1     
MENTAL HEALTH AMENDMENTS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Nelson T. Abbott

5     
Senate Sponsor: Todd D. Weiler

6     

7     LONG TITLE
8     General Description:
9          This bill addresses the rights and privileges of individuals under commitment to the
10     custody or treatment services of a local mental health authority.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     amends provisions relating to the rights and privileges to which an individual is
15     entitled when under commitment to the custody or to the treatment services of a
16     local mental health authority; and
17          ▸     makes technical and conforming changes.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          26B-5-301, as renumbered and amended by Laws of Utah 2023, Chapter 308
25          26B-5-310, as renumbered and amended by Laws of Utah 2023, Chapter 308
26     

27     Be it enacted by the Legislature of the state of Utah:
28          Section 1. Section 26B-5-301 is amended to read:
29          26B-5-301. Definitions.
30          As used in this part, Part 4, Commitment of Persons Under Age 18, and Part 5,
31     Essential Treatment and Intervention:
32          (1) "Adult" means an individual 18 years old or older.
33          (2) "Approved treatment facility or program" means a mental health or substance use
34     treatment provider that meets the goals and measurements described in Subsection
35     26B-5-102(2)(j).
36          (3) "Assisted outpatient treatment" means involuntary outpatient mental health
37     treatment ordered under Section 26B-5-351.
38          (4) "Attending physician" means a physician licensed to practice medicine in this state
39     who has primary responsibility for the care and treatment of the declarant.
40          (5) "Attorney-in-fact" means an adult properly appointed under this part to make
41     mental health treatment decisions for a declarant under a declaration for mental health
42     treatment.
43          (6) "Commitment to the custody of a local mental health authority" means that an adult
44     is committed to the custody of the local mental health authority that governs the mental health
45     catchment area where the adult resides or is found.
46          (7) "Community mental health center" means an entity that provides treatment and
47     services to a resident of a designated geographical area, that operates by or under contract with
48     a local mental health authority, and that complies with state standards for community mental
49     health centers.
50          (8) "Designated examiner" means:
51          (a) a licensed physician, preferably a psychiatrist, who is designated by the division as
52     specially qualified by training or experience in the diagnosis of mental or related illness; or
53          (b) a licensed mental health professional designated by the division as specially
54     qualified by training and who has at least five years' continual experience in the treatment of
55     mental illness.
56          (9) "Designee" means a physician who has responsibility for medical functions
57     including admission and discharge, an employee of a local mental health authority, or an
58     employee of a person that has contracted with a local mental health authority to provide mental
59     health services under Section 17-43-304.
60          (10) "Essential treatment" and "essential treatment and intervention" mean
61     court-ordered treatment at a local substance abuse authority or an approved treatment facility or
62     program for the treatment of an adult's substance use disorder.
63          (11) "Harmful sexual conduct" means the following conduct upon an individual
64     without the individual's consent, including the nonconsensual circumstances described in
65     Subsections 76-5-406(2)(a) through (l):
66          (a) sexual intercourse;
67          (b) penetration, however slight, of the genital or anal opening of the individual;
68          (c) any sexual act involving the genitals or anus of the actor or the individual and the
69     mouth or anus of either individual, regardless of the gender of either participant; or
70          (d) any sexual act causing substantial emotional injury or bodily pain.
71          (12) "Informed waiver" means the patient was informed of a right and, after being
72     informed of that right and the patient's right to waive the right, expressly communicated his or
73     her intention to waive that right.
74          (13) "Incapable" means that, in the opinion of the court in a guardianship proceeding
75     under Title 75, Utah Uniform Probate Code, or in the opinion of two physicians, a person's
76     ability to receive and evaluate information effectively or communicate decisions is impaired to
77     such an extent that the person currently lacks the capacity to make mental health treatment
78     decisions.
79          (14) "Institution" means a hospital or a health facility licensed under Section
80     26B-2-206.
81          (15) "Lay person" means an individual identified and authorized by a patient to
82     participate in activities related to the patient's commitment, including court appearances,
83     discharge planning, and grievances, except that a patient may revoke a lay person's
84     authorization at any time.
