This document includes House Floor Amendments incorporated into the bill on Tue, Feb 28, 2017 at 3:17 PM by jeyring.
Representative LaVar Christensen proposes the following substitute bill:


1     
ESSENTIAL TREATMENT AND INTERVENTION ACT

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: LaVar Christensen

5     
Senate Sponsor: J. Stuart Adams

6     

7     LONG TITLE
8     General Description:
9          This bill establishes a process for an individual suffering from a substance use disorder
10     to receive court-ordered essential treatment and intervention.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     enacts the Essential Treatment and Intervention Act; and
15          ▸     establishes a system for court-ordered essential treatment and intervention for an
16     individual suffering from a substance use disorder.
17     Money Appropriated in this Bill:
18          None
19     Other Special Clauses:
20          None
21     Utah Code Sections Affected:
22     AMENDS:
23          62A-15-602, as last amended by Laws of Utah 2012, Chapter 248
24          62A-15-641, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
25     Chapter 8

26     ENACTS:
27          62A-15-1201, Utah Code Annotated 1953
28          62A-15-1202, Utah Code Annotated 1953
29          62A-15-1203, Utah Code Annotated 1953
30          62A-15-1204, Utah Code Annotated 1953
31          62A-15-1205, Utah Code Annotated 1953
32          62A-15-1206, Utah Code Annotated 1953
33          62A-15-1207, Utah Code Annotated 1953
34          62A-15-1208, Utah Code Annotated 1953
35          62A-15-1209, Utah Code Annotated 1953
36     

37     Be it enacted by the Legislature of the state of Utah:
38          Section 1. Section 62A-15-602 is amended to read:
39          62A-15-602. Definitions.
40          As used in this part, Part 7, Commitment of Persons Under Age 18 to Division of
41     Substance Abuse and Mental Health, Part 8, Interstate Compact on Mental Health, Part 9, Utah
42     Forensic Mental Health Facility, [and] Part 10, Declaration for Mental Health Treatment, and
43     Part 12, Essential Treatment and Intervention Act:
44          (1) "Adult" means a person 18 years of age or older.
45          (2) "Approved treatment facility or program" means a treatment provider that meets the
46     standards described in Subsection 62A-15-103(2)(a)(v).
47          [(2)] (3) "Commitment to the custody of a local mental health authority" means that an
48     adult is committed to the custody of the local mental health authority that governs the mental
49     health catchment area in which the proposed patient resides or is found.
50          [(3)] (4) "Designated examiner" means a licensed physician familiar with severe
51     mental illness, preferably a psychiatrist, designated by the division as specially qualified by
52     training or experience in the diagnosis of mental or related illness or another licensed mental
53     health professional designated by the division as specially qualified by training and at least five
54     years' continual experience in the treatment of mental or related illness. At least one
55     designated examiner in any case shall be a licensed physician. No person who is the applicant,
56     or who signs the certification, under Section 62A-15-631 may be a designated examiner in the

57     same case.
58          [(4)] (5) "Designee" means a physician who has responsibility for medical functions
59     including admission and discharge, an employee of a local mental health authority, or an
60     employee of an agency that has contracted with a local mental health authority to provide
61     mental health services under Section 17-43-304.
62          (6) "Essential treatment" and "essential treatment and intervention" mean court-ordered
63     treatment at a local substance abuse authority or an approved treatment facility or program for
64     the treatment of an adult's substance use disorder.
65          [(5)] (7) "Harmful sexual conduct" means any of the following conduct upon an
66     individual without the individual's consent, or upon an individual who cannot legally consent
67     to the conduct including under the circumstances described in Subsections 76-5-406(1) through
68     (12):
69          (a) sexual intercourse;
70          (b) penetration, however slight, of the genital or anal opening of the individual;
71          (c) any sexual act involving the genitals or anus of the actor or the individual and the
72     mouth or anus of either individual, regardless of the gender of either participant; or
73          (d) any sexual act causing substantial emotional injury or bodily pain.
74          [(6)] (8) "Institution" means a hospital, or a health facility licensed under the
75     provisions of Section 26-21-9.
76          [(7)] (9) "Licensed physician" means an individual licensed under the laws of this state
77     to practice medicine, or a medical officer of the United States government while in this state in
78     the performance of official duties.
79          [(8)] (10) "Local comprehensive community mental health center" means an agency or
80     organization that provides treatment and services to residents of a designated geographic area,
81     operated by or under contract with a local mental health authority, in compliance with state
82     standards for local comprehensive community mental health centers.
83          (11) "Local substance abuse authority" means the same as that term is defined in
84     Section 62A-15-102 and described in Section 17-43-201.
85          [(9)] (12) "Mental health facility" means the Utah State Hospital or other facility that
86     provides mental health services under contract with the division, a local mental health
87     authority, or organization that contracts with a local mental health authority.

