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§ 37-1-1.
As used in this title, the term:
(1) 'Addictive disease' means the abuse of, addiction to, or
dependence upon alcohol or other drugs and includes substance abuse.
(2) 'Board' means the Board of Human Resources.
(3) 'Commissioner' means the commissioner of human resources.
(4) 'Community service board' means a public mental health, developmental
disabilities, and addictive diseases board established pursuant to Code Section
37-2-6 which provides one or more mental health, developmental disability, and
addictive disease services through contract with the department. Such community
service board may enroll with the department to become a provider of specific
mental health, developmental disability, and addictive disease services with
such services being negotiated and contracted annually with the department.
(5) 'Consumer' means a natural person who has been or is a
recipient of disability services as defined in Code Section 37-2-2.
(6) 'County board of health' means a county board of health established in
accordance with Chapter 3 of Title 31 and includes its duly authorized agents.
(7) 'Department' means the Department of Human Resources and includes its duly
authorized agents and designees.
(8) 'Division' means the Division of Mental Health, Developmental Disabilities,
and Addictive Diseases.
(9) 'Peace officer' means any federal, city, or county
police officer, any officer of the Georgia State Patrol, or any sheriff or
deputy sheriff.
(10) 'Penal offense' means a violation of a law of the United States, this
state, or a political subdivision thereof for which the offender may be
confined in a state prison or a city or county jail or any other penal
institution.
(11) 'Physician' means any person duly authorized to
practice medicine in this state under Chapter 34 of Title 43.
(12) 'Psychologist' means any person authorized under the
laws of this state to practice as a licensed psychologist as set forth in
paragraph (3) of Code Section 43-39-1.
(13) 'Regional board' means a regional mental health, mental
retardation, and substance abuse board established in accordance with Code
Section 37-2-4.1 as that Code section existed on June 30, 2002.
(14) 'Regional coordinator' means an employee of the
department who acts as the departmentīs agent and
designee to manage community and hospital services for consumers of disability
services within a mental health, developmental disabilities, and addictive
diseases region established in accordance with Code Section 37-2-3.
(15) 'Regional office' means a Division of Mental Health,
Developmental Disabilities, and Addictive Diseases of the Department of Human
Resources office created pursuant to Code Section 37-2-4.1. Such office shall
serve as the entity for the administration of disability services in a region.
(16) 'Regional planning board' means a mental health,
developmental disabilities, and addictive diseases planning board established
in accordance with Code Section 37-2-4.1.
(17) 'Regional services administrator' means an employee of the
department who, under the supervision of the regional coordinator, manages the
purchase or authorization of services, or both, for consumers of disability
services, the assessment and coordination of services, and ongoing monitoring
and evaluation of services provided within a mental health, developmental
disabilities, and addictive diseases region established in accordance with Code
Section 37-2-3.
(18) 'Regional state hospital administrator' means the chief
administrative officer of a state owned or state operated hospital and the
state owned or operated community programs in a region. The regional state
hospital administrator, under the supervision of the regional coordinator, has
overall management responsibility for the regional state hospital and manages
services provided by employees of the regional state hospital and employees of
state owned or operated community programs within a mental health,
developmental disabilities, and addictive diseases region established in
accordance with Code Section 37-2-3.
(19) 'Resident' means a person who is a legal resident of
the State of
(20) 'Service area' means a community service area.
§ 37-1-2.
(a) The General Assembly finds that the state has a need to
continually improve its system for providing effective, efficient, and quality
mental health, developmental disability, and addictive disease services. The
General Assembly also finds that the needs of the publicly funded mental
health, developmental disability, and addictive disease system and the state
can best be met through reorganizing the regional mental health, mental
retardation, and substance abuse boards and certain functions of the Department
of Human Resources. Further, the General Assembly finds that a comprehensive
range of quality services and opportunities is vitally important to the
existence and well-being of individuals with mental health, developmental
disability, or addictive disease needs and their families. The General Assembly
further finds that the state has an obligation and a responsibility to develop
and implement planning and service delivery systems which focus on a core set
of consumer oriented, community based values and principles which include, but
are not limited to, the following:
(1) Consumers and families should have choices about services and providers and
should have substantive input into the planning and delivery of all services;
(2) A single point of accountability should exist for fiscal, service, and
administrative issues to ensure better coordination of services among all
programs and providers and to promote cost-effective, efficient service
delivery and administration;
(3) The system should be appropriately comprehensive and adaptive to allow
consumers and their families to access the services they desire and need;
(4) Public programs are the foundation of the service planning and delivery
system and they should be valued and nurtured; at the same time, while assuring
comparable standards of quality, private sector involvement should be increased
to allow for expanded consumer choice and improved cost effectiveness;
(5) Planning should reside at the local level, with the primary authority
vested in local government, consumers, families, advocates, and other
interested local parties;
(6) The system should ensure that the needs of consumers who are most in need
are met at the appropriate service levels; at the same time, prevention
strategies should be emphasized for those disabilities which are known to be
preventable;
(7) The system should be designed to provide the highest quality of services
utilizing flexibility in funding, incentives, and outcome evaluation techniques
which reinforce quality, accountability, efficiency, and consumer satisfaction;
(8) The functions of service planning, coordination, contracting, resource
allocation, and consumer assessment should be separated from the actual
treatment, habilitation, and prevention services provided by contractors;
(9) Consumers and families should have a single, community based point of entry
into the system;
(10) Consumers, staff, providers, and regional planning board and community
service board members should receive ongoing training and education and should
have access to key management resources such as information systems and technical
and professional support services; and
(11) The department is responsible for ensuring the appropriate use of state,
federal, and other funds to provide quality services for individuals with
mental health, developmental disabilities, or addictive disease needs who are
served by the public system and to protect consumers of these services from
abuse and maltreatment.
(b) Local governments, specifically county governing authorities, have provided
outstanding leadership and support for mental health, developmental disability,
and addictive disease programs, and the General Assembly finds that their
investments, both personal and capital, should be valued and utilized in any
improved system. As such, the state and any new governing structure should take
special precautions to ensure that the county governing authorities have an
expanded level of input into decision making and resource allocation and that
any services or programs should continue to use and expand their use of county
facilities and resources wherever appropriate and possible.
(c) The purpose of this chapter and Chapter 2 of this title is to provide for a
comprehensive and improved mental health, developmental disability, and
addictive disease services planning and delivery system in this state which
will develop and promote the essential public interests of the state and its
citizens. The provisions of this chapter and Chapter 2 of this title shall be
liberally construed to achieve their purposes.
§ 37-1-20.
(a) The Division of Mental Health, Developmental Disabilities, and Addictive
Diseases shall be a division of the department and shall be managed by a
director whose qualifications meet standards set by the board.
(b) The department, through the division, shall:
(1) Establish, administer, and supervise the state programs for mental health,
developmental disabilities, and addictive diseases;
(2) Direct, supervise, and control the medical and physical care, treatment,
and rehabilitation provided by the institutions and programs under its control,
management, or supervision;
(3) Have authority to contract for services with: community service boards,
private agencies, and other public entities for the provision of services
within a service area so as to provide an adequate array of services, choice of
providers for consumers, and to comply with the applicable federal laws, rules
and regulations related to public or private hospitals; hospital authorities;
medical schools, and training and educational institutions; departments and agencies
of this state; county or municipal governments; any person, partnership,
corporation, or association, whether public or private; the United States
government or the government of any other state;
(4) Establish and support programs for the training of professional and
technical personnel as well as regional planning boards and community service
boards;
(5) Have authority to conduct research into the causes and treatment of
disability and into the means of effectively promoting mental health;
(6) Assign specific responsibility to one or more units of the division for the
development of a disability prevention program. The objectives of such program
shall include, but are not limited to, monitoring of completed and ongoing
research related to the prevention of disability, implementation of programs
known to be preventive, and testing, where practical, of those measures having
a substantive potential for the prevention of disability;
(7) Establish a system for regional administration of
mental health, developmental disability, and addictive disease services in
institutions and in the community under the supervision of a regional
coordinator;
(8) Make and administer budget allocations to regional offices of the division
established by the board pursuant to Code Section 37-2-4.1, to fund the
operation of mental health, developmental disabilities, and addictive diseases
facilities and programs;
(9) Coordinate in consultation with providers, professionals, and other experts
the development of appropriate outcome measures for client centered service
delivery systems;
(10) Establish, operate, supervise, and staff programs and facilities for the
treatment of disabilities throughout this state;
(11) Disseminate information about available services and the facilities
through which such services may be obtained;
(12) Supervise the regional officeīs
exercise of its responsibility and authority concerning funding and delivery of
disability services;
(13) Supervise the regional offices concerning the receipt and administration
of grants, gifts, moneys, and donations for purposes pertaining to mental
health, developmental disabilities, and addictive diseases;
(14) Supervise the regional offices concerning making contracts with any
hospital, community service board, or any public or private providers without
regard to regional or state boundaries for the provision of disability services
and in making and entering into all contracts necessary or incidental to the
performance of the duties and functions of the division and the regional
offices;
(15) Regulate the delivery of care, including behavioral interventions and
medication administration by licensed staff, or certified staff as determined
by the division, within residential settings serving only persons who are
receiving services authorized or financed, in whole or in part, by the
division; and
(16) Establish 'community living arrangements' which shall be defined as any
residence, whether operated for profit or not, which undertakes through its
ownership or management to provide or arrange for the provision of housing,
food, one or more personal services, supports, care, or treatment exclusively
for two or more persons who are not related to the owner or administrator of
the residence by blood or marriage and whose services are financially
supported, in whole or in part, by funds authorized through the Division of
Mental Health, Developmental Disabilities, and Addictive Diseases of the
Department of Human Resources.
(c) The department shall:
(1) Establish a unit of the department which shall receive and consider
complaints from individuals receiving services, make recommendations to the
director of the division regarding such complaints, and ensure that the rights
of individuals receiving services are fully protected;
(2) Exercise all powers and duties provided for in this title or which may be
deemed necessary to effectuate the purposes of this title;
(3) Assign specific responsibility to one or more units of the division for the
development of programs designed to serve disabled infants, children, and
youth. To the extent practicable, such units shall cooperate with the Georgia
Department of Education and the University System of Georgia in developing such
programs; and
(4) Classify and license community living arrangements, as defined in paragraph
(16) of subsection (b) of this Code section, in accordance with the rules and
regulations promulgated by the department for the licensing of community living
arrangements and the enforcement of licensing requirements. To be eligible for
licensing as a community living arrangement, the residence and services
provided must be integrated within the local community. All community living
arrangements licensed by the department shall be subject to the provisions of
Code Sections
§ 37-1-21.
(a) The department is designated and empowered as the agency of this state
responsible for supervision and administrative control of: state facilities for
the treatment of mental illness or the habilitation and treatment of
individuals with developmental disabilities; state hospitals for the treatment
of tubercular patients; programs for the care, custody, and treatment of
addictive disease; and other facilities, institutions, or programs which now or
hereafter come under the supervision and administrative control of the
department. With respect to all such facilities, institutions, or programs the
department shall have the following powers and duties:
(1) To create all necessary offices, appoint and remove all officers of such
facilities, institutions, or programs, prescribe and change the duties of such
officers from time to time, and fix their salaries as provided for by the pay
plan covering positions under the State Merit System of Personnel
Administration and in accordance with rules and regulations of the State
Personnel Board, except that the commissioner shall not be subject to the State
Merit System of Personnel Administration or the rules and regulations of the
State Personnel Board. The department shall discharge and cause to be
prosecuted any officer or other person who shall assault any patient in any of
such facilities or institutions or who shall knowingly use toward any such
patient any other or greater force than the occasion may require;
(2) To refuse or accept and hold in trust for any such facility, institution,
or program any grant or devise of land or bequest or donation of money or other
property for the particular use specified or, if no use is specified, for the
general use of such facility, institution, or program;
(3) To bring suit in its name for any claims which any such facility or
institution may have, however arising;
(4) To appoint police of such facilities, institutions, or programs who are
authorized, while on the grounds or in the buildings of the respective
facilities, institutions, or programs to make arrests with the same authority,
power, privilege, and duties as the sheriffs of the respective counties in
which such facilities, institutions, or programs are situated. If because of
the contagious or infectious nature of the disease of persons arrested
facilities are not available for their detention, such police shall be
authorized to confine such persons within the respective facilities,
institutions, or programs pending trial as provided in other cases. After trial
and conviction of any such person, he or she shall be sentenced to serve his or
her term of sentence in the secured ward of the facility, institution, or program;
and
(5) To have full authority to receive patients ordered admitted to such
facilities, institutions, or programs pursuant to any law, to receive any
voluntary patients, to discharge such patients pursuant to law, to contract
with patients or other persons acting on behalf of patients or legally
responsible therefor, and in general to exercise any
power or function with respect to patients provided by law. It is the intent of
the General Assembly to provide always the highest quality of diagnosis, treatment,
custody, and care consistent with medical, therapeutic, and habilitative
evidence based practice and knowledge. It is the further intent of the General
Assembly that the powers and duties of the department with respect to patients
shall be administered by persons properly trained professionally for the
exercise of their duties, consistent with the intention expressed in this Code
section.
