
facility shall occur no later than the expiration of the five-day evaluation period established68
under Code Section 37-3-64.69
(b) Prior to a psychologist's or nurse examiner's discharging the patient under70
subsection (a) of this Code section, the treating such psychologist or nurse examiner shall71
obtain the concurrence of a physician. In addition, within the time period the facility is72
authorized to retain the patient, the facility at which or on behalf of which the patient was73
examined, which facility shall be the 'referring facility' for purposes of this part, shall74
prepare an individualized service plan for the patient. Such This plan shall be prepared in75
consultation with the facility at which available outpatient treatment is to be provided the76
patient, which facility shall be the 'receiving facility' for purposes of this part. The77
referring facility shall also make arrangements with the receiving facility to provide interim78
outpatient treatment, in accordance with the individualized service plan, to the patient79
pending the full and fair hearing or waiver thereof. Nothing in this Code section shall80
prevent a referring facility for a patient from also being the receiving facility for that such81
patient.82
(c) Prior to discharge, the referring facility shall provide to the patient written notification83
of:84
(1) The time, date, place, and address for an appointment with the receiving facility;85
(2) The consequences if the patient does not obtain the treatment or attend the86
appointment with the receiving facility; and87
(3) That a full and fair hearing under Code Section 37-3-92 shall be provided at a future88
time and date unless waived.89
(d) At any appointment during the interim outpatient treatment, the receiving facility shall90
provide to the patient:91
(1) A written copy of the individualized service plan for such patient; and92
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(2) Written notification of the consequences if the patient does not follow the93
individualized service plan.94
(c) A patient for whom interim outpatient treatment is arranged pursuant to subsection (b)95
of this Code section shall obtain that treatment or be subject to the provisions of Code96
Section 37-3-82. Written notice of the time, date, place, and address for that interim97
outpatient treatment shall be provided the patient prior to the patient's discharge, along with98
written notification that if the patient does not comply with the interim outpatient treatment99
or attend or waive a hearing, the time and date of which hearing will later be provided the100
patient, the patient may be involuntarily admitted for examination, treatment, or both.101
(e) Notice of the discharge shall be provided to persons other than the patient in the same102
manner and under the same conditions as required by subsection (c) of Code103
Section 37-3-43 and subsection (d) of Code Section 37-3-64, and that. Such notice shall104
also include a notice regarding the interim outpatient treatment and the consequences if the105
patient does not obtain the treatment or attend or waive the hearing. 106
(d)(f) Within three days after a referring facility has discharged a patient pursuant to107
subsection (a) of this Code section, that such facility shall transmit to the receiving facility108
a copy of the referring facility's examination report, individualized service plan, and such109
other necessary clinical information the referring facility may have regarding the patient.110
Within five days after receiving such report, plan, and information, the receiving facility111
shall petition the court of the county in which the patient is located for a full and fair112
hearing pursuant to Code Section 37-3-92 and shall include with the petition a copy of the113
examination report, the individualized service plan, and the address to which the patient114
was discharged by the referring facility.115
(e)(g) Notwithstanding the provisions of subsection (a) of this Code section, a patient116
detained in a treatment facility pursuant to a certificate and petition under Code117
Section 37-3-81, whether or not that such patient is subsequently determined by that such118
facility during the time of such detention to meet all of the outpatient treatment119
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requirements of paragraphs (1) and (2) of provided in subsection (c) of Code Section120
37-3-90, may not be discharged from that such facility until a full and fair hearing is held121
pursuant to Code Section 37-3-81.1, which hearing may not be waived by any patient so122
determined to meet all of such outpatient treatment requirements."123
SECTION 5.124
Said chapter is further amended by adding a new Code section to read as follows:125
"37-3-91.1.126
(a) When a physician, psychologist, or nurse examiner on behalf of a community mental127
health center determines and certifies under this article that there is reason to believe a128
patient examined outside of an emergency receiving facility, evaluating facility, or129
treatment facility is a mentally ill person requiring involuntary treatment, such physician,130
psychologist, or nurse examiner shall further determine and certify whether there is reason131
to believe the patient is:132
(1) An inpatient or outpatient; and133
(2) If an outpatient, whether there is available outpatient treatment.134
(b) Within three days of the determination and certification that a patient is an outpatient135
pursuant to subsection (a) of this Code section, the community mental health center at136
which or on behalf of which the person was examined, which shall be the 'referring facility'137
for purposes of this part, shall prepare an individualized service plan for such patient. This138
plan shall be prepared in consultation with the facility at which available outpatient139
treatment is to be provided the patient, which facility shall be the 'receiving facility' for140
