FIRSTREGULARSESSION
HOUSEBILLNO.1154
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVECROSSLEY.
0928H.01I JOSEPHENGLER,ChiefClerk
ANACT
Toamendchapter632,RSMo,byaddingtheretoeightnewsectionsrelatingtoassisted
outpatienttreatment.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Chapter632,RSMo,isamendedbyaddingtheretoeightnewsections,to
2beknownassections632.580,632.585,632.590,632.593,632.595,632.600,632.605,and
3632.610,toreadasfollows:
632.580.Thedefinitionssetforthinsection632.005shallapplytosections
2632.580to632.610.Inaddition,asusedinsections632.580to632.610,unlessthecontext
3clearlyrequiresotherwise,thefollowingtermsmean:
4 (1)"Assistedoutpatienttreatment",court-orderedinvoluntaryoutpatient
5mentalhealthcareservicesthatareprovidedbyamentalhealthprogramundera
6treatmentplandevelopedandmonitoredbyamaster'slevelmentalhealthprofessional.
7Suchservicesmayinclude,butarenotlimitedto:
8 (a)Casemanagement;
9 (b)Medicationmanagement;
10 (c)Therapyorcounseling;
11 (d)Substanceusetreatment,ifapplicable;
12 (e)Crisisinterventionservices;and
13 (f)Assistancewithhousing,employment,orothercommunityresources
14necessaryforanindividual'sstability;
15 (2)"Casemanager",amentalhealthprofessionalemployedbyacertified
16communitybehavioralhealthclinicwhoisassignedtoarespondenttooverseethe
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17respondent'scompliancewiththeoutpatienttreatmentplanorderedbythecourtunder
18sections632.580to632.610;
19 (3)"Communitymentalhealthcenter",thesamemeaninggiventothetermin
20section205.975;
21 (4)"Comprehensivementalhealthservices",thesamemeaninggiventothe
22terminsection205.975;
23 (5)"Localpublichealthagency",acountyhealthcenterboardestablished
24underchapter205,acountyhealthdepartment,acombinedcityandcountyhealth
25departmentoragency,amulticountyhealthdepartmentoragency,oranyothercounty
26healthauthority;
27 (6)"Petition",apetitionforassistedoutpatienttreatmentfiledundersection
28632.585orforcontinuedassistedoutpatienttreatmentfiledundersection632.600;
29 (7)"Respondent",apersonwhoisallegedinapetitiontomeetthecriteriafor
30assistedoutpatienttreatmentinsection632.590;
31 (8)"Servicearea",thesamemeaninggiventotheterminsection205.975.
632.585.1.Apetitionforanorderauthorizinginvoluntaryoutpatienttreatment
2maybefiledby:
3 (1)Thedirector,administrator,ortreatingphysicianofamentalhealthprogram
4inwhichtherespondentishospitalized;
5 (2)Thedirector,administrator,ortreatingphysicianofanemergencyreceiving
6centerinwhichtherespondentisreceivingservices;or
7 (3)Thedepartmentofhealthandseniorservices,thedepartmentofmental
8health,oranylocalpublichealthagencylocatedwithinthejudicialdistrictinwhichthe
9petitionisfiled.
10 2.Thepetitionmaybefiledinthejudicialdistrictinwhichtherespondentis
11presentorreasonablybelievedtobepresentorinthejudicialdistrictinwhichthe
12respondentresides.
13 3.Thepetitionshallallegeunderoath,withoutanotarizationrequirement,that
14thepetitionerhasreasontobelievethattherespondentmeetsthecriteriaforassisted
15outpatienttreatmentinsection632.590.Thepetitionshallspecifyfactualinformation
16onwhichsuchbeliefisbasedandshallcontainthenamesandaddressesofallpersons
17knowntothepetitionerwhohaveknowledgeofsuchfactsthroughpersonalobservation.
18 4.Nonotarizationshallberequiredforapetitionorforanyaffidavits,
19declarations,orotherdocumentssupportingapetition.Thepetitionandanyaffidavits,
20declarations,orotherdocumentssupportingthepetitionshallbesubjecttothe
21provisionsofsection492.060allowingfordeclarationunderpenaltyofperjury.