(b) The board is empowered to prescribe all rules and regulations for the
management of such facilities, institutions, and programs not conflicting with
the law.
§ 37-1-24.
No provision in this title shall require the department or any facility or
private facility or any community service board to utilize a physician in lieu
of a psychologist or a psychologist in lieu of a physician in performing
functions under this title even though this title authorizes either a physician
or a psychologist to perform the function.
§ 37-2-1.
(a) The State of Georgia recognizes its responsibility for its citizens who are
mentally ill or developmentally disabled including individuals with epilepsy,
cerebral palsy, autism, and other neurologically disabling conditions or who
abuse alcohol, narcotics, or other drugs and recognizes an obligation to such
citizens to meet their needs through a coordinated system of community
facilities, programs, and services.
(b) It is the policy of this state to provide adequate
mental health, developmental disability, addictive disease, and other
disability services to all its citizens. It is further the policy of this state
to provide such services through a unified system which encourages cooperation
and sharing of resources among all providers of such services, both
governmental and private.
(c) It is the purpose of this chapter to enable and encourage
the development of comprehensive, preventive, early detection, habilitative, rehabilitative, and treatment disability
services; to improve and expand community programs for the disabled; to provide
continuity of care through integration of county, area, regional, and state
services and facilities for the disabled; to provide for joint disability
services and the sharing of manpower and other resources; and to monitor and
restructure the system of providing disability services in the State of Georgia
to make better use of the combined public and private resources of the state
and local communities.
(d) The provisions of this chapter shall be liberally
construed to achieve the objectives set forth in this Code section.
§ 37-2-2.
As used in
this chapter, the term:
(1) 'Addictive disease' means the abuse of, addiction to, or
dependence upon alcohol or other drugs and includes substance abuse.
(2) 'Community service board' means a public mental health,
developmental disabilities, and addictive diseases board established pursuant
to Code Section 37-2-6 which provides one or more mental health, developmental
disabilities, and addictive diseases services through contract with the
department. Such community service board may enroll with the department to
become a provider of specific mental health, developmental disabilities, and
addictive diseases services with such services being negotiated and contracted
annually with the department.
(3) 'Consumer' means a natural person who has been or is a
recipient of disability services as defined in this Code section.
(4) 'Developmental disability' includes mental retardation and other
neurologically disabling conditions, including epilepsy, cerebral palsy, and
autism, which require treatment similar to that for individuals with mental
retardation.
(5) 'Director' means the director of the Division of Mental Health,
Developmental Disabilities, and Addictive Diseases.
(6) 'Disability' means:
(A) Mental or emotional illness;
(B) Developmental disability; or
(C) Addictive disease.
(7) 'Disability services' means services to the disabled or
services which are designed to prevent or ameliorate the effect of a
disability.
(8) 'Disabled' means any person or persons having a disability.
(9) 'Division' means the Division of Mental Health, Developmental Disabilities,
and Addictive Diseases of the Department of Human Resources.
(10) 'Hospital' means a state owned or state operated facility providing
services which include, but are not limited to, inpatient care and the
diagnosis, care, and treatment or habilitation of the disabled. Such hospital
may also provide or manage state owned or operated programs in the community.
(11) 'Regional board' means a regional mental health, mental retardation, and
substance abuse board established in accordance with Code Section 37-2-4.1 as
that Code section existed on June 30, 2002.
(12) 'Regional office' means the Division of Mental Health, Developmental
Disabilities, and Addictive Diseases of the Department of Human Resources
office created pursuant to Code Section 37-2-4.1. Such office shall be an
office of the division which shall serve as the entity for the administration
of disability services in a region.
(13) 'Regional planning board' means a regional mental health, developmental
disabilities, and addictive diseases board established in accordance with Code
Section 37-2-4.1.
§ 37-2-2.1.
The Department of Human Resources shall have a Division of Mental Health,
Developmental Disabilities, and Addictive Diseases.
§ 37-2-3.
(a) The board shall designate boundaries for mental health,
developmental disabilities, and addictive diseases regions and may modify the
boundaries of such regions from time to time as deemed necessary by the board.
(b) The division, with the approval of the commissioner,
shall designate community service areas, which shall serve as boundaries for
the establishment and operation of community service boards within this state
for the purpose of delivering disability services. The division shall be
authorized to initiate the redesignation of such
community service area boundaries and may consider requests from a county or
group of counties for recommended changes to the boundaries of the community
service areas.
(c) To the extent practicable, the boundaries for regional planning boards and
offices and community service areas shall not subdivide any county unit or
conflict with any districts established by the department and the state
relating to the planning for, or delivery of, health services. In dividing the
state into areas, the board, the department, and the division shall take into
consideration such factors as geographic boundaries, roads and other means of
transportation, population concentrations, city and county lines, other
relevant community services, and community economic and social relationships.
Consideration shall also be given to the existence of facilities and personnel
available in the areas for the delivery of disability services.
§ 37-3-1.
As used in this chapter, the term:
(.1) 'Available outpatient treatment' means outpatient
treatment, either public or private, available in the patientīs community, including but not limited to
supervision and support of the patient by family, friends, or other responsible
persons in that community. Outpatient treatment at state expense shall be
available only within the limits of state funds specifically appropriated therefor.
(1) 'Chief medical officer' means the physician with overall
responsibility for patient treatment at any facility receiving patients under
this chapter or a physician appointed in writing as the designee of such chief
medical officer.
(2) 'Clinical record' means a written record pertaining to
an individual patient and shall include all medical records, progress notes, charts,
admission and discharge data, and all other information which is recorded by a
facility or other entities responsible for a patientīs
care and treatment under this chapter and which pertains to the patientīs hospitalization and treatment. Such other
information as may be required by rules and regulations of the board shall also
be included.
(3) 'Community mental health center' means an organized
program for the care and treatment of the mentally ill operated by a community
service board or other appropriate public provider.
(4) 'Court' means:
(A) In the case of an individual who
is 17 years of age or older, the probate court of the county of residence of
the patient or the county in which such patient is found. Notwithstanding Code
Section 15-9-13, in any case in which the judge of such court is unable to hear
a case brought under this chapter within the time required for such hearing or
is unavailable to issue the order specified in subsection (b) of Code Section
37-3-41, such judge shall appoint a person to serve and exercise all the
jurisdiction of the probate court in such case. Any person so appointed shall
be a member of the State Bar of Georgia and shall be otherwise qualified for
his duties by training and experience. Such appointment may be made on a
case-by-case basis or by making a standing appointment of one or more persons.
Any person receiving such standing appointment shall serve at the pleasure of
the judge making the appointment or his successor in office to hear such cases
if and when necessary. The compensation of a person so appointed shall be as
agreed upon by the judge who makes the appointment and the person appointed
with the approval of the governing authority of the county for which such
person is appointed and shall be paid from the county funds of said county. All
fees collected for the services of such appointed person shall be paid into the
general funds of the county served; or
(B) In the case of an individual who
is under the age of 17 years, the juvenile court of the county of residence of
the patient or the county in which such patient is found.
(5) 'Emergency receiving facility' means a facility
designated by the department to receive patients under emergency conditions as
provided in Part 1 of Article 3 of this chapter.
(6) 'Evaluating facility' means a facility designated by the
department to receive patients for psychiatric evaluation as provided in Part 2
of Article 3 of this chapter.
(7) 'Facility' means any state owned or state operated
hospital, community mental health center, or other facility utilized for the
diagnosis, care, treatment, or hospitalization of persons who are mentally ill;
any facility operated or utilized for such purpose by the United States
Department of Veterans Affairs or other federal agency; and any other hospital
or facility within the State of Georgia approved for such purpose by the
department.
(8) 'Full and fair hearing' or 'hearing' means a proceeding
before a hearing examiner under Code Section 37-3-83 or Code Section 37-3-93 or
before a court as defined in paragraph (4) of this Code section. The hearing
may be held in a regular courtroom or in an informal setting, in the discretion
of the hearing examiner or the court, but the hearing shall be recorded
electronically or by a qualified court reporter. The patient shall be provided
with effective assistance of counsel. If the patient cannot afford counsel, the
court shall appoint counsel for him or the hearing examiner shall have the
court appoint such counsel; provided, however, that the patient shall have the
right to refuse in writing the appointment of counsel, in the discretion of the
hearing examiner or the court. The patient shall have the right to confront and
cross-examine witnesses and to offer evidence. The patient shall have the right
to subpoena witnesses and to require testimony before the hearing examiner or
in court in person or by deposition from any physician upon whose evaluation
the decision of the hearing examiner or the court may rest. The patient shall
have the right to obtain a continuance for any reasonable time for good cause
shown. The hearing examiner and the court shall apply the rules of evidence
applicable in civil cases. The burden of proof shall be upon the party seeking
treatment of the patient. The standard of proof shall be by clear and
convincing evidence. At the request of the patient, the public may be excluded
from the hearing. The patient may waive his right to be present at the hearing,
in the discretion of the hearing examiner or the court. The reason for the
action of the court or hearing examiner in excluding the public or permitting
the hearing to proceed in the patientīs absence shall
be reflected in the record.
(9) 'Individualized service plan' means a proposal developed
during a patientīs stay in a facility and which is
specifically tailored to the individual patientīs
treatment needs. Each plan shall clearly include the following:
(A) A statement of treatment goals
or objectives, based upon and related to a proper
evaluation, which can be reasonably achieved within a designated time interval;
(B) Treatment methods and procedures
to be used to obtain these goals, which methods and procedures are related to
these goals and which include a specific prognosis for achieving these goals;
(C) Identification of the types of
professional personnel who will carry out the treatment and procedures,
including appropriate medical or other professional involvement by a physician
or other health professional properly qualified to fulfill legal requirements
mandated under state and federal law;
(D) Documentation of patient
involvement and, if applicable, the patientīs
accordance with the service plan; and
(E) A statement attesting that the
chief medical officer has made a reasonable effort to meet the planīs individualized treatment goals in the least
restrictive environment possible closest to the patientīs
home community.
(9.1) 'Inpatient' means a person who is mentally ill and:
(A)(i) Who
presents a substantial risk of imminent harm to that person or others, as
manifested by either recent overt acts or recent expressed threats of violence
which present a probability of physical injury to that person or other persons;
or
(ii) Who is so unable to care for
that personīs own physical health and safety as to create
an imminently life-endangering crisis; and
(B) Who is in need of involuntary
inpatient treatment.
(9.2) 'Inpatient treatment' or 'hospitalization' means a
program of treatment for mental illness within a hospital facility setting.
(9.3) 'Involuntary treatment' means inpatient or outpatient
treatment which a patient is required to obtain pursuant to this chapter.
(10) 'Least restrictive alternative,' 'least restrictive
environment,' or 'least restrictive appropriate care and treatment' means that
which is the least restrictive available alternative, environment, or care and
treatment, respectively, within the limits of state funds specifically
appropriated therefor.
