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COMMITTEE REPORT
March 29, 2000
S. 755
S. Printed 3/29/00--H
Read the first time February 16, 2000.
To whom was referred a Bill (S. 755), to amend Sections 44-9-90 and 44-9-100 of the Code of Laws of South Carolina, 1976, relating to the general rights, duties and powers of the Mental Health Commission, etc., respectfully
That they have duly and carefully considered the same, and recommend that the same do pass with amendment:
Amend the bill, as and if amended, Section 44-17-410, the fourth undesignated paragraph following item (3) page 5, line 6 after /required/ by inserting /and reasons have been set forth in the report/ so when amended the fourth undesignated paragraph of Section 44-17-410 following item (3) reads:
/ If the report of the designated examiners is that the patient is not mentally ill to the extent that involuntary treatment is required and reasons have been set forth in the report, the court shall dismiss the petition and the patient must be discharged immediately by the facility unless the designated examiners report that the patient is a chemically dependent person in need of emergency commitment and that procedures have been initiated pursuant to Section 44-52-50. In which case, emergency commitment procedures must be complied with in accordance with Chapter 52, and the facility shall transfer the patient to an appropriate treatment facility as defined by Section 44-52-10, provided that confirmation has been obtained from the facility that a bed is available; transportation must be provided by the department./
Amend the bill, further Section 44-17-580(2) page 6, line 25 after /and/ by inserting /not/ so when amended, Section 44-17-580(2) reads:
/ (2) there is a likelihood of serious harm to himself or others, it shall order in-patient or out-patient treatment at a mental health facility, public or private, designated or licensed by the Department of Mental Health. If the court finds that he is not mentally ill and not in need of involuntary treatment, it shall dismiss the proceedings./
Amend the bill, further by adding an appropriately numbered SECTION to read:
/SECTION ___. Section 20-7-7815 of the 1976 Code, as amended by Act 135 of 1997, is further amended by adding at the end:
/ "(C) If a juvenile transferred to another state agency pursuant to this section is absent from a treatment facility without proper authorization, any state or local law enforcement officer upon the request of the director, or a designee, of the state agency to which the juvenile has been transferred and without the necessity of a warrant or a court order, may take the juvenile into custody and return the juvenile to the facility designated by the agency director or the designee."/
Renumber sections to conform.
Amend totals and title to conform.
JOE E. BROWN, for Committee.
EXPLANATION OF IMPACT:
Because the bill reflects policies and practices in which the department is already engaging, there is no impact on the expenditures of the department nor on federal and/or other funds.
SPECIAL NOTES:
The Department of Mental Health's community mental health programs collect approximately $2.5 million annually from paying patients. The bill's deletion of language directing the department to serve only those patients who can not afford to pay might result in slightly more revenues if the department pursued competing with some managed care companies for "private" contracts. In contrast to the community mental health programs, over 90% of current admissions to the department's mental health facilities and hospitals are involuntary.
Approved By:
Don Addy
Office of State Budget
TO AMEND SECTIONS 44-9-90 AND 44-9-100 OF THE CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE GENERAL RIGHTS, DUTIES, AND POWERS OF THE MENTAL HEALTH COMMISSION, SO AS TO DELETE THE REQUIREMENT THAT THE COMMISSION COLLECT STATISTICS AND ADOPT REGULATIONS ON MENTAL DEFICIENCIES AND EPILEPTICS; TO AMEND SECTION 44-11-10, RELATING TO STATE MENTAL HEALTH FACILITIES, SO AS TO PROVIDE THAT HALL PSYCHIATRIC INSTITUTE SHALL NO LONGER BE MAINTAINED AS A TEACHING HOSPITAL FOR THE PRIMARY PURPOSES OF TRAINING MENTAL HEALTH PERSONNEL AND PSYCHIATRIC RESEARCH; TO AMEND SECTION 44-15-50, RELATING TO GRANTS AUTHORIZED AND APPROVED BY THE DEPARTMENT OF MENTAL HEALTH, SO AS TO DELETE REQUIREMENTS AS TO HOW FUNDS MAY BE EXPENDED; TO AMEND SECTION 44-15-80, RELATING TO THE DUTIES AND POWERS OF THE DEPARTMENT OF MENTAL HEALTH, SO AS TO PROVIDE THAT ANYONE WHO CANNOT AFFORD TREATMENT IS ELIGIBLE TO RECEIVE CERTAIN SERVICES; TO AMEND SECTION 44-17-410, RELATING TO THE EMERGENCY ADMISSION OF PERSONS TO A PUBLIC OR PRIVATE HOSPITAL, MENTAL HEALTH CLINIC, OR MENTAL HEALTH FACILITY, SO AS TO PROVIDE FOR EXTENUATING CIRCUMSTANCES FOR REVIEWING INVOLUNTARY TREATMENT; TO AMEND SECTION 44-17-540, RELATING TO THE EXAMINATION OF PERSONS ADMITTED FOR INVOLUNTARY TREATMENT OF MENTAL ILLNESS, SO AS TO PROVIDE CERTAIN REQUIREMENTS WHEN INVOLUNTARY TREATMENT IS REQUIRED; TO AMEND SECTION 44-17-580, RELATING TO HOSPITALIZATION FOR INVOLUNTARY TREATMENT OF MENTAL ILLNESS, SO AS TO PROVIDE FOR THE DISMISSAL OF PROCEEDINGS WHEN A PERSON IS NOT IN NEED OF INVOLUNTARY TREATMENT; TO AMEND SECTION 44-22-150, RELATING TO THE RESTRAINT, SECLUSION, OR PHYSICAL COERCION OF PATIENTS RESIDING IN MENTAL HEALTH OR ALCOHOL AND DRUG ABUSE FACILITIES, SO AS TO DEFINE RESTRAINT; TO AMEND SECTION 44-23-1100, RELATING TO THE DISCLOSURE OF INFORMATION, SO AS TO PROVIDE FOR THE RELEASE OF INFORMATION PURSUANT TO SECTION 44-22-100; AND TO REPEAL SECTION 44-23-50.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 44-9-90(4) of the 1976 Code is amended to read:
