ENROLLED ACT No. 369 2017 Regular Session HOUSE BILL NO. 341 BY REPRESENTATIVE DUSTIN MILLER 1 AN ACT 2 To amend and reenact R.S. 17:1607, the heading of Title 28 of the Louisiana Revised 3 Statutes of 1950, the heading of Chapter 1 of Title 28 of the Louisiana Revised 4 Statutes of 1950, R.S. 28:1, 2(1), (7), (9), (10), (14), (17), (20), (21), (26), (29), and 5 (32)(a) and (b), 3, the heading of Part I-A of Chapter 1 of Title 28 of the Louisiana 6 Revised Statutes of 1950, R.S. 28:11, 12, 13(introductory paragraph), (1), and (3) 7 through (5), 14, 15(A)(introductory paragraph), (3), (9), and (B), the heading of Part 8 II of Chapter 1 of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:21(A) 9 and (B), 21.1, 22(B)(introductory paragraph) and (C)(1), 22.5, 22.7(A), 22.9, 23, 25, 10 25.1(A), (C)(1)(a)(introductory paragraph) and (v), (b), (c), (2)(a)(iv), and (D), 25.2, 11 the heading of Part III of Chapter 1 of Title 28 of the Louisiana Revised Statutes of 12 1950, R.S. 28:50(1), (3), (4), and (6), 51(C), 51.1(A)(1), 52(A) through (C), 13 (G)(2)(a), and (H)(2), 52.2, 52.3, 52.4(A) through (C), 53(A), (B)(1) and (2)(b) and 14 (d)(introductory paragraph), (G)(2) and (6), (J), (K)(1), and (L)(1) and (3), 15 53.2(A)(introductory paragraph) and (1), (B), (C)(3), and (F), 54(A) and 16 (D)(1)(introductory paragraph) and (a) and (3), 55(B), (E)(1) and (3) through (5), (F), 17 (G), (I), and (J), 56(A)(1)(a) and (2)(b), (B), (C), and (G), 59(A), (C), and (D), 62, 18 64(F), 67(1) and (3), 69(A)(1), 70(A), (B)(introductory paragraph) and (1), and 19 (E)(2)(f), 71(B), (C), (E), and (F), 72(A), 73, 91 through 93, 94(A), 96(A) through 20 (C) and (E) through (H), 96.1(A), (B), and (D) through (F), 97 through 100, 101 21 through 145, 146(A), 147, the heading of Part VI of Chapter 1 of Title 28 of the 22 Louisiana Revised Statutes of 1950, R.S. 28:171(C)(4)(a) and (D)(5), 23 171.1(introductory paragraph) and (5) through (8), 172 through 181, 183, 184, 24 185(A), 200 through 202, 215.2(1)(introductory paragraph) and (2), 215.3(A) and Page 1 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (B), 215.4(A), the heading of Part X of Chapter 1 of Title 28 of the Louisiana 2 Revised Statutes of 1950, R.S. 28:221(1) through (6), (8), (9), and (11) through (13), 3 222 through 225, 227(A), (C), and (E), 228, 229(A) and (C), 230(A)(introductory 4 paragraph) and (2)(a) and (d)(i), (B), and (C), 232, 233(2), 234(introductory 5 paragraph) and (2), the heading of Chapter 5 of Title 28 of the Louisiana Revised 6 Statutes of 1950, R.S. 28:475, 476, 477(1) and (3)(a)(introductory paragraph) and 7 (b), 478(A), the heading of Chapter 11 of Title 28 of the Louisiana Revised Statutes 8 of 1950, R.S. 28:771, 772(A)(1) and (2)(c) and (B), the heading of Chapter 15 of 9 Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:841(A), 911(1), 10 913(A)(2) and (3), 915(A)(3), and 931(B)(2), R.S. 36:258(C) and 259(C)(10) and 11 (16), R.S. 40:1237.1(A)(9)(a)(ii)(introductory paragraph) and 2142(A), Code of 12 Criminal Procedure Articles 648(A)(1) and (B)(1), 657, 657.1(A)(4), and 657.2(A), 13 and Children's Code Article 1404(9), to enact R.S. 28:2(33) through (39), and to 14 repeal R.S. 28:2(11), 22.4, 22.10, 52.1, 95, 100.1, 182, Chapter 6 of Title 28 of the 15 Louisiana Revised Statutes of 1950, comprised of R.S. 28:501 through 506, and 16 Chapter 7 of Title 28 of the Louisiana Revised Statutes of 1950, comprised of R.S. 17 28:561, relative to mental health and behavioral health laws; to revise terminology 18 and definitions of terms relating to mental health and behavioral health; to provide 19 relative to healthcare services for persons with mental illness and substance-related 20 and addictive disorders; to provide for care and treatment of persons with behavioral 21 health needs; to provide relative to facilities where such care is delivered; to provide 22 for the administration of state psychiatric hospitals; to make technical changes and 23 corrections in laws pertaining to mental health and behavioral health; and to provide 24 for related matters. 25 Be it enacted by the Legislature of Louisiana: 26 Section 1. R.S. 17:1607 is hereby amended and reenacted to read as follows: 27 §1607. Medical scholarship; recipient to serve as physician at the forensic unit of 28 East Louisiana State Hospital Eastern Louisiana Mental Health System 29 A. Upon the recommendation of the director of the forensic unit of the East 30 Louisiana State Hospital Eastern Louisiana Mental Health System at Jackson and Page 2 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 subsequent approval by the medical school of the Louisiana State University and 2 Agricultural and Mechanical College, the board of supervisors of the Louisiana State 3 University and Agricultural and Mechanical College shall award annually a four year 4 four-year scholarship to the medical school of the Louisiana State University and 5 Agricultural and Mechanical College. The recipient of any such scholarship may 6 attend the medical school without the necessity of paying tuition, matriculation, 7 registration, laboratory, athletic, medical or other special fees, and may receive a 8 stipend from the board of supervisors. No person shall be awarded any such 9 scholarship unless such person agrees to serve as a physician at the forensic unit of 10 the East Louisiana State Hospital Eastern Louisiana Mental Health System at 11 Jackson at the rate of pay provided in appropriate civil service pay schedules for a 12 period of two years after such person is awarded a certificate to practice medicine 13 in the state of Louisiana. Any person awarded such a scholarship shall pay back to 14 the state of Louisiana all funds received from such a scholarship if he fails to 15 complete this required two year two-year service or a pro rata percentage of funds 16 received if he completes less than two years service. 17 B. Information concerning any scholarships awarded pursuant to the 18 provisions of Subsection A of this Section shall be published on the Louisiana 19 Department of Health website. Such information shall include the name of the 20 recipient and the award amount. 21 Section 2. The heading of Title 28 of the Louisiana Revised Statutes of 1950, the 22 heading of Chapter 1of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:1, 2(1), 23 (7), (9), (10), (14), (17), (20), (21), (26), (29), and (32)(a) and (b), 3, the heading of Part I-A 24 of Chapter 1 of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:11, 12, 25 13(introductory paragraph), (1), and (3) through (5), 14, 15(A)(introductory paragraph), (3), 26 (9), and (B), the heading of Part II of Chapter 1 of Title 28 of the Louisiana Revised Statutes 27 of 1950, R.S. 28:21(A) and (B), 21.1, 22(B)(introductory paragraph) and (C)(1), 22.5, 28 22.7(A), 22.9, 23, 25, 25.1(A), (C)(1)(a)(introductory paragraph) and (v), (b), (c), (2)(a)(iv), 29 and (D), 25.2, the heading of Part III of Chapter 1 of Title 28 of the Louisiana Revised 30 Statutes of 1950, R.S. 28:50(1), (3), (4), and (6), 51(C), 51.1(A)(1), 52(A) through (C), Page 3 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (G)(2)(a), and (H)(2), 52.2, 52.3, 52.4(A) through (C), 53(A), (B)(1) and (2)(b) and 2 (d)(introductory paragraph), (G)(2) and (6), (J), (K)(1), and (L)(1) and (3), 3 53.2(A)(introductory paragraph) and (1), (B), (C)(3), and (F), 54(A) and (D)(1)(introductory 4 paragraph) and (a) and (3), 55(B), (E)(1) and (3) through (5), (F), (G), (I), and (J), 5 56(A)(1)(a) and (2)(b), (B), (C), and (G), 59(A), (C), and (D), 62, 64(F), 67(1) and (3), 6 69(A)(1), 70(A), (B)(introductory paragraph) and (1), and (E)(2)(f), 71(B), (C), (E), and (F), 7 72(A), 73, 91 through 93, 94(A), 96(A) through (C) and (E) through (H), 96.1(A), (B), and 8 (D) through (F), 97 through 100, 101 through 145, 146(A), 147, the heading of Part VI of 9 Chapter 1 of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:171(C)(4)(a) and 10 (D)(5), 171.1(introductory paragraph) and (5) through (8), 172 through 181, 183, 184, 11 185(A), 200 through 202, 215.2(1)(introductory paragraph) and (2), 215.3(A) and (B), 12 215.4(A), the heading of Part X of Chapter 1 of Title 28 of the Louisiana Revised Statutes 13 of 1950, R.S. 28:221(1) through (6), (8), (9), and (11) through (13), 222 through 225, 14 227(A), (C), and (E), 228, 229(A) and (C), 230(A)(introductory paragraph) and (2)(a) and 15 (d)(i), (B), and (C), 232, 233(2), 234(introductory paragraph) and (2), the heading of Chapter 16 5 of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:475, 476, 477(1) and 17 (3)(a)(introductory paragraph) and (b), 478(A), the heading of Chapter 11 of Title 28 of the 18 Louisiana Revised Statutes of 1950, R.S. 28:771, 772(A)(1) and (2)(c) and (B), the heading 19 of Chapter 15 of Title 28 of the Louisiana Revised Statutes of 1950, R.S. 28:841(A), 911(1), 20 913(A)(2) and (3), 915(A)(3), and 931(B)(2) are hereby amended and reenacted and R.S. 21 28:2(33) through (39) are hereby enacted to read as follows: 22 TITLE 28. MENTAL BEHAVIORAL HEALTH 23 CHAPTER 1. MENTAL BEHAVIORAL HEALTH LAW 24 PART I. SHORT TITLE, INTERPRETATIONS, AND DEFINITIONS 25 §1. Short title 26 This Chapter may be cited as the Mental Behavioral Health Law. 27 §2. Definitions 28 Whenever used in this Title, the masculine shall include the feminine, the 29 singular shall include the plural, and the following definitions shall apply: Page 4 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (1) "Conditional discharge" means the physical release of a judicially 2 committed person from a treatment facility by the director or administrator or by the 3 court. The patient may be required to report for outpatient treatment as a condition 4 of his release. The judicial commitment of such persons shall remain in effect for 5 a period of up to one hundred twenty days and during this time the person may be 6 hospitalized involuntarily for appropriate medical reasons upon court order. 7 * * * 8 (7) "Director" or "superintendent" "administrator" means a person in charge 9 of a treatment facility or his deputy. 10 * * * 11 (9) "Formal voluntary admission" means the admission of a person suffering 12 from mental illness or substance abuse a substance-related or addictive disorder 13 desiring admission to a treatment facility for diagnosis and/or or treatment of such 14 condition who may be formally admitted upon his written request. Such persons 15 may be detained following a request for discharge pursuant to R.S. 28:52.2. 16 (10) "Gravely disabled" means the condition of a person who is unable to 17 provide for his own basic physical needs, such as essential food, clothing, medical 18 care, and shelter, as a result of serious mental illness or substance abuse a substance- 19 related or addictive disorder and is unable to survive safely in freedom or protect 20 himself from serious harm; the. The term also includes incapacitation by alcohol, 21 which means the condition of a person who, as a result of the use of alcohol, is 22 unconscious or whose judgment is otherwise so impaired that he is incapable of 23 realizing and making a rational decision with respect to his need for treatment. 24 * * * 25 (14) "Mental health advocacy service" means a service established by the 26 state of Louisiana for the purpose of providing legal counsel and representation for 27 persons with mental disabilities illness or substance-related or addictive disorders 28 and for children and to ensure ensuring that their the legal rights of those persons are 29 protected. 30 * * * Page 5 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (17) "Patient" means any person detained and taken care of as a person who 2 is mentally ill has a mental illness or person who is suffering from substance abuse 3 a substance-related or addictive disorder. 4 * * * 5 (20) "Person with who has a mental illness" means any person with a 6 psychiatric disorder which has substantial adverse effects on his ability to function 7 and who requires care and treatment. It does not refer to a person with, solely, an 8 intellectual disability; or who suffers solely from epilepsy, alcoholism, or drug abuse 9 or a substance-related or addictive disorder. 10 (21) "Petition" means a written civil complaint filed by a person of legal age 11 alleging that a person is mentally ill has a mental illness or is suffering from 12 substance abuse a substance-related or addictive disorder and requires judicial 13 commitment to a treatment facility. 14 * * * 15 (26) "Respondent" means a person alleged to be mentally ill have a mental 16 illness or be suffering from substance abuse a substance-related or addictive disorder 17 and for whom an application for commitment to a treatment facility has been filed. 18 * * * 19 (29) "Substance abuse" means the condition of a person who uses narcotic, 20 stimulant, depressant, soporific, tranquilizing, or hallucinogenic drugs or alcohol to 21 the extent that it renders the person dangerous to himself or others or renders the 22 person gravely disabled. "Substance use disorder" refers to a pattern of symptoms 23 resulting from use of a substance which the individual continues to take, despite 24 experiencing problems as a result. Substance use disorders occur when the recurrent 25 use of alcohol, drugs, or both causes clinically and functionally significant 26 impairment, such as health problems, disability, and failure to meet major 27 responsibilities at work, school, or home. Substance use disorder is based on 28 evidence of impaired control, social impairment, risky use, and pharmacological 29 criteria. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 30 allows clinicians to specify how severe the substance use disorder is, depending on Page 6 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 how many symptoms are identified. Based on a set of eleven criteria, two or three 2 symptoms indicate a mild substance use disorder, four or five symptoms indicate a 3 moderate substance use disorder, and six or more symptoms indicate a severe 4 substance use disorder. 5 * * * 6 (32)(a) "Treatment facility" means any public or private hospital, retreat, 7 institution, mental health center, or facility licensed by the state in which any person 8 who is mentally ill has a mental illness or person who is suffering from substance 9 abuse a substance-related or addictive disorder is received or detained as a patient 10 or client. The term includes Veterans Administration and public health hospitals and 11 forensic facilities. "Treatment facility" includes but is not limited to the following, 12 and shall be selected with consideration of first, medical suitability; second, least 13 restriction of the person's liberty; third, nearness to the patient's usual residence; and 14 fourth, financial or other status of the patient, except that such considerations shall 15 not apply to forensic facilities: 16 (i) Community mental health centers Public and private behavioral health 17 services providers licensed pursuant to R.S. 40:2151 et seq. 18 (ii) Private clinics Licensed residential treatment facilities. 19 (iii) Public or private halfway houses. 20 (iv) Public or private nursing homes. 21 (v) (iv) Public or private general hospitals. 22 (vi) (v) Public or private mental psychiatric hospitals. 23 (vii) Detoxification centers. 24 (viii) Substance abuse clinics. 25 (ix) Substance abuse in-patient facility. 26 (x) (vi) Forensic facilities. 27 (b) Patients involuntarily hospitalized by emergency certificate or mental 28 health treatment shall not be admitted to the facilities listed in Items (ii), (iii), (iv), 29 (viii) or (x) of Subparagraph (a) of this Paragraph, except that patients Clients in 30 custody of the Department of Public Safety and Corrections may be admitted to Page 7 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 forensic facilities by emergency certificate provided that judicial commitment 2 proceedings are initiated during the period of treatment at the forensic facility 3 authorized by emergency certificate. Patients involuntarily hospitalized by 4 emergency certificate for substance abuse treatment shall not be admitted to the 5 facilities listed in Items (ii), (iii), (iv), or (x) of Subparagraph (a) of this Paragraph. 6 Judicial commitments, however, may be made to any of the above facilities listed in 7 Subparagraph (a) of this Paragraph except forensic facilities. However, in the case 8 of any involuntary hospitalization as a result of such emergency certificate for 9 substance abuse a substance-related or addictive disorder or in the case of any 10 judicial commitment as the result of substance abuse a substance-related or addictive 11 disorder, such commitment or hospitalization may be made to any of the above 12 facilities listed in Subparagraph (a) of this Paragraph, except forensic facilities, 13 provided that such facility has a substance abuse in-patient substance-related or 14 addictive disorder inpatient operation maintained separate and apart from any mental 15 health in-patient inpatient operation at such facility. 16 * * * 17 (33)(a) "Addictive disorder" is a primary, chronic neurobiologic disease with 18 genetic, psychosocial, and environmental factors influencing its development and 19 manifestations. An addictive disorder is characterized by behaviors that include one 20 or more of the following: 21 (i) Impaired control over drug use. 22 (ii) Compulsive use. 23 (iii) Continued use despite harm. 24 (iv) Cravings. 25 (b) Addictive disorders include mood-altering behaviors or activities or 26 process addictions. Examples of process addictions include, without limitation, 27 gambling, spending, shopping, eating, and sexual activity. 28 (34) "Behavioral health" is a term used to refer to both mental health and 29 substance use. Page 8 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (35) "Client" refers to a recipient of services who has been charged with or 2 convicted of a crime and who requires special protection and restraint in a forensic 3 treatment facility. 4 (36) "Legal guardian" means a person judicially or statutorily designated 5 with the duty and authority to make decisions in matters having a permanent effect 6 on the life and development of the individual on whose behalf the guardianship is 7 established. 8 (37) "Local governing entity" means an integrated human services delivery 9 system with local accountability and management and which provides behavioral 10 health and developmental disabilities services through local human services districts 11 and authorities. 12 (38) "State psychiatric hospital" means a public, state-owned and operated 13 inpatient facility for the treatment of mental illness and substance-related and 14 addictive disorders. 15 (39) "Substance-related disorders" encompass disorders relating to the use 16 of drugs in any of the following classes, which are not fully distinct: 17 (a) Alcohol. 18 (b) Caffeine. 19 (c) Cannabis. 20 (d) Hallucinogens, with separate categories for phencyclidine or similarly 21 acting arylcyclohexylamines and for other hallucinogens. 22 (e) Inhalants. 23 (f) Opioids. 24 (g) Sedatives, hypnotics, and anxiolytics. 25 (h) Stimulants, including amphetamine-type substances and cocaine. 26 (i) Tobacco. 27 (j) Other or unknown substances. 28 §3. Application of Chapter; costs 29 The provisions of this Chapter apply to persons who are suffering from 30 mental illness or substance abuse substance-related or addictive disorders. Nothing Page 9 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 in this Chapter referring to costs shall be construed to defer or prevent the care of a 2 person in a state mental institution psychiatric hospital or state treatment facility, nor 3 their his release therefrom. 4 * * * 5 PART I-A. MENTAL AND BEHAVIORAL HEALTH SERVICES 6 PRESERVATION ACT 7 §11. Short title 8 This Part shall be known and may be cited as the "Mental and Behavioral 9 Health Services Preservation Act". 10 §12. Legislative declaration of intent 11 It is the intent of the legislature to preserve vital state funding for mental 12 behavioral health services to ensure delivery of and access to quality care for those 13 in desperate need of such services throughout the state. Many citizens in the state 14 have limited access to mental and behavioral health services because of the massive 15 cuts, both federal and state, in mental and behavioral health funding. The legislature 16 also finds that the provision of high-quality mental and behavioral health services, 17 regardless of setting, is of overriding importance. The state wholly supports efforts 18 to assist individuals suffering from serious and persistent mental illness, substance- 19 related or addictive disorders, or both in their efforts to participate fully in society. 