(11) 'Mentally ill' means having a disorder of thought or
mood which significantly impairs judgment, behavior, capacity to recognize
reality, or ability to cope with the ordinary demands of life.
(12) 'Mentally ill person requiring involuntary treatment'
means a person who is an inpatient or an outpatient.
(12.1) 'Outpatient' means a person who is mentally ill and:
(A) Who is not an inpatient but who, based on the personīs
treatment history or current mental status, will require outpatient treatment
in order to avoid predictably and imminently becoming an inpatient;
(B) Who because of the personīs current mental status, mental history, or nature
of the personīs mental illness is unable voluntarily
to seek or comply with outpatient treatment; and
(C) Who is in need of involuntary treatment.
(12.2) 'Outpatient treatment' means a program of treatment
for mental illness outside a hospital facility setting which includes, without
being limited to, medication and prescription monitoring, individual or group
therapy, day or partial programming activities, case management services, and
other services to alleviate or treat the patientīs
mental illness so as to maintain the patientīs
semi-independent functioning and to prevent the patientīs
becoming an inpatient.
(13) 'Patient' means any mentally ill person who seeks
treatment under this chapter or any person for whom such treatment is sought.
(14) 'Private facility' means any hospital facility that is
a proprietary hospital or a hospital operated by a nonprofit corporation or
association approved for the purposes of this chapter, as provided herein, or
any hospital facility operated by a hospital authority created pursuant to the
'Hospital Authorities Law,' Article 4 of Chapter 7 of Title 31.
(14.1) 'Psychologist' means a licensed psychologist who
meets the criteria of training and experience as a health service provider
psychologist as provided in Code Section 31-7-162.
(14.2) 'Regional state hospital administrator' means the
chief administrative officer of a state owned or state operated hospital and
the state owned or operated community programs in a region. The regional state
hospital administrator, under the supervision of the regional coordinator, has
overall management responsibility for the regional state hospital and manages
services provided by employees of the regional state hospital and employees of
state owned or operated community programs within a mental health,
developmental disabilities, and addictive diseases region established in
accordance with Code Section 37-2-3.
(15) 'Representatives' means the persons appointed as
provided in Code Section 37-3-147 to receive notice of the proceedings for
voluntary or involuntary treatment.
(16) 'Superintendent' means the chief administrative officer
who has overall management responsibility at any facility receiving patients
under this chapter, other than a regional state hospital or state owned or
operated community program, or an individual appointed as the designee of such
superintendent.
(16.1) 'Traumatic brain injury' means a traumatic insult to
the brain and its related parts resulting in organic damage thereto which may
cause physical, intellectual, emotional, social, or vocational changes in a
person. It shall also be recognized that a person having a traumatic brain
injury may have organic damage or physical or social disorders, but for the
purposes of this chapter, traumatic brain injury shall not be considered mental
illness as defined in paragraph (11) of this Code section.
(17) 'Treatment' means care, diagnostic and therapeutic
services, including the administration of drugs, and any other service for the
treatment of an individual.
(18) 'Treatment facility' means a facility designated by the
department to receive patients for psychiatric treatment as provided in Code
Sections 37-3-80 through 37-3-84.
§ 37-3-2.
(a) The board shall issue regulations to implement this chapter in accordance
with the intent of this chapter to safeguard the rights of the mentally ill, as
set forth in Code Sections 37-3-100, 37-3-101, and 37-3-120, and Article 6 of
this chapter.
(b) In addition to the other powers provided by this chapter, the department
shall have the authority:
(1) To enforce the regulations issued by the board;
(2) To prescribe the forms of applications, records, medical certificates, and
any other forms required or used under this chapter and the information
required to be contained therein;
(3) To require such reports from any facility as it may find necessary to the
performance of its duties or functions;
(4) To visit facilities regularly to review the hospitalization procedures
applied to all patients;
(5) To determine the care and treatment being given all patients;
(6) To investigate complaints and make reports and recommendations relative to
the same; and
(7) To make effective such procedures and orders as may be appropriate to carry
out this chapter.
Notwithstanding the powers granted to the department under this Code section,
the requirements of this Code section as to determination of treatment and care
of patients and the investigation of complaints shall not apply to patients
hospitalized in an institution operated by or under the control of the United
States Department of Veterans Affairs or any other federal agency.
§ 37-3-3.
No hospitalization of a mentally ill person lawful before
§ 37-3-4.
Any physician, psychologist, peace officer, attorney, or health official, or
any hospital official, agent, or other person employed by a private hospital or
at a facility operated by the state, by a political subdivision of the state,
or by a hospital authority created pursuant to Article 4 of Chapter 7 of Title
31, who acts in good faith in compliance with the admission and discharge
provisions of this chapter shall be immune from civil or criminal liability for
his actions in connection with the admission of a patient to a facility or the
discharge of a patient from a facility.
§ 37-3-5.
If, during the period of involuntary hospitalization
pursuant to any valid physicianīs certificate, court
order, or order by the hearing examiner authorized by this chapter, a patient
escapes or otherwise leaves a facility without permission, the facility may
advise any peace officer that the patient has escaped or otherwise left the
facility without permission; and the peace officer shall be authorized to take
the patient into custody and return him to such facility.
§ 37-3-6.
Any private facility within this state may be approved as an emergency
receiving facility, an evaluating facility, or a treatment facility by the
department at the request of or with the consent of the governing officers of such
private facility. When so approved, the private facility shall have all powers
given to the corresponding type of state owned or state operated facility under
the provisions of this chapter on voluntary admission, emergency admission,
admission for evaluation, and involuntary hospitalization and shall have all
duties and obligations of such facilities imposed by this chapter, except that
any such private facility may decline to accept any patient who is unable to
pay it for hospitalization or for whom it has no available space.
§ 37-3-7.
Any person who abandons or leaves any patient on the grounds
of any state owned or state operated psychiatric hospital without the
permission of the regional state hospital administrator of the hospital commits
the offense of criminal trespass.
§ 37-3-8.
Any person who loiters about or trespasses on the property of any state owned
or state operated psychiatric hospital or drives or rides over the grounds or
roads of such hospital property with horses, automobiles, bicycles,
motorcycles, or other vehicles, except in accordance with such rules and
regulations as may be posted under the authority of the board, commits the
offense of criminal trespass.
§ 37-3-20.
(a) The chief medical officer of any facility may receive
for observation and diagnosis any patient 12 years of age or older making
application therefor, any patient under 18 years of
age for whom such application is made by his parent or guardian, and any
patient who has been declared legally incompetent and for whom such application
is made by his guardian. If found to show evidence of mental illness and to be
suitable for treatment, such person may be given care and treatment at such
facility; and such person may be detained by such facility until discharged
pursuant to Code Section 37-3-21 or 37-3-22. The parents or guardian of a minor
child must give written consent to such treatment. An individualized service
plan shall be developed for such person as soon as possible.
(b) Any individual voluntarily admitted to a facility under
this Code section shall be given notice of his rights under this chapter at the
time of his admission.
§ 37-3-21.
(a) The chief medical officer of the facility shall
discharge any voluntary patient who has recovered from his mental illness or
who has sufficiently improved that the chief medical officer determines, after
consideration of the recommendations of the treatment team, that
hospitalization of the patient is no longer necessary, provided that in no
event shall any such patient be so discharged if, in the judgment of the chief
medical officer of such facility, such discharge would be unsafe for the
patient or others. The chief medical officer may designate in writing a
physician or psychologist, who may be the attending physician or treating
psychologist, to make these discharge decisions. If the decision of the
designee is contrary to the recommendations of the treatment team or of a
physician or psychologist member of the treatment team, the issue must go to
the chief medical officer for final determination. Where there is concurrence,
the decision of the designee will be final.
(b) Notice of discharge of patients who have been transferred from involuntary
to voluntary status shall be given pursuant to Code Section 37-3-24.
§ 37-3-22.
(a) A voluntary patient, other than a minor child for whom admission has been
sought by his parents or guardian, who has admitted himself to a facility
pursuant to subsection (a) of Code Section 37-3-20 or any voluntary patientīs personal representative, legal guardian, parent,
spouse, attorney, or adult next of kin may request such patientīs
discharge in writing at any time after his admission. If the patient was
admitted on his own application and the request for discharge is made by a
person other than the patient, the discharge shall be conditioned upon the
agreement of the patient thereto, unless such other person is the legal
guardian of the patientīs person. The request for
discharge may be submitted to the chief medical officer or to any staff physician
or staff psychologist or staff registered nurse of the facility for transmittal
to the chief medical officer. If the patient or another on his behalf makes an
oral request for release to any member of the staff or other service provider,
the patient must within 24 hours be given assistance in preparing a written
request. The person to whom a written request is submitted shall deliver the
request to the chief medical officer within 24 hours, Saturdays, Sundays, and
legal holidays excluded. Within 72 hours, excluding Sundays and legal holidays,
of the delivery of a written request for release to the chief medical officer,
the patient must be discharged from the facility, unless the chief medical
officer finds that the discharge would be unsafe for the patient or others, in
which case proceedings for involuntary treatment must be initiated under either
Code Section 37-3-41, Code Section 37-3-61, or Code Section 37-3-81.
(b) Notice of discharge of patients who have been
transferred from involuntary to voluntary status shall be given pursuant to
Code Section 37-3-24.
§ 37-3-23.
At the time of his admission and each six months thereafter, any voluntary
patient admitted to a facility under Code Section 37-3-20 or transferred to
voluntary status under Code Section 37-3-24 shall be notified in writing of his
right to discharge upon application under Code Section 37-3-22 and of all other
rights granted to patients under this chapter.
§ 37-3-24.
Any involuntary patient may apply to be transferred to voluntary status of
hospitalization and shall be so transferred if he is able to understand and
exercise the rights and powers of a voluntary patient unless the chief medical
officer finds that this would not be in the best interest of the patient, which
finding shall be entered in the patientīs clinical
record and signed by the chief medical officer. In any case in which such
transfer to voluntary status occurs and in any case in which a patient
transferred to voluntary status is discharged, notice of such transfer or discharge,
as the case may be, shall be given: to the patient and his representatives; if
the patientīs hospitalization was ordered by the
court, to the court which entered such order; if the patient was admitted to a
facility under subsection (a) of Code Section 37-3-41, to the physician or
psychologist executing the certificate; and, if the patient was under criminal
charges, of which the facility received written notification, by certified mail
or statutory overnight delivery to the law enforcement agency originally having
custody of the patient. An involuntary patient transferred to voluntary status,
which patient is under criminal charges, notice of which charges have been
given in writing to the facility, may only be discharged into the physical
custody of the law enforcement agency originally having custody of the patient.
Such agency shall assume such custody within five days after the mailing of
notification to the agency pursuant to this Code section.
§ 37-3-40.
Any state owned and state operated facility may be designated by the department
as an emergency receiving facility. The department shall maintain an emergency
receiving facility at each
§ 37-3-41.
(a) Any physician within this state may execute a certificate stating that he
has personally examined a person within the preceding 48 hours and found that,
based upon observations set forth in the certificate, the person appears to be
a mentally ill person requiring involuntary treatment. A physicianīs
certificate shall expire seven days after it is executed. Any peace officer,
within 72 hours after receiving such certificate, shall make diligent efforts
to take into custody the person named in the certificate and to deliver him forthwith
to the nearest available emergency receiving facility serving the county in
which the patient is found, where he shall be received for examination.
(b) The appropriate court of the county in which a person
may be found may issue an order commanding any peace officer to take such
person into custody and deliver him forthwith for examination, either to the
nearest available emergency receiving facility serving the county in which the
patient is found, where such person shall be received for examination, or to a
physician who has agreed to examine such patient and who will provide, where
appropriate, a certificate pursuant to subsection (a) of this Code section to
permit delivery of such patient to an emergency receiving facility pursuant to
subsection (a) of this Code section. Such order may only be issued if based
either upon an unexpired physicianīs
certificate, as provided in subsection (a) of this Code section, or upon the
affidavits of at least two persons who attest that, within the preceding 48 hours,
they have seen the person to be taken into custody and that, based upon
observations contained in their affidavit, they have reason to believe such
person is a mentally ill person requiring involuntary treatment. The court
order shall expire seven days after it is executed.
