MISSISSIPPI LEGISLATURE

2015 Regular Session

To: Public Health and Human Services; Judiciary A

By: Representatives Barker, Holland, White

House Bill 693

AN ACT TO AMEND SECTIONS 41-21-67, 41-21-69, 41-21-71, 41-21-77, 41-21-79, 41-21-103 AND 41-30-27, MISSISSIPPI CODE OF 1972, TO EXPAND THE TYPES OF PROFESSIONALS WHO ARE AUTHORIZED TO CONDUCT SCREENINGS, EXAMINATIONS AND EVALUATIONS IN COMMITMENT PROCEEDINGS TO INCLUDE LICENSED CLINICAL SOCIAL WORKERS, LICENSED MARRIAGE AND FAMILY THERAPISTS AND LICENSED PROFESSIONAL COUNSELORS; TO BRING FORWARD SECTION 41-31-5, MISSISSIPPI CODE OF 1972, FOR THE PURPOSES OF POSSIBLE AMENDMENT; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  Section 41-21-67, Mississippi Code of 1972, is amended as follows:

     41-21-67.  (1)  Whenever the affidavit provided for in Section 41-21-65 is filed with the chancery clerk, the clerk, upon direction of the chancellor of the court, shall issue a writ directed to the sheriff of the proper county to take into custody the person alleged to be in need of treatment and to bring the person before the clerk or chancellor, who shall order pre-evaluation screening and treatment by the appropriate community mental health center established under Section 41-19-31.  The community mental health center will be designated as the first point of entry for screening and treatment.  If the community mental health center is unavailable, any reputable licensed physician, psychologist, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor as allowed in the discretion of the court, may conduct the pre-evaluation screening and examination as set forth in Section 41-21-69.  The order may provide where the person shall be held before the appearance before the clerk or chancellor.  However, when the affidavit fails to set forth factual allegations and witnesses sufficient to support the need for treatment, the chancellor shall refuse to direct issuance of the writ.  Reapplication may be made to the chancellor.  If a pauper's affidavit is filed by a guardian for commitment of the ward of the guardian, the court shall determine if the ward is a pauper and if the ward is determined to be a pauper, the county of the residence of the respondent shall bear the costs of commitment, unless funds for those purposes are made available by the state.

     In any county in which a Crisis Intervention Team has been established under the provisions of Sections 41-21-131 through 41-21-143, the clerk, upon the direction of the chancellor, may require that the person be referred to the Crisis Intervention Team for appropriate psychiatric or other medical services before the issuance of the writ.

     (2)  Upon issuance of the writ, the chancellor shall immediately appoint and summon two (2) reputable, licensed physicians, or either one (1) reputable, licensed physician or one (1) reputable, licensed nurse practitioner and * * *either one (1) psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor to conduct a physical and mental examination of the person at a place to be designated by the clerk or chancellor and to report their findings to the clerk or chancellor.  However, any nurse practitioner or physician assistant conducting the examination shall be independent from, and not under the supervision of, the other physician conducting the examination.  In all counties in which there is a county health officer, the county health officer, if available, may be one (1) of the physicians so appointed.  Neither of the physicians nor the psychologist, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor selected shall be related to that person in any way, nor have any direct or indirect interest in the estate of that person nor shall any full-time staff of residential treatment facilities operated directly by the State Department of Mental Health serve as examiner.

     (3)  The clerk shall ascertain whether the respondent is represented by an attorney, and if it is determined that the respondent does not have an attorney, the clerk shall immediately notify the chancellor of that fact.  If the chancellor determines that the respondent for any reason does not have the services of an attorney, the chancellor shall immediately appoint an attorney for the respondent at the time the examiners are appointed.

     (4)  If the chancellor determines that there is probable cause to believe that the respondent is mentally ill and that there is no reasonable alternative to detention, the chancellor may order that the respondent be retained as an emergency patient at any licensed medical facility for evaluation by a physician, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor and that a peace officer transport the respondent to the specified facility.  If the community mental health center serving the county has partnered with Crisis Intervention Teams under the provisions of Sections 41-21-131 through 41-21-143, the order may specify that the licensed medical facility be a designated single point of entry within the county or within an adjacent county served by the community mental health center.  If the person evaluating the respondent finds that the respondent is mentally ill and in need of treatment, the chancellor may order that the respondent be retained at the licensed medical facility or any other available suitable location as the court may so designate pending an admission hearing.  If necessary, the chancellor may order a peace officer or other person to transport the respondent to that facility or suitable location.  Any respondent so retained may be given such treatment as is indicated by standard medical practice.  However, the respondent shall not be held in a hospital operated directly by the State Department of Mental Health, and shall not be held in jail unless the court finds that there is no reasonable alternative.

