Representative Edward H. Redd proposes the following substitute bill:


1     
SUBSTANCE ABUSE AND MENTAL HEALTH ACT AMENDMENTS

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Edward H. Redd

5     
Senate Sponsor: Todd Weiler

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions of the Substance Abuse and Mental Health Act.
10     Highlighted Provisions:
11          This bill:
12          ▸     clarifies the role of a mental health officer;
13          ▸     modifies definitions;
14          ▸     removes references to the Utah State Hospital Board, which no longer exists;
15          ▸     removes the exemption of security officers from the public safety retirement system;
16          ▸     updates code provisions in accordance with the existing practice of private hospitals
17     providing inpatient mental health treatment;
18          ▸     makes changes to procedures and criteria for civil commitments;
19          ▸     gives officers authority to not take a mentally ill individual into custody in order to
20     avoid escalating a dangerous situation; and
21          ▸     makes technical changes.
22     Money Appropriated in this Bill:
23          None
24     Other Special Clauses:
25          None
26     Utah Code Sections Affected:
27     AMENDS:
28          62A-15-602, as last amended by Laws of Utah 2012, Chapter 248
29          62A-15-603, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
30     Chapter 8
31          62A-15-613, as last amended by Laws of Utah 2006, Chapter 139
32          62A-15-625, as last amended by Laws of Utah 2003, Chapter 195
33          62A-15-627, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
34     Chapter 8
35          62A-15-628, as last amended by Laws of Utah 2003, Chapter 195
36          62A-15-629, as last amended by Laws of Utah 2011, Chapter 366
37          62A-15-631, as last amended by Laws of Utah 2013, Chapters 29 and 312
38          62A-15-632, as last amended by Laws of Utah 2011, Chapter 366
39          62A-15-635, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
40     Chapter 8
41          62A-15-637, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
42     Chapter 8
43          62A-15-703, as last amended by Laws of Utah 2008, Chapter 3
44     

45     Be it enacted by the Legislature of the state of Utah:
46          Section 1. Section 62A-15-602 is amended to read:
47          62A-15-602. Definitions.
48          As used in this part, Part 7, Commitment of Persons Under Age 18 to Division of
49     Substance Abuse and Mental Health, Part 8, Interstate Compact on Mental Health, Part 9, Utah
50     Forensic Mental Health Facility, and Part 10, Declaration for Mental Health Treatment:
51          (1) "Adult" means [a person] an individual 18 years of age or older.
52          (2) "Commitment to the custody of a local mental health authority" means that an adult
53     is committed to the custody of the local mental health authority that governs the mental health
54     catchment area [in which the proposed patient] where the adult resides or is found.
55          (3) "Community mental health center" means an entity that provides treatment and
56     services to a resident of a designated geographical area, that operates by or under contract with
57     a local mental health authority, and that complies with state standards for community mental
58     health centers.
59          [(3)] (4) "Designated examiner" means a licensed physician [familiar with severe
60     mental illness, preferably a psychiatrist], preferably a psychiatrist, who is designated by the
61     division as specially qualified by training or experience in the diagnosis of mental or related
62     illness or [another] a licensed mental health professional designated by the division as specially
63     qualified by training and who has at least five years' continual experience in the treatment of
64     mental [or related] illness. [At least one designated examiner in any case shall be a licensed
65     physician. No person who is the applicant, or who signs the certification, under Section
66     62A-15-631 may be a designated examiner in the same case.]
67          [(4)] (5) "Designee" means a physician who has responsibility for medical functions
68     including admission and discharge, an employee of a local mental health authority, or an
69     employee of an [agency] entity that has contracted with a local mental health authority to
70     provide mental health services under Section 17-43-304.
71          [(5)] (6) "Harmful sexual conduct" means [any of] the following conduct upon an
72     individual without the individual's consent, [or upon an individual who cannot legally consent
73     to the conduct including under the] including the nonconsensual circumstances described in
74     Subsections 76-5-406(1) through (12):
75          (a) sexual intercourse;
76          (b) penetration, however slight, of the genital or anal opening of the individual;
77          (c) any sexual act involving the genitals or anus of the actor or the individual and the
78     mouth or anus of either individual, regardless of the gender of either participant; or
79          (d) any sexual act causing substantial emotional injury or bodily pain.
80          [(6)] (7) "Institution" means a hospital[,] or a health facility licensed under [the
81     provisions of] Section 26-21-9.
82          [(7) "Licensed physician" means an individual licensed under the laws of this state to
83     practice medicine, or a medical officer of the United States government while in this state in
84     the performance of official duties.]
85          [(8) "Local comprehensive community mental health center" means an agency or
86     organization that provides treatment and services to residents of a designated geographic area,
87     operated by or under contract with a local mental health authority, in compliance with state
88     standards for local comprehensive community mental health centers.]
89          [(9)] (8) "Mental health facility" means the Utah State Hospital or other facility that
90     provides mental health services under contract with the division, a local mental health
91     authority, [or organization] an entity that contracts with a local mental health authority, or an
92     entity that provides acute inpatient psychiatric services to a patient.
93          [(10)] (9) "Mental health officer" means an individual who is designated by a local
94     mental health authority as qualified by training and experience in the recognition and
95     identification of mental illness, to [interact with and transport persons to any mental health
96     facility.]:
97          (a) apply for and provide certification for a temporary commitment; or
98          (b) assist in the arrangement of transportation to a designated mental health facility.
99          [(11)] (10) "Mental illness" means [a psychiatric disorder as defined by the current
100     edition of the Diagnostic and Statistical Manual of Mental Disorders published by the
101     American Psychiatric Association which substantially impairs a person's mental, emotional,
102     behavioral, or related functioning.]:
103          (a) a psychiatric disorder that substantially impairs a person's mental, emotional,
104     behavioral, or related functioning; or
105          (b) the same as that term is defined in:
106          (i) the current edition of the Diagnostic and Statistical Manual of Mental Disorders
107     published by the American Psychiatric Association; or
108          (ii) the current edition of the International Statistical Classification of Diseases and
109     Related Health Problems.
110          [(12)] (11) "Patient" means an individual under commitment to the custody or to the
111     treatment services of a local mental health authority.
