HLS 12RS-786 ENGROSSED Page 1 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Regular Session, 2012 HOUSE BILL NO. 326 BY REPRESENTATIVE WILLMOTT MENTAL HEALTH: Authorizes certain health professionals to execute an emergency certificate for admission to a treatment facility of a minor suffering from mental illness or substance abuse AN ACT1 To amend and reenact Children's Code Articles 1421, 1422(A)(1) and (2), and 1423(A)(2)2 and to enact Children's Code Article 1404(23) and (24), relative to the emergency3 certificate admission procedure; to provide for definitions; to authorize a psychiatric4 mental health nurse practitioner or psychologist to execute an emergency certificate5 under certain circumstances; to require the inclusion of the date that an examination6 was conducted by a psychiatric mental health nurse practitioner or psychologist on7 the emergency certificate; to require the director of a treatment facility to provide the8 parish coroner with the name of the psychiatric mental health nurse practitioner or9 psychologist that executed an emergency certificate for a minor's admission to10 treatment; and to provide for related matters.11 Be it enacted by the Legislature of Louisiana:12 Section 1. Children's Code Articles 1421, 1422(A)(1) and (2), and 1423(A)(2) are13 hereby amended and reenacted and Children's Code Article 1404(23) and (24) are hereby14 enacted to read as follows: 15 Art. 1404. Definitions16 As used in this Title17 * * *18 (23)(a) "Psychiatric mental health nurse practitioner" means an advanced19 practice registered nurse licensed to practice as a nurse practitioner or clinical nurse20 HLS 12RS-786 ENGROSSED HB NO. 326 Page 2 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. specialist by the Louisiana State Board of Nursing, in accordance with the provisions1 of R.S. 37:911 et seq., who focuses clinical practice on individuals, families, or2 populations across the life span at risk for developing or having a diagnosis of3 psychiatric disorders, mental health problems, or both. A psychiatric mental health4 nurse practitioner means a specialist who provides primary mental health care to5 patients seeking mental health services in a wide range of settings. Primary mental6 health care provided by a psychiatric mental health nurse practitioner involves the7 continuous and comprehensive services necessary for the promotion of optimal8 mental health, prevention and treatment of psychiatric disorders, and health9 maintenance. Such primary health care includes the assessment, diagnosis, and10 management of mental health problems and psychiatric disorders. A psychiatric11 mental health nurse practitioner means a provider of direct mental health care12 services who synthesizes theoretical, scientific, and clinical knowledge for the13 assessment and management of both health and illness states and who is licensed to14 practice as a nurse practitioner in Louisiana, in accordance with R.S. 37:911 et seq.15 (b) For purposes of this Title, a psychiatric mental health nurse practitioner16 shall have at least two years training, primary experience, or both, in diagnosis and17 treatment of mental illness. For purposes of this Title, a psychiatric mental health18 nurse practitioner shall also have authority from the Louisiana State Board of19 Nursing to prescribe legend and certain controlled drugs, in accordance with the20 provisions of R.S. 37:913(3)(b), (8), and (9).21 (24) "Psychologist" means an individual licensed to practice psychology in22 Louisiana in accordance with R.S. 37:2351 et seq., or licensed to practice medical23 psychology in Louisiana in accordance with R.S. 37:1360.51 et seq., and who has24 been engaged in the practice of a clinical specialty for not less than three years.25 * * *26 HLS 12RS-786 ENGROSSED HB NO. 326 Page 3 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Art. 1421. Examination required1 Any physician, psychiatric mental health nurse practitioner, or psychologist2 may execute an emergency certificate only after an actual examination of a minor3 alleged to be mentally ill or suffering from substance abuse who is determined to be4 in need of immediate medical treatment in a treatment facility because the examining5 physician, psychiatric mental health nurse practitioner, or psychologist determines6 him to be dangerous to himself or others or to be gravely disabled. Failure to7 conduct an examination prior to the execution of the certificate will be evidence of8 gross negligence.9 Art. 1422. Certificate; contents10 A. The emergency certificate shall state all of the following:11 (1) The date of the physician's examination of the physician, psychiatric12 mental health nurse practitioner, or psychologist examined the minor, which shall not13 be more than seventy-two hours prior to the date of the signature of the certificate.14 (2) The objective findings of the physician , psychiatric mental health nurse15 practitioner, or psychologist relative to the physical and mental condition of the16 minor, leading to the conclusion that he is dangerous to himself or others or is17 gravely disabled as a result of substance abuse or mental illness.18 * * *19 Art. 1423. Coroner; notice; independent examination; discharge20 A. Upon admission of any minor by emergency certificate to a treatment21 facility, it shall be the duty of the director of the treatment facility immediately to22 notify the coroner of the parish in which the treatment