purposes of this part. The referring facility shall also make arrangements with the receiving141
facility to provide interim outpatient treatment, in accordance with the individualized142
service plan, to such patient pending the full and fair hearing or waiver thereof. Nothing143
in this Code section shall prevent a referring facility for a patient from also being the144
receiving facility for such patient.145
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(c) The referring facility shall provide to the patient written notification of:146
(1) The time, date, place, and address for an appointment with the receiving facility;147
(2) The consequences if the patient does not obtain the treatment or attend the148
appointment with the receiving facility; and149
(3) That a full and fair hearing under Code Section 37-3-92 shall be provided at a future150
time and date unless waived.151
(d) At any appointment during the interim outpatient treatment, the receiving facility shall152
provide to the patient:153
(1) A written copy of the individualized service plan for the patient; and154
(2) Written notification of the consequences if the patient does not follow the155
individualized service plan.156
(e) Within three days of the determination and certification that a patient is an outpatient157
pursuant to subsection (a) of this Code section, the referring facility shall transmit to the158
receiving facility a copy of the referring facility's examination report, the individualized159
service plan, and such other necessary clinical information the referring facility has160
regarding such patient. Within five days of receiving such report, plan, and information,161
the receiving facility shall petition the court of the county in which the patient is located162
for a full and fair hearing pursuant to Code Section 37-3-92 and shall include with such163
petition a copy of the examination report, the individualized service plan, and the last164
known address for the patient.165
(f) A determination and certification made pursuant to subsection (a) of this Code section166
shall not authorize a facility to detain such patient. Nothing in this Code section shall167
prevent a certification by a physician under Code Section 37-3-41."168
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SECTION 6.
169
Said chapter is further amended in Code Section 37-3-92, relating to hearing, notice, waiver170
of hearing, apprehension and detention of patient failing to appear, and treatment upon171
waiver, by revising subsection (a) as follows:172
"(a) Except when a hearing is waived as provided in this subsection, within 30 days after173
the filing of the petition under subsection (d)
(f) of Code Section 37-3-91 or subsection (e)174
of Code Section 37-3-91.1, the court shall hold a full and fair hearing. At least ten days175
prior to that such hearing, the court shall have served on the patient and the such patient's176
representatives the same notices and information required by paragraphs (1) through (4)177
of subsection (a) of Code Section 37-3-81, as well as a notice that the patient may waive178
in writing the hearing but if the patient does not either attend or waive the hearing the court179
may order the patient to be taken into custody, hospitalized, evaluated, and treated. The180
patient and such patient's representatives shall have the rights specified in those notices.181
Hearings held pursuant to this subsection shall be held as provided in Code182
Section 37-3-81.1, and the court holding the hearing may issue any order authorized by and183
subject to the limitations of that Code Section 37-3-81.1 such Code section."184
SECTION 7.185
Said chapter is further amended in Code Section 37-3-93, relating to court order for186
outpatient treatment, physician's or psychologist's petition to extend order, review of petition,187
hearing on extension petition, and patients under juvenile court jurisdiction, by revising188
subsection (b) as follows:189
"(b) If it is necessary to continue available outpatient treatment beyond the period190
authorized pursuant to subsection (a) of this Code section, at least 60 days prior to the191
expiration of that period the physician, or psychologist, or nurse examiner responsible for192
that such treatment or the person responsible for the patient's treatment under the direction193
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and with approval of the physician or psychologist such physician, psychologist, or nurse194
examiner shall:195
(1) Update the patient's individualized service plan;196
(2) Prepare a report containing evidence that the patient meets all the requirements for197
available outpatient treatment under paragraphs (1) and (2) of provided in subsection (c)198
of Code Section 37-3-90; and199
(3) Petition the hearing examiners appointed to hold hearings under Code200
Section 37-3-83 for an order requiring the patient to obtain available outpatient treatment201
beyond the period previously ordered for the patient.202
The petition shall contain a plain and simple statement that the patient or the such patient's203
representatives may file a request for a hearing with a hearing examiner appointed to hold204
hearings pursuant to Code Section 37-3-83 within 15 days after service of the petition, that205
the patient has a right to counsel at the hearing, that the patient or the such patient's206
representatives may apply immediately to the court to have counsel appointed if the patient207
cannot afford counsel, and that the court will appoint counsel for the patient unless the208
patient indicates in writing that the patient he or she does not desire to be represented by209
counsel or has made the patient's his or her own arrangements for counsel."210
SECTION 8.211
This Act shall become effective upon its approval by the Governor or upon its becoming law212
without such approval.213
SECTION 9.214
All laws and parts of laws in conflict with this Act are repealed.215
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