| 47 | | - | SECTION 1. The purpose of this Act is to increase the likelihood that persons suffering from serious mental illness or severe substance abuse will receive timely and appropriate care and treatment, whether when brought to an emergency department for evaluation, hospitalized in a psychiatric facility under an emergency hospitalization or involuntary commitment order, or while being considered for assisted community treatment, by requiring the assessment of certain patients subject to emergency hospitalization to determine if a surrogate or guardian should be appointed to make appropriate health care decisions for the patient. SECTION 2. Section 334-59, Hawaii Revised Statutes, is amended by amending subsection (d) to read as follows: "(d) Emergency hospitalization. If the psychiatrist or advanced practice registered nurse [with] having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who performs [the] an emergency examination has reason to believe that the patient is: (1) Mentally ill or suffering from substance abuse; (2) Imminently dangerous to self or others; and (3) In need of care or treatment, or both; the psychiatrist or advanced practice registered nurse [with] having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization shall direct that the patient be hospitalized on an emergency basis or cause the patient to be transferred to another psychiatric facility for emergency hospitalization, or both. [The] Immediately upon admission, the patient shall have the right [immediately upon admission] to telephone the patient's guardian or a family member including a reciprocal beneficiary, or an adult friend and an attorney. If the patient declines to exercise that right, the staff of the facility shall inform the adult patient of the right to waive notification to the family, including a reciprocal beneficiary, and shall make reasonable efforts to ensure that the patient's guardian or family, including a reciprocal beneficiary, is notified of the emergency admission; but the patient's family, including a reciprocal beneficiary, need not be notified if the patient is an adult and requests that there be no notification. The patient shall be allowed to confer with an attorney in private. A patient who is seen in an emergency department or hospitalized on an emergency basis pursuant to this subsection, diagnosed with a mental illness or severe substance use disorder pursuant to subsection (b), and found to be lacking decisional capacity by a psychiatrist or advanced practice registered nurse having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, shall be assessed to determine whether a surrogate under section 327E-5 or a guardian under article V of chapter 560 is needed to make appropriate health care decisions for the patient." SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 4. This Act shall take effect on July 1, 2060. |
|---|
| 47 | + | SECTION 1. The purpose of this Act is to increase the likelihood that persons suffering from serious mental illness or severe substance abuse will receive timely and appropriate care and treatment, whether when brought to an emergency department for evaluation, hospitalized in a psychiatric facility under an emergency hospitalization or involuntary commitment order, or while being considered for assisted community treatment, by: (1) Amending the definition of "imminently dangerous to self or others"; (2) Authorizing the involuntary treatment of certain patients subject to emergency hospitalization; and (3) Requiring the assessment of certain patients subject to emergency hospitalization to determine if a surrogate or guardian needs to be appointed to make appropriate health care decisions for the patient. SECTION 2. Section 334-1, Hawaii Revised Statutes, is amended by amending the definition of "imminently dangerous to self or others" to read as follows: ""Imminently dangerous to self or others" means that, without intervention, the person will likely become dangerous to self or dangerous to others within the next [forty-five] ninety days." SECTION 3. Section 334-59, Hawaii Revised Statutes, is amended by amending subsection (d) to read as follows: "(d) Emergency hospitalization. If the psychiatrist or advanced practice registered nurse [with] having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who performs [the] an emergency examination has reason to believe that the patient is: (1) Mentally ill or suffering from substance abuse; (2) Imminently dangerous to self or others; and (3) In need of care or treatment, or both; the psychiatrist or advanced practice registered nurse [with] having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization [shall] may direct that the patient be hospitalized on an emergency basis or cause the patient to be transferred to another psychiatric facility for emergency hospitalization, or both. The patient shall have the right immediately upon admission to telephone the patient's guardian or a family member including a reciprocal beneficiary, or an adult friend and an attorney. If the patient declines to exercise that right, the staff of the facility shall inform the adult patient of the right to waive notification to the family, including a reciprocal beneficiary, and shall make reasonable efforts to ensure that the patient's guardian or family, including a reciprocal beneficiary, is notified of the emergency admission but the patient's family, including a reciprocal beneficiary, need not be notified if the patient is an adult and requests that there be no notification. The patient shall be allowed to confer with an attorney in private. Notwithstanding any law to the contrary, a patient who is seen in an emergency department or hospitalized on an emergency basis pursuant to this subsection, diagnosed with a serious mental illness or severe substance use disorder pursuant to subsection (b), and found to be lacking decisional capacity by a psychiatrist, or by an advanced practice registered nurse having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, may be involuntarily treated for up to thirty days, including through the use of long-term injectable psychotropics, or until a psychiatrist, or an advanced practice registered nurse having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, determines that the patient has regained decisional capacity, whichever occurs first. A patient who is seen in an emergency department or hospitalized on an emergency basis pursuant to this subsection, diagnosed with a serious mental illness or severe substance use disorder pursuant to subsection (b), and found to be lacking decisional capacity by a psychiatrist, or by an advanced practice registered nurse having prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, shall be assessed to determine whether a surrogate under section 327E-5 or a guardian under article V of chapter 560 is needed to make appropriate health care decisions for the patient." SECTION 4. Section 334-161, Hawaii Revised Statutes, is amended to read as follows: "[[]§334-161[]] Criteria for issuance of court or administrative order for treatment over the patient's objection. [(a)] A patient who has been committed to a psychiatric facility for involuntary hospitalization or who is in the custody of the director and residing in a psychiatric facility may be ordered to receive treatment over the patient's objection, including the taking or application of medication, if the court, or administrative panel through the administrative authorization process established pursuant to section 334-162, finds that: (1) The patient suffers from a physical or mental disease, disorder, or defect; (2) The patient is imminently dangerous to self or others; (3) The proposed treatment is medically appropriate; and (4) After considering less intrusive alternatives, treatment is necessary to forestall the danger posed by the patient. [(b) For the purposes of this section, "imminently dangerous to self or others" means that, without intervention, the person will likely become dangerous to self or dangerous to others within the next forty-five days.]" SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 6. This Act shall take effect on July 1, 2060. |
|---|