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EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
[PERFECTED]
SENATE SUBSTITUTE FOR
SENATE COMMITTEE SUBSTITUTE FOR
SENATE BILL NO. 1015
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR NURRENBERN.
4051S.03P KRISTINA MARTIN, Secretary
AN ACT
To repeal section 632.305, RSMo, and to enact in lieu thereof nine new sections relating to court-
ordered mental health treatment.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 632.305, RSMo, is repealed and nine 1
new sections enacted in lieu thereof, to be known as sections 2
632.305, 632.580, 632.585, 632.590, 632.593, 632.595, 632.600, 3
632.605, and 632.610, to read as follows:4
632.305. 1. An application for detention for 1
evaluation and treatment at a mental health facility may be 2
executed by any adult person, who need not be an attorney or 3
represented by an attorney, on a form provided by the court 4
for such purpose, and shall allege under oath[, without a 5
notarization requirement,] that the applicant has reason to 6
believe that the respondent is suffering from a mental 7
disorder and presents a likelihood of serious harm to 8
himself or herself or to others. The application shall 9
specify the factual information on which such belief is 10
based and should contain the names and addresses of all 11
persons known to the applicant who have knowledge of such 12
facts through personal observation. 13
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2. The filing of a written application in court by any 14
adult person, who need not be an attorney or represented by 15
an attorney, shall authorize the applicant to bring the 16
matter before the court on an ex parte basis to determine 17
whether the respondent should be taken into custody and 18
transported to a mental health facility. The application 19
may be filed in the court having probate jurisdiction in any 20
county where the respondent may be found. If the court 21
finds that there is probable cause, either upon testimony 22
under oath or upon a review of affidavits, declarations, or 23
other supporting documentation, to believe that the 24
respondent may be suffering from a mental disorder and 25
presents a likelihood of serious harm to himself or herself 26
or others, it shall direct a peace officer to take the 27
respondent into custody and transport him or her to a mental 28
health facility for detention for evaluation and treatment 29
for a period not to exceed ninety-six hours unless further 30
detention and treatment is authorized pursuant to this 31
chapter. Nothing herein shall be construed to prohibit the 32
court, in the exercise of its discretion, from giving the 33
respondent an opportunity to be heard. 34
3. A peace officer may take a person into custody for 35
detention for evaluation and treatment at a mental health 36
facility for a period not to exceed ninety-six hours only 37
when such peace officer has reasonable cause to believe that 38
such person is suffering from a mental disorder and that the 39
likelihood of serious harm by such person to himself or 40
herself or others is imminent unless such person is 41
immediately taken into custody. Upon arrival at the mental 42
health facility, the peace officer who conveyed such person 43
or caused him or her to be conveyed shall either present the 44
application for detention for evaluation and treatment upon 45
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which the court has issued a finding of probable cause and 46
the respondent was taken into custody or complete an 47
application for initial detention for evaluation and 48
treatment for a period not to exceed ninety-six hours which 49
shall be based upon his or her own personal observations or 50
investigations and shall contain the information required in 51
subsection 1 of this section. 52
4. If a person presents himself or herself or is 53
presented by others to a mental health facility and a 54
licensed physician, a registered professional nurse or a 55
mental health professional designated by the head of the 56
facility and approved by the department for such purpose has 57
reasonable cause to believe that the person is mentally 58
disordered and presents an imminent likelihood of serious 59
harm to himself or herself or others unless he or she is 60
accepted for detention, the licensed physician, the mental 61
health professional or the registered professional nurse 62
designated by the facility and approved by the department 63
may complete an application for detention for evaluation and 64
treatment for a period not to exceed ninety-six hours. The 65
application shall be based on his or her own personal 66
observations or investigation and shall contain the 67
information required in subsection 1 of this section. 68
5. (1) No notarization shall be required for an 69
application, or for any affidavits, declarations, or other 70
documents supporting an application, completed or executed, 71
by: 72
(a) A peace officer under subsection 3 of this section; 73
(b) A licensed physician, mental health professional, 74
or registered professional nurse under subsection 4 of this 75
section; or 76
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(c) An employee acting on behalf of a hospital, as 77
defined in section 197.020, under subsections 1 and 2 of 78
this section. 79
(2) The application and any affidavits, declarations, 80
or other documents supporting the application shall be 81
subject to the provisions of section 492.060 allowing for 82
declaration under penalty of perjury. 83
632.580. The definitions set forth in section 632.005 1
shall apply to sections 632.580 to 632.610. In addition, as 2
used in sections 632.580 to 632.610, unless the context 3
