Involuntary commitment-appointment of gatekeepers.

2017
STATE OF WYOMING
17LSO-0583
Introduced
1.2

HOUSE BILL

NO.

HB0184

Involuntary commitment-appointment of gatekeepers.

Sponsored by:
Representative(s) Connolly, Furphy and Haley and Senator(s) Moniz

A BILL

for

AN ACT relating to involuntary commitment; amending provisions related to the designation of gatekeepers; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S.
25
‑
10
‑
101(a)(xvi), 25
‑
10
‑
109(e), (f) and (h), 25
‑
10
‑
110(d)(intro) and (vii), (h), (j)(i)(E) and (n), 25
‑
10
‑
110.1(c
) and (f),
25
‑
10
‑
112(g)
, 25
‑
10
‑
127(a)(intro) and (iii) and 25
‑
10
‑
128 are
amended to read:

25
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10
‑
101
.

Definitions
.

(a)

As used in this act:

(xvi)

"Gatekeeper" means the single point of responsibility which may be designated
by the department
pursuant to W.S. 25
‑
10
‑
112(
g);

25
‑
10
‑
109
.

Emergency detention
.

(e)

The law enforcement officer or examiner who initially detained the person shall make a written statement of the facts of the emergency detention. A copy of the statement shall be given to the detained person, to any gatekeeper
designated by the department
and to any subsequent examiner.

(f)

When a person is detained under emergency circumstances, treatment may be given during the emergency detention period if the person voluntarily and knowingly consents. The parent or guardian of a minor or incompetent person may consent to treatment. If the parent or guardian of a minor patient does not consent to treatment, a
petition may be filed under the Child Protection Act. Treatment may be given without the consent of the detained person or his parent or guardian when treatment is limited to diagnosis or evaluation or when treatment is necessary to prevent immediate and serious physical harm to the person or others. Prior to treatment, the person shall be fully advised of the scope of treatment, and a report of the treatment shall be provided to any gatekeeper
designated by the department
and filed with the court if directed outpatient commitment or involuntary hospitalization proceedings are commenced. An examiner or a physician who provides treatment in good faith pursuant to this subsection shall be immune from civil liability for the treatment except there shall be no immunity from liability for negligent acts or deliberate misconduct.

(h)

When a person is detained in emergency detention and an application for directed outpatient commitment or involuntary hospitalization is filed by the county attorney, the court shall appoint an attorney to represent the detained person unless he has his own attorney, and the court shall conduct a hearing within seventy
‑
two (72)
hours, excluding Saturdays, Sundays and legal holidays, of the initial detention to determine whether continued detention is required pending directed outpatient commitment or involuntary hospitalization proceedings. The county attorney of the county where the application is filed shall appear on behalf of the state at the hearing. Any gatekeeper designated
by the department
pursuant to W.S. 25
‑
10
‑
112(
g) shall appear at the hearing and provide testimony concerning continued detention and, if applicable, the issues outlined in subsection (m) of this section. Notice of the preliminary hearing shall be given to the county attorney, any gatekeeper
,

designated by the department,
the detained person and his attorney. The court may delay the hearing only at the request of the detained person or his parent, guardian or his attorney. An emergency detention hearing may be waived at the request of the detained person or the detained person's attorney. If an emergency detention hearing has been waived, the court may immediately conduct the directed outpatient commitment or involuntary hospitalization hearing.

25
‑
10
‑
110
.

Involuntary hospitalization proceedings
.

(d)

Upon receipt of an application, the court shall issue notice thereof to the proposed patient, the person responsible for the care or custody of the proposed patient, any gatekeeper
designated by the department
and other persons designated by the court. The notice shall be served as provided by the Wyoming Rules of Civil Procedure. The notice shall apprise the proposed patient:

(vii)

Of the identity of any gatekeeper designated
by the department
pursuant to W.S. 25
‑
10
‑
112(
g).

(h)

The proposed patient, the applicant, and all others to whom notice is required may appear at the hearing to testify and may present witnesses. The court shall consider the testimony of any gatekeeper
designated by the department
and may receive the testimony of other persons. The proposed patient shall be present at the hearing unless he waives his right to appear. All persons not necessary to protect the rights of the parties shall be excluded from the hearing. The hearing shall be conducted in as informal a manner as is consistent with orderly procedure and in a
physical setting which will not have a harmful effect on the mental health of the proposed patient. Any hearing conducted under this subsection shall be recorded by the court reporter or by electronic, mechanical or other appropriate means.