HB1154 2 22 5.Theprosecutingattorneyofthecountyinwhichahearingonapetitiontakes
23placeshallrepresentthepetitionerandfileandprosecuteincourtallpetitions.Such
24dutyshallbefulfilledbythecountycounselorincountieshavingacountycounselorand
25bythecircuitattorneyinanycitynotwithinacounty.
632.590.Followingreceiptofapetitionandcompletionoftheprocedures
2requiredinsection632.593,acourtmayissueanorderrequiringarespondentto
3participateinassistedoutpatienttreatmentif:
4 (1)Therespondent:
5 (a)Iseighteenyearsofageorolder;
6 (b)Issufferingfromamentaldisorder;
7 (c)Willnotobtaintreatmentinthecommunityvoluntarily;and
8 (d)Isunabletomakeaninformeddecisiontoseekortocomplywithvoluntary
9treatment;and
10 (2)Either:
11 (a)Becauseoftherespondent'sfulfillmentofthecriteriaofsubdivision(1)of
12thissection,therespondentrequirestreatmenttopreventadeteriorationinthe
13respondent'smentaldisorderthatwouldbelikelytoresultinseriousharmtothe
14respondentorothersasdescribedinsection632.305;or
15 (b)Therespondenthasahistoryofalackofcompliancewithtreatmentforthe
16respondent'smentaldisorder,andwithinthethirty-sixmonthsimmediatelypreceding
17thedateofthefilingofthepetitionsuchlackofcompliancehaseither:
18 a.Atleasttwice,beenasignificantfactorinnecessitatingacivildetentionperiod
19fortreatmentinstitutedundersection632.305orreceiptofservicesinaforensicor
20othermentalhealthunitofanystateorlocalcorrectionalfacility,notincludingany
21periodduringwhichtherespondentwashospitalizedorincarceratedimmediately
22precedingthedateofthefilingofthepetition;or
23 b.Resultedinoneormoreactsofseriousviolentbehaviortowardselforothers
24orthreatsof,orattemptsof,seriousphysicalharmtoselforothers,notincludingany
25periodduringwhichtherespondentwashospitalizedorincarceratedimmediately
26precedingthedateofthefilingofthepetition.
632.593.1.Atthetimeoffilingthepetition,thecourtclerkshallsetadateand
2timeforthehearing,whichshalltakeplacewithintwojudicialdaysofthefilingofthe
3petition.Anattorneyshallbeappointedtorepresenttherespondentasrequiredunder
4section632.450fromtheregisterofattorneysdescribedinsection632.415.Anattorney
5soappointedshallbeentitledtoattorney'sfeestothesameextentasallowedunder
6section632.415.Theclerkshallpromptlynotifytherespondent,therespondent's
7attorney,thepetitioner,andthepetitioner'sattorneyofthedateandtimeforthe
HB1154 3 8hearing.Thecourtshallnotgrantcontinuancesexceptuponashowingofgoodand
9sufficientcause.
10 2.Thehearingshallbeconductedinasinformalamannerasmaybeconsistent
11withorderlyprocedureandinaphysicalsettingnotlikelytohaveaharmfuleffecton
12therespondent.Therespondentshallhavethefollowingrightsinadditiontothose
13specifiedelsewhere:
14 (1)Toberepresentedbyanattorney;
15 (2)Topresentevidenceonhisorherownbehalf;
16 (3)Tocross-examinewitnesseswhotestifyagainsthimorher;
17 (4)Toremainsilent;
18 (5)Toviewandcopyallpetitionsandreportsinthecourtfileofhisorhercase;
19 (6)Tohavethehearingopenorclosedtothepublicasheorsheelects;
20 (7)Tobeproceededagainstaccordingtotherulesofevidenceapplicabletocivil
21judicialproceedings;and
22 (8)Tohavethehearingbeforeajuryifrequestedbytherespondentorhisorher
23attorney.
24 3.Therespondentshallbepresentatthehearingunlesstherespondent's
25physicalconditionissuchthatheorshecannotbepresentinthecourtroomorifthe
26courtdeterminesthattherespondent'sconductinthecourtroomissodisruptivethat
27theproceedingscannotreasonablycontinue.
28 4.Theburdenofproofatthehearingshallbebyclearandconvincingevidence
29andshallbeuponthepetitioner.
30 5.Ifthematteristriedbeforeajury,thejuryshalldetermineandshallbe
31instructedonlyupontheissueofwhethertherespondentmeetsthecriteriaforassisted
32outpatienttreatmentinsection632.590.Theremainingproceduresforthejurytrial
33shallbeasinothercivilmatters.
