HLS 18RS-520 REENGROSSED
2018 Regular Session
HOUSE BILL NO. 158
BY REPRESENTATIVE FOIL AND SENATOR CLAITOR
CORONERS: Provides relative to admissions to treatment facilities under an emergency
certificate
1 AN ACT
2To amend and reenact R.S. 28:53(B)(1) and (G)(8) and 63(A)(1) and (B), relative to
3 admissions to treatment facilities by emergency certificate; to provide relative to
4 transfers between parishes; to provide relative to duties of physicians and coroners;
5 to provide for standard of care; and to provide for related matters.
6Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 28:53(B)(1) and (G)(8) and 63(A)(1) and (B) are hereby amended and
8reenacted to read as follows:
9 §53. Admission by emergency certificate; extension; payment for services rendered
10 * * *
11 B.(1) Any physician licensed or permitted by the Louisiana State Board of
12 Medical Examiners, physician assistant when acting in accordance with their
13 respective clinical practice guidelines, psychiatric mental health nurse practitioner,
14 other nurse practitioner who acts in accordance with a collaborative practice
15 agreement and receives verbal approval for executing the certificate from his
16 collaborating physician, or psychologist may execute an emergency certificate only
17 after an actual examination of a person alleged to have a mental illness or be
18 suffering from a substance-related or addictive disorder who is determined to be in
19 need of immediate care and treatment in a treatment facility because the examining
20 physician, physician assistant when acting in accordance with their respective
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1 clinical practice guidelines, psychiatric mental health nurse practitioner, other nurse
2 practitioner who acts in accordance with a collaborative practice agreement and
3 receives verbal approval for executing the certificate from his collaborating
4 physician, or psychologist determines the person to be dangerous to self or others or
5 to be gravely disabled. The actual examination of the person by a psychiatrist may
6 be conducted by telemedicine utilizing video conferencing technology provided that
7 a licensed healthcare professional who can adequately and accurately assist with
8 obtaining any necessary information including but not limited to the information
9 listed in Paragraph (4) of this Subsection shall be in the examination room with the
10 patient at the time of the video conference. A patient examined in such a manner
11 shall be medically cleared prior to admission to a mental health treatment facility.
12 Failure to conduct an examination prior to the execution of the certificate will be
13 evidence of gross negligence.
14 * * *
15 G.
16 * * *
17 (8) As it relates to all other parishes, the parishes of East Baton Rouge,
18 Jefferson, Orleans, and Ouachita, the following shall apply:
19 (a) When a patient is transferred from another parish pursuant to an
20 emergency certificate, a second physician's emergency certificate, when appropriate,
21 shall be executed by a physician at the admitting facility.
22 (b) The coroner shall be notified immediately following the execution of the
23 second emergency certificate and shall conduct an independent examination within
24 seventy-two hours as provided in Paragraph (2) of this Subsection, in the manner
25 provided in accordance with Subparagraph (G)(7)(a) of this Section 7(a) of this
26 Subsection.
27 (c) Nothing herein shall be construed to authorize a period of commitment
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HB NO. 158
1 to exceed fifteen days from the date and time the initial emergency certificate was
2 executed in the parish of origin.
3 * * *
4 §63. Standard of care; limitation of liability; penalties
5 A.(1) Any licensed physician licensed or permitted by the Louisiana State
6 Board of Medical Examiners, physician assistant, psychologist, medical
7 psychologist, psychiatric mental health nurse practitioner, other nurse practitioner
8 who acts in accordance with a collaborative practice agreement and receives verbal
9 approval for executing the certificate from his collaborating physician, or public and
10 private general hospital personnel exercising that degree of skill and care ordinarily
11 employed, under similar circumstances by members of his profession in good
12 standing in the same community or locality, and using reasonable care and diligence
13 with his best judgment in the application of his skill, shall not be held civilly liable
14 or subject to criminal prosecution for acts arising from his professional opinions
15 which fall within the scope of his duties, judgments, actions, or duties pursuant to
16 any of the provisions of this Part, unless the damage or injury was caused by willful
17 or wanton negligence or gross misconduct. This limitation of liability shall apply
18 only to public and private general hospital personnel who within the preceding
19 twelve-month period have received appropriate training in nonviolent crisis
20 intervention. Such training shall be documented in their personnel files. The training
21 shall be provided by an instructor who has attended a course in crisis intervention
22 taught by a certified instructor.
23 * * *
24 B. Any licensed physician licensed or permitted by the Louisiana State
25 Board of Medical Examiners, physician assistant, psychologist, medical
26 psychologist, or psychiatric mental health nurse practitioner, or other nurse
27 practitioner who acts in accordance with a collaborative practice agreement and
28 receives verbal approval for executing the certificate from his collaborating
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1 physician, who executes an emergency certificate shall be held to that degree of skill
2 and care ordinarily employed, under similar circumstances, by members of his
3 profession in good standing in the same community or locality, and using reasonable
4 care and diligence with his best judgment in the application of his skill.
5 * * *
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 158 Reengrossed 2018 Regular Session Foil
Abstract: Expands list of parishes to all in Louisiana that require notification to the coroner
when a second physician's emergency certificate is executed following a patient's
transfer from one parish to another. Adds that physicians issuing emergency
certificates must be licensed or permitted by the Louisiana State Board of Medical
Examiners.
Present law allows the admission and detention of a person to a treatment facility for
observation and diagnosis by emergency certificate if the person is mentally ill or is
suffering from substance abuse. However, treatment shall not exceed fifteen days under an
emergency certificate.
Proposed law retains present law.
Present law, in the parishes of East Baton Rouge, Jefferson, Orleans, and Ouachita, requires
that the coroner be notified when a patient is transferred from one parish to another and a
second physician's emergency certificate is executed. Further requires the coroner to
conduct an independent examination in such cases.
Proposed law maintains present law but expands present law to include all parishes of
Louisiana.
Present law also contains requirements specific to St. Tammany Parish.
Proposed law retains present law.
Present law provides that any physician may execute an emergency certificate only after a
thorough examination.
Proposed law requires that the physician executing the emergency certificate be licensed or
permitted by the Louisiana State Board of Medical Examiners.
Present law provides for liability and the standard of care for licensed physicians executing
emergency certificates.
Proposed law adds physician assistants and nurse practitioners as persons covered under
liability and the standard of care for issuing emergency certificates.
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Proposed law requires that the physicians covered by liability and exercising the standard
of care required for emergency certificates, be licensed or permitted by the Louisiana State
Board of Medical Examiners.
(Amends R.S. 28:53(B)(1) and (G)(8) and 63(A)(1) and (B))
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Require physicians issuing emergency certificates to be licensed and permitted
by the Louisiana State Board of Medical Examiners.
2. Require physicians covered by liability and exercising the standard of care
required for emergency certificates, be licensed or permitted by the Louisiana
State Board of Medical Examiners.
3. Make technical changes.
The House Floor Amendments to the engrossed bill:
1. Add physician assistants and nurse practitioners as persons covered under
liability and the standard of care for issuing emergency certificates.
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