85          [(15)] (16) "Local substance abuse authority" means the same as that term is defined in
86     Section 26B-5-101 and described in Section 17-43-201.
87          [(16)] (17) "Mental health facility" means the Utah State Hospital or other facility that
88     provides mental health services under contract with the division, a local mental health
89     authority, a person that contracts with a local mental health authority, or a person that provides
90     acute inpatient psychiatric services to a patient.
91          [(17)] (18) "Mental health officer" means an individual who is designated by a local
92     mental health authority as qualified by training and experience in the recognition and
93     identification of mental illness, to:
94          (a) apply for and provide certification for a temporary commitment; or
95          (b) assist in the arrangement of transportation to a designated mental health facility.
96          [(18)] (19) "Mental illness" means:
97          (a) a psychiatric disorder that substantially impairs an individual's mental, emotional,
98     behavioral, or related functioning; or
99          (b) the same as that term is defined in:
100          (i) the current edition of the Diagnostic and Statistical Manual of Mental Disorders
101     published by the American Psychiatric Association; or
102          (ii) the current edition of the International Statistical Classification of Diseases and
103     Related Health Problems.
104          [(19)] (20) "Mental health treatment" means convulsive treatment, treatment with
105     psychoactive medication, or admission to and retention in a facility for a period not to exceed
106     17 days.
107          [(20)] (21) "Patient" means an individual who is:
108          (a) under commitment to the custody or to the treatment services of a local mental
109     health authority; or
110          (b) undergoing essential treatment and intervention.
111          [(21)] (22) "Physician" means an individual who is:
112          (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
113          (b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
114     Practice Act.
115          [(22)] (23) "Serious bodily injury" means bodily injury that involves a substantial risk
116     of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or
117     protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
118          [(23)] (24) "State hospital" means the Utah State Hospital established in Section
119     26B-5-302.
120          [(24)] (25) "Substantial danger" means that due to mental illness, an individual is at
121     serious risk of:
122          (a) suicide;
123          (b) serious bodily self-injury;
124          (c) serious bodily injury because the individual is incapable of providing the basic
125     necessities of life, including food, clothing, or shelter;
126          (d) causing or attempting to cause serious bodily injury to another individual;
127          (e) engaging in harmful sexual conduct; or
128          (f) if not treated, suffering severe and abnormal mental, emotional, or physical distress
129     that:
130          (i) is associated with significant impairment of judgment, reason, or behavior; and
131          (ii) causes a substantial deterioration of the individual's previous ability to function
132     independently.
133          [(25)] (26) "Treatment" means psychotherapy, medication, including the administration
134     of psychotropic medication, or other medical treatments that are generally accepted medical or
135     psychosocial interventions for the purpose of restoring the patient to an optimal level of
136     functioning in the least restrictive environment.
137          Section 2. Section 26B-5-310 is amended to read:
138          26B-5-310. Restrictions and limitations -- Civil rights and privileges.
