AN ACT relating to the care and treatment of individuals with mental illness.

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AN ACT relating to the care and treatment of individuals with mental illness. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
Section 1. KRS 202A.011 is amended to read as follows: 3
As used in this chapter, unless the context otherwise requires: 4
(1) "Authorized staff physician" means a physician who is a bona fide member of the 5
hospital's medical staff; 6
(2) "Benefit from treatment" means the desired outcomes of treatment in a 7
psychiatric hospital for an individual with a mental illness, including but not 8
limited to: 9
(a) Symptom management and increased stability; 10
(b) A lessening of irrational thoughts and behaviors; 11
(c) Reduced risk of harm; or 12
(d) Acquisition of skills for self -care and for interacting and living in the 13
community; 14
(3) "Cabinet" means the [Kentucky ]Cabinet for Health and Family Services; 15
(4)[(3)] "Contract mental health evaluator" means a qualified mental health 16
professional who is employed by or under contract with a community mental health 17
center, crisis stabilization unit, mental institution, or any other facility designated by 18
the secretary to provide mental health evaluations to determine whether an 19
individual meets the criteria for involuntary hospitalization; 20
(5)[(4)] "Danger" or "threat of danger to self, family, or others" means , as a result of 21
mental illness, a person: 22
(a) Presents a substantial risk of serious physical harm to[or threat of substantial 23
physical harm upon] self, family, or others as evidenced by recent behavior, 24
threats, or conduct demonstrating such risk;[,] 25
(b) Has attempted or threatened suicide or has expressed suicidal ideations and 26
there is a reasonable probability of serious self -harm unless prompt and 27
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adequate treatment is provided; 1
(c) Is unable without supervision or assistance to provide for [including actions 2
which deprive self, family, or others of the] basic personal needs,[means of 3
survival] including provision for reasonable shelter, food, [or ] clothing, or 4
medical care, so that there exists a substantial likelihood of death, serious 5
physical injury, or serious physical debilitation. For purposes of this 6
paragraph, a person shall be deemed unable to provide for basic personal 7
needs even if a guard ian, family member, or friend is willing and able to 8
provide assistance; or 9
(d) Is experiencing psychiatric deterioration, demonstrated by a substantial 10
decline in functioning from the person's baseline, such that the person's 11
judgment, insight, or ability to recognize the need for treatment is impaired, 12
and without intervention, the person's condition will predictably result in: 13
1. A substantial risk of serious physical harm to self, family, or others; 14
2. Serious physical debilitation or self-neglect; or 15
3. Further loss of ability to engage in safe or necessary self -care or to 16
voluntarily seek needed treatment; 17
(6)[(5)] "Forensic psychiatric facility" means a mental institution or facility, or part 18
thereof, designated by the secretary for the purpose and fu nction of providing 19
inpatient evaluation, care, and treatment for [mentally ill persons or ] individuals 20
with an intellectual disability or mental illness , who have been charged with or 21
convicted of a felony; 22
(7)[(6)] "Hospital" means: 23
(a) A state mental h ospital or institution or other licensed public or private 24
hospital, institution, health -care facility, or part thereof, approved by the 25
cabinet[Kentucky Cabinet for Health and Family Services] as equipped to 26
provide full -time residential care and treatmen t for [mentally ill persons or 27
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]individuals with an intellectual disability or mental illness; or 1
(b) A hospital, institution, or health -care facility of the government of the United 2
States equipped to provide residential care and treatment for [mentally i ll 3
persons or ]individuals with an intellectual disability or mental illness; 4
(8) "Individual with a mental illness" means a person with substantially impaired 5
capacity to use self-control, judgment, or discretion in the conduct of the person's 6
affairs and social relations, associated with maladaptive behavior or recognized 7
emotional symptoms where impaired capacity, maladaptive behavior, or 8
emotional symptoms can be related to physiological, psychological, or social 9
factors; 10
(9)[(7)] "Judge" means any judg e or justice of the Court of Justice or a trial 11
commissioner of the District Court acting under authority of SCR 5.030; 12
(10)[(8)] "Least restrictive alternative mode of treatment" means that treatment which 13
will give an[a mentally ill] individual with a me ntal illness a realistic opportunity 14
to improve the individual's level of functioning, consistent with accepted 15
professional practice in the least confining setting available;[ 16
(9) "Mentally ill person" means a person with substantially impaired capacity t o use 17
self-control, judgment, or discretion in the conduct of the person's affairs and social 18
relations, associated with maladaptive behavior or recognized emotional symptoms 19
where impaired capacity, maladaptive behavior, or emotional symptoms can be 20
related to physiological, psychological, or social factors;] 21
(11)[(10)] "Patient" means a person under observation, care, or treatment in a hospital 22
pursuant to the provisions of this chapter; 23
(12)[(11)] "Petitioner" means a person who institutes a proceeding under this chapter; 24
(13)[(12)] "Psychiatric facility" means a crisis stabilization unit or any facility licensed 25
by the cabinet and which provides inpatient, outpatient, psychosocial rehabilitation, 26
emergency, and consultation and education services for the diagnosis and treatment 27
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of persons who have a mental illness; 1
(14)[(13)] "Qualified mental health professional" means: 2
(a) A physician licensed under the laws of Kentucky to practice medicine or 3
osteopathy, or a medical officer of the government of the United States while 4
engaged in the performance of official duties; 5
(b) A psychiatrist licensed under the laws of Kentucky to practice medicine or 6
osteopathy, or a medical officer of the government of the United States while 7
engaged in the practice of official duties, who is certified or eligible to apply 8
for certification by the American Board of Psychiatry and Neurology, Inc.; 9
(c) A psychologist with the health service provider designation, a psychological 10
practitioner, a certified psychologist, or a psychological associate, licensed 11
under the provisions of KRS Chapter 319; 12
(d) A licensed registered nurse with a master's degree in psychiatric nursing from 13
an accredited institution and two (2) years of clinical experience with 14
individuals with a mental illness [mentally ill persons] , or a licensed 15
registered nurse, with a ba chelor's degree in nursing from an accredited 16
institution, who is certified as a psychiatric and mental health nurse by the 17
American Nurses Association and who has three (3) years of inpatient or 18
outpatient clinical experience in psychiatric nursing and is currently employed 19
by a hospital or forensic psychiatric facility licensed by the Commonwealth or 20
a psychiatric unit of a general hospital or a private agency or company 21
engaged in the provision of mental health services or a regional community 22
program for mental health and individuals with an intellectual disability; 23
(e) A licensed clinical social worker licensed under the provisions of KRS 24
335.100, or a certified social worker licensed under the provisions of KRS 25
335.080 with three (3) years of inpatient or outpatient clinical experience in 26
psychiatric social work and currently employed by a hospital or forensic 27
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psychiatric facility licensed by the Commonwealth or a psychiatric unit of a 1
general hospital or a private agency or company engaged in the provi sion of 2
mental health services or a regional community program for mental health and 3
individuals with an intellectual disability; 4
(f) A marriage and family therapist licensed under the provisions of KRS 5
335.300 to 335.399 with three (3) years of inpatient or outpatient clinical 6
experience in psychiatric mental health practice and currently employed by a 7
hospital or forensic facility licensed by the Commonwealth, a psychiatric unit 8
of a general hospital, a private agency or company engaged in providing 9
mental health services, or a regional community program for mental health 10
and individuals with an intellectual disability; 11
(g) A professional counselor credentialed under the provisions of KRS Chapter 12
335.500 to 335.599 with three (3) years of inpatient or outp atient clinical 13
experience in psychiatric mental health practice and currently employed by a 14
hospital or forensic facility licensed by the Commonwealth, a psychiatric unit 15
of a general hospital, a private agency or company engaged in providing 16
mental healt h services, or a regional community program for mental health 17
and individuals with an intellectual disability; or 18
(h) A physician assistant licensed under KRS 311.840 to 311.862, who meets one 19
(1) of the following requirements: 20
1. Provides documentation th at he or she has completed a psychiatric 21
residency program for physician assistants; 22
2. Has completed at least one thousand (1,000) hours of clinical experience 23
under a supervising physician, as defined by KRS 311.840, who is a 24
psychiatrist and is certifie d or eligible for certification by the American 25
Board of Psychiatry and Neurology, Inc.; 26
3. Holds a master's degree from a physician assistant program accredited 27
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by the Accreditation Review Commission on Education for the 1
Physician Assistant or its predece ssor or successor agencies, is 2
practicing under a supervising physician as defined by KRS 311.840, 3
and: 4
a. Has two (2) years of clinical experience in the assessment, 5
evaluation, and treatment of mental disorders; or 6
b. Has been employed by a hospital or f orensic psychiatric facility 7
licensed by the Commonwealth or a psychiatric unit of a general 8
hospital or a private agency or company engaged in the provision 9
of mental health services or a regional community program for 10
mental health and individuals with a n intellectual disability for at 11
least two (2) years; or 12
4. Holds a bachelor's degree, possesses a current physician assistant 13
certificate issued by the board prior to July 15, 2002, is practicing under 14
a supervising physician as defined by KRS 311.840, and: 15
a. Has three (3) years of clinical experience in the assessment, 16
evaluation, and treatment of mental disorders; or 17
b. Has been employed by a hospital or forensic psychiatric facility 18
licensed by the Commonwealth or a psychiatric unit of a general 19
hospital or a private agency or company engaged in the provision 20
of mental health services or a regional community program for 21
mental health and individuals with an intellectual disability for at 22
least three (3) years; 23
(15)[(14)] "Residence" means legal residenc e as determined by applicable principles 24
governing conflicts of law; 25
(16)[(15)] "Respondent" means a person alleged in a hearing under this chapter to be [a 26
mentally ill person or ] an individual with an intellectual disability or mental 27
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illness;[ and] 1
(17)[(16)] "Secretary" means the secretary of the Cabinet for Health and Family 2
Services[.]; and 3
(18) "Serious mental illness": 4
(a) Means a diagnosable mental, behavioral, or emotional disorder that causes 5
significant functional impairment that substantially i nterferes with or limits 6
major life activities, including but not limited to: 7
1. Severe cognitive difficulties, including disorganized thinking, 8
delusions, hallucinations, or memory impairment; or 9
2. Extreme mood fluctuations, apathy, or lack of motivation; and 10
(b) Includes but is not limited to the following disorders: 11
1. Schizophrenia spectrum and other psychotic disorders; 12
2. Bipolar and related disorders; and 13
3. Major depressive disorders that require treatment. 14
Section 2. KRS 202A.028 is amended to read as follows: 15
(1) Prior to completion of an examination by a qualified mental health professional 16
under this section, the professional shall make a good -faith attempt to contact the 17
petitioner to obtain any additional relevant information necessary to the petition. 18
(2) (a) Prior to the completion of an examination under this section, the county 19
attorney may make an ex parte motion for a certification review hearing. 20
The court shall review the ex parte motion upon its receipt. 21
(b) If the review indicates that the person presents an imminent threat of 22
danger to self, family, or others, the court shall order the qualified mental 23
health professional to immediately notify the court if the profess ional has 24
certified that the person: 25
1. Is an individual with a mental illness; 26
2. Presents a danger or threat of danger to self, family, or others as a 27
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result of the mental illness; and 1
3. Does not meet the other criteria for involuntary hospitalization u nder 2
Section 27 of this Act. 3
(c) The court shall review the certification under paragraph (b) of this 4
subsection and consider if the person has been the subject of proceedings 5
under this chapter, prior to the current proceeding, and is exhibiting an 6
escalation of dangerous behavior. After review, the court may: 7
1. Order the person to be hospitalized in a place designated by the 8
cabinet until the certification review hearing is held within forty -eight 9
(48) hours, excluding weekends and holidays; 10
2. Release the person and set the certification review hearing to be held 11
within forty-eight (48) hours, excluding weekends and holidays; or 12
3. Deny the county attorney's motion for a certification review. 13
(d) At the certification review hearing: 14
1. The qualified ment al health professional that performed the 15
examination shall testify about the certification under paragraph (b) 16
of this subsection. This testimony may be given remotely; and 17
2. The person shall be appointed counsel who may present evidence and 18
cross examine witnesses on the person's behalf. 19
(e) Upon conclusion of the certification review hearing, if the court finds by 20
clear and convincing evidence that the person is an individual with a mental 21
illness, who presents a danger or threat of danger to self, fami ly, or others 22
as a result of the mental illness, who may reasonably benefit from court -23
ordered outpatient treatment or release with other reasonable conditions, 24
and for whom court -ordered outpatient treatment or release with other 25
reasonable conditions is the least restrictive alternative mode of treatment 26
available, the court shall order: 27
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1. a. The person to receive community-based outpatient treatment that 1
shall not exceed three hundred sixty (360) days; and 2
b. The person to comply with any other reasonab le conditions 3
necessary to ensure compliance; or 4
2. The person to be released with any reasonable conditions necessary to 5
ensure the safety of self, family, or others and avoid readmittance to a 6
hospital setting. 7
(3) (a) Failure to comply with any reasonab le conditions or an order for 8
community-based outpatient treatment under subsection (2)(e) of this 9
section shall not be grounds to find the person in contempt of court but 10
shall be prima facie evidence that: 11
1. The person can benefit from inpatient hospitalization; and 12
2. Inpatient hospitalization is the least restrictive mode of treatment. 13
(b) If a new petition for involuntary hospitalization is filed within twelve (12) 14