88          [(10)] (13) "Mental health officer" means an individual who is designated by a local
89     mental health authority as qualified by training and experience in the recognition and
90     identification of mental illness, to interact with and transport persons to any mental health
91     facility.
92          [(11)] (14) "Mental illness" means a psychiatric disorder as defined by the current
93     edition of the Diagnostic and Statistical Manual of Mental Disorders published by the
94     American Psychiatric Association which substantially impairs a person's mental, emotional,
95     behavioral, or related functioning.
96          [(12)] (15) "Patient" means an individual who is:
97          (a) under commitment to the custody or to the treatment services of a local mental
98     health authority[.]; or
99          (b) undergoing essential treatment and intervention.
100          [(13)] (16) "Serious bodily injury" means bodily injury which involves a substantial
101     risk of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or
102     protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
103          [(14)] (17) "Substantial danger" means the person, by his or her behavior, due to
104     mental illness:
105          (a) is at serious risk to:
106          (i) commit suicide;
107          (ii) inflict serious bodily injury on himself or herself; or
108          (iii) because of his or her actions or inaction, suffer serious bodily injury because he or
109     she is incapable of providing the basic necessities of life, such as food, clothing, and shelter; or
110          (b) is at serious risk to cause or attempt to cause serious bodily injury or engage in
111     harmful sexual conduct.
112          [(15)] (18) "Treatment" means psychotherapy, medication, including the administration
113     of psychotropic medication, and other medical treatments that are generally accepted medical
114     and psychosocial interventions for the purpose of restoring the patient to an optimal level of
115     functioning in the least restrictive environment.
116          Section 2. Section 62A-15-641 is amended to read:
117          62A-15-641. Restrictions and limitations -- Civil rights and privileges.
118          (1) Subject to the general rules of the division, and except to the extent that the director

119     or his designee determines that it is necessary for the welfare of the patient to impose
120     restrictions, every patient is entitled to:
121          (a) communicate, by sealed mail or otherwise, with persons, including official
122     agencies, inside or outside the facility;
123          (b) receive visitors; and
124          (c) exercise all civil rights, including the right to dispose of property, execute
125     instruments, make purchases, enter contractual relationships, and vote, unless the patient has
126     been adjudicated to be incompetent and has not been restored to legal capacity.
127          (2) When any right of a patient is limited or denied, the nature, extent, and reason for
128     that limitation or denial shall be entered in the patient's treatment record. Any continuing
129     denial or limitation shall be reviewed every 30 days and shall also be entered in that treatment
130     record. Notice of that continuing denial in excess of 30 days shall be sent to the division [or
131     to], the appropriate local mental health authority[.], the appropriate local substance abuse
132     authority, or an approved treatment facility or program whichever is most applicable to the
133     patient.
134          (3) Notwithstanding any limitations authorized under this section on the right of
135     communication, each patient is entitled to communicate by sealed mail with the appropriate
136     local mental health authority, the appropriate local substance abuse authority, an approved
137     treatment facility or program, the division, [his] the patient's attorney, and the court, if any, that
138     ordered [his] the patient's commitment or essential treatment. In no case may the patient be
139     denied a visit with the legal counsel or clergy of the patient's choice.
140          (4) Local mental health authorities, local substance abuse authorities, and approved
141     treatment facilities or programs shall provide reasonable means and arrangements for
142     informing involuntary patients of their right to release as provided in this chapter, and for
143     assisting them in making and presenting requests for release.
144          (5) Mental health facilities, local substance abuse authorities, and approved treatment
145     facilities or programs shall post a statement, [promulgated] created by the division, describing a
146     patient's rights under Utah law.
147          (6) Notwithstanding Section 53B-17-303, [any person] an individual committed under
148     this chapter has the right to determine the final disposition of [his] that individual's body after
149     death.

150          Section 3. Section 62A-15-1201 is enacted to read:
151     
Part 12. Essential Treatment and Intervention Act

