1     
CIVIL COMMITMENT EXAMINER REQUIREMENTS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Nelson T. Abbott

5     
Senate Sponsor: Michael S. Kennedy

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions related to designated examiners.
10     Highlighted Provisions:
11          This bill:
12          ▸     related to civil commitments, adds certain psychiatric mental health nurse
13     practitioners and psychiatric mental health clinical nurse specialists to the use of the
14     term "designated examiner"; and
15          ▸     makes technical and conforming changes.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     AMENDS:
22          26B-5-332, as renumbered and amended by Laws of Utah 2023, Chapter 308
23     

24     Be it enacted by the Legislature of the state of Utah:
25          Section 1. Section 26B-5-332 is amended to read:
26          26B-5-332. Involuntary commitment under court order -- Examination --
27     Hearing -- Power of court -- Findings required -- Costs.

28          (1) A responsible individual who has credible knowledge of an adult's mental illness
29     and the condition or circumstances that have led to the adult's need to be involuntarily
30     committed may initiate an involuntary commitment court proceeding by filing, in the court in
31     the county where the proposed patient resides or is found, a written application that includes:
32          (a) unless the court finds that the information is not reasonably available, the proposed
33     patient's:
34          (i) name;
35          (ii) date of birth; and
36          (iii) social security number;
37          (b) (i) a certificate of a licensed physician or a designated examiner stating that within
38     the seven-day period immediately preceding the certification, the physician or designated
39     examiner examined the proposed patient and is of the opinion that the proposed patient has a
40     mental illness and should be involuntarily committed; or
41          (ii) a written statement by the applicant that:
42          (A) the proposed patient has been requested to, but has refused to, submit to an
43     examination of mental condition by a licensed physician or designated examiner;
44          (B) is sworn to under oath; and
45          (C) states the facts upon which the application is based; and
46          (c) a statement whether the proposed patient has previously been under an assisted
47     outpatient treatment order, if known by the applicant.
48          (2) Before issuing a judicial order, the court:
49          (a) shall require the applicant to consult with the appropriate local mental health
50     authority at or before the hearing; and
51          (b) may direct a mental health professional from the local mental health authority to
52     interview the applicant and the proposed patient to determine the existing facts and report the
53     existing facts to the court.
54          (3) The court may issue an order, directed to a mental health officer or peace officer, to
55     immediately place a proposed patient in the custody of a local mental health authority or in a
56     temporary emergency facility, as described in Section 26B-5-334, to be detained for the
57     purpose of examination if:
58          (a) the court finds from the application, any other statements under oath, or any reports

59     from a mental health professional that there is a reasonable basis to believe that the proposed
60     patient has a mental illness that poses a danger to self or others and requires involuntary
61     commitment pending examination and hearing; or
62          (b) the proposed patient refuses to submit to an interview with a mental health
63     professional as directed by the court or to go to a treatment facility voluntarily.
64          (4) (a) The court shall provide notice of commencement of proceedings for involuntary
65     commitment, setting forth the allegations of the application and any reported facts, together
66     with a copy of any official order of detention, to a proposed patient before, or upon, placement
67     of the proposed patient in the custody of a local mental health authority or, with respect to any
68     proposed patient presently in the custody of a local mental health authority whose status is
69     being changed from voluntary to involuntary, upon the filing of an application for that purpose
70     with the court.
71          (b) The place of detention shall maintain a copy of the order of detention.
72          (5) (a) The court shall provide notice of commencement of proceedings for involuntary
73     commitment as soon as practicable to the applicant, any legal guardian, any immediate adult
74     family members, legal counsel for the parties involved, the local mental health authority or the
75     local mental health authority's designee, and any other persons whom the proposed patient or
76     the court designates.
77          (b) Except as provided in Subsection (5)(c), the notice under Subsection (5)(a) shall
78     advise the persons that a hearing may be held within the time provided by law.
79          (c) If the proposed patient refuses to permit release of information necessary for
80     provisions of notice under this subsection, the court shall determine the extent of notice.
81          (6) Proceedings for commitment of an individual under 18 years old to a local mental
82     health authority may be commenced in accordance with Part 4, Commitment of Persons Under
83     Age 18.
84          (7) (a) The court may, in the court's discretion, transfer the case to any other district
85     court within this state, if the transfer will not be adverse to the interest of the proposed patient.
86          (b) If a case is transferred under Subsection (7)(a), the parties to the case may be
87     transferred and the local mental health authority may be substituted in accordance with Utah
88     Rules of Civil Procedure, Rule 25.
89          (8) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the issuance