months due to failure to comply with any reasonable conditions or an order 15
for communit y-based outpatient treatment under subsection (2)(e) of this 16
section, the court shall notify the qualified mental health professional who 17
is conducting the examination of the person's: 18
1. Prior conditions or any order for community -based outpatient 19
treatment; and 20
2. Failure to comply with those conditions or treatment. 21
(c) The qualified mental health professional who conducts the examination as 22
described under paragraph (b) of this subsection, shall independently 23
evaluate the person, considering the person's prior noncompliance, and 24
certify that he or she meets the criteria for involuntary hospitalization under 25
Section 27 of this Act. 26
(d) A person shall not be involuntarily hospitalized based solely on his or her 27
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failure to comply with conditions or an order for community -based 1
outpatient treatment. 2
(4) Following an examinati on by a qualified mental health professional and a 3
certification by that professional that the person meets the criteria for involuntary 4
hospitalization, a judge may order the person hospitalized for a period not to exceed 5
seventy-two (72) hours, excluding weekends and holidays. For the purposes of this 6
section, the qualified mental health professional shall be: 7
(a) A staff member of a regional community program for mental health or 8
individuals with an intellectual disability; 9
(b) An individual qualified an d licensed to perform the examination through the 10
use of telehealth services; or 11
(c) The psychiatrist ordered, subject to the court's discretion, to perform the 12
required examination. 13
(5)[(2)] Any person who has been admitted to a hospital under subsection (1) of this 14
section shall be released from the hospital within seventy-two (72) hours, excluding 15
weekends and holidays, unless further held under the applicable provisions of this 16
chapter. 17
(6)[(3)] (a) Any person admitted to a hospital under subsection (1) of this section or 18
transferred to a hospital while ordered hospitalized under subsection (1) of 19
this section shall be transported from the person's home county by the sheriff 20
of that county or other peace officer as ordered by the court. 21
(b) The sheriff or other peace officer may, upon agreement of a person authorized 22
by the peace officer, authorize the cabinet, a private agency on contract with 23
the cabinet, or an ambulance service designated by the cabinet to transport the 24
person to the hospital. 25
(c) The transportation costs of the sheriff, other peace officer, ambulance service, 26
or other private agency on contract with the cabinet shall be paid by the 27
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cabinet in accordance with an administrative regulation promulgated by the 1
cabinet in accordance with[, pursuant to] KRS Chapter 13A. 2
(7)[(4)] (a) Any person released from the hospital under subsection (2) of this 3
section shall be transported to the person's county of discharge by a sheriff or 4
other peace officer, by an ambulance service designated by the cab inet, or by 5
other appropriate means of transportation which is consistent with the 6
treatment plan of that person. 7
(b) The transportation cost of transporting the patient to the patient's county of 8
discharge when performed by a peace officer, ambulance serv ice, or other 9
private agency on contract with the cabinet shall be paid by the cabinet in 10
accordance with an administrative regulation promulgated[issued] by the 11
cabinet in accordance with[pursuant to] KRS Chapter 13A. 12
(8)[(5)] A[No] person who has been held under subsection (1) of this section shall not 13
be held in jail pending evaluation and transportation to the hospital. 14
(9) A court order under subsection (4) of this section shall expire after thirty (30) 15
days if not served upon the person subject to the order. 16
SECTION 3. A NEW SECTION OF KRS CHAPTER 202A IS CREATED TO 17
READ AS FOLLOWS: 18
(1) (a) Upon motion of the county attorney, the hospital shall give notice to the 19
court and the county attorney i f the hospital plans to discharge the 20
respondent following the certification by a qualified mental health 21
professional and before the preliminary hearing. Prior to discharge, the 22
county attorney may make an ex parte motion for a certification review 23
hearing. The court shall review the ex parte motion upon its receipt. 24
(b) If the review indicates that the respondent presents an imminent threat of 25
danger to self, family, or others, the court shall order the qualified mental 26
health professional to immediately notify the court if the professional has 27
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certified that the respondent: 1
1. Is an individual with a mental illness; 2
2. Presents a danger or threat of danger to self, family, or others as a 3
result of the mental illness; and 4
3. Does not meet the other criteri a for involuntary hospitalization under 5
Section 27 of this Act. 6
(c) The court shall review the certification under paragraph (b) of this 7
subsection and consider if the respondent has been the subject of 8
proceedings under this chapter, prior to the current proceeding, and is 9
exhibiting an escalation of dangerous behavior. After review, the court 10
may: 11
1. Order the respondent to be hospitalized in a place designated by the 12
cabinet until the certification review hearing is held within forty -eight 13
(48) hours, excluding weekends and holidays; 14
2. Release the respondent and set the certification review hearing to be 15
held within forty-eight (48) hours; or 16
3. Deny the county attorney's motion for a certification review. 17
(d) At the certification review hearing: 18
1. The qualified mental health professional that performed the 19
examination shall testify about the certification under paragraph (b) 20
of this subsection. This testimony may be given remotely; and 21
2. The respondent shall be appointed counsel who may present evi dence 22
and cross examine witnesses on the respondent's behalf. 23
(e) Upon conclusion of the certification review hearing, if the court finds by 24
clear and convincing evidence that the respondent is an individual with a 25
mental illness, who presents a danger or threat of danger to self, family, or 26
others as a result of the mental illness, who may reasonably benefit from 27
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court-ordered outpatient treatment or release with reasonable conditions, 1
and for whom court-ordered outpatient treatment or release with reasonable 2
conditions is the least restrictive alternative mode of treatment available, the 3
court shall order the respondent to: 4
1. a. Receive community -based outpatient treatment that shall not 5
exceed three hundred sixty (360) days; and 6
b. Comply with any other reasonable conditions necessary to 7
ensure compliance; or 8
2. Be released with any reasonable conditions necessary to ensure the 9
safety of self, family, or others and avoid readmittance to a hospital 10
setting. 11
(2) (a) Failure to comply with any reasonable con ditions or an order for 12
community-based outpatient treatment under subsection (1)(e) of this 13
section shall not be grounds to find the person in contempt of court but 14
shall be prima facie evidence that: 15
1. The respondent can benefit from inpatient hospitalization; and 16
2. Inpatient hospitalization is the least restrictive mode of treatment. 17
(b) If a new petition for involuntary hospitalization is filed within twelve (12) 18
months due to failure to comply with any reasonable conditions or an order 19
for community -based outpatient treatment under subsection (1)(e) of this 20
section, the court shall notify the qualified mental health professional who 21
is conducting the examination of the respondent's: 22
1. Prior conditions or any order for community -based outpatient 23
treatment; and 24
2. Failure to comply with those conditions or treatment. 25
(c) The qualified mental health professional who conducts the examination as 26
described under paragraph (b) of this subsection, shall independently 27
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evaluate the respondent, considering the r espondent's prior noncompliance, 1
and certify that he or she meets the criteria for involuntary hospitalization 2
under Section 27 of this Act. 3
(d) A respondent shall not be involuntarily hospitalized based solely on his or 4
her failure to comply with conditio ns or an order for community -based 5
outpatient treatment. 6
Section 4. KRS 202A.051 is amended to read as follows: 7
(1) Proceedings for up to sixty (60) days or up to three hundred sixty (360) days of 8
involuntary hospitaliza tion of an individual shall be initiated by the filing of a 9
verified petition in District Court. 10
(2) The petition and all subsequent court documents shall be entitled: "In the interest of 11
(name of respondent)." 12
(3) The petition shall be filed by a qualifie d mental health professional, peace officer, 13
county attorney, Commonwealth's attorney, spouse, relative, friend, or guardian of 14
the individual concerning whom the petition is filed, or any responsible adult[other 15
interested person]. 16
(4) The petition shall set forth: 17
(a) Petitioner's relationship to the respondent; 18
(b) Respondent's name, residence, and current location, if known; 19
(c) The name and residence of respondent's parents, if living and if known, or 20
respondent's legal guardian, if any and if known; 21
(d) The name and residence of respondent's husband or wife, if any and if known; 22
(e) The name and residence of the person having custody of the respondent, if 23
any, or if no such person is known, the name and residence of a near relative 24
or that the person is unknown; and 25
(f) Petitioner's belief, including the factual basis therefor, that the respondent is 26
an individual with a mental illness [mentally ill] and presents a danger or 27
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threat of danger to self, family or others if not restrained;[ and] 1
(g) If the petition seeks a three hundred sixty (360) day involuntary 2
hospitalization of the respondent, the petition shall further set forth that the 3
respondent has been hospitalized in a hospital or a forensic psychiatric facility 4
for a period of thirty (30) days under the provisions of this chapter or KRS 5
Chapter 504 within the preceding six (6) months; and 6
(h) Upon request of the county attorney, that the county attorney receives notice 7
of any discharge by a hospital prior to the preliminary hearing under 8
subsection (10) of this section. 9
(5) If the petition seeks a sixty (60) day involuntary hospitalization of the respondent, 10
the county attorney may motion the c ourt to amend the petition to seek up to a 11
three hundred sixty (360) day involuntary hospitalization of the individual if the 12
respondent has been hospitalized in a hospital or a forensic psychiatric facility 13
for a period of thirty (30) days under the provi sions of this chapter or KRS 14
Chapter 504 within the preceding six (6) months. 15
(6) Upon receipt of the petition, the court shall examine the petitioner under oath as to 16
the contents of the petition. If the petitioner is a qualified mental health 17
professional, the court may dispense with the examination. 18
(7)[(6)] If after reviewing the allegations contained in the petition and examining the 19
petitioner under oath, it appears to the court that there is probable cause to believe 20
the respondent should be involuntarily hospitalized, the court shall, unless either the 21
court or one (1) of the parties objects, implement the procedures provided in KRS 22
202A.028 and order the individual to be examined without unnecessary delay by a 23
qualified mental health professional. I f the person is not being hospitalized[held] 24
under the provisions of this chapter, the court may order that the sheriff of the 25
county or other peace officer transport the person to a hospital or psychiatric facility 26
designated by the cabinet for the purpos e of the evaluation. The sheriff or other 27
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peace officer may, upon agreement of a person authorized by the peace officer, 1
authorize the cabinet, a private agency on contract with the cabinet, or an 2
ambulance service designated by the cabinet to transport th e person to a hospital or 3
psychiatric facility. Following that, the procedures as set forth in KRS 202A.028 4
shall be carried out. Otherwise, the court shall: 5
(a) Set a date for a preliminary hearing within six (6) days from the date of 6
hospitalization of [holding] the person under the provisions of this section, 7
[section (] excluding holidays and weekends ,[)] to determine if there is 8
probable cause to believe the person should be involuntarily hospitalized; 9
(b) Notify the respondent, the legal guardian, if an y, and if known, and the 10
spouse, parents, or nearest relative or friend of the respondent concerning the 11
allegations and contents of the petition and the date and purpose of the 12
preliminary hearing; and the name, address, and telephone number of the 13
attorney appointed to represent the respondent; and 14
(c) Cause the respondent to be examined without unnecessary delay by two (2) 15
qualified mental health professionals, at least one (1) of whom is a physician. 16
The qualified mental health professionals shall certi fy within twenty-four (24) 17
hours, [(]excluding weekends and holidays,[)] their findings. 18
(8)[(7)] (a) If the respondent is being presently hospitalized[held] under the 19
provisions of this chapter, the court may order further 20
hospitalization[holding] of the respondent to accomplish the examination 21
ordered by the court. 22
(b) If the respondent is not being presently hospitalized[held] under the 23
provisions of this chapter, the court may order that the sheriff of the county or 24
a peace officer transport the respondent to a hospital or a psychiatric facility 25
designated by the cabinet so that the respondent shall be examined without 26
unnecessary delay by two (2) qualified mental health professionals, at least 27
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one (1) of whom is a physician. The sheriff or other peace officer may 1
authorize, upon agreement of a person authorized by the peace officer, the 2
cabinet, a private agency on contract with the cabinet, or an ambulance 3
service designated by the cabinet to transport the person to a hospital or 4
psychiatric facility. 5
(9)[(8)] (a) When the court is authorized to issue an order that the respondent be 6
transported to a hospital or psychiatric facility, the court may, in its discretion, 7
issue a summons. A summons so issued shall be directed to the respondent, 8
shall command the respondent to appear at a time and place [therein ]specified 9
in the summons where the respondent shall be [there ]examined by two (2) 10
qualified mental health professionals, at least one (1) of whom is a physician, 11
and shall command the respondent's appearance at the preliminary hearing. 12
(b) If a respondent who has been summoned fails to appear for such examination 13
or at the preliminary hearing, the court may order that the sheriff of the county 14
or a peace officer transport the respondent to a hospital or psychiatric facility 15
designated by the cabinet for the purpose of an evaluation. 16
(10)[(9)] If upon completion of the preliminary hearing, the court finds: 17
(a) 1. There is probable cause to believe the respondent should be 18
involuntarily hospitalized, the court shall order a final hearing within 19
twenty-one (21) days from the date of hospitalization of [holding] the 20
respondent under [the provisions of ] this secti on to determine if the 21
respondent should be involuntarily hospitalized. 22
2. If the court finds that probable cause exists under subparagraph 1. of 23
this paragraph, the county attorney may motion the court at the 24
conclusion of the preliminary hearing to requi re that a hearing be 25