34 6.Therespondentshallnotberequiredtofileananswerorotherresponsive
35pleading.
36 7.Attheconclusionofthehearing,ifthecourtorjuryfinds,baseduponclear
37andconvincingevidence,thattherespondentmeetsthecriteriaforassistedoutpatient
38treatmentinsection632.590,andthecourtfindsthatamentalhealthprogram
39appropriatetohandletherespondent'sconditionhasagreedtoaccepttherespondent,
40thecourtshallissueanorderrequiringtherespondenttoparticipateinassisted
41outpatienttreatmentwiththementalhealthprogramforaperiodnottoexceedtwo
42years.
HB1154 4 43 8.Attheconclusionofthehearing,ifthecourtorjurydoesnotfindbyclearand
44convincingevidencethattherespondentmeetsthecriteriaforassistedoutpatient
45treatmentinsection632.590,thecourtshalldismissthepetition.
46 9.Anorderrequiringtherespondenttoparticipateinassistedoutpatient
47treatmentbasedonsatisfactionoftheprovisionsofsubparagrapha.ofparagraph(b)of
48subdivision(2)ofsection632.590shallnotbeissuedunlessthecourthasconsidered,or
49thejuryhasbeeninstructedtoconsider,atleastthefollowingfactors:
50 (1)Therespondent'sabilitytoaccessfinancesinordertoobtainfoodor
51medicine;
52 (2)Therespondent'sabilitytoobtaintreatmentfortherespondent'smedical
53condition;
54 (3)Therespondent'sabilitytoaccessnecessaryresourcesinthecommunity
55withoutassistance;
56 (4)Thedegreetowhichthereareriskstotherespondent'ssafety;
57 (5)Thelikelihoodthattherespondentwilldecompensatewithoutimmediate
58careortreatment;
59 (6)Therespondent'spreviousattemptstoinflictphysicalinjuryonselfor
60others;
61 (7)Therespondent'shistoryofbehavioralhealthtreatmentinthecommunity;
62 (8)Therespondent'spatternsofdecompensationinthepast;
63 (9)Therespondent'sriskofbeingvictimizedorharmedbyothers;and
64 (10)Therespondent'saccesstothemeanstoinflictharmonselforothers.
65 10.Nothinginthissectionshallpreventthecourtorjuryfromconsideringany
66otherfactornotdescribedinthissection.
67 11.Ifrequestedbytherespondent,thecourtshallappointanavailablelicensed
68physicianorlicensedpsychologisttoexaminetherespondentandtestifyatthe
69respondent'srequest.Iftherespondentortherespondent'sattorneysorequests,the
70courtshallnotappointalicensedphysicianorlicensedpsychologistwhoisanemployee
71ofanyentityinwhichtherespondentishospitalizedorreceivingservicesorwhoisan
72employeeofanyentitythatfiledthepetition.Theappointmentproceduresinsection
73632.420shallapplytoanyappointmentunderthissubsection.
74 12.Thephysician-patientprivilegerecognizedbysection491.060andthe
75psychologist-patientprivilegerecognizedbysection337.055shallbedeemedwaivedin
76proceedingsundersections632.580to632.610.Thefactthatsuchprivilegeshavebeen
77waivedinaccordancewiththissectionshallnotbyitselfwaivetheprivilegesinany
78otherproceeding,civilorcriminal.Thewaiveroftheprivilegesshallextendonlytothat
HB1154 5 79evidencethatisdirectlymaterialandrelevanttotheproceedingsundersections632.580
80to632.610.
81 13.Appealsfromcourtordersunderthissectionmaybemadeasdescribedin
82section632.430.
83 14.Assistedoutpatienttreatmentshallnotbedeemedoutpatientdetentionfor
84purposesofthischapter,andnoprovisionofthischapterrelatingtotherequirements
85forinpatientoroutpatientdetentionproceedingsshallapplytoassistedoutpatient
86treatmentundersections632.580to632.610unlesssuchprovisionhasbeenspecifically
87incorporatedintosections632.580to632.610byreferenceorotherwise.
632.595.1.Thecourtshallassignacasemanagerfromacertifiedcommunity
2behavioralhealthclinictoeachrespondentorderedtoparticipateinassistedoutpatient
3treatment.