20 As such, the department Louisiana Department of Health, referred to hereafter in this 21 Part as the "department", should streamline the delivery of mental and behavioral 22 health services through the prudent allocation of existing resources. The Louisiana 23 Department of Health department will improve the safety and health of individuals, 24 families, and communities by providing leadership and establishing and participating 25 in partnerships for the continuation of mental and behavioral health services 26 throughout the state, including cooperative agreements, mergers, joint ventures, and 27 consolidations among mental and behavioral health care facilities. Consumer and 28 advocate participation in the process can only aid in the delivery of services to those 29 most in need. To improve the quality of services available and promote treatment, 30 which often involves the rehabilitation, recovery, and reintegration of persons Page 10 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 suffering from mental illness, substance-related or addictive disorders, or both, the 2 state should secure adequate funding for mental and behavioral health services and 3 require state departments to exercise fiscal responsibility in the allocation of these 4 resources. 5 §13. Management of mental and behavioral health resources 6 In the operational management of the office of behavioral health, the 7 department may guarantee the efficient and effective use and retention of the state's 8 scarce mental and behavioral health resources to adequately provide for the peace, 9 health, safety, and general welfare of the public, by ensuring the following: 10 (1) Accountability of efficient and effective services through state-of-the-art 11 quality and performance measures and statewide standards for monitoring quality of 12 service and performance and reporting of quality of service and performance 13 information. These processes may be designed so as to maximize the use of 14 available resources for direct care of people with who have a mental illness or a 15 substance-related or addictive disorder and to assure uniform data collection across 16 the state. 17 * * * 18 (3) Coordination of integration of services offered by department and mental 19 and behavioral health communities, including the office of behavioral health and 20 their its respective contract providers, involved in the delivery of mental and 21 behavioral health treatment, along with local systems and groups, public and private, 22 such as state mental psychiatric hospitals, public health organizations, parish 23 authorities, child protection, and regional support networks, aimed at reducing 24 duplication in service delivery and promoting complementary services among all 25 entities that provide mental and behavioral health services to adults and children 26 throughout the state. 27 (4) Implementation of a system of reimbursement by the Medical Assistance 28 Program to private hospitals and to state hospitals for covered Medicaid services 29 that, to the extent possible, allocates funding in the areas of the state based on needs, 30 population, and acuity level as determined by the Louisiana Department of Health Page 11 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 department. The above-mentioned system of reimbursement provided for in this 2 Paragraph may be subject to approval by the Centers for Medicare and Medicaid 3 Services. 4 (5) Recognition of the respective regions of the department local governing 5 entities of the state as the a focal point of all mental and behavioral health planning 6 activities, including budget submissions, grant applications, contracts, and other 7 arrangements that can be effected at the state and regional local levels. 8 * * * 9 §14. Funding priorities; cost-effectiveness 10 A. The department may ensure that all current and future funds are expended 11 in the most cost-effective manner and services are provided in accordance with 12 recommended best practices subject to state oversight to ensure accountability to 13 taxpayers and the public. The department may evaluate existing proposed 14 expenditure plans for mental and behavioral health services and determine the best 15 use of such funds to achieve positive policy outcomes in the mental and behavioral 16 health communities community. This effort may involve the use of innovative 17 methods of expanding the reach of current funding and securing increased local, 18 regional, state, federal, or private source funding in the future. The department may 19 develop methods for estimating the need for mental and behavioral health services 20 in certain regions of the state, with special attention to underfunded and inaccessible 21 programs, and allocate state funds or resources according to that need. 22 B. The state may continue to provide funding for mental and behavioral 23 health services that are not less than the existing allocations from the state general 24 fund. 25 §15. Innovative mental and behavioral health services; programs 26 A. The department may develop goals, objectives, and priorities for the 27 creation of innovative programs which promote and improve the mental and 28 behavioral health of the citizens of the state by making treatment and support Page 12 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 services available to those persons who are most in need and least able to pay. These 2 programs may achieve the following: 3 * * * 4 (3) Promote interagency collaboration by improving the integration and 5 effectiveness of state agencies responsible for mental and behavioral health care. 6 * * * 7 (9) Promote emerging best practices and increased quality of care in the 8 delivery of mental and behavioral health services. 9 B. The department may collaborate with mental and behavioral health 10 advocates, clinicians, physicians, professional organizations, parish human service 11 authorities local governing entities, local citizens, consumers, and family members 12 in the planning, designing, and implementation of innovative mental and behavioral 13 health service programs and priorities in their respective regions throughout the state. 14 PART II. INSTITUTIONS FACILITIES AND PLACES FOR MENTAL 15 BEHAVIORAL HEALTH PATIENTS OR CLIENTS 16 * * * 17 §21. State psychiatric hospitals for persons with mental illness and addictive 18 disorders 19 A. The For purposes of this Part, "state psychiatric hospital" refers to the 20 hospital at Jackson, known as the East Louisiana State Hospital Eastern Louisiana 21 Mental Health System, and the hospital at Pineville, known as the Central Louisiana 22 State Hospital, and the hospital at Mandeville, known as the Southeast Louisiana 23 Hospital, which are designated as the hospitals for persons with who have a mental 24 illness and addictive disorders or a substance-related or addictive disorder until such 25 time as separate or other hospitals are established. The assistant secretary of the 26 office of behavioral health of the department may reorganize and consolidate the 27 administration of the hospitals or facilities, including the Feliciana Forensic Facility, 28 the Greenwell Springs Hospital, and the New Orleans Adolescent Hospital as 29 necessary to comply with the provisions of the State Mental Health Plan. Page 13 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 B. The assistant secretary of the office of behavioral health of the department 2 may establish residential settings as satellite facilities to these hospitals from funds 3 presently allocated or to be allocated to these institutions hospitals by the legislature. 4 * * * 5 §21.1. Alcoholism Substance-related and addictive disorders; treatment in state 6 supported psychiatric hospitals 7 A. The Louisiana Department of Health is authorized to accept as indigent 8 patients poor and destitute persons suffering from alcoholism co-occurring 9 substance-related or addictive disorders and to give such patients the care and 10 treatment required to restore them in mind and body. 11 B. The purpose of this Section is to recognize alcoholism substance-related 12 and addictive disorders as a sickness or disease and to place those suffering from it 13 in the same position relative to obtaining treatment as persons suffering from other 14 diseases. 15 §22. Crisis response system 16 * * * 17 B. Each human service district, authority, local governing entity, or region 18 of the Louisiana Department of Health shall develop a plan to do all of the following: 19 * * * 20 C. Each crisis response system will be designed by a local collaborative 21 which shall include but not be limited to: 22 (1) The local provider of mental health, substance-related or addictive 23 disorders, and developmental disability services. 24 * * * 25 §22.5. Community mental health centers behavioral health clinics; behavioral health 26 services providers 27 The community mental health centers located in Lafayette, Pineville, Lake 28 Charles, Baton Rouge, New Orleans, Crowley, Shreveport, and Monroe for the care, 29 treatment, and rehabilitation at the community level of persons with mental illness 30 and persons who are mentally defective as defined in R.S. 28:2 are created and Page 14 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 continued as units of the department under its supervision and administration. 2 Guidance centers heretofore established may be converted to mental health centers 3 by the department or two or more of them may be merged and consolidated into a 4 mental health center by the department. 5 A. Community behavioral health clinics are facilities operating as behavioral 6 health services providers as defined in R.S. 40:2153 and licensed by the department 7 pursuant to the provisions of R.S. 40:2151 et seq. Community behavioral health 8 clinics may be operated or contracted by local governing entities and may be a 9 component of the crisis response system. 10 B. Community behavioral health clinics are differentiated from community 11 mental health centers, which are certified by the federal government and defined by 12 42 CFR 410.2 as entities that provide certain services as described in the Public 13 Health Service Act and meet federal criteria for operation and reimbursement. 14 * * * 15 §22.7. Geriatric hospitals and units 16 A. The department may establish and administer geriatric hospitals or units 17 to receive and care for persons who are elderly or infirm who have been discharged 18 by a hospital for persons with who have a mental illness and for other persons who 19 are elderly or infirm and in need of nursing and medical care. Such hospitals or units 20 may be established on sites designated by the department, provided that no such 21 geriatric hospital or unit may be established on any site located more than five air 22 miles from the administrative office of East Louisiana State Hospital Eastern 23 Louisiana Mental Health System or more than one air mile from the administrative 24 office of Central Louisiana State Hospital. Persons admitted to such geriatric 25 hospitals or units or their responsible relatives shall pay the cost of their maintenance 26 and care. 27 * * * 28 §22.9. Rosenblum Mental Health Center 29 The name of the Hammond Mental Health Center is changed to the 30 Rosenblum Mental Health Center and under such name it shall continue to serve as Page 15 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 an outpatient center for the care, treatment, and rehabilitation of persons with who 2 have a mental illness and persons who are mentally defective with intellectual or 3 developmental disabilities at the region level. 4 §23. Psychiatric inpatient units in state general hospitals 5 The department shall may establish psychiatric inpatient units in state-owned 6 or state-contracted general hospitals for the emergency and temporary care of cases 7 of acute mental illness. 8 §25. Provisions for close confinement of certain mental patients who have a mental 9 illness 10 A. At institutions hospitals that it may designate, the department may 11 provide facilities for the care and confinement of mental patients who have a mental 12 illness and who require close confinement in the interest of themselves and of the 13 public. 14 B. The department shall designate places of confinement for patients of 15 dangerous tendencies and for those clients charged with or convicted of a crime or 16 misdemeanor who require special protection and restraint. 17 §25.1. Establishment of Feliciana Forensic Facility; authorization to establish 18 forensic facilities in New Orleans, Baton Rouge, Shreveport, and Alexandria 19 A. The forensic unit at East Louisiana State Hospital Eastern Louisiana 20 Mental Health System is hereby declared to be a separate and distinct facility from 21 East Louisiana State Hospital and hereafter shall be known as the Feliciana Forensic 22 Facility. 23 * * * 24 C.(1)(a) The superintendent director or administrator of any such facility 25 shall admit only those persons: 26 * * * 27 (v) Judicially committed to and transferred from any state hospital for 28 persons with who have a mental illness or who are inebriate substance-related or 29 addictive disorder. Page 16 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (b) A transfer from any other state hospital shall be had only after the 2 director or administrator of the transferring facility, in concurrence with two 3 psychiatrists, has determined and certified in writing to such forensic facility that the 4 person to be transferred is dangerous to others and that the transferring facility 5 cannot adequately protect its staff and patients from such person. 6 (c) The decision to transfer shall not be made until after the person who is 7 proposed to be transferred has had an opportunity to be heard regarding his actions 8 upon which the proposed transfer is based by the director or administrator and two 9 concurring psychiatrists. 10 * * * 11 (2)(a) The administrator of the Feliciana Forensic Facility shall refuse 12 admission to any person if: 13 * * * 14 (iv) The person from a state hospital or correctional institution is not 15 accompanied by a summary of the facts presented at the hearing at which the person 16 objected to his transfer to the forensic facility and a summary of the person's 17 objections. 18 * * * 19 D. The department may contract with local law enforcement agencies and 20 the Department of Public Safety and Corrections to provide security personnel for 21 mental health patients clients placed in such forensic units, or other facilities to 22 which such patients clients may be temporarily referred for medical treatment. 23 §25.2. Granting of passes to patients Feliciana Forensic Facility clients 24 A. Notwithstanding any other provision of law to the contrary, including any 25 provision of the Code of Criminal Procedure, the administrator of the Feliciana 26 Forensic Facility, in his discretion, may grant any patient client committed to his 27 custody a pass or furlough from the facility, except those patients clients who are 28 under commitment to the Department of Public Safety and Corrections. 29 B. The administrator shall not grant any patient client a pass or furlough for 30 release from the facility except upon the recommendation of the patient's client's Page 17 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 treating psychiatrist and with prior approval of the committing court. The 2 administrator may impose conditions on a pass or furlough. Any pass or furlough 3 granted shall be for a fixed period of time. 4 * * * 5 PART III. EXAMINATION, ADMISSION, COMMITMENT, AND 6 TREATMENT OF PERSONS SUFFERING FROM MENTAL ILLNESS AND 7 SUBSTANCE ABUSE SUBSTANCE-RELATED OR ADDICTIVE DISORDERS 8 §50. Declaration of policy 9 The underlying policy of this Chapter is as follows: 10 (1) That persons with who have a mental illness and persons suffering from 11 substance abuse a substance-related or addictive disorder be encouraged to seek 12 voluntary treatment. 13 * * * 14 (3) That continuity of care for persons with who have a mental illness and 15 persons suffering from substance abuse a substance-related or addictive disorder be 16 provided. 17 (4) That mental health and substance abuse substance-related and addictive 18 disorder treatment services be delivered as near to the place of residence of the 19 person receiving such services as is reasonably possible and medically appropriate. 20 * * * 21 (6) That no person solely as a result of mental illness, or alcoholism 22 substance-related or addictive disorder, or incapacitation by alcohol shall be confined 23 in any jail, prison, correctional facility, or criminal detention center. This shall not 24 apply to persons arrested, charged, or convicted under Title 14 of the Louisiana 25 Revised Statutes of 1950. 26 * * * 27 §51. Procedures for admission 28 * * * 29 C. The Louisiana Department of Health, through its hospitals, mental 30 behavioral health clinics, and similar institutions, shall have the duty to assist Page 18 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 facilities, may direct petitioners and other persons in the preparation of to appropriate 2 resources regarding petitions for commitment, requests for protective custody orders, 3 and requests for emergency certificates, upon request of such persons. 4 §51.1. Treatment facility; staff membership and institutional privileges; certain 5 health care healthcare providers 6 A.(1) Notwithstanding any provision of the law to the contrary, the 7 governing body of a treatment facility, as defined in R.S. 28:2, may grant staff 8 membership, specifically delineated institutional privileges, or both, to any duly 9 licensed, certified, or registered health care healthcare provider in accordance with 10 the needs and bylaws of the treatment facility, including but not limited to a 11 physician, psychiatrist, psychologist, medical psychologist, or psychiatric mental 12 health nurse practitioner, as defined in R.S. 28:2. 13 * * * 14 §52. Voluntary admissions; general provisions 15 A. Any person who is mentally ill has a mental illness or person who is 16 suffering from substance abuse a substance-related or addictive disorder may apply 17 for voluntary admission to a treatment facility. The admitting physician may admit 18 the person on either a formal or informal basis, as hereinafter provided. 19 B. Admitting physicians are encouraged to admit persons with who have a 20 mental illness or persons suffering from substance abuse a substance-related or 21 addictive disorder to treatment facilities on voluntary admission status whenever 22 medically feasible. 23 C. No director or administrator of a treatment facility shall prohibit any 24 person who is mentally ill has a mental illness or person who is suffering from 25 substance abuse a substance-related or addictive disorder from applying for 26 conversion of involuntary or emergency admission status to voluntary admission 27 status. Any patient on an involuntary admission status shall have the right to apply 28 for a writ of habeas corpus in order to have his admission status changed to voluntary 29 status. 30 * * * Page 19 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 G. 2 * * * 3 (2) Knowing and voluntary consent shall be determined by the ability of the 4 individual to understand all of the following: 5 (a) That the treatment facility to which the patient is requesting admission 6 is one for persons with who have a mental illness or persons suffering from 7 substance abuse a substance-related or addictive disorder. 8 * * * 9 H. 10 * * * 11 (2)(a) Notwithstanding the provision provisions of Paragraph (1) of this 12 Subsection, any licensed physician may administer medication to a patient without 13 his consent and against his wishes in a situation which, in the reasonable judgment 14 of the physician who is observing the patient during the emergency, constitutes a 15 psychiatric or behavioral emergency. For purposes of this Paragraph a "psychiatric 16 or behavioral emergency" occurs when a patient, as a result of mental illness, 17 substance abuse a substance-related or addictive disorder, or intoxication, engages 18 in behavior which, in the clinical judgment of the physician, places the patient or 19 others at significant and imminent risk of damage to life or limb. The emergency 20 administration of medication may be continued until the emergency subsides, but in 21 no event shall it exceed forty-eight hours, except on weekends or holidays when it 22 may be extended for an additional twenty-four hours. 