1     
SUBSTANCE ABUSE AND MENTAL HEALTH ACT

2     
AMENDMENTS

3     
2018 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Edward H. Redd

6     
Senate Sponsor: Todd Weiler

7     

8     LONG TITLE
9     General Description:
10          This bill amends provisions of the Substance Abuse and Mental Health Act.
11     Highlighted Provisions:
12          This bill:
13          ▸     modifies definitions;
14          ▸     changes the date by which local substance abuse authorities and local mental health
15     authorities shall annually submit a service plan to the Division of Substance Abuse
16     and Mental Health within the Department of Human Services;
17          ▸     expands the division's responsibilities with respect to peer support services to
18     include peer support services for individuals with mental health disorders;
19          ▸     amends peer support services provisions;
20          ▸     recodifies peer support services provisions;
21          ▸     requires rulemaking;
22          ▸     clarifies the role of a mental health officer;
23          ▸     removes obsolete references to the Utah State Hospital Board;
24          ▸     removes the exemption of security officers from the public safety retirement system;
25          ▸     updates code provisions in accordance with the existing practice of private hospitals
26     providing inpatient mental health treatment;
27          ▸     makes changes to procedures and criteria for civil commitments;
28          ▸     gives officers authority to not take a mentally ill individual into custody in order to
29     avoid escalating a dangerous situation; and
30          ▸     makes technical changes.
31     Money Appropriated in this Bill:
32          None
33     Other Special Clauses:
34          None
35     Utah Code Sections Affected:
36     AMENDS:
37          62A-15-103, as last amended by Laws of Utah 2017, Chapter 163
38          62A-15-602, as last amended by Laws of Utah 2017, Chapter 408
39          62A-15-603, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
40     Chapter 8
41          62A-15-613, as last amended by Laws of Utah 2006, Chapter 139
42          62A-15-625, as last amended by Laws of Utah 2003, Chapter 195
43          62A-15-627, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
44     Chapter 8
45          62A-15-628, as last amended by Laws of Utah 2003, Chapter 195
46          62A-15-629, as last amended by Laws of Utah 2011, Chapter 366
47          62A-15-631, as last amended by Laws of Utah 2013, Chapters 29 and 312
48          62A-15-632, as last amended by Laws of Utah 2011, Chapter 366
49          62A-15-635, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
50     Chapter 8
51          62A-15-637, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
52     Chapter 8
53          62A-15-703, as last amended by Laws of Utah 2017, Chapter 181
54          62A-15-705, as last amended by Laws of Utah 2003, Chapter 195
55     REPEALS:
56          62A-15-402, as enacted by Laws of Utah 2012, Chapter 179
57     

58     Be it enacted by the Legislature of the state of Utah:
59          Section 1. Section 62A-15-103 is amended to read:
60          62A-15-103. Division -- Creation -- Responsibilities.
61          (1) There is created the Division of Substance Abuse and Mental Health within the
62     department, under the administration and general supervision of the executive director. The
63     division is the substance abuse authority and the mental health authority for this state.
64          (2) The division shall:
65          (a) (i) educate the general public regarding the nature and consequences of substance
66     abuse by promoting school and community-based prevention programs;
67          (ii) render support and assistance to public schools through approved school-based
68     substance abuse education programs aimed at prevention of substance abuse;
69          (iii) promote or establish programs for the prevention of substance abuse within the
70     community setting through community-based prevention programs;
71          (iv) cooperate with and assist treatment centers, recovery residences, and other
72     organizations that provide services to individuals recovering from a substance abuse disorder,
73     by identifying and disseminating information about effective practices and programs;
74          (v) [promulgate] make rules in accordance with Title 63G, Chapter 3, Utah
75     Administrative Rulemaking Act, to develop, in collaboration with public and private programs,
76     minimum standards for public and private providers of substance abuse and mental health
77     programs licensed by the [Department of Human Services] department under Title 62A,
78     Chapter 2, Licensure of Programs and Facilities;
79          (vi) promote integrated programs that address an individual's substance abuse, mental
80     health, physical health, and criminal risk factors;
81          (vii) establish and promote an evidence-based continuum of screening, assessment,
82     prevention, treatment, and recovery support services in the community for individuals with
83     substance [abuse] use disorder and mental illness that addresses criminal risk factors;
84          (viii) evaluate the effectiveness of programs described in this Subsection (2);
85          (ix) consider the impact of the programs described in this Subsection (2) on:
86          (A) emergency department utilization;
87          (B) jail and prison populations;
88          (C) the homeless population; and
89          (D) the child welfare system; and
90          (x) promote or establish programs for education and certification of instructors to
91     educate persons convicted of driving under the influence of alcohol or drugs or driving with
92     any measurable controlled substance in the body;
93          (b) (i) collect and disseminate information pertaining to mental health;
94          (ii) provide direction over the state hospital including approval of its budget,
95     administrative policy, and coordination of services with local service plans;
96          (iii) [promulgate] make rules in accordance with Title 63G, Chapter 3, Utah
97     Administrative Rulemaking Act, to educate families concerning mental illness and promote
98     family involvement, when appropriate, and with patient consent, in the treatment program of a
99     family member; and
100          (iv) [promulgate] make rules in accordance with Title 63G, Chapter 3, Utah
101     Administrative Rulemaking Act, to direct that [all individuals] an individual receiving services
102     through a local mental health [authorities] authority or the Utah State Hospital be informed
103     about and, if desired by the individual, provided assistance in the completion of a declaration
104     for mental health treatment in accordance with Section 62A-15-1002;
105          (c) (i) consult and coordinate with local substance abuse authorities and local mental
106     health authorities regarding programs and services;
107          (ii) provide consultation and other assistance to public and private agencies and groups
108     working on substance abuse and mental health issues;
109          (iii) promote and establish cooperative relationships with courts, hospitals, clinics,
110     medical and social agencies, public health authorities, law enforcement agencies, education and
111     research organizations, and other related groups;
112          (iv) promote or conduct research on substance abuse and mental health issues, and
113     submit to the governor and the Legislature recommendations for changes in policy and
114     legislation;
115          (v) receive, distribute, and provide direction over public funds for substance abuse and
116     mental health services;
117          (vi) monitor and evaluate programs provided by local substance abuse authorities and
118     local mental health authorities;
119          (vii) examine expenditures of [any] local, state, and federal funds;
120          (viii) monitor the expenditure of public funds by:
121          (A) local substance abuse authorities;
122          (B) local mental health authorities; and
123          (C) in counties where they exist, [the] a private contract provider that has an annual or
124     otherwise ongoing contract to provide comprehensive substance abuse or mental health
125     programs or services for the local substance abuse authority or local mental health [authorities]
126     authority;
127          (ix) contract with local substance abuse authorities and local mental health authorities
128     to provide a comprehensive continuum of services that include community-based services for
129     individuals involved in the criminal justice system, in accordance with division policy, contract
130     provisions, and the local plan;
131          (x) contract with private and public entities for special statewide or nonclinical
132     services, or services for individuals involved in the criminal justice system, according to
133     division rules;
134          (xi) review and approve each local substance abuse authority's plan and each local
135     mental health authority's plan in order to ensure:
136          (A) a statewide comprehensive continuum of substance abuse services;
137          (B) a statewide comprehensive continuum of mental health services;
138          (C) services result in improved overall health and functioning;
139          (D) a statewide comprehensive continuum of community-based services designed to
140     reduce criminal risk factors for individuals who are determined to have substance abuse or
141     mental illness conditions or both, and who are involved in the criminal justice system;
142          (E) compliance, where appropriate, with the certification requirements in Subsection
143     (2)[(i)](j); and
144          (F) appropriate expenditure of public funds;
145          (xii) review and make recommendations regarding each local substance abuse
146     authority's contract with [its] the local substance abuse authority's provider of substance abuse
147     programs and services and each local mental health authority's contract with [its] the local
148     mental health authority's provider of mental health programs and services to ensure compliance
149     with state and federal law and policy;
150          (xiii) monitor and ensure compliance with division rules and contract requirements;
151     and
152          (xiv) withhold funds from local substance abuse authorities, local mental health
153     authorities, and public and private providers for contract noncompliance, failure to comply
154     with division directives regarding the use of public funds, or for misuse of public funds or
155     money;
156          (d) [assure] ensure that the requirements of this part are met and applied uniformly by
157     local substance abuse authorities and local mental health authorities across the state;
158          (e) require each local substance abuse authority and each local mental health authority,
159     in accordance with Subsections 17-43-201(5)(b) and 17-43-301(5)(a)(ii), to submit [its] a plan
160     to the division [by May 1] on or before May 15 of each year;
161          (f) conduct an annual program audit and review of each local substance abuse authority
162     [in the state and its] and each local substance abuse authority's contract provider, and each local