     (5)  (a)  Whenever a licensed psychologist, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor who is certified to complete examinations for the purpose of commitment or a licensed physician has reason to believe that a person poses an immediate substantial likelihood of physical harm to himself or others or is gravely disabled and unable to care for himself by virtue of mental illness, as defined in Section 41-21-61(e), then the physician, psychologist, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor may hold the person or may admit the person to and treat the person in a licensed medical facility, without a civil order or warrant for a period not to exceed seventy-two (72) hours.  However, if the seventy-two-hour period begins or ends when the chancery clerk's office is closed, or within three (3) hours of closing, and the chancery clerk's office will be continuously closed for a time that exceeds seventy-two (72) hours, then the seventy-two-hour period is extended until the end of the next business day that the chancery clerk's office is open.  The person may be held and treated as an emergency patient at any licensed medical facility, available regional mental health facility, or crisis intervention center.  The physician or psychologist, nurse practitioner * * *or, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor who holds the person shall certify in writing the reasons for the need for holding.

     If a person is being held and treated in a licensed medical facility, and that person decides to continue treatment by voluntarily signing consent for admission and treatment, the seventy-two-hour hold may be discontinued without filing an affidavit for commitment.  Any respondent so held may be given such treatment as indicated by standard medical practice.  Persons acting in good faith in connection with the detention and reporting of a person believed to be mentally ill shall incur no liability, civil or criminal, for those acts.

          (b)  Whenever an individual is held for purposes of receiving treatment as prescribed under paragraph (a) of this subsection, and it is communicated to the mental health professional holding the individual that the individual resides or has visitation rights with a minor child, and if the individual is considered to be a danger to the minor child, the mental health professional shall notify the Department of Human Services prior to discharge if the threat of harm continues to exist, as is required under Section 43-21-353.

     This paragraph shall be known and may be cited as the "Andrew Lloyd Law."

     SECTION 2.  Section 41-21-69, Mississippi Code of 1972, is amended as follows:

     41-21-69.  (1)  (a)  The physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor so appointed shall immediately make a full inquiry into the condition of the person alleged to be in need of treatment and shall make a mental examination and physical evaluation of the person, and shall make a report and certificate of their findings of all mental and acute physical problems to the clerk of the court.  The report and certificate shall set forth the facts as found by the physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor, and shall state whether or not the examiner is of the opinion that the proposed patient is suffering a disability defined in Sections 41-21-61 through 41-21-107 and should be committed to a treatment facility.  The statement shall include the reasons for that opinion.  The examination may be based upon a history provided by the patient and the report and certificate of findings shall include an identification of all mental and physical problems identified by the examination.

          (b)  If the physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor so appointed finds:  (i) the respondent has mental illness; (ii) the respondent is capable of surviving safely in the community with available supervision from family, friends or others; (iii) based on the respondent's treatment history and other applicable medical or psychiatric indicia, the respondent is in need of treatment in order to prevent further disability or deterioration that would result in significant deterioration in the ability to carry out activities of daily living; and (iv) his or her current mental status or the nature of his or her illness limits or negates his or her ability to make an informed decision to seek voluntarily or comply with recommended treatment; the physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor so appointed shall so show on the examination report and certification and shall recommend outpatient commitment.  The examining physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor shall also show the name, address and telephone number at the proposed outpatient treatment physician or facility.

     (2)  The examinations shall be conducted and concluded within forty-eight (48) hours after the order for examination and appointment of attorney, and the certificates of the physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor shall be filed with the clerk of the court within that time, unless the running of that period extends into nonbusiness hours, in which event the certificate shall be filed at the beginning of the next business day.  However, if the examining physicians or the physician or nurse practitioner and the psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor is of the opinion that additional time to complete the examination is necessary, and this fact is communicated to the chancery clerk or chancellor, the clerk or chancellor shall have authority to extend the time for completion of the examination and the filing of the certificate, the extension to be not more than eight (8) hours.