23 (b) The physician shall make a reasonable effort to consult with the primary 24 physician or primary care provider outside the facility that has previously treated the 25 patient for his mental behavioral health condition at the earliest possible time, but in 26 no event more than forty-eight hours after the emergency administration of 27 medication has begun, except on weekends or holidays, when the time period may 28 be extended an additional twenty-four hours. The physician shall record in the 29 patient's file either the date and time of the consultation and a summary of the 30 comments of the primary physician or primary care provider or, if the physician is Page 20 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 unable to consult with the primary physician or primary care provider, the date and 2 time that a consultation with the primary physician or primary care provider was 3 attempted. 4 §52.2. Formal voluntary admission 5 A. Any person who is mentally ill has a mental illness or person who is 6 suffering from substance abuse a substance-related or addictive disorder desiring 7 admission to a treatment facility for diagnosis and/or or treatment of a psychiatric 8 disorder or substance abuse a substance-related or addictive disorder and who is 9 deemed suitable for formal voluntary admission by the admitting physician may be 10 so admitted upon his written request. 11 B. A patient admitted under the provisions of this Section shall not be 12 detained in the treatment facility for longer than seventy-two hours after making a 13 valid written request for discharge to the director or administrator of the treatment 14 facility unless an emergency certificate is executed pursuant to R.S. 28:53, or unless 15 judicial commitment is instituted pursuant to R.S. 28:54, after making a valid written 16 request for discharge to the director of the treatment facility. 17 §52.3. Noncontested admission 18 A. A person who is mentally ill has a mental illness or person who is 19 suffering from substance abuse a substance-related or addictive disorder who does 20 not have the capacity to make a knowing and voluntary consent to a voluntary 21 admission status and who does not object to his admission to a treatment facility may 22 be admitted to a treatment facility as a noncontested admission. Such person shall 23 be subject to the same rules and regulations as a person admitted on a voluntary 24 admission status and his treatment shall be governed by the provisions of R.S. 25 28:52(H). 26 B. A noncontested admission may be made by a physician to a treatment 27 facility in order to initiate a complete diagnostic and evaluative study. The diagnosis 28 and evaluation shall include complete medical, social, and psychological studies and, 29 when medically indicated, any other scientific study which may be necessary in 30 order to make decisions relative to the treatment needs of the patient. In the absence Page 21 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 of specified medical reasons, the diagnostic studies shall be completed in fourteen 2 days. Alternative community-based services shall be thoroughly considered. 3 C. Following a review of the diagnostic evaluation study, the director or 4 administrator of the treatment facility shall determine if the person is to remain on 5 noncontested status, is to be discharged, is to be converted to formal or informal 6 voluntary status, or is to be involuntarily hospitalized pursuant to R.S. 28:53 or R.S. 7 28:54. Nothing in this Section shall be interpreted to prohibit the director of a 8 treatment facility from transferring the patient to another treatment facility when it 9 is medically indicated. 10 C. D. A person admitted pursuant to this Section may object to his admission 11 at any time. If the person informs a staff member of his desire to object to his 12 admission, a staff member shall assist him in preparing and submitting a valid 13 written objection to the director or administrator of the treatment facility. Upon 14 receipt of a valid objection, the director or administrator shall release the person 15 within seventy-two hours unless proceedings are instituted pursuant to R.S. 28:53 or 16 R.S. 28:54. 17 D. E. In no case shall a patient remain on noncontested status longer than 18 three months. Within that time, the patient must be converted to either a formal or 19 an informal voluntary status, or be involuntarily hospitalized pursuant to R.S. 28:53 20 or R.S. 28:54, or be discharged. 21 §52.4. Admission by relative or legal guardian for substance-related or addictive 22 disorder treatment 23 A. A person suffering from substance abuse a substance-related or addictive 24 disorder may be admitted and detained at a public or private general hospital or a 25 substance abuse in-patient other treatment facility for observation, diagnosis, and 26 treatment for a medically necessary period not to exceed twenty-eight days, when a 27 parent, spouse, legal guardian, or the major child of the person if that child has 28 attained the age of 18 eighteen years has admitted the person or caused him to be 29 admitted pursuant to the provisions of R.S. 28:53.2. Page 22 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 B. At the time of admission of the person, the parent, spouse, legal guardian, 2 or the major child of the person if that child has attained the age of 18 eighteen years 3 shall execute or provide a written statement of facts, including personal observations, 4 leading to the conclusion that the person is suffering from substance abuse a 5 substance-related or addictive disorder and is dangerous to himself or others or is 6 gravely disabled, specifically describing any dangerous acts or threats, and stating 7 that the person has been encouraged to seek treatment but is unwilling to be 8 evaluated on a voluntary basis. 9 C. As soon as practicable, but in no event more than twelve hours after 10 admission to the hospital or in-patient other treatment facility, a physician shall 11 examine the person and either execute an emergency certificate in accordance with 12 R.S. 28:53(B) or order the person discharged. If an emergency certificate is 13 executed, the physician or the director or administrator of the hospital or in-patient 14 other treatment facility shall immediately notify the coroner, and the coroner or his 15 deputy shall conduct an independent examination, in accordance with R.S. 28:53(G). 16 If the coroner or his deputy executes a second emergency certificate, the person may 17 be detained for treatment for a medically necessary period not to exceed twenty-eight 18 days from the date of his admission. Otherwise, he shall be discharged. 19 * * * 20 §53. Admission by emergency certificate; extension; payment for services rendered 21 A.(1) A person who is mentally ill has a mental illness or a person who is 22 suffering from substance abuse a substance-related or addictive disorder may be 23 admitted and detained at a treatment facility for observation, diagnosis, and treatment 24 for a period not to exceed fifteen days under an emergency certificate. 25 (2) A person suffering from substance abuse a substance-related or addictive 26 disorder may be detained at a treatment facility for one additional period, not to 27 exceed fifteen days, provided that a second emergency certificate is executed. A 28 second certificate may be executed only if and when a physician at the treatment 29 facility and any other physician have examined the detained person within seventy- 30 two hours prior to the termination of the initial fifteen-day period and certified in Page 23 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 writing on the second certificate that the person remains dangerous to himself or 2 others or gravely disabled, and that his condition is likely to improve during the 3 extended period. The director shall inform the patient of the execution of the second 4 certificate, the length of the extended period, and the specific reasons therefor, and 5 shall also give notice of the same to the patient's nearest relative or other designated 6 responsible party initially notified pursuant to Subsection F of this Section. 7 B.(1) Any physician, psychiatric mental health nurse practitioner, or 8 psychologist may execute an emergency certificate only after an actual examination 9 of a person alleged to be mentally ill have a mental illness or be suffering from 10 substance abuse a substance-related or addictive disorder who is determined to be in 11 need of immediate care and treatment in a treatment facility because the examining 12 physician, psychiatric mental health nurse practitioner, or psychologist determines 13 the person to be dangerous to self or others or to be gravely disabled. The actual 14 examination of the person by a psychiatrist may be conducted by telemedicine 15 utilizing video conferencing technology provided that a licensed health care 16 healthcare professional who can adequately and accurately assist with obtaining any 17 necessary information including but not limited to the information listed in 18 Paragraph (4) of this Subsection shall be in the examination room with the patient 19 at the time of the video conference. A patient examined in such a manner shall be 20 medically cleared prior to admission to a mental health treatment facility. Failure 21 to conduct an examination prior to the execution of the certificate will be evidence 22 of gross negligence. 23 (2) The certificate shall state: 24 * * * 25 (b) The objective findings of the physician, psychiatric mental health nurse 26 practitioner, or psychologist relative to the physical or mental condition of the 27 person, leading to the conclusion that the person is dangerous to self or others or is 28 gravely disabled as a result of substance abuse a substance-related or addictive 29 disorder or mental illness. 30 * * * Page 24 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (d) The determination of whether the person examined is in need of 2 immediate care and treatment in a treatment facility because the patient is either any 3 of the following: 4 * * * 5 G. 6 * * * 7 (2) Within seventy-two hours of admission, the person shall be 8 independently examined by the coroner or his deputy who shall execute an 9 emergency certificate, pursuant to Subsection B of this Section, which shall be a 10 necessary precondition to the person's continued confinement. Except as provided 11 in Paragraph (7) of this Subsection, if the actual examination by the psychiatrist 12 referred to in Paragraph (1) of Subsection B (B)(1) of this Section is conducted by 13 telemedicine, the seventy-two-hour independent examination by the coroner shall be 14 conducted in person. 15 * * * 16 (6) When a person is confined in a treatment facility other than a state mental 17 institution psychiatric hospital, the examining coroner in the parish where the patient 18 is confined shall be entitled to the usual fee paid for this service to the coroner of the 19 parish in which the patient is domiciled or residing. When a person is confined in 20 a state mental institution psychiatric hospital in a parish other than his parish of 21 domicile or residence, the examining coroner shall be entitled to the fee authorized 22 by law in his parish for the service. In either case, the fee shall be paid and accurate 23 records of such payments kept by the governing authority of the parish in which the 24 patient is domiciled or residing from parish funds designated for the purpose of 25 payment to the coroner. All coroners Each coroner shall keep accurate records 26 showing the number of patients confined in their parishes his parish pursuant to this 27 Section. 28 * * * 29 J.(1) Upon the request of a credible person of legal age who is financially 30 unable to afford a private physician or who cannot immediately obtain an Page 25 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 examination by a physician, the parish coroner may render, or the coroner or a judge 2 of a court of competent jurisdiction may cause to be rendered by a physician, an 3 actual examination of a person alleged to be mentally ill have a mental illness or be 4 suffering from substance abuse a substance-related or addictive disorder and in need 5 of immediate medical treatment because he is dangerous to himself or others or is 6 gravely disabled. The actual examination of the person by a psychiatrist may be 7 conducted by telemedicine utilizing video conferencing technology provided that a 8 licensed health care healthcare professional who can adequately and accurately assist 9 with obtaining any necessary information including but not limited to the 10 information listed in Paragraph (B)(4) of this Section shall be in the examination 11 room with the patient at the time of the video conference. If the coroner is not a 12 physician he may deputize a physician to perform this examination. To accomplish 13 the examination authorized by this Subsection, if the coroner or the judge is 14 apprehensive that his own safety or that of the deputy or other physician may be 15 endangered thereby, he shall issue a protective custody order pursuant to R.S. 16 28:53.2. 17 (2) If the examining physician determines that the above standard provided 18 in Paragraph (1) of this Subsection is met, he shall execute an emergency certificate 19 and shall transport or cause to be transported the person named in the emergency 20 certificate to a treatment facility. Failure to render an actual examination prior to 21 execution of the emergency certificate shall be evidence of gross negligence. 22 (3) In any instance where the coroner or his deputy executes the first 23 emergency certificate, the second emergency certificate shall not be executed by the 24 coroner or his deputy, but the second emergency certificate may be executed by any 25 other physician including a physician at the treatment center facility. However, if 26 the first examination by the coroner is conducted by a psychiatrist utilizing video 27 conferencing technology, the second examination shall be conducted in person. 28 K.(1)(a) Patients admitted by emergency certificate may receive medication 29 and treatment without their consent, but no major surgical procedure or electroshock 30 therapy may be performed without the written consent of a court of competent Page 26 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 jurisdiction after a hearing. With regard to the administration of medicine, if the 2 patient objects to being medicated, prior to making a final decision, the treating 3 physician shall make a reasonable effort to consult with the primary physician or 4 primary care provider outside of the facility that has previously treated the patient 5 for his mental behavioral health condition. The treating physician shall, prior to the 6 administration of such medication, record in the patient's file either the date and time 7 of the consultation and a summary of the comments of the primary physician or 8 primary care provider or, if the treating physician is unable to consult with the 9 primary physician or primary care provider, the date and time that a consultation 10 with the primary physician or primary care provider was attempted. 11 (b) Notwithstanding the provisions of Subparagraph (a) of this Paragraph, 12 any licensed physician may administer medication to a patient without his consent 13 and against his wishes in a situation which, in the reasonable judgment of the 14 physician who is observing the patient during the emergency, constitutes a 15 psychiatric or behavioral health emergency. For purposes of this Paragraph a 16 "psychiatric or behavioral health emergency" occurs when a patient, as a result of 17 mental illness, substance abuse a substance-related or addictive disorder, or 18 intoxication engages in behavior which, in the clinical judgment of the physician, 19 places the patient or others at significant and imminent risk of damage to life or limb. 20 The emergency administration of medication may be continued until the emergency 21 subsides, but in no event shall it exceed forty-eight hours, except on weekends or 22 holidays when it may be extended for an additional twenty-four hours. 23 (c) The physician shall make a reasonable effort to consult with the primary 24 physician or primary care provider outside the facility that who has previously 25 treated the patient for his mental behavioral health condition at the earliest possible 26 time, but in no event more than forty-eight hours after the emergency administration 27 of medication has begun, except on weekends or holidays, when the time period may 28 be extended an additional twenty-four hours. The physician shall record in the 29 patient's file either the date and time of the consultation and a summary of the 30 comments of the primary physician or primary care provider or, if the physician is Page 27 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 unable to consult with the primary physician or primary care provider, the date and 2 time that a consultation with the primary physician or primary care provider was 3 attempted. 4 * * * 5 L.(1) A peace officer or a peace officer accompanied by an emergency 6 medical service trained technician may take a person into protective custody and 7 transport him to a treatment facility for a medical evaluation when, as a result of his 8 personal observation, the peace officer or emergency medical service technician has 9 reasonable grounds to believe the person is a proper subject for involuntary 10 admission to a treatment facility because the person is acting in a manner dangerous 11 to himself or dangerous to others, is gravely disabled, and is in need of immediate 12 hospitalization to protect such a person or others from physical harm. The person 13 may only be transported only to one of the following facilities: a treatment facility 14 as defined in R.S. 28:2. 15 (a) A community mental health center. 16 (b) A public or private general hospital. 17 (c) A public or private mental hospital. 18 (d) A detoxification center. 19 (e) A substance abuse clinic. 20 (f) A substance abuse in-patient facility. 21 * * * 22 (3) In the case of a person suffering from substance abuse a substance- 23 related or addictive disorder and where any of the above facilities are unavailable no 24 treatment facility is available, the peace officer and emergency medical service 25 technician may use whatever means or facilities available to protect the health and 26 safety of the person suffering from substance abuse a substance-related or addictive 27 disorder until such time as any of the above facilities a treatment facility become 28 becomes available. In taking a person into protective custody the peace officer and 29 emergency medical service technician may take reasonable steps to protect 30 themselves. A peace officer or emergency medical service technician who acts in Page 28 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 compliance with this section Section is acting in the course of his official duty and 2 cannot shall not be subjected subject to criminal or civil liability as a result thereof. 3 * * * 4 §53.2. Order for custody; grounds; civil liability; criminal penalty for making a false 5 statement 6 A. Any parish coroner or judge of a court of competent jurisdiction may 7 order a person to be taken into protective custody and transported to a treatment 8 facility or the office of the coroner for immediate examination when a peace officer 9 or other credible person executes a statement under private signature specifying that, 10 to the best of his knowledge and belief, the person is mentally ill has a mental illness 11 or is suffering from substance abuse a substance-related or addictive disorder and is 12 in need of immediate treatment to protect the person or others from physical harm. 13 The statement may include the following information: 14 (1) A statement of facts, including the affiant's observations, leading to the 15 conclusion that the person is mentally ill has a mental illness or is suffering from 16 substance abuse a substance-related or addictive disorder and is dangerous to himself 17 or others or gravely disabled. 