163     mental health authority [in the state and its] and each local mental health authority's contract
164     provider, including:
165          (i) a review and determination regarding whether:
166          (A) public funds allocated to the local substance abuse [authorities and] authority or
167     the local mental health authorities are consistent with services rendered by the authority or the
168     authority's contract provider, and with outcomes reported by[ them or their contract providers]
169     the authority's contract provider; and
170          (B) each local substance abuse authority and each local mental health authority is
171     exercising sufficient oversight and control over public funds allocated for substance [abuse]
172     use disorder and mental health programs and services; and
173          (ii) items determined by the division to be necessary and appropriate; and
174          (g) define "prevention" by rule as required under Title 32B, Chapter 2, Part 4,
175     Alcoholic Beverage and Substance Abuse Enforcement and Treatment Restricted Account Act;
176          (h) (i) train and certify an adult as a peer support specialist, qualified to provide peer
177     supports services to an individual with:
178          (A) a substance use disorder;
179          (B) a mental health disorder; or
180          (C) a substance use disorder and a mental health disorder;
181          (ii) certify a person to carry out, as needed, the division's duty to train and certify an
182     adult as a peer support specialist;
183          (iii) make rules in accordance with Title 63G, Chapter 3, Utah Administrative
184     Rulemaking Act, that:
185          (A) establish training and certification requirements for a peer support specialist;
186          (B) specify the types of services a peer support specialist is qualified to provide;
187          (C) specify the type of supervision under which a peer support specialist is required to
188     operate; and
189          (D) specify continuing education and other requirements for maintaining or renewing
190     certification as a peer support specialist; and
191          (iv) make rules in accordance with Title 63G, Chapter 3, Utah Administrative
192     Rulemaking Act, that:
193          (A) establish the requirements for a person to be certified to carry out, as needed, the
194     division's duty to train and certify an adult as a peer support specialist; and
195          (B) specify how the division shall provide oversight of a person certified to train and
196     certify a peer support specialist;
197          [(h)] (i) establish by rule, in accordance with Title 63G, Chapter 3, Utah
198     Administrative Rulemaking Act, minimum standards and requirements for the provision of
199     substance [abuse] use disorder and mental health treatment to [individuals] an individual who
200     [are] is required to participate in treatment by the court or the Board of Pardons and Parole, or
201     who [are] is incarcerated, including:
202          (i) collaboration with the Department of Corrections and the Utah Substance Use and
203     Mental Health Advisory Council to develop and coordinate the standards, including standards
204     for county and state programs serving individuals convicted of class A and class B
205     misdemeanors;
206          (ii) determining that the standards ensure available treatment [includes], including the
207     most current practices and procedures demonstrated by recognized scientific research to reduce
208     recidivism, including focus on the individual's criminal risk factors; and
209          (iii) requiring that all public and private treatment programs meet the standards
210     established under this Subsection (2)[(h)](i) in order to receive public funds allocated to the
211     division, the Department of Corrections, or the Commission on Criminal and Juvenile Justice
212     for the costs of providing screening, assessment, prevention, treatment, and recovery support;
213          [(i)] (j) establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative
214     Rulemaking Act, the requirements and procedures for the certification of licensed public and
215     private providers who provide, as part of their practice, substance [abuse] use disorder and
216     mental health treatment to [individuals] an individual involved in the criminal justice system,
217     including:
218          (i) collaboration with the Department of Corrections, the Utah Substance Use and
219     Mental Health Advisory Council, and the Utah Association of Counties to develop, coordinate,
220     and implement the certification process;
221          (ii) basing the certification process on the standards developed under Subsection
222     (2)[(h)](i) for the treatment of [individuals] an individual involved in the criminal justice
223     system; and
224          (iii) the requirement that [all] a public [and] or private [providers] provider of
225     treatment to [individuals] an individual involved in the criminal justice system shall obtain
226     certification on or before July 1, 2016, and shall renew the certification every two years, in
227     order to qualify for funds allocated to the division, the Department of Corrections, or the
228     Commission on Criminal and Juvenile Justice on or after July 1, 2016;
229          [(j)] (k) collaborate with the Commission on Criminal and Juvenile Justice to analyze
230     and provide recommendations to the Legislature regarding:
231          (i) pretrial services and the resources needed [for the reduced] to reduce recidivism
232     [efforts];
233          (ii) county jail and county behavioral health early-assessment resources needed for
234     [offenders] an offender convicted of a class A or class B misdemeanor; and
235          (iii) the replacement of federal dollars associated with drug interdiction law
236     enforcement task forces that are reduced;
237          [(k)] (l) (i) establish performance goals and outcome measurements for all treatment
238     programs for which minimum standards are established under Subsection (2)[(h)](i), including
239     recidivism data and data regarding cost savings associated with recidivism reduction and the
240     reduction in the number of inmates, that are obtained in collaboration with the Administrative
241     Office of the Courts and the Department of Corrections; and
242          (ii) collect data to track and determine whether the goals and measurements are being
243     attained and make this information available to the public;
244          [(l)] (m) in [its] the division's discretion, use the data to make decisions regarding the
245     use of funds allocated to the division, the Administrative Office of the Courts, and the
246     Department of Corrections to provide treatment for which standards are established under
247     Subsection (2)[(h)](i); and
248          [(m)] (n) annually, on or before August 31, submit the data collected under Subsection
249     (2)[(j)](k) to the Commission on Criminal and Juvenile Justice, which shall compile a report of
250     findings based on the data and provide the report to the [legislative] Judiciary Interim
251     Committee, the Health and Human Services Interim Committee, the Law Enforcement and
252     Criminal Justice Interim Committee, and the related appropriations subcommittees.
253          (3) (a) The division may refuse to contract with and may pursue [its] legal remedies
254     against any local substance abuse authority or local mental health authority that fails, or has
255     failed, to expend public funds in accordance with state law, division policy, contract
256     provisions, or directives issued in accordance with state law.
257          (b) The division may withhold funds from a local substance abuse authority or local
258     mental health authority if the authority's contract [with its] provider of substance abuse or
259     mental health programs or services fails to comply with state and federal law or policy.
260          (4) Before reissuing or renewing a contract with any local substance abuse authority or
261     local mental health authority, the division shall review and determine whether the local
262     substance abuse authority or local mental health authority is complying with [its] the oversight
263     and management responsibilities described in Sections 17-43-201, 17-43-203, 17-43-303, and
264     17-43-309. Nothing in this Subsection (4) may be used as a defense to the responsibility and
265     liability described in Section 17-43-303 and to the responsibility and liability described in
266     Section 17-43-203.
267          (5) In carrying out [its] the division's duties and responsibilities, the division may not
268     duplicate treatment or educational facilities that exist in other divisions or departments of the
269     state, but shall work in conjunction with those divisions and departments in rendering the
270     treatment or educational services that those divisions and departments are competent and able
271     to provide.
272          (6) The division may accept in the name of and on behalf of the state donations, gifts,
273     devises, or bequests of real or personal property or services to be used as specified by the
274     donor.
275          (7) The division shall annually review with each local substance abuse authority and
276     each local mental health authority the authority's statutory and contract responsibilities
277     regarding:
278          (a) [the] use of public funds;
279          (b) oversight [responsibilities regarding] of public funds; and
280          (c) governance of substance [abuse] use disorder and mental health programs and
281     services.
282          (8) The Legislature may refuse to appropriate funds to the division upon the division's
283     failure to comply with the provisions of this part.
284          (9) If a local substance abuse authority contacts the division under Subsection
285     17-43-201(10) for assistance in providing treatment services to a pregnant woman or pregnant
286     minor, the division shall:
287          (a) refer the pregnant woman or pregnant minor to a treatment facility that has the
288     capacity to provide the treatment services; or
289          (b) otherwise ensure that treatment services are made available to the pregnant woman
290     or pregnant minor.
291          Section 2. Section 62A-15-602 is amended to read:
292          62A-15-602. Definitions.
293          As used in this part, Part 7, Commitment of Persons Under Age 18 to Division of
294     Substance Abuse and Mental Health, Part 8, Interstate Compact on Mental Health, Part 9, Utah
295     Forensic Mental Health Facility, Part 10, Declaration for Mental Health Treatment, and Part
296     12, Essential Treatment and Intervention Act:
297          (1) "Adult" means [a person] an individual 18 years of age or older.
298          (2) "Approved treatment facility or program" means a treatment provider that meets the
299     standards described in Subsection 62A-15-103(2)(a)(v).
300          (3) "Commitment to the custody of a local mental health authority" means that an adult
301     is committed to the custody of the local mental health authority that governs the mental health
302     catchment area [in which the proposed patient] where the adult resides or is found.