     (3)  At the beginning of the examination, the respondent shall be told in plain language of the purpose of the examination, the possible consequences of the examination, of his or her right to refuse to answer any questions, and his or her right to have his or her attorney present.

     SECTION 3.  Section 41-21-71, Mississippi Code of 1972, is amended as follows:

     41-21-71.  If, as a result of the examination, the examiners certify that the person is not in need of treatment, the chancellor or clerk shall dismiss the affidavit without the need for a further hearing.  If the chancellor or chancery clerk finds, based upon the physicians' certificate or the * * * physician's certificate of the physician or nurse practitioner and a * * *psychologist's, psychologist,  * * *nurse practitioner's or physician * * *assistant's certificate assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor and any other relevant evidence, that the respondent is in need of treatment and that certificate is filed with the chancery clerk within forty-eight (48) hours after the order for examination, or extension of that time as provided in Section 41-21-69, the clerk shall immediately set the matter for a hearing.  The hearing shall be set within seven (7) days of the filing of the certificate unless an extension is requested by the respondent's attorney.  In no event shall the hearing be more than ten (10) days after the filing of the certificate.

     SECTION 4.  Section 41-21-77, Mississippi Code of 1972, is amended as follows:

     41-21-77.  If admission is ordered at a treatment facility, the sheriff, his or her deputy or any other person appointed or authorized by the court shall immediately deliver the respondent to the director of the appropriate facility.  Neither the Board of Mental Health or its members, nor the Department of Mental Health or its related facilities, nor any employee of the Department of Mental Health or its related facilities, shall be appointed, authorized or ordered to deliver the respondent for treatment, and no person shall be so delivered or admitted until the director of the admitting institution determines that facilities and services are available.  Persons who have been ordered committed and are awaiting admission may be given any such treatment in the facility by a licensed physician as is indicated by standard medical practice.  Any county facility used for providing housing, maintenance and medical treatment for involuntarily committed persons pending their transportation and admission to a state treatment facility shall be certified by the State Department of Mental Health under the provisions of Section 41-4-7(kk).  No person shall be delivered or admitted to any non-Department of Mental Health treatment facility unless the treatment facility is licensed and/or certified to provide the appropriate level of psychiatric care for persons with mental illness.  It is the intent of this Legislature that county-owned hospitals work with regional community mental health/intellectual disability centers in providing care to local patients.  The clerk shall provide the director of the admitting institution with a certified copy of the court order, a certified copy of the physicians' certificate or the * * *physician's certificate of the physician or nurse practitioner and * * *psychologist's a psychologist, * * *nurse practitioner's orphysician * * *assistant's certificate assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor, a certified copy of the affidavit, and any other information available concerning the physical and mental condition of the respondent.  Upon notification from the United States Veterans Administration or other agency of the United States government, that facilities are available and the respondent is eligible for care and treatment in those facilities, the court may enter an order for delivery of the respondent to or retention by the Veterans Administration or other agency of the United States government, and, in those cases the chief officer to whom the respondent is so delivered or by whom he is retained shall, with respect to the respondent, be vested with the same powers as the director of the Mississippi State Hospital at Whitfield, or the East Mississippi State Hospital at Meridian, with respect to retention and discharge of the respondent.

     SECTION 5.  Section 41-21-79, Mississippi Code of 1972, is amended as follows:

     41-21-79.  The costs incidental to the court proceedings including, but not limited to, court costs, prehearing hospitalization costs, cost of transportation, reasonable physician's, psychologist's, nurse practitioner's * * *or, physician assistant's, licensed clinical social worker's, licensed marriage and family therapist's or licensed professional counselor's fees set by the court, and reasonable attorney's fees set by the court, shall be paid out of the funds of the county of residence of the respondent in those instances where the patient is indigent unless funds for those purposes are made available by the state.  However, if the respondent is not indigent, those costs shall be taxed against the respondent or his or her estate.  The total amount that may be charged for all of the costs incidental to the court proceedings shall not exceed Four Hundred Dollars ($400.00).