18 * * * 19 B. Any parish coroner or judge of a court of competent jurisdiction may 20 order that a person be taken into protective custody and transported to a treatment 21 facility or the office of the coroner for immediate examination when a physician, 22 psychiatric mental health nurse practitioner, psychologist, or assigned case manager 23 pursuant to Part III-A of Chapter 1 of this Title presents to the coroner or judge an 24 order of involuntary outpatient treatment, and executes a statement specifying that 25 there is substantial evidence that the patient is not in compliance with the order and 26 there are reasonable grounds to believe that he poses a significant risk of being a 27 danger to self or others. Page 29 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 C. The order for custody shall be in writing, in the name of the state of 2 Louisiana, signed by the district judge or parish coroner, and shall state the 3 following: 4 * * * 5 (3) A description of the acts or threats which have led to the belief that the 6 person is mentally ill has a mental illness or is suffering from substance abuse a 7 substance-related or addictive disorder and is in need of immediate hospitalization 8 to protect the person or others from physical harm, and. 9 * * * 10 F. Any person who is found guilty of executing a statement that another 11 person is mentally ill has a mental illness or is suffering from substance abuse a 12 substance-related or addictive disorder and is in need of immediate treatment to 13 protect the person or others that the affiant knows or should know is false may be 14 imprisoned, with or without hard labor, for not more than one year, or fined not more 15 than one thousand dollars. 16 * * * 17 §54. Judicial commitment; procedure 18 A. Any person of legal age may file with the court a petition which asserts 19 his belief that a person is suffering from mental illness which contributes or causes 20 that person to be a danger to himself or others or to be gravely disabled, or is 21 suffering from substance abuse a substance-related or addictive disorder which 22 contributes or causes that person to be a danger to himself or others or to be gravely 23 disabled and may thereby request a hearing. The petition may be filed in the judicial 24 district in which the respondent is confined, or if not confined, in the judicial district 25 where he resides or may be found. The hearing shall not be transferred to another 26 district except for good cause shown. A petitioner who is unable to afford an 27 attorney may seek the assistance of any legal aid society or similar agency if 28 available. 29 * * * Page 30 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 D.(1) As soon as practical after the filing of the petition, the court shall 2 review the petition and supporting documents, and determine whether there exists 3 probable cause to believe that the respondent is suffering from mental illness which 4 contributes to his being or causes him to be a danger to himself or others or gravely 5 disabled, or is suffering from substance abuse a substance-related or addictive 6 disorder which contributes to his being or causes him to be a danger to himself or 7 others or gravely disabled. If the court determines that probable cause exists, the 8 court shall appoint a physician, preferably a psychiatrist, or medical psychologist to 9 examine the respondent and make a written report to the court and the respondent's 10 attorney on the form provided by the office of behavioral health of the Louisiana 11 Department of Health. The court-appointed physician or medical psychologist may 12 be the respondent's treating physician or medical psychologist. The written report 13 shall be made available to counsel for the respondent at least three days before the 14 hearing. This report shall set forth specifically the objective factors leading to the 15 conclusion that the person has a mental illness or suffers from substance abuse a 16 substance-related or addictive disorder, the actions or statements by the person 17 leading to the conclusion that the mental illness or substance abuse substance-related 18 addictive disorder causes the person to be dangerous to himself or others or to be 19 gravely disabled and in need of immediate treatment as a result of such illness or 20 abuse disorder, and why involuntary confinement and treatment are indicated. The 21 following criteria should be considered by the physician or medical psychologist: 22 (a) The respondent is suffering from serious mental illness which contributes 23 or causes him to be dangerous to himself or others or to be gravely disabled or from 24 substance abuse a substance-related or addictive disorder which contributes or causes 25 him to be dangerous to himself or others or to be gravely disabled. 26 * * * 27 (3) If the respondent refuses to be examined by the court appointed court- 28 appointed physician or medical psychologist as herein provided, or if the judge, after 29 reviewing the petition and an affidavit filed pursuant to R.S. 28:53.2 or the report of 30 the treating physician or medical psychologist or the court appointed court-appointed Page 31 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 physician or medical psychologist, finds that the respondent is mentally ill has a 2 mental illness or is suffering from substance abuse a substance-related or addictive 3 disorder and is in need of immediate hospitalization to protect the person or others 4 from physical harm, or that the respondent's condition may be markedly worsened 5 by delay, then the court may issue a court order for custody of the respondent, and 6 a peace officer shall deliver the respondent to a treatment facility designated by the 7 court. The court shall also issue an order to the treatment facility authorizing 8 detention of the respondent until the commitment hearing is completed, unless he is 9 discharged by the director or administrator. 10 * * * 11 §55. Judicial hearings 12 * * * 13 B. The court shall provide the respondent a reasonable opportunity to select 14 his own counsel. In the event the respondent does not select counsel and is unable 15 to pay for counsel, or in the event counsel selected by the respondent refuses to 16 represent said the respondent or is not available for such representation, then the 17 court shall appoint counsel for the respondent provided by the mental health 18 advocacy service. Reasonable compensation of appointed counsel shall be 19 established by the court and may be ordered paid by the respondent or the petitioner 20 in the discretion of the court if either is found financially capable. If it is determined 21 by the court that the costs shall not be borne by the respondent or the petitioner, then 22 compensation to the attorney shall be paid from funds appropriated to the judiciary. 23 * * * 24 E.(1) If the court finds by clear and convincing evidence that the respondent 25 is dangerous to self or others or is gravely disabled, as a result of substance abuse a 26 substance-related or addictive disorder or mental illness, it shall render a judgment 27 for his commitment. After considering all relevant circumstances, including any 28 preference of the respondent or his family, the court shall determine whether the 29 respondent should be committed to a treatment facility which is medically suitable 30 and least restrictive of the respondent's liberty. However, if the placement Page 32 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 determined by the court is unavailable, the court shall commit the respondent to the 2 Louisiana Department of Health for placement in a state treatment facility until such 3 time as an opening is available for transfer to the treatment center facility determined 4 by the court, unless the respondent waives the requirement for such transfer. Within 5 fifteen days following an alternative placement, the department shall submit a report 6 to the court stating the reasons for such placement and seeking court approval of the 7 placement. 8 * * * 9 (3) Unless prohibited by the respondent, the department shall notify the 10 respondent's family of his placement at and/or or transfer to a state treatment facility. 11 (4) The director or administrator shall notify the court in writing when a 12 patient has been discharged or conditionally discharged. 13 (5) The court order shall order a suitable person to convey such person to the 14 treatment facility and deliver respondent, together with a copy of the judgment and 15 certificates, to the director or administrator. In appointing a person to execute the 16 order, the court should give preference to a legal guardian, near relative, or friend of 17 the respondent. 18 * * * 19 F. Notice of any action taken by the court shall be given to the respondent 20 and his attorney as well as to the director or administrator of the designated treatment 21 facility in such manner as the court concludes would be appropriate under the 22 circumstances. 23 G. Each court shall keep a record of the cases relating to persons with who 24 have a mental illness coming before it under this Title and the disposition of them 25 those cases. It shall also keep on file the original petition and certificates of 26 physicians required by this Section, or a microfilm duplicate of such records. All 27 records maintained in the courts under the provisions of this Section shall be sealed 28 and available only to the respondent or his attorney, unless the court, after hearing Page 33 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 held with notice to the respondent, determines such records should be disclosed to 2 a petitioner for cause shown. 3 * * * 4 I.(1)(a) A patient confined to a treatment facility by judicial commitment 5 may receive medication and treatment without his consent, but no major surgical 6 procedures or electroshock therapy may be performed without the written authority 7 of a court of competent jurisdiction after a hearing. With regard to the 8 administration of medicine, if the patient objects to being medicated, prior to making 9 a final decision, the treating physician shall make a reasonable effort to consult with 10 the primary physician or the primary care provider outside of the facility that who 11 has previously treated the patient for his mental behavioral health condition. The 12 treating physician shall, prior to the administration of such medication, record in the 13 patient's file either the date and time of the consultation and a summary of the 14 comments of the primary physician or primary care provider or, if the treating 15 physician is unable to consult with the primary physician or primary care provider 16 the date and time that a consultation with the primary physician or primary care 17 provider was attempted. 18 (b) Notwithstanding the provisions of Subparagraph (a) of this Paragraph, 19 any licensed physician may administer medication to a patient without his consent 20 and against his wishes in situations which, in the reasonable judgment of the 21 physician who is observing the patient during the emergency, constitutes a 22 psychiatric or behavioral health emergency. For purposes of this Paragraph, a 23 "psychiatric or behavioral health emergency" occurs when a patient, as a result of 24 mental illness, substance abuse a substance-related or addictive disorder, or 25 intoxication engages in behavior which, in the clinical judgment of the physician, 26 places the patient or others at significant and imminent risk of damage to life or limb. 27 The emergency administration of medication may be continued until the emergency 28 subsides, but in no event shall it exceed forty-eight hours, except on weekends or 29 holidays when it may be extended for an additional twenty-four hours. Page 34 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (c) The physician shall make a reasonable effort to consult with the primary 2 physician or primary care provider outside the facility that who has previously 3 treated the patient for his mental behavioral health condition at the earliest possible 4 time, but in no event more than forty-eight hours after the emergency administration 5 of medication has begun, except on weekends or holidays, when the time period may 6 be extended an additional twenty-four hours. The physician shall record in the 7 patient's file either the date and time of the consultation and a summary of the 8 comments of the primary physician or primary care provider or, if the physician is 9 unable to consult with the primary physician or primary care provider, the date and 10 time that a consultation with the primary physician or primary care provider was 11 attempted. 12 (2) If the director or administrator of the hospital, in consultation with two 13 physicians, determines that the condition of a committed patient is of such critical 14 nature that it may be life-threatening unless major surgical procedures or 15 electroshock treatment is administered, such measures may be performed without the 16 consent otherwise provided for in this Section. 17 J. No director or administrator of a treatment facility shall prohibit any 18 person who is mentally ill has a mental illness or person who is suffering from 19 substance abuse a substance-related or addictive disorder from applying for 20 conversion of involuntary or emergency admission status to voluntary admission 21 status. Any patient on an involuntary admission status shall have the right to apply 22 for a writ of habeas corpus to have his admission status changed to voluntary status. 23 §56. Judicial commitment; review; appeals 24 A.(1)(a) Except as provided in Subparagraph (b) of this Paragraph, all 25 judicial commitments except those for alcoholism alcohol use disorder shall be for 26 a period not to exceed one hundred eighty days. The period of commitment shall 27 expire at the end of the judicial commitment period, and the patient, if not converted 28 to a voluntary status, shall be discharged unless a petition for judicial commitment 29 has been filed prior to the expiration of the commitment period. If the court finds by 30 clear and convincing evidence that the patient is dangerous to self or others or is Page 35 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 gravely disabled as a result of mental illness, it shall render a judgment for his 2 commitment for an additional period. Except as provided in Subparagraph (b) of 3 this Paragraph, each additional judicial commitment shall expire at the end of one 4 hundred eighty days. 5 * * * 6 (2) 7 * * * 8 (b) All judicial commitments shall be reviewed by the court issuing the order 9 for commitment every ninety days, except those for alcoholism alcohol use disorder 10 and except those individuals committed pursuant to Code of Criminal Procedure 11 Article 648(B) whose cases shall continue to be reviewed annually. The director or 12 administrator of the treatment facility to which the person has been judicially 13 committed shall issue reports to the court and to counsel of record at these intervals 14 setting forth the patient's response to treatment, his current condition, and the reasons 15 why continued involuntary treatment is necessary to improve the patient's condition 16 or to prevent it from deteriorating. These reports shall be treated by the court as 17 confidential and shall not be available for public examination, nor shall they be 18 subject to discovery in any proceedings other than those initiated pursuant to this 19 Title. 20 * * * 21 B. A commitment for alcoholism alcohol use disorder shall expire after 22 forty-five days and the patient, if not converted to a voluntary status, shall be 23 discharged, unless the court, upon application by the director or administrator of the 24 treatment facility, finds that continued involuntary treatment is necessary and orders 25 the patient recommitted for a period not to exceed sixty days; however, not more 26 than two such sixty-day recommitments may be ordered in connection with the same 27 continuous confinement. 28 C. Notwithstanding an order of judicial commitment, the director or 29 administrator of the treatment facility to which the individual is committed is 30 encouraged to explore treatment measures that are medically appropriate and less Page 36 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 restrictive. The director or administrator may at any time convert an involuntary 2 commitment to a voluntary one should he deem that action medically appropriate. 3 He shall inform the court of any action in that regard. The director or administrator 4 may discharge any patient if in his opinion discharge is appropriate. The director or 5 administrator shall not be legally responsible to any person for the subsequent acts 6 or behavior of a patient discharged in good faith. 7 * * * 8 G.(1) A person who is judicially committed may be conditionally discharged 9 for a period of up to one hundred twenty days by the director or administrator or by 10 the court. The patient may be required to report for outpatient treatment as a 11 condition of his release. The terms and conditions of the conditional discharge shall 12 be specifically set forth in writing and signed by the patient. A copy of the 13 conditional discharge shall be given to the patient and explained to him before he is 14 discharged. 15 (2) If the patient is conditionally discharged by the director or administrator, 16 a copy of the conditional discharge shall be sent to the court which judicially 17 committed him. If the patient is conditionally discharged by the court, a copy of the 18 conditional discharge shall be sent to the facility to which the patient has been 19 committed. 20 (3) If a patient does not comply with the terms and conditions of his 21 conditional discharge, he is subject to any of the procedures for involuntary 22 treatment, including but not limited to the issuance of an order for custody and the 23 execution of an emergency certificate. A conditionally discharged patient who is 24 confined pursuant to any of these involuntary procedures shall have all rights of an 25 involuntary patient, including the right to demand a probable cause hearing, the right 26 to periodic reports and review, and a hearing pursuant to Subsections A and B of this 27 Section. 28 (4) An extension of a conditional discharge may be granted upon application 29 by the director or administrator of the treatment facility to the court and notification 30 to respondent's counsel of record. The court may grant the extension of the Page 37 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 conditional discharge for a period of up to one hundred twenty days. No further 2 extension may be made without a contradictory hearing. The burden of proof is on 3 the director or administrator of the treatment facility to show why continued 4 treatment is necessary. 5 * * * 6 §59. Commitment of prisoners 7 A. Any person acquitted of a crime or misdemeanor by reason of insanity or 8 mental defect may be committed to the proper institution in accordance with Code 9 of Criminal Procedure Arts. 654 et seq. 10 * * * 11 C. Any person serving a sentence who becomes mentally ill develops a 12 mental illness may be committed to the proper institution in the manner provided for 13 judicial commitment by the district court of the place of incarceration and 14 contradictorily with the superintendent director or administrator of the place of 15 incarceration or with the sheriff of that parish. The period of commitment shall be 16 credited against the sentence imposed by the court. 17 D. The department shall designate institutions treatment facilities for the care 18 of mental patients clients who have a mental illness committed in accordance with 19 this Section. 20 §62. Commitment to United States veterans and public health service hospitals 21 A. The judge of the civil district court may commit to a United States 22 veterans hospital or United States public health service hospital any eligible 23 incompetent veteran or other person who is in need of institutional inpatient 24 psychiatric care. 25 B. Prior to commitment, the superintendent director or administrator of the 26 hospital shall have indicated his willingness to accept the patient and the ability to 27 care for him. Upon admission, the patient is subject to the rules and regulations of 28 the hospital and its officials are vested with the same powers exercised by 29 superintendents directors or administrators of state mental psychiatric hospitals with 30 reference to the retention of custody of the committed patient. Page 38 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 C. In the commitment of patients under pursuant to the provisions of this 2 Section, the court shall notify the patient of the proceedings and shall give him an 3 opportunity to appear and defend himself. 