112          (12) "Physician" means an individual who is:
113          (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
114          (b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
115     Practice Act.
116          (13) "Serious bodily injury" means bodily injury [which] that involves a substantial
117     risk of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or
118     protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
119          (14) "Substantial danger" means [the person, by his or her behavior, due to mental
120     illness] that due to mental illness, an individual is at serious risk of:
121          [(a) is at serious risk to:]
122          [(i) commit suicide;]
123          [(ii) inflict serious bodily injury on himself or herself; or]
124          [(iii) because of his or her actions or inaction, suffer serious bodily injury because he or
125     she is incapable of providing the basic necessities of life, such as food, clothing, and shelter;
126     or]
127          [(b) is at serious risk to cause or attempt to cause serious bodily injury or engage in
128     harmful sexual conduct.]
129          (a) suicide;
130          (b) serious bodily self-injury;
131          (c) serious bodily injury because the individual is incapable of providing the basic
132     necessities of life, including food, clothing, or shelter;
133          (d) causing or attempting to cause serious bodily injury to another individual; or
134          (e) engaging in harmful sexual conduct.
135          (15) "Treatment" means psychotherapy, medication, including the administration of
136     psychotropic medication, [and] or other medical treatments that are generally accepted medical
137     [and] or psychosocial interventions for the purpose of restoring the patient to an optimal level
138     of functioning in the least restrictive environment.
139          Section 2. Section 62A-15-603 is amended to read:
140          62A-15-603. Administration of state hospital -- Division -- Authority.
141          (1) The administration of the state hospital is vested in the division where it shall
142     function and be administered as a part of the state's comprehensive mental health program and,
143     to the fullest extent possible, shall be coordinated with local mental health authority programs.
144     [When it becomes feasible the board may direct that the hospital be decentralized and
145     administered at the local level by being integrated with, and becoming a part of, the community
146     mental health services.]
147          [(2) The division shall succeed to all the powers, discharge all the duties, and perform
148     all the functions, duties, rights, and responsibilities pertaining to the state hospital which by
149     law are conferred upon it or required to be discharged or performed. However, the functions,
150     powers, duties, rights, and responsibilities of the division and of the board otherwise provided
151     by law and by this part apply.]
152          (2) The division has the same powers, duties, rights, and responsibilities as, and shall
153     perform the same functions that by law are conferred or required to be discharged or performed
154     by, the state hospital.
155          (3) Supervision and administration of security responsibilities for the state hospital is
156     vested in the division. The executive director shall designate, as special function officers,
157     individuals with peace officer authority to perform special security functions for the state
158     hospital [that require peace officer authority. These special function officers may not become
159     or be designated as members of the Public Safety Retirement System].
160          [(4) Directors of mental health facilities that house involuntary detainees or detainees
161     committed pursuant to judicial order may establish secure areas, as prescribed in Section
162     76-8-311.1, within the mental health facility for the detainees.]
163          (4) A director of a mental health facility that houses an involuntary patient or a patient
164     committed by judicial order may establish secure areas, as provided in Section 76-8-311.1,
165     within the mental health facility for the patient.
166          Section 3. Section 62A-15-613 is amended to read:
167          62A-15-613. Appointment of superintendent -- Qualifications -- Powers and
168     responsibilities.
169          (1) The director, with the advice [and], consent [of the board], and [the] approval of the
170     executive director, shall appoint a superintendent of the state hospital, who shall hold office at
171     the will of the director.
172          (2) The superintendent shall have a bachelor's degree from an accredited university or
173     college, be experienced in administration, and be knowledgeable in matters concerning mental
174     health.
175          (3) [Subject to the rules of the board, the] The superintendent has general responsibility
176     for the buildings, grounds, and property of the state hospital. The superintendent shall appoint,
177     with the approval of the director, as many employees as necessary for the efficient and
178     economical care and management of the state hospital, and shall fix [their] the employees'
179     compensation and administer personnel functions according to the standards of the Department
180     of Human Resource Management.
181          Section 4. Section 62A-15-625 is amended to read:
182          62A-15-625. Voluntary admission of adults.
183          [(1) A local mental health authority or its designee may admit to that authority, for
184     observation, diagnosis, care, and treatment any individual who is mentally ill or has symptoms
185     of mental illness and who, being 18 years of age or older, applies for voluntary admission.]
186          [(2) (a) No adult may be committed or continue to be committed to a local mental
187     health authority against his will except as provided in this chapter.]
188          [(b) A person under 18 years of age may be committed to the physical custody of a local
189     mental health authority only after a court commitment proceeding in accordance with the
190     provisions of Part 7, Commitment of Persons Under Age 18 to Division of Substance Abuse
191     and Mental Health.]
192          (1) A local mental health authority, a designee of a local mental health authority, or
193     another mental health facility may admit for observation, diagnosis, care, and treatment an
194     adult who applies for voluntary admission and who has a mental illness or exhibits the
195     symptoms of a mental illness.
196          (2) No adult may be committed to a local mental health authority against that adult's
197     will except as provided in this chapter.
198          (3) An adult may be voluntarily admitted to a local mental health authority for
199     treatment at the Utah State Hospital as a condition of probation or stay of sentence only after
200     the requirements of Subsection 77-18-1(13) have been met.
201          Section 5. Section 62A-15-627 is amended to read:
202          62A-15-627. Release of voluntary patient -- Exceptions.
203          (1) A [voluntary] patient who is voluntarily admitted, as described in Section
204     62A-15-625, and who requests release, verbally or in writing, or whose release is requested in
205     writing by [his] the patient's legal guardian, parent, spouse, or adult next of kin, shall be
206     immediately released except that:
207          [(1) if the patient was voluntarily admitted on his own application, and]
208          (a) release may be conditioned upon the agreement of the patient, if the request for
209     release is made by [a person] an individual other than the patient[, release may be conditioned
210     upon the agreement of the patient; and]; or
211          [(2)] (b) if [a] the admitting local mental health authority, [or its designee is of the
212     opinion that release of a patient would be unsafe for that patient or others,] designee of the
213     local mental health authority, or mental health facility has cause to believe that release of the
214     patient would be unsafe for the patient or others, release of that patient may be postponed for
215     up to 48 hours, excluding weekends and holidays, provided that the [local mental health]
216     admitting authority, [or its] designee, or facility shall cause to be instituted involuntary
217     commitment proceedings with the district court within the specified time period.[, unless cause
218     no longer exists for instituting those proceedings. Written]
219          (2) The admitting authority, designee, or facility shall provide written notice of [that]
220     the postponement [with] and the reasons[, shall be given] for the postponement to the patient
221     without undue delay.