     SECTION 6.  Section 41-21-103, Mississippi Code of 1972, is amended as follows:

     41-21-103.  (1)  Unless he or she has a legal guardian or conservator, a married person or a person eighteen (18) years of age or older may be admitted to a treatment facility as a voluntary admittee for treatment, provided that the director deems  the person suitable for admission, upon the filing of an application with the director, accompanied by certificates of two (2) physicians, or * * *by either one (1) physician or one (1) nurse practitioner and one (1) psychologist, * * *one (1) nurse practitioner or one (1)physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor who certify that they examined the person within the last five (5) days and that the person is in need of observation, diagnosis and treatment.  The director may accept applications from the person seeking admission or any interested person with the applicant's written consent.

     (2)  A person with an intellectual disability who is under the age of eighteen (18) years and who is not married may be admitted to a treatment facility upon application of his or her parent or legal guardian if the following has occurred:

          (a)  An investigation by the director that carefully probes the person's social, psychological and developmental background; and

          (b)  A determination by the director that the person will benefit from care and treatment of his or her disorder at the facility and that services and facilities are available.  The reasons for the determination shall be recorded in writing.

     (3)  A person with an intellectual disability or with mental illness who is married or eighteen (18) years of age or older and who has a legal guardian or conservator may be admitted to a treatment facility upon application of his or her legal guardian or conservator if authorization to make the application has been received from the court having jurisdiction of the guardianship or conservatorship and the following has occurred:

          (a)  An investigation by the director that carefully probes the person's social, psychological and developmental background; and

          (b)  A determination by the director that the person will benefit from care and treatment of his or her disorder at the facility and that services and facilities are available.  The reasons for the determination shall be recorded in writing.

     (4)  A person with mental illness who is under the age of fourteen (14) years may be admitted to a treatment facility upon the application of his or her parent or legal guardian if the following has occurred:

          (a)  An investigation by the director that carefully probes the person's social, psychological and developmental background; and

          (b)  A determination by the director that the person will benefit from care and treatment of his or her disorder at the facility and that services and facilities are available.  The reasons for the determination shall be recorded in writing.

     (5)  A person with mental illness who is fourteen (14) years of age or older but less than eighteen (18) years of age may be admitted to a treatment facility in the same manner as an adult may be involuntarily committed.

     (6)  Any voluntary admittee may leave a treatment facility after five (5) days, excluding Saturdays, Sundays and holidays, after he or she gives any member of the treatment facility staff written notice of his or her desire to leave, unless before leaving, the patient withdraws the notice by written withdrawal or unless within those five (5) days a petition and the certificates of two (2) examining physicians, or either one (1) examining physician or one (1) examining nurse practitioner and one (1) psychologist, * * *nurse practitioner or physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor stating that the patient is in need of treatment, are filed with the chancery clerk in the county of the patient's residence or the county in which the treatment facility is located; however, if the admittee is at Mississippi State Hospital at Whitfield, the petition and certificate shall be filed with the chancery clerk in the county of patient's residence or with the Chancery Clerk for the First Judicial District of Hinds County, and the chancellor or clerk shall order a hearing under Sections 41-21-61 through 41-21-107.  The patient may continue to be hospitalized pending a final order of the court in the court proceedings.

     (7)  The written application form for voluntary admission shall contain in large, bold-face type a statement in simple, nontechnical terms that the admittee may not leave for five (5) days, excluding Saturdays, Sundays and holidays, after giving written notice of his or her desire to leave.  This right to leave must also be communicated orally to the admittee at the time of his or her admission, and a copy of the application form given to the admittee and to any parent, guardian, relative, attorney or friend who accompanied the patient to the treatment facility.

     SECTION 7.  Section 41-30-27, Mississippi Code of 1972, is amended as follows:

     41-30-27.  (1)  (a)  A person may be admitted to an approved public or private treatment facility for emergency care and treatment upon a decree of the chancery court accepting an application for admission thereto accompanied by the certificate of two (2) licensed physicians, or either one (1) reputable, licensed physician and one (1) psychologist, nurse practitioner, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor.  The application shall be to the chancery court of the county of such person's residence and may be made by any one (1) of the following:  Either certifying physician or other designated professional, the patient's spouse or guardian, any relative of the patient, or any other person responsible for health, safety or welfare of all or part of the citizens within said chancery court's territorial jurisdiction.  The application shall state facts to support the need for immediate commitment, including factual allegations showing that the person to be committed has threatened, attempted or actually inflicted physical harm upon himself or another.  The physicians' certificates or the certificates of the physician and a psychologist, nurse practitioner, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor shall state that they examined the person within two (2) days of the certificate date and shall set out the facts to support * * *the physicians' their professional conclusion that the person is an alcoholic or drug addict who has lost the power of self-control with respect to the use of alcoholic beverages or habit-forming drugs and that unless immediately committed he is likely to inflict physical harm upon himself or others.  A hearing on such applications shall be heard by the chancery court in term time or in vacation, and the hearing shall be held in the presence of the person sought to be admitted unless he fail or refuse to attend.  Notice of the hearing shall be given to the person sought to be admitted, as soon as practicable after the examination by the certifying physicians or certifying physician and psychologist, nurse practitioner, physician assistant, licensed clinical social worker, licensed marriage and family therapist or licensed professional counselor, and the person sought to be admitted shall have an opportunity to be represented by counsel, and shall be entitled to have compulsory process for the attendance of witnesses.

          (b)  For the purpose of this section, the term "drug addict" shall have the meaning ascribed to it by Section 41-31-1(d).

     (2)  The chancery judge may refuse an application if in his opinion the application and certificate fail to sustain the grounds for commitment.  Upon acceptance of the application after hearing thereon and decree sustaining the application by the judge, the person shall be transported to the facility by a peace officer, health officer, the applicant for commitment, the patient's spouse or the patient's guardian.  The person shall be retained at the facility that admitted him, or be transferred to any other appropriate treatment resource, until discharged pursuant to subsection (3).

     (3)  The attending physician shall discharge any person committed pursuant to this section when he determines that the grounds for commitment no longer exist, but no person committed pursuant to this section shall be retained in any facility for more than five (5) days.

     (4)  The application filed pursuant to subsection (1) of this section shall also contain a petition for involuntary commitment pursuant to * * *Title 41, Chapter 31, Title 41, Mississippi Code of 1972.  If the application for emergency involuntary commitment is accepted under subsection (2) of this section, the chancery judge shall order a hearing on the petition for commitment pursuant to  * * *Title 41, Chapter 31, Title 41, Mississippi Code of 1972, to be held on the fifth day of such involuntary emergency commitment, the provisions of Section 41-31-5 regarding the time of hearing to the contrary notwithstanding; provided, however, that at the time of such involuntary commitment the alleged alcoholic or drug addict shall be served with a citation to appear at said hearing and shall have an opportunity to be represented by counsel.

     SECTION 8.  Section 41-31-5, Mississippi Code of 1972, is brought forward as follows:

     41-31-5.  Whenever such a petition shall be filed the chancellor of said court shall, by order, fix a time upon a day certain for the hearing thereof, either in termtime or in vacation, which hearing shall be fixed not less than five (5) days nor more than twenty (20) days from the filing of said petition.  The person alleged to be an alcoholic or drug addict shall be served with a citation to appear at said hearing not less than three (3) days prior to the day fixed for said hearing, and there shall be served with such citation a true and correct copy of said petition.  At the time fixed, the chancellor shall hear evidence on said petition, with or without the presence of the alleged alcoholic or drug addict, and all persons interested shall have the right to appear and present evidence touching upon the truth and correctness of the allegations of said petition.  The said chancellor, in his discretion, may require that the alleged alcoholic or drug addict be examined by the county health officer or by such other competent physician or physicians as the chancellor may select, and may consider the results of such examination in reaching a decision in said matter.  If the alleged alcoholic or drug addict shall admit the truth and correctness of the allegations of said petition, or if the chancellor should find from the evidence that such person is an alcoholic or drug addict, and is in need of detention, care and treatment in an institution, and that the other material allegations of said petition are true, then he shall enter an order so finding, and shall order that such person be remanded and committed to and confined in the proper state institution or in the case of an alcoholic to an approved public or private treatment facility pursuant to the provisions of Chapter 30 of Title 41, Mississippi Code of 1972, for care and treatment for a period of not less than thirty (30) days nor more than ninety (90) days as the necessity of the case may, in his discretion, require.  However, when such person shall be so committed, the medical director of the said institution shall be vested with full discretion as to the treatment and discharge of such person, and may discharge and release such person at any time when the condition of such person shall so justify.

     SECTION 9.  This act shall take effect and be in force from and after July 1, 2015.