(c) Any peace officer taking into custody and delivering for
examination a person, as authorized by subsection (a) or (b) of this Code
section, shall execute a written report detailing the circumstances under which
such person was taken into custody. The report and either the physicianīs certificate or court order authorizing such
taking into custody shall be made a part of the patientīs
clinical record.
(d) Any psychologist, clinical social worker, or clinical nurse specialist in
psychiatric/mental health may perform any act specified by this Code section to
be performed by a physician. Any reference in any part of this chapter to a
physician acting under this Code section shall be deemed to refer equally to a
psychologist, a clinical social worker, or a clinical nurse specialist in
psychiatric/mental health acting under this Code section. For purposes of this
subsection, the term 'psychologist' means any person authorized under the laws
of this state to practice as a licensed psychologist, the term 'clinical social
worker' means any person authorized under the laws of this state to practice as
a licensed clinical social worker, and the term 'clinical nurse specialist in
psychiatric/mental health' means any person authorized under the laws of this
state to practice as a registered professional nurse and who is recognized by
the Georgia Board of Nursing to be engaged in advanced nursing practice as a
clinical nurse specialist in psychiatric/mental health.
§ 37-3-42.
(a) A peace officer may take any person to a physician
within the county or an adjoining county for emergency examination by the
physician, as provided in Code Section 37-3-41, or directly to an emergency
receiving facility if (1) the person is committing a penal offense, and (2) the
peace officer has probable cause for believing that the person is a mentally
ill person requiring involuntary treatment. The peace officer need not formally
tender charges against the individual prior to taking the individual to a
physician or an emergency receiving facility under this Code section. The peace
officer shall execute a written report detailing the circumstances under which
the person was taken into custody; and this report shall be made a part of the patientīs clinical record.
(b) Any psychologist may perform any act specified by this
Code section to be performed by a physician. Any reference in any part of this
chapter to a physician acting under this Code section shall be deemed to refer
equally to a psychologist acting under this Code section. For purposes of this
subsection, the term 'psychologist' means any person authorized under the laws
of this state to practice as a licensed psychologist.
§ 37-3-43.
(a) A patient who is admitted to an emergency receiving
facility shall be examined by a physician as soon thereafter as possible but in
any event within 48 hours and may be given such emergency treatment as is
indicated by good medical practice. The patient must be discharged within 48
hours of his admission unless:
(1) An examining physician or psychologist concludes that there is reason to
believe that the patient may be a mentally ill person requiring involuntary
treatment and executes a certificate to that effect within such time; or
(2) The patient is under criminal charges, notice of which has been given in
writing to the facility, in which case the provisions of Code Section 37-3-95
shall apply.
Nothing in this chapter shall be construed to prohibit a physician or
psychologist who previously executed a certificate authorized by the provisions
of this chapter from executing any other certificate provided for in this
chapter for the same or any other patient.
(b) Within 24 hours of the execution of the certificate under paragraph (1) of
subsection (a) of this Code section, the patient shall be transported, as
provided in Code Section 37-3-101, to an evaluating facility where he shall be
received pursuant to Code Section 37-3-63 unless the patient has been
determined and certified to meet all of the outpatient treatment requirements
of paragraphs (1) and (2) of subsection (c) of Code Section 37-3-90, in which
event the patient shall be discharged under the conditions provided in Code
Section 37-3-91, except that if the patient is under criminal charges, notice
of which has been given in writing to the facility, the provisions of Code
Section 37-3-95 shall apply.
(c) Notice of any proposed discharge shall be given to the patient and his
representatives; if the patient was admitted to the facility under subsection
(a) of Code Section 37-3-41, to the physician or psychologist who executed the
certificate; if the patient was admitted to the facility under subsection (b)
of Code Section 37-3-41, to the court which issued the order; and, if the
patient was under criminal charges, written notice of which had been given to
the facility, by certified mail or statutory overnight delivery to the law
enforcement agency originally having custody of the patient.
§ 37-3-44.
(a) Immediately upon arrival of a patient at an emergency
receiving facility under Code Section 37-3-43, the facility shall give the
patient written notice of his right to petition for a writ of habeas corpus or
for a protective order under Code Section 37-3-148. This written notice shall
also inform the patient that he has a right to legal counsel and that, if the
patient is unable to afford counsel, the court will appoint counsel.
(b) The notice informing the patientīs
representatives of the patientīs hospitalization in
an emergency receiving facility shall include a clear notification that the
representatives may petition for a writ of habeas corpus or for a protective
order under Code Section 37-3-148.
§ 37-3-60.
Any state owned or state operated facility may be designated by the department
as an evaluating facility. The department shall maintain an evaluating facility
at each
§ 37-3-61.
Proceedings for a court ordered evaluation may be initiated in the following
manner:
(1) Any person may file an
application executed under oath with the community mental health center for a
court ordered evaluation of a person located within that county who is alleged
by such application to be a mentally ill person requiring involuntary treatment.
Upon the filing of such application, the community mental health center shall
make a preliminary investigation and, if the investigation shows that there is
probable cause to believe that such allegation is true, it shall file a
petition with the court in the county where the patient is located seeking an
involuntary admission for evaluation; and
(2) Any person may file with the court a petition executed under oath alleging
that a person within the county is a mentally ill person requiring involuntary
treatment. The petition must be accompanied by the certificate of a physician
or psychologist stating that he has examined the patient within the preceding
five days and has found that the patient may be a mentally ill person requiring
involuntary treatment and that a full evaluation of the patient is necessary.
§ 37-3-62.
(a) The court shall review the petition filed under Code Section 37-3-61 and,
if it finds reasonable cause to believe that the patient may be a mentally ill
person requiring involuntary treatment, the court shall hold a full and fair
hearing on the petition no sooner than ten days and no later than 15 days after
such petition is filed. Within five days after the filing of such petition, the
court shall serve notice of the hearing upon the patient and his
representatives and upon the petitioner. Representatives for the patient shall
be appointed pursuant to Code Section 37-3-147, provided that the court shall
designate the second representative or, in the absence of designation of one representative
by the patient, both representatives; and, in the absence of such
representatives or if the department is the guardian, the court shall appoint a
guardian ad litem who is not the department. The notice required by this Code
section shall include the time and place of the hearing; notice of the patientīs right to counsel, that the patient or his
representatives may apply for court appointed counsel if the patient cannot
afford counsel, and that the court will appoint counsel unless the patient indicates
in writing that he does not wish to be represented by counsel; and notice that
the patient may waive his rights to a hearing under this Code section. A copy
of the petition filed under Code Section 37-3-61 shall be attached to the
notice. The patient shall have a right to counsel. If the patient is unable to
afford counsel, the court shall appoint counsel for the patient unless the
patient indicates in writing that he does not desire to be represented by
counsel. The hearing may be waived by the patient after appointment or waiver
of counsel.
(b) After a full and fair hearing or, if the hearing is
waived, after a full review of the evidence, if the court is satisfied that
immediate evaluation is necessary, the court shall issue an order to any peace
officer to deliver the patient forthwith to the evaluating facility designated
by the department to admit persons ordered by that court to be evaluated.
§ 37-3-63.
Any person who is brought to an evaluating facility under Code Section 37-3-43
or under a court order as provided in Code Section 37-3-62 shall be received
for evaluation and such treatment as is indicated by good medical practice.
§ 37-3-64.
(a) A patient who has been admitted to an evaluating facility pursuant to Code
Section 37-3-43, 37-3-63, or subparagraph (a)(3)(B) of Code Section 37-3-81.1
may be detained for a period not to exceed five days, Saturdays, Sundays, and
holidays excluded. The patient shall be discharged upon a finding that the
patient is not a mentally ill person requiring involuntary treatment or upon a
finding and certification that the patient meets all of the outpatient
treatment requirements of paragraphs (1) and (2) of subsection (c) of Code
Section 37-3-90, in which event a patient meeting those outpatient treatment requirements
shall be discharged under the conditions provided in Code Section 37-3-91 but,
in any event, upon the expiration of the five-day evaluation period unless:
(1) Within that period:
(A) The patient is admitted as a voluntary patient under Code Section 37-3-20;
or
(B) The patient is admitted for involuntary inpatient treatment under Code
Section 37-3-81; or
(2) The patient is under criminal charges, notice of which has been given in
writing to the facility, in which case the provisions of Code Section 37-3-95
shall apply.
(b) If hospitalization appears desirable, the staff physicians or psychologists
of the evaluating facility shall encourage the patient to apply for voluntary
hospitalization unless the attending physician or treating psychologist finds
that the patient is unable to understand the nature of voluntary
hospitalization, that voluntary hospitalization would be harmful to the
patient, or that the patient is determined to be a mentally ill person in need
of involuntary treatment, which finding shall be entered in the patientīs record.
(c) If, after evaluation of the patient, it is determined by the chief medical
officer that proceedings for involuntary treatment of the patient should be
initiated pursuant to Code Section 37-3-81 or pursuant to Part 4 of this
article, the chief medical officer shall direct that an individualized service
plan be developed for that patient during the five-day period that he is
detained for evaluation in the facility.
(d) Notice of the discharge shall be given to the patient and his
representatives; to the person who filed the petition; if the patient was
admitted to the evaluating facility from an emergency receiving facility under
Code Section 37-3-43, to the physician or psychologist who executed the certificate
or to the court which issued the order pursuant to Code Section 37-3-41; if the
patient was under criminal charges of which the facility received written
notification, by certified mail or statutory overnight delivery to the law
enforcement agency originally having custody of the patient; and, if the
patient was admitted to the evaluating facility under Code Section 37-3-62, to
the court that ordered the evaluation.
§ 37-3-65.
Any patient admitted to an evaluating facility may apply to
the chief medical officer of that facility for transfer at his own expense to
any other approved evaluating facility. If the evaluating facility to which
transfer is requested agrees to admit the patient, and if the patient is able
to pay for evaluation at such facility, he shall be transferred forthwith. In
such case, Code Section 37-3-64 shall apply; and the time periods specified
shall be counted from the date of admission to the evaluating facility to which
the patient is transferred. Notice of the transfer shall be given to the patientīs representatives; to the person who filed the
original petition, if any; if the patient was admitted to the evaluating
facility from an emergency receiving facility under Code Section 37-3-43, to
the physician or psychologist who executed the certificate or to the court
which issued the order pursuant to Code Section 37-3-41; if the patient was
under criminal charges of which the facility received written notification, by
certified mail or statutory overnight delivery to the law enforcement agency
originally having custody of the patient; and, if the patient was admitted to
the evaluating facility under Code Section 37-3-62, to the court that ordered
the evaluation.
§ 37-3-80.
Any state owned or state operated facility may be designated
by the department as a treatment facility. The department shall maintain a
treatment facility at each regional hospital which shall accept patients found
in any county in the service region of the hospital. Any other facility within
the State of
§ 37-3-81.
(a) The patient may be detained at a facility beyond the evaluation period
unless voluntary hospitalization is sought under subparagraph (a)(1)(A) of Code
Section 37-3-64 only upon the recommendation of the chief medical officer of an
evaluating facility where the patient has been examined under Part 2 of this
article, which recommendation is supported by the opinions of two physicians or
a physician and a psychologist who have personally examined the patient within
the preceding five days and who agree that the patient is a mentally ill person
requiring involuntary treatment but who does not meet the outpatient treatment
requirements of paragraphs (1) and (2) of subsection (c) of Code Section
37-3-90. Such recommendation of the chief medical officer and the opinions of
the physicians or physician and psychologist shall be entered on a certificate.