clearly requires otherwise, the following terms mean: 4
(1) "Assisted outpatient treatment", court-ordered 5
involuntary outpatient mental health care services that are 6
provided by a mental health program under a treatment plan 7
developed and monitored by a master's level mental health 8
professional. Such services may include, but are not 9
limited to: 10
(a) Case management; 11
(b) Medication management; 12
(c) Therapy or counseling; 13
(d) Substance use treatment, if applicable; 14
(e) Crisis intervention services; and 15
(f) Assistance with housing, employment, or other 16
community resources necessary for an individual's stability; 17
(2) "Case manager", a mental health professional 18
employed by a certified community mental health center who 19
is assigned to a respondent to oversee the respondent's 20
compliance with the outpatient treatment plan ordered by the 21
court under sections 632.580 to 632.610; 22
(3) "Community mental health center", the same meaning 23
given to the term in section 205.975; 24
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(4) "Comprehensive mental health services", the same 25
meaning given to the term in section 205.975; 26
(5) "Local public health agency", a county health 27
center board established under chapter 205, a county health 28
department, a combined city and county health department or 29
agency, a multicounty health department or agency, or any 30
other county health authority; 31
(6) "Petition", a petition for assisted outpatient 32
treatment filed under section 632.585 or for continued 33
assisted outpatient treatment filed under section 632.600; 34
(7) "Respondent", a person who is alleged in a 35
petition to meet the criteria for assisted outpatient 36
treatment in section 632.590; 37
(8) "Service area", the same meaning given to the term 38
in section 205.975. 39
632.585. 1. A petition for an order authorizing 1
assisted outpatient treatment may be filed by: 2
(1) The director, administrator, or treating physician 3
of a mental health program in which the respondent is 4
hospitalized; 5
(2) The director, administrator, or treating physician 6
of an emergency receiving center in which the respondent is 7
receiving services; 8
(3) A licensed physician, a registered professional 9
nurse designated by the community mental health center and 10
approved by the department of mental health, or a mental 11
health professional from whom the respondent is receiving 12
services; 13
(4) The appointed guardian or limited guardian of a 14
ward who is the respondent; or 15
(5) The department of health and senior services, the 16
department of mental health, or any local public health 17
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agency located within the probate jurisdiction in which the 18
petition is filed. 19
2. The petition may be filed in the court having 20
probate jurisdiction in which the respondent is present or 21
reasonably believed to be present or in the probate 22
jurisdiction in which the respondent resides. 23
3. The petition shall allege under oath, without a 24
notarization requirement, that the petitioner has reason to 25
believe that the respondent meets the criteria for assisted 26
outpatient treatment in section 632.590. The petition shall 27
specify factual information on which such belief is based 28
and shall contain the names and addresses of all persons 29
known to the petitioner who have knowledge of such facts 30
through personal observation. 31
4. No notarization shall be required for a petition or 32
for any affidavits, declarations, or other documents 33
supporting a petition. The petition and any affidavits, 34
declarations, or other documents supporting the petition 35
shall be subject to the provisions of section 492.060 36
allowing for declaration under penalty of perjury. 37
5. The prosecuting attorney of the county in which a 38
hearing on a petition takes place shall represent the 39
petitioner and file and prosecute in court all petitions. 40
Such duty shall be fulfilled by the county counselor in 41
counties having a county counselor and by the circuit 42
attorney in any city not within a county. 43
632.590. Following receipt of a petition and 1
completion of the procedures required in section 632.593, a 2
court may issue an order requiring a respondent to 3
participate in assisted outpatient treatment if: 4
(1) The respondent: 5
(a) Is eighteen years of age or older; 6
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(b) Is suffering from a mental illness; 7
(c) Will not obtain treatment in the community 8
voluntarily; and 9
(d) Is unable to make an informed decision to seek or 10
to comply with voluntary treatment; and 11
(2) Either: 12
(a) Because of the respondent's fulfillment of the 13
criteria of subdivision (1) of this section, the respondent 14
requires treatment to prevent a deterioration in the 15
respondent's mental illness that would be likely to result 16
in serious harm to the respondent or others as described in 17
section 632.305; or 18
(b) The respondent has a history of a lack of 19
compliance with treatment for the respondent's mental 20
illness, and within the thirty-six months immediately 21
preceding the date of the filing of the petition such lack 22
of compliance has either: 23
a. At least twice, been a significant factor in 24
necessitating a civil detention period for treatment 25
instituted under sections 632.120 or 632.305 or receipt of 26
services in a forensic or other mental health unit of any 27
state or local correctional facility, not including any 28
period during which the respondent was hospitalized or 29
incarcerated immediately preceding the date of the filing of 30
the petition; or 31
b. Resulted in one or more acts of violent behavior 32