4 * * * 5 §64. Mental Health Advocacy Service; creation; board of trustees; organization; 6 powers; duties 7 * * * 8 F.(1) Any attorney representing a person with who has a mental illness or a 9 respondent as defined herein in R.S. 28:2 shall have ready access to view and copy 10 all mental health and developmental disability records pertaining to his client, unless 11 the client objects. If the patient or respondent later retains a private attorney to 12 represent him, the mental health advocacy service shall destroy all copies of records 13 pertaining to his case. 14 (2) Any attorney representing a person with who has a mental illness or a 15 respondent as defined herein in R.S. 28:2 shall have the opportunity to consult with 16 his client whenever necessary in the performance of his duties. A treatment facility 17 shall provide adequate space and privacy for the purpose of attorney-client 18 consultation. 19 * * * 20 §67. Petition to the court 21 A petition for an order authorizing involuntary outpatient treatment may be 22 filed in the judicial district in the parish in which the patient is present or reasonably 23 believed to be present. A petition to obtain an order authorizing involuntary 24 outpatient treatment may be initiated by one of the following persons: 25 (1) The director or administrator of a hospital in which the patient is 26 hospitalized. 27 * * * 28 (3) The director of the human service district local governing entity, or his 29 designee, or the manager of the regional office of the Louisiana Department of Page 39 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 Health, office of behavioral health, or his designee, in the parish in which the patient 2 is present or reasonably believed to be present. 3 * * * 4 §69. Procedure 5 A.(1) Upon the filing of the petition authorized by R.S. 28:67, the court shall 6 assign a time and place for a hearing, which may be conducted before any judge in 7 the judicial district, within five days, and shall cause reasonable notice thereof and 8 a copy of the petition to be served upon the respondent, respondent's attorney, the 9 petitioner and the director of the human service district or the regional manager of 10 the Louisiana Department of Health, office of behavioral health, local governing 11 entity in the parish where the petition has been filed. The notice shall inform the 12 respondent that he has a right to be present, a right to counsel, which may be 13 appointed, if he is indigent or otherwise qualified, has the right to counsel appointed 14 to represent him by the Mental Health Advocacy Service, and a right to cross 15 examine witnesses. Continuances shall be granted only for good cause shown. 16 * * * 17 §70. Written treatment plan for involuntary outpatient treatment 18 A. The court shall not order involuntary outpatient treatment unless an 19 examining physician, psychiatric mental health nurse practitioner, or psychologist 20 appointed by the appropriate director of the human service district or regional 21 manager of the Louisiana Department of Health, office of behavioral health, local 22 governing entity develops and provides to the court a proposed written treatment 23 plan. The written treatment plan shall be developed by a treatment team which shall 24 include a case manager, clinical social worker, and licensed physician, psychiatrist, 25 psychiatric mental health nurse practitioner, or psychologist and other specialized 26 service providers as deemed appropriate by the director or regional manager as well 27 as the patient and upon his request, an individual significant to him and concerned 28 with his welfare. The written treatment plan shall include appropriate services to 29 provide care coordination. Such services shall include case management services or 30 assertive community treatment teams. The written treatment plan shall also include Page 40 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 appropriate categories of services, as set forth in Subsection E of this Section, which 2 such team recommends the patient should receive. If the written treatment plan 3 includes medication, it shall state whether the medication should be self- 4 administered or administered by authorized personnel, and shall specify type and 5 dosage range of medication most likely to provide maximum benefit for the patient. 6 B. If the written treatment plan includes alcohol or substance abuse 7 substance-related or addictive disorder counseling and treatment, it may include a 8 provision requiring testing for either alcohol or illegal substances provided the 9 clinical basis for recommending such plan provides sufficient facts for the court to 10 find all of the following: 11 (1) The patient has a history of alcohol or substance abuse a substance- 12 related or addictive disorder that is clinically related to the mental illness. 13 * * * 14 E. 15 * * * 16 (2) Services may include, but are not limited to, the following: 17 * * * 18 (f) Alcohol or substance abuse Substance-related or addictive disorder 19 treatment. 20 * * * 21 §71. Disposition 22 * * * 23 B. If the court finds by clear and convincing evidence that the patient meets 24 the criteria for involuntary outpatient treatment, and no less restrictive alternative is 25 feasible, the court shall order that the patient receive involuntary outpatient treatment 26 for an initial period not to exceed one year. The court shall state reasons why the 27 proposed treatment plan is the least restrictive treatment appropriate and feasible for 28 the patient. The order shall state the categories of involuntary outpatient treatment 29 as set forth in R.S. 28:70, which the patient is to receive, and the court may not order 30 treatment that has not been recommended by the physician, psychiatric mental health Page 41 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 nurse practitioner, or psychologist in consultation with the treatment team and 2 included in the written treatment plan. The plan shall be certified by the director of 3 the human service district or the regional manager of the Louisiana Department of 4 Health, office of behavioral health, local governing entity responsible for services 5 in the district where the petition is filed, as offering services which are available 6 through their offices. The court shall not order an outpatient commitment unless the 7 director or regional manager so certifies. 8 C. If the court finds by clear and convincing evidence that the patient meets 9 the criteria for involuntary outpatient treatment, and a written proposed treatment 10 plan has not been submitted, the court shall order the director of the human service 11 district or the regional manager of the Louisiana Department of Health, office of 12 behavioral health, local governing entity to provide a plan and testimony within five 13 days of the date of the order. 14 * * * 15 E. If the petitioner is the director or administrator of a hospital that operates 16 an involuntary outpatient treatment program, the court order shall direct the hospital 17 to provide all categories of involuntary outpatient treatment services. If the hospital 18 does not have such a program or if the patient is discharged to a different district or 19 region local governing entity, or if the director of the human service district or 20 regional manager for the Louisiana Department of Health, office of behavioral 21 health, local governing entity has filed the petition and certified services are 22 available, the court order shall require the appropriate director or regional manager 23 to provide for all categories of involuntary outpatient treatment services. 24 F. The director or regional manager shall apply for court approval prior to 25 instituting a proposed material change in the involuntary outpatient treatment order 26 unless such change is contemplated in the order. For purposes of this Subsection, a 27 material change shall mean an addition or deletion of a category of involuntary 28 outpatient treatment service, or any deviation without the consent of the patient from 29 the terms of an existing order relating to the administration of psychotropic drugs, 30 or a change of residence from one district or region local governing entity to another. Page 42 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 Any application for court approval shall be served upon all persons required to be 2 served with notice of a petition for an order authorizing involuntary outpatient 3 treatment. Either party may move for a hearing on the application. If a motion is not 4 filed within five days from the date the application is filed, the court shall grant the 5 application. 6 * * * 7 §72. Application for additional periods of treatment 8 A. The court order for outpatient treatment shall expire at the end of the 9 specified period unless a petition or motion for an extension has been filed. If the 10 director or regional manager determines that a patient requires further involuntary 11 outpatient treatment, he shall file a petition or motion for continued treatment prior 12 to the expiration of the initial involuntary outpatient treatment ordered by the court. 13 If a patient has been ordered to receive outpatient treatment for four consecutive six- 14 month to one-year periods, the period of any subsequent order may exceed one year 15 but shall not exceed two years. 16 * * * 17 §73. Application to stay, vacate, or modify 18 In addition to any right or remedy available by law, the patient may apply to 19 the court to stay, vacate, or modify the order and he shall notify the director or 20 manager of his application. 21 * * * 22 §91. Transfer to mental institution psychiatric hospital 23 A. The judge shall designate or shall request the superintendent administrator 24 to provide an attendant to conduct transfer the patient to the institution psychiatric 25 hospital and may authorize the employment of assistants if necessary. 26 B. Wherever practicable, the mental patient to be hospitalized shall be 27 permitted to be accompanied by one or more of his friends or relatives. 28 Upon delivering the patient, the attendant shall indorse that fact upon a 29 warrant and the superintendent receiving the patient shall sign the warrant in 30 acknowledgment. Page 43 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §92. Transfer of patients from military establishments 2 A. Any resident and rightful charge upon the state who becomes mentally 3 ill suffers from a mental illness while in military service and is returned to the state 4 because of need of institutional inpatient psychiatric care, shall be directly 5 transferred from the military establishment to a state psychiatric hospital, provided 6 arrangements to receive him are made in advance with the superintendent hospital 7 administrator. 8 B. Unless sooner discharged from military service, the patient shall be 9 detained for a period of observation not to exceed thirty days. If it is found that he 10 should remain at the hospital, he shall, after discharge from military service, be 11 committed in accordance with the provisions of this Chapter. 12 §93. Transfer of veterans to United States veterans hospitals 13 A. Any veteran eligible for treatment in a United States veterans hospital 14 who has been committed to a mental psychiatric hospital within the state may be 15 transferred to a United States veterans hospital. 16 B. The transfer shall be by order of the committing court or by order of the 17 superintendent director or administrator of the mental psychiatric hospital in which 18 the veteran is confined or by order of the division if the veteran is on leave. 19 §94. Transfer of patients between institutions psychiatric hospitals 20 A.(1) Except as otherwise provided in this Subsection, the department may 21 transfer any patient from one mental institution psychiatric hospital to another if 22 applicable eligibility criteria are met. Moreover, the superintendent of an institution 23 administrator of a psychiatric hospital may request the department to transfer a 24 patient when he believes that a transfer is necessary. 25 (1) (2) A patient may be transferred to or from a private mental institution 26 psychiatric hospital only upon the joint application of the superintendent director or 27 administrator of that institution hospital and of the legal or natural guardian or the 28 person liable for the support of the patient. However, no private mental institution 29 psychiatric hospital shall be obligated to retain a patient because of the refusal to 30 sign the application by the legal guardian or the person liable for support. Page 44 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (2) (3) A person under sentence or acquitted of a crime or misdemeanor on 2 the ground of mental illness or defect disability shall be transferred only upon 3 authority of the committing court. 4 (3) (4) A voluntary patient shall be transferred only with his written consent. 5 * * * 6 §96. Discharge by the superintendent administrator or treating physician 7 A. Except as otherwise provided in this Section, the superintendent 8 administrator or treating physician may discharge any patient committed to his 9 institution a psychiatric hospital if he believes that the patient has sufficiently 10 recovered and that no harm will result from his discharge. 11 B. The superintendent administrator or treating physician shall as frequently 12 as practicable, but not less often than every six months, examine or cause to be 13 examined every patient and may discharge the patient and immediately make a report 14 thereof to the division court when necessary or appropriate. 15 C. A patient client committed in accordance with the provisions of Article 16 267 648 of the Code of Criminal Procedure shall be discharged only in the manner 17 provided in that Article. 18 * * * 19 E. A patient who has shown dangerous tendencies shall be discharged upon 20 conditional release with the written consent of the division court after an 21 examination and after sufficient guarantee of proper supervision of the patient by a 22 reputable person who is approved by the court. 23 F. A patient whose discharge is opposed by a legal guardian, relative, or 24 other interested person shall be discharged only after the person opposing has been 25 notified and given an opportunity to state his reasons why the patient should be 26 detained for further care and treatment. 27 G. A mental defective patient who has a mental illness who no longer 28 requires treatment may be discharged with the approval of the division attending 29 physician and treatment team. and with the approval of the committing court if 30 commitment was by court order. Page 45 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 H. A mental defective patient who has a mental illness and is convicted of 2 a crime or misdemeanor prior to his transfer to an institution for mental defectives 3 a psychiatric hospital shall not be discharged prior to the time he might have been 4 discharged from his original place of detention. 5 §96.1. Discharge by the superintendent director or administrator of a private mental 6 psychiatric hospital 7 A. Except as otherwise provided in this Section the superintendent director, 8 administrator, or head of a private mental psychiatric hospital may discharge any 9 patient committed to his institution hospital only on the certificate of either two 10 physicians, or one physician and one psychologist, medical psychologist, or 11 psychiatric mental health nurse practitioner stating that the patient has sufficiently 12 recovered and that no harm will result from his discharge. 13 B. A patient committed in accordance with the provisions of Article 267 648 14 of the Code of Criminal Procedure shall be discharged only in the manner provided 15 in that Article. 16 * * * 17 D. A patient whose discharge from a private mental psychiatric hospital is 18 opposed by a legal guardian, relative, or other interested person shall be discharged 19 only after the person opposing has been notified and given an opportunity to state the 20 reasons why the patient should be detained for further care and treatment. 21 E. A patient committed to a private mental psychiatric hospital who has 22 shown dangerous tendencies shall be discharged only upon the certificate of either 23 two physicians, or one physician and one psychologist, medical psychologist, or 24 psychiatric mental health nurse practitioner after an examination, and after sufficient 25 guarantee has been provided of proper supervision of the patient by a reputable 26 person who is approved by the court. 27 F. A mental defective who patient who has a mental illness and no longer 28 requires treatment may be discharged on the certificate of either two physicians, or 29 one physician and one psychologist, medical psychologist, or psychiatric mental Page 46 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 health nurse practitioner and with the approval of the committing court if the 2 commitment was by criminal court order. 3 §97. Discharge by the department 4 The department may order the examination and the discharge of any patient, 5 except those committed in accordance with R.S. 28:59 and under Title XXI relating 6 to insanity proceedings of the Code of Criminal Procedure, if as a result of the 7 examination it believes that the patient should no longer be detained. When a 8 discharge in accordance with this Section is contemplated, the department shall give 9 notice to the superintendent director or administrator and to the person who caused 10 filed the original petition causing the patient to be committed, in order that they may 11 state their reasons why the patient should be detained for further treatment. 12 §98.2. Immunity of superintendent and mental psychiatric hospital and director or 13 administrator 14 Any detentions, confinements, commitments or discharges made of a mental 15 patient who has a mental illness in accordance with this Chapter to any state or 16 private mental psychiatric hospital or institution by the superintendent director or 17 administrator thereof, acting in good faith, reasonably and without negligence, are 18 hereby declared to be administrative acts of the superintendent and/or director, 19 administrator, or the hospital, and the superintendent director, administrator, and the 20 hospital are hereby granted immunity from liability for damages to any patient so 21 detained, confined, or committed for false imprisonment or otherwise,; provided, 22 however, that the superintendent and/or director, administrator, or the hospital shall 23 not thereby be exempt from liability for negligence in the care or treatment of such 24 patient. 25 §99. Discharge by lapse of time 26 Any patient continuously absent from an institution a psychiatric hospital 27 without authorized leave for twelve months seventy-two hours is automatically 28 discharged and may be readmitted only according to law. This Section does shall not 29 apply to mental defectives or epileptics, whose leaves are indefinite and who can be Page 47 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 returned at any time until formal discharge, nor to patients clients committed in 2 accordance with R.S. 28:59 or Code of Criminal Procedure Article 648 or 654. 3 §100. Leaves of absence for patients 4 A. The superintendent treating physician may grant to patients leaves of 5 absence for such time and upon such conditions as he prescribes. In granting leave, 6 the superintendent director or administrator is subject to the restrictions provided in 7 R.S. 28:96. 8 B. A patient on leave may be returned at any time by the superintendent 9 director, administrator, or the person to whom he has been released. The cost of 10 return shall be paid by the latter. 11 Mental defectives and epileptics, whose leaves are indefinite, can be returned 12 at any time until formal discharge, but other patients shall renew their leaves yearly 13 or are liable to become automatically discharged in accordance with R.S. 28:99. 14 * * * 15 §101. Boarding out patients 16 A. Under conditions indicating rehabilitation possibilities, the superintendent 17 director or administrator, with the consent of the department, may permit patients to 18 board out with responsible persons who may be paid for their care of the patients. 