The certificate shall be filed along with a petition for a hearing in the court
of the county in which the patient is being detained for evaluation. Nothing in
this chapter shall be construed to prohibit a physician or psychologist or a
chief medical officer who has previously executed any other certificate
authorized by the provisions of this chapter from executing a certificate
provided for in this Code section for the same or any other patient. The
certificate and petition shall be filed within five days, Saturdays, Sundays,
and holidays excluded, after the patient is admitted to a facility for
evaluation under Code Section 37-3-63. Such filing shall authorize detention of
the patient by the facility pending completion of a full and fair hearing under
this Code section. Copies of the certificate shall be served on the patient and
his representatives within five days after the certificate is filed and shall
be accompanied by:
(1) A notice that a hearing will be held and the time and place thereof;
(2) A notice that the patient has a right to counsel, that the patient or his
representatives may apply immediately to the court to have counsel appointed if
the patient cannot afford counsel, and that in such case the court will appoint
counsel for the patient unless the patient indicates in writing that he does
not desire to be represented by counsel;
(3) A copy of the individualized service plan developed by the facility under
this chapter shall be sent to the patient and shall be sent to the patientīs representative if requested by such representative.
Notice of the right to receive such plan shall be given to the representatives
at the time the service plan is sent to the patient;
(4) A notice that the patient has a right to be examined by a physician or
psychologist of his own choice at his own expense and to have that physician or
psychologist submit a suggested service plan for the patient which conforms
with the requirements of paragraph (9) of Code Section 37-3-1; and
(5) A notice that the patient may waive in writing the hearing described in
subsection (c) of this Code section.
(b) If the hearing is waived, the certificate shall serve as authorization for
the patient to begin treatment under the terms of the individualized service
plan; and the chief medical officer of the facility where the patient is
located shall be responsible for the supervision of the service plan.
(c) In any case in which a patient is retained in an evaluating facility
pursuant to a petition filed under subsection (a) of this Code section, the
court shall hold a full and fair hearing as provided in Code Section 37-3-81.1
unless the hearing is waived in writing by the patient. The hearing shall be
held no sooner than seven days and no later than 12 days after the petition is
filed with the court.
§ 37-3-81.1.
(a) At those hearings required under subsection (c) of Code Section 37-3-81 and subsection (a) of Code Section 37-3-92, the court shall determine whether the patient is a mentally ill person requiring involuntary treatment and, if so, whether the patient is an inpatient or outpatient and, unless otherwise provided in this subsection, the type of involuntary treatment the patient should be ordered to obtain. At such hearing, if the court determines:
(1) That the patient is not a mentally ill person requiring involuntary treatment, the court shall order that the patient be immediately discharged;
(2) That the patient is an outpatient, the court shall further determine, based upon either the individualized service plan required to be prepared under subsection (c) of Code Section 37-3-64 or subsection (b) of Code Section 37-3-91 or the individualized service plan proposed by the physician or psychologist chosen by the patient, whether there is available outpatient treatment for the patient which meets the requirements of the plan chosen by the court and whether the patient will likely obtain that treatment so as to minimize the likelihood of the patient´s becoming an inpatient. If the court determines that there is such available outpatient treatment which the patient will likely obtain so as to minimize the likelihood of the patient´s becoming an inpatient, then the court shall order the patient to obtain that treatment and shall discharge the patient subject to such order;
(3) That the patient is an outpatient who does not meet the requirements for discharge under paragraph (2) of this subsection and:
(A) The patient has been admitted to either an evaluating or treatment facility and there received an evaluation within 45 days prior to the date of the hearing under this Code section, the court shall order that the patient be discharged; or
(B) The patient has not been admitted to either an evaluating or treatment facility and there received an evaluation within 45 days prior to the date of the hearing under this Code section, the court shall order that the patient be admitted to an evaluating facility, and this chapter shall thereafter apply to that patient as though that patient had been ordered by a court to be admitted to that facility pursuant to Code Section 37-3-62; or
(4) That the patient is an inpatient, the court shall order that the patient shall be transported to a treatment facility where the patient shall be admitted for care and treatment, which order may also require that a period of such inpatient treatment be followed by available outpatient treatment if there is such outpatient treatment which will meet the requirements of the patient´s individualized service plan and the patient will likely obtain the treatment so as to minimize the likelihood of the patient´s becoming an inpatient.
(b) If the court at a hearing under subsection (a) of this Code section concludes that the patient is a mentally ill person requiring involuntary treatment, it shall make findings of fact and conclusions of law in support of that conclusion as part of its final order.
(c) The court may order the hospitalization of any patient pursuant to paragraph (4) of subsection (a) of this Code section for any period not to exceed six months, subject to the power of the chief medical officer to discharge the patient under subsection (b) of Code Section 37-3-85. If continued hospitalization is necessary at the end of that period, the chief medical officer shall apply for an order authorizing such continued hospitalization under Code Section 37-3-83.
(d) The court may order the patient to obtain available outpatient treatment under the additional conditions specified in Code Sections 37-3-93 and 37-3-94.
§ 37-3-82.
(a) If at any time during a period of involuntary outpatient treatment,
including but not limited to interim outpatient treatment arranged pursuant to
subsection (b) of Code Section 37-3-91, the physician or psychologist in charge
of the patientīs outpatient service plan determines
that, because of a change in the patientīs condition,
the least restrictive alternative which would accomplish the treatment goals is
hospitalization of the patient, then that physician or psychologist may execute
a certificate under the conditions specified in subsection (a) of Code Section
37-3-41. That certificate shall have the same duration and effect as a
certificate issued pursuant to subsection (a) of Code Section 37-3-41.
(b) If at any time during a period of involuntary outpatient treatment,
including but not limited to interim outpatient treatment arranged pursuant to
subsection (b) of Code Section 37-3-91, the patient fails without good cause or
refuses to comply with the outpatient service plan, the physician or psychologist
in charge of the outpatient service plan or that physicianīs
or psychologistīs designee may petition the court
originally approving the involuntary treatment of the patient or the court of
the county in which the patient is a resident or where the patient may be found
for an order authorizing a peace officer to take the patient and immediately
deliver the patient to the community mental health center in charge of the patientīs outpatient service plan, if a physician or
psychologist is available there to examine the patient, or to the nearest
emergency receiving facility serving the county in which the patient is found.
If in the discretion of the court such an order is issued, the patient shall be
delivered to the facility and may be given such emergency or other medical
treatment as is indicated by good medical practice. The patient must be
released from the custody of the community mental health center within four
hours and from the custody of the emergency receiving facility within 48 hours
after being taken into the custody of that center or facility unless the
examining physician or psychologist concludes that, because of a change in the patientīs condition, the least restrictive alternative
which would accomplish the treatment goals is hospitalization of the patient.
The physician or a psychologist may then execute a certificate under the
conditions specified therefor in subsection (a) of
Code Section 37-3-41, if the examination is done in a community mental health
center, or under the conditions specified therefor in
Code Section 37-3-43, if the examination is done in an emergency receiving
facility. That certificate shall have the same duration and effect as a
certificate issued pursuant to subsection (a) of Code Section 37-3-41 or Code
Section 37-3-43, as applicable.
(c) With regard to a patient required to obtain involuntary outpatient
treatment, the court may issue any order authorized under subsection (b) of
Code Section 37-3-41, but if the court knows that patient is required to obtain
involuntary outpatient treatment, that court may issue such order only upon the
courtīs determination, in addition to any other
conditions for the issuance of that order, that such patient has not complied
with the involuntary outpatient treatment or that the patient reasonably
appears to be an inpatient.
(d) Any patient detained in a facility pursuant to this Code section shall not
be required during that period of detention to obtain outpatient treatment
required by any order which is then in effect and which was issued pursuant to
this chapter. That order shall otherwise remain in full force and effect
notwithstanding the patientīs detention in or release
from the facility unless that facility obtains a court order authorized by Code
Section 37-3-81.1 which expressly supersedes the prior order.
§ 37-3-83.
(a) If it is necessary to continue involuntary treatment of a hospitalized
patient beyond the end of the period during which the treatment facility is
currently authorized under this chapter to retain the patient, the chief
medical officer prior to the expiration of the period shall seek an order
authorizing such continued treatment in the manner provided in this Code
section. The chief medical officer may seek such an order authorizing continued
involuntary treatment involving inpatient treatment, outpatient treatment, or
both under the procedures of this Code section and Code Section 37-3-93.
(b) If the chief medical officer finds that continued involuntary treatment is
necessary (1) for an individual who was admitted while serving a criminal
sentence but whose sentence is about to expire or (2) for an individual who was
hospitalized while under the jurisdiction of a juvenile court but who is about
to reach the age of 17, the chief medical officer shall seek an order
authorizing such continued treatment in the manner provided in this Code
section; and this chapter shall apply fully to such a patient after that time.
(c) A Committee for Continued Involuntary Treatment Review shall be established
by the chief medical officer of each hospital and shall consist of not less
than five persons of professional status, at least one of whom shall be a
physician and at least two others of whom shall be either physicians or
psychologists. The committee may conduct its meetings with a quorum of any
three members at least one of whom shall be a physician. The function of this
committee shall be to review and evaluate the updated individualized service
plan of each patient of the hospital and to report to the chief medical officer
its recommendations concerning the patientīs need for
continued involuntary treatment. No person who has responsibility for the care
and treatment of the individual patient for whom continued involuntary
treatment is requested shall serve on any committee which reviews such individualīs case.
(d) If the chief medical officer desires to seek an order under this Code
section authorizing continued involuntary treatment for up to 12 months beyond
the expiration of the currently authorized period of hospitalization, he shall
first file a notice of such intended action with the Committee for Continued
Involuntary Treatment Review, which notice shall be forwarded to the committee
at least 60 days prior to the expiration of that period.
(e) Within ten days of the date of the notice, the committee shall meet to
consider the matter of the chief medical officerīs
intention to seek an order for continued involuntary treatment. Prior to the committeeīs meeting, the patient and his representatives
shall be notified of the following: the purpose of such meeting, the time and
place of such meeting, their right to be present at such meeting, and their
right to present any alternative individualized service plan secured at their
expense. In those cases in which the patient will not or cannot appear, at
least one member of the committee will make all reasonable efforts to interview
the patient and report to the committee. The physician or psychologist
proposing the treatment plan shall present an updated individualized service
plan for the patient to the committee. The committee shall report to the chief
medical officer or his designee, other than the physician or psychologist
proposing the treatment plan or a member of the committee, its written
recommendations along with any minority recommendations which may also be
submitted. Such report will specify whether or not the patient is a mentally
ill person requiring involuntary treatment and whether continued
hospitalization is the least restrictive alternative available.
(f) If, after considering the committeeīs
recommendations and minority recommendations, if any, the chief medical officer
or his designee, other than the attending physician or a member of the
committee, determines that the patient is not a mentally ill person requiring
involuntary treatment, the patient shall be immediately discharged from
involuntary hospitalization pursuant to subsection (b) of Code Section 37-3-85.
(g) If, after considering the committeeīs
recommendations and minority recommendations, if any, the chief medical officer
or his designee, other than the attending physician or member of the committee,
determines that the patient is a mentally ill person requiring involuntary
treatment, he shall, within ten days after receiving the committeeīs
recommendations, serve a petition for an order authorizing continued
involuntary treatment along with copies of the updated individualized service
plan and the committeeīs report on the designated
office within the department and shall also serve such petition along with a
copy of the updated individualized service plan on the patient. A copy of the
petition shall be served on the patientīs
representatives. The petition shall contain a plain and simple statement that
the patient or his representatives may file a request for a hearing with a
hearing examiner appointed pursuant to Code Section 37-3-84 within 15 days
after service of the petition, that the patient has a right to counsel at the
hearing, that the patient or his representatives may apply immediately to the
court to have counsel appointed if the patient cannot afford counsel, and that
the court will appoint counsel for the patient unless the patient indicates in
writing that he does not desire to be represented by counsel or has made his
own arrangements for counsel.
(h) If a hearing is not requested by the patient or the representatives within
15 days of service of the petition on the patient and his representatives, the
hearing examiner shall make an independent review of the committeeīs
report, the updated individualized service plan, and the petition. If he
concludes that continued involuntary treatment may not be necessary or if he
finds any member of the committee so concluded, then he shall order that a
hearing be held pursuant to subsection (i) of this
Code section. If he concludes that continued involuntary treatment is
necessary, then he shall order continued involuntary treatment involving
inpatient treatment, outpatient treatment, or both for a period not to exceed
one year.