with the intention of causing serious physical injury toward 33
self or others or threats of, or attempts of, serious 34
physical harm to self or others, not including any period 35
during which the respondent was hospitalized or incarcerated 36
immediately preceding the date of the filing of the petition. 37
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632.593. 1. At the time of filing the petition, the 1
court clerk shall set a date and time for the hearing, which 2
shall take place within two judicial days of the filing of 3
the petition. An attorney shall be appointed to represent 4
the respondent as required under section 632.450 from the 5
register of attorneys described in section 632.415. An 6
attorney so appointed shall be entitled to attorney's fees 7
to the same extent as allowed under section 632.415. The 8
clerk shall promptly notify the respondent, the respondent's 9
attorney, the petitioner, and the petitioner's attorney of 10
the date and time for the hearing. The court shall not 11
grant continuances except upon a showing of good and 12
sufficient cause. 13
2. The hearing shall be conducted in as informal a 14
manner as may be consistent with orderly procedure and in a 15
physical setting not likely to have a harmful effect on the 16
respondent. The respondent shall have the following rights 17
in addition to those specified elsewhere: 18
(1) To be represented by an attorney; 19
(2) To present evidence on his or her own behalf; 20
(3) To cross-examine witnesses who testify against him 21
or her; 22
(4) To remain silent; 23
(5) To view and copy all petitions and reports in the 24
court file of his or her case; 25
(6) To have the hearing open or closed to the public 26
as he or she elects; 27
(7) To be proceeded against according to the rules of 28
evidence applicable to civil judicial proceedings; and 29
(8) To have the hearing before a jury if requested by 30
the respondent or his or her attorney. 31
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3. The respondent shall be present at the hearing 32
unless the respondent's physical condition is such that he 33
or she cannot be present in the courtroom or if the court 34
determines that the respondent's conduct in the courtroom is 35
so disruptive that the proceedings cannot reasonably 36
continue. 37
4. The burden of proof at the hearing shall be by 38
clear and convincing evidence and shall be upon the 39
petitioner. 40
5. If the matter is tried before a jury, the jury 41
shall determine and shall be instructed only upon the issue 42
of whether the respondent meets the criteria for assisted 43
outpatient treatment in section 632.590. The remaining 44
procedures for the jury trial shall be as in other civil 45
matters. 46
6. The respondent shall not be required to file an 47
answer or other responsive pleading. 48
7. At the conclusion of the hearing, if the court or 49
jury finds, based upon clear and convincing evidence, that 50
the respondent meets the criteria for assisted outpatient 51
treatment in section 632.590, and the court finds that a 52
mental health program appropriate to handle the respondent's 53
condition has agreed to accept the respondent, the court 54
shall issue an order requiring the respondent to participate 55
in assisted outpatient treatment with the mental health 56
program for a period not to exceed two years. 57
8. At the conclusion of the hearing, if the court or 58
jury does not find by clear and convincing evidence that the 59
respondent meets the criteria for assisted outpatient 60
treatment in section 632.590, the court shall dismiss the 61
petition. 62
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9. An order requiring the respondent to participate in 63
assisted outpatient treatment based on satisfaction of the 64
provisions of subparagraph a. of paragraph (b) of 65
subdivision (2) of section 632.590 shall not be issued 66
unless the court has considered, or the jury has been 67
instructed to consider, at least the following factors: 68
(1) The respondent's ability to access finances in 69
order to obtain food or medicine; 70
(2) The respondent's ability to obtain treatment for 71
the respondent's medical condition; 72
(3) The respondent's ability to access necessary 73
resources in the community without assistance; 74
(4) The degree to which there are risks to the 75
respondent's safety; 76
(5) The likelihood that the respondent will 77
decompensate without immediate care or treatment; 78
(6) The respondent's previous attempts to inflict 79
physical injury on self or others; 80
(7) The respondent's history of behavioral health 81
treatment in the community; 82
(8) The respondent's patterns of decompensation in the 83
past; 84
(9) The respondent's risk of being victimized or 85
harmed by others; and 86
(10) The respondent's access to the means to inflict 87
harm on self or others. 88
10. Nothing in this section shall prevent the court or 89
jury from considering any other factor not described in this 90
section. 91
11. If requested by the respondent, the court shall 92
appoint an available licensed physician or licensed 93
psychologist to examine the respondent and testify at the 94
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respondent's request. If the respondent or the respondent's 95
attorney so requests, the court shall not appoint a licensed 96
physician or licensed psychologist who is an employee of any 97
entity in which the respondent is hospitalized or receiving 98
services or who is an employee of any entity that filed the 99
petition. The appointment procedures in section 632.420 100
shall apply to any appointment under this subsection. 101
12. The physician-patient privilege recognized by 102
section 491.060 and the psychologist-patient privilege 103