"(4) It shall collect statistics bearing on mental illness, mental deficiency, epilepsy, drug addiction, and alcoholism, as well as study the cause, pathology, and prevention of mental defects and diseases;"
SECTION 2. Section 44-9-100(4) of the 1976 Code is amended to read:
"(4) adopt regulations not inconsistent with this chapter, Chapter 11, Chapter 13, Article 1 of Chapter 15, Chapter 17, Chapter 22, Chapter 23, Chapter 24, Chapter 27, and Chapter 52 as it may find to be reasonably necessary for the government of all institutions over which it has authority and of state mental health facilities and the proper and efficient institutionalization of the mentally ill, mentally defective, epileptic, psychotic senile, drug addicted, or alcoholic;"
SECTION 3. Section 44-11-10 of the 1976 Code is amended to read:
"Section 44-11-10. The following facilities shall continue in existence and shall be maintained for the following purposes:
(1) Those inpatient facilities as authorized by the Department of Mental Health and funded by legislative appropriations, including facilities for the evaluation and treatment of mentally ill persons, facilities for the evaluation and treatment of chemically dependent persons, and long-term care facilities; and
(2) The William S. Hall Psychiatric Institute at Columbia shall be maintained as a teaching hospital for the primary purposes of training mental health personnel and psychiatric research, in connection with the general purposes described in this section; and
(2) (3) The mental health clinics shall be maintained for the diagnosis, treatment, and prevention of mental illness."
SECTION 4. Section 44-15-50 of the 1976 Code is amended to read:
"Section 44-15-50. Except as provided by this section, grants for any program shall not exceed fifty percent of the total expenditures for the year 1974-75 only for (a) salaries, (b) contract facilities and services, (c) operation, maintenance and service costs, (d) per diem and travel expenses of members of community mental health boards and (e) other expenditures specifically approved and authorized by the Department of Mental Health. Grants may be made for expenditures for mental health services whether provided by operation of a local facility or through contract with other public or private agencies or individual persons."
SECTION 5. Section 44-15-80(2) and (3) are amended to read:
"(2) Govern eligibility for service so that no person will be denied service on the basis of inability to pay and so that any one who cannot afford to pay for necessary treatment at the rate customarily charged in available private practice shall be eligible to receive services from the community mental health clinic;
(3) Provide for establishment of fee schedules and reduction of balance due which shall be based upon ability to pay, the guiding principles of which shall be that no one who can afford to pay for his own treatment at the rate customarily charged in available private practice shall be treated in the community mental health services clinic except as provided in this section;"
SECTION 6. Section 44-17-410 of the 1976 Code is amended to read:
"Section 44-17-410. A person may be admitted to a public or private hospital, mental health clinic, or mental health facility for emergency admission upon:
(1) written affidavit under oath by a person stating:
(a) a belief that the person is mentally ill and because of this condition is likely to cause serious harm to himself or others if not immediately hospitalized;
(b) the specific type of serious harm thought probable if the person is not immediately hospitalized and the factual basis for this belief;
(2) a certification in triplicate by at least one licensed physician stating that the physician has examined the person and is of the opinion that the person is mentally ill and because of this condition is likely to cause harm to himself through neglect, inability to care for himself, or personal injury, or otherwise, or to others if not immediately hospitalized. The certification must contain the grounds for the opinion. A person for whom a certificate has been issued may not be admitted on the basis of that certificate after the expiration of three calendar days after the date of the examination;
(3) within forty-eight hours after admission, exclusive of Saturdays, Sundays, and legal holidays, the place of admission shall forward the affidavit and certification to the probate court of the county in which the person resides or, in extenuating circumstances, where the acts or conduct leading to the hospitalization occurred.