222          (3) No judicial proceedings for involuntary commitment may be commenced with
223     respect to a voluntary patient unless [he] the patient has requested release.
224          Section 6. Section 62A-15-628 is amended to read:
225          62A-15-628. Involuntary commitment -- Procedures.
226          (1) An adult may not be involuntarily committed to the custody of a local mental health
227     authority except under the following provisions:
228          (a) emergency procedures for temporary commitment upon medical or designated
229     examiner certification, as provided in Subsection 62A-15-629(1)(a);
230          (b) emergency procedures for temporary commitment without endorsement of medical
231     or designated examiner certification, as provided in Subsection 62A-15-629[(2)](1)(b); or
232          (c) commitment on court order, as provided in Section 62A-15-631.
233          (2) A person under 18 years of age may be committed to the physical custody of a local
234     mental health authority only [after a court commitment proceeding] in accordance with the
235     provisions of Part 7, Commitment of Persons Under Age 18 to Division of Substance Abuse
236     and Mental Health.
237          Section 7. Section 62A-15-629 is amended to read:
238          62A-15-629. Temporary commitment -- Requirements and procedures.
239          (1) [(a) ] An adult [may] shall be temporarily, involuntarily committed to a local mental
240     health authority upon:
241          (a) a written application that:
242          (i) [written application] is completed by a responsible [person] individual who has
243     reason to know, stating a belief that the [individual] adult, due to mental illness, is likely to
244     [cause serious injury] pose substantial danger to self or others if not [immediately] restrained[,]
245     and stating the personal knowledge of the [individual's] adult's condition or circumstances
246     [which] that lead to [that] the individual's belief; and
247          (ii) includes a certification by a licensed physician or designated examiner stating that
248     the physician or designated examiner has examined the [individual] adult within a three-day
249     period immediately preceding that certification, and that the physician or designated examiner
250     is of the opinion that the [individual has a mental illness and, because of the individual's mental
251     illness, is likely to injure self or others if not immediately restrained.] adult due to mental
252     illness poses a substantial danger to self or others; or
253          [(b) Application and certification as described in Subsection (1)(a) authorizes any
254     peace officer to take the individual into the custody of a local mental health authority and
255     transport the individual to that authority's designated facility.]
256          [(2) If a duly authorized peace officer observes a person involved in conduct that gives
257     the officer probable cause to believe that the person has a mental illness, as defined in Section
258     62A-15-602, and because of that apparent mental illness and conduct, there is a substantial
259     likelihood of serious harm to that person or others, pending proceedings for examination and
260     certification under this part, the officer may take that person into protective custody. The peace
261     officer shall transport the person to be transported to the designated facility of the appropriate
262     local mental health authority pursuant to this section, either on the basis of the peace officer's
263     own observation or on the basis of a mental health officer's observation that has been reported
264     to the peace officer by that mental health officer. Immediately thereafter, the officer shall place
265     the person in the custody of the local mental health authority and make application for
266     commitment of that person to the local mental health authority. The application shall be on a
267     prescribed form and shall include the following:]
268          [(a) a statement by the officer that the officer believes, on the basis of personal
269     observation or on the basis of a mental health officer's observation reported to the officer by the
270     mental health officer, that the person is, as a result of a mental illness, a substantial and
271     immediate danger to self or others;]
272          [(b) the specific nature of the danger;]
273          [(c) a summary of the observations upon which the statement of danger is based; and]
274          [(d) a statement of facts which called the person to the attention of the officer.]
275          (b) a peace officer or a mental health officer:
276          (i) observing an adult's conduct that gives the officer probable cause to believe that:
277          (A) the adult has a mental illness; and
278          (B) because of the adult's mental illness and conduct, the adult poses a substantial
279     danger to self or others; and
280          (ii) completing a temporary commitment application that:
281          (A) is on a form prescribed by the division;
282          (B) states the officer's belief that the adult poses a substantial danger to self or others;
283          (C) states the specific nature of the danger;
284          (D) provides a summary of the observations upon which the statement of danger is
285     based; and
286          (E) provides a statement of the facts that called the adult to the officer's attention.
287          (2) If at any time a patient committed under this section no longer meets the
288     commitment criteria described in Subsection (1), the local mental health authority or the local
289     mental health authority's designee shall document the change and release the patient.
290          (3) A [person] patient committed under this section may be held for a maximum of 24
291     hours after commitment, excluding Saturdays, Sundays, and legal holidays[. At the expiration
292     of that time period, the person shall be released unless application for involuntary commitment
293     has been commenced pursuant to Section 62A-15-631. If that application has been made, an
294     order of detention may be entered under Subsection 62A-15-631(3). If no order of detention is
295     issued, the patient shall be released unless he has made voluntary application for admission.],
296     unless:
297          (a) as described in Section 62A-15-631, an application for involuntary commitment is
298     commenced, which may be accompanied by an order of detention under Subsection
299     62A-15-631(4); or
300          (b) the patient has made a voluntary application for admission.
301          [(4) Transportation of persons with a mental illness pursuant to Subsections (1) and (2)
302     shall be conducted by the appropriate municipal, or city or town, law enforcement authority or,
303     under the appropriate law enforcement's authority, by ambulance to the extent that Subsection
304     (5) applies. However, if the designated facility is outside of that authority's jurisdiction, the
305     appropriate county sheriff shall transport the person or cause the person to be transported by
306     ambulance to the extent that Subsection (5) applies.]
307          [(5) Notwithstanding Subsections (2) and (4), a peace officer shall cause a person to be
308     transported by ambulance if the person meets any of the criteria in Section 26-8a-305. In
309     addition, if the person requires physical medical attention, the peace officer shall direct that
310     transportation be to an appropriate medical facility for treatment.]