(i) If a hearing is requested within 15 days of
service of the petition on the patient and his representatives or if the
hearing examiner orders a hearing pursuant to subsection (h) or (j) of this
Code section, the hearing examiner shall set a time and place for the hearing
to be held within 25 days of the time the hearing examiner receives the request
but in any event no later than the day on which the current order of
involuntary inpatient treatment expires. Notice of the hearing shall be served
on the patient, his representatives, the facility, and, when appropriate, on
counsel for the patient. The hearing examiner, within his discretion, may grant
a change of venue for the convenience of parties or witnesses. Such hearing
shall be a full and fair hearing, except that the patientīs
attorney, when the patient is unable to attend the hearing and is incapable of
consenting to a waiver of his appearance, may move that the patient not be
required to appear; however, the record shall reflect the reasons for the
hearing examinerīs actions. After such hearing, the
hearing examiner may issue any order which the court is authorized to issue
under Code Section 37-3-81.1 and subject to the limitations of that Code
Section 37-3-81.1, provided that a patient who is an outpatient who does not
meet the requirements for discharge under paragraph (2) of subsection (a) of
Code Section 37-3-81.1 shall nevertheless be discharged and provided that the
hearing examiner may order the patientīs continued
inpatient treatment, outpatient treatment, or both for a period not to exceed
one year, subject to the power to discharge the patient under subsection (b) of
Code Section 37-3-85 or under Code Section 37-3-94. In the event that an order
approving continued hospitalization is entered for an individual who was
admitted while serving a criminal sentence under the jurisdiction of the
Department of Corrections, but whose sentence is about to expire, the chief
medical officer shall serve a copy of that order upon the Department of
Corrections within five working days of the issuance of the order.
(j) The hearing examiner for a patient who was admitted under the jurisdiction
of the juvenile court and who reaches the age of 17 without having had a full
and fair hearing pursuant to any provisions of this chapter or without having
waived such hearing shall order that a hearing be held pursuant to subsection (i) of this Code section.
§ 37-3-84.
(a) One or more hearing examiners shall be appointed by the Justices of the
Supreme Court to hold the hearings under Code Section 37-3-83. Such hearing
examiners shall be members of the State Bar of Georgia and shall be compensated
by the department.
(b) The hearing examiners shall have the authority to:
(1) Administer oaths and affirmations;
(2) Sign and issue subpoenas;
(3) Rule upon offers of proof;
(4) Regulate the course of the hearing;
(5) Provide for the taking of testimony by deposition;
(6) Reprimand or exclude from the hearing any person for any indecorous or
improper conduct committed in the presence of the hearing examiner; and
(7) Make all appropriate orders authorized by this chapter.
(c) If a subpoena issued by the hearing examiner is disobeyed, the hearing
examiner may apply to the superior court of the county in which the hearing is
held for an order requiring obedience. Failure to comply with such order shall
be cause for punishment as for contempt of court.
(d) In the event a patient desires counsel in a hearing before the hearing
examiner but cannot afford such counsel, the hearing examiner shall apply to
the court of the county in which the hearing is held and that court shall
appoint counsel for the patient. Payment for such representation shall be made
by the county of the patientīs legal residence.
§ 37-3-85.
(a) Each individualized service plan for a patient receiving involuntary
inpatient treatment shall be reviewed at regular intervals to determine the patientīs progress toward the stated goals and objectives
of the plan and to determine whether the plan should be modified because of the
patientīs present condition. These reviews should be
based upon relevant progress notes in the patientīs
clinical record and upon other related information; and input from the patient
should be obtained and utilized where feasible.
(b) Any time a patient receiving involuntary inpatient treatment is found by
the chief medical officer, after consideration of the recommendations of the
treatment team, no longer to be a mentally ill person requiring involuntary
inpatient treatment, the chief medical officer may:
(1) Discharge the patient from involuntary outpatient or inpatient treatment,
or both, subject to the conditions of Code Section 37-3-95;
(2) Discharge the patient from involuntary inpatient treatment and require that
the patient obtain available outpatient treatment for the remaining period the
patient was to have been required to obtain inpatient treatment, as long as the
patient then meets the standards for being discharged to outpatient treatment
under paragraph (2) of subsection (a) of Code Section 37-3-81.1 and subject to
the conditions of Code Section 37-3-95; or
(3) Transfer the patient to voluntary status at the patientīs
request, as provided in Code Section 37-3-24.
(c) The chief medical officer may designate in writing another physician, who
may be the attending physician, to make these discharge decisions. If the
decision of the designee is contrary to the recommendations of the treatment
team, the issue must go to the chief medical officer for final determination.
Where the treatment team and the designee concur, the decision of the designee
will be final.
(d) Notice of the discharge or the transfer of status shall be given to the
patient and his representatives; if the patientīs
hospitalization was authorized by order of a court, to the court which entered
such order; and, if the patient was under criminal charges of which the
facility received written notification, by certified mail or statutory
overnight delivery to the law enforcement agency originally having custody of
the patient.
§ 37-3-90.
(a) When a physician or psychologist at a facility or on behalf of a facility
determines and certifies under this article that there is reason to believe a
patient admitted to or examined at the facility is a mentally ill person
requiring involuntary treatment, that physician or psychologist shall further
determine and certify whether there is reason to believe the patient is:
(1) An inpatient or outpatient; and
(2) If an outpatient, whether there is available outpatient treatment.
(b) Unless otherwise specifically provided, the determination and certification
as to paragraphs (1) and (2) of subsection (a) of this Code section shall be
made within the time period required for determining whether a patient is a
mentally ill person requiring involuntary treatment, except that if such
determination is made by a physician or psychologist at or on behalf of a
community mental health center, the determination and certification shall be
made within four hours after the patient is examined by the physician or psychologist.
(c) A person determined and certified to be:
(1) An outpatient; and
(2) A person for whom there is available outpatient treatment shall be
considered to be in need of involuntary outpatient treatment and not
involuntary inpatient treatment for purposes of further proceedings under this
article until such time as that personīs status is
determined to be otherwise pursuant to those proceedings.
(d) A person determined and certified to be a mentally ill
person requiring involuntary treatment who does not meet all of the
requirements of paragraphs (1) and (2) of subsection (c) of this Code section
shall be considered to be in need of involuntary inpatient treatment and not
involuntary outpatient treatment for purposes of further proceedings under this
article until such time as that personīs status is
determined to be otherwise pursuant to those proceedings.
(e) Any minor admitted voluntarily shall be released at any
time after written request is made by the minorīs
parent or legal guardian.
§ 37-3-91.
(a) A person who is in the physical custody of a community mental health
center, emergency receiving facility, or evaluating facility and who is
determined by a physician or a psychologist, at or on behalf of that facility,
to meet all of the outpatient treatment requirements of paragraphs (1) and (2)
of subsection (c) of Code Section 37-3-90 shall be discharged from that
facility as provided in this Code section pending a full and fair hearing or
waiver thereof under Code Section 37-3-92. That discharge from a community
mental health center shall occur within four hours after the patient is
examined by a physician or a psychologist at or on behalf of that center. That
discharge from an emergency receiving facility shall occur within 48 hours
after the patientīs admission thereto. That discharge
from an evaluating facility shall occur no later than the expiration of the
five-day evaluation period established under Code Section 37-3-64.
(b) Prior to a psychologistīs discharging the patient
under subsection (a) of this Code section, the treating psychologist shall
obtain the concurrence of a physician. In addition, within the time period the
facility is authorized to retain the patient, the facility at which or on
behalf of which the patient was examined, which facility shall be the
'referring facility' for purposes of this part, shall prepare an individualized
service plan for the patient. This plan shall be prepared in consultation with
the facility at which available outpatient treatment is to be provided the
patient, which facility shall be the 'receiving facility' for purposes of this
part. The referring facility shall also make arrangements with the receiving
facility to provide interim outpatient treatment, in accordance with the
individualized service plan, to the patient pending the full and fair hearing
or waiver thereof. Nothing in this Code section shall prevent a referring
facility for a patient from also being the receiving facility for that patient.
(c) A patient for whom interim outpatient treatment is arranged pursuant to
subsection (b) of this Code section shall obtain that treatment or be subject
to the provisions of Code Section 37-3-82. Written notice of the time, date,
place, and address for that interim outpatient treatment shall be provided the
patient prior to the patientīs discharge, along with
written notification that if the patient does not comply with the interim
outpatient treatment or attend or waive a hearing, the time and date of which
hearing will later be provided the patient, the patient may be involuntarily
admitted for examination, treatment, or both. Notice of the discharge shall be
provided to persons other than the patient in the same manner and under the
same conditions as required by subsection (c) of Code Section 37-3-43 and
subsection (d) of Code Section 37-3-64, and that notice shall also include a
notice regarding the interim outpatient treatment and the consequences if the
patient does not obtain the treatment or attend or waive the hearing.
(d) Within three days after a referring facility has discharged a patient
pursuant to subsection (a) of this Code section, that facility shall transmit
to the receiving facility a copy of the referring facilityīs
examination report, individualized service plan, and such other necessary
clinical information the referring facility may have regarding the patient.
Within five days after receiving such report, plan, and information, the
receiving facility shall petition the court of the county in which the patient
is located for a full and fair hearing pursuant to Code Section 37-3-92 and
include with the petition a copy of the examination report, the individualized
service plan, and the address to which the patient was discharged by the
referring facility.
(e) Notwithstanding the provisions of subsection (a) of this Code section, a
patient detained in a treatment facility pursuant to a certificate and petition
under Code Section 37-3-81, whether or not that patient is subsequently
determined by that facility during the time of such detention to meet all of
the outpatient treatment requirements of paragraphs (1) and (2) of subsection
(c) of Code Section 37-3-90, may not be discharged from that facility until a
full and fair hearing is held pursuant to Code Section 37-3-81.1, which hearing
may not be waived by any patient so determined to meet all of such outpatient
treatment requirements.
§ 37-3-92.
(a) Except when a hearing is waived as provided in this subsection, within 30
days after the filing of the petition under subsection (d) of Code Section
37-3-91, the court shall hold a full and fair hearing. At least ten days prior
to that hearing, the court shall have served on the patient and the patientīs representatives the same notices and information
required by paragraphs (1) through (4) of subsection (a) of Code Section
37-3-81, as well as a notice that the patient may waive in writing the hearing
but if the patient does not either attend or waive the hearing the court may
order the patient to be taken into custody, hospitalized, evaluated, and
treated. The patient and representatives shall have the rights specified in
those notices. Hearings held pursuant to this subsection shall be held as
provided in Code Section 37-3-81.1, and the court holding the hearing may issue
any order authorized by and subject to the limitations of that Code Section
37-3-81.1.
(b) If the patient is notified of the hearing as required
under subsection (a) of this Code section and does not appear at or waive that
hearing, absent a showing of good cause for not appearing, the court may issue
an order commanding any peace officer to take such person into custody and
deliver that person to an emergency receiving facility or the referring
facility if there is a physician or psychologist available there, and this
chapter shall thereafter apply to that patient as though the patient had been
admitted to that facility pursuant to subsection (b) of Code Section 37-3-41.
(c) If the hearing is waived as provided in subsection (a) of this Code
section, that hearing shall not be held but the court shall order the patient
to obtain available outpatient treatment under the individualized service plan
submitted with the petition for hearing.
§ 37-3-93.
(a) Pursuant to Code Section 37-3-81.1 or Code Section 37-3-92, the court may
order the patient to obtain available outpatient treatment for any period not
to exceed one year, but the total period of involuntary treatment required by
such order, including inpatient treatment within the limitations of Code
Section 37-3-81.1, shall not exceed one year.