90     of a judicial order, or after commitment of a proposed patient to a local mental health authority
91     or the local mental health authority's designee under court order for detention or examination,
92     the court shall appoint two designated examiners:
93          (a) who did not sign the civil commitment application nor the civil commitment
94     certification under Subsection (1);
95          (b) one of whom is:
96          (i) a licensed physician; or
97          (ii) a psychiatric mental health nurse practitioner or a psychiatric mental health clinical
98     nurse specialist who:
99          (A) is nationally certified;
100          (B) is doctorally trained; and
101          (C) has at least two years of inpatient mental health experience, regardless of the
102     license the individual held at the time of that experience; and
103          (c) one of whom may be designated by the proposed patient or the proposed patient's
104     counsel, if that designated examiner is reasonably available.
105          (9) The court shall schedule a hearing to be held within 10 calendar days after the day
106     on which the designated examiners are appointed.
107          (10) (a) The designated examiners shall:
108          (i) conduct the examinations separately;
109          (ii) conduct the examinations at the home of the proposed patient, at a hospital or other
110     medical facility, or at any other suitable place, including through telehealth, that is not likely to
111     have a harmful effect on the proposed patient's health;
112          (iii) inform the proposed patient, if not represented by an attorney:
113          (A) that the proposed patient does not have to say anything;
114          (B) of the nature and reasons for the examination;
115          (C) that the examination was ordered by the court;
116          (D) that any information volunteered could form part of the basis for the proposed
117     patient's involuntary commitment;
118          (E) that findings resulting from the examination will be made available to the court;
119     and
120          (F) that the designated examiner may, under court order, obtain the proposed patient's

121     mental health records; and
122          (iv) within 24 hours of examining the proposed patient, report to the court, orally or in
123     writing, whether the proposed patient is mentally ill, has agreed to voluntary commitment, as
124     described in Section 26B-5-360, or has acceptable programs available to the proposed patient
125     without court proceedings.
126          (b) If a designated examiner reports orally under Subsection (10)(a), the designated
127     examiner shall immediately send a written report to the clerk of the court.
128          (11) If a designated examiner is unable to complete an examination on the first attempt
129     because the proposed patient refuses to submit to the examination, the court shall fix a
130     reasonable compensation to be paid to the examiner.
131          (12) If the local mental health authority, the local mental health authority's designee, or
132     a medical examiner determines before the court hearing that the conditions justifying the
133     findings leading to a commitment hearing no longer exist, the local mental health authority, the
134     local mental health authority's designee, or the medical examiner shall immediately report the
135     determination to the court.
136          (13) The court may terminate the proceedings and dismiss the application at any time,
137     including before the hearing, if the designated examiners or the local mental health authority or
138     the local mental health authority's designee informs the court that the proposed patient:
139          (a) does not meet the criteria in Subsection (16);
140          (b) has agreed to voluntary commitment, as described in Section 26B-5-360;
141          (c) has acceptable options for treatment programs that are available without court
142     proceedings; or
143          (d) meets the criteria for assisted outpatient treatment described in Section 26B-5-351.
144          (14) (a) Before the hearing, the court shall provide the proposed patient an opportunity
145     to be represented by counsel, and if neither the proposed patient nor others provide counsel, the
146     court shall appoint counsel and allow counsel sufficient time to consult with the proposed
147     patient before the hearing.
148          (b) In the case of an indigent proposed patient, the county in which the proposed
149     patient resides or is found shall make payment of reasonable attorney fees for counsel, as
150     determined by the court.
151          (15) (a) (i) The court shall afford the proposed patient, the applicant, and any other

152     person to whom notice is required to be given an opportunity to appear at the hearing, to
153     testify, and to present and cross-examine witnesses.
154          (ii) The court may, in the court's discretion, receive the testimony of any other person.
155          (iii) The court may allow a waiver of the proposed patient's right to appear for good
156     cause, which cause shall be set forth in the record, or an informed waiver by the patient, which
157     shall be included in the record.
158          (b) The court is authorized to exclude any person not necessary for the conduct of the
159     proceedings and may, upon motion of counsel, require the testimony of each designated
160     examiner to be given out of the presence of any other designated examiners.
161          (c) The court shall conduct the hearing in as informal a manner as may be consistent
162     with orderly procedure, and in a physical setting that is not likely to have a harmful effect on
163     the mental health of the proposed patient, while preserving the due process rights of the
164     proposed patient.
165          (d) The court shall consider any relevant historical and material information that is
166     offered, subject to the rules of evidence, including reliable hearsay under Utah Rules of
167     Evidence, Rule 1102.
168          (e) (i) A local mental health authority or the local mental health authority's designee or
169     the physician in charge of the proposed patient's care shall, at the time of the hearing, provide
170     the court with the following information:
171          (A) the detention order;
172          (B) admission notes;
173          (C) the diagnosis;
174          (D) any doctors' orders;
175          (E) progress notes;
176          (F) nursing notes;
177          (G) medication records pertaining to the current commitment; and
178          (H) whether the proposed patient has previously been civilly committed or under an
179     order for assisted outpatient treatment.
180          (ii) The information described in Subsection (15)(e)(i) shall also be supplied to the
181     proposed patient's counsel at the time of the hearing, and at any time prior to the hearing upon
182     request.

