Bill S.1087

SENATE DOCKET, NO. 849 FILED ON: 1/19/2017

SENATE . . . . . . . . . . . . . . No. 1087

By Mr. Donnelly, a petition (accompanied by bill, Senate, No. 1087) of Kenneth J. Donnelly, Kenneth I. Gordon, Barbara A. L'Italien, Marjorie C. Decker and others for legislation to provide critical community services. Mental Health, Substance Use and Recovery.

The Commonwealth of Massachusetts

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In the One Hundred and Ninetieth General Court
(2017-2018)

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An Act to provide critical community services.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Section 1 of chapter 123 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after the word “health.”, in line 4, the following words:-

“Critical community health services”, health, behavioral health and social services that can be provided in a community setting, and do not require continuous inpatient hospitalization.

“Critical community health service treatment plan”, a plan defining a set of health, behavioral health or social services delivered to an individual.

SECTION 2. Said section 1 of chapter 123 is hereby further amended by inserting after the word “program.”, in line 18, the following words:-

“Gravely disabled”, a condition evidenced by behavior in which a person, as a result of a mental disorder, is at substantial risk of inflicting serious harm to himself or others, and has shown an inability to provide for his basic physical needs, including medical and psychiatric treatment and shelter because of the mental disorder.

SECTION 3. Said section 1 of chapter 123 is hereby further amended by inserting after the word “movement.”, in line 87, the following words:-

“Service plan”, a critical community health service treatment plan.

SECTION 4. Said section 1 of chapter 123 is hereby further amended by inserting after the word “facility.”, in line 92, the following words:-

“Supervising mental health professional”, any person who holds himself out to the general public as one providing mental health services and who is required pursuant to such practice to obtain a license from the commonwealth or who, at the discretion of the court, is deemed suitable to supervise a critical community health service treatment plan.

SECTION 5. Said chapter 123 is hereby further amended by inserting after section 8 the following section:-

Section 8 1/2. (a) Any physician licensed pursuant to section 2 of chapter 112 after examining a patient, the department of mental health, any person age 18 or older with whom the subject of the petition resides, the parent, spouse, sibling age 18 or older, child age 18 or older of the subject of the petition, the superintendent of any public or private facility or hospital authorized for the commitment or treatment of mentally ill persons, or the medical director of the Bridgewater state hospital, may petition the district court in whose jurisdiction a facility is located that shall provide critical community health services for any individual who is

(1) mentally ill, (2) at least 18 years old and (3) meets the following criteria:

(i) is gravely disabled;

(ii) has a history of lack of compliance with treatment for mental illness that, prior to the filing of the petition, has: (A) at least twice within the last 36 months, been a significant factor in necessitating hospitalization, or receipt of mental health services in a forensic or department of correction facility or house of corrections or the Bridgewater state hospital; or (B) committed one or more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the last 36 months;

(iii) based on his or her treatment history and current behavior, is in need of critical community health services in order to prevent a relapse or deterioration which would be likely to result in serious harm to the person or others; and

(iv) is likely to benefit from critical community health services.

The petition shall include a written service plan prepared in consultation with, when possible, those familiar with the patient, the superintendent or physician in charge of the care of the patient or those familiar with the case history of the patient. The plan shall include each of the following:

(1) a statement of the requirements for supervision, medication, and assistance in obtaining basic necessities such as employment, food, clothing, and shelter;

(2) if known, the address of the residence where the patient resides and the name of the person or persons in charge of the residence;

(3) if known, the name and address of any person, agency, or organization assigned to supervise a critical community health service treatment plan or care for the patient; and

(4) the conditions for continued receipt of critical community health services, which may require reporting, continuation of medication, submission to testing, or other such reasonable conditions.

(b) A petition for critical community health services may be filed along with and in the alternative to a petition for inpatient commitment under sections 7 or 8(a).

(c) A hearing shall be commenced within 4 days of the filing of the petition. The periods of time prescribed or allowed under the provisions of this section shall be computed pursuant to Rule 6 of the Massachusetts Rules of Civil Procedure. Adjournments shall be permitted only for good cause shown. In granting adjournments, the court shall consider the need for further examination by a physician or the potential need to provide treatment expeditiously.

(d) A court may not issue a critical community service health service treatment plan unless it finds that providing critical community health services is the least restrictive alternative available to the person.