recognized by section 337.055 shall be deemed waived in 104
proceedings under sections 632.580 to 632.610. The fact 105
that such privileges have been waived in accordance with 106
this section shall not by itself waive the privileges in any 107
other proceeding, civil or criminal. The waiver of the 108
privileges shall extend only to that evidence that is 109
directly material and relevant to the proceedings under 110
sections 632.580 to 632.610. 111
13. Appeals from court orders under this section may 112
be made as described in section 632.430. 113
14. Assisted outpatient treatment shall not be deemed 114
outpatient detention for purposes of this chapter, and no 115
provision of this chapter relating to the requirements for 116
inpatient or outpatient detention proceedings shall apply to 117
assisted outpatient treatment under sections 632.580 to 118
632.610 unless such provision has been specifically 119
incorporated into sections 632.580 to 632.610 by reference 120
or otherwise. 121
15. The provisions of section 632.440 shall apply to 122
assisted outpatient treatment under sections 632.580 to 123
632.610. 124
632.595. 1. The court shall assign a case manager 1
from a certified community behavioral health clinic to each 2
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respondent ordered to participate in assisted outpatient 3
treatment. 4
2. The case manager and the respondent shall report to 5
the court at least once every ninety days. The court may, 6
at its discretion, request more frequent appearances. The 7
case manager shall immediately report to the court a 8
substantial failure of the respondent or the mental health 9
program providing the assisted outpatient treatment to 10
comply with the conditions of the assisted outpatient 11
treatment. 12
632.600. 1. The court order for assisted outpatient 1
treatment shall expire at the end of the period specified in 2
the order unless a petition for an extension has been 3
filed. If any person or entity authorized to file a 4
petition under section 632.585 determines that a respondent 5
requires further involuntary assisted outpatient treatment, 6
the person or entity shall file a petition for continued 7
assisted outpatient treatment before the expiration of the 8
involuntary assisted outpatient treatment ordered by the 9
court. 10
2. The procedure for obtaining an extension shall be 11
the same as for obtaining the original order, except that 12
the thirty-six-month time period provided in paragraph (b) 13
of subdivision (2) of section 632.590 shall not be 14
applicable in determining the appropriateness of an 15
extension. 16
632.605. 1. During the period of an order for 1
assisted outpatient treatment, if the mental health program 2
or mental health professional who is providing the 3
respondent's assisted outpatient treatment determines that 4
the respondent is not complying with the court order, the 5
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mental health program or mental health professional shall 6
notify the court immediately. 7
2. If it comes to the attention of the court that a 8
respondent subject to an order of assisted outpatient 9
treatment is not complying with the order, the court may 10
require one or more of the following, without a hearing: 11
(1) That the respondent be taken for evaluation to a 12
community mental health center providing comprehensive 13
mental health services to individuals residing in the 14
service area in which the respondent resides; 15
(2) That the respondent be hospitalized in a 16
psychiatric hospital for a period of not more than ten days; 17
and 18
(3) Upon recommendation by the community mental health 19
center providing comprehensive mental health services to 20
individuals residing in the service area in which the 21
respondent resides, that the individual be hospitalized for 22
a period of more than ten days, but not longer than the 23
duration of the order for assisted outpatient treatment, or 24
not longer than ninety days, whichever is less. 25
3. The court may direct peace officers to transport 26
the respondent to a designated facility or a community 27
mental health center, as applicable, and the court may 28
specify conditions under which the respondent may return to 29
assisted outpatient treatment before the order expires. 30
Reimbursement for transportation costs shall be allowed as 31
provided under section 632.312. 32
4. A respondent hospitalized without a hearing as 33
provided in subsection 2 of this section may object to the 34
hospitalization. Upon transfer of the respondent to the 35
hospital, the hospital shall notify the respondent of his or 36
her right to object under this section. Upon receipt of an 37
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objection to the hospitalization, the court shall schedule a 38
hearing for a determination that the individual requires 39
hospitalization. The respondent shall have all rights 40
specified in section 632.593 at the hearing. The court 41
shall order the respondent discharged from hospitalization 42
unless the court or jury finds, based upon clear and 43
convincing evidence, that the respondent requires 44
hospitalization as a result of the respondent's failure to 45
comply with the order for assisted outpatient treatment. 46
632.610. Beginning December 1, 2028, the office of 1
state courts administrator shall submit an annual report to 2
the general assembly summarizing: 3
(1) The number of individuals subject to orders for 4
assisted outpatient treatment; 5
(2) Statistics on compliance and noncompliance rates 6
with assisted outpatient treatment; and 7
(3) Any impact that assisted outpatient treatment has 8
on hospitalization and incarceration rates. 9
✓