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HB1225
HOUSE OF REPRESENTATIVES
H.B. NO.
1225
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII
A BILL FOR AN ACT
Relating
to mental health
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
�
The legislature finds that Hawaii's current
standard for involuntary hospitalization does not adequately prevent harm
either to members of the public or persons suffering from mental illness or
substance abuse.
�
By requiring proof that
a person is "imminently dangerous to self or others", the law
essentially requires the point of danger--and thus potential harm--to have
already been reached.
�
Instead, the
standard should be more flexible to allow the person to receive treatment
before
the point of danger has been
reached and avoidable harm occurs.
����
The legislature notes that the
National Alliance on Mental Illness, in its December 2016 public policy
platform, asserts that states should "adopt broader, more flexible
standards that would provide for involuntary commitment and/or court ordered treatment
when an individual, due to mental illness is gravely disabled..." in
addition to other grounds.
�
The policy
platform defines a "gravely disabled" person as one who "is
substantially unable...to provide for any of his or her basic needs, such as
food, clothing, shelter, health or safety[.]"
�
The policy platform also explains that
"requir[ing] proof of dangerousness often produce[s] unsatisfactory
outcomes because individuals are allowed to deteriorate needlessly before
involuntary commitment and/or court-ordered treatment can be instituted."
����
The legislature acknowledges that,
collectively, Act 221, Session Laws of Hawaii 2013, and Act 114, Session Laws
of Hawaii 2016, deleted the term "gravely disabled" from the criteria
for involuntary hospitalization and increased dependence on a danger-based
definition, in furtherance of a pilot program for assisted community treatment
that is now permanent.
�
Mentally ill
persons who are gravely disabled may not be
imminently
dangerous to themselves or others, but still pose a
very real danger to themselves or the public and thus should be covered by the
law.
�
While the legislature supports the
continuation of the assisted community treatment program and its complementary
role in treating mental illness and substance abuse on an outpatient basis, the
legislature is cognizant that a portion of the mentally ill population,
including the chronically homeless, are being deprived of urgent, medically
appropriate mental health intervention that is best administered on an inpatient
basis.
����
The purpose of this Act is to
protect mentally ill individuals and the public more effectively by
amending the
definition of
"dangerous
to self"
,
defining the terms "gravely disabled" and "psychiatric
deterioration",
broadening the term of "imminently dangerous
to self and others", and increasing the maximum period of emergency
hospitalization.
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SECTION
2
.
�
Section 334-1,
Hawaii Revised Statutes, is amended to read as follows:
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"
PART I.
�
GENERAL AND ADMINISTRATIVE PROVISIONS
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�334-1
�
Definitions.
�
As used in this chapter unless otherwise
indicated by the context:
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"Administrator" means the
person in charge of a public or private hospital.
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"Admission procedures"
mean the various methods for admission of mentally ill persons or of persons
habituated to the excessive use of drugs or alcohol to public and private
psychiatric facilities.
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"Authorized absence" means
absence of a patient from a psychiatric facility for any period of time with
permission.
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"Behavioral health crisis
center" means a facility that is specifically designed and staffed to
provide care, diagnosis, or treatment for persons who are experiencing a mental
illness or substance use disorder crisis.
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"Community mental health center"
means one or more facilities which alone or in conjunction with other
facilities, public or private, are part of a coordinated program providing a
variety of mental health services principally for persons residing in a
community or communities in or near which the center is located.
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"Conservator" shall have
the meaning provided in section 560:5-102.
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"Court" means any duly
constituted court and includes proceedings, hearings of per diem judges as
authorized by law.
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"Dangerous to others"
means likely to do substantial physical or emotional injury on another, as
evidenced by a recent act, attempt or threat.
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"Dangerous to property"
means inflicting, attempting or threatening imminently to inflict damage to any
property in a manner which constitutes a crime, as evidenced by a recent act,
attempt or threat.