303          (4) "Community mental health center" means an entity that provides treatment and
304     services to a resident of a designated geographical area, that operates by or under contract with
305     a local mental health authority, and that complies with state standards for community mental
306     health centers.
307          [(4)] (5) "Designated examiner" means:
308          (a) a licensed physician [familiar with severe mental illness, preferably a psychiatrist],
309     preferably a psychiatrist, who is designated by the division as specially qualified by training or
310     experience in the diagnosis of mental or related illness; or [another]
311          (b) a licensed mental health professional designated by the division as specially
312     qualified by training and who has at least five years' continual experience in the treatment of
313     mental [or related] illness. [At least one designated examiner in any case shall be a licensed
314     physician. No person who is the applicant, or who signs the certification, under Section
315     62A-15-631 may be a designated examiner in the same case.]
316          [(5)] (6) "Designee" means a physician who has responsibility for medical functions
317     including admission and discharge, an employee of a local mental health authority, or an
318     employee of [an agency] a person that has contracted with a local mental health authority to
319     provide mental health services under Section 17-43-304.
320          [(6)] (7) "Essential treatment" and "essential treatment and intervention" mean
321     court-ordered treatment at a local substance abuse authority or an approved treatment facility or
322     program for the treatment of an adult's substance use disorder.
323          [(7)] (8) "Harmful sexual conduct" means [any of] the following conduct upon an
324     individual without the individual's consent, [or upon an individual who cannot legally consent
325     to the conduct including under the] including the nonconsensual circumstances described in
326     Subsections 76-5-406(1) through (12):
327          (a) sexual intercourse;
328          (b) penetration, however slight, of the genital or anal opening of the individual;
329          (c) any sexual act involving the genitals or anus of the actor or the individual and the
330     mouth or anus of either individual, regardless of the gender of either participant; or
331          (d) any sexual act causing substantial emotional injury or bodily pain.
332          [(8)] (9) "Institution" means a hospital[,] or a health facility licensed under [the
333     provisions of Section 26-21-9] Section 26-21-8.
334          [(9) "Licensed physician" means an individual licensed under the laws of this state to
335     practice medicine, or a medical officer of the United States government while in this state in
336     the performance of official duties.]
337          [(10) "Local comprehensive community mental health center" means an agency or
338     organization that provides treatment and services to residents of a designated geographic area,
339     operated by or under contract with a local mental health authority, in compliance with state
340     standards for local comprehensive community mental health centers.]
341          [(11)] (10) "Local substance abuse authority" means the same as that term is defined in
342     Section 62A-15-102 and described in Section 17-43-201.
343          [(12)] (11) "Mental health facility" means the Utah State Hospital or other facility that
344     provides mental health services under contract with the division, a local mental health
345     authority, [or organization] a person that contracts with a local mental health authority, or a
346     person that provides acute inpatient psychiatric services to a patient.
347          [(13)] (12) "Mental health officer" means an individual who is designated by a local
348     mental health authority as qualified by training and experience in the recognition and
349     identification of mental illness, to [interact with and transport persons to any mental health
350     facility.]:
351          (a) apply for and provide certification for a temporary commitment; or
352          (b) assist in the arrangement of transportation to a designated mental health facility.
353          [(14)] (13) "Mental illness" means [a psychiatric disorder as defined by the current
354     edition of the Diagnostic and Statistical Manual of Mental Disorders published by the
355     American Psychiatric Association which substantially impairs a person's mental, emotional,
356     behavioral, or related functioning.]:
357          (a) a psychiatric disorder that substantially impairs an individual's mental, emotional,
358     behavioral, or related functioning; or
359          (b) the same as that term is defined in:
360          (i) the current edition of the Diagnostic and Statistical Manual of Mental Disorders
361     published by the American Psychiatric Association; or
362          (ii) the current edition of the International Statistical Classification of Diseases and
363     Related Health Problems.
364          [(15)] (14) "Patient" means an individual who is:
365          (a) under commitment to the custody or to the treatment services of a local mental
366     health authority; or
367          (b) undergoing essential treatment and intervention.
368          (15) "Physician" means an individual who is:
369          (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
370          (b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
371     Practice Act.
372          (16) "Serious bodily injury" means bodily injury [which] that involves a substantial
373     risk of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or
374     protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
375          (17) "Substantial danger" means [the person, by his or her behavior, due to mental
376     illness] that due to mental illness, an individual is at serious risk of:
377          [(a) is at serious risk to:]
378          [(i) commit suicide;]
379          [(ii) inflict serious bodily injury on himself or herself; or]
380          [(iii) because of his or her actions or inaction, suffer serious bodily injury because he or
381     she is incapable of providing the basic necessities of life, such as food, clothing, and shelter;
382     or]
383          [(b) is at serious risk to cause or attempt to cause serious bodily injury or engage in
384     harmful sexual conduct.]
385          (a) suicide;
386          (b) serious bodily self-injury;
387          (c) serious bodily injury because the individual is incapable of providing the basic
388     necessities of life, including food, clothing, or shelter;
389          (d) causing or attempting to cause serious bodily injury to another individual; or
390          (e) engaging in harmful sexual conduct.
391          (18) "Treatment" means psychotherapy, medication, including the administration of
392     psychotropic medication, [and] or other medical treatments that are generally accepted medical
393     [and] or psychosocial interventions for the purpose of restoring the patient to an optimal level
394     of functioning in the least restrictive environment.
395          Section 3. Section 62A-15-603 is amended to read:
396          62A-15-603. Administration of state hospital -- Division -- Authority.
397          [(1) The administration of the state hospital is vested in the division where it shall
398     function and be administered as a part of the state's comprehensive mental health program and,
399     to the fullest extent possible, shall be coordinated with local mental health authority programs.
400     When it becomes feasible the board may direct that the hospital be decentralized and
401     administered at the local level by being integrated with, and becoming a part of, the community
402     mental health services.]
403          [(2) The division shall succeed to all the powers, discharge all the duties, and perform
404     all the functions, duties, rights, and responsibilities pertaining to the state hospital which by
405     law are conferred upon it or required to be discharged or performed. However, the functions,
406     powers, duties, rights, and responsibilities of the division and of the board otherwise provided
407     by law and by this part apply.]
408          (1) The division shall administer the state hospital as part of the state's comprehensive
409     mental health program and, to the fullest extent possible, shall, as the state hospital's
410     administrator, coordinate with local mental health authority programs.
411          (2) The division has the same powers, duties, rights, and responsibilities as, and shall
412     perform the same functions that by law are conferred or required to be discharged or performed
413     by, the state hospital.
414          (3) Supervision and administration of security responsibilities for the state hospital is
415     vested in the division. The executive director shall designate, as special function officers,
416     individuals with peace officer authority to perform special security functions for the state
417     hospital [that require peace officer authority. These special function officers may not become
418     or be designated as members of the Public Safety Retirement System].
419          [(4) Directors of mental health facilities that house involuntary detainees or detainees
420     committed pursuant to judicial order may establish secure areas, as prescribed in Section
421     76-8-311.1, within the mental health facility for the detainees.]
422          (4) A director of a mental health facility that houses an involuntary patient or a patient
423     committed by judicial order may establish secure areas, as provided in Section 76-8-311.1,
424     within the mental health facility for the patient.
425          Section 4. Section 62A-15-613 is amended to read:
426          62A-15-613. Appointment of superintendent -- Qualifications -- Powers and
427     responsibilities.
428          (1) The director, with the [advice and consent of the board and the approval] consent of
429     the executive director, shall appoint a superintendent of the state hospital, who shall hold office
430     at the will of the director.
431          (2) The superintendent shall have a bachelor's degree from an accredited university or
432     college, be experienced in administration, and be knowledgeable in matters concerning mental
433     health.
434          (3) [Subject to the rules of the board, the] The superintendent has general responsibility
435     for the buildings, grounds, and property of the state hospital. The superintendent shall appoint,
436     with the approval of the director, as many employees as necessary for the efficient and
437     economical care and management of the state hospital, and shall fix [their] the employees'
438     compensation and administer personnel functions according to the standards of the Department
439     of Human Resource Management.
440          Section 5. Section 62A-15-625 is amended to read:
441          62A-15-625. Voluntary admission of adults.
442          [(1) A local mental health authority or its designee may admit to that authority, for
443     observation, diagnosis, care, and treatment any individual who is mentally ill or has symptoms
444     of mental illness and who, being 18 years of age or older, applies for voluntary admission.]
445          [(2) (a) No adult may be committed or continue to be committed to a local mental
446     health authority against his will except as provided in this chapter.]