facility is located of the23 admission, giving the following information if known:24 * * *25 (2) Name of certifying physician , psychiatric mental health nurse26 practitioner, or psychologist.27 * * *28 HLS 12RS-786 ENGROSSED HB NO. 326 Page 4 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. DIGEST The digest printed below was prepared by House Legislative Services. It constitutes no part of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)] Willmott HB No. 326 Abstract: Authorizes a psychiatric mental health nurse practitioner or psychologist to execute an emergency certificate for admission to a treatment facility of a minor suffering from mental illness or substance abuse. Proposed law (Ch.C. Art. 1404(23) and (24)) defines "psychiatric mental health nurse practitioner" as meaning advanced practice registered nurse licensed to practice as a nurse practitioner or clinical nurse specialist by the La. State Board of Nursing, in accordance with the provisions of state law, who focuses clinical practice on individuals, families, or populations across the life span at risk for developing or having a diagnosis of psychiatric disorders, mental health problems, or both. Provides that a psychiatric mental health nurse practitioner means a specialist who provides primary mental health care to patients seeking mental health services in a wide range of settings. Primary mental health care provided by a psychiatric mental health nurse practitioner involves the continuous and comprehensive services necessary for the promotion of optimal mental health, prevention and treatment of psychiatric disorders, and health maintenance. Provides that such primary health care includes the assessment, diagnosis, and management of mental health problems and psychiatric disorders. Further, provides that a psychiatric mental health nurse practitioner means a provider of direct mental health care services who synthesizes theoretical, scientific, and clinical knowledge for the assessment and management of both health and illness states and who is licensed to practice as a nurse practitioner in La., in accordance with state law. Specifies that for purposes of state law, a psychiatric mental health nurse practitioner shall have at least two years training, primary experience, or both, in diagnosis and treatment of mental illness. Also, specifies that for purposes of state law, a psychiatric mental health nurse practitioner must also have authority from the La. State Board of Nursing to prescribe legend and certain controlled drugs, in accordance with the provisions of state law. Also, proposed law defines "psychologist" as meaning an individual licensed to practice psychology in La. in accordance with state law or licensed to practice medical psychology in La. in accordance with state law and who has been engaged in the practice of a clinical specialty for not less than three years. Present law (Ch.C. Art. 1421) authorizes any physician to execute an emergency certificate only after an actual examination of a minor alleged to be mentally ill or suffering from substance abuse who is determined to be in need of immediate medical treatment in a treatment facility because the examining physician determines him to be dangerous to himself or others or to be gravely disabled. Further provides that the failure to conduct an examination prior to the execution of the certificate constitutes evidence of gross negligence. Proposed law adds authorization for a psychiatric mental health nurse practitioner or psychologist to execute an emergency certificate after examination of the minor and a determination that such minor is a danger to himself or others. Present law (Ch.C. Art. 1422(A)(1) and (2)) in pertinent part, requires that an emergency certificate state the following: (1) The date of the physician's examination of the minor, which must not be more than 72 hours prior to the date of the signature of the certificate. HLS 12RS-786 ENGROSSED HB NO. 326 Page 5 of 5 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (2) The objective findings of the physician relative to the physical and mental condition of the minor, leading to the conclusion that he is dangerous to himself or others or is gravely disabled as a result of substance abuse or mental illness. Proposed law modifies present law by specifying that the date a psychiatric mental health nurse practitioner or psychologist examined the minor must also be included in an emergency certificate. Present law (Ch.C. Art. 1423(A)(2)) provides that whenever a minor is admitted to a treatment facility by emergency certificate, the director of the treatment facility must immediately notify the coroner of the parish in which the treatment facility is located of the admission and provide the name of the certifying physician. Proposed law adds a requirement that if a psychiatric mental health nurse practitioner or psychologist executes the emergency certificate for a minor's admission to a treatment facility, the director of such facility must provide the name of that health professional to the parish coroner. (Amends Ch.C. Arts. 1421, 1422(A)(1) and (2), and 1423(A)(2); Adds Ch.C.Art. 1404(23) and (24)) Summary of Amendments Adopted by House Committee Amendments Proposed by House Committee on Health and Welfare to the original bill. 1. Added definitions of the terms "psychiatric mental health nurse practitioner" and "psychologist" to proposed law. 2. Made technical changes.