152          62A-15-1201. Statement of legislative intent.
153          To address the serious public health crisis of substance use disorder related deaths and
154     life-threatening opioid addiction, and to allow and enable caring relatives to seek essential
155     treatment and intervention, as may be necessary, on behalf of a sufferer of a substance use
156     disorder, the Legislature enacts the Essential Treatment and Intervention Act.
157          Section 4. Section 62A-15-1202 is enacted to read:
158          62A-15-1202. Definitions.
159          As used in this part:
160          (1) "Essential treatment examiner" means:
161          (a) a licensed physician, preferably a psychiatrist, who is designated by the division as
162     specifically qualified by training or experience in the diagnosis of substance use disorder; or
163          (b) a licensed mental health professional designated by the division as specially
164     qualified by training and who has at least five years' continual experience in the treatment of
165     substance use disorder.
166          (2) "Relative" means an adult who is a spouse, parent, stepparent, grandparent, child,
167     or sibling of an individual.
168          (3) "Serious harm" means the individual, due to substance use disorder, is at serious
169     risk of:
170          (a) drug overdose;
171          (b) suicide;
172          (c) serious bodily self-injury;
173          (d) serious bodily injury because the individual is incapable of providing the basic
174     necessities of life, including food, clothing, or shelter; or
175          (e) causing or attempting to cause serious bodily injury to another individual.
176          (4) "Substance use disorder" means the same as that term is defined in the current
177     edition of the Diagnostic and Statistical Manual of Mental Disorders published by the
178     American Psychiatric Association.
179          Section 5. Section 62A-15-1203 is enacted to read:
180          62A-15-1203. Petition for essential treatment -- Contents -- Guarantee for costs.

181          (1) A relative seeking essential treatment and intervention for a sufferer of a substance
182     use disorder may file a petition with the district court of the county in which the sufferer of the
183     substance use disorder resides or is found.
184          (2) The petition shall include:
185          (a) the respondent's:
186          (i) legal name;
187          (ii) date of birth, if known;
188          (iii) social security number, if known; and
189          (iv) residence and current location, if known;
190          (b) the petitioner's relationship to the respondent;
191          (c) the name and residence of the respondent's legal guardian, if any and if known;
192          (d) a statement that the respondent:
193          (i) is suffering from a substance use disorder; and
194          (ii) if not treated for the substance use disorder presents a serious harm to self or
195     others;
196          (e) the factual basis for the statement described in Subsection (4)(d); and
197          (f) at least one specified local substance abuse authority or approved treatment facility
198     or program where the respondent may receive essential treatment.
199          (3) Any petition filed under this section:
200          (a) may be accompanied by proof of health insurance to provide for the respondent's
201     essential treatment; and
202          (b) shall be accompanied by a financial guarantee, signed by the petitioner or another
203     individual, obligating the petitioner or other individual to pay all treatment costs beyond those
204     covered by the respondent's health insurance policy for court-ordered essential treatment for the
205     respondent.
206          (4) Nothing in this section alters the contractual relationship between a health insurer
207     and an insured individual.
208          Section 6. Section 62A-15-1204 is enacted to read:
209          62A-15-1204. Criteria for essential treatment and intervention.
210          A district court shall order an individual to undergo essential treatment for a substance
211     use disorder when the district court determines by clear and convincing evidence that the

212     individual:
213          (1) suffers from a substance use disorder;
214          (2) can reasonably benefit from the essential treatment;
215          (3) is unlikely to substantially benefit from a less-restrictive alternative treatment; and
216          (4) presents a serious harm to self or others.
217          Section 7. Section 62A-15-1205 is enacted to read:
218          62A-15-1205. Proceeding for essential treatment -- Duties of court -- Disposition.
219          (1) A district court shall review the assertions contained in the verified petition
220     described in Section 62A-15-1203.
221          (2) If the court determines that the assertions, if true, are sufficient to order the
222     respondent to undergo essential treatment, the court shall:
223          (a) set an expedited date for a time-sensitive hearing to determine whether the court
224     should order the respondent to undergo essential treatment for a substance use disorder;
225          (b) provide notice of:
226          (i) the contents of the petition, including all assertions made;
227          (ii) a copy of any order for detention or examination;
228          (iii) the date of the hearing;
229          (iv) the purpose of the hearing;
230          (v) the right of the respondent to be represented by legal counsel; and
231          (vi) the right of the respondent to request a preliminary hearing before submitting to an
232     order for examination;
233          (c) provide notice to:
234          (i) the respondent;
235          (ii) the respondent's guardian, if any; and
236          (iii) the petitioner; and
237          (d) subject to the right described in Subsection (2)(b)(vi), order the respondent to be
238     examined before the hearing date by two essential treatment examiners;
239          (3) The essential treatment examiners shall examine the respondent to determine:
240          (a) whether the respondent meets each of the criteria described in Section
241     62A-15-1204;
242          (b) the severity of the respondent's substance use disorder, if any;