311          (4) Upon a written application described in Subsection (1)(a) or the observation and
312     belief described in Subsection (1)(b), the adult shall be:
313          (a) taken into a peace officer's protective custody, by reasonable means, if necessary for
314     public safety; and
315          (b) transported for temporary commitment to a facility designated by the local mental
316     health authority, by means of:
317          (i) an ambulance, if the adult meets any of the criteria of Section 26-8a-305;
318          (ii) an ambulance, if a peace officer is not necessary for public safety, and
319     transportation arrangements are made by a physician, designated examiner, or mental health
320     officer;
321          (iii) the city, town, or municipal law enforcement authority with jurisdiction over the
322     location where the individual to be committed is present, if the individual is not transported by
323     ambulance; or
324          (iv) the county sheriff, if the designated facility is outside of the jurisdiction of the law
325     enforcement authority described in Subsection (4)(b)(iii) and the individual is not transported
326     by ambulance.
327          (5) Notwithstanding Subsection (4):
328          (a) an individual shall be transported by ambulance to an appropriate medical facility
329     for treatment if the individual requires physical medical attention; and
330          (b) if an officer determines through the officer's experience and training that taking an
331     individual into protective custody or transporting an individual for temporary commitment
332     would increase the risk of substantial danger to the individual or others, a peace officer may
333     exercise discretion to not take the individual into custody or transport the individual, as
334     permitted by policies and procedures established by the officer's law enforcement agency and
335     any applicable federal or state statute, or case law.
336          (6) Title 63G, Chapter 7, Governmental Immunity Act of Utah, applies to this section.
337     This section does not create a special duty of care.
338          Section 8. Section 62A-15-631 is amended to read:
339          62A-15-631. Involuntary commitment under court order -- Examination --
340     Hearing -- Power of court -- Findings required -- Costs.
341          [(1) Proceedings for involuntary commitment of an individual who is 18 years of age
342     or older may be commenced by filing a written application with the district court of the county
343     in which the proposed patient resides or is found, by a responsible person who has reason to
344     know of the condition or circumstances of the proposed patient which lead to the belief that the
345     individual has a mental illness and should be involuntarily committed. The application shall
346     include:]
347          (1) A responsible person who has reason to know of an adult's mental illness and the
348     condition or circumstances that have lead to the adult's need to be involuntarily committed may
349     initiate an involuntary commitment court proceeding by filing, in the district court in the
350     county where the proposed patient resides or is found, a written application that includes:
351          (a) unless the court finds that the information is not reasonably available, the
352     [individual's] proposed patient's:
353          (i) name;
354          (ii) date of birth; and
355          (iii) social security number; and
356          [(b) either:]
357          (b) (i) a certificate of a licensed physician or a designated examiner stating that within
358     a seven-day period immediately preceding the certification the physician or designated
359     examiner has examined the individual, and that the physician or designated examiner is of the
360     opinion that the individual [is mentally ill] has a mental illness and should be involuntarily
361     committed; or
362          (ii) a written statement by the applicant that:
363          (A) the individual has been requested to, but has refused to, submit to an examination
364     of mental condition by a licensed physician or designated examiner;
365          (B) is sworn to under oath; and
366          (C) states the facts upon which the application is based.
367          (2) (a) Subject to Subsection (2)(b), before issuing a judicial order, the court may
368     require the applicant to consult with the appropriate local mental health authority, and may
369     direct a mental health professional from that local mental health authority to interview the
370     applicant and the proposed patient to determine the existing facts and report them to the court.
371          (b) The consultation described in Subsection (2)(a):
372          (i) may take place at or before the hearing; and
373          (ii) is required if the local mental health authority appears at the hearing.
374          (3) In a commitment application, at least one designated examiner shall be a licensed
375     physician. Neither the civil commitment applicant nor the individual who signs the certification
376     under Subsection (1) may be a designated examiner in the same application.
377          [(3)] (4) If the court finds from the application, from any other statements under oath,
378     or from any reports from a mental health professional that there is a reasonable basis to believe
379     that the proposed patient has a mental illness that poses a substantial danger, as defined in
380     Section 62A-15-602, to self or others requiring involuntary commitment pending examination
381     and hearing; or, if the proposed patient has refused to submit to an interview with a mental
382     health professional as directed by the court or to go to a treatment facility voluntarily, the court
383     may issue an order, directed to a mental health officer or peace officer, to immediately place
384     the proposed patient in the custody of a local mental health authority or in a temporary
385     emergency facility as provided in Section 62A-15-634 to be detained for the purpose of
386     examination. Within 24 hours of the issuance of the order for examination, a local mental
387     health authority or its designee shall report to the court, orally or in writing, whether the patient
388     is, in the opinion of the examiners, mentally ill, whether the patient has agreed to become a
389     voluntary patient under Section 62A-15-625, and whether treatment programs are available and
390     acceptable without court proceedings. Based on that information, the court may, without
391     taking any further action, terminate the proceedings and dismiss the application. In any event,
392     if the examiner reports orally, the examiner shall immediately send the report in writing to the
393     clerk of the court.
394          [(4)] (5) Notice of commencement of proceedings for involuntary commitment, setting
395     forth the allegations of the application and any reported facts, together with a copy of any
396     official order of detention, shall be provided by the court to a proposed patient before, or upon,
397     placement in the custody of a local mental health authority or, with respect to any individual
398     presently in the custody of a local mental health authority whose status is being changed from
399     voluntary to involuntary, upon the filing of an application for that purpose with the court. A
400     copy of that order of detention shall be maintained at the place of detention.
401          [(5)] (6) Notice of commencement of those proceedings shall be provided by the court
402     as soon as practicable to the applicant, any legal guardian, any immediate adult family
403     members, legal counsel for the parties involved, the local mental health authority or its
404     designee, and any other persons whom the proposed patient or the court shall designate. That
405     notice shall advise those persons that a hearing may be held within the time provided by law. If
406     the patient has refused to permit release of information necessary for provisions of notice under
407     this subsection, the extent of notice shall be determined by the court.
408          [(6)] (7) Proceedings for commitment of an individual under the age of 18 years to [the
409     division] a local mental health authority may be commenced [by filing a written application
410     with the juvenile court in accordance with the provisions of] in accordance with Part 7,
411     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
412          [(7)] (8) The district court may, in its discretion, transfer the case to any other district
413     court within this state, provided that the transfer will not be adverse to the interest of the
414     proposed patient.