139          (1) Subject to the general rules of the division, and except to the extent that the director
140     or [his] the director's designee determines that it is necessary for the welfare of the patient to
141     impose restrictions, every patient is entitled to:
142          (a) (i) communicate, by sealed mail or otherwise, with persons, including official
143     agencies, inside or outside the [facility] responsible local mental health authority, local
144     substance abuse authority, or approved treatment facility or program;
145          (ii) be provided with letter-writing materials, including postage; and
146          (iii) have staff of the responsible local mental health authority, local substance abuse
147     authority, or approved treatment facility or program assist the patient if the patient is unable to
148     write, prepare, or mail correspondence;
149          (b) have frequent and consistent opportunities to receive visitors at reasonable times
150     that do not interfere with clinical activities; [and]
151          (c) speak or visit with the patient's attorney or clergy member within a reasonable
152     period of time;
153          [(c)] (d) exercise all civil rights, including the right to dispose of property, execute
154     instruments, make purchases, enter contractual relationships, and vote, unless the patient has
155     been adjudicated to be incompetent and has not been restored to legal capacity[.];
156          (e) have access to adequate water and food, and to have the patient's nutritional needs
157     met in a manner that is consistent with recognized dietary practices;
158          (f) be treated fairly, with respect and recognition of the patient's dignity and
159     individuality;
160          (g) not be discriminated against on the basis of a characteristic identified in Subsection
161     57-21-5(1);
162          (h) within 72 business hours after the patient's request, see and receive the services of a
163     patient representative, including a peer specialist, who has no direct or indirect clinical,
164     administrative, or financial responsibility for the patient;
165          (i) have the patient's behavioral health orders for scope of treatment, declaration for
166     mental health treatment, or other psychiatric advance directive reviewed and considered as the
167     preferred treatment option for involuntary administration of medications by the responsible
168     local mental health authority, local substance abuse authority, or approved treatment facility or
169     program, unless by clear and convincing evidence the patient's directive does not qualify as
170     effective participation in behavioral health decision-making;
171          (j) with the patient's consent, have the patient's information or records disclosed to an
172     adult family member, the patient's lay person, or, in accordance with state and federal law, to a
173     protection and advocacy system designated pursuant to 42 U.S.C. Sec. 10801 et seq.;
174          (k) (i) access to a telephone to make and receive private calls, unless determined a
175     clinical or safety risk; and
176          (ii) staff assistance to be able to communicate with others, if the patient does not have a
177     contact list;
178          (l) wear the patient's own clothes, keep and use the patient's own possessions, and keep
179     and be allowed to spend a reasonable amount of the patient's own money, unless deemed a
180     clinical or safety risk; and
181          (m) be told:
182          (i) the reason for the patient's detainment and the limitations of the patient's
183     detainment, including a description of the patient's right to refuse medication unless the patient
184     requires emergency medications; and
185          (ii) that the patient's commitment does not mean all treatment during commitment is
186     mandatory.
187          (2) (a) When any right of a patient is limited or denied, the nature, extent, and reason
188     for that limitation or denial shall be entered in the patient's treatment record.
189          (b) Information pertaining to a denial of any right of a patient shall be made available,
190     upon request, to the patient, the patient's attorney, and the patient's lay person.
191          (c) Any continuing denial or limitation of any right of a patient shall be reviewed every
192     30 days and shall also be entered in [that] the patient's treatment record.
193          (d) Notice of [that] a continuing denial of any right of a patient in excess of 30 days
194     shall be sent to the division, the [appropriate] responsible local mental health authority, the
195     appropriate local substance abuse authority, or an approved treatment facility or program[,
196     whichever is most applicable to the patient].
197          [(3) Notwithstanding any limitations authorized under this section on the right of
198     communication, each patient is entitled to communicate by sealed mail with the appropriate
199     local mental health authority, the appropriate local substance abuse authority, an approved
200     treatment facility or program, the division, the patient's attorney, and the court, if any, that
201     ordered the patient's commitment or essential treatment. In no case may the patient be denied a
202     visit with the legal counsel or clergy of the patient's choice.]
203          [(4)] (3) Local mental health authorities, local substance abuse authorities, and
204     approved treatment facilities or programs shall provide reasonable means and arrangements for
205     informing involuntary patients of their right to release as provided in this chapter, and for
206     assisting them in making and presenting requests for release.
207          [(5) Mental] (4) Local mental health facilities, local substance abuse authorities, and
208     approved treatment facilities or programs shall post a statement, created by the division,
209     describing a patient's rights under Utah law.
210          (5) A local mental health authority, local substance abuse authority, or approved
211     treatment facility or program may not intentionally retaliate or discriminate against a detained
212     patient or employee for contacting or providing information to any official or to an employee of
213     any state protection and advocacy agency or for initiating, participating in, or testifying in a
214     grievance procedure or in an action for any remedy authorized pursuant to this section.
215          (6) Notwithstanding Section 53B-17-303, an individual committed under this chapter
216     has the right to determine the final disposition of that individual's body after death.
217          Section 3. Effective date.
218          This bill takes effect on May 1, 2024.