held prior to discharge of a respondent from the hospital. If the court 26
grants this motion, the hospital shall be required to notify the court 27
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and the county attorney of the hospital's intent to discharge the 1
respondent and the court s hall conduct the hearing at the earliest 2
practicable time, consistent with due process and the availability of 3
counsel, and in no event later than seven (7) days after notice is given 4
by the hospital, except upon a finding of good cause for further delay. 5
3. Upon completion of the hearing, if the court finds that the respondent 6
is an individual with a mental illness, who presents a danger or threat 7
of danger to self, family, or others as a result of the mental illness, 8
who may reasonably benefit from court -ordered outpatient treatment 9
or release with other reasonable conditions, and for whom court -10
ordered outpatient treatment or release with other reasonable 11
conditions is the least restrictive alternative mode of treatment 12
available, the court shall order: 13
a. For a respondent who meets the criteria for court -ordered 14
assisted outpatient treatment set forth in Section 13 of this Act: 15
i. That a treatment plan be developed in accordance with 16
KRS 202A.0817 within forty-eight (48) hours; and 17
ii. The respondent to r eceive court-ordered assisted outpatient 18
treatment under KRS 202A.0811 to 202A.0831; 19
b. For any other respondent who may benefit from outpatient 20
treatment: 21
i. A qualified mental health professional to develop a 22
treatment plan within forty-eight (48) hours; 23
ii. The respondent to receive community -based outpatient 24
treatment that shall not exceed three hundred sixty (360) 25
days; and 26
iii. The respondent to comply with any other reasonable 27
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conditions necessary to ensure compliance; or 1
c. The respondent to be released with any reasonable conditions 2
necessary to ensure the safety of self, family, or others and avoid 3
readmittance into a hospital setting; 4
(b) There is no probable cause to believe the respondent should be involuntarily 5
hospitalized but that the respondent is an individual with a mental illness, 6
who presents a danger or threat of danger to self, family, or others as a 7
result of the mental illness, who may reasonably benefit from court -ordered 8
outpatient treatment or release with other reasonable conditions, and for 9
whom court -ordered outpatient treatment or release with other reasonable 10
conditions is the least restrictive alternative mode of treatment available, the 11
court shall order: 12
1. For a respondent who meets the criteria fo r court -ordered assisted 13
outpatient treatment set forth in Section 13 of this Act: 14
a. That a treatment plan be developed in accordance with KRS 15
202A.0817 within forty-eight (48) hours; and 16
b. The respondent to receive court -ordered assisted outpatient 17
treatment under KRS 202A.0811 to 202A.0831; 18
2. For any other respondent who may benefit from outpatient treatment: 19
a. A qualified mental health professional to develop a treatment 20
plan within forty-eight (48) hours; 21
b. The respondent to receive community-based outpatient treatment 22
that shall not exceed three hundred sixty (360) days; and 23
c. The respondent to comply with any other reasonable conditions 24
necessary to ensure compliance; or 25
3. The respondent to be released with any reasonable conditions 26
necessary to ensure the safety of self, family, or others and avoid 27
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readmittance into a hospital setting; or 1
(c)[(10)] [If the court finds ]There is no probable cause to believe the respondent: 2
1. Should be involuntarily hospitalized; or 3
2. Is an individual with a mental illness: 4
a. Who presents a danger or threat of danger to self, family, or 5
others as a result of the mental illness; 6
b. Who may reasonably benefit from outpatient treatment or 7
release with reasonable conditions; and 8
c. For whom outpatient treatment or r elease with reasonable 9
conditions is the least restrictive alternative mode of treatment 10
available;[,] 11
the proceedings against the respondent shall be dismissed, and the respondent 12
shall be released from any hospitalization[holding]. 13
(11) If upon completion of the final hearing, the court finds: 14
(a) 1. The respondent should be involuntarily hospitalized, the court shall 15
order the respondent: 16
a. Hospitalized in a hospital for a period not to exceed sixty (60) 17
consecutive days from the date of the court order or a period not to 18
exceed three hundred sixty (360) consecutive days from the date of 19
the court order, whatever was the period of time that was requested 20
in the petition; and 21
b. To comply with all conditions of the hospital's discharge plan. 22
2. If the co urt orders the respondent to be hospitalized under 23
subparagraph 1. of this paragraph, the county attorney may motion 24
the court at the conclusion of the final hearing to require that a 25
hearing be held: 26
a. Prior to discharge of a respondent from the hospital . If the court 27
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grants this motion, the hospital shall be required to notify the 1
court and the county attorney of the hospital's intent to 2
discharge the respondent and the court shall conduct the hearing 3
at the earliest practicable time, consistent with due process and 4
the availability of counsel, and in no event later than seven (7) 5
days after notice is given by the hospital, except upon a finding 6
of good cause for further delay; or 7
b. If the respondent within the past twelve (12) months has been 8
found inco mpetent to stand trial in a criminal proceeding and 9
has not been committed under KRS Chapter 202C in accordance 10
with Section 9 of this Act. 11
3. Upon completion of the hearing described in subparagraph 2.a. of this 12
paragraph, if the court finds that the resp ondent is an individual with 13
a mental illness, who presents a danger or threat of danger to self, 14
family, or others as a result of the mental illness, who may reasonably 15
benefit from court -ordered outpatient treatment or release with other 16
reasonable condi tions, and for whom court -ordered outpatient 17
treatment or release with other reasonable conditions is the least 18
restrictive alternative mode of treatment available, the court shall 19
order: 20
a. For a respondent who meets the criteria for court -ordered 21
assisted outpatient treatment set forth in Section 13 of this Act: 22
i. That a treatment plan be developed in accordance with 23
KRS 202A.0817 within forty-eight (48) hours; and 24
ii. The respondent to rec eive court-ordered assisted outpatient 25
treatment under KRS 202A.0811 to 202A.0831; 26
b. For any other respondent who may benefit from outpatient 27
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treatment: 1
i. A qualified mental health professional to develop a 2
treatment plan within forty-eight (48) hours; 3
ii. The respondent to receive community -based outpatient 4
treatment that shall not exceed three hundred sixty (360) 5
days; and 6
iii. The respondent to comply with any other reasonable 7
conditions necessary to ensure compliance; or 8
c. The respondent to be releas ed with any reasonable conditions 9
necessary to ensure the safety of self, family, or others and avoid 10
readmittance into a hospital setting; 11
(b) The respondent should not be involuntarily hospitalized but that the 12
respondent is an individual with a mental i llness, who presents a danger or 13
threat of danger to self, family, or others as a result of the mental illness, 14
who may reasonably benefit from court -ordered outpatient treatment or 15
release with other reasonable conditions, and for whom court -ordered 16
outpatient treatment or release with other reasonable conditions is the least 17
restrictive alternative mode of treatment available, the court shall order: 18
1. For a respondent who meets the criteria for court -ordered assisted 19
outpatient treatment set forth in Section 13 of this Act: 20
a. That a treatment plan be developed in accordance with KRS 21
202A.0817 within forty-eight (48) hours; and 22
b. The respondent to receive court -ordered assisted outpatient 23
treatment under KRS 202A.0811 to 202A.0831; 24
2. For any other respondent who may benefit from outpatient treatment: 25
a. A qualified mental health professional to develop a treatment 26
plan within forty-eight (48) hours; 27
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b. The respondent to receive community-based outpatient treatment 1
that shall not exceed three hundred sixty (360) days; and 2
c. The respondent to comply with any other reasonable conditions 3
necessary to ensure compliance; or 4
3. The respondent to be released with any reasonable conditions 5
necessary to ensure the safety of self, family, or others and avoid 6
readmittance into a hospital setting; or 7
(c) The respondent: 8
1. Should not be involuntary hospitalized; or 9
2. Is not an individual with a mental illness: 10
a. Who presents a danger or threat of danger to self, family, or 11
others as a result of the mental illness; 12
b. Who may reasonably benefit from outpatient treatment or 13
release with reasonable conditions; and 14
c. For whom outpatient treatment or release with reasonable 15
conditions is the least restrictive mode of treatment available; 16
the proceedings against the resp ondent shall be dismissed, and the 17
respondent shall be released from any hospitalization. 18
(12) (a) Failure to comply with any reasonable conditions under subsection (10) or 19
(11) of this section shall not be grounds to find the person in contempt of 20
court but shall be prima facie evidence that: 21
1. The person can benefit from inpatient hospitalization; and 22
2. Inpatient hospitalization is the least restrictive mode of treatment. 23
(b) If a new petition for involuntary hospitalization is filed within twelve (12) 24
months due to failure to comply with any reasonable conditions under 25
subsection (10) or (11) of this section, the court shall notify the qualified 26
mental health professional who is conducting the examination of the 27
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person's prior conditions and failure to comply with those conditions. 1
(c) The qualified mental health professional who conducts the examination as 2
described under paragraph (b) of this subsection, shall independently 3
evaluate the person, considering the person's prior noncompliance, and 4
certify that he or she meets the criteria for involuntary hospitalization under 5
Section 27 of this Act. 6
(d) A person shall not be involuntarily hospitalized based solely on his or her 7
failure to comply with conditions. 8
(13) Any petition under this section shall expire after thirty (30) days if not served 9
upon the respondent. 10
Section 5. KRS 202A.053 is amended to read as follows: 11
(1) (a) Except as provided in paragraph (b) of this subsection, a respondent who has 12
been ordered involuntarily hospitalized following the preliminary hearing 13
shall have venue for all subsequent proceedings, including the final hearing, 14
transferred to the court of the county where the respondent is hospitalized. 15
(b) A court may order venue be transferred back to the county where the 16
respondent resides if the court has ordered the respondent to receive 17
outpatient treatment under Section 4 or 9 of this Act. The receiving county 18
shall then assume venue and responsibility for the respondent's treatment 19
plan and supervision, and shall make orders as the court sees fit. 20
(2) The court of the county where the prelimina ry hearing was held may, upon its own 21
motion, or shall, upon motion of one (1) of the parties, retain venue over 22
proceedings subsequent to the preliminary hearing. 23
(3) The court of the county where the county attorney has filed a motion for a 24
certification review hearing under Section 2, 3, or 6 of this Act shall retain venue 25
over the proceedings. 26
Section 6. KRS 202A.061 is amended to read as follows: 27
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(1) Prior to completion of an examination by a qualified mental health professional 1
under this section, the professional shall make a good -faith attempt to contact the 2
petitioner to obtain any additional relevant information necessary to the petition. 3
(2) (a) Prior to the completion of an examination under this section, the c ounty 4
attorney may make an ex parte motion for a certification review hearing. 5
The court shall review the ex parte motion upon its receipt. 6
(b) If the review indicates that the person presents an imminent threat of 7
danger to self, family, or others, the co urt shall order the qualified mental 8
health professionals to immediately notify the court if either of the 9
professionals have certified that the person: 10
1. Is an individual with mental illness; 11
2. Presents a danger or threat of danger to self, family, or o thers as a 12
result of the mental illness; and 13
3. Does not meet the other criteria for involuntary hospitalization under 14
Section 27 of this Act. 15
(c) The court shall review the certification under paragraph (b) of this 16
subsection and consider if the person ha s been the subject of proceedings 17
under this chapter, prior to the current proceeding, and is exhibiting an 18
escalation of dangerous behavior. After review, the court may: 19
1. Order the person to be hospitalized in a place designated by the 20
cabinet until the certification review hearing is held within forty -eight 21
(48) hours, excluding weekends and holidays; 22
2. Release the person and set the certification review hearing to be held 23
within forty-eight (48) hours; or 24
3. Deny the county attorney's motion for a certification review. 25
(d) At the certification review hearing: 26
1. The qualified mental health professional that performed the 27
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examination shall testify about the certification under paragraph (b) 1
of this subsection. This testimony may be given remotely; and 2
2. The person shall be appointed counsel who may present evidence and 3
cross examine witnesses on the person's behalf. 4
(e) Upon conclusion of the certification review hearing, if the court finds by 5
clear and convincing evidence that the person is an individual with a mental 6
illness, who presents a danger or threat of danger to self, family, or others 7
as a result of the mental illness, who may reasonably benefit from court -8
ordered outpatient treatment or release with reasonable conditions, and for 9
whom court -ordered outpatient treatment or release with reasonable 10
conditions is the least restrictive alternative mode of treatment available, the 11
court shall order the person to: 12
1. a. Receive community -based outpatient treatment that shall not 13
exceed three hundred sixty (360) days; and 14
b. Comply with any other reasonable conditions necessary to 15
ensure compliance; or 16
2. Be released wi th any reasonable conditions necessary to ensure the 17
safety of self, family, or others. 18
(3) (a) Failure to comply with any reasonable conditions or an order for 19
community-based outpatient treatment under subsection (2)(e) of this 20
section shall not be groun ds to find the person in contempt of court but 21
shall be prima facie evidence that: 22
1. The person can benefit from inpatient hospitalization; and 23
2. Inpatient hospitalization is the least restrictive mode of treatment; 24
if the person is subject to subsequen t proceedings under this chapter within 25
twelve (12) months. 26
(b) If a new petition for involuntary hospitalization is filed within the twelve 27
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(12) month period due to failure to comply with any reasonable conditions 1
or an order for community -based outpatien t treatment under subsection 2
(2)(e) of this section, the court shall notify the qualified mental health 3
professional who is conducting the examination of the person's: 4
1. Prior conditions or any order for community -based outpatient 5
treatment; and 6