447          [(b) A person under 18 years of age may be committed to the physical custody of a local
448     mental health authority only after a court commitment proceeding in accordance with the
449     provisions of Part 7, Commitment of Persons Under Age 18 to Division of Substance Abuse
450     and Mental Health.]
451          (1) A local mental health authority, a designee of a local mental health authority, or
452     another mental health facility may admit for observation, diagnosis, care, and treatment an
453     adult who applies for voluntary admission and who has a mental illness or exhibits the
454     symptoms of a mental illness.
455          (2) No adult may be committed to a local mental health authority against that adult's
456     will except as provided in this chapter.
457          (3) An adult may be voluntarily admitted to a local mental health authority for
458     treatment at the Utah State Hospital as a condition of probation or stay of sentence only after
459     the requirements of Subsection 77-18-1(13) have been met.
460          Section 6. Section 62A-15-627 is amended to read:
461          62A-15-627. Release of voluntary patient -- Exceptions.
462          (1) A [voluntary] patient who is voluntarily admitted, as described in Section
463     62A-15-625, and who requests release, verbally or in writing, or whose release is requested in
464     writing by [his] the patient's legal guardian, parent, spouse, or adult next of kin, shall be
465     immediately released except that:
466          [(1) if the patient was voluntarily admitted on his own application, and]
467          (a) release may be conditioned upon the agreement of the patient, if the request for
468     release is made by [a person] an individual other than the patient[, release may be conditioned
469     upon the agreement of the patient; and]; or
470          [(2)] (b) if [a] the admitting local mental health authority, [or its designee is of the
471     opinion that release of a patient would be unsafe for that patient or others,] a designee of the
472     local mental health authority, or a mental health facility has cause to believe that release of the
473     patient would be unsafe for the patient or others, release of that patient may be postponed for
474     up to 48 hours, excluding weekends and holidays, provided that the [local mental health]
475     admitting authority, [or its] the designee, or the facility shall cause to be instituted involuntary
476     commitment proceedings with the district court within the specified time period.[, unless cause
477     no longer exists for instituting those proceedings. Written]
478          (2) The admitting authority, the designee, or the facility shall provide written notice of
479     [that] the postponement [with] and the reasons[, shall be given] for the postponement to the
480     patient without undue delay.
481          (3) No judicial proceedings for involuntary commitment may be commenced with
482     respect to a voluntary patient unless [he] the patient has requested release.
483          Section 7. Section 62A-15-628 is amended to read:
484          62A-15-628. Involuntary commitment -- Procedures.
485          (1) An adult may not be involuntarily committed to the custody of a local mental health
486     authority except under the following provisions:
487          (a) emergency procedures for temporary commitment upon medical or designated
488     examiner certification, as provided in Subsection 62A-15-629(1)(a);
489          (b) emergency procedures for temporary commitment without endorsement of medical
490     or designated examiner certification, as provided in Subsection 62A-15-629[(2)](1)(b); or
491          (c) commitment on court order, as provided in Section 62A-15-631.
492          (2) A person under 18 years of age may be committed to the physical custody of a local
493     mental health authority only [after a court commitment proceeding] in accordance with the
494     provisions of Part 7, Commitment of Persons Under Age 18 to Division of Substance Abuse
495     and Mental Health.
496          Section 8. Section 62A-15-629 is amended to read:
497          62A-15-629. Temporary commitment -- Requirements and procedures.
498          (1) [(a) ] An adult [may] shall be temporarily, involuntarily committed to a local mental
499     health authority upon:
500          (a) a written application that:
501          (i) [written application] is completed by a responsible [person] individual who has
502     reason to know, stating a belief that the [individual] adult, due to mental illness, is likely to
503     [cause serious injury] pose substantial danger to self or others if not [immediately] restrained[,]
504     and stating the personal knowledge of the [individual's] adult's condition or circumstances
505     [which] that lead to [that] the individual's belief; and
506          (ii) includes a certification by a licensed physician or designated examiner stating that
507     the physician or designated examiner has examined the [individual] adult within a three-day
508     period immediately preceding that certification, and that the physician or designated examiner
509     is of the opinion that [the individual has a mental illness and, because of the individual's mental
510     illness, is likely to injure self or others if not immediately restrained.], due to mental illness, the
511     adult poses a substantial danger to self or others; or
512          [(b) Application and certification as described in Subsection (1)(a) authorizes any
513     peace officer to take the individual into the custody of a local mental health authority and
514     transport the individual to that authority's designated facility.]
515          [(2) If a duly authorized peace officer observes a person involved in conduct that gives
516     the officer probable cause to believe that the person has a mental illness, as defined in Section
517     62A-15-602, and because of that apparent mental illness and conduct, there is a substantial
518     likelihood of serious harm to that person or others, pending proceedings for examination and
519     certification under this part, the officer may take that person into protective custody. The peace
520     officer shall transport the person to be transported to the designated facility of the appropriate
521     local mental health authority pursuant to this section, either on the basis of the peace officer's
522     own observation or on the basis of a mental health officer's observation that has been reported
523     to the peace officer by that mental health officer. Immediately thereafter, the officer shall place
524     the person in the custody of the local mental health authority and make application for
525     commitment of that person to the local mental health authority. The application shall be on a
526     prescribed form and shall include the following:]
527          [(a) a statement by the officer that the officer believes, on the basis of personal
528     observation or on the basis of a mental health officer's observation reported to the officer by the
529     mental health officer, that the person is, as a result of a mental illness, a substantial and
530     immediate danger to self or others;]
531          [(b) the specific nature of the danger;]
532          [(c) a summary of the observations upon which the statement of danger is based; and]
533          [(d) a statement of facts which called the person to the attention of the officer.]
534          (b) a peace officer or a mental health officer:
535          (i) observing an adult's conduct that gives the peace officer or mental health officer
536     probable cause to believe that:
537          (A) the adult has a mental illness; and
538          (B) because of the adult's mental illness and conduct, the adult poses a substantial
539     danger to self or others; and
540          (ii) completing a temporary commitment application that:
541          (A) is on a form prescribed by the division;
542          (B) states the peace officer's or mental health officer's belief that the adult poses a
543     substantial danger to self or others;
544          (C) states the specific nature of the danger;
545          (D) provides a summary of the observations upon which the statement of danger is
546     based; and
547          (E) provides a statement of the facts that called the adult to the peace officer's or
548     mental health officer's attention.
549          (2) If at any time a patient committed under this section no longer meets the
550     commitment criteria described in Subsection (1), the local mental health authority or the local
551     mental health authority's designee shall document the change and release the patient.
552          (3) A [person] patient committed under this section may be held for a maximum of 24
553     hours after commitment, excluding Saturdays, Sundays, and legal holidays[. At the expiration
554     of that time period, the person shall be released unless application for involuntary commitment
555     has been commenced pursuant to Section 62A-15-631. If that application has been made, an
556     order of detention may be entered under Subsection 62A-15-631(3). If no order of detention is
557     issued, the patient shall be released unless he has made voluntary application for admission.],
558     unless:
559          (a) as described in Section 62A-15-631, an application for involuntary commitment is
560     commenced, which may be accompanied by an order of detention described in Subsection
561     62A-15-631(4); or
562          (b) the patient makes a voluntary application for admission.
563          [(4) Transportation of persons with a mental illness pursuant to Subsections (1) and (2)
564     shall be conducted by the appropriate municipal, or city or town, law enforcement authority or,
565     under the appropriate law enforcement's authority, by ambulance to the extent that Subsection
566     (5) applies. However, if the designated facility is outside of that authority's jurisdiction, the
567     appropriate county sheriff shall transport the person or cause the person to be transported by
568     ambulance to the extent that Subsection (5) applies.]
569          [(5) Notwithstanding Subsections (2) and (4), a peace officer shall cause a person to be
570     transported by ambulance if the person meets any of the criteria in Section 26-8a-305. In
571     addition, if the person requires physical medical attention, the peace officer shall direct that
572     transportation be to an appropriate medical facility for treatment.]
573          (4) Upon a written application described in Subsection (1)(a) or the observation and
574     belief described in Subsection (1)(b)(i), the adult shall be:
575          (a) taken into a peace officer's protective custody, by reasonable means, if necessary for
576     public safety; and
577          (b) transported for temporary commitment to a facility designated by the local mental
578     health authority, by means of:
579          (i) an ambulance, if the adult meets any of the criteria described in Section 26-8a-305;
580          (ii) an ambulance, if a peace officer is not necessary for public safety, and
581     transportation arrangements are made by a physician, designated examiner, or mental health
582     officer;
583          (iii) the city, town, or municipal law enforcement authority with jurisdiction over the
584     location where the individual to be committed is present, if the individual is not transported by
585     ambulance; or
586          (iv) the county sheriff, if the designated facility is outside of the jurisdiction of the law
587     enforcement authority described in Subsection (4)(b)(iii) and the individual is not transported
588     by ambulance.