415          [(8)] (9) (a) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the
416     issuance of a judicial order, or after commitment of a proposed patient to a local mental health
417     authority under court order for detention or examination, the court shall appoint two designated
418     examiners to examine the proposed patient. If requested by the proposed patient's counsel, the
419     court shall appoint, as one of the examiners, a reasonably available qualified person designated
420     by counsel. The examinations, to be conducted separately, shall be held at the home of the
421     proposed patient, a hospital or other medical facility, or at any other suitable place that is not
422     likely to have a harmful effect on the patient's health.
423          (b) The examiner shall inform the patient if not represented by an attorney that, if
424     desired, the patient does not have to say anything, the nature and reasons for the examination,
425     that it was ordered by the court, that any information volunteered could form part of the basis
426     for the patient's involuntary commitment, and that findings resulting from the examination will
427     be made available to the court.
428          (c) A time shall be set for a hearing to be held within 10 calendar days of the
429     appointment of the designated examiners, unless those examiners or a local mental health
430     authority or its designee informs the court prior to that hearing date that the patient is not
431     mentally ill, that the patient has agreed to become a voluntary patient under Section
432     62A-15-625, or that treatment programs are available and acceptable without court
433     proceedings, in which event the court may, without taking any further action, terminate the
434     proceedings and dismiss the application.
435          (d) If the local mental health authority or the designee determines before the court
436     hearing that the conditions justifying the findings leading to a hearing for commitment no
437     longer exist, the local mental health authority or the designee shall immediately report that
438     determination to the court.
439          [(9)] (10) (a) Before the hearing, an opportunity to be represented by counsel shall be
440     afforded to every proposed patient, and if neither the patient nor others provide counsel, the
441     court shall appoint counsel and allow counsel sufficient time to consult with the patient before
442     the hearing. In the case of an indigent patient, the payment of reasonable attorney fees for
443     counsel, as determined by the court, shall be made by the county in which the patient resides or
444     was found.
445          (b) The proposed patient, the applicant, and all other persons to whom notice is
446     required to be given shall be afforded an opportunity to appear at the hearing, to testify, and to
447     present and cross-examine witnesses. The court may, in its discretion, receive the testimony of
448     any other person. The court may allow a waiver of the patient's right to appear only for good
449     cause shown, and that cause shall be made a matter of court record.
450          (c) The court is authorized to exclude all persons not necessary for the conduct of the
451     proceedings and may, upon motion of counsel, require the testimony of each examiner to be
452     given out of the presence of any other examiners.
453          (d) The hearing shall be conducted in as informal a manner as may be consistent with
454     orderly procedure, and in a physical setting that is not likely to have a harmful effect on the
455     mental health of the proposed patient.
456          (e) The court shall consider all relevant historical and material information that is
457     offered, subject to the rules of evidence, including reliable hearsay under Rule 1102, Utah
458     Rules of Evidence.
459          (f) (i) A local mental health authority or its designee, or the physician in charge of the
460     patient's care shall, at the time of the hearing, provide the court with the following information:
461          (A) the detention order;
462          (B) admission notes;
463          (C) the diagnosis;
464          (D) any doctors' orders;
465          (E) progress notes;
466          (F) nursing notes; and
467          (G) medication records pertaining to the current commitment.
468          (ii) That information shall also be supplied to the patient's counsel at the time of the
469     hearing, and at any time prior to the hearing upon request.
470          [(10)] (11) The court shall order commitment of an individual who is 18 years of age or
471     older to a local mental health authority if, upon completion of the hearing and consideration of
472     the information presented in accordance with Subsection [(9)] (10)(e), the court finds by clear
473     and convincing evidence that:
474          (a) the proposed patient has a mental illness;
475          (b) because of the proposed patient's mental illness the proposed patient poses a
476     substantial danger[, as defined in Section 62A-15-602,] to self or others, which may include the
477     inability to provide the basic necessities of life such as food, clothing, [and] or shelter, if
478     allowed to remain at liberty;
479          (c) the patient lacks the ability to engage in a rational decision-making process
480     regarding the acceptance of mental treatment as demonstrated by evidence of inability to weigh
481     the possible risks of accepting or rejecting treatment;
482          (d) there is no appropriate less-restrictive alternative to a court order of commitment;
483     and
484          (e) the local mental health authority can provide the individual with treatment that is
485     adequate and appropriate to the individual's conditions and needs. In the absence of the
486     required findings of the court after the hearing, the court shall [forthwith] dismiss the
487     proceedings.
488          [(11)] (12) (a) The order of commitment shall designate the period for which the
489     individual shall be treated. When the individual is not under an order of commitment at the
490     time of the hearing, that period may not exceed six months without benefit of a review hearing.
491     Upon such a review hearing, to be commenced prior to the expiration of the previous order, an
492     order for commitment may be for an indeterminate period, if the court finds by clear and
493     convincing evidence that the required conditions in Subsection [(10)] (11) will last for an
494     indeterminate period.
495          (b) The court shall maintain a current list of all patients under its order of commitment.
496     That list shall be reviewed to determine those patients who have been under an order of
497     commitment for the designated period. At least two weeks prior to the expiration of the
498     designated period of any order of commitment still in effect, the court that entered the original
499     order shall inform the appropriate local mental health authority or its designee. The local
500     mental health authority or its designee shall immediately reexamine the reasons upon which the
501     order of commitment was based. If the local mental health authority or its designee determines
502     that the conditions justifying that commitment no longer exist, it shall discharge the patient
503     from involuntary commitment and immediately report that to the court. Otherwise, the court
504     shall immediately appoint two designated examiners and proceed under Subsections [(8)] (9)
505     through [(10)] (11).
506          (c) The local mental health authority or its designee responsible for the care of a patient
507     under an order of commitment for an indeterminate period, shall at six-month intervals
508     reexamine the reasons upon which the order of indeterminate commitment was based. If the
509     local mental health authority or its designee determines that the conditions justifying that
510     commitment no longer exist, that local mental health authority or its designee shall discharge
511     the patient from its custody and immediately report the discharge to the court. If the local
512     mental health authority or its designee determines that the conditions justifying that
513     commitment continue to exist, the local mental health authority or its designee shall send a
514     written report of those findings to the court. The patient and the patient's counsel of record
515     shall be notified in writing that the involuntary commitment will be continued, the reasons for
516     that decision, and that the patient has the right to a review hearing by making a request to the
517     court. Upon receiving the request, the court shall immediately appoint two designated
518     examiners and proceed under Subsections [(8)] (9) through [(10)] (11).