19 This Section does not apply to patients clients committed in accordance with R.S. 20 28:59. 21 A. B. In determining the amount to be paid, the value of any services to be 22 rendered by the patient while boarding shall be considered and should the services 23 of the patient justify, he shall be paid a sum in excess of his board to compensate him 24 for these services. 25 B. C. The superintendent director or administrator may require the person 26 applying to board a patient to give bond with security for the proper care of the 27 patient. 28 C. D. Agents of the institution state psychiatric hospital shall visit frequently 29 visit every boarding patient. If it is determined that the patient is not being cared for Page 48 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 properly, the superintendent director or administrator shall recall him to the 2 institution state psychiatric hospital with the consent of the department. 3 §102. Return State psychiatric hospitals; return of escaped patients 4 Any escaped patient from a state psychiatric hospital shall be returned at the 5 expense of the institution state psychiatric hospital from which he escaped left 6 without authorization unless his discharge is granted before his return. 7 §103. Deportation of nonresident patients 8 A. The department or executive authority of this state may return any 9 nonresident patient to the state or county country of which he is a legal resident. 10 Pending the return, the department shall provide necessary temporary care for the 11 patient. He shall be suitably clothed and, if necessary, shall be accompanied by an 12 attendant who shall deliver the patient with due care to the proper officials at the 13 destination. If the patient is able to travel alone, he shall be provided with sufficient 14 funds for sustenance and travel. 15 B. The department or executive authority of this state may enter into 16 agreements with other states for reciprocity in deporting mental psychiatric patients. 17 §104. Importation of mental nonresident psychiatric patients prohibited 18 A. No person or public carrier shall knowingly import a non-resident 19 nonresident mental psychiatric patient into this state for the purpose of having him 20 committed. 21 B. Any person who violates the provisions of this Section shall be fined one 22 hundred dollars or imprisoned for sixty days, or both, and the patient shall be 23 removed from the state at the expense of the offending person or public carrier. 24 §105. Extradition of escaped patients 25 The extradition of escaped patients shall be in accordance with the Uniform 26 Act for the Extradition of Persons of Unsound Mind. 27 A. For purposes of this Section, the following definitions relative to 28 extradition of escaped patients apply: Page 49 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (1) "Executive authority" means the governor of a state or other executive 2 of a territory, district, or insular or other possession of the United States, or his 3 appointed designee. 4 (2) "Flight" and "fled" shall mean any departure from the jurisdiction of the 5 court where the proceedings provided for in this Section may have been instituted 6 and are still pending, with the effect of avoiding, impeding, or delaying the action 7 of the court in which such proceedings may have been instituted or be pending. 8 (3) "State" shall include any state, territory, district, and insular and other 9 possession of the United States. 10 B.(1) Whenever the executive authority of any state other than Louisiana 11 demands the return of an escaped nonresident patient and produces a certified copy 12 of the decree or other judicial process and proceedings for involuntary commitment 13 with an affidavit showing the person to be an escapee, it shall be the duty of the 14 executive authority of Louisiana to apprehend and secure the escapee. 15 (2) The executive authority of Louisiana shall give immediate notice of the 16 apprehension of the escapee to the executive authority making such demand, or to 17 the agent of the authority appointed to receive the escapee, and shall cause the 18 escapee to be delivered to such agent. If no agent appears within forty days from the 19 time of apprehension, the escapee may be discharged. 20 C. All costs and expenses incurred in apprehending, securing, maintaining, 21 and transmitting the escapee shall be paid by the state making the demand for the 22 return of the escapee. Any agent so appointed who receives the escapee into his 23 custody shall be empowered to transmit him to the state from which he has fled. 24 PART V. FEES AND COSTS 25 §141. Costs of commitment and examination 26 A. If financially able, the patient or his legally responsible relative legal 27 guardian shall pay the costs of commitment, including examination fees, expenses 28 incurred in calling witnesses, fees of counsel for the patient, and fees of the 29 commission, otherwise the parish of domicile in the case of a resident or the division 30 department in the case of a non-resident shall pay these costs. Page 50 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 B. Fees for services rendered by coroners or other experts in the commitment 2 of patients shall be in accordance with the provisions contained in Article 267 659 3 of the Code of Criminal Procedure and the special laws relating to the fees of 4 coroners and assisting physicians in interdiction proceedings. Except for emergency 5 commitments which do not result in court commitment and voluntary admissions, 6 the coroner of the parish of domicile shall receive the usual fee allowed in a formal 7 commitment, for all types of commitment under this Chapter, even though he does 8 not act personally in the commitment proceeding. 9 §142. Costs of transportation 10 A. If financially able, the patient or his legally responsible relative legal 11 guardian shall pay all the costs incident to transporting the patient to the mental state 12 psychiatric hospital; otherwise the department, in the case of a nonresident, or the 13 parish in which the hearing was held, in the case of a resident, shall pay these costs. 14 If a patient's domicile is in a parish other than that in which the hearing was held, the 15 former parish shall reimburse the latter for these costs. 16 B. Fees for transporting patients shall be in accordance with the special laws 17 establishing fees for transporting prisoners. 18 §143. Costs of maintenance and boarding out daily care 19 A. The superintendent director or administrator of each mental institution 20 state psychiatric hospital shall include the costs of maintenance and boarding out 21 daily care of patients as an expense of the institution state psychiatric hospital and 22 shall prepare budgets in accordance with the provisions of Chapter 1 of Title 39 of 23 the Louisiana Revised Statutes of 1950. 24 B. If financially able, the patient or his legally responsible relative legal 25 guardian shall reimburse the institution state psychiatric hospital for all or a part of 26 the cost of his maintenance or boarding out daily care. 27 §144. Investigation and assessment of charges 28 The department shall develop procedures to determine the ability of a patient 29 or his legally responsible relative legal guardian to pay all or a part of the costs of the Page 51 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 patient's care and shall adopt a policy including rules and regulations for the 2 assessment of charges in accordance with the ability to pay. 3 §145. Costs of transfer 4 The person requesting the transfer shall pay the costs of transferring a patient 5 between institutions hospitals. The department shall pay the costs of transfers made 6 at its request. 7 §146. Expenses incident to discharge, removal, or funeral 8 A. If financially able, the patient or his legally responsible relative legal 9 guardian shall pay the costs of the patient's funeral or his discharge and removal, 10 including traveling expenses to his home; otherwise the institution state psychiatric 11 hospital shall pay these costs. If discharge is ordered by the department and the 12 institution has to pay state psychiatric hospital pays the patient's traveling expenses 13 to his home, the department shall reimburse the institution state psychiatric hospital 14 out of appropriations for persons who are indigent and have a mental illness. 15 * * * 16 §147. Method of collection 17 The department may demand and receive any sums assessed as costs against 18 a patient or his legally responsible relative legal guardian, and in the case of 19 nonpayment, may sue to enforce collection. 20 * * * 21 PART VI. RIGHTS OF PERSONS SUFFERING FROM MENTAL ILLNESS AND 22 SUBSTANCE ABUSE SUBSTANCE-RELATED OR ADDICTIVE DISORDERS 23 §171. Enumerations of rights guaranteed 24 * * * 25 C. 26 * * * 27 (4)(a) The director of any substance abuse use treatment facility may restrict 28 the visitation rights of a patient who is voluntarily admitted to such treatment facility 29 under the provisions of R.S. 28:52, 52.1, 52.2, 52.3, and 52.4 for the initial phase of 30 treatment but no longer than seven days unless good cause exists to extend the Page 52 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 restriction and is so documented in the patient's record. This restriction shall not 2 apply to visitation by the patient's attorney, or if he is not represented by counsel, the 3 mental health advocate, or the patient's minister. This restriction shall also not apply 4 to a parent or legal guardian of a patient who is a minor unless the director 5 determines that good cause exists that such restriction shall be in the best interest of 6 the patient and is so documented in the patient's record. When the facility director 7 determines the need to restrict visitation of new patients he shall post notice of such 8 restriction in places prominent to all new admissions, and shall inform each new 9 patient of the restriction prior to the admission of the patient, and the length and 10 duration thereof, and further, that such restriction may be extended on an individual 11 basis as determined to be in the patient's interest by the treatment staff with the 12 concurrence of the medical director. 13 * * * 14 D. Seclusion or restraint shall only be used to prevent a patient from 15 physically injuring himself or others. Seclusion or restraint may not be used to 16 punish or discipline a patient or used as a convenience to the staff of the treatment 17 facility. Seclusion or restraint shall be used only in accordance with the following 18 standards: 19 * * * 20 (5) A renewal order for up to twelve hours of seclusion or restraint may be 21 issued by a physician, psychologist, medical psychologist, or psychiatric mental 22 health nurse practitioner with institutional authority to order seclusion or restraint 23 after determining that there is no less restrictive means of preventing injury to the 24 patient or others. If any patient is held in seclusion or restraint for twenty-four 25 consecutive hours, the physician, psychologist, medical psychologist, or psychiatric 26 mental health nurse practitioner with institutional authority shall conduct an actual 27 examination of the patient and document the reason why the use of seclusion or 28 restraint beyond twenty-four consecutive hours is necessary, and the next of kin or 29 responsible party shall be notified by the twenty-sixth hour. 30 * * * Page 53 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §171.1. Principles for the mental behavioral health system 2 The department and any entity which receives funding through a state 3 contract to provide services to persons who are mentally ill with needs relating to 4 behavioral health, as defined in R.S. 28:2, shall provide, to the maximum extent 5 possible, mental behavioral health treatment, services, and supports which are 6 consistent with the following principles: 7 * * * 8 (5) Persons with mental illness behavioral health needs are generally best 9 able to determine their own needs, rather than their needs being determined by 10 others. 11 (6) For children with mental illness behavioral health needs, the needs of the 12 entire family should be considered in the development of family supports. 13 (7) Family supports may enable children to live in stable family 14 environments with enduring relationships with one or more adults regardless of the 15 severity of the mental illness behavioral health needs of the child or the degree of 16 support necessary. 17 (8) Children and young adults with mental illness behavioral health needs 18 receive and participate in an appropriate education which enables them to have 19 increased opportunities for well being, development, and inclusion in their 20 communities. 21 * * * 22 §172. Deposit of patients' funds; disbursement 23 A. The superintendent administrator of each state psychiatric hospital for 24 persons with mental illness is authorized to receive and receipt for funds belonging 25 to a patient and shall keep such funds on deposit for the use and benefit of the 26 patient. Such funds shall be considered as being on deposit with an agency of the 27 state of Louisiana and no bond shall be required of the superintendent department. 28 Disbursement thereof shall be made only on order of the court having jurisdiction 29 over the patient if he has been judicially interdicted or if not, an order of the person 30 or governmental agency making the deposit in behalf of the patient. Page 54 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 B. When a patient dies who has funds on deposit to his credit, the 2 superintendent administrator may at his discretion use whatever portion of such those 3 funds is needed to give the patient a decent burial. The remainder of the patient's 4 funds may be claimed by his heirs by appropriate legal action. If such funds are not 5 claimed by the heirs of a deceased patient within five years of the date of his death, 6 then his funds shall become the property of the state and be used by the 7 superintendent administrator for the benefit of other patients in the hospital. 8 §173. Interest earned on funds of mental psychiatric hospital patients 9 Interest earned on funds of mental patients deposited with the institution shall 10 be expended by the institution for recreational purposes for the benefit of the inmates 11 therein psychiatric hospital shall be remitted to the individual patient. 12 PART VII. PENALTIES 13 §181. Improper commitment 14 Any person who, alone or in conspiracy with others, unlawfully, wilfully 15 willfully, maliciously, and without reasonable cause, commits or attempts to commit 16 to any mental institution any person not sufficiently ill to require suffering from 17 mental illness or a substance-related or addictive disorder to the extent that he 18 requires care shall be fined not more than one thousand dollars, or imprisoned for not 19 more than one year, or both. 20 §183. Furnishing weapons 21 Any person who knowingly makes available any dangerous instrument or 22 weapon to any patient client of any mental institution treatment facility shall be fined 23 not more than five hundred dollars, or imprisoned for not more than two years, or 24 both. 25 §184. Furnishing intoxicants 26 Any person who knowingly makes available any intoxicant to any patient 27 client of any mental institution treatment facility, except with the permission of the 28 superintendent director or administrator, shall be fined not more than five hundred 29 dollars, or imprisoned for not more than one year, or both. Page 55 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §185. Unlicensed counseling 2 A. No person shall hold himself out to be a counselor with a specific 3 specialty to provide mental health or substance abuse substance-related or addictive 4 disorder treatment services, or attempt to provide counseling services in this state, 5 and receive fees either from the patient or a third party, unless he is authorized to 6 practice in the specific specialty area by the appropriate state or regulatory authority. 7 * * * 8 §200. Promotion of a community-based system of care 9 It is hereby declared to be a function of the Louisiana Department of Health 10 to promote the establishment and administration of a community-based system of 11 care, including but not limited to community behavioral health centers clinics for 12 persons with who have a mental illness, persons with developmental disabilities, or 13 persons with both conditions as contemplated by the provisions of R.S. 40:2013. 14 Behavioral health centers as used herein shall include guidance centers. 15 §201. Transfer of administration 16 The department may continue to administer any such existing centers clinics, 17 but its primary endeavor shall be to transfer responsibility for the administration of 18 existing facilities or facilities that may hereafter be created to local associations, 19 nonprofit corporations, police juries, school boards, municipalities, or other public 20 agencies that have demonstrated a desire to establish, maintain, and operate facilities 21 for persons with who have a mental illness, developmental disabilities, or both 22 conditions on a municipal, parish, or other local area basis. 23 §202. Lease of land, buildings, and equipment 24 The department may lease to responsible local organizations or to the 25 governing bodies of local public agencies any state owned state-owned land, 26 buildings, and equipment designed for or being operated as a behavioral health 27 center clinic. 28 * * * Page 56 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §215.2. Coroner's Strategic Initiative for a Health Information and Intervention 2 Program; powers and duties 3 Subject to the availability of adequate funding, a CSI/HIP may perform any 4 of the following functions: 5 (1) Provide a home-based support system, which shall not provide any 6 mental behavioral health treatment but rather shall provide aid to the individual to 7 ensure that the treatment protocol is being met and to access available mental 8 behavioral health resources in the community for persons who satisfy all of the 9 following criteria: 10 * * * 11 (2) Establish a community resource center that is accessible by telephone or 12 Internet to provide twenty-four hour support for persons suffering from a mental 13 health or substance abuse condition or illness or substance-related or addictive 14 disorder by providing educational and outreach materials about the resources for 15 mental behavioral health patients which are available in the community, including 16 the location, transportation, and methods for accessing these resources. 17 * * * 18 §215.3. Treatment facilities; dissemination of information 19 A. For Notwithstanding R.S. 28.2, for the purposes of this Section, 20 "treatment facility" shall mean any healthcare facility which provides services or 21 treatment to a person who is suffering from a mental health or substance abuse 22 condition or illness or substance-related or addictive disorder except for a nursing 23 home as defined in R.S. 40:2009.2. 24 B. A treatment facility shall provide to all individuals in the parish suffering 25 from a mental health condition illness or substance-related or addictive disorder upon 26 discharge or release an information and consent form which details the information, 27 programs, and services which can be provided by the CSI/HIP to individuals 28 suffering from mental health conditions illness and substance-related or addictive 29 disorders and includes a voluntary consent form for the individual to complete if the 30 individual desires to have the treatment facility notify the CSI/HIP on behalf of the Page 57 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 individual that the individual would like to be contacted by the CSI/HIP to receive 2 additional information about the program. 3 * * * 4 §215.4. Consent 5 A. Prior to personnel of the coroner's office or CSI/HIP providing any home- 6 based supports or services to an individual, the personnel of the coroner's office or 7 of the CSI/HIP shall provide to the individual in writing a full disclosure of all 8 services to be provided, frequency of home visits, and notice that the individual may 9 withdraw his consent in writing at any time. In addition, the individual shall also 10 consent in writing to the list of persons, if any, with whom the personnel of the 11 coroner or the CSI/HIP may discuss his mental behavioral health condition. 