2. Failure to comply with those conditions or treatment. 7
(c) The qualified mental health professional who conducts the examination as 8
described under paragraph (b) of this subsection, shall independently 9
evaluate the person, considering the person's prior noncompli ance, and 10
certify that he or she meets the criteria for involuntary hospitalization under 11
Section 27 of this Act. 12
(d) A person shall not be involuntarily hospitalized based solely on his or her 13
failure to comply with conditions or an order for community -based 14
outpatient treatment. 15
(4) (a) In any proceeding for involuntary hospitalization under the applicable 16
provisions of this chapter, if the criteria for involuntary hospitalization are not 17
certified by at least two (2) examining qualified mental health pro fessionals, 18
the court shall, without taking any further action, terminate the proceedings 19
and order the release of the person. 20
(b) The qualified mental health professionals shall certify to the court within 21
twenty-four (24) hours , [(]excluding weekends an d holidays ,[)] of the 22
examination, their findings and opinions as to whether the person shall be 23
involuntarily hospitalized. 24
SECTION 7. A NEW SECTION OF KRS CHAPTER 202A IS CREATED TO 25
READ AS FOLLOWS: 26
(1) If the court or ders community -based outpatient mental health treatment under 27
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this chapter, the court shall: 1
(a) Appoint an outpatient provider agency recognized by the cabinet which 2
shall assemble a multidisciplinary team; and 3
(b) Report every order for community -based outpatient treatment issued under 4
this section to the Department for Behavioral Health, Developmental and 5
Intellectual Disabilities. 6
(2) (a) The multidisciplinary team shall: 7
1. Regularly monitor the person's adherence to the conditions of the 8
order and reg ularly report this information to the court, the county 9
attorney, respondent's counsel, and any other party the court deems 10
necessary; and 11
2. Consist of three (3) mental health professionals, including any of the 12
following: 13
a. The respondent's doctor; 14
b. A nurse practitioner; 15
c. A prescriber; 16
d. A therapist; 17
e. A case manager; 18
f. A peer support specialist; or 19
g. Any other person deemed qualified by the court. 20
(b) Any responsible adult may report nonadherence to the conditions of the 21
order to the court, the county attorney, respondent's counsel, and any other 22
party the court deems necessary. 23
(3) Reports may be provided in written format, in person, or via electronic means, at 24
the court's discretion. 25
(4) The cabinet shall promulgate administrative regulations in accordance with KRS 26
Chapter 13A necessary to implement this section. 27
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SECTION 8. A NEW SECTION OF KRS CHAPTER 202A IS CREAT ED TO 1
READ AS FOLLOWS: 2
(1) A person's substantial failure to comply with a court order for community -based 3
outpatient treatment may constitute presumptive grounds for the court or an 4
authorized staff physician to order a seventy-two (72) hour emergency admission. 5
(2) (a) Failure to comply with an order for community -based outpatient treatment 6
shall not be grounds to find the person in contempt of court but shall be 7
prima facie evidence that: 8
1. The person can benefit from inpatient hospitalization; and 9
2. Inpatient hospitalization is the least restrictive mode of treatment. 10
(b) If a new petition for involuntary hospitalization is filed within twelve (12) 11
months due to failure to comply with any order for community -based 12
outpatient treatment, the court shall notify the qualified mental health 13
professional who is conducting the examination of the failure to comply. 14
(3) (a) Any person admitted to a hospital under subsection (1) of this section or 15
transferred to a hospital while ordered hospitalized under subsect ion (1) of 16
this section shall be transported from the person's home county by the 17
sheriff of that county or other peace officer as ordered by the court. 18
(b) The sheriff or other peace officer may, upon agreement of a person 19
authorized by the peace officer, authorize the cabinet, a private agency on 20
contract with the cabinet, or an ambulance service designated by the cabinet 21
to transport the person to the hospital. 22
(c) The transportation costs of the sheriff, other peace officer, ambulance 23
service, or other private agency on contract with the cabinet shall be paid by 24
the cabinet in accordance with an administrative regulation promulgated by 25
the cabinet in accordance with KRS Chapter 13A. 26
(4) (a) Any person released from the hospital under subsection (1) of th is section 27
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shall be transported to the person's county of discharge by a sheriff or other 1
peace officer, by an ambulance service designated by the cabinet, or by 2
other appropriate means of transportation which is consistent with the 3
treatment plan of that person. 4
(b) The transportation cost of transporting the patient to the patient's county of 5
discharge when performed by a peace officer, ambulance service, or other 6
private agency on contract with the cabinet shall be paid by the cabinet in 7
accordance with an administrative regulation promulgated by the cabinet in 8
accordance with KRS Chapter 13A. 9
SECTION 9. A NEW SECTION OF KRS CHAPTER 202A IS CREATED TO 10
READ AS FOLLOWS: 11
(1) (a) Upon motion of the county attorney under sub section (11)(a)2.b. of Section 12
4 of this Act, no later than seventy -two (72) hours prior to the request for 13
early release by a hospital of the period of involuntary hospitalization, the 14
hospital shall provide a copy of the discharge plan to the court, the county 15
attorney, and the respondent's counsel of record. The court, upon motion of 16
the county attorney or the court's own motion, shall conduct a review 17
hearing to determine if the discharge plan gives the respondent a realistic 18
opportunity to avoid immine nt readmittance into an inpatient psychiatric 19
hospital for treatment. 20
(b) This hearing shall only be conducted for a respondent who within the past 21
twelve (12) months has been found incompetent to stand trial in a criminal 22
proceeding and has not been committed under KRS Chapter 202C. 23
(2) The court shall verify that discharge planning procedures were completed to give 24
the respondent a realistic opportunity to avoid recurrence of substantial symptom 25
burden that would necessitate psychiatric hospitalization. T hose procedures shall 26
include but not be limited to any of the following: 27
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(a) Documenting the housing status of the respondent or that housing services 1
were offered and the respondent declined; 2
(b) Scheduling an outpatient treatment appointment for no late r than seven (7) 3
days after discharge; 4
(c) Providing or prescribing a thirty (30) day supply of medication; 5
(d) Documenting a transportation plan t hat may include securing a bus pass, 6
taxi voucher, or an acknowledgment that the respondent will walk or the 7
respondent's family will provide transportation; 8
(e) Developing and documenting a crisis plan with contact information for 9
services that are available twenty-four (24) hours a day; 10
(f) Developing a transfer of care plan or attempting to develop a transfer of 11
care plan with the respondent if the respondent has met with an outpatient 12
provider or an appointment with the outpatient provider has been 13
scheduled; or 14
(g) Contacting the respondent's family or other support systems, if the 15
respondent consents. 16
(3) For respondents with decision -making capacity who refuse housing or other 17
services under subsection (2) of this section, the discharge plan shall document: 18
(a) That housing and other services were offered and explained; 19
(b) The respondent's reasons for refusal; 20
(c) That the respondent understands the potential consequences of his or her 21
choices; 22
(d) That risk reduction strategies were offered, includin g access to crisis 23
contacts, mobile crisis services, drop -in services, and other safety -oriented 24
resources; and 25
(e) That there is a plan for periodic outreach to offer services. 26
(4) If the court finds by clear and convincing evidence that the discharge pla n does 27
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not give the respondent a realistic opportunity to avoid imminent readmittance 1
into an inpatient psychiatric hospital for treatment, then the respondent shall not 2
be discharged and the court shall order the hospital to submit within seventy -two 3
(72) hours a revised discharge plan that gives the respondent a realistic 4
opportunity to avoid imminent readmittance into an inpatient psychiatric hospital 5
for treatment. 6
(5) (a) If a respondent is not discharged under subsection (4) of this section, a 7
review hearing shall be conducted by the court within seven (7) days of the 8
hospital's submission of a revised discharge plan. 9
(b) A review hearing may be conducted in an informal manner, consistent with 10
orderly procedures, and in a physical setting not likely to have a harmful 11
effect on the mental or physical health of the respondent. The hearing may 12
be held by the court in chambers, remotely from a hospital, or in another 13
suitable place. The respondent shall be present in person or remotely for all 14
review hearin gs, unless presence is waived by the respondent through 15
counsel. 16
(c) 1. The Commonwealth shall present evidence regarding whether: 17
a. The respondent continues to meet the criteria for involuntary 18
commitment under Section 27 of this Act; and 19
b. The discharge plan gives the respondent a realistic opportunity 20
to avoid imminent readmittance into an inpatient psychiatric 21
hospital for treatment. 22
2. The respondent shall be afforded an opportunity to present evidence 23
and to cross-examine any witnesses. 24
(d) The Kentucky Rules of Evidence shall apply and proceedings shall be heard 25
by a judge without a jury. 26
(e) The respondent's right to this hearing shall not be waived. 27
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(f) 1. At the conclusion of a review hearing, the court shall make written 1
findings of fact concerning whether: 2
a. The criteria for involuntary commitment under Section 27 of this 3
Act continue to be satisfied; and 4
b. The discharge plan gives the respondent a realistic opportunity 5
to avoid imminent readmittance into an inpatient psychiatric 6
hospital for treatment. 7
2. If the court finds, by clear and convincing evidence, that the criteria 8
continue to be satisfied and that the discharge plan does not give the 9
respondent a realistic opportunity to avoid imminent readmittance into 10
an inpatient psychiatric hospital for treatment, the court shall enter an 11
order authorizing the continued care and treatment of the respondent 12
until the expiration of the order under subsection (11)(a) of Section 4 13
of this Act. 14
3. If the court does not make the finding required in subparagraph 2. of 15
this paragraph, the court shall discharge the respondent to comply 16
with the discharge plan unless the court finds that the respondent is 17
an individual with a mental illness, who presents a danger or threat of 18
danger to self, family, or others as a result of the mental illness, who 19
may reasonably benefit from court -ordered outpatient treatment or 20
release with other reasonable conditions, and for whom court -ordered 21
outpatient treatment or release with other reasonable conditions is the 22
least restrictive alternative mode of treatment available, in which case 23
the court shall discharge the respondent and may order: 24
a. For a respondent who meets the criteria for court -ordered 25
assisted outpatient treatment set forth in Section 13 of this Act: 26
i. That at a treatment plan be developed in accordance with 27
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Section 13 of this Act within forty-eight (48) hours; and 1
ii. The respondent to receive court -ordered assisted outpatient 2
treatment under KRS 202A.0811 to 202A.0831; 3
b. For any other respondent who may benefit from outpatient 4
treatment: 5
i. A qualified mental health professional to develop a 6
treatment plan within forty-eight (48) hours; 7
ii. The respondent to receive community -based outpatient 8
treatment that shall not exceed three hundred sixty (360) 9
days; and 10
iii. The respondent to comply with any other reasonable 11
condition necessary to ensure compliance; or 12
c. The respondent to be released with any reasonable conditions 13
necessary to ensure the safety o f self, family, or others and avoid 14
readmittance into a hospital setting. 15
(6) The Commonwealth, respondent, or hospital where the respondent is being 16
hospitalized may make a motion for an additional review hearing if a material 17
change in circumstances has occurred and the respondent no longer meets the 18
criteria for involuntary hospitalization under Section 27 of this Act. If the court 19
has probable cause to believe that a material change in circumstances has 20
occurred, the court shall: 21
(a) Conduct a review he aring within fourteen (14) days of the filing of the 22
motion for an additional review hearing; and 23
(b) Order the respondent to be evaluated as described under subsection (5)(b) of 24
this section. 25
(7) (a) Any respondent being hospitalized under this section sh all be transferred to 26
an inpatient psychiatric hospital owned by the Commonwealth upon request 27
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of the hospital or psychiatric facility where the respondent is being held. 1
(b) An inpatient psychiatric hospital contracted with the cabinet shall not 2
request transfer under paragraph (a) of this subsection. 3
SECTION 10. A NEW SECTION OF KRS CHAPTER 202A IS CREATED 4
TO READ AS FOLLOWS: 5
(1) By October 1 of each year beginning in 2027, the cabinet in coordination with the 6
Administrative Office of the Courts shall submit to the Legislative Research 7
Commission for referral to the Interim Joint Committee on Health Services and 8
the Interim Joint Committee on Judiciary a report that includes: 9
(a) The number of: 10
1. Petitions filed under Section 4 of this Act; 11
2. Petitions filed under Section 12 of this Act; 12
3. Court orders for seventy-two (72) hour hospital admission; 13
4. Petitions dismissed prior to a final order under Section 4 of this Act or 14
KRS 202A.0819; 15
5. Petitions that result in an order for involuntary hospitalization under 16
Section 4 of this Act and if the orders were for sixty (60) days or three 17
hundred sixty (360) days of involuntary hospitalization; 18
6. Petitions that result in an order for outpatient treatment or any other 19
reasonable conditions; 20
7. Petitions filed following a respondent's violation of court -ordered 21
outpatient treatment or other reasonable conditions; 22
8. Precertification review hearings conducted under this chapter; 23
9. Discharge hearings conducted under Section 4 of this Act; and 24
10. Review hearings conducted under Section 9 of this Act; 25
(b) The stage of a proceeding under this chapter where a: 26
1. Petition is dismissed; and 27
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2. Court has ordered a respondent to court -ordered outpatient or any 1
other reasonable conditions; 2
(c) The length of time a respondent receives treatment under this chapter prior 3
to discharge by a hospital or termination of an order to re ceive outpatient 4
treatment; and 5
(d) A summary of the services provided to a respondent who is ordered to 6
involuntary hospitalization or to receive outpatient treatment. 7
(2) Any hospital, qualified mental health professional, and any other mental health 8
agency who evaluates or treats a respondent under this chapter shall be required 9
to report data to the cabinet as required under this section. The cabinet shall 10
promulgate administrative regulations in accordance with KRS Chapter 13A to 11
implement this section. 12
(3) The cabinet and the Administrative Office of the Courts shall enter into an 13