519          [(12)] (13) In the event that the designated examiners are unable, because a proposed
520     patient refuses to submit to an examination, to complete that examination on the first attempt,
521     the court shall fix a reasonable compensation to be paid to those designated examiners for their
522     services.
523          [(13)] (14) Any person committed as a result of an original hearing or a person's legally
524     designated representative who is aggrieved by the findings, conclusions, and order of the court
525     entered in the original hearing has the right to a new hearing upon a petition filed with the court
526     within 30 days of the entry of the court order. The petition must allege error or mistake in the
527     findings, in which case the court shall appoint three impartial designated examiners previously
528     unrelated to the case to conduct an additional examination of the patient. The new hearing
529     shall, in all other respects, be conducted in the manner otherwise permitted.
530          [(14)] (15) Costs of all proceedings under this section shall be paid by the county in
531     which the proposed patient resides or is found.
532          Section 9. Section 62A-15-632 is amended to read:
533          62A-15-632. Circumstances under which conditions justifying initial involuntary
534     commitment shall be considered to continue to exist.
535          (1) After [a person] an individual has been involuntarily committed to the custody of a
536     local mental health authority under Subsection 62A-15-631[(10)](11), the conditions justifying
537     commitment under that subsection shall be considered to continue to exist, for purposes of
538     continued treatment under Subsection 62A-15-631[(11)](12) or conditional release under
539     Section 62A-15-637, if the court finds that the patient is still mentally ill, and that absent an
540     order of involuntary commitment and without continued treatment the patient will suffer severe
541     and abnormal mental and emotional distress as indicated by recent past history, and will
542     experience deterioration in the patient's ability to function in the least restrictive environment,
543     thereby making the patient a substantial danger to self or others.
544          (2) A patient whose treatment is continued or who is conditionally released under the
545     terms of this section, shall be maintained in the least restrictive environment available that can
546     provide the patient with the treatment that is adequate and appropriate.
547          Section 10. Section 62A-15-635 is amended to read:
548          62A-15-635. Notice of commitment.
549          Whenever a patient has been temporarily, involuntarily committed to a local mental
550     health authority [pursuant to] under Section 62A-15-629 on the application of [any person] an
551     individual other than [his] the patient's legal guardian, spouse, or next of kin, the local mental
552     health authority or [its] a designee of the local mental health authority shall immediately notify
553     the patient's legal guardian, spouse, or next of kin, if known.
554          Section 11. Section 62A-15-637 is amended to read:
555          62A-15-637. Release of patient to receive other treatment -- Placement in more
556     restrictive environment -- Procedures.
557          (1) A local mental health authority or [its] a designee of a local mental health authority
558     may release an improved patient to less restrictive treatment [as it may specify, and when
559     agreed to in writing by the patient.] when:
560          (a) the authority specifies the less restrictive treatment; and
561          (b) the patient agrees in writing to the less restrictive treatment.
562          (2) Whenever a local mental health authority or [its designee] a designee of a local
563     mental health authority determines that the conditions justifying commitment no longer exist,
564     the [patient shall be discharged] local mental health authority or the designee shall discharge
565     the patient. If the patient has been committed through judicial proceedings, [a report
566     describing that determination shall be sent] the local mental health authority or the designee
567     shall prepare a report describing the determination and shall send the report to the clerk of the
568     court where the proceedings were held.
569          [(2)] (3) (a) A local mental health authority or [its designee] a designee of a local
570     mental health authority is authorized to issue an order for the immediate placement of a current
571     patient [not previously released from an order of commitment] into a more restrictive
572     environment, if:
573          (i) the local mental health authority or [its designee] a designee of a local mental health
574     authority has reason to believe that the [less restrictive environment in which the patient has
575     been placed] patient's current environment is aggravating the patient's mental illness [as
576     defined in Subsection 62A-15-631(10), or that]; or
577          (ii) the patient has failed to comply with the specified treatment plan to which [he] the
578     patient had agreed in writing.
579          (b) [That] An order for a more restrictive environment shall include the reasons
580     therefor and shall authorize any peace officer to take the patient into physical custody and
581     transport [him] the patient to a facility designated by the [division] local mental health
582     authority. Prior to or upon admission to the more restrictive environment, or upon imposition
583     of additional or different requirements as conditions for continued release from inpatient care,
584     copies of the order shall be personally delivered to the patient and sent to the person in whose
585     care the patient is placed. The order shall also be sent to the patient's counsel of record and to
586     the court that entered the original order of commitment. The order shall inform the patient of
587     the right to a hearing, as prescribed in this section, the right to appointed counsel, and the other
588     procedures prescribed in Subsection 62A-15-631[(9)](10).
589          (c) If the patient [has been in the] was in a less restrictive environment for more than
590     30 days and is aggrieved by the change to a more restrictive environment, the patient or [his]
591     the patient's representative may request a hearing within 30 days of the change. Upon receiving
592     the request, the court shall immediately appoint two designated examiners and proceed
593     pursuant to Section 62A-15-631, with the exception of Subsection 62A-15-631[(10)](11),
594     unless, by the time set for the hearing, the patient has [again been placed in] returned to the less
595     restrictive environment[,] or the patient has in writing withdrawn [his] the request for a
596     hearing.
597          [(3) The court shall find that either:]
598          [(a) the less restrictive environment in which the patient has been placed is aggravating
599     the patient's dangerousness or mental illness as defined in Subsection 62A-15-631(10), or the
600     patient has failed to comply with a specified treatment plan to which he had agreed in writing;
601     or]
602          [(b) the less restrictive environment in which the patient has been placed is not
603     aggravating the patient's mental illness or dangerousness, and the patient has not failed to
604     comply with any specified treatment plan to which he had agreed in writing, in which event the
605     order shall designate that the individual shall be placed and treated in a less restrictive
606     environment appropriate for his needs.]
607          (d) The court shall make findings as to whether the criteria in Subsections (3)(a) and
608     (b) were met and whether the patient is in the least restrictive environment that is appropriate
609     for the patient's needs.