(b) If it is necessary to continue available outpatient treatment beyond the
period authorized pursuant to subsection (a) of this Code section, at least 60
days prior to the expiration of that period the physician or psychologist responsible
for that treatment or the person responsible for the patientīs
treatment under the direction and with approval of the physician or
psychologist shall:
(1) Update the patientīs individualized service plan;
(2) Prepare a report containing evidence that the patient meets all the
requirements for available outpatient treatment under paragraphs (1) and (2) of
subsection (c) of Code Section 37-3-90; and
(3) Petition the hearing examiners appointed to hold hearings under Code
Section 37-3-83 for an order requiring the patient to obtain available
outpatient treatment beyond the period previously ordered for the patient.
The petition shall contain a plain and simple statement that the patient or the
patientīs representatives may file a request for a
hearing with a hearing examiner appointed to hold hearings pursuant to Code
Section 37-3-83 within 15 days after service of the petition, that the patient
has a right to counsel at the hearing, that the patient or the patientīs representatives may apply immediately to the
court to have counsel appointed if the patient cannot afford counsel, and that
the court will appoint counsel for the patient unless the patient indicates in
writing that the patient does not desire to be represented by counsel or has
made the patientīs own arrangements for counsel.
(c) If a hearing is not requested by the patient or the representatives within
15 days of service of the petition on the patient and the patientīs
representatives, the hearing examiner shall make an independent review of the
report, the updated individualized service plan, and the petition. If the
hearing examiner concludes from that review that the patient is no longer a
mentally ill person requiring involuntary treatment, then that hearing examiner
shall order that a hearing be held pursuant to subsection (d) of this Code
section. If the hearing examiner concludes that the patient meets all the
requirements for available outpatient treatment under paragraphs (1) and (2) of
subsection (c) of Code Section 37-3-90, then the hearing examiner shall order
continued outpatient treatment for a period not to exceed one year.
(d) If the hearing examiner orders a hearing pursuant to subsection (c) or (e)
of this Code section or if a hearing is requested within 15 days of service of
the petition on the patient and the patientīs
representatives, the hearing examiner shall set a time and place for the
hearing to be held within 25 days of the time the hearing examiner receives the
request but in any event no later than the day on which the current order of
involuntary outpatient treatment expires. Notice of the hearing shall be served
on the patient, the patientīs representatives, the
facility providing outpatient treatment for the patient, and, when appropriate,
on counsel for the patient. The hearing examiner, within that personīs discretion, may grant a change of venue for the
convenience of parties or witnesses. Such hearing shall be a full and fair
hearing. After such hearing, the hearing examiner may issue any order which the
court is authorized to issue under paragraphs (1), (2), and (3) of subsection
(a) of Code Section 37-3-81.1 and subject to the limitations of that Code
section. If the patient does not appear at the hearing, absent a showing of
good cause, the hearing examiner may issue any order the court is authorized to
issue under subsection (b) of Code Section 37-3-92.
(e) The hearing examiner for a patient who is ordered to obtain available
outpatient treatment, who is under the jurisdiction of the juvenile court, and
who reaches the age of 17 without having had a full and fair hearing pursuant
to any provisions of this article or without having waived such hearing shall
order that a hearing be held pursuant to subsection (d) of this Code section.
§ 37-3-94.
(a) Each individualized service plan for available outpatient treatment shall
be reviewed at regular intervals to determine the patientīs
progress toward the stated goals and objectives of the plan and to determine
whether the plan should be modified because of the patientīs
present condition. These reviews should be based upon relevant progress notes
in the patientīs clinical record and upon other
related information; and input from the patient should be obtained and utilized
where feasible.
(b) Any time a patient is found by the physician or psychologist in charge of
the patientīs outpatient treatment no longer to be a
mentally ill person requiring involuntary treatment, that physician or
psychologist shall discharge the patient from further compliance with the treatment.
(c) Notice of the discharge under subsection (b) of this
Code section shall be given to the patient and his representatives; to the
court which originally ordered such involuntary treatment; and, if the patient
was under criminal charges of which the facility received written notification,
by certified mail or statutory overnight delivery to the law enforcement agency
originally having custody of the patient.
§ 37-3-95.
Notwithstanding any other provisions of any part of this article, a patient under
criminal charges, notice of which has been given in writing to the facility,
may only be discharged from the physical custody of a facility if the facility,
by certified mail or statutory overnight delivery, provides written
notification of the proposed discharge to the law enforcement agency originally
having custody of the patient and the patient is discharged into the physical
custody of a peace officer from that agency. That agency shall be required to
assume such physical custody within five days after receipt in writing of the
notification of proposed discharge.
§ 37-3-100.
(a) The department may designate the state owned or state operated facility to
which a patient is to be admitted under this chapter. The department may
instead designate a private facility, approved under Code Section 37-3-6, to
which the patient is to be admitted, if the department has obtained the prior
agreement of the private facility and of the patient or his representatives.
(b) A patient hospitalized in a state owned or state
operated facility under this chapter may apply for transfer at his own expense
to a private facility approved under Code Section 37-3-6 if he is able to pay
for treatment at such private facility. If the private facility agrees to
accept the patient, the department shall transfer the patient to that facility.
(c) If a private facility requests the department to take custody of a patient
who has been hospitalized therein under this chapter and if the patient meets
the criteria for admission under this chapter, then the department shall accept
the patient and designate the state owned or state operated facility to which
the patient shall be admitted.
(d) When the needs of the patient or efficient utilization of any facility so
requires, a patient may be transferred from one facility to another. At the
time of any such transfer, notice shall be given in writing to the patient and
to his representatives and the patient shall be advised in writing of the
reasons for his transfer. A voluntary patient may be transferred only with his
consent.
(e) A patient hospitalized in a private facility, approved under Code Section
37-3-6, or that patientīs representative may request
that facility to transfer the patient to a state owned or operated facility.
That private facility shall then request the department to take custody of the
patient. If the patient meets the criteria for admission under this chapter,
then the private facility shall transfer the patient and the department shall
accept the patient and designate the state owned or operated facility to which
the patient shall be admitted.
§ 37-3-101.
(a) The governing authority of the county where the patient is found or located
shall arrange for initial emergency transport of a patient to an emergency
receiving facility. Except as otherwise authorized under subsection (b) of this
Code section, the governing authority of the county of the patientīs
residence shall arrange for all required transportation for mental health
purposes subsequent to the initial transport. The type of vehicle employed
shall be in the discretion of the governing authority of the county, provided
that, whenever possible, marked vehicles normally used for the transportation
of criminals or those accused of crimes shall not be used for the transportation
of patients. The court shall, upon the request of the community mental health
center, order the sheriff to transport the patient in such manner as the patientīs condition demands. At any time the community
mental health center is satisfied that the patient can be transported safely by
family members or friends, such private transportation shall be encouraged and
authorized. In nonemergency situations, no female
patient shall be transported at any time without another female in attendance
who is not a patient, unless such female patient is accompanied by her husband,
father, adult brother, or adult son.
(b) Notwithstanding the provisions of subsection (a) of this Code section, when
a patient is under the care of a facility, the facility shall have the
discretion to determine the type of vehicle to safely transport the patient and
to arrange for such transportation without the need to obtain the prior
approval of the governing authority of the county of the patientīs
residence, the court, or the community mental health center. This subsection
shall not prevent the facility from requesting and receiving transportation
services from the governing authority of the county of the patientīs
residence and shall not relieve the county sheriff of the duty of providing
transportation. Persons providing transportation are authorized to transport a
patient from a sending facility to a receiving facility but shall not release
the patient under any circumstances except into the custody of the receiving
facility. The use of physical restraints to ensure the safe transport of the
patient shall comply with the requirements of Code Section 37-3-165. When
transportation is not provided by the county sheriff, the expense of such
transportation shall not be billed to the county governing authority but may be
billed to the patient and, unless agreed to in writing by the facility, shall
not be billed to or considered an obligation of the facility.
§ 37-3-102.
(a) If a patient ordered to be hospitalized pursuant to this
chapter is eligible for hospital care or treatment by the United States
Department of Veterans Affairs or any other federal agency, the department
shall transfer the patient to the custody of the nearest such agency with
available bed space for diagnosis, care, or treatment. When any such patient is
admitted under this Code section to any such hospital or institution within or
outside the state, he shall be subject to the rules and regulations of such
agency. Upon notification from the superintendent or the chief medical officer
of the United States Department of Veterans Affairs Medical Center for those
patients therein who may require involuntary treatment pursuant to this
chapter, the patient will be evaluated, while remaining in the physical custody
of the United States Department of Veterans Affairs Medical Center, by the
nearest emergency receiving facility. The superintendent and chief medical
officer of any hospital or institution operated by such agency in which the
individual is so hospitalized shall, with respect to such individual, be vested
with the same powers and duties as the superintendent and chief medical officer
of facilities within this state with respect to all matters under this chapter.
Jurisdiction is retained in the appropriate courts of this state at any time to
inquire into the mental condition of an individual so hospitalized to determine
the necessity for continuance of his hospitalization and to order his release;
and every transfer of a patient by the department pursuant to this Code section
is so conditioned.
(b) An order of a court of competent jurisdiction of another
state, territory, or possession or of the District of Columbia authorizing
hospitalization of a patient by any agency of the United States shall have the
same force and effect as to the patient while in this state as in the
jurisdiction in which is situated the court entering the order; and the courts
of the state, territory, possession, or district issuing such order shall be
deemed to have retained jurisdiction of the patient so hospitalized for the
purpose of inquiring into his mental condition and determining the necessity
for continuance of his hospitalization, as is provided in subsection (a) of
this Code section with respect to patients ordered hospitalized by the courts
of this state. Consent is given for the application of the law of the state,
territory, possession, or district in which is located the court issuing the
order for hospitalization with respect to the authority of the chief medical
officer of any hospital or institution operated in this state by the United
States Department of Veterans Affairs or any other federal agency to retain
custody, transfer, furlough, or discharge the patient therein
hospitalized.
§ 37-3-103.
Upon application to the department by a parent, spouse, next of kin, or
guardian or by an agency of another state in which the patient is hospitalized,
a patient shall be eligible to be hospitalized in the State of
§ 37-3-104.
If a hospitalized patient is discovered not to be a resident, the regional
state hospital administrator of the treatment facility in which the patient is
hospitalized shall seek his transfer to the custody of authorities of the state
of his residence or to a publicly owned or publicly operated psychiatric
hospital in that state. Notwithstanding an individualīs
status as a nonresident, nothing contained in this Code section shall prevent
the voluntary hospitalization of such individual under this chapter for which
due payment is made by such individual or others on his behalf nor shall it
prevent the transfer, custody, care, or treatment of such individual in
accordance with the terms of any reciprocal agreement between the State of
Georgia and any other state, the District of Columbia, or any territory or
possession of the United States. This Code section shall not apply to persons
confined to any facility operated by or under the control of the United States
Department of Veterans Affairs or any other federal agency.
§ 37-3-120.
It is the policy of this state that no person shall be
denied care and treatment for mental illness nor shall services be delayed at a
facility of the state or a political subdivision of the state because of
inability to pay for such care and treatment.
§ 37-3-121.
(a) The responsibility for paying the expenses for transporting, examining, and
caring for patients, which expenses are not provided for under Chapter 9 of
this title, relating to the payment of costs of care of persons admitted to
state institutions under the department, shall be in the following order:
(1) The patient or his estate;
(2) Persons legally obligated or legally responsible for the support of the
patient;
(3) The county of the patientīs legal residence,
provided that the county governing authority passes an appropriate resolution
assuming such responsibility; and
(4) The department, when the General Assembly appropriates funds for such
purpose.
(b) The patient or those legally obligated for his support shall not be
responsible for such expenses as described above when they were incurred in
transporting a patient who is released by a court or a facility before
involuntary treatment as not being a mentally ill person in need of involuntary
treatment.
(c) The board is authorized to issue rules and regulations governing the
provisions of this Code section as it relates to the department.
§ 37-3-122.
(a) Except as provided in this Code section, the expenses of any hearing held
under this chapter by a court or by a hearing examiner, including attorneysī
fees authorized by paragraph (1) of subsection (b) of this Code section and
including hearing officer expenses authorized by paragraph (3) of subsection
(b) of this Code section, shall be paid by the county in which the patient has
his residence or, if the patient is a transient, by the county in which the
patient was initially taken into the custody of the state. Payment by such
county of the hearing expenses shall only be required if the person who
actually presides over the hearing executes an affidavit or includes a
statement in his final order relating to the hearing that the assets of the
patient, his estate, and any persons legally obligated to support the patient
appear to be insufficient to defray such expenses, based upon all relevant
information available to the person who actually presides over the hearing.