agreement to share data necessary to prepare the report required under this 14
section. 15
(4) The report prepared under this section shall not identify specific individuals. 16
SECTION 11. A NEW SECTION OF KRS CHAPTER 202A IS CREATED 17
TO READ AS FOLLOWS: 18
(1) In any proceeding under this chapter, if the respondent agrees: 19
(a) To comply with a treatment plan; and 20
(b) That he or she meets the criteria for involuntary hospitalization under 21
Section 27 of this Act, except that outpatient treatment is the least restrictive 22
mode of treatment; and 23
upon agreement of the court, county attorney, respondent, respondent's counsel , 24
and qualified mental health professional, the court may enter a consent order for 25
the respondent to receive court -ordered assisted outpatient treatment or 26
community-based outpatient treatment and order other reasonable conditions. 27
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(2) An order entered under subsection (1) of this section shall: 1
(a) Be filed with the court and made a part of the record in the proceeding; 2
(b) Specify the terms and conditions of treatment to which the respondent has 3
agreed to; 4
(c) Specify that the respondent is subject to sa me monitoring, reporting, and 5
review requirements as any contested order to receive court -ordered assisted 6
outpatient treatment or community-based outpatient treatment; 7
(d) Remain in effect for a period not to exceed three hundred sixty (360) days, 8
subject to early termination or modification by the court. 9
(3) The failure of a respondent to comply with a consent order entered under this 10
section shall be treated in the same manner as noncompliance with a contested 11
order under this chapter. 12
Section 12. KRS 202A.0811 is amended to read as follows: 13
(1) Proceedings for court -ordered assisted outpatient treatment of a person shall be 14
initiated by the filing of a verified petition for that purpose in District Court. 15
(2) The petition and all subsequent court documents shall be entitled: "In the interest of 16
(name of respondent)." 17
(3) The petition shall be filed by a qualified mental health professional; peace officer; 18
county attorney; Commonwealth's attorney; spouse, relative, frien d, or guardian of 19
the person concerning whom the petition is filed; or any responsible adult [other 20
interested person]. 21
(4) The petition shall set forth: 22
(a) Petitioner's relationship to the respondent; 23
(b) Respondent's name, residence, and current location, if known; 24
(c) Petitioner's belief, including the factual basis therefor, that the respondent 25
meets the criteria for court-ordered assisted outpatient treatment as set forth in 26
KRS 202A.0817; and 27
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(d) Whether, within five (5) days prior to the filing of the petition, the respondent 1
has been evaluated by a qualified mental health professional to determine 2
whether the respondent meets the criteria for court -ordered assisted outpatient 3
treatment pursuant to KRS 202A.0815. 4
(5) Upon receipt of the petition, the court shall examine the petitioner under oath as to 5
the contents of the petition. If the petitioner is a qualified mental health 6
professional, the court may dispense with the examination. 7
(6) If, after revi ewing the allegations contained in the petition and examining the 8
petitioner under oath, it appears to the court that there is probable cause to believe 9
the respondent should be court -ordered to assisted outpatient treatment, the court 10
shall: 11
(a) Order the respondent to be evaluated without unnecessary delay by a qualified 12
mental health professional to determine whether the respondent meets the 13
criteria for court -ordered assisted outpatient treatment set forth in KRS 14
202A.0815, unless the court has already received the certified findings of such 15
an evaluation conducted no earlier than five (5) days prior to the filing of the 16
petition. The qualified mental health professional shall certify his or her 17
findings to the court within seventy -two (72) hours from re ceipt of the order, 18
excluding weekends and holidays; and 19
(b) Set a date for a hearing within six (6) days from the date of the filing of the 20
petition under the provisions of this section, excluding weekends and 21
holidays, to determine if the respondent shou ld be court -ordered to assisted 22
outpatient treatment. 23
(7) If the court finds there is no probable cause to believe the respondent should be 24
court-ordered to assisted outpatient treatment, the proceedings against the 25
respondent shall be dismissed. 26
Section 13. KRS 202A.0815 is amended to read as follows: 27
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A[No] person shall not be court -ordered to assisted outpatient mental health treatment 1
unless the person: 2
(1) Is diagnosed with a serious mental illness; 3
(2) Has a history of repeated nonadherence with mental health treatment, which has: 4
(a) At least twice within the last forty-eight (48) months, been a significant factor 5
in necessitating hospitalization or arrest of the person; or 6
(b) Within the last twenty -four (24) months , resulted in an act, threat, or attempt 7
at serious physical injury to self or others; 8
(3) Is unlikely to adequately adhere to outpatient treatment on a voluntary basis 9
based on a qualified mental health professional's [: 10
(a) ]clinical observation[; and 11
(b) Identification of specific characteristics of the person's clinical condition that 12
significantly impair the person's ability to make and maintain a rational and 13
informed decision as to whether to engage in outpatient treatment 14
voluntarily]; and 15
(4) Is in need of court -ordered assisted outpatient treatment as the least restrictive 16
alternative mode of treatment presently available and appropriate. 17
Section 14. KRS 202A.0819 is amended to read as follows: 18
(1) At a hearing a nd at all stages of a proceeding for court -ordered assisted outpatient 19
treatment, the respondent shall be: 20
(a) Represented by counsel; 21
(b) Accompanied by a peer support specialist or other person in a support 22
relationship, if requested by the respondent; and 23
(c) Afforded an opportunity to present evidence, call witnesses on his or her 24
behalf, and cross-examine adverse witnesses. 25
(2) If a respondent does not appear at the hearing, and appropriate attempts to elicit the 26
respondent's appearance have failed, th e court may conduct the hearing in the 27
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respondent's absence. 1
(3) A qualified mental health professional who recommends court -ordered assisted 2
outpatient treatment for the respondent shall: 3
(a) Testify at the hearing, in person or via electronic means; 4
(b) State the facts and clinical determinations which support the allegation that 5
the respondent meets the criteria stated in KRS 202A.0815; and 6
(c) Testify in support of the treatment plan provided pursuant to KRS 202A.0817, 7
and for each category of proposed evidence -based treatment, he or she shall 8
state the specific recommendation and the clinical basis for his or her belief 9
that such treatment is essential to the maintenance of the respondent's health 10
or safety. 11
(4) If after hearing all relevant evidence, the court does not find by clear and 12
convincing evidence that the respondent meets the criteria stated in KRS 13
202A.0815, the court shall deny the petition and the proceedings against the 14
respondent shall be dismissed. 15
(5) If after hearing all relevant evidence, the court finds by clear and convincing 16
evidence that the respondent meets the criteria stated in KRS 202A.0815, the court 17
may order the respondent to receive assisted outpatient treatment for a period of 18
time not to exceed three hundred sixty (360) days and to comply with any other 19
reasonable conditions necessary to ensure compliance . The court's order shall 20
incorporate a treatment plan, which shall be limited in scope to the 21
recommendations included in the treatment plan provided by the qualified mental 22
health professional pursuant to KRS 202A.0817. 23
(6) The court shall report every order for assisted outpatient treatment issued under this 24
section to the Department for Behavioral Health, De velopmental and Intellectual 25
Disabilities. 26
Section 15. KRS 202A.0823 is amended to read as follows: 27
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(1) A person's substantial failure to comply with a court order for assisted outpatient 1
treatment may constitute presump tive grounds for the court or an authorized staff 2
physician to order a seventy -two (72) hour emergency admission [ pursuant to KRS 3
202A.031]. 4
(2) (a) Upon the refusal of a person subject to a court order for assisted outpatient 5
treatment to participate in a ny or all aspects of his or her treatment plan, 6
the person's outpatient provider may establish a review committee that is 7
made up of three (3) qualified mental health professionals to examine the 8
appropriateness of the person's treatment plan. Within three (3) days of the 9
refusal, the review committee shall meet the person and his or her counsel 10
or other representative to discuss its recommendations. 11
(b) If the person still refuses to participate in any or all aspects of his or her 12
treatment plan, the perso n's outpatient provider may petition the District 13
Court for a de novo determination of the appropriateness of the proposed 14
treatment. 15
(c) Within seven (7) days, the court shall conduct a hearing, consistent with the 16
person's rights to due process of law, and shall utilize the following factors 17
in reaching its determination: 18
1. Whether the treatment is necessary to protect the person or others 19
from harm; 20
2. Whether the person is incapable of giving informed consent to the 21
proposed treatment; 22
3. Whether any less restrictive alternative treatment exists; and 23
4. Whether the proposed treatment carries any risk of permanent side 24
effects. 25
(d) Upon completion of the hearing, the court shall enter an appropriate 26
judgment. 27
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(e) A judgment entered under paragraph (d) o f this subsection may extend to 1
treatment provided during a seventy-two (72) hour emergency admission. 2
(3) (a) Failure to comply with an order for assisted outpatient treatment shall not be 3
grounds to find the person in contempt of court but shall be prima facie 4
evidence that: 5
1. The person can benefit from inpatient hospitalization; and 6
2. Inpatient hospitalization is the least restrictive mode of treatment. 7
(b) If a new petition for involuntary hospitalization is filed within twelve (12) 8
months due to fai lure to comply with any order for assisted outpatient 9
treatment, the court shall notify the qualified mental health professional 10
who is conducting the examination of the person's: 11
1. Prior order for assisted outpatient treatment; and 12
2. Failure to comply with assisted outpatient treatment. 13
(c) The qualified mental health professional who conducts the examination as 14
described under paragraph (b) of this subsection, shall independently 15
evaluate the person, considering the person's prior noncompliance, and 16
certify that he or she meets the criteria for involuntary hospitalization under 17
Section 27 of this Act. 18
(d) A person shall not be involuntarily hospitalized based solely on his or her 19
failure to comply with an order for assisted outpatient treatment. 20
(4) (a) Any person admitted to a hospital under subsection (1) of this section or 21
transferred to a hospital while ordered hospitalized under subsection (1) of 22
this section shall be transported from the person's home county by the 23
sheriff of that county or other peace officer as ordered by the court. 24
(b) The sheriff or other peace officer may, upon agreement of a person 25
authorized by the peace officer, authorize the cabinet, a private agency on 26
contract with the cabinet, or an ambulance service designated by the cabinet 27
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to transport the person to the hospital. 1
(c) The transportation costs of the sheriff, other peace officer, ambulance 2
service, or other private agency on contract with the cabinet shall be paid by 3
the cabinet in accordance with an administrative re gulation promulgated by 4
the cabinet in accordance with KRS Chapter 13A. 5
(5) (a) Any person released from the hospital under subsection (1) of this section 6
shall be transported to the person's county of discharge by a sheriff or other 7
peace officer, by an a mbulance service designated by the cabinet, or by 8
other appropriate means of transportation which is consistent with the 9
treatment plan of that person. 10
(b) The transportation cost of transporting the patient to the patient's county of 11
discharge when perfor med by a peace officer, ambulance service, or other 12
private agency on contract with the cabinet shall be paid by the cabinet in 13
accordance with an administrative regulation promulgated by the cabinet in 14
accordance with KRS Chapter 13A. 15
Section 16. KRS 202A.091 is amended to read as follows: 16
(1) The court records of a respondent made in all proceedings pursuant to this[KRS] 17
chapter [202A ]are hereby declared to be confidential and shall not be open to the 18
general public for inspection except when such disclosure is provided in KRS 19
202A.016. 20
(2) Following the discharge of a respondent from a treatment facility or the issuance of 21
a court orde r denying a petition for a commitment, a respondent may at any time 22
move to have all court records pertaining to the proceedings expunged from the 23
files of the court. The county attorney shall be given notice of the[any such] motion 24
and shall have five (5) days in which to respond to the motion[same] or request a 25
hearing on the motion[thereon]. 26
(3) (a) Any petitioner under Section 4 of this Act who qualifies as a responsible 27
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party under KRS 311.631 may motion the court to participate in court 1
proceedings and be informed by a hospital of the discharge plan prior to a 2
respondent's release under this chapter, except for any confidential 3
therapeutic communication or any other medical records. 4
(b) The court may enter a written order allowing the petitioner to par ticipate as 5
described in paragraph (a) of this subsection, unless the court finds the 6
petitioner's participation is not in the best interests of the respondent. 7
(4) Any person seeking information contained in the court files or the court records of 8
proceedings involving persons under this chapter may file a written motion in the 9
cause setting out why the information is needed. A District Judge may issue an 10
order to disclose the information sought if he or she finds the[such] order is 11
appropriate under the circumstances and if he or she finds it is in the best interest of 12
the person or of the public to have the[such] information disclosed. 13
Section 17. KRS 202A.101 is amended to read as follows: 14
(1) The court which orders an y person to the receiving hospital or psychiatric facility, 15
under the provisions of this chapter [,] shall immediately[at once] notify the 16
receiving hospital or psychiatric facility that the[such] order has been made, 17
advising of the sex and condition of the person. 18
(2) After the facility has been [so ] notified, the court shall order the sheriff of the 19
county or other peace officer to transport the patient within forty -eight (48) hours , 20
[(]excluding weekends and holidays ,[)] from the county in which the pers on is 21
located to the hospital or psychiatric facility designated by the cabinet. The sheriff 22
or other peace officer may, upon agreement of a person authorized by the peace 23
officer, authorize the cabinet, a private agency on contract with the cabinet, or an 24
ambulance service designated by the cabinet to transport the person to the hospital. 25
(3) The transportation costs of transporting a person to a hospital or psychiatric facility, 26
