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HOUSE DOCKET, NO. 3255 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1980
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Marjorie C. Decker
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to ending unnecessary hospitalizations and reducing emergency department
boarding.
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PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Marjorie C. Decker25th Middlesex1/13/2023Lindsay N. Sabadosa1st Hampshire1/20/2023 1 of 4
HOUSE DOCKET, NO. 3255 FILED ON: 1/20/2023
HOUSE . . . . . . . . . . . . . . . No. 1980
By Representative Decker of Cambridge, a petition (accompanied by bill, House, No. 1980) of
Marjorie C. Decker and Lindsay N. Sabadosa relative to the involuntary hospitalization of
individuals if no less restrictive alternatives exist to reduce the likelihood of serious harm by
reason of mental illness. Mental Health, Substance Use and Recovery.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 3962 OF 2021-2022.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act relative to ending unnecessary hospitalizations and reducing emergency department
boarding.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Section 12 of chapter 123 of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by striking out subsection (a) and inserting in place thereof
3the following subsection:-
4 (a) (i) For the purposes of this subsection, “mental health professional” shall, unless the
5context clearly requires otherwise, mean a physician who is licensed pursuant to section 2 of
6chapter 112; a qualified psychologist licensed pursuant to sections 118 to 129, inclusive, of said
7chapter 112; a qualified psychiatric nurse mental health clinical specialist authorized to practice
8as such under regulations promulgated pursuant to section 80B of said chapter 112; a nurse
9authorized to practice in advanced practice nursing by the board of registration in nursing 2 of 4
10pursuant to said section 80B of said chapter 112; a licensed independent clinical social worker
11licensed pursuant to sections 130 to 137, inclusive, of said chapter 112; or other less restrictive
12and voluntary community mental health services.
13 (ii) A mental health professional may only seek involuntary hospitalization of an
14individual if no less restrictive alternative exists to reduce the likelihood of serious harm by
15reason of mental illness, as defined in section 1. To prevent unnecessary hospitalization, a mental
16health professional shall exhaust community-based treatment alternatives, including, but not
17limited to: (i) the nationally-mandated 988 Suicide and Crisis Lifeline; (ii) the Behavioral Health
18Help Line of the Roadmap for Behavioral Health Reform; (iii) services offered through
19Community Behavioral Health Centers including mobile crisis intervention, behavioral health
20urgent care, and community crisis stabilization; (iv) peer respite and other peer-run alternatives
21to emergency department visits and hospitalization; (v) Children’s Behavioral Health Initiative
22(CBHI) or Behavioral Health Services for Children and Adolescents (BHCA) services; (v)
23family supports; and (vi) technologically-supported behavioral health services, prior to seeking
24involuntary transportation, restraint and hospitalization pursuant to this section. The mental
25health professional shall document on the application for hospitalization that the mental health
26professional has exhausted community-based alternatives, the reasons for the restraint of such
27person and any other relevant information that may assist the admitting physician or physicians.
28 If the mental health professional has exhausted all community-based alternatives to
29reduce the likelihood of serious harm by reason of mental illness, the mental health professional,
30after examining a person or, in the event that examination is not possible because of the
31emergency nature of the case and because of the refusal of the person to consent to such
32examination, based on the facts and circumstances, may complete an application for evaluation 3 of 4
33and treatment, which shall authorize law enforcement officers, as defined in section 1 of chapter
346E, or emergency medical technicians to transport the individual to the regional crisis
35stabilization program.
36 In an emergency if a mental health professional is not available to evaluate the individual
37for involuntary hospitalization, a law enforcement officer, who believes that failure to restrain a
38person would create a likelihood of serious harm by reason of mental illness shall take the
39individual directly to the nearest Community Behavioral Health Center for evaluation and
40treatment. If the director of the Community Behavioral Health Center or designee determines and
41documents, after a personal evaluation, that the Community Behavioral Health Center is unable
42to prevent the individual from harming themself or others, or if the individual does not agree to
43accept treatment voluntarily through the crisis stabilization program, the law enforcement officer
44or emergency medical technician may transport the person directly to the nearest inpatient
45psychiatric facility with a bed available, utilizing the centralized database established pursuant to
46section 12A. The individual may only be transported to a hospital emergency department if there
47is no availability within a 30-mile radius of the initial restraint.
48 If there is no availability at an inpatient psychiatric facility, and the individual is
49transported to an emergency department of a general hospital, then within 12 hours of arrival at
50the emergency department, the person shall be informed of their right to speak with an attorney
51and to request a probable cause hearing. The emergency department staff shall provide the
52individual with notice of their rights pursuant to this section and, if the person requests counsel,
53shall promptly contact the mental health litigation division of the committee for public counsel
54services to request appointment of counsel in accordance with chapter 211D. The committee for
55public counsel services shall appoint counsel forthwith. 4 of 4
56 Any individual who remains in an emergency department for 48 hours from the time of
57arrival shall be entitled to a probable cause hearing upon request to determine if the person meets
58the criteria for emergency detention. The hearing shall be held by the district or municipal court
59with jurisdiction over the hospital no later than the next business day. The hearing shall be
60conducted at the hospital where the individual is admitted, with all participants attending either
61in-person or virtually.
62 SECTION 2. Said section 12 of said chapter 123, as so appearing, is hereby further
63amended by adding the following subsection:-
64 (f) The department shall collect information regarding all applications pursuant to this
65section. The department shall annually, not later than July 31, report to the house and senate
66committees on ways and means, joint committee on public health and the joint committee on
67mental health, substance use and recovery the number of applications pursuant to said section 12,
68such other information as may be relevant, and any actions the department has taken in response
69to the information it has received, including any licensing actions.
70 SECTION 3. Said chapter 123 of the General Laws is hereby amended by inserting after
71section 12 the following section:-
72 Section 12A. The department shall establish and maintain a database of inpatient
73psychiatric facilities licensed pursuant to section 19 of chapter 19 within the Commonwealth for
74use by law enforcement officers, as defined in section 1 of chapter 6E, emergency medical
75technicians and healthcare professionals. The database shall be updated daily and show available
76capacity at all inpatient psychiatric facilities.