183          (16) (a) The court shall order commitment of an adult proposed patient to a local
184     mental health authority if, upon completion of the hearing and consideration of the information
185     presented, the court finds by clear and convincing evidence that:
186          (i) the proposed patient has a mental illness;
187          (ii) because of the proposed patient's mental illness the proposed patient poses a
188     substantial danger to self or others;
189          (iii) the proposed patient lacks the ability to engage in a rational decision-making
190     process regarding the acceptance of mental treatment as demonstrated by evidence of inability
191     to weigh the possible risks of accepting or rejecting treatment;
192          (iv) there is no appropriate less-restrictive alternative to a court order of commitment;
193     and
194          (v) the local mental health authority can provide the proposed patient with treatment
195     that is adequate and appropriate to the proposed patient's conditions and needs.
196          (b) (i) If, at the hearing, the court determines that the proposed patient has a mental
197     illness but does not meet the other criteria described in Subsection (16)(a), the court may
198     consider whether the proposed patient meets the criteria for assisted outpatient treatment under
199     Section 26B-5-351.
200          (ii) The court may order the proposed patient to receive assisted outpatient treatment in
201     accordance with Section 26B-5-351 if, at the hearing, the court finds the proposed patient
202     meets the criteria for assisted outpatient treatment under Section 26B-5-351.
203          (iii) If the court determines that neither the criteria for commitment under Subsection
204     (16)(a) nor the criteria for assisted outpatient treatment under Section 26B-5-351 are met, the
205     court shall dismiss the proceedings after the hearing.
206          (17) (a) (i) The order of commitment shall designate the period for which the patient
207     shall be treated.
208          (ii) If the patient is not under an order of commitment at the time of the hearing, the
209     patient's treatment period may not exceed six months without a review hearing.
210          (iii) Upon a review hearing, to be commenced before the expiration of the previous
211     order of commitment, an order for commitment may be for an indeterminate period, if the court
212     finds by clear and convincing evidence that the criteria described in Subsection (16) will last
213     for an indeterminate period.

214          (b) (i) The court shall maintain a current list of all patients under the court's order of
215     commitment and review the list to determine those patients who have been under an order of
216     commitment for the court designated period.
217          (ii) At least two weeks before the expiration of the designated period of any order of
218     commitment still in effect, the court that entered the original order of commitment shall inform
219     the appropriate local mental health authority or the local mental health authority's designee of
220     the expiration.
221          (iii) Upon receipt of the information described in Subsection (17)(b)(ii), the local
222     mental health authority or the local mental health authority's designee shall immediately
223     reexamine the reasons upon which the order of commitment was based.
224          (iv) If, after reexamination under Subsection (17)(b)(iii), the local mental health
225     authority or the local mental health authority's designee determines that the conditions
226     justifying commitment no longer exist, the local mental health authority or the local mental
227     health authority's designee shall discharge the patient from involuntary commitment and
228     immediately report the discharge to the court.
229          (v) If, after reexamination under Subsection (17)(b)(iii), the local mental health
230     authority or the local mental health authority's designee determines that the conditions
231     justifying commitment continue to exist, the court shall immediately appoint two designated
232     examiners and proceed under Subsections (8) through (14).
233          (c) (i) The local mental health authority or the local mental health authority's designee
234     responsible for the care of a patient under an order of commitment for an indeterminate period
235     shall, at six-month intervals, reexamine the reasons upon which the order of indeterminate
236     commitment was based.
237          (ii) If the local mental health authority or the local mental health authority's designee
238     determines that the conditions justifying commitment no longer exist, the local mental health
239     authority or the local mental health authority's designee shall discharge the patient from the
240     local mental health authority's or the local mental health authority designee's custody and
241     immediately report the discharge to the court.
242          (iii) If the local mental health authority or the local mental health authority's designee
243     determines that the conditions justifying commitment continue to exist, the local mental health
244     authority or the local mental health authority's designee shall send a written report of the

245     findings to the court.
246          (iv) A patient and the patient's counsel of record shall be notified in writing that the
247     involuntary commitment will be continued under Subsection (17)(c)(iii), the reasons for the
248     decision to continue, and that the patient has the right to a review hearing by making a request
249     to the court.
250          (v) Upon receiving a request under Subsection (17)(c)(iv), the court shall immediately
251     appoint two designated examiners and proceed under Subsections (8) through (14).
252          (18) (a) Any patient committed as a result of an original hearing or a patient's legally
253     designated representative who is aggrieved by the findings, conclusions, and order of the court
254     entered in the original hearing has the right to a new hearing upon a petition filed with the court
255     within 30 days after the day on which the court order is entered.
256          (b) The petition shall allege error or mistake in the findings, in which case the court
257     shall appoint three impartial designated examiners previously unrelated to the case to conduct
258     an additional examination of the patient.
259          (c) Except as provided in Subsection (18)(b), the court shall, in all other respects,
260     conduct the new hearing in the manner otherwise permitted.
261          (19) The county in which the proposed patient resides or is found shall pay the costs of
262     all proceedings under this section.
263          Section 2. Effective date.
264          This bill takes effect on May 1, 2024.