when performed by a peace officer, an ambulance service, or other private age ncy 27
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on contract with the cabinet shall be paid by the cabinet in accordance with 1
administrative regulation promulgated by the cabinet under the provisions of KRS 2
Chapter 13A. 3
(4) In returning any patient to the county from which the patient is sent, the 4
transportation cost of the sheriff or other peace officer, the ambulance service, or 5
the other agency on contract with the cabinet transporting the patient shall be paid 6
as provided in KRS 202A.028(5)[(4)], when necessary. 7
(5) Whenever an individual is invol untarily hospitalized by a court order the patient 8
shall be transported to the hospital designated by the cabinet and accompanied by 9
the following documents: 10
(a) A copy of the petition for involuntary hospitalization, unless hospitalization 11
takes place pursuant to KRS 202A.041 or Section 8 or 15 of this Act; 12
(b) The certificate of qualified mental health professionals, if any; and 13
(c) The order of involuntary hospitalization. 14
(6) The hospital may refuse to receive any person who has been ordered to be 15
involuntarily hospitalized by a court order if the papers presented with the[such] 16
person at the hospital do not comply with the provisions of this chapter or if it does 17
not receive notification of the order of involuntary hospitalization as required by 18
this chapter. 19
Section 18. KRS 202A.171 is amended to read as follows: 20
Except as provided otherwise in this chapter, an authorized staff physician of a hospital 21
shall discharge an involuntary patient when he no longer meets the criteria for 22
involuntary hospitalization. 23
Section 19. KRS 202C.010 is amended to read as follows: 24
As used in this chapter, unless the context otherwise requires: 25
(1) "Cabinet" means the [Kentucky ]Cabinet for Health and Family Services; 26
(2) "Commitment hearing" means the hearing under KRS 202C.040 to determine if a 27
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respondent meets the criteria for involuntary commitment under this chapter; 1
(3) "Danger" means substantial physical harm or threat of substantial physical harm 2
upon self or others; 3
(4) "Evidentiary hearing" means the hearing under KRS 202C.030 to determine if the 4
respondent is responsible for [defendant committed] the qualifying offense for 5
which he or she was charged by a preponderance of the evidence; 6
(5) "Forensic psychiatric facility" means a mental institution or facility, or part thereof, 7
designated by the secretary for the purpose and function of providing inpatient 8
evaluation, care, and treatment for [mentally ill persons or ] individuals with an 9
intellectual disability or mental illness who have been charged with or convicted of 10
a felony; 11
(6) "Hospital" means: 12
(a) A state mental hospital or institution or other licensed public or private 13
hospital, institution, health -care facility, or part thereof, approved by the 14
cabinet[Kentucky Cabinet for Health and Family Services] as equipped to 15
provide full -time residential care and treatment for [mentally ill persons or 16
]individuals with an intellectual disability or mental illness; or 17
(b) A hospital, institution, or health -care facility of the government of the United 18
States equipped to provide residential care and treatment for [mentally ill 19
persons or ]individuals with an intellectual disability or mental illness; 20
(7) "Individual with a mental illness" means a person with substantial ly impaired 21
capacity to use self-control, judgment, or discretion in the conduct of the person's 22
affairs and social relations, associated with maladaptive behavior or recognized 23
emotional symptoms where impaired capacity, maladaptive behavior, or 24
emotional symptoms can be related to physiological, psychological, or social 25
factors; 26
(8) "Individual with an intellectual disability" means a person with significantly 27
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subaverage general intellectual functioning existing concurrently with deficits in 1
adaptive behavior and manifested during the developmental period; 2
(9)[(8)] "Judge" means the judge who found the respondent incompetent to stand trial 3
in the criminal proceeding from which the petition for involuntary commitment 4
arose; 5
(10)[(9)] "Less restrictive alter native mode of treatment" means a treatment given 6
outside of a forensic psychiatric facility which would provide a respondent with 7
appropriate treatment or care consistent with accepted professional practice 8
standards and protect the respondent's safety and the safety of others;[ 9
(10) "Mentally ill person" means a person with substantially impaired capacity to use 10
self-control, judgment, or discretion in the conduct of the person's affairs and social 11
relations, associated with maladaptive behavior or recogn ized emotional symptoms 12
where impaired capacity, maladaptive behavior, or emotional symptoms can be 13
related to physiological, psychological, or social factors;] 14
(11) "Qualified mental health professional" means: 15
(a) A physician licensed under the laws of K entucky to practice medicine or 16
osteopathy, or a medical officer of the government of the United States while 17
engaged in the performance of official duties; 18
(b) A psychiatrist licensed under the laws of Kentucky to practice medicine or 19
osteopathy, or a med ical officer of the government of the United States while 20
engaged in the practice of official duties, who is certified or eligible to apply 21
for certification by the American Board of Psychiatry and Neurology, Inc.; 22
(c) A psychologist with the health servic e provider designation, a psychological 23
practitioner, a certified psychologist, or a psychological associate, licensed 24
under the provisions of KRS Chapter 319; 25
(d) A licensed registered nurse with a master's degree in psychiatric nursing from 26
an accredited institution and two (2) years of clinical experience with 27
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individuals with a mental illness [mentally ill persons] , or a licensed 1
registered nurse, with a bachelor's degree in nursing from an accredited 2
institution, who is certified as a psychiatric and me ntal health nurse by the 3
American Nurses Association and who has three (3) years of inpatient or 4
outpatient clinical experience in psychiatric nursing and is currently employed 5
by a hospital or forensic psychiatric facility licensed by the Commonwealth or 6
a psychiatric unit of a general hospital or a private agency or company 7
engaged in the provision of mental health services or a regional community 8
program for mental health and individuals with an intellectual disability; 9
(e) A licensed clinical social wor ker licensed under the provisions of KRS 10
335.100, or a certified social worker licensed under the provisions of KRS 11
335.080 with three (3) years of inpatient or outpatient clinical experience in 12
psychiatric social work and currently employed by a hospital or forensic 13
psychiatric facility licensed by the Commonwealth or a psychiatric unit of a 14
general hospital or a private agency or company engaged in the provision of 15
mental health services or a regional community program for mental health and 16
individuals with an intellectual disability; 17
(f) A marriage and family therapist licensed under the provisions of KRS 18
335.300 to 335.399 with three (3) years of inpatient or outpatient clinical 19
experience in psychiatric mental health practice and currently employed by a 20
hospital or forensic facility licensed by the Commonwealth, a psychiatric unit 21
of a general hospital, a private agency or company engaged in providing 22
mental health services, or a regional community program for mental health 23
and individuals with an intellectual disability; 24
(g) A professional counselor credentialed under the provisions of KRS Chapter 25
335.500 to 335.599 with three (3) years of inpatient or outpatient clinical 26
experience in psychiatric mental health practice and currently employed by a 27
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hospital or forensic facility licensed by the Commonwealth, a psychiatric unit 1
of a general hospital, a private agency or company engaged in providing 2
mental health services, or a regional community program for mental health 3
and individuals with an intellectual disability; or 4
(h) A physician assistant licensed under KRS 311.840 to 311.862, who meets one 5
(1) of the following requirements: 6
1. Provides documentation that he or she has completed a psychiatric 7
residency program for physician assistants; 8
2. Has completed at least one thousand (1,000) hours of clinical experience 9
under a supervising physician, as defined by KRS 311.840, who is a 10
psychiatrist and is certified or eligible for certification by the American 11
Board of Psychiatry and Neurology, Inc.; 12
3. Holds a master's degree from a physician assistant program accredited 13
by the Accreditation Review Commission on Education for the 14
Physician Assistant or its predecessor or successor agencies, is 15
practicing under a supervising physician as defined by KRS 311.840, 16
and: 17
a. Has two (2) years of clinical experience in the assessment, 18
evaluation, and treatment of mental disorders; or 19
b. Has been employed by a hospital or forensic psychiatric facility 20
licensed by the Commonwealth or a psychiatric unit of a general 21
hospital or a private agency or company engaged in the provision 22
of mental health services or a regional community program for 23
mental health and individuals with an intellectual disability for at 24
least two (2) years; or 25
4. Holds a bachelor's degree, possesses a current physician assistant 26
certificate issued by the board prior to July 15, 2002, is practicing under 27
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a supervising physician as defined by KRS 311.840, and: 1
a. Has three (3) years of clinical experience in the asse ssment, 2
evaluation, and treatment of mental disorders; or 3
b. Has been employed by a hospital or forensic psychiatric facility 4
licensed by the Commonwealth or a psychiatric unit of a general 5
hospital or a private agency or company engaged in the provision 6
of mental health services or a regional community program for 7
mental health and individuals with an intellectual disability for at 8
least three (3) years; 9
(12) "Qualifying offense" means a capital offense, a Class A felony, a Class B felony 10
resulting in deat h or serious physical injury, or a violation of KRS 510.040 or 11
510.070; 12
(13) "Respondent" means a person who was a criminal defendant found incompetent to 13
stand trial who is or was the subject of a petition for involuntary commitment filed 14
under KRS Chapter 504; 15
(14) "Review hearing" means any hearing conducted to determine if a respondent 16
continues to meet the criteria for involuntary commitment after the initial order for 17
involuntary commitment has been issued under this chapter; and 18
(15) "Secretary" means the secretary of the Cabinet for Health and Family Services. 19
Section 20. KRS 202C.020 is amended to read as follows: 20
(1) When a defendant who is charged with a qualifying offense has been found, after a 21
hearing under KRS Chapter 504, to be incompetent to stand trial with no substantial 22
probability that the defendant will attain competency within three hundred sixty 23
(360) days, the Commonwealth's attorney's office serving the county of criminal 24
prosecution shall immediat ely petition the Circuit Court that found the defendant 25
incompetent to stand trial or, if the finding was by a District Court, the Circuit 26
Court in the county of the criminal prosecution, for an involuntary commitment 27
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proceeding, to include an evidentiary hearing and a commitment hearing, if 1
applicable, under this chapter. 2
(2) (a) Upon the filing of the petition, the court shall assign a guardian ad litem to 3
represent the [needs and ] best interest of the respondent , independent of the 4
respondent's defense attorney. 5
(b) The guardian ad litem shall: 6
1. Be a full and active participant in all proceedings other than the 7
evidentiary hearing under KRS 202C.030 . At the evidentiary hearing, 8
the guardian ad litem's role shall be limited to assisting the respondent 9
with decision-making related to the hearing, including but not limited 10
to whether to waive the hearing, whether to stipulate to the allegations, 11
and whether to testify. The guardian ad litem shall not act as an 12
attorney advocate at the evidentiary hearing;[ and shall] 13
2. Independently investigate, assess, and advocate for the 14
respondent's[defendant's] best interest;[. The guardian ad litem is] 15
3. Not be a replacement for the respondent's defense attorney; and 16
4. Be paid an hourly rate not to exceed the maximum hourly rate 17
provided in the Legal Services Duties and Maximum Rate Schedule 18
promulgated by the Government Contract Review Committee 19
established pursuant to KRS 45A.705, to be paid by the Finance and 20
Administration Cabinet. 21
(c) If the respondent[defendant] has retained or been appointed a defense 22
attorney in the criminal case, that attorney may continue to represent the 23
respondent[defendant] in proceedings under this chapter. If, at any time 24
during the penden cy of proceedings under this chapter, the 25
respondent[defendant] is not represented by an attorney, the court shall 26
appoint counsel for the respondent[defendant], without a showing of 27
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indigency, to be provided by the Department of Public Advocacy or its 1
designee. 2
(3) The Circuit Court shall have exclusive jurisdiction over all proceedings under this 3
chapter. 4
(4) The Circuit Court in the county of the criminal prosecution shall retain 5
jurisdiction over all proceedings under this chapter until the respondent i s 6
discharged. 7
Section 21. KRS 202C.030 is amended to read as follows: 8
(1) An adversarial evidentiary hearing on the record shall be held within forty-five 9
(45)[twenty (20)] days, excluding weekends and holidays, of the f iling of a petition 10
pursuant to KRS 202C.020, unless the court orders a later hearing for good cause 11
shown. Appropriate notice shall be served on all parties. The court shall order the 12
Commonwealth to provide all available discovery to the respondent no la ter than 13
seven (7) days, excluding weekends and holidays, before the hearing , unless the 14
court orders a later date for good cause shown . [No ]Evidence that has not been 15
disclosed through discovery shall not [may] be presented at the hearing [ that has 16
not been disclosed through discovery]. 17
(2) The respondent may stipulate to potential responsibility[guilt] and waive the 18
hearing. A stipulation of potential responsibility shall not [guilt cannot] be used 19
against the respondent in any future criminal prosecution or civil litigation. 20
(3) (a) The purpose of the evidentiary hearing shall be to determine whether 21
sufficient evidence exists to support a finding that the respondent is 22
responsible for[guilty of] the charged crime against him or her. 23
(b) The Commonwealth's attorney's office serving the county of criminal 24
prosecution shall have the burden of proving the sufficiency of the evidence 25
by a preponderance of the evidence. 26
(4) The evidentiary hearing shall be held before a judge without a jury. The rules of 27
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evidence shall apply. The respondent shall be permitted to present evidence and 1
cross examine witnesses. The respondent may present evidence of affirmative 2
defenses that could be raised at a criminal trial on the charged crime , except for the 3
defense of insanity. The Commonwealth shall not have the burden of disproving an 4
affirmative defense. The respondent must prove an affirmative defense by a 5
preponderance of the evidence. 6
(5) (a) If the court determines that sufficient evidence has been presented to support a 7
