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SENATE DOCKET, NO. 1472 FILED ON: 1/19/2023
SENATE . . . . . . . . . . . . . . No. 980
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Cindy F. Friedman
_________________
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 to provide critical community health services.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Cindy F. FriedmanFourth MiddlesexJohn J. CroninWorcester and Middlesex2/3/2023Hannah Kane11th Worcester2/9/2023Joanne M. ComerfordHampshire, Franklin and Worcester2/9/2023Marc T. Lombardo22nd Middlesex2/14/2023James B. EldridgeMiddlesex and Worcester2/15/2023Bruce E. TarrFirst Essex and Middlesex2/21/2023 1 of 8
SENATE DOCKET, NO. 1472 FILED ON: 1/19/2023
SENATE . . . . . . . . . . . . . . No. 980
By Ms. Friedman, a petition (accompanied by bill, Senate, No. 980) of Cindy F. Friedman, John
J. Cronin, Hannah Kane, Joanne M. Comerford and other members of the General Court for
legislation to provide critical community services. The Judiciary.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 942 OF 2019-2020.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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An Act to provide critical community health services.
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 1 of chapter 123 of the General Laws, as appearing in the 2020
2Official Edition, is hereby amended by inserting after the definition of “Commissioner” the
3following definitions:-
4 “Critical community health services”, health, behavioral health and social services that
5can be provided in a community setting and do not require continuous inpatient hospitalization.
6 “Critical community health service treatment plan”, a plan defining a set of health,
7behavioral health or social services delivered to an individual.
8 SECTION 2. Said section 1 of said chapter 123, as so appearing, is hereby further
9amended by inserting after the definition of “Funds” the following definition:- 2 of 8
10 “Gravely disabled”, a condition evidenced by behavior in which a person, as a result of a
11mental illness, is at substantial risk of inflicting serious harm to self or others, or is in danger of
12serious physical harm resulting from a failure to provide for his or her essential human needs of
13health or safety; or manifests severe deterioration in routine functioning evidenced by repeated
14and escalating loss of cognitive or volitional control over his or her actions; and has shown an
15inability to provide for his or her basic physical needs, including medical and psychiatric
16treatment and shelter, because of the mental illness.
17 SECTION 3. Said section 1 of said chapter 123, as so appearing, is hereby further
18amended by inserting after the definition of “Superintendent” the following definition:-
19 “Supervising mental health professional”, a mental health services provider who is
20required pursuant to such practice to obtain a license from the commonwealth or who, at the
21discretion of the court, is deemed suitable to supervise a critical community health service
22treatment plan.
23 SECTION 4. Said chapter 123 is hereby further amended by inserting after section 8 the
24following section:-
25 Section 8 1/2. (a) Any physician licensed pursuant to section 2 of chapter 112, the
26department of mental health, the superintendent of a medical facility or residence where the
27individual receives medical care, or the medical director of the Bridgewater state hospital, or the
28spouse, blood relative, legal relative, legal guardian or individual partner in a substantive dating
29relationship, shall be authorized to petition for an order of a critical community health service
30treatment plan in the district court in whose jurisdiction a facility is located that shall provide
31such services, for any individual who: 3 of 8
32 (1) has a primary diagnosis of a serious mental illness;
33 (2) is at least 18 years old; and
34 (3) meets the following criteria:
35 (i) is gravely disabled;
36 (ii) has a history of lack of compliance with treatment for mental illness that, prior to the
37filing of the petition, has been a significant factor in: (A) necessitating, at least twice within the
38previous 36 months, hospitalization or receipt of mental health services in a forensic or
39department of correction facility or house of corrections or the Bridgewater state hospital; or (B)
40the commission of one or more acts of serious violent behavior toward self or others or threats
41of, or attempts at, serious physical harm to self or others within the previous 36 months;
42 (iii) is in need of, based on the individual’s treatment history and current behavior,
43critical community health services in order to prevent a relapse or deterioration that would likely
44result in serious harm to the individual or others; and
45 (iv) is likely to benefit from critical community health services.
46 The petition shall include a written critical community health service treatment plan
47prepared in consultation with, when possible, those familiar with the individual, the
48superintendent or physician in charge of the care of the individual or those familiar with the case
49history of the individual. The treatment plan shall include:
50 (1) a statement of the requirements for supervision, medication, and assistance in
51obtaining basic necessities such as employment, food, clothing, and shelter; 4 of 8
52 (2) if known, the address of the residence where the individual resides and the name of
53the person or persons in charge of the residence;
54 (3) if known, the name and address of any person, agency, or organization assigned to
55supervise a critical community health service treatment plan or care for the individual; and
56 (4) the conditions for continued receipt of critical community health services, which may
57require reporting, continuation of medication, submission to testing, or other reasonable
58conditions.
59 (b) A petition for critical community health services may be filed along with, and as an
60alternative to, a petition for inpatient commitment under section 7.