Within forty-eight hours of receipt of the affidavit and certification exclusive of Saturdays, Sundays, and legal holidays, the court shall conduct preliminary review of all the evidence to determine if probable cause exists to continue emergency detention of the patient. If the court finds that probable cause does not exist, it shall issue an order of release for the patient. Upon a finding of probable cause, the court shall make a written order detailing its findings and may order the continued detention of the patient.
With each affidavit and certification, the treatment facility shall provide the court with a designated examiner appointment form listing the names of two designated examiners at the treatment facility.
If the court appoints these two designated examiners, the examination must be performed at the treatment facility and a report must be submitted to the court within seven days from the date of admission. The court may appoint independent designated examiners who shall submit a report to the court within the time allotted above. In the process of examination by the designated examiners, previous hospitalization records must be considered. At least one of the examiners appointed by the court must be a licensed physician. The examiners' reports must include the grounds for the examiners' conclusions.
If the report of the designated examiners is that the patient is not mentally ill to the extent that involuntary treatment is required, the court shall dismiss the petition and the patient must be discharged immediately by the facility unless the designated examiners report that the patient is a chemically dependent person in need of emergency commitment and that procedures have been initiated pursuant to Section 44-52-50. In which case, emergency commitment procedures must be complied with in accordance with Chapter 52, and the facility shall transfer the patient to an appropriate treatment facility as defined by Section 44-52-10, provided that confirmation has been obtained from the facility that a bed is available; transportation must be provided by the department.
If the report of the designated examiners is that the patient is mentally ill and involuntary treatment is required, the court may order that the person be detained, appoint counsel for the patient if counsel has not been retained, and fix a date for a full hearing to be held pursuant to Section 44-17-570 within fifteen days from the date of admission. The court shall give notice of the hearing pursuant to Section 44-17-420.
The examiners' report must be available to the person's counsel before the full hearing. The person must be given the opportunity to request an independent designated examiner pursuant to Section 44-17-530."
SECTION 7. Section 44-17-540 of the 1976 Code is amended to read:
"Section 44-17-540. If the report of the two designated examiners, other than the independent designated examiner, is to the effect that they are of the opinion that the person is not mentally ill to the extent that involuntary treatment is required, the court shall terminate the proceedings and dismiss the petition immediately upon receipt of the report. If the report of the two designated examiners, other than the independent designated examiner, is divided, the court may terminate the proceedings or may designate a third examiner, who must be a psychiatrist, and charge the three examiners to render a majority opinion within five days. If the report of the designated examiners is to the effect that they are of the opinion that the person is mentally ill and involuntary treatment is required, the court shall conduct a hearing. For persons admitted pursuant to Section 44-17-410, the hearing may be held on the same day as the designated examinations unless the person or his counsel objects. Upon objection by the person or his counsel, the court shall delay the hearing. For persons whose admission is sought under Section 44-17-510, the court immediately shall fix a date for and give notice of a hearing, to be held not less than five nor more than seven days, excluding Saturdays, Sundays, and legal holidays, from receipt of the report."
SECTION 8. Section 44-17-580 of the 1976 Code is amended to read:
"Section 44-17-580. If, upon completion of the hearing and consideration of the record, the court finds upon clear and convincing evidence that the person is mentally ill, needs involuntary treatment and because of his condition:
(1) lacks sufficient insight or capacity to make responsible decisions with respect to his treatment; or
(2) there is a likelihood of serious harm to himself or others, it shall order in-patient or out-patient treatment at a mental health facility, public or private, designated or licensed by the Department of Mental Health. If the court finds that he is not mentally ill and in need of involuntary treatment, it shall dismiss the proceedings.
If the court orders out-patient treatment and the respondent fails to adhere to the prescribed out-patient treatment program, on report of the failure by the treatment facility the court upon notice to the respondent and his counsel may order a supplemental hearing and further order in-patient treatment in a designated or licensed facility. The probate court issuing the order shall maintain jurisdiction over the person for the purpose of supplemental proceedings as herein set forth and every order issued pursuant to this paragraph shall be so conditioned. An order for in-patient treatment at a mental health facility shall not raise a presumption of incompetency and no rights shall be denied a person unless specifically ordered by the court."
SECTION 9. Section 44-22-150 of the 1976 Code is amended by adding:
"(C) `Restraint' shall not include medical protective devices used as a regular part of medical, diagnostic, or surgical procedures; used to posturally support a patient; or used to obtain or maintain normative bodily functioning."
SECTION 10. Section 44-23-1100 of the 1976 Code is amended to read:
"Section 44-23-1100. Any copies of completed forms retained by judges of probate shall be safeguarded in a confidential file, and the information therein contained shall not be disclosed except pursuant to Section 44-23-1090 Section 44-22-100."
SECTION 11. Section 44-23-50 of the 1976 Code is repealed.
SECTION 12. This act takes effect ninety days after approval by the Governor.
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