finding that the respondent is responsible for [guilty of] the charged crime 8
against him or her, the court shall immediately schedule a commitment 9
hearing under this chapter to be held within forty-five (45)[twenty (20)] days, 10
unless the court orders a later hearing for good cause shown , excluding 11
weekends and holidays. 12
(b) 1. The court shall cause the respondent to be examined without 13
unnecessary delay by two (2) qualified mental health professionals, at 14
least one (1) of whom is a physician. The qualified mental health 15
professionals shall, no fewer than [within] seven (7) days, excluding 16
weekends and holidays, prior to the hearing, certify to the court their 17
findings as to whether the respondent meets the criteria for involuntarily 18
commitment under KRS 202C.050. 19
2. A copy of the findings submitted under subparagraph 1. of this 20
paragraph shall be sent to the Commonwealth, the respondent's 21
attorney of record, the respondent's guardian ad litem, and all other 22
parties of record. 23
(6) If the court determines that insufficient evidence has been presented to support a 24
finding that the res pondent is responsible for[guilty of] the charged crime against 25
him or her, the court shall order the immediate release of the respondent. 26
(7) Any[No] evidence or statement submitted by the respondent at the evidentiary 27
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hearing shall not be admissible in any criminal prosecution or civil litigation. 1
Section 22. KRS 202C.040 is amended to read as follows: 2
(1) A commitment hearing shall be held within forty-five (45) [twenty (20)] days, 3
unless the court orders a later hearing for good cause shown, excluding weekends 4
and holidays, after the court finds that the evidence presented in an evidentiary 5
hearing pursuant to KRS 202C.030 supports a finding that the respondent is 6
responsible for[guilty of] the charged crime against him or her by a preponderance 7
of the evidence. 8
(2) The commitment hearing may be conducted in an informal manner, consistent with 9
orderly procedures, and in a physical setting not likely to have a harmful effect on 10
the mental or physical health of the respond ent. The hearing may be held by the 11
court in chambers, at a forensic psychiatric facility, or other suitable place. 12
(3) (a) The Commonwealth's attorney's office serving the county of criminal 13
prosecution which led to the finding that the respondent was inc ompetent to 14
stand trial shall present evidence regarding whether the respondent meets the 15
criteria for involuntary commitment under KRS 202C.050. 16
(b) The respondent [and the respondent's guardian ad litem ] shall be afforded an 17
opportunity to testify, and t he respondent's counsel shall conduct the 18
hearing on the respondent's behalf to present evidence [,] and to cross -19
examine any witnesses. 20
(c) The respondent's guardian ad litem shall participate in the proceeding in a 21
best-interest, friend -of-the-court capac ity and may submit independent 22
recommendations to the court or jury, if a jury has been requested, 23
regarding the respondent's best interest. 24
(4) The manner of proceeding and the rules of evidence shall be the same as those in 25
any criminal proceeding. The s tandard of proof shall be proof beyond a reasonable 26
doubt. Proceedings shall be heard by the judge unless a party or the guardian ad 27
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litem requests a jury. 1
(5) The respondent's right to the commitment hearing shall not be waived. 2
Section 23. KRS 202C.050 is amended to read as follows: 3
(1) A[No] respondent shall not be involuntarily committed under this chapter unless 4
there is a determination that: 5
(a) The respondent presents , or would present if released, a danger to self or 6
others as a result of his or her mental condition; and 7
(b) [The respondent needs care, training, or treatment in order to mitigate or 8
prevent substantial physical harm to self or others; 9
(c) The respondent has a demonstrated history or recent manifestation of criminal 10
behavior that has endangered or caused injury to others or has a substantial 11
history of involuntary hospitalizations under KRS Chapter 202A or 202B 12
prior to the commission of the charged crime; or 13
(d) ]A presently availabl e less restrictive alternative mode of treatment would 14
endanger the safety of the respondent or others. 15
(2) When a respondent is involuntarily committed under this chapter, the cabinet shall 16
place that respondent in a forensic psychiatric facility designated by the secretary. 17
Section 24. KRS 202C.060 is amended to read as follows: 18
(1) (a) A review hearing to determine if a respondent involuntarily committed under 19
this chapter should remain in a forensic psychiatric facili ty shall be conducted 20
by the court that issued the initial order in accordance with [according to the 21
provisions of] subsection (2) of this section; and 22
(b) If at any point during the respondent's placement at a forensic psychiatric 23
facility it appears tha t the respondent no longer meets the criteria for 24
involuntary commitment under KRS 202C.050 because there has been a 25
material change in circumstances or there is new evidence to present, the 26
respondent or the respondent's guardian ad litem may request a review hearing 27
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pursuant to this section. 1
(2) The schedule for review hearings shall be as follows: 2
(a) From the initial order of commitment, a [standard ] review hearing shall be 3
conducted no earlier[not sooner] than ninety (90) days and no[not] later than 4
one hundred twenty (120) days; and 5
(b) After the review hearing under paragraph (a) of this subsection, review 6
hearings shall be conducted not less than once every two (2) years unless a 7
review hearing has been requested under subsection (1)(b) of this 8
section[For the first two (2) years after the initial order of commitment, 9
standard review hearings shall be conducted not less than one hundred eighty 10
(180) days and not more than two hundred ten (210) days from the most 11
recent review; 12
(c) Beginning two (2) years after the initial order of commit ment, a standard 13
review hearing shall be conducted not more than three hundred sixty -five 14
(365) days from the most recent review hearing; and 15
(d) A heightened review hearing shall be conducted not more than five (5) years 16
from the initial order of commitme nt and, thereafter, not more than five (5) 17
years from the most recent heightened review hearing]. 18
(3) (a) Prior to each [standard ]review hearing, the court shall cause the respondent to 19
be examined without unnecessary delay by two (2) qualified mental hea lth 20
professionals, at least one (1) of whom is a physician. The qualified mental 21
health professionals shall, no fewer than [within] seven (7) days prior to the 22
hearing, excluding weekends and holidays, certify to the court their findings 23
as to whether the r espondent meets the criteria for involuntarily commitment 24
under KRS 202C.050. 25
(b) 1. In addition to the examinations required under paragraph (a) of this 26
subsection, the respondent shall undergo evaluations of competency at 27
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least once every two (2) years t o be conducted at a forensic psychiatric 1
facility. 2
2. Upon a finding by the forensic psychiatric facility that the 3
respondent's competency has been restored, the forensic psychiatric 4
facility shall provide written notice of restoration to the court, the 5
Commonwealth, the respondent's attorney of record, the respondent's 6
guardian ad litem, and all other parties of record within ten (10) days 7
of the determination of restoration. 8
3. Upon receipt of the notice of restoration of the respondent's 9
competency, a st atus conference shall be held within thirty (30) days, 10
unless the court orders a later hearing for good cause shown. 11
(4) A [standard ]review hearing may be conducted in an informal manner, consistent 12
with orderly procedures, and in a physical setting not likely to have a harmful effect 13
on the mental or physical health of the respondent. The hearing may be held by the 14
court in chambers, [or ] remotely from a forensic psychiatric facility, or in 15
another[other] suitable place. The respondent shall be present in person or remotely 16
for all review hearings, unless presence is waived by the respondent through 17
counsel. 18
(5) (a) The Commonwealth's attorney's office serving the county of criminal 19
prosecution which led to finding that the respondent was incompetent to st and 20
trial shall present evidence regarding whether the respondent [ remains 21
incompetent to stand trial and] continues to meet the criteria for involuntary 22
commitment under KRS 202C.050. 23
(b) The respondent , through counsel, [and the respondent's guardian ad litem 24
]shall be afforded an opportunity to present evidence, and to cross -examine 25
any witnesses. 26
(c) The respondent's guardian ad litem shall be permitted to participate in the 27
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review hearing in a best -interest, friend -of-the-court capacity and may 1
submit independent recommendations to the court regarding the 2
respondent's best interest. 3
(6) The manner of proceeding and the rules of evidence shall be the same as those in 4
any criminal proceeding. The standard of proof shall be proof beyond a reasonable 5
doubt. Proceedings shall be heard by a judge without a jury [, except that a 6
respondent shall be entitled to a jury upon request if the respondent has not had a 7
review hearing with a jury during the preceding twelve (12) months]. 8
(7) The respondent's right to this hearing shall not be waived. 9
(8) At the conclusion of a [standard ] review hearing, the court shall make written 10
findings of fact concerning whether the criteria for involuntary commitment under 11
KRS 202C.050 continue to be satisfied based upon proof beyon d a reasonable 12
doubt. If the court finds that the criteria continue to be satisfied, the court shall enter 13
an order authorizing the continued care and treatment of the respondent at the 14
forensic psychiatric facility. Otherwise, the court shall enter an ord er requiring the 15
respondent to be discharged.[ 16
(9) During a heightened review hearing, the procedures of a standard review hearing 17
shall apply. Additionally, the qualified mental health professionals who evaluated 18
the respondent in preparation for the hearing shall be required to give live testimony 19
and answer questions before the court. The respondent shall be physically present in 20
the courtroom for the hearing. If the respondent is unable to attend for any reason, 21
the hearing shall be rescheduled to a tim e, place, and manner in which the 22
respondent is able to attend.] 23
Section 25. KRS 202C.130 is amended to read as follows: 24
(1) Forensic psychiatric facilities ordered to receive an involuntarily committed 25
respondent shall have standing to petition the Circuit Court for any necessary 26
clarification or modification of orders or judgments entered in proceedings under 27
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this chapter and to appeal from final judgments or orders entered in proceedings 1
which have not complied with the provisions of this chapter. 2
(2) A copy of any motions filed under subsection (1) of this section shall be sent to 3
the involuntarily committed respondent, the r espondent's guardian ad litem, [and 4
]the respondent's attorney of record, the Commonwealth, and all other parties of 5
record[ of whatever pleadings are filed by the hospital]. 6
Section 26. KRS 202A.014 is amended to read as follows: 7
All proceedings for the involuntary hospitalization of individuals with a mental 8
illness[mentally ill persons] shall be initiated in the District Court of the county where the 9
person to be hospitalized resides or in which he may be at the time o f the filing of a 10
petition. 11
Section 27. KRS 202A.026 is amended to read as follows: 12
A[No] person shall not be involuntarily hospitalized unless the[such] person is an 13
individual with a mental illness[a mentally ill person]: 14
(1) Who presents a danger or threat of danger to self, family or others as a result of the 15
mental illness; 16
(2) Who can reasonably benefit from treatment; and 17
(3) For whom hospitalization is th e least restrictive alternative mode of treatment 18
presently available. 19
Section 28. KRS 202A.231 is amended to read as follows: 20
(1) Upon receipt of a certificate of the United States Public Health Service or [such 21
]other agency of the United States government that facilities are available for the 22
care or treatment of any person [heretofore ]hospitalized in any mental hospital or 23
other institution in this state for the care of individuals with a mental 24
illness[mentally ill persons] and that such person is eligible for such care or 25
treatment, the secretary, upon recommendation by any such hospital or institution in 26
this state, is [hereby ] authorized to cause the transfer of any such person to the 27
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United States Public Health S ervice or other agency of the United States 1
government for care or treatment. Upon effecting any such transfer, the 2
hospitalizing court shall be notified [thereof ]by the secretary. 3
(2) Any person transferred as provided in this section shall be deemed to be placed in 4
the custody of the United States Public Health Service or other agency of the United 5
States government pursuant to the original hospitalization the same as if he or she 6
had been originally so hospitalized. 7
(3) A[No] person shall not be transferred to any agency of the United States if he or 8
she be confined pursuant to conviction of any felony or misdemeanor or if he or 9
she has been acquitted of the charge solely on the ground of mental illness unless 10
prior to transfer the court issui ng the confining order shall enter an order to transfer 11
after the motion and hearing. Any person transferred as provided in this section to 12
any agency of the United States shall be hospitalized by such agency pursuant to the 13
original order of hospitalization. 14
Section 29. KRS 202A.261 is amended to read as follows: 15
No public or private hospital, other than a state -operated or contracted mental hospital or 16
institution, shall be required to provide services under KRS 202A.00 8, 202A.011, 17
202A.028, 202A.041, 202A.051, 202A.071, [202A.081, ] 202A.0811 to 202A.0831, 18
202A.101, 202A.141, 202A.241, 202A.251, 202A.261, 202A.271, 202B.170, 202B.200, 19
387.540, 504.085, 600.020, 645.020, 645.120, and 645.280 unless the hospital agrees to 20
provide the services. Any hospital shall make every reasonable attempt to cooperate with 21
the implementation of KRS 202A.008, 202A.011, 202A.028, 202A.041, 202A.051, 22
202A.071, [202A.081, ] 202A.101, 202A.141, 202A.241, 202A.251, 202A.261, 23
202A.271, 202B.170, 202B.200, 387.540, 504.085, 600.020, 645.020, 645.120, and 24
645.280. 25
Section 30. KRS 202A.271 is amended to read as follows: 26
Each public or private hospital, other than a state -operated or contracted mental hospital 27
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or i nstitution, which provides services under KRS 202A.008, 202A.011, 202A.028, 1
202A.041, 202A.051, 202A.071, [202A.081, ] 202A.0811 to 202A.0831, 202A.101, 2
202A.141, 202A.241, 202A.251, 202A.261, 202A.271, 202B.170, 202B.200, 387.540, 3
504.085, 600.020, 645.020 , 645.120, and 645.280 shall be paid for the services at the 4
same rates the hospital negotiates with the Department for Behavioral Health, 5
Developmental and Intellectual Disabilities or the regional community program for 6
mental health and for individuals with an intellectual disability. 7
Section 31. KRS 387.540 is amended to read as follows: 8
(1) (a) Prior to a hearing on a petition for a determination of partial disability or 9
disability and the appointment of a limited gua rdian, guardian, limited 10
conservator, or conservator, an interdisciplinary evaluation report shall be 11