243          (c) what forms of treatment would substantially benefit the respondent, if the examiner
244     determines that the respondent has a substance use disorder; and
245          (d) the appropriate duration for essential treatment, if essential treatment is
246     recommended.
247          (4) An essential treatment examiner shall certify the examiner's findings to the court
248     within 24 hours after completion of the examination.
249          (5) The court may, based upon the findings of the essential treatment examiners,
250     terminate the proceedings and dismiss the petition.
251          (6) The parties may, at any time, make a binding stipulation to an essential treatment
252     plan and submit that plan to the court for court order.
253          (7) At the hearing, the petitioner and the respondent may testify and may
254     cross-examine witnesses.
255          (8) If, upon completion of the hearing, the court finds that the criteria in Section
256     62A-15-1204 are met, the court shall order essential treatment for an initial period that:
257          (a) does not exceed 360 days, subject to periodic review as provided in Section
258     62A-15-1206; and
259          (b) (i) is recommended by an essential treatment examiner; or
260          (ii) is otherwise agreed to at the hearing.
261          (9) The court shall designate the facility for the essential treatment, as:
262          (a) described in the petition;
263          (b) recommended by an essential treatment examiner; or
264          (c) agreed to at the hearing.
265          (10) The court shall issue an order that includes the court's findings and the reasons for
266     the court's determination.
267          (11) The court may order the petitioner to be the respondent's personal representative,
268     as described in 45 C.F.R. Sec. 164.502(g), for purposes of the respondent's essential treatment.
269          Section 8. Section 62A-15-1206 is enacted to read:
270          62A-15-1206. Periodic review -- Discharge.
271          A local substance abuse authority or an approved treatment facility or program that
272     provides essential treatment shall:
273          (1) Ĥ→ [
as frequently as practicable] at least every 90 days after the day on which a
273a     patient is admitted, unless a court orders otherwise ←Ĥ , examine or cause to be examined a
273b     patient who has

274     been ordered to receive essential treatment;
275          (2) notify the patient and the patient's personal representative or guardian, if any, of the
276     substance and results of the examination;
277          (3) discharge an essential treatment patient if the examination determines that the
278     conditions justifying essential treatment and intervention no longer exist; and
279          (4) after discharging an essential treatment patient, send a report describing the reasons
280     for discharge to the clerk of the court where the proceeding for essential treatment was held and
281     to the patient's personal representative or guardian, if any.
282          Section 9. Section 62A-15-1207 is enacted to read:
283          62A-15-1207. Seventy-two-hour emergency treatment.
284          (1) A court may order a respondent to be hospitalized for up to 72 hours if:
285          (a) an essential treatment examiner has examined the respondent and certified that the
286     respondent meets the criteria described in Section 62A-15-1204; and
287          (b) the court finds by clear and convincing evidence that the respondent presents an
288     imminent threat of serious harm to self or others as a result of a substance use disorder.
289          (2) An individual who is admitted to a hospital under this section shall be released
290     from the hospital within 72 hours after admittance, unless a treating physician or essential
291     treatment examiner determines that the individual continues to pose an imminent threat of
292     serious harm to self or others.
293          (3) If a treating physician or essential treatment examiner makes the determination
294     described in Subsection (2), the individual may be Ĥ→ [
essential treatment] detained ←Ĥ for as
294a     long as the threat
295     of serious harm remains imminent, but not more than 10 days after the day on which the
296     individual was hospitalized, unless a court orders otherwise.
297          (4) A treating physician or an essential treatment examiner shall, as frequently as
298     practicable, examine an individual hospitalized under this section and release the individual if
299     the examination determines that a threat of imminent serious harm no longer exists.
300          Section 10. Section 62A-15-1208 is enacted to read:
301          62A-15-1208. Confidentiality.
302          (1) The purpose of Title 62A, Chapter 15, Part 12, Essential Treatment and
303     Intervention Act, is to provide a process for essential treatment and intervention to save lives,
304     preserve families, and reduce substance use disorder, including opioid addiction.

305          (2) An essential treatment petition and any other document filed in connection with the
306     petition for essential treatment is confidential and protected.
307          (3) A hearing on an essential treatment petition is closed to the public, and only the
308     following individuals and their legal counsel may be admitted to the hearing:
309          (a) parties to the petition;
310          (b) the essential treatment examiners who completed the court-ordered examination
311     under Subsection 62A-15-1205(3);
312          (c) individuals who have been asked to give testimony; and
313          (d) individuals to whom notice of the hearing is required to be given under Subsection
314     62A-15-1205(2)(c).
315          (4) Testimony, medical evaluations, the petition, and other documents directly related
316     to the adjudication of the petition and presented to the court in the interest of the respondent
317     may not be construed or applied as an admission of guilt to a criminal offense.
318          (5) A court may, if applicable, enforce a previously existing warrant for a respondent or
319     a warrant for a charge that is unrelated to the essential treatment petition filed under this part.
320          Section 11. Section 62A-15-1209 is enacted to read:
321          62A-15-1209. Essential treatment for substance use disorder -- Rights of patient.
322          All applicable rights guaranteed to a patient by Sections 62A-15-641 and 62A-15-642
323     shall be guaranteed to an individual who is ordered to undergo essential treatment for a
324     substance use disorder.