4 2.Thecasemanagerandtherespondentshallreporttothecourtatleastonce
5everyninetydays.Thecourtmay,atitsdiscretion,requestmorefrequentappearances.
6Thecasemanagershallimmediatelyreporttothecourtasubstantialfailureofthe
7respondentorthementalhealthprogramprovidingtheassistedoutpatienttreatmentto
8complywiththeconditionsoftheassistedoutpatienttreatment.
632.600.1.Thecourtorderforassistedoutpatienttreatmentshallexpireatthe
2endoftheperiodspecifiedintheorderunlessapetitionforanextensionhasbeenfiled.
3Ifanypersonorentityauthorizedtofileapetitionundersection632.585determines
4thatarespondentrequiresfurtherinvoluntaryassistedoutpatienttreatment,theperson
5orentityshallfileapetitionforcontinuedassistedoutpatienttreatmentbeforethe
6expirationoftheinvoluntaryassistedoutpatienttreatmentorderedbythecourt.
7 2.Theprocedureforobtaininganextensionshallbethesameasforobtaining
8theoriginalorder,exceptthatthethirty-six-monthtimeperiodprovidedinparagraph
9(b)ofsubdivision(2)ofsection632.590shallnotbeapplicableindeterminingthe
10appropriatenessofanextension.
632.605.1.Duringtheperiodofanorderforassistedoutpatienttreatment,if
2thementalhealthprogramormentalhealthprofessionalwhoisprovidingthe
3respondent'sassistedoutpatienttreatmentdeterminesthattherespondentisnot
4complyingwiththecourtorder,thementalhealthprogramormentalhealth
5professionalshallnotifythecourtimmediately.
6 2.Ifitcomestotheattentionofthecourtthatarespondentsubjecttoanorderof
7assistedoutpatienttreatmentisnotcomplyingwiththeorder,thecourtmayrequireone
8ormoreofthefollowing,withoutahearing:
HB1154 6 9 (1)Thattherespondentbetakenforevaluationtoacommunitymentalhealth
10centerprovidingcomprehensivementalhealthservicestoindividualsresidinginthe
11serviceareainwhichtherespondentresides;
12 (2)Thattherespondentbehospitalizedinapsychiatrichospitalforaperiodof
13notmorethantendays;and
14 (3)Uponrecommendationbythecommunitymentalhealthcenterproviding
15comprehensivementalhealthservicestoindividualsresidingintheserviceareainwhich
16therespondentresides,thattheindividualbehospitalizedforaperiodofmorethanten
17days,butnotlongerthanthedurationoftheorderforassistedoutpatienttreatment,or
18notlongerthanninetydays,whicheverisless.
19 3.Thecourtmaydirectpeaceofficerstotransporttherespondenttoa
20designatedfacilityoracommunitymentalhealthcenter,asapplicable,andthecourt
21mayspecifyconditionsunderwhichtherespondentmayreturntoassistedoutpatient
22treatmentbeforetheorderexpires.Reimbursementfortransportationcostsshallbe
23allowedasprovidedundersection632.312.
24 4.Arespondenthospitalizedwithoutahearingasprovidedinsubsection2of
25thissectionmayobjecttothehospitalization.Upontransferoftherespondenttothe
26hospital,thehospitalshallnotifytherespondentofhisorherrighttoobjectunderthis
27section.Uponreceiptofanobjectiontothehospitalization,thecourtshallschedulea
28hearingforadeterminationthattheindividualrequireshospitalization.The
29respondentshallhaveallrightsspecifiedinsection632.593atthehearing.Thecourt
30shallordertherespondentdischargedfromhospitalizationunlessthecourtorjury
31finds,baseduponclearandconvincingevidence,thattherespondentrequires
32hospitalizationasaresultoftherespondent'sfailuretocomplywiththeorderfor
33assistedoutpatienttreatment.
632.610.Theofficeofstatecourtsadministratorshallsubmitanannualreportto
2thegeneralassemblysummarizing:
3 (1)Thenumberofindividualssubjecttoordersforassistedoutpatient
4treatment;
5 (2)Statisticsoncomplianceandnoncompliancerateswithassistedoutpatient
6treatment;and
7 (3)Anyimpactthatassistedoutpatienttreatmenthasonhospitalizationand
8incarcerationrates.
âś”
HB1154 7