filed with the court. The report may be filed as a single and joint report of the 12
interdisciplinary evaluation team, or it may otherwise be constituted by the 13
separate reports filed by each individual of the team. 14
(b) If the court and all parties to the proceeding and their attorneys agree to the 15
admissibility of the report or reports, the report or reports shall be admitted 16
into evidence and shall be consi dered by the court or the jury if one is 17
impaneled. 18
(c) The report shall be compiled by at least three (3) individuals, including: 19
1. A physician, an advanced practice registered nurse, or a physician 20
assistant; 21
2. A psychologist licensed or certified unde r the provisions of KRS 22
Chapter 319; and 23
3. A person licensed or certified as a social worker or an employee of the 24
Cabinet for Health and Family Services who has at least one (1) year of 25
investigative experience and has completed training in conducting 26
decisional capacity assessments. The social worker shall, when possible, 27
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be chosen from among employees of the Cabinet for Health and Family 1
Services residing or working in the area, and there shall be no additional 2
compensation for their service on the interdisciplinary evaluation team. 3
(2) At least one (1) person participating in the compilation of the report shall have 4
knowledge of the particular disability which the respondent is alleged to have or 5
knowledge of the skills required of the respondent to care for himself and his estate. 6
(3) If the respondent is alleged to be partially disabled or disabled due to mental illness, 7
at least one (1) person participating in the compilation of the interdisciplinary 8
evaluation report shall be a qualified mental healt h professional as defined in KRS 9
202A.011[(13)]. If the respondent is alleged to be partially disabled or disabled due 10
to an intellectual disability, at least one (1) person participating in the compilation 11
of the evaluation report shall be a qualified pro fessional in the area of intellectual 12
disabilities as defined in KRS 202B.010(12). 13
(4) The interdisciplinary evaluation report shall contain: 14
(a) A description of the nature and extent of the respondent's disabilities, if any; 15
(b) Current evaluations of th e respondent's social, intellectual, physical, and 16
educational condition, adaptive behavior, and social skills. Such evaluations 17
may be based on prior evaluations not more than three (3) months old, except 18
that evaluations of the respondent's intellectual condition may be based on 19
individual intelligence test scores not more than one (1) year old; 20
(c) An opinion as to whether guardianship or conservatorship is needed, the type 21
of guardianship or conservatorship needed, if any, and the reasons therefor; 22
(d) An opinion as to the length of time guardianship or conservatorship will be 23
needed by the respondent, if at all, and the reasons therefor; 24
(e) If limited guardianship or conservatorship is recommended, a further 25
recommendation as to the scope of the guardi anship or conservatorship, 26
specifying particularly the rights to be limited and the corresponding powers 27
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and duties of the limited guardian or limited conservator; 1
(f) A description of the social, educational, medical, and rehabilitative services 2
currently being utilized by the respondent, if any; 3
(g) A determination whether alternatives to guardianship or conservatorship are 4
available; 5
(h) A recommendation as to the most appropriate treatment or rehabilitation plan 6
and living arrangement for the respondent and the reasons therefor; 7
(i) A listing of all medications the respondent is receiving, the dosage, and a 8
description of the impact of th e medication upon the respondent's mental and 9
physical condition and behavior; 10
(j) An opinion whether attending a hearing on a petition filed under KRS 11
387.530 would subject the respondent to serious risk of harm; 12
(k) The names and addresses of all individ uals who examined or interviewed the 13
respondent or otherwise participated in the evaluation; and 14
(l) Any dissenting opinions or other comments by the evaluators. 15
(5) The evaluation report may be compiled by a community center for mental health or 16
individuals with an intellectual disability, a licensed facility for mentally ill or 17
developmentally disabled persons, if the respondent is a resident of such facility, or 18
a similar agency. 19
(6) In all cases where the respondent is a resident of a licensed facility for mentally ill 20
or developmentally disabled persons and the petition is filed by an employee of that 21
facility, the petition shall be accompanied by an interdisciplinary evaluation report 22
prepared by the facility. 23
(7) Except as provided in subsection (6) o f this section, the court shall order 24
appropriate evaluations to be performed by qualified persons or a qualified agency. 25
The report shall be prepared and filed with the court and copies mailed to the 26
attorneys for both parties at least ten (10) days prior to the hearing. All items 27
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specified in subsection (4) of this section shall be included in the report. 1
(8) If the person evaluated is a poor person as defined in KRS 453.190, the examiners 2
shall be paid by the county in which the petition is filed upon an order of allowance 3
entered by the court. Payment shall be in an amount which is reasonable as 4
determined by the court, except no payment shall be required of the county for an 5
evaluation performed by a salaried employee of a state agency for an evaluation 6
performed within the course of his employment. Additionally, no payment shall be 7
required of the county for an evaluation performed by a salaried employee of a 8
community center for mental health or individuals with an intellectual disability or 9
private facility or agency where the costs incurred by the center, facility, or agency 10
are reimbursable through third-party payors. Affidavits or other competent evidence 11
shall be admissible to prove the services rendered but not to prove their value. 12
(9) The respondent may file a response to the evaluation report no later than five (5) 13
days prior to the hearing. 14
(10) The respondent may secure an independent evaluation. If the respondent is unable 15
to pay for the evaluation, compensation for the independent evaluation may be paid 16
by the county in an amount which is reasonable as determined by the court. 17
Section 32. KRS 625.090 is amended to read as follows: 18
(1) The Circuit Court may involuntarily terminate all parental rights of a pa rent of a 19
named child, if the Circuit Court finds from the record by clear and convincing 20
evidence that: 21
(a) 1. The child has been adjudged to be an abused or neglected child, as 22
defined in KRS 600.020[(1)], by a court of competent jurisdiction; 23
2. The child is found to be an abused or neglected child, as defined in KRS 24
600.020[(1)], by the Circuit Court in this proceeding; 25
3. The child is found to have been diagnosed with neonatal abstinence 26
syndrome at the time of birth, unless his or her birth mother: 27
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a. Was prescribed and properly using medication for a legitimate 1
medical condition as directed by a health care practitioner that may 2
have led to the neonatal abstinence syndrome; 3
b. Is currently, or within ninety (90) days after the birth, enrolled in 4
and m aintaining substantial compliance with both a substance 5
abuse treatment or recovery program and a regimen of prenatal 6
care or postnatal care as recommended by her health care 7
practitioner throughout the remaining term of her pregnancy or the 8
appropriate time after her pregnancy; or 9
c. In the absence of a prescription for the treatment of a legitimate 10
medical condition, agrees, prior to discharge from the hospital, to 11
participate in a court -ordered assessment by a drug treatment 12
provider and the assigning of a certified peer support specialist for 13
referral to appropriate treatment, and agrees to participate in 14
treatment which shall commence within ninety (90) days after the 15
birth; or 16
4. The parent has been convicted of a criminal charge relating to the 17
physical or sexual abuse or neglect of any child and that physical or 18
sexual abuse, neglect, or emotional injury to the child named in the 19
present termination action is likely to occur if the parental rights are not 20
terminated; 21
(b) 1. The Cabinet for Health and Family Services has filed a petition with the 22
court pursuant to KRS 620.180 or 625.050; or 23
2. A child -placing agency licensed by the cabinet, any county or 24
Commonwealth's attorney, or a parent has filed a petition with the court 25
under KRS 625.050; and 26
(c) Termination would be in the best interest of the child. 27
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(2) A[No] termination of parental rights shall not be ordered unless the Circuit Court 1
also finds by clear and convincing evidence the existence of one (1) or more of the 2
following grounds: 3
(a) That the parent has abandoned the child for a period of not less than ninety 4
(90) days; 5
(b) That the parent has inflicted or allowed to be inflicted upon the child, by other 6
than accidental means, serious physical injury; 7
(c) That the parent has continuous ly or repeatedly inflicted or allowed to be 8
inflicted upon the child, by other than accidental means, physical injury or 9
emotional harm; 10
(d) That the parent has been convicted of a felony that involved the infliction of 11
serious physical injury to any child; 12
(e) That the parent, for a period of not less than six (6) months, has continuously 13
or repeatedly failed or refused to provide or has been substantially incapable 14
of providing essential parental care and protection for the child and that there 15
is no reas onable expectation of improvement in parental care and protection, 16
considering the age of the child; 17
(f) That the parent has caused or allowed the child to be sexually abused or 18
exploited; 19
(g) That the parent, for reasons other than poverty alone, has cont inuously or 20
repeatedly failed to provide or is incapable of providing essential food, 21
clothing, shelter, medical care, or education reasonably necessary and 22
available for the child's well -being and that there is no reasonable expectation 23
of significant imp rovement in the parent's conduct in the immediately 24
foreseeable future, considering the age of the child; 25
(h) That: 26
1. The parent's parental rights to another child have been involuntarily 27
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terminated; 1
2. The child named in the present termination action wa s born subsequent 2
to or during the pendency of the previous termination; and 3
3. The conditions or factors which were the basis for the previous 4
termination finding have not been corrected; 5
(i) That the parent has been convicted in a criminal proceeding of having caused 6
or contributed to the death of another child as a result of physical or sexual 7
abuse or neglect; 8
(j) That the child has been in foster care under the responsibility of the cabinet 9
for fifteen (15) cumulative months out of forty -eight (48) mon ths preceding 10
the filing of the petition to terminate parental rights; or 11
(k) That the child has been removed from the biological or legal parents more 12
than two (2) times in a twenty -four (24) month period by the cabinet or a 13
court. 14
(3) In determining the best interest of the child and the existence of a ground for 15
termination, the Circuit Court shall consider the following factors: 16
(a) Mental illness as defined by KRS 202A.011 [(9)], or an intellectual disability 17
as defined by KRS 202B.010(9) of the parent as certified by a qualified 18
mental health professional, or a disability as defined in KRS 199.011, if the 19
mental illness, intellectual disability, or disability renders the parent 20
consistently unable to care for the immediate and ongoing physical or 21
psychological needs of the child for extended periods of time; 22
(b) Acts of abuse or neglect as defined in KRS 600.020 [(1)] toward any child in 23
the family; 24
(c) If the child has been placed with the cabinet, whether the cabinet has, prior to 25
the filing of the petition: 26
1. Made reasonable efforts as defined in KRS 620.020 to reunite the child 27
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with the parents unless one or more of the circumstances enumerated in 1
KRS 610.127 for not requiring reasonable efforts have been 2
substantiated in a written finding by the District Court; or 3
2. Provided a parent with a disability as defined in KRS 199.011 with 4
targeted adaptive and supportive services based on an individual 5
assessment of the parent, or has received a written acknowledgement 6
from the parent knowingly and affirmat ively rejecting the offered 7
services; 8
(d) The efforts and adjustments the parent has made in his or her circumstances, 9
conduct, or conditions to make it in the child's best interest to return the child 10
to his or her home within a reasonable period of time, considering the age of 11
the child; 12
(e) The physical, emotional, and mental health of the child and the prospects for 13
the improvement of the child's welfare if termination is ordered; and 14
(f) The payment or the failure to pay a reasonable portion of substit ute physical 15
care and maintenance if financially able to do so. 16
(4) If the child has been placed with the cabinet, the parent may present testimony 17
concerning the reunification, adaptive or supportive services offered by the cabinet, 18
and whether additional services would be likely to bring about lasting parental 19
adjustment enabling a return of the child to the parent. 20
(5) If the parent proves by a preponderance of the evidence that the child will not 21
continue to be an abused or neglected child as defined in KRS 600.020 [(1)] if 22
returned to the parent, or if the parent proves by a preponderance of the evidence 23
that appropriate and specifically targeted adaptive or supportive services based 24
upon an individual assessment of the parent have not been offered or pr ovided to 25
the parent, the court in its discretion may determine not to terminate parental rights. 26
(6) Upon the conclusion of proof and argument of counsel, the Circuit Court shall enter 27
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findings of fact, conclusions of law, and a decision as to each parent -respondent 1
within thirty (30) days either: 2
(a) Terminating the right of the parent; or 3
(b) Dismissing the petition and stating whether the child shall be returned to the 4
parent or shall remain in the custody of the state. 5
Section 33. The following KRS section is repealed: 6
202A.081 Court-ordered community-based outpatient treatment. 7
Section 34. By November 1, 2026, the Cabinet for Health and Family Services 8
shall provide a repor t to the Legislative Research Commission for referral to the Interim 9
Joint Committee on Health Services and the Interim Joint Committee on Judiciary 10
describing the existing services, treatments, and supports for mental illness and serious 11
mental illness av ailable to persons who are subject to proceedings under KRS Chapter 12
202A and 202C and making recommendations for ways to strengthen, increase, and 13
broaden these services, treatments, and supports as appropriate. The descriptions shall 14
include type of provi ders, eligibility criteria, accessibility, and geographical locations of 15
the services, treatments, and supports. 16
Section 35. The Cabinet for Health and Family Services and Department for 17
Behavioral Health, Developmental and Intellectual Disabilities shall engage the services 18
of the Treatment Advocacy Center to develop and implement a statewide training 19
program to facilitate implementation of this Act and ensure consistent application of this 20
Act across state and local agencies. 21
Section 36. This Act takes effect October 1, 2026. 22