12 * * * 13 PART X. ADVANCE DIRECTIVES FOR MENTAL 14 BEHAVIORAL HEALTH TREATMENT 15 §221. Definitions 16 As used in this Part: 17 (1) "Advance directive for mental behavioral health treatment" or "advance 18 directive" means a written document voluntarily executed by a principal in 19 accordance with the requirements of this Part and includes a declaration or the 20 appointment of a representative or both. 21 (2) "Declaration for mental behavioral health treatment" or "declaration" 22 means a written document executed by a principal, in accordance with the 23 requirements of this Part, setting forth preferences or instructions regarding mental 24 behavioral health treatment in the event the principal is determined to be incapable 25 and mental behavioral health treatment is necessary. 26 (3) "Director" or "superintendent" "administrator" means a person in charge 27 of a treatment facility or his deputy. 28 (4) "Incapable" means that, due to any infirmity, the principal is currently 29 unable to make or to communicate reasoned decisions regarding the principal's 30 mental behavioral health treatment. Page 58 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (5) "Mental Behavioral health treatment" shall have the same meaning as 2 provided in R.S. 28:2(28) and includes but is not limited to electroshock therapy, 3 means treatment of mental illness with psychoactive psychotropic medication, 4 admission to and retention in a treatment facility, and or outpatient services. 5 However, "mental behavioral health treatment" shall not include admission to or 6 retention in a mental health treatment facility for a period in excess of fifteen days. 7 (6) "Outpatient services" means treatment for a mental or emotional illness 8 or a substance-related or addictive disorder that is obtained on an outpatient basis. 9 * * * 10 (8) "Principal" means an individual who has executed an advance directive 11 for mental behavioral health treatment. 12 (9) "Provider" means a mental behavioral health treatment provider. 13 * * * 14 (11) "Representative" means a competent adult validly appointed under R.S. 15 28:223 to make mental behavioral health treatment decisions for a principal and also 16 means an alternative representative. 17 (12) "Treating physician" means the physician who has primary 18 responsibility for the mental behavioral health treatment of the principal. 19 (13) "Treatment facility" shall have the same meaning as provided in R.S. 20 28:2(29)(a) R.S. 28.2. 21 §222. Individuals who may make an advance directive for mental behavioral health 22 treatment; period of validity 23 A. An adult who is not incapable may make an advance directive for mental 24 behavioral health treatment. The preferences or instructions may include consent to 25 or refusal of mental behavioral health treatment. 26 B. An advance directive for mental behavioral health treatment shall 27 continue in effect for a period of five years or until revoked, whichever occurs first. 28 The authority of a named representative and any alternative representative named in 29 the advance directive for mental behavioral health treatment shall continue in effect Page 59 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 as long as the advance directive appointing the representative is in effect or until the 2 representative has withdrawn. 3 C. If an advance directive for mental behavioral health treatment has been 4 delivered to the principal's treating physician or other provider and the principal has 5 been determined to be incapable pursuant to R.S. 28:226, at the expiration of five 6 years after its execution, it shall remain effective until the principal is no longer 7 incapable. 8 §223. Designation of representative for decisions about mental behavioral health 9 treatment 10 An advance directive for mental behavioral health treatment may designate 11 a competent adult to act as a representative to make decisions about mental 12 behavioral health treatment. An alternative representative may also be designated 13 to act as representative if the original designee is unable or unwilling to act at any 14 time. A representative who has accepted the appointment in writing may make 15 decisions about mental behavioral health treatment on behalf of the principal only 16 when the principal is determined to be incapable pursuant to R.S. 28:226. The 17 decisions shall be consistent with any desires the principal has expressed in the 18 declaration. 19 §224. Execution of advance directive; witnesses; mental status psychiatric 20 examination 21 A. An advance directive for mental behavioral health treatment shall be valid 22 only if it is signed by the principal and two competent witnesses and accompanied 23 by a written mental status psychiatric examination performed by a physician or 24 psychologist attesting to the principal's ability to make reasoned decisions 25 concerning his mental behavioral health treatment. The witnesses shall attest that the 26 principal is known to them, signed the advance directive in their presence, and does 27 not appear to be unable to make reasoned decisions concerning his mental behavioral 28 health treatment or under duress, fraud, or undue influence. Individuals specified in 29 R.S. 28:234 may not act as witnesses. Page 60 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 B. In determining the principal's ability, the physician or psychologist should 2 consider all of the following: 3 (1) whether Whether the principal demonstrates an awareness of the nature 4 of his illness and situation;. 5 (2) whether Whether the principal demonstrates an understanding of 6 treatment and the risks, benefits, and alternatives; and. 7 (3) whether Whether the principal communicates a clear choice regarding 8 treatment that is a reasoned one, even though it may not be in the person's best 9 interest. 10 §225. Operation of advance directive; physician or provider to act in accordance 11 with advance directive 12 A. An advance directive shall become operative when it is delivered to the 13 principal's treating physician or other mental behavioral health treatment provider 14 and shall remain valid until revoked or expired. 15 B. The treating physician or provider shall act in accordance with an 16 operative advance directive when the principal has been found to be incapable 17 pursuant to R.S. 28:226. Notwithstanding the operative advance directive, the 18 treating physician or provider shall endeavor to communicate with the principal 19 regarding his proposed mental behavioral health treatment and even continue to 20 obtain the principal's informed consent to all mental behavioral health treatment 21 decisions if the principal is capable of providing informed consent or refusal. 22 * * * 23 §227. Scope of authority of representative; powers and duties; limitation on liability 24 A. The representative shall not have the authority to make mental behavioral 25 health treatment decisions unless the principal is determined to be incapable as 26 provided in R.S. 28:226. 27 * * * 28 C. Except to the extent the right is limited by the advance directive or any 29 state or federal law, a representative shall have the same right as the principal to 30 receive information regarding both proposed and administered mental behavioral Page 61 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 health treatment and to receive, review, and consent to disclosure or use of medical 2 records relating to that treatment. This representative's right of access to the 3 principal's mental behavioral health treatment information shall not waive any 4 evidentiary privilege. 5 * * * 6 E. A representative shall not be subject to criminal prosecution, civil 7 liability, or professional disciplinary action for any action taken in good faith 8 pursuant to an advance directive for mental behavioral health treatment. 9 §228. Prohibitions against requiring an individual to execute or refrain from 10 executing an advance directive 11 An individual shall not be required to execute or to refrain from executing an 12 advance directive for mental behavioral health treatment as a criterion for insurance, 13 as a condition for receiving mental behavioral or physical health services, or as a 14 condition of discharge from a treatment facility. 15 §229. Advance directive for mental behavioral health treatment; part of medical 16 record; physician or provider compliance; withdrawal of physician or 17 provider 18 A. Upon being presented with an advance directive for mental behavioral 19 health treatment, a physician or other provider shall make the advance directive a 20 part of the principal's medical record. When acting under authority of an advance 21 directive, a physician or provider shall comply with it to the fullest extent possible, 22 consistent with the appropriate standard of care, reasonable medical practice, the 23 availability of treatments requested, and applicable law. If the physician or other 24 provider is unable or unwilling at any time to carry out preferences or instructions 25 contained in an advance directive for mental behavioral health treatment or the 26 decisions of the representative, the physician or provider may withdraw from 27 providing treatment to the principal. 28 * * * Page 62 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 C. For the purposes of this Section, "physician" means the treating physician 2 or any other physician proposing or administering mental behavioral health treatment 3 to the principal. 4 §230. Disregarding advance directives; circumstances 5 A. The physician or provider may subject a principal determined to be 6 incapable pursuant to R.S. 28:226 to mental behavioral health treatment in a manner 7 contrary to the principal's wishes as expressed in an advance directive for mental 8 behavioral health treatment only: 9 * * * 10 (2) When the treating physician determines that psychotropic medication is 11 essential and after compliance with the following procedures: 12 (a) When a principal's advance directive for behavioral health treatment or 13 his representative refuses medication that the treating physician believes is essential, 14 the director or administrator of the treatment facility shall conduct an administrative 15 review to determine whether the principal should be forcibly medicated contrary to 16 his wishes. 17 * * * 18 (d) A principal may be medicated contrary to the wishes expressed in his 19 advance directive if, based on a review of the advance directive and the reasons 20 stated therein, the patient's medical chart, a personal examination of the patient, the 21 wishes of the principal's representative, if any, and the recommendations of the 22 treating physician, the director determines that the medication is medically essential. 23 The director shall consider the following criteria in making that decision: 24 (i) The patient is mentally ill has a mental illness and is dangerous to himself 25 or others or gravely disabled without the medication. 26 * * * 27 B. An advance directive shall not limit the authority provided in R.S. 28:2 28 et seq., this Chapter to take a principal into protective custody or to involuntarily 29 admit or commit a principal to a treatment facility. Page 63 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 C. An advance directive shall not authorize admission to or retention in a 2 mental health treatment facility for a period in excess of fifteen days. 3 * * * 4 §232. Limitations on liability of physician or provider 5 A physician or provider who administers or does not administer mental 6 behavioral health treatment according to and in good faith reliance upon the validity 7 of an advance directive for mental behavioral health treatment shall not be subject 8 to criminal prosecution, civil liability, or professional disciplinary action resulting 9 from a subsequent finding of an advance directive's invalidity. 10 §233. Individuals prohibited from serving as representative 11 The following individuals shall be prohibited from serving as a 12 representative: 13 * * * 14 (2) An owner, operator, or employee of a health care treatment facility in 15 which the principal is a patient, client, or resident if the owner, operator, or employee 16 is unrelated to the principal by blood, marriage, or adoption. 17 §234. Individuals prohibited from serving as witnesses to advance directive for 18 mental behavioral health treatment 19 The following individuals shall be prohibited from serving as a witness to the 20 signing of an advance directive for mental behavioral health treatment: 21 * * * 22 (2) An owner, operator, or relative of an owner or operator of a mental 23 behavioral health treatment facility in which the principal is a patient or resident. 24 * * * 25 CHAPTER 5. GROUP HOME FOR PERSONS 26 WITH WHO HAVE MENTAL ILLNESS OR 27 DEVELOPMENTAL DISABILITIES ACT 28 §475. Short title 29 This Chapter shall be known and may be cited as the "Group Home for 30 Persons with who have Mental Illness or Developmental Disabilities Act". Page 64 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §476. Declaration of policy 2 The legislature hereby declares that it is the policy of this state as declared 3 and established in this Title, particularly in the Developmental Disability Law and 4 the Mental Behavioral Health Law, that persons with mental or physical disabilities 5 are entitled to live in the least restrictive environment in their own community and 6 in normal residential surroundings and should not be excluded therefrom because of 7 their disabilities. The legislature further declares that the provisions of this Chapter 8 are intended to secure to all of the citizens of this state the right to individual dignity 9 as provided in Article I, Section 3 of the Constitution of Louisiana and to protect the 10 rights and promote the happiness and general welfare of the people of this state. To 11 that end, the legislature hereby declares that the provisions of this Chapter are an 12 exercise of the police power reserved to the state by Article I, Section 4 and Article 13 VI, Section 9(B) of the Constitution of Louisiana. 14 §477. Definitions 15 As used in this Chapter, unless otherwise clearly indicated, these words and 16 phrases have the following meanings: 17 (1) "Community home" means a facility certified, licensed, or monitored by 18 the Louisiana Department of Health to provide resident services and supervision to 19 six or fewer persons with who have mental illness or developmental disabilities. 20 Such facility shall provide supervisory personnel in order to function as a single 21 family unit but not to exceed two live-in persons. 22 * * * 23 (3)(a) "Person with who has a mental illness or a developmental disability" 24 means any person who has a physical or mental impairment which substantially 25 limits one or more of the following major life activities: 26 * * * 27 (b) This definition shall not include persons with substance use substance- 28 related or addictive disorders, nor shall it apply to persons with who have mental 29 illness or developmental disabilities and are currently under sentence or on parole Page 65 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 from any criminal violation or who have been found not guilty of a criminal charge 2 by reason of insanity. 3 §478. Promotion of community based homes 4 A. In order to achieve uniform statewide implementation of the policies of 5 this Title and of those of the Developmental Disabilities Law and of the Mental 6 Behavioral Health Law, it is necessary to establish the statewide policy that 7 community homes are permitted by right in all residential districts zoned for 8 multiple-family dwellings. 9 * * * 10 CHAPTER 11. SUBSTANCE-RELATED AND ADDICTIVE DISORDERS 11 §771. Office of behavioral health; functions related to regarding substance-related 12 and addictive disorders 13 A. The office of behavioral health of the Louisiana Department of Health, 14 hereinafter referred to as the "office", shall perform the functions of the state relating 15 to the care, training, treatment, and education of persons suffering from substance- 16 related and addictive disorders and the prevention of addictive those disorders. It 17 shall administer residential and outpatient care facilities of the state for substance- 18 related and addictive disorder patients and administer the substance-related and 19 addictive disorders programs in the state. 20 B. The office shall additionally perform have the following duties and 21 responsibilities: 22 (1) Formulation and implementation of policies relating to the treatment and 23 prevention of substance-related and addictive disorders in accordance with 24 applicable state law; however, the provisions of this Section shall not apply to the 25 Substance Abuse Prevention Program of the Department of Education and the 26 Highway Safety Act of 1966 (P.L. 89-564) administered by the Highway Safety 27 Commission of the Department of Public Safety and Corrections. 28 (2) Provision of all services to persons suffering from substance-related and 29 addictive disorders which were formerly provided by the office of prevention and 30 recovery from alcohol and drug abuse of the Louisiana Department of Health and Page 66 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 such services otherwise required by law. The office may provide such services 2 directly or through contracts with local, state, or federal agencies or private care 3 providers. 4 (3) Administration of all programs relating to substance-related and 5 addictive disorders listed in this Title. 6 (4) Coordination of all programs of all state departments relating to 7 substance-related and addictive disorders, including assisting such agencies in the 8 assessment and referral of persons subject to their jurisdiction. The office shall also 9 establish and implement an employee assistance program on substance-related and 10 addictive disorders for state employees. 11 (5)(a) Provision of assessment, referral, and treatment services for substance- 12 related and addictive disorders to persons subject to the custody of state, municipal, 13 or parish correctional institutions pursuant to agreements with such institutions and 14 to persons subject to driving while intoxicated programs. In addition to any charges 15 established by the department for treatment services by the office provided to 16 persons subject to driving while intoxicated programs, the department may assess 17 every patient in such program to whom the office provides treatment services a 18 standard copayment fee of ten dollars per session subject to applicable federal 19 regulations. A patient whose treatment is provided by the office through a private 20 contractor shall not be assessed a copayment fee as provided above. Nothing in this 21 Paragraph shall be construed to prohibit such a private provider from assessing fees 22 otherwise allowable under applicable federal and state laws. The department shall 23 provide by rule for the implementation of such copayment not later than March 15, 24 1987. 25 (b) Notwithstanding the provisions of Subparagraph (a) and otherwise 26 subject to its provisions, not later than September 1, 1987, the department, by rule, 27 shall increase the amount of the standard copayment fee to twenty dollars per 28 session. 29 (c) (b) The copayment provided for in this Paragraph shall be deposited in 30 the state treasury pursuant to R.S. 39:82 and shall be accounted for by the Page 67 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 commissioner of administration through appropriations control pursuant to R.S. 2 39:334(B)(6). The commissioner of administration shall establish a separate cost 3 center in the office of behavioral health and the office for citizens with 4 developmental disabilities for revenue generated pursuant to this Paragraph. All 5 funds not obligated shall revert to the state general fund at the end of the fiscal year. 6 (6) Maintenance of complete statistics and other relevant information on 7 substance-related and addictive disorders within the state of Louisiana and provision 8 of such information to interested agencies, groups, and individuals upon request. 9 (7) Receive any federal funds available under Title 18, Title 19, and Title 20 10 Title XVIII, Title XIX, and Title XX of the Social Security Act and any other funds 11 specifically allocated for the prevention or treatment of substance-related and 12 addictive disorders and to use any such funds received. 