610          [(4)] (e) The court order shall also designate the environment for the patient's care and
611     the period for which the [individual] patient shall be treated, in no event to extend beyond
612     expiration of the original order of commitment.
613          [(5)] (4) Nothing contained in this section prevents a local mental health authority or
614     its designee, pursuant to Section 62A-15-636, from discharging a patient from commitment or
615     from placing a patient in an environment that is less restrictive than that ordered by the court.
616          Section 12. Section 62A-15-703 is amended to read:
617          62A-15-703. Residential and inpatient settings -- Commitment proceeding --
618     Child in physical custody of local mental health authority.
619          (1) A child may receive services from a local mental health authority in an inpatient or
620     residential setting only after a commitment proceeding, for the purpose of transferring physical
621     custody, has been conducted in accordance with the requirements of this section.
622          (2) That commitment proceeding shall be initiated by a petition for commitment, and
623     shall be a careful, diagnostic inquiry, conducted by a neutral and detached fact finder, pursuant
624     to the procedures and requirements of this section. If the findings described in Subsection (4)
625     exist, the proceeding shall result in the transfer of physical custody to the appropriate local
626     mental health authority, and the child may be placed in an inpatient or residential setting.
627          (3) The neutral and detached fact finder who conducts the inquiry:
628          (a) shall be a designated examiner, as defined in Subsection 62A-15-602(3); and
629          (b) may not profit, financially or otherwise, from the commitment or physical
630     placement of the child in that setting.
631          (4) Upon determination by [the] a fact finder that the following circumstances clearly
632     exist, [he] the fact finder may order that the child be committed to the physical custody of a
633     local mental health authority:
634          (a) the child has a mental illness, as defined in Subsection 62A-15-602(8);
635          (b) the child demonstrates a risk of [harm to himself], or a reasonable fear of the risk
636     of, substantial danger to self or others;
637          [(c) the child is experiencing significant impairment in his ability to perform socially;]
638          [(d)] (c) the child will benefit from care and treatment by the local mental health
639     authority; and
640          [(e)] (d) there is no appropriate less-restrictive alternative.
641          (5) (a) The commitment proceeding before the neutral and detached fact finder shall be
642     conducted in as informal manner as possible[,] and in a physical setting that is not likely to
643     have a harmful effect on the child.
644          (b) The child, the child's parent or legal guardian, the [person who submitted the
645     petition for commitment] petitioner, and a representative of the appropriate local mental health
646     authority shall all receive informal notice of the date and time of the proceeding. Those parties
647     shall also be afforded an opportunity to appear and to address the petition for commitment.
648          (c) The neutral and detached fact finder may, in [his] the fact finder's discretion,
649     receive the testimony of any other person.
650          (d) The fact finder may allow [the] a child to waive [his] the child's right to be present
651     at the commitment proceeding, for good cause shown. If that right is waived, the purpose of
652     the waiver shall be made a matter of record at the proceeding.
653          (e) At the time of the commitment proceeding, the appropriate local mental health
654     authority, its designee, or the psychiatrist who has been in charge of the child's care prior to the
655     commitment proceeding, shall provide the neutral and detached fact finder with the following
656     information, as it relates to the period of current admission:
657          (i) the petition for commitment;
658          (ii) the admission notes;
659          (iii) the child's diagnosis;
660          (iv) physicians' orders;
661          (v) progress notes;
662          (vi) nursing notes; and
663          (vii) medication records.
664          (f) The information described in Subsection (5)(e) shall also be provided to the child's
665     parent or legal guardian upon written request.
666          (g) (i) The neutral and detached fact finder's decision of commitment shall state the
667     duration of the commitment. Any commitment to the physical custody of a local mental health
668     authority may not exceed 180 days. Prior to expiration of the commitment, and if further
669     commitment is sought, a hearing shall be conducted in the same manner as the initial
670     commitment proceeding, in accordance with the requirements of this section.
671          (ii) [When] At the conclusion of the hearing and subsequently in writing, when a
672     decision for commitment is made, the neutral and detached fact finder shall inform the child
673     and [his] the child's parent or legal guardian of that decision[,] and of the reasons for ordering
674     commitment [at the conclusion of the hearing, and also in writing].
675          (iii) The neutral and detached fact finder shall state in writing the basis of [his] the
676     decision, with specific reference to each of the criteria described in Subsection (4), as a matter
677     of record.
678          [(6) Absent the procedures and findings required by this section, a child may be
679     temporarily committed to the physical custody of a local mental health authority only in
680     accordance with the emergency procedures described in Subsection 62A-15-629(1) or (2). A
681     child temporarily committed in accordance with those emergency procedures may be held for a
682     maximum of 72 hours, excluding Saturdays, Sundays, and legal holidays. At the expiration of
683     that time period, the child shall be released unless the procedures and findings required by this
684     section have been satisfied.]
685          (6) A child may be temporarily committed for a maximum of 72 hours, excluding
686     Saturdays, Sundays, and legal holidays, to the physical custody of a local mental health
687     authority in accordance with the procedures described in Section 62A-15-629 and upon
688     satisfaction of the risk factors described in Subsection (4). A child who is temporarily
689     committed shall be released at the expiration of the 72 hours unless the procedures and findings
690     required by this section for the commitment of a child are satisfied.
691          (7) A local mental health authority shall have physical custody of each child committed
692     to it under this section. The parent or legal guardian of a child committed to the physical
693     custody of a local mental health authority under this section, retains legal custody of the child,
694     unless legal custody has been otherwise modified by a court of competent jurisdiction. In cases
695     when the Division of Child and Family Services or the Division of Juvenile Justice Services
696     has legal custody of a child, that division shall retain legal custody for purposes of this part.
697          (8) The cost of caring for and maintaining a child in the physical custody of a local
698     mental health authority shall be assessed to and paid by the child's parents, according to their
699     ability to pay. For purposes of this section, the Division of Child and Family Services or the
700     Division of Juvenile Justice Services shall be financially responsible, in addition to the child's
701     parents, if the child is in the legal custody of either of those divisions at the time the child is
702     committed to the physical custody of a local mental health authority under this section, unless
703     Medicaid regulation or contract provisions specify otherwise. The Office of Recovery Services
704     shall assist those divisions in collecting the costs assessed pursuant to this section.