61 (c) A hearing shall be commenced within 4 days of the filing of the petition. The periods
62of time prescribed or allowed under the provisions of this section shall be computed pursuant to
63Rule 6 of the Massachusetts Rules of Civil Procedure. Adjournments shall be permitted only for
64good cause shown. In granting adjournments, the court shall consider the need for further
65examination by a physician or the potential need to provide treatment expeditiously.
66 (d) A court may not issue a critical community health service treatment plan unless it
67finds that providing critical community health services is the least restrictive alternative available
68to the person.
69 (e) If, after the hearing, the court finds by clear and convincing evidence that the
70individual who is the subject of the petition meets the criteria for critical community health
71services included in subsection (a), the court may order the supervising mental health
72professional of an appropriate treatment program to supervise the plan for such services. 5 of 8
73 Critical community health services shall not be ordered unless the court approves a
74written critical community health service treatment plan presented to the court which conforms
75to the requirements of this section and which contains the name of the designated director of the
76facility that will supervise and administer the service plan.
77 (f) The first order for critical community health services shall not exceed 180 days, and
78any subsequent order shall not exceed 365 days.
79 (g) Before an order for critical community health services can commence, the individual
80shall be provided with copies of the court order and full explanations of the approved service
81plan. The approved service plan shall be filed with the court and the supervising mental health
82professional in charge of the individual's service plan.
83 (h) During any period in which an individual receives critical community health services,
84the individual or the supervising mental health professional may petition the court to amend the
85critical community health service treatment plan. The court may order an amended service plan
86or, if contested, the court may order a hearing on the amended plan. If an amended service plan
87is contested, the party wishing to amend the service plan shall provide the opposing party the
88proposed amended service plan at least 7 days before the filing of a petition.
89 (i) A supervising mental health professional may petition the court for a hearing if the
90supervising mental health professional has determined that the individual is not complying with
91the critical community health service treatment plan.
92 When a supervising mental health professional determines that the individual has not
93complied with any condition of the service plan, that monitor shall notify the court of the
94conditions of the treatment plan that have been violated. 6 of 8
95 Upon receiving notice from the supervising mental health professional, the court shall
96appoint counsel, if necessary, and schedule a service plan non-compliance hearing for a date no
97less than 7 days and not more than 14 days after receiving said petition, except in extraordinary
98circumstances, as determined by the court. The court shall create a standard “notice of service
99plan non-compliance” form, which the monitor shall complete with the times and dates of the
100alleged non-compliance of the individual.
101 The notice of service plan non-compliance shall set forth the conditions of the plan that
102the supervising mental health professional alleges have not been complied with and shall order
103the individual to appear at a specific date and time for the non-compliance hearing, and shall be
104delivered to all parties to the original proceeding under which the service plan order was issued.
105 Service plan non-compliance hearings shall proceed in two distinct steps, the first to
106adjudicate the factual issue of whether the plan is being complied with and the second to
107determine the disposition of the matter, if plan non-compliance is found by the court to have
108occurred.
109 If the court finds that the individual has not complied with one or more conditions of the
110service plan as alleged, the supervising mental health professional shall recommend to the court
111a course of immediate action and may present argument and evidence in support of that
112recommendation. If the court determines that the individual is not complying with the terms of
113the order, the court may amend the service plan as the court deems necessary. The amended
114order may alter the service plan, or the court may request, under the provisions of section 12 of
115this chapter, an emergency evaluation to determine whether the failure to hospitalize the
116individual would create a likelihood of serious harm. 7 of 8
117 (j) The supervising mental health professional shall require periodic reports, not more
118frequently than every 30 days, concerning the condition of individuals receiving critical
119community health services from any person, agency, or organization assigned to treat such
120individuals.
121 (k) The supervising mental health professional shall review the condition of an individual
122ordered to receive critical community services at least once every 30 days.
123 (l) The supervising mental health professional may, at any time, petition the court for
124termination of an individual’s critical community health service plan if the supervising mental
125health professional determines that critical community health services are no longer the least
126restrictive appropriate treatment available.
127 (m) Nothing in this section shall prevent the supervising mental health professional from
128authorizing involuntary commitment and treatment in cases of emergency under section 12 of
129this chapter.
130 (n) The individual or their representative may petition for termination of an order for
131critical community health services.
132 (o) All hearings under this section shall be conducted by a judge consistent with the
133requirements of this chapter and applicable law with such flexibility and informality as the court
134may deem appropriate. The individual shall be entitled to the assistance of counsel, and the court,
135if necessary, shall appoint counsel. All testimony shall be taken under oath. The standard of
136proof at such hearing will be that of clear and convincing evidence. 8 of 8
137 (p) Reasonable expense incurred in providing critical community health services may be
138paid for out of the estate of the individual, by the petitioner or by the commonwealth, as may be
139determined by the court.
140 SECTION 5. Section 9 of said chapter 123, as so appearing, is hereby amended by
141inserting after the words “of section eight B.”, in line 39, the following words:- Any person may
142apply to the court stating their belief that an individual currently receiving critical community
143health services under section 8 1/2 should no longer be so treated.