589          (5) Notwithstanding Subsection (4):
590          (a) an individual shall be transported by ambulance to an appropriate medical facility
591     for treatment if the individual requires physical medical attention; and
592          (b) if an officer determines through the officer's experience and training that taking an
593     individual into protective custody or transporting an individual for temporary commitment
594     would increase the risk of substantial danger to the individual or others, a peace officer may
595     exercise discretion to not take the individual into custody or transport the individual, as
596     permitted by policies and procedures established by the officer's law enforcement agency and
597     any applicable federal or state statute, or case law.
598          (6) Title 63G, Chapter 7, Governmental Immunity Act of Utah, applies to this section.
599     This section does not create a special duty of care.
600          Section 9. Section 62A-15-631 is amended to read:
601          62A-15-631. Involuntary commitment under court order -- Examination --
602     Hearing -- Power of court -- Findings required -- Costs.
603          [(1) Proceedings for involuntary commitment of an individual who is 18 years of age
604     or older may be commenced by filing a written application with the district court of the county
605     in which the proposed patient resides or is found, by a responsible person who has reason to
606     know of the condition or circumstances of the proposed patient which lead to the belief that the
607     individual has a mental illness and should be involuntarily committed. The application shall
608     include:]
609          (1) A responsible person who has reason to know of an adult's mental illness and the
610     condition or circumstances that have lead to the adult's need to be involuntarily committed may
611     initiate an involuntary commitment court proceeding by filing, in the district court in the
612     county where the proposed patient resides or is found, a written application that includes:
613          (a) unless the court finds that the information is not reasonably available, the
614     [individual's] proposed patient's:
615          (i) name;
616          (ii) date of birth; and
617          (iii) social security number; and
618          [(b) either:]
619          (b) (i) a certificate of a licensed physician or a designated examiner stating that within
620     [a] the seven-day period immediately preceding the certification, the physician or designated
621     examiner [has] examined the [individual, and that the physician or designated examiner]
622     proposed patient and is of the opinion that the [individual is mentally ill] proposed patient has a
623     mental illness and should be involuntarily committed; or
624          (ii) a written statement by the applicant that:
625          (A) the [individual] proposed patient has been requested to, but has refused to, submit
626     to an examination of mental condition by a licensed physician or designated examiner;
627          (B) is sworn to under oath; and
628          (C) states the facts upon which the application is based.
629          (2) (a) Subject to Subsection (2)(b), before issuing a judicial order, the court may
630     require the applicant to consult with the appropriate local mental health authority, and the court
631     may direct a mental health professional from that local mental health authority to interview the
632     applicant and the proposed patient to determine the existing facts and report them to the court.
633          (b) The consultation described in Subsection (2)(a):
634          (i) may take place at or before the hearing; and
635          (ii) is required if the local mental health authority appears at the hearing.
636          (3) If the court finds from the application, from any other statements under oath, or
637     from any reports from a mental health professional that there is a reasonable basis to believe
638     that the proposed patient has a mental illness that poses a substantial danger[, as defined in
639     Section 62A-15-602,] to self or others requiring involuntary commitment pending examination
640     and hearing; or, if the proposed patient has refused to submit to an interview with a mental
641     health professional as directed by the court or to go to a treatment facility voluntarily, the court
642     may issue an order, directed to a mental health officer or peace officer, to immediately place
643     the proposed patient in the custody of a local mental health authority or in a temporary
644     emergency facility as provided in Section 62A-15-634 to be detained for the purpose of
645     examination. [Within 24 hours of the issuance of the order for examination, a local mental
646     health authority or its designee shall report to the court, orally or in writing, whether the patient
647     is, in the opinion of the examiners, mentally ill, whether the patient has agreed to become a
648     voluntary patient under Section 62A-15-625, and whether treatment programs are available and
649     acceptable without court proceedings. Based on that information, the court may, without
650     taking any further action, terminate the proceedings and dismiss the application. In any event,
651     if the examiner reports orally, the examiner shall immediately send the report in writing to the
652     clerk of the court.]
653          (4) Notice of commencement of proceedings for involuntary commitment, setting forth
654     the allegations of the application and any reported facts, together with a copy of any official
655     order of detention, shall be provided by the court to a proposed patient before, or upon,
656     placement in the custody of a local mental health authority or, with respect to any [individual]
657     proposed patient presently in the custody of a local mental health authority whose status is
658     being changed from voluntary to involuntary, upon the filing of an application for that purpose
659     with the court. A copy of that order of detention shall be maintained at the place of detention.
660          (5) Notice of commencement of those proceedings shall be provided by the court as
661     soon as practicable to the applicant, any legal guardian, any immediate adult family members,
662     legal counsel for the parties involved, the local mental health authority or its designee, and any
663     other persons whom the proposed patient or the court shall designate. That notice shall advise
664     those persons that a hearing may be held within the time provided by law. If the proposed
665     patient has refused to permit release of information necessary for provisions of notice under
666     this subsection, the extent of notice shall be determined by the court.
667          (6) Proceedings for commitment of an individual under the age of 18 years to [the
668     division] a local mental health authority may be commenced [by filing a written application
669     with the juvenile court in accordance with the provisions of] in accordance with Part 7,
670     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
671          (7) The district court may, in its discretion, transfer the case to any other district court
672     within this state, provided that the transfer will not be adverse to the interest of the proposed
673     patient.
674          [(8) (a) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the
675     issuance of a judicial order, or after commitment of a proposed patient to a local mental health
676     authority under court order for detention or examination, the court shall appoint two designated
677     examiners to examine the proposed patient. If requested by the proposed patient's counsel, the
678     court shall appoint, as one of the examiners, a reasonably available qualified person designated
679     by counsel. The examinations, to be conducted separately, shall be held at the home of the
680     proposed patient, a hospital or other medical facility, or at any other suitable place that is not
681     likely to have a harmful effect on the patient's health.]
682          [(b) The examiner shall inform the patient if not represented by an attorney that, if
683     desired, the patient does not have to say anything, the nature and reasons for the examination,
684     that it was ordered by the court, that any information volunteered could form part of the basis
685     for the patient's involuntary commitment, and that findings resulting from the examination will
686     be made available to the court.]
687          [(c) A time shall be set for a hearing to be held within 10 calendar days of the
688     appointment of the designated examiners, unless those examiners or a local mental health
689     authority or its designee informs the court prior to that hearing date that the patient is not
690     mentally ill, that the patient has agreed to become a voluntary patient under Section
691     62A-15-625, or that treatment programs are available and acceptable without court
692     proceedings, in which event the court may, without taking any further action, terminate the
693     proceedings and dismiss the application.]
694          (8) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the issuance
695     of a judicial order, or after commitment of a proposed patient to a local mental health authority
696     or its designee under court order for detention or examination, the court shall appoint two
697     designated examiners:
698          (a) who did not sign the civil commitment application nor the civil commitment
699     certification under Subsection (1);
700          (b) one of whom is a licensed physician; and
701          (c) one of whom may be designated by the proposed patient or the proposed patient's
702     counsel, if that designated examiner is reasonably available.
703          (9) The court shall schedule a hearing to be held within 10 calendar days of the day on
704     which the designated examiners are appointed.
705          (10) The designated examiners shall:
706          (a) conduct their examinations separately;
707          (b) conduct the examinations at the home of the proposed patient, at a hospital or other
708     medical facility, or at any other suitable place that is not likely to have a harmful effect on the
709     proposed patient's health;
710          (c) inform the proposed patient, if not represented by an attorney:
711          (i) that the proposed patient does not have to say anything;
712          (ii) of the nature and reasons for the examination;
713          (iii) that the examination was ordered by the court;
714          (iv) that any information volunteered could form part of the basis for the proposed
715     patient's involuntary commitment; and
716          (v) that findings resulting from the examination will be made available to the court;
717     and
718          (d) within 24 hours of examining the proposed patient, report to the court, orally or in
719     writing, whether the proposed patient is mentally ill, has agreed to voluntary commitment, as
720     described in Section 62A-15-625, or has acceptable programs available to the proposed patient
721     without court proceedings. If the designated examiner reports orally, the designated examiner
722     shall immediately send a written report to the clerk of the court.
723          (11) If a designated examiner is unable to complete an examination on the first attempt
724     because the proposed patient refuses to submit to the examination, the court shall fix a
725     reasonable compensation to be paid to the examiner.
726          (12) If the local mental health authority, its designee, or a medical examiner determines
727     before the court hearing that the conditions justifying the findings leading to a commitment
728     hearing no longer exist, the local mental health authority, its designee, or the medical examiner
729     shall immediately report that determination to the court.