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"Dangerous to self" means
the person [
recently has
]:
����
(1)
�
[
Threatened
]
Recently
has threatened
or attempted suicide or serious bodily harm; or
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(2)
�
[
Behaved in
such a manner as to indicate that the person is unable, without supervision and
the assistance of others, to satisfy the need for nourishment, essential
medical care, including treatment for a mental illness, shelter or
self-protection, so that it is probable that death, substantial bodily injury,
or serious physical debilitation or disease will result unless adequate
treatment is afforded.
]
Is gravely disabled.
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"Department" means the
department of health.
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"Director" means the
director of health.
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"Discharge" means the
formal termination on the records of a psychiatric facility of a patient's
period of treatment at the facility.
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"Gravely disabled"
means a condition in which a person is unable, without supervision and the
assistance of others, to prevent physical or psychiatric deterioration or to
satisfy the need for nourishment, essential medical care including treatment
for a mental illness, shelter, or self-protection, so that it is probable that
death, substantial bodily injury, or serious physical debilitation or disease
will result unless adequate treatment is afforded.
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"Guardian" shall have the
meaning provided in section 560:5-102.
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"Health care operations" means
the services and activities conducted by an institution, facility, or agency
licensed, certified, or otherwise authorized or permitted by law to provide
medical or health services in the ordinary course of business, including case
management and care coordination, quality assessment and improvement
activities, medical reviews, and administrative activities.
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"Health care provider" means an
individual or entity licensed, certified, or otherwise authorized or permitted
by law to provide medical or health services in the ordinary course of business
or practice of a profession.
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"Homeless individual"
means an individual who is homeless as defined under section 346-361 and who
has a serious and persistent mental illness or is otherwise eligible for
treatment.
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"Imminently dangerous to self
or others" means that, without intervention, the person will likely become
dangerous to self or dangerous to others within the next [
forty-five
]
ninety
days.
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"Incapacitated person"
shall have the meaning provided in section 560:5-102.
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"Interested person" means
an interested, responsible adult, including but not limited to a public
official, the legal guardian, spouse, parent, legal counsel, adult child, or
next of kin of a person allegedly mentally ill, mentally deficient or suffering
from substance abuse or as otherwise provided in article I of chapter 560.
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"Intoxicated person" means
a person who is deprived of reasonable self-control because of intake of
alcohol or because of any substance which includes in its composition volatile
organic solvents.
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"Judge" means any judge of
the family court or per diem judge appointed by the chief justice as provided
in section 604-2.
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"Law enforcement officer"
has the same meaning as in section 710-1000.
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"Licensed physician" means
a physician or surgeon licensed by the State to practice medicine, including a
physician and surgeon granted a limited and temporary license under section
453-3(1), (2), and (5) or a resident physician and surgeon granted a limited
and temporary license under paragraph (4) thereof, or a medical officer of the
United States while in this State in the performance of the medical officer's
official duties.
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"Mental health" means a
state of social, psychological, and physical well-being, with capacity to
function effectively in a variety of social roles.
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"Mentally ill person"
means a person having psychiatric disorder or other disease which substantially
impairs the person's mental health and necessitates treatment or supervision.
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"Patient" means a person
under observation, care, or treatment at a psychiatric facility.
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"Person suffering from
substance abuse" means a person who uses narcotic, stimulant, depressant,
or hallucinogenic drugs or alcohol to an extent which interferes with the
person's personal, social, family, or economic life.
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"Protected person" shall
have the meaning provided in section 560:5-102.
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"Psychiatric
deterioration" means a substantial impairment or an obvious decline of an
individual's judgment, reasoning, or ability to control behavior.
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"Psychiatric facility"
means a public or private hospital or part thereof which provides inpatient or
outpatient care, custody, diagnosis, treatment or rehabilitation services for
mentally ill persons or for persons habituated to the excessive use of drugs or
alcohol or for intoxicated persons.
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"Special treatment
facility" means a public or private facility which provides a therapeutic
residential program for care, diagnosis, treatment or rehabilitation services
for emotionally distressed persons, mentally ill persons or persons suffering
from substance abuse.