(e) If, after the hearing, the court finds by clear and convincing evidence that the subject of the petition meets the criteria for critical community health services included in subsection (a), the court may order the supervising mental health professional of an appropriate treatment program to supervise the plan for such services.

Critical community health services shall not be ordered unless the court approves a written critical community health service treatment plan presented to the court which conforms to the requirements of this section and which contains the name of the designated director of the facility that will supervise and administer the service plan.

(f) The first order for critical community health services shall not exceed 180 days, and any subsequent order shall not exceed 365 days.

(g) Before an order for critical community health services can commence, the patient shall be provided with copies of the court order and full explanations of the approved service plan. The approved service plan shall be filed with the court and the supervising mental health professional in charge of the patient's service plan.

(h) During any period in which an individual receives critical community health services, the patient or the supervising mental health professional may petition the court to amend the critical community health service treatment plan. The court may order an amended service plan or, if contested, the court may order a hearing on the amended plan. If an amended service plan is contested, the party wishing to amend the service plan shall provide the opposing party the proposed amended service plan at least 7 days before the filing of a petition.

(i) A supervising mental health professional may petition the court for a hearing if the supervising mental health professional has determined that the patient is not complying with the critical community health service treatment plan.

When a supervising mental health professional determines that a patient has not complied with any condition of the service plan, that monitor shall notify the court of the conditions of the treatment plan that have been violated.

(1) Upon receipt of notice from the supervising mental health professional, the court shall appoint counsel, if necessary, and schedule a service plan non-compliance hearing for a date no less than 7 days and not more than 14 days later except in extraordinary circumstances, as determined by the court. The court shall create a standard “notice of service plan non-compliance” form, which the monitor shall complete with times and dates of alleged non-compliance of the patient.

(2) The notice of service plan non-compliance shall set forth the conditions of plan that the supervising mental health professional alleges have not been complied with and shall order the patient to appear at a specific date and time for the non-compliance hearing, and shall be delivered to all parties to the original proceeding under which the service plan order was issued.

(3) Service plan non-compliance hearings shall proceed in two distinct steps, the first to adjudicate the factual issue of whether the plan is being complied with and the second to determine the disposition of the matter, if plan non-compliance is found by the court to have occurred.

(4) If the court finds that the patient has not complied with one or more conditions of the service plan as alleged, the supervising mental health professional shall recommend to the court a course of immediate action and may present argument and evidence in support of that recommendation. If the court determines that the patient is not complying with the terms of the order, the court may amend the service plan as the court deems necessary. The amended order may alter the service plan, or the court may request, under the provisions of section 12 of this chapter, an emergency evaluation to determine whether the failure to hospitalize such person would create a likelihood of serious harm.

(j) The supervising mental health professional shall require periodic reports, not more frequently than every 30 days, concerning the condition of patients receiving critical community health services from any person, agency, or organization assigned to treat such patients.

(k) The supervising mental health professional shall review the condition of a patient ordered to receive critical community services at least once every 30 days.

(l) The supervising mental health professional may, at any time, petition the court for termination of a patient’s critical community health service plan if the supervising mental health professional determines that critical community health services are no longer the least restrictive appropriate treatment available.

(m) Nothing in this section shall prevent the supervising mental health professional from authorizing involuntary commitment and treatment in an emergency under section 12 of this chapter.

(n) The patient or his or her representative may petition for termination of an order for critical community health services order.

(o) All hearings under this section shall be conducted by a judge consistent by the requirements of this chapter and applicable law with such flexibility and informality as the court may deem appropriate. The patient shall be entitled to the assistance of counsel and the court, if necessary, shall appoint counsel. All testimony shall be taken under oath. The standard of proof at such hearing will be clear and convincing evidence.

(p) Reasonable expense incurred in providing critical community health services may be paid out of the estate of such person, by the petitioner or by the commonwealth, as may be determined by the court.

SECTION 6. Section 9 of said chapter 123 is hereby amended by inserting after the words “of section eight B.”, in line 39, the following words:- Any person may apply to the court stating his or her belief that a person currently receiving critical community health services under section 8 1/2 should no longer be so treated.

Name:	District/Address:
Kenneth J. Donnelly	Fourth Middlesex
Kenneth I. Gordon	21st Middlesex	1/27/2017
Barbara A. L'Italien	Second Essex and Middlesex	1/27/2017
Marjorie C. Decker	25th Middlesex	2/1/2017
Sal N. DiDomenico	Middlesex and Suffolk	2/3/2017