730          (13) The court may terminate the proceedings and dismiss the application at any time,
731     including prior to the hearing, if the designated examiners or the local mental health authority
732     or its designee informs the court that the proposed patient:
733          (a) is not mentally ill;
734          (b) has agreed to voluntary commitment, as described in Section 62A-15-625; or
735          (c) has acceptable options for treatment programs that are available without court
736     proceedings.
737          [(9) (a)] (14) Before the hearing, an opportunity to be represented by counsel shall be
738     afforded to every proposed patient, and if neither the proposed patient nor others provide
739     counsel, the court shall appoint counsel and allow counsel sufficient time to consult with the
740     proposed patient before the hearing. In the case of an indigent proposed patient, the payment
741     of reasonable attorney fees for counsel, as determined by the court, shall be made by the county
742     in which the proposed patient resides or [was] is found.
743          [(b)] (15) (a) The proposed patient, the applicant, and all other persons to whom notice
744     is required to be given shall be afforded an opportunity to appear at the hearing, to testify, and
745     to present and cross-examine witnesses. The court may, in its discretion, receive the testimony
746     of any other person. The court may allow a waiver of the proposed patient's right to appear
747     only for good cause shown, and that cause shall be made a matter of court record.
748          [(c)] (b) The court is authorized to exclude all persons not necessary for the conduct of
749     the proceedings and may, upon motion of counsel, require the testimony of each examiner to be
750     given out of the presence of any other examiners.
751          [(d)] (c) The hearing shall be conducted in as informal a manner as may be consistent
752     with orderly procedure, and in a physical setting that is not likely to have a harmful effect on
753     the mental health of the proposed patient.
754          [(e)] (d) The court shall consider all relevant historical and material information that is
755     offered, subject to the rules of evidence, including reliable hearsay under Rule 1102, Utah
756     Rules of Evidence.
757          [(f)] (e) (i) A local mental health authority or its designee, or the physician in charge of
758     the proposed patient's care shall, at the time of the hearing, provide the court with the following
759     information:
760          (A) the detention order;
761          (B) admission notes;
762          (C) the diagnosis;
763          (D) any doctors' orders;
764          (E) progress notes;
765          (F) nursing notes; and
766          (G) medication records pertaining to the current commitment.
767          (ii) That information shall also be supplied to the proposed patient's counsel at the time
768     of the hearing, and at any time prior to the hearing upon request.
769          [(10)] (16) The court shall order commitment of [an individual] a proposed patient who
770     is 18 years of age or older to a local mental health authority if, upon completion of the hearing
771     and consideration of the information presented in accordance with Subsection [(9)(e)] (15)(d),
772     the court finds by clear and convincing evidence that:
773          (a) the proposed patient has a mental illness;
774          (b) because of the proposed patient's mental illness the proposed patient poses a
775     substantial danger[, as defined in Section 62A-15-602,] to self or others[, which may include
776     the inability to provide the basic necessities of life such as food, clothing, and shelter, if
777     allowed to remain at liberty];
778          (c) the proposed patient lacks the ability to engage in a rational decision-making
779     process regarding the acceptance of mental treatment as demonstrated by evidence of inability
780     to weigh the possible risks of accepting or rejecting treatment;
781          (d) there is no appropriate less-restrictive alternative to a court order of commitment;
782     and
783          (e) the local mental health authority can provide the [individual] proposed patient with
784     treatment that is adequate and appropriate to the [individual's] proposed patient's conditions
785     and needs. In the absence of the required findings of the court after the hearing, the court shall
786     [forthwith] dismiss the proceedings.
787          [(11)] (17) (a) The order of commitment shall designate the period for which the
788     [individual] patient shall be treated. When the [individual] patient is not under an order of
789     commitment at the time of the hearing, that period may not exceed six months without benefit
790     of a review hearing. Upon such a review hearing, to be commenced prior to the expiration of
791     the previous order, an order for commitment may be for an indeterminate period, if the court
792     finds by clear and convincing evidence that the required conditions in Subsection [(10)] (16)
793     will last for an indeterminate period.
794          (b) The court shall maintain a current list of all patients under its order of commitment.
795     That list shall be reviewed to determine those patients who have been under an order of
796     commitment for the designated period. At least two weeks prior to the expiration of the
797     designated period of any order of commitment still in effect, the court that entered the original
798     order shall inform the appropriate local mental health authority or its designee. The local
799     mental health authority or its designee shall immediately reexamine the reasons upon which the
800     order of commitment was based. If the local mental health authority or its designee determines
801     that the conditions justifying that commitment no longer exist, it shall discharge the patient
802     from involuntary commitment and immediately report [that] the discharge to the court.
803     Otherwise, the court shall immediately appoint two designated examiners and proceed under
804     Subsections (8) through [(10)] (14).
805          (c) The local mental health authority or its designee responsible for the care of a patient
806     under an order of commitment for an indeterminate period[,] shall, at six-month intervals,
807     reexamine the reasons upon which the order of indeterminate commitment was based. If the
808     local mental health authority or its designee determines that the conditions justifying that
809     commitment no longer exist, that local mental health authority or its designee shall discharge
810     the patient from its custody and immediately report the discharge to the court. If the local
811     mental health authority or its designee determines that the conditions justifying that
812     commitment continue to exist, the local mental health authority or its designee shall send a
813     written report of those findings to the court. The patient and the patient's counsel of record
814     shall be notified in writing that the involuntary commitment will be continued, the reasons for
815     that decision, and that the patient has the right to a review hearing by making a request to the
816     court. Upon receiving the request, the court shall immediately appoint two designated
817     examiners and proceed under Subsections (8) through [(10)] (14).
818          [(12) In the event that the designated examiners are unable, because a proposed patient
819     refuses to submit to an examination, to complete that examination on the first attempt, the
820     court shall fix a reasonable compensation to be paid to those designated examiners for their
821     services.]
822          [(13)] (18) Any [person] patient committed as a result of an original hearing or a
823     [person's] patient's legally designated representative who is aggrieved by the findings,
824     conclusions, and order of the court entered in the original hearing has the right to a new hearing
825     upon a petition filed with the court within 30 days of the entry of the court order. The petition
826     must allege error or mistake in the findings, in which case the court shall appoint three
827     impartial designated examiners previously unrelated to the case to conduct an additional
828     examination of the patient. The new hearing shall, in all other respects, be conducted in the
829     manner otherwise permitted.
830          [(14)] (19) Costs of all proceedings under this section shall be paid by the county in
831     which the proposed patient resides or is found.
832          Section 10. Section 62A-15-632 is amended to read:
833          62A-15-632. Circumstances under which conditions justifying initial involuntary
834     commitment shall be considered to continue to exist.
835          (1) After [a person has been] an individual is involuntarily committed to the custody of
836     a local mental health authority under Subsection 62A-15-631[(10)](16), the conditions
837     justifying commitment under that subsection shall be considered to continue to exist, for
838     purposes of continued treatment under Subsection 62A-15-631[(11)](17) or conditional release
839     under Section 62A-15-637, if the court finds that the patient is still mentally ill, and that absent
840     an order of involuntary commitment and without continued treatment the patient will suffer
841     severe and abnormal mental and emotional distress as indicated by recent past history, and will
842     experience deterioration in the patient's ability to function in the least restrictive environment,
843     thereby making the patient a substantial danger to self or others.
844          (2) A patient whose treatment is continued or who is conditionally released under the
845     terms of this section, shall be maintained in the least restrictive environment available that can
846     provide the patient with the treatment that is adequate and appropriate.
847          Section 11. Section 62A-15-635 is amended to read:
848          62A-15-635. Notice of commitment.
849          Whenever a patient has been temporarily, involuntarily committed to a local mental
850     health authority [pursuant to] under Section 62A-15-629 on the application of [any person] an
851     individual other than [his] the patient's legal guardian, spouse, or next of kin, the local mental
852     health authority or [its] a designee of the local mental health authority shall immediately notify
853     the patient's legal guardian, spouse, or next of kin, if known.
854          Section 12. Section 62A-15-637 is amended to read:
855          62A-15-637. Release of patient to receive other treatment -- Placement in more
856     restrictive environment -- Procedures.
857          (1) A local mental health authority or [its] a designee of a local mental health authority
858     may release an improved patient to less restrictive treatment [as it may specify, and when
859     agreed to in writing by the patient.] when:
860          (a) the authority specifies the less-restrictive treatment; and
861          (b) the patient agrees in writing to the less restrictive treatment.