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"Therapeutic living
program" means a supervised living arrangement that provides mental health
or substance abuse services for individuals or families who do not need the
structure of a special treatment facility and are transitioning from a more
restrictive treatment setting to independent living.
�
The program aids residents in meeting basic
needs and provides supportive services through a required service plan.
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"Treatment" means the
broad range of emergency, out-patient, intermediate, domiciliary, and inpatient
services and care, including diagnostic evaluation, medical, psychiatric,
psychological, and social service care, vocational rehabilitation, career
counseling, and other special services which may be extended to handicapped
persons.
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"Treatment summary" means a
record of information including present history and physical examination,
mental status examination, emergency department record, intake evaluation,
eligibility determination, current medication list and prescription history,
treatment plan, consultant reports, diagnosis and problem lists, recent
laboratory and diagnostic testing, clinical or discharge summaries, and
discharge instructions, or any combination of such information.
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"Unauthorized absence"
means absence of a patient from a psychiatric facility for any period of time
without permission."
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SECTION
3
.
�
Section 334-59,
Hawaii Revised Statutes, is amended by amending subsections (d) and (e) to read
as follows:
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"
(d)
�
Emergency hospitalization.
�
If the physician, advanced practice
registered nurse, or psychologist who performs the emergency examination has
reason to believe that the patient is:
����
(1)
�
Mentally ill or
suffering from substance abuse;
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(2)
�
Imminently dangerous
to self or others; and
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(3)
�
In need of care or
treatment, or both;
the physician, advanced practice registered nurse, or
psychologist may direct that the patient be hospitalized on an emergency basis
or cause the patient to be transferred to another psychiatric facility for
emergency hospitalization, or both.
�
The
patient shall have the right
,
immediately upon admission
,
to
telephone the patient's guardian [
or
]
,
a family member [
including
]
,
a reciprocal beneficiary, or an adult friend
,
and an attorney.
�
If the patient declines to exercise that
right, the staff of the facility shall inform the adult patient of the right to
waive notification to the
guardian,
family [
including a
]
member,
or
reciprocal beneficiary, and shall make reasonable efforts to ensure that
the patient's guardian [
or
]
,
family [
including a
]
, or
reciprocal beneficiary[
, is
]
are
notified of the emergency
admission
,
but the patient's family [
including a
]
or
reciprocal beneficiary[
,
] need not be notified if the patient is an
adult and requests that there be no notification.
�
The patient shall be allowed to confer with
an attorney in private.
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(e)
�
Release from emergency hospitalization.
�
If at any time during the period of emergency hospitalization the
responsible physician concludes that the patient no longer meets the criteria
for emergency hospitalization the physician shall discharge the patient.
�
If the patient is under criminal charges, the
patient shall be returned to the custody of a law enforcement officer.
�
In any event, the patient must be released
within [
forty-eight
]
seventy-two
hours of the patient's
admission, unless the patient voluntarily agrees to further hospitalization, or
a proceeding for court-ordered evaluation or hospitalization, or both, is
initiated as provided in section 334-60.3.
�
If that time expires on a Saturday, Sunday, or holiday, the time for
initiation is extended to the close of the next court day.
�
Upon initiation of the proceedings the
facility shall be authorized to detain the patient until further order of the
court."
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SECTION 4.
�
This Act does not affect rights and duties
that matured, penalties that were incurred, and proceedings that were begun
before its effective date.
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SECTION 5.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.
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SECTION 6.
�
This Act shall take effect on July 1, 2025.
INTRODUCED BY:
_____________________________
Report Title:
Mental
Illness; Hospitalization
Description:
Amends
the definition of "dangerous to self".
�
Defines the terms "gravely
disabled" and "psychiatric deterioration".
�
Broadens the term of "imminently
dangerous to self and others".
�
Increases
the maximum period of emergency hospitalization.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.