705          (9) Whenever application is made for commitment of a minor to a local mental health
706     authority under any provision of this section by a person other than the child's parent or
707     guardian, the local mental health authority or its designee shall notify the child's parent or
708     guardian. The parents shall be provided sufficient time to prepare and appear at any scheduled
709     proceeding.
710          (10) (a) Each child committed pursuant to this section is entitled to an appeal within 30
711     days after any order for commitment. The appeal may be brought on the child's own petition[,]
712     or that of [his] the child's parent or legal guardian, to the juvenile court in the district where the
713     child resides or is currently physically located. With regard to a child in the custody of the
714     Division of Child and Family Services or the Division of Juvenile Justice Services, the attorney
715     general's office shall handle the appeal, otherwise the appropriate county attorney's office is
716     responsible for appeals brought pursuant to this Subsection (10)(a).
717          (b) Upon receipt of the petition for appeal, the court shall appoint a designated
718     examiner previously unrelated to the case, to conduct an examination of the child in accordance
719     with the criteria described in Subsection (4), and file a written report with the court. The court
720     shall then conduct an appeal hearing to determine whether the findings described in Subsection
721     (4) exist by clear and convincing evidence.
722          (c) Prior to the time of the appeal hearing, the appropriate local mental health authority,
723     its designee, or the mental health professional who has been in charge of the child's care prior
724     to commitment, shall provide the court and the designated examiner for the appeal hearing with
725     the following information, as it relates to the period of current admission:
726          (i) the original petition for commitment;
727          (ii) admission notes;
728          (iii) diagnosis;
729          (iv) physicians' orders;
730          (v) progress notes;
731          (vi) nursing notes; and
732          (vii) medication records.
733          (d) Both the neutral and detached fact finder and the designated examiner appointed for
734     the appeal hearing shall be provided with an opportunity to review the most current
735     information described in Subsection (10)(c) prior to the appeal hearing.
736          (e) The child, [his] the child's parent or legal guardian, the person who submitted the
737     original petition for commitment, and a representative of the appropriate local mental health
738     authority shall be notified by the court of the date and time of the appeal hearing. Those
739     persons shall be afforded an opportunity to appear at the hearing. In reaching its decision, the
740     court shall review the record and findings of the neutral and detached fact finder, the report of
741     the designated examiner appointed pursuant to Subsection (10)(b), and may, in its discretion,
742     allow or require the testimony of the neutral and detached fact finder, the designated examiner,
743     the child, the child's parent or legal guardian, the person who brought the initial petition for
744     commitment, or any other person whose testimony the court deems relevant. The court may
745     allow the child to waive [his] the right to appear at the appeal hearing, for good cause shown.
746     If that waiver is granted, the purpose shall be made a part of the court's record.
747          (11) Each local mental health authority has an affirmative duty to conduct periodic
748     evaluations of the mental health and treatment progress of every child committed to its physical
749     custody under this section, and to release any child who has sufficiently improved so that the
750     criteria justifying commitment no longer exist.
751          (12) (a) A local mental health authority or its designee, in conjunction with the child's
752     current treating mental health professional may release an improved child to a less restrictive
753     environment, as they determine appropriate. Whenever the local mental health authority or its
754     designee, and the child's current treating mental health professional, determine that the
755     conditions justifying commitment no longer exist, the child shall be discharged and released to
756     [his] the child's parent or legal guardian. With regard to a child who is in the physical custody
757     of the State Hospital, the treating psychiatrist or clinical director of the State Hospital shall be
758     the child's current treating mental health professional.
759          (b) A local mental health authority or its designee, in conjunction with the child's
760     current treating mental health professional, is authorized to issue a written order for the
761     immediate placement of a child not previously released from an order of commitment into a
762     more restrictive environment, if the local authority or its designee and the child's current
763     treating mental health professional has reason to believe that the less restrictive environment in
764     which the child has been placed is exacerbating [his] the child's mental illness, or increasing
765     the risk of harm to [himself] self or others.
766          (c) The written order described in Subsection (12)(b) shall include the reasons for
767     placement in a more restrictive environment and shall authorize any peace officer to take the
768     child into physical custody and transport [him] the child to a facility designated by the
769     appropriate local mental health authority in conjunction with the child's current treating mental
770     health professional. Prior to admission to the more restrictive environment, copies of the order
771     shall be personally delivered to the child, [his] the child's parent or legal guardian, the
772     administrator of the more restrictive environment, or [his] the administrator's designee, and the
773     child's former treatment provider or facility.
774          (d) If the child has been in a less restrictive environment for more than 30 days and is
775     aggrieved by the change to a more restrictive environment, the child or [his] the child's
776     representative may request a review within 30 days of the change, by a neutral and detached
777     fact finder as described in Subsection (3). The fact finder shall determine whether:
778          (i) the less restrictive environment in which the child has been placed is exacerbating
779     [his] the child's mental illness[,] or increasing the risk of harm to [himself] self or others; or
780          (ii) the less restrictive environment in which the child has been placed is not
781     exacerbating [his] the child's mental illness[,] or increasing the risk of harm to [himself] self or
782     others, in which case the fact finder shall designate that the child remain in the less restrictive
783     environment.
784          (e) Nothing in this section prevents a local mental health authority or its designee, in
785     conjunction with the child's current mental health professional, from discharging a child from
786     commitment or from placing a child in an environment that is less restrictive than that
787     designated by the neutral and detached fact finder.
788          (13) Each local mental health authority or its designee, in conjunction with the child's
789     current treating mental health professional shall discharge any child who, in the opinion of that
790     local authority, or its designee, and the child's current treating mental health professional, no
791     longer meets the criteria specified in Subsection (4), except as provided by Section 78A-6-120.
792     The local authority and the mental health professional shall assure that any further supportive
793     services required to meet the child's needs upon release will be provided.
794          (14) Even though a child has been committed to the physical custody of a local mental
795     health authority [pursuant to] under this section, the child is still entitled to additional due
796     process proceedings, in accordance with Section 62A-15-704, before any treatment [which]
797     that may affect a constitutionally protected liberty or privacy interest is administered. Those
798     treatments include, but are not limited to, antipsychotic medication, electroshock therapy, and
799     psychosurgery.