862          (2) Whenever a local mental health authority or [its designee] a designee of a local
863     mental health authority determines that the conditions justifying commitment no longer exist,
864     the [patient shall be discharged] local mental health authority or the designee shall discharge
865     the patient. If the patient has been committed through judicial proceedings, [a report
866     describing that determination shall be sent] the local mental health authority or the designee
867     shall prepare a report describing the determination and shall send the report to the clerk of the
868     court where the proceedings were held.
869          [(2)] (3) (a) A local mental health authority or [its designee] a designee of a local
870     mental health authority is authorized to issue an order for the immediate placement of a current
871     patient [not previously released from an order of commitment] into a more restrictive
872     environment, if:
873          (i) the local mental health authority or [its designee] a designee of a local mental health
874     authority has reason to believe that the [less restrictive environment in which the patient has
875     been placed] patient's current environment is aggravating the patient's mental illness [as
876     defined in Subsection 62A-15-631(10), or that]; or
877          (ii) the patient has failed to comply with the specified treatment plan to which [he had]
878     the patient agreed in writing.
879          (b) [That] An order for a more restrictive environment shall include the reasons
880     [therefor] for the order and shall authorize any peace officer to take the patient into physical
881     custody and transport [him] the patient to a facility designated by the [division] local mental
882     health authority. Prior to or upon admission to the more restrictive environment, or upon
883     imposition of additional or different requirements as conditions for continued release from
884     inpatient care, copies of the order shall be personally delivered to the patient and sent to the
885     person in whose care the patient is placed. The order shall also be sent to the patient's counsel
886     of record and to the court that entered the original order of commitment. The order shall
887     inform the patient of the right to a hearing, as prescribed in this section, the right to appointed
888     counsel, and the other procedures prescribed in Subsection 62A-15-631[(9)](14).
889          (c) If the patient [has been in the] was in a less restrictive environment for more than
890     30 days and is aggrieved by the change to a more restrictive environment, the patient or [his]
891     the patient's representative may request a hearing within 30 days of the change. Upon receiving
892     the request, the court shall immediately appoint two designated examiners and proceed
893     pursuant to Section 62A-15-631, with the exception of Subsection 62A-15-631[(10)](16),
894     unless, by the time set for the hearing, the patient [has again been placed in] is returned to the
895     less restrictive environment[,] or the patient [has in writing withdrawn his] withdraws the
896     request for a hearing, in writing.
897          [(3) The court shall find that either:]
898          [(a) the less restrictive environment in which the patient has been placed is aggravating
899     the patient's dangerousness or mental illness as defined in Subsection 62A-15-631(10), or the
900     patient has failed to comply with a specified treatment plan to which he had agreed in writing;
901     or]
902          [(b) the less restrictive environment in which the patient has been placed is not
903     aggravating the patient's mental illness or dangerousness, and the patient has not failed to
904     comply with any specified treatment plan to which he had agreed in writing, in which event the
905     order shall designate that the individual shall be placed and treated in a less restrictive
906     environment appropriate for his needs.]
907          (d) The court shall:
908          (i) make findings regarding whether the conditions described in Subsections (3)(a) and
909     (b) were met and whether the patient is in the least restrictive environment that is appropriate
910     for the patient's needs; and
911          [(4)] (ii) [The order shall also] designate, by order, the environment for the patient's
912     care and the period for which the [individual] patient shall be treated, [in no event to] which
913     may not extend beyond expiration of the original order of commitment.
914          [(5)] (4) Nothing contained in this section prevents a local mental health authority or
915     its designee, pursuant to Section 62A-15-636, from discharging a patient from commitment or
916     from placing a patient in an environment that is less restrictive than that ordered by the court.
917          Section 13. Section 62A-15-703 is amended to read:
918          62A-15-703. Residential and inpatient settings -- Commitment proceeding --
919     Child in physical custody of local mental health authority.
920          (1) A child may receive services from a local mental health authority in an inpatient or
921     residential setting only after a commitment proceeding, for the purpose of transferring physical
922     custody, has been conducted in accordance with the requirements of this section.
923          (2) That commitment proceeding shall be initiated by a petition for commitment, and
924     shall be a careful, diagnostic inquiry, conducted by a neutral and detached fact finder, pursuant
925     to the procedures and requirements of this section. If the findings described in Subsection (4)
926     exist, the proceeding shall result in the transfer of physical custody to the appropriate local
927     mental health authority, and the child may be placed in an inpatient or residential setting.
928          (3) The neutral and detached fact finder who conducts the inquiry:
929          (a) shall be a designated examiner, as defined in [Subsection] Section
930     62A-15-602[(3)]; and
931          (b) may not profit, financially or otherwise, from the commitment or physical
932     placement of the child in that setting.
933          (4) Upon determination by [the] a fact finder that the following circumstances clearly
934     exist, [he] the fact finder may order that the child be committed to the physical custody of a
935     local mental health authority:
936          (a) the child has a mental illness, as defined in Subsection 62A-15-602[(11)](13);
937          (b) the child demonstrates [a risk of harm to himself] a reasonable fear of the risk of
938     substantial danger to self or others;
939          [(c) the child is experiencing significant impairment in his ability to perform socially;]
940          [(d)] (c) the child will benefit from care and treatment by the local mental health
941     authority; and
942          [(e)] (d) there is no appropriate less-restrictive alternative.
943          (5) (a) The commitment proceeding before the neutral and detached fact finder shall be
944     conducted in as informal manner as possible[,] and in a physical setting that is not likely to
945     have a harmful effect on the child.
946          (b) The child, the child's parent or legal guardian, the [person who submitted the
947     petition for commitment] petitioner, and a representative of the appropriate local mental health
948     authority [shall all]:
949          (i) shall receive informal notice of the date and time of the proceeding[. Those parties
950     shall also be afforded an opportunity to appear and to]; and
951          (ii) may appear and address the petition for commitment.
952          (c) The neutral and detached fact finder may, in [his] the fact finder's discretion,
953     receive the testimony of any other person.
954          (d) The fact finder may allow [the] a child to waive [his] the child's right to be present
955     at the commitment proceeding, for good cause shown. If that right is waived, the purpose of
956     the waiver shall be made a matter of record at the proceeding.
957          (e) At the time of the commitment proceeding, the appropriate local mental health
958     authority, its designee, or the psychiatrist who has been in charge of the child's care prior to the
959     commitment proceeding, shall provide the neutral and detached fact finder with the following
960     information, as it relates to the period of current admission:
961          (i) the petition for commitment;
962          (ii) the admission notes;
963          (iii) the child's diagnosis;
964          (iv) physicians' orders;
965          (v) progress notes;
966          (vi) nursing notes; and
967          (vii) medication records.
968          (f) The information described in Subsection (5)(e) shall also be provided to the child's
969     parent or legal guardian upon written request.
970          (g) (i) The neutral and detached fact finder's decision of commitment shall state the
971     duration of the commitment. Any commitment to the physical custody of a local mental health
972     authority may not exceed 180 days. Prior to expiration of the commitment, and if further
973     commitment is sought, a hearing shall be conducted in the same manner as the initial
974     commitment proceeding, in accordance with the requirements of this section.
975          (ii) [When] At the conclusion of the hearing and subsequently in writing, when a
976     decision for commitment is made, the neutral and detached fact finder shall inform the child
977     and [his] the child's parent or legal guardian of that decision[,] and of the reasons for ordering
978     commitment [at the conclusion of the hearing, and also in writing].
979          (iii) The neutral and detached fact finder shall state in writing the basis of [his] the
980     decision, with specific reference to each of the criteria described in Subsection (4), as a matter
981     of record.
982          [(6) Absent the procedures and findings required by this section, a child may be
983     temporarily committed to the physical custody of a local mental health authority only in
984     accordance with the emergency procedures described in Subsection 62A-15-629(1) or (2). A
985     child temporarily committed in accordance with those emergency procedures may be held for a
986     maximum of 72 hours, excluding Saturdays, Sundays, and legal holidays. At the expiration of
987     that time period, the child shall be released unless the procedures and findings required by this
988     section have been satisfied.]
989          (6) A child may be temporarily committed for a maximum of 72 hours, excluding
990     Saturdays, Sundays, and legal holidays, to the physical custody of a local mental health
991     authority in accordance with the procedures described in Section 62A-15-629 and upon
992     satisfaction of the risk factors described in Subsection (4). A child who is temporarily
993     committed shall be released at the expiration of the 72 hours unless the procedures and findings
994     required by this section for the commitment of a child are satisfied.
995          (7) A local mental health authority shall have physical custody of each child committed
996     to it under this section. The parent or legal guardian of a child committed to the physical
997     custody of a local mental health authority under this section, retains legal custody of the child,
998     unless legal custody has been otherwise modified by a court of competent jurisdiction. In cases
999     when the Division of Child and Family Services or the Division of Juvenile Justice Services
1000     has legal custody of a child, that division shall retain legal custody for purposes of this part.