(j)

If, upon completion of the hearing and consideration of the record, the court or the jury finds by clear and convincing evidence that the proposed patient is mentally ill the court shall consider the least restrictive and most therapeutic alternatives, give consideration to any recommendations by the gatekeeper and shall:

(i)

Order his hospitalization, assign him to a hospital, and:

(E)

Make findings as to his competence to make informed choices regarding treatment and his need for prescribed psychotropic medication. If the court finds the person incompetent to make an informed decision, the court may order the administration of prescribed psychotropic medication. The order for medication shall be reviewed by
a physician upon commitment and by a psychiatrist upon admission to the hospital. The prescribed medication shall be continued if found medically appropriate by the investigation review committee of the hospital or institution, subject to review by the medical director of the hospital or institution. Any action by the medical director of the hospital or institution shall be reviewable pursuant to the Wyoming Administrative Procedure Act. All orders for prescribed medication or a summary of all orders shall be provided to the gatekeeper designated
by the departmen
t
under W.S. 25
‑
10
‑
112(
g).

(n)

The court shall inquire into the medical condition of every patient found to be mentally ill. If the court determines based upon the advice of a physician or other qualified professional, and in consultation with any gatekeeper designated
by the department
pursuant to W.S. 25
‑
10
‑
112(g), that the patient's present primary need is for medical treatment or care and whose need for psychiatric care is secondary, the court may delay ordering directed outpatient commitment or involuntary hospitalization of the patient until such time as the
patient receives medical care and the patient's need for psychiatric care is primary.

25
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10
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110.1
.

Directed outpatient commitment proceedings.

(c)

The terms and conditions of the treatment plan shall be established by an examiner in consultation with any gatekeeper
designated by the department
and approved by the court. In preparing the plan, the examiner shall consult with the county attorney, treating health care providers and the patient or the person responsible for the care and custody of the patient, if known.

(f)

The treatment center or treatment provider or any other person identified in the treatment plan shall report to the county attorney and any gatekeeper
designated by the department
any material noncompliance by the patient with the treatment plan.

25
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10
‑
112
.

Liability for costs of detention, involuntary hospitalization and proceedings therefor.

(g)

The department in consultation wit
h
E
ach
board of county commissioners may establish a single point of responsibility or gatekeeper. Gatekeeper duties shall include, but are not limited to, providing guidance on issues of detention and involuntary treatment and monitoring and coordinating timely, efficient and effective patient treatment prior to, during and after any emergency detention or involuntary treatment under this act. No gatekeeper designated under this subsection shall provide inpatient psychiatric treatment to patients under this act, unless the gatekeeper has been approved by the department of health to provide these services.

25
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10
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127
.

Convalescent status; discharge; readmittance
.

(a)

After providing notice to the court, the county attorney who initiated involuntary hospitalization procedures, any gatekeeper
designated by the department
and all interested parties, the hospital may release an
improved patient on convalescent leave subject to the following:

(iii)

Release on convalescent leave shall include a plan of treatment on an outpatient or nonhospital basis and other provisions for continuing responsibility of the patient by the hospital. Prior to the end of one (1) year on convalescent leave, and not less than annually thereafter, the hospital shall reexamine the facts relating to the hospitalization of the patient on convalescent leave and if the hospital determines hospitalization is no longer anticipated, the hospital shall discharge the patient and make a report of discharge to the court, to any gatekeeper
designated by the department
and to the county attorney who initiated procedures for the involuntary hospitalization.

25
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10
‑
128
.

Access to patient information
.

Any disclosure of patient information required by this article shall be subject to limitations imposed by state and federal law. The department shall promulgate rules facilitating the exchange of information required by this
article to the maximum extent allowed by state and federal law. At the discretion of the court considering a matter under this article, the court may order the disclosure of information required by this article. The court also may designate and direct the actions of a gatekeeper otherwise designated
by the department
under W.S. 25
‑
10
‑
112(
g) for the purpose of allowing the gatekeeper access to patient information.

Section
2
.

This
act is effective July 1,
201
7
.

(END)

1
HB0184