13 (8) Development of procedures and criteria for determining, and, in 14 accordance with such procedures and criteria, determination of the ability of a patient 15 or person receiving services, or his legally responsible relative legal guardian, to pay 16 all or a part of the costs of the care or treatment of the patient or recipient. The 17 department shall promulgate rules and regulations to provide for such determination 18 and for the assessment of charges for care or treatment based on such determination. 19 (9) Provide a twenty-four-hour, toll-free telephone service to provide 20 information regarding available services to assist with compulsive or problem 21 gambling behavior disorders. 22 (10) Require any patient who is given a urine drug screen in a state-operated 23 outpatient or inpatient alcohol or drug abuse facility as part of his treatment by the 24 office of behavioral health to pay a copayment of not more than twelve dollars per 25 screen to the provider of the screen if he is able to pay such copayment based on a 26 sliding fee scale. Such copayments shall be charged and collected by the provider. 27 The office of behavioral health department shall promulgate rules and regulations to 28 establish a sliding fee scale and criteria for determining a patient's ability to pay. 29 Any patient eligible to receive Medicaid shall be exempt from the provisions of the 30 copayment requirements. The copayments shall be exempt from the provisions of Page 68 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 R.S. 49:971(A)(3) which provide that no state agency shall increase any existing fee 2 or impose any new fee unless the fee increase or fee adoption is expressly authorized 3 pursuant to a fee schedule established by statute or specifically authorized by federal 4 law, rules, or regulations for the purpose of satisfying an express mandate of such 5 federal law, rule, or regulation. 6 C. The services and programs as described in Subsections A and B of this 7 Section shall be the responsibility of and shall be performed by the Jefferson Parish 8 Human Services Authority for Jefferson Parish only. The department shall not be 9 responsible for and shall not perform these services and programs in Jefferson 10 Parish. 11 D. The services and programs as described in Subsections A and B of this 12 Section, excluding the operation and management of any in-patient inpatient facility 13 under the jurisdiction of the department, shall be the responsibility of and shall be 14 performed by the Capital Area Human Services District for the parishes of 15 Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe Coupee, West Baton 16 Rouge, and West Feliciana only. The department shall not be responsible for and 17 shall not perform these services and programs in said such parishes provided that if 18 funds are not appropriated by the legislature for the district to provide these services 19 and programs in said those parishes, the department shall continue to be responsible 20 for and shall perform these services and programs in said those parishes. 21 E. The services and programs as described in Subsections A and B of this 22 Section, excluding the operation and management of any inpatient facility for 23 developmental disabilities and mental health under the jurisdiction of the department, 24 shall be the responsibility of and shall be performed by the Florida Parishes Human 25 Services Authority for the parishes of Livingston, St. Helena, St. Tammany, 26 Tangipahoa, and Washington only. The department shall not be responsible for and 27 shall not perform these services and programs in said such parishes provided that if 28 funds are not appropriated by the legislature for the authority to provide these 29 services and programs in said those parishes, the department shall continue to be 30 responsible for and shall perform these services and programs in said those parishes. Page 69 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 F. The services and programs as described in Subsections A and B of this 2 Section, excluding the operation and management of any inpatient facility under the 3 jurisdiction of the department, shall be the responsibility of and shall be performed 4 by the Metropolitan Human Services District for the parishes of Orleans, St. Bernard, 5 and Plaquemines only. The department shall not be responsible for and shall not 6 perform these services and programs in said such parishes provided that if funds are 7 not appropriated by the legislature for the district to provide these services and 8 programs in said those parishes, the department shall continue to be responsible for 9 and shall perform these services and programs in said those parishes. 10 G. The services and programs as described in Subsections A and B of this 11 Section, excluding the operation and management of any inpatient facility under the 12 jurisdiction of the department, shall be the responsibility of and shall be performed 13 by the South Central Louisiana Human Services District for the parishes of 14 Assumption, Lafourche, St. Charles, St. James, St. John the Baptist, St. Mary, and 15 Terrebonne only. The department shall not be responsible for and shall not perform 16 these services and programs in said such parishes provided that if funds are not 17 appropriated by the legislature for the district to provide these services and programs 18 in said those parishes, the department shall continue to be responsible for and shall 19 perform these services and programs in said those parishes. 20 H. The services and programs as described in Subsections A and B of this 21 Section, excluding the operation and management of any inpatient facility under the 22 jurisdiction of the department, shall be the responsibility of and shall be performed 23 by the Northeast Delta Human Services Authority for the parishes of Caldwell, East 24 Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, 25 Tensas, Union, and West Carroll only. The department shall not be responsible for 26 and shall not perform these services and programs in said such parishes provided that 27 if funds are not appropriated by the legislature for the district to provide these 28 services and programs in said those parishes, the department shall continue to be 29 responsible for and shall perform these services and programs in said those parishes. Page 70 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 §772. Funding of regional addictive disorder services 2 A.(1) Funding for regional substance-related and addictive disorder services 3 as defined in Subsection B of this Section shall be allocated to each region according 4 to a formula developed by the assistant secretary of the office of behavioral health, 5 promulgated in accordance with the Administrative Procedure Act, and evaluated 6 each year to determine necessary changes. 7 (2) The formula developed by the office shall weigh certain elements in 8 determining the formula. The elements and their assigned weights are as follows: 9 * * * 10 (c) The estimated number of adults in a region needing treatment for 11 substance-related and addictive disorders shall be assigned a weight of twenty 12 percent. 13 * * * 14 B. "Regional substance-related and addictive disorder services" shall include 15 all treatment and prevention/education prevention or education services provided in 16 each region. 17 * * * 18 CHAPTER 15. COMPULSIVE AND PROBLEM GAMBLING DISORDERS 19 §841. Office of behavioral health; functions related to compulsive and problem 20 gambling disorders 21 A. The office of behavioral health of the Louisiana Department of Health 22 shall establish a program to provide information and referral services related to 23 compulsive or problem gambling disorders. The program may include treatment 24 services and shall include provision of a twenty-four hour, toll-free telephone 25 service, operated by persons with knowledge of programs and services available to 26 assist persons suffering from compulsive or problem gambling behavior gambling 27 disorders. 28 * * * 29 §911. Definitions 30 As used in this Chapter and unless the context clearly requires otherwise: Page 71 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (1) "Behavioral health services" means community-based mental health and 2 substance-related and addictive disorders services. 3 * * * 4 §913. Governing board; membership; appointment; terms; compensation 5 A. 6 * * * 7 (2) The parish appointees shall be persons with professional experience or 8 parents, consumers, or advocates in the fields of substance-related and addictive 9 disorders, developmental disabilities, mental health, or public health. 10 (3)(a) The governor's three appointees shall be one member with experience 11 in the financial operation of a business enterprise, one member who is a parent, 12 consumer, or caregiver of a consumer of services, and one member who represents 13 one of the following fields: substance-related and addictive disorders, 14 developmental disabilities, mental health, or public health. 15 (b) The governing authority of each parish may submit three names to the 16 governor for consideration as one of the governor's three appointees. 17 * * * 18 §915. Districts; functions, powers, and duties 19 A. Pursuant to a contract with the department, all human services districts 20 shall: 21 * * * 22 (3) Perform community-based functions for the care, diagnosis, training, 23 treatment, and education related to substance-related and addictive disorders, 24 including but not limited to alcohol, drug abuse, or gambling. 25 * * * 26 §931. Definitions; purposes 27 * * * 28 B. The purposes of an intervention and stabilization unit include, without 29 limitation, all of the following: 30 * * * Page 72 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (2) To diminish the need in a community for recurrent crisis services for 2 persons suffering from mental illness, substance abuse a substance-related or 3 addictive disorder, or both conditions. 4 * * * 5 Section 3. R.S. 36:258(C) and 259(C)(10) and (16) are hereby amended and 6 reenacted to read as follows: 7 §258. Offices; purposes and functions 8 * * * 9 C. The consolidation of the administration of the offices for mental illness 10 health and of addictive disorders into the office of behavioral health will offer less 11 redundancy and greater benefits to Louisiana citizens in need of these services. The 12 office of behavioral health shall perform the functions of the state which provide 13 oversee services and continuity of care for the prevention, detection, treatment, 14 rehabilitation, and follow-up care of mental and emotional illness in Louisiana and 15 shall perform functions related to mental health. It shall also perform the functions 16 of the state relating to the care, training, treatment, and education of those suffering 17 from substance-related or addictive disorders and the prevention of substance-related 18 and addictive disorders and administer the substance-related and addictive disorders 19 programs in the state. It shall administer monitor residential and outpatient care 20 facilities of the state for persons who are mentally ill with mental illness, persons 21 suffering from substance-related or addictive disorders, and persons suffering from 22 co-occurring mental illness and substance-related or addictive disorders. 23 * * * 24 §259. Transfer of agencies and functions to Louisiana Department of Health 25 C. The following agencies, as defined by R.S. 36:3, are transferred to and 26 hereafter shall be within the Louisiana Department of Health, as provided in Part II 27 of Chapter 22 of this Title: 28 * * * Page 73 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 (10) East Louisiana State Hospital Eastern Louisiana Mental Health System 2 (Jackson) 3 * * * 4 (16) The mental behavioral health facilities located in New Orleans, Baton 5 Rouge, Shreveport, Monroe, Lake Charles, Alexandria, Lafayette, Metairie, 6 Hammond, Natchitoches, Ruston, Chalmette, Houma, Harvey, Marksville, Bogalusa, 7 Pineville, Many, New Roads, Covington, Crowley, Donaldsonville, Plaquemine, 8 Raceland, Leesville, Norco, Mandeville, Ville Platte, Patterson, Tallulah, Columbia, 9 Oakdale, and any other state owned or operated state-owned or state-operated 10 facilities as may be hereinafter established (R.S. 28:22.4-22.5 R.S. 28:22.5) 11 * * * 12 Section 4. R.S. 40:1237.1(A)(9)(a)(ii)(introductory paragraph) and 2142(A) are 13 hereby amended and reenacted to read as follows: 14 §1237.1. Definitions and general application 15 A. As used in this Part: 16 * * * 17 (9)(a) "State health care provider" or "person covered by this Part" means: 18 * * * 19 (ii) A person acting in a professional capacity in providing health care 20 services, by or on behalf of the state, including but not limited to a physician, 21 psychologist, coroner, and assistant coroner who is a licensed physician when acting 22 solely in accordance with the Mental Behavioral Health Law as provided in R.S. 23 28:50 et seq., provided that the premium costs of such malpractice coverage shall be 24 the responsibility of the coroner's office, dentist, a licensed dietician or licensed 25 nutritionist employed by, referred by, or performing work under contract for, a state 26 health care provider or other person already covered by this Part, registered nurse, 27 licensed practical nurse, nurse practitioner, clinical nurse specialist, pharmacist, 28 optometrist, podiatrist, physical therapist, occupational therapist, licensed respiratory 29 therapist, licensed radiologic technologist, licensed clinical laboratory scientist, Page 74 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 social worker, hospital administrator, or licensed professional counselor, who is 2 either: 3 * * * 4 §2142. Geriatric hospitals and units 5 A. The department may establish and administer geriatric hospitals or units 6 to receive and care for persons who are elderly or infirm who have been discharged 7 by a hospital for persons with mental illness and for other persons who are elderly 8 or infirm who are in need of nursing and medical care. Such hospitals or units may 9 be established on sites designated by the department in quarters constructed or 10 designated by the department, provided that no such geriatric hospital or unit may 11 be established on any site located more than five air miles from the administrative 12 office of East Louisiana State Hospital Eastern Louisiana Mental Health System or 13 more than one air mile from the administrative office of Central Louisiana State 14 Hospital. 15 * * * 16 Section 5. Code of Criminal Procedure Articles 648(A)(1) and (B)(1), 657, 17 657.1(A)(4), and 657.2(A) are hereby amended and reenacted to read as follows: 18 Art. 648. Procedure after determination of mental capacity or incapacity 19 A. The criminal prosecution shall be resumed unless the court determines by 20 a preponderance of the evidence that the defendant does not have the mental capacity 21 to proceed. If the court determines that the defendant lacks mental capacity to 22 proceed, the proceedings shall be suspended and one of the following dispositions 23 made: 24 (1) If the court determines that the defendant's mental capacity is likely to 25 be restored within ninety days by outpatient care and treatment at an institution a 26 treatment facility as defined by R.S. 28:2(29) R.S. 28:2 while remaining in the 27 custody of the criminal authorities, and if the person is not charged with a felony or 28 a misdemeanor classified as an offense against the person and is considered by the Page 75 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 court to be unlikely to commit crimes of violence, then the court may order 2 outpatient care and treatment at any institution as defined by R.S. 28:2(29) R.S. 28:2. 3 * * * 4 B.(1) In no instance shall such custody, care, and treatment exceed the time 5 of the maximum sentence the defendant could receive if convicted of the crime with 6 which he is charged. At any time after commitment and on the recommendation of 7 the superintendent of the institution director or administrator of the treatment facility 8 that the defendant will not attain the capacity to proceed with his trial in the 9 foreseeable future, the court shall, within sixty days and after at least ten days notice 10 to the district attorney, defendant's counsel, and the Bureau of Legal Services bureau 11 of legal services of the Louisiana Department of Health, conduct a contradictory 12 hearing to determine whether the mentally defective defendant is, and will in the 13 foreseeable future be, incapable of standing trial and whether he is a danger to 14 himself or others. 15 * * * 16 Art. 657. Discharge or release; hearing 17 After considering the report or reports filed pursuant to Articles 655 and 656, 18 the court may either continue the commitment or hold a contradictory hearing to 19 determine whether the committed person is no longer mentally ill has a mental 20 illness as defined by R.S. 28:2(14) R.S. 28:2 and can be discharged, or can be 21 released on probation, without danger to others or to himself as defined by R.S. 22 28:2(3) and (4) R.S. 28:2. At the hearing the burden shall be upon the state to seek 23 continuance of the confinement by proving by clear and convincing evidence that the 24 committed person is currently both mentally ill has a mental illness and is dangerous. 25 After the hearing, and upon filing written findings of fact and conclusions of law, the 26 court may order the committed person discharged, released on probation subject to 27 specified conditions for a fixed or an indeterminate period, or recommitted to the 28 state mental institution. A copy of the judgment and order containing the written 29 findings of fact and conclusions of law shall be forwarded to the administrator of the 30 forensic facility. Notice to the counsel for the committed person and the district Page 76 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 attorney of the contradictory hearing shall be given at least thirty days prior to the 2 hearing. 3 Art. 657.1. Conditional release; criteria 4 A. At any time the court considers a recommendation from the hospital- 5 based review panel that the person may be discharged or released on probation, it 6 may place the insanity acquittee on conditional release if it finds the following: 7 * * * 8 (4) Conditional release will not present an undue risk of danger to others or 9 self, as defined in R.S. 28:2(3) and (4) R.S. 28:2. 10 * * * 11 Art. 657.2. Conditional release; additional requirements 12 A. Upon an application for conditional release of a person, who has been 13 committed to a state hospital or other treatment facility pursuant to this Chapter upon 14 the grounds that the adverse effects of a mental illness are in remission, and if after 15 a hearing the court determines that the applicant will not likely be a danger to others 16 or himself, as defined in R.S. 28:2(3) and (4) R.S. 28:2, if he is under supervision 17 and his treatment is monitored in the community, the court shall not consider the 18 applicant to be in stable remission from the adverse effects of a mental illness until 19 the applicant is placed with an appropriate forensic conditional release program for 20 at least one year but not more than five years. 21 * * * 22 Section 6. Children's Code Article 1404(9) is hereby amended and reenacted to read 23 as follows: 24 Art. 1404. Definitions 25 As used in this Title: 26 * * * 27 (9) "Family psychiatric mental health nurse practitioner" means an individual 28 who maintains the credentials as such and meets the requirements of a "psychiatric 29 mental health nurse practitioner" as provided in R.S. 28:2(21.2) R.S. 28:2. Further, Page 77 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HB NO. 341 ENROLLED 1 a family psychiatric mental health nurse practitioner shall have been engaged in 2 clinical practice for not less than three years. 3 * * * 4 Section 7. R.S. 28:2(11), 22.4, 22.10, 52.1, 95, 100.1, 182, Chapter 6 of Title 28 of 5 the Louisiana Revised Statutes of 1950, comprised of R.S. 28:501 through 506, and Chapter 6 7 of Title 28 of the Louisiana Revised Statutes of 1950, comprised of R.S. 28:561, are 7 hereby repealed in their entirety. SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED: Page 78 of 78 CODING: Words in struck through type are deletions from existing law; words underscored are additions.