1001          (8) The cost of caring for and maintaining a child in the physical custody of a local
1002     mental health authority shall be assessed to and paid by the child's parents, according to their
1003     ability to pay. For purposes of this section, the Division of Child and Family Services or the
1004     Division of Juvenile Justice Services shall be financially responsible, in addition to the child's
1005     parents, if the child is in the legal custody of either of those divisions at the time the child is
1006     committed to the physical custody of a local mental health authority under this section, unless
1007     Medicaid regulation or contract provisions specify otherwise. The Office of Recovery Services
1008     shall assist those divisions in collecting the costs assessed pursuant to this section.
1009          (9) Whenever application is made for commitment of a minor to a local mental health
1010     authority under any provision of this section by a person other than the child's parent or
1011     guardian, the local mental health authority or its designee shall notify the child's parent or
1012     guardian. The parents shall be provided sufficient time to prepare and appear at any scheduled
1013     proceeding.
1014          (10) (a) Each child committed pursuant to this section is entitled to an appeal within 30
1015     days after any order for commitment. The appeal may be brought on the child's own petition[,]
1016     or [that of his] on petition of the child's parent or legal guardian, to the juvenile court in the
1017     district where the child resides or is currently physically located. With regard to a child in the
1018     custody of the Division of Child and Family Services or the Division of Juvenile Justice
1019     Services, the attorney general's office shall handle the appeal, otherwise the appropriate county
1020     attorney's office is responsible for appeals brought pursuant to this Subsection (10)(a).
1021          (b) Upon receipt of the petition for appeal, the court shall appoint a designated
1022     examiner previously unrelated to the case, to conduct an examination of the child in accordance
1023     with the criteria described in Subsection (4), and file a written report with the court. The court
1024     shall then conduct an appeal hearing to determine whether the findings described in Subsection
1025     (4) exist by clear and convincing evidence.
1026          (c) Prior to the time of the appeal hearing, the appropriate local mental health authority,
1027     its designee, or the mental health professional who has been in charge of the child's care prior
1028     to commitment, shall provide the court and the designated examiner for the appeal hearing with
1029     the following information, as it relates to the period of current admission:
1030          (i) the original petition for commitment;
1031          (ii) admission notes;
1032          (iii) diagnosis;
1033          (iv) physicians' orders;
1034          (v) progress notes;
1035          (vi) nursing notes; and
1036          (vii) medication records.
1037          (d) Both the neutral and detached fact finder and the designated examiner appointed for
1038     the appeal hearing shall be provided with an opportunity to review the most current
1039     information described in Subsection (10)(c) prior to the appeal hearing.
1040          (e) The child, [his] the child's parent or legal guardian, the person who submitted the
1041     original petition for commitment, and a representative of the appropriate local mental health
1042     authority shall be notified by the court of the date and time of the appeal hearing. Those
1043     persons shall be afforded an opportunity to appear at the hearing. In reaching its decision, the
1044     court shall review the record and findings of the neutral and detached fact finder, the report of
1045     the designated examiner appointed pursuant to Subsection (10)(b), and may, in its discretion,
1046     allow or require the testimony of the neutral and detached fact finder, the designated examiner,
1047     the child, the child's parent or legal guardian, the person who brought the initial petition for
1048     commitment, or any other person whose testimony the court deems relevant. The court may
1049     allow the child to waive [his] the right to appear at the appeal hearing, for good cause shown.
1050     If that waiver is granted, the purpose shall be made a part of the court's record.
1051          (11) Each local mental health authority has an affirmative duty to conduct periodic
1052     evaluations of the mental health and treatment progress of every child committed to its physical
1053     custody under this section, and to release any child who has sufficiently improved so that the
1054     criteria justifying commitment no longer exist.
1055          (12) (a) A local mental health authority or its designee, in conjunction with the child's
1056     current treating mental health professional may release an improved child to a less restrictive
1057     environment, as they determine appropriate. Whenever the local mental health authority or its
1058     designee, and the child's current treating mental health professional, determine that the
1059     conditions justifying commitment no longer exist, the child shall be discharged and released to
1060     [his] the child's parent or legal guardian. With regard to a child who is in the physical custody
1061     of the State Hospital, the treating psychiatrist or clinical director of the State Hospital shall be
1062     the child's current treating mental health professional.
1063          (b) A local mental health authority or its designee, in conjunction with the child's
1064     current treating mental health professional, is authorized to issue a written order for the
1065     immediate placement of a child not previously released from an order of commitment into a
1066     more restrictive environment, if the local authority or its designee and the child's current
1067     treating mental health professional has reason to believe that the less restrictive environment in
1068     which the child has been placed is exacerbating [his] the child's mental illness, or increasing
1069     the risk of harm to [himself] self or others.
1070          (c) The written order described in Subsection (12)(b) shall include the reasons for
1071     placement in a more restrictive environment and shall authorize any peace officer to take the
1072     child into physical custody and transport [him] the child to a facility designated by the
1073     appropriate local mental health authority in conjunction with the child's current treating mental
1074     health professional. Prior to admission to the more restrictive environment, copies of the order
1075     shall be personally delivered to the child, [his] the child's parent or legal guardian, the
1076     administrator of the more restrictive environment, or [his] the administrator's designee, and the
1077     child's former treatment provider or facility.
1078          (d) If the child has been in a less restrictive environment for more than 30 days and is
1079     aggrieved by the change to a more restrictive environment, the child or [his] the child's
1080     representative may request a review within 30 days of the change, by a neutral and detached
1081     fact finder as described in Subsection (3). The fact finder shall determine whether:
1082          (i) the less restrictive environment in which the child has been placed is exacerbating
1083     [his] the child's mental illness[,] or increasing the risk of harm to [himself] self or others; or
1084          (ii) the less restrictive environment in which the child has been placed is not
1085     exacerbating [his] the child's mental illness[,] or increasing the risk of harm to [himself] self or
1086     others, in which case the fact finder shall designate that the child remain in the less restrictive
1087     environment.
1088          (e) Nothing in this section prevents a local mental health authority or its designee, in
1089     conjunction with the child's current mental health professional, from discharging a child from
1090     commitment or from placing a child in an environment that is less restrictive than that
1091     designated by the neutral and detached fact finder.
1092          (13) Each local mental health authority or its designee, in conjunction with the child's
1093     current treating mental health professional shall discharge any child who, in the opinion of that
1094     local authority, or its designee, and the child's current treating mental health professional, no
1095     longer meets the criteria specified in Subsection (4), except as provided by Section 78A-6-120.
1096     The local authority and the mental health professional shall assure that any further supportive
1097     services required to meet the child's needs upon release will be provided.
1098          (14) Even though a child has been committed to the physical custody of a local mental
1099     health authority [pursuant to] under this section, the child is still entitled to additional due
1100     process proceedings, in accordance with Section 62A-15-704, before any treatment [which]
1101     that may affect a constitutionally protected liberty or privacy interest is administered. Those
1102     treatments include, but are not limited to, antipsychotic medication, electroshock therapy, and
1103     psychosurgery.
1104          Section 14. Section 62A-15-705 is amended to read:
1105          62A-15-705. Commitment proceedings in juvenile court -- Criteria -- Custody.
1106          (1) (a) Subject to Subsection (1)(b), commitment proceedings for a child may be
1107     commenced by filing a written application with the juvenile court of the county in which the
1108     child resides or is found, in accordance with the procedures described in Section 62A-15-631.
1109          (b) Commitment proceedings under this section may be commenced only after a
1110     commitment proceeding under Section 62A-15-703 has concluded without the child being
1111     committed.
1112          (2) The juvenile court shall order commitment to the physical custody of a local mental
1113     health authority if, upon completion of the hearing and consideration of the record, it finds by
1114     clear and convincing evidence that:
1115          (a) the child has a mental illness, as defined in [Subsection] Section 62A-15-602[(8)];
1116          (b) the child demonstrates a risk of harm to himself or others;
1117          (c) the child is experiencing significant impairment in [his] the child's ability to
1118     perform socially;
1119          (d) the child will benefit from the proposed care and treatment; and
1120          (e) there is no appropriate less restrictive alternative.
1121          (3) The local mental health authority has an affirmative duty to conduct periodic
1122     reviews of children committed to its custody pursuant to this section, and to release any child
1123     who has sufficiently improved so that the local mental health authority or its designee
1124     determines that commitment is no longer appropriate.
1125          Section 15. Repealer.
1126          This bill repeals:
1127          Section 62A-15-402, Rules for substance use disorder peer support specialist
1128     training and certification.




Legislative Review Note
Office of Legislative Research and General Counsel