Such affidavit or statement may include the patientīs
name, address, and age. The cost on appeal to the appropriate court shall be
the same as provided for in other appeals from the probate and juvenile courts.
(b) Expenses of any hearing held under this chapter shall include:
(1) The fee to be paid to an attorney appointed under this chapter to represent
a patient at such hearing. Such fee shall be as agreed between the attorney and
the appointing court but shall not exceed an amount determined under the fee
schedule followed by the county when computing the fees to be paid to an
attorney who has been appointed to represent an indigent criminal defendant
plus actual expenses which an attorney may incur and which have been approved
by the court holding the hearing. In exceptional circumstances, the attorney
may apply to the superior court of the judicial circuit in which the hearing
was held for an order granting reasonable fees in excess of the amounts
specified in this paragraph;
(2) The fee to be paid to the court, which fee shall be to defray the cost of
clerical help and the cost of any additional office space and equipment
required for the conduct of such hearing. In hearings conducted pursuant to
Code Section 37-3-83 such fee shall be $20.00 and in all other hearings under
this chapter such fee shall be $40.00, excluding attorneysī fees and expenses
of the hearing officer; and
(3) The fee to be paid to the hearing officer appointed pursuant to subparagraph
(A) of paragraph (4) of Code Section 37-3-1 to conduct a hearing. Such fee
shall be as agreed between the hearing officer and the appointing court, but
shall not exceed an amount determined under the fee schedule followed by the
county when computing the fees to be paid to an attorney who has been appointed
to represent an indigent criminal defendant plus actual expenses which the
hearing officer may incur and which have been approved by the court holding the
hearing. In exceptional circumstances, the hearing officer may apply to the
superior court of the judicial circuit in which the hearing was held for an
order granting reasonable fees in excess of the amounts specified in this
paragraph. The $40.00 court cost authorized by paragraph (2) of this subsection
shall also be authorized to defray the cost of clerical help and additional
office space and equipment required for the conduct of such hearings.
(c) The expenses incurred by a county for a mental health hearing held by a
probate court judge or an attorney on his or her staff for an out-of-county
patient shall be reimbursed by the county in which the patient has his or her
residence. Such amount shall not exceed the amount which would have been paid
by the county to a noncounty employed hearing
officer, plus any other authorized expenses in connection with the hearing.
§ 37-3-140.
Patients shall retain all rights and privileges granted
other persons or citizens. Notwithstanding any other provision of law to the
contrary, no person who is receiving or has received services for a mental
illness shall be deprived of any civil, political, personal, or property rights
or be considered legally incompetent for any purpose without due process of
law.
§ 37-3-141.
It shall be the responsibility of the department to see that every patient is
given the opportunity to secure legal counsel at his own expense to represent
him in connection with private, personal, domestic, business, civil, criminal,
and all other legal matters in which he may be involved during hospitalization.
§ 37-3-142.
(a) Each patient in a facility shall have the right to
communicate freely and privately with persons outside the facility and to
receive visitors inside the facility.
(b) Except as otherwise provided in this Code section, each
patient shall be allowed to receive and send sealed, unopened mail; and no patientīs incoming or outgoing mail shall be opened,
delayed, held, or censored by the facility.
(c) If there are reasonable grounds to believe that incoming
mail contains items or substances which may be dangerous to the patient or
others, the chief medical officer may direct reasonable examination of such
mail and, after examination, may regulate the disposition of such items or
substances found therein. All writings must be presented to the patient within
24 hours of inspection.
(d) The chief medical officer may apply to the court for a
temporary order to restrict outgoing mail. If the court determines that
probable cause exists that such mail is dangerous to the patient or others, the
court may order such mail temporarily restricted, provided that a full and fair
hearing shall be held within five days after the issuance of such temporary
order to determine whether or not an order of restriction for an extended time
shall issue. In no event shall mail be restricted pursuant to such temporary
order for more than five days after the date of the temporary order. A full and
fair hearing shall be held after the issuance of the temporary order. If, at
such hearing, the patientīs outgoing mail is
determined to be dangerous to the patient or others, the court may order such
mail restricted for an extended period not to exceed 30 days. Restrictions for
extended periods may be renewed for additional periods not to exceed 30 days
each, provided that no such restriction shall be renewed except upon a renewed
finding at another full and fair hearing for each such renewal that such mail
is dangerous to the patient or others.
(e) If an injunction against the sending of mail by a
patient is issued by a court, the chief medical officer shall restrict outgoing
mail as provided by the order of the court.
(f) No restriction of either incoming or outgoing mail under
subsection (c) or (d) of this Code section shall exceed a period of five days,
notwithstanding the authority to restrict such mail for longer periods,
provided that such restrictions may be continued as necessary for periods not
to exceed five days each upon determination by the chief medical officer, prior
to each continuation, that such mail continues to be dangerous to the patient
or others; provided, further, that, in the case of outgoing mail, such
continuation periods in the aggregate shall not exceed the restriction period
authorized in the court order.
(g) Correspondence of the patient with his attorney shall
not be restricted in any manner under this Code section. Correspondence of the
patient with public officials shall not be restricted in any manner under
subsection (c) of this Code section.
(h) Each time a patientīs incoming
mail is ordered examined by the chief medical officer and each time a patientīs outgoing mail is ordered examined by a temporary
court order, written notice of such order and notice of a right to a full and
fair hearing within five days after such temporary court order shall be served
on the patient and his representatives as provided in Code Section 37-3-147. A
voluntary patient may waive in writing such notice to his representatives.
(i) The circumstances surrounding
the examination of any mail under subsection (c), (d), (e), or (f) of this Code
section shall be recorded on the patientīs clinical
record.
(j) The chief medical officer is authorized to establish
reasonable regulations governing visitors, visiting hours, and the use of
telephones by patients.
§ 37-3-143.
A patientīs rights to his personal effects shall be
respected. The chief medical officer may take temporary custody of such effects
when required for medical reasons. The facility shall make reasonable efforts
to assure the safety of the patientīs belongings, but
no employee or staff member shall be responsible for loss of or damage to such
property where reasonable safety precautions have been taken.
§ 37-3-144.
Each patient in a facility who is eligible to vote shall be given his right to
vote in primary, special, and general elections and in
referendums. The superintendent or regional state hospital administrator of
each facility shall permit and reasonably assist patients:
(1) To obtain voter registration forms, applications for absentee ballots, and
absentee ballots;
(2) To comply with other requirements which are prerequisite for voting; and
(3) To vote by absentee ballot if necessary.
§ 37-3-145.
If a patient wishes to be employed outside a facility and if such employment
will aid in the patientīs treatment, he shall be
assisted in his efforts to secure suitable employment and all benefits flowing
from such employment. The department shall encourage such employment of
patients and shall promote the training of patients for gainful employment
after discharge. All benefits of such employment shall accrue solely to the
patient.
§ 37-3-146.
The rights of any child under treatment in a facility to an appropriate
education at public expense shall not be abridged during hospitalization; and
the special educational needs of each child shall be individually considered
and respected. The Department of Human Resources and the State Department of
Education shall ensure that education is provided for all patients of school
age who are hospitalized in any state owned, state operated, or any other
designated facility.
§ 37-3-147.
(a) At the time a patient is admitted to any facility under this chapter, that
facility shall use diligent efforts to secure the names and addresses of at
least two representatives, which names and addresses shall be entered in the patientīs clinical record.
(b) The patient may designate one representative; the second representative or,
in the absence of designation of one representative by the patient, both
representatives shall be selected by the facility. If the facility is to select
both representatives, it must make one selection from among the following
persons in the order of listing: the patientīs legal
guardian, spouse, adult child, parent, attorney, adult next of kin, or adult
friend, provided that, in the case of a patient whose representative or
representatives have been appointed by the court under Code Section 37-3-62,
the facility shall not select a different representative. The second
representative shall also be selected from the above list but without regard to
the order of listing, provided that the second representative shall not be the
person who filed the petition to have the patient admitted to the facility.
(c) If the facility is unable to secure at least two representatives after
diligent search or if the department is the guardian of the patient, that fact
shall be entered in the patientīs clinical record and
the facility shall apply to the court in the county of the patientīs
residence for the appointment of a guardian ad litem, which guardian ad litem
shall not be the department. On application of any person or on its own motion,
the court may also appoint a guardian ad litem for a patient for whom two
representatives have been named whenever the appointment of a guardian ad litem
is deemed necessary for protection of the patientīs
rights. Such guardian ad litem shall also act as representative of the patient
and shall have the powers granted to representatives by this chapter.
(d) At any time notice is required by this chapter to be given to the patientīs representatives, such notice shall be served on
the representatives designated under this Code section. The patientīs
guardian ad litem, if any, shall likewise be served. Unless otherwise provided,
notice may be served in person or by first-class mail. When notice is served by
mail, a record shall be made of the date of mailing and shall be placed in the patientīs clinical record. Service shall be completed upon
mailing.
(e) At any time notice is required by this chapter to be given to the patient,
the date on which notice is given shall be entered on the patientīs
clinical record. If the patient is unable to comprehend the written notice, a
reasonable effort shall be made to explain the notice to him.
(f) At the time a court enters an order pursuant to this chapter, such order
and notice of the date of entry of the order shall be served on the patient and
his representatives as provided in subsection (d) of this Code section.
(g) Notice of an involuntary patientīs admission to a
facility shall be given to his representatives in writing. If such involuntary
admission is to an emergency receiving facility, notice shall also be given by
that facility to the patientīs representatives by
telephone or in person as soon as possible.
(h) In every instance in which a court shall appoint a guardian ad litem for
any person pursuant to the terms of this chapter, such guardianship shall be
for the limited purpose stated in the order of the court and shall expire
automatically after 90 days or after a lesser time stated in the order. The
responsibility of the guardian ad litem shall not extend beyond the specific
purpose of the appointment.
§ 37-3-148.
(a) At any time and without notice, a person detained by a facility or a
relative or friend on behalf of such person may petition, as provided by law,
for a writ of habeas corpus to question the cause and legality of detention and
to request any court of competent jurisdiction on its own initiative to issue a
writ for release, provided that, in the case of any such petition for the
release of a person detained in a facility pursuant to a court order under Code
Section 17-7-130 or 17-7-131, a copy of the petition along with proper
certificate of service shall also be served upon the presiding judge of the
court ordering such detention and the prosecuting attorney for such court,
which service may be made by certified mail or statutory overnight delivery,
return receipt requested.
(b) A patient or his representatives may file a petition in
the appropriate court alleging that the patient is being unjustly denied a
right or privilege granted by this chapter or that a procedure authorized by
this chapter is being abused. Upon the filing of such a petition, the court
shall have the authority to conduct a judicial inquiry and to issue appropriate
orders to correct any abuse under this chapter.
§ 37-3-149.
Each facility shall establish procedures whereby complaints of the patient or
complaints of the staff concerning treatment of the patient can be speedily
heard, with final decisions to be made by the superintendent, the regional
state hospital administrator, or an advisory committee, whichever is
appropriate. The board shall establish reasonable rules and regulations for the
implementation of such procedures. However, the patient shall not be required
to utilize these procedures in lieu of other available legal remedies.
§ 37-3-150.
The patient, the patientīs
representatives, or the patientīs attorney may appeal
any order of the probate court or hearing officer rendered in a proceeding
under this chapter to the superior court of the county in which the proceeding
was held, except as otherwise provided in Article 6 of Chapter 9 of Title 15,
and may appeal any order of the juvenile court rendered in a proceeding under
this chapter to the Court of Appeals and the Supreme Court. The appeal to the
superior court shall be made in the same manner as appeals from the probate
court to the superior court, except that the appeal shall be heard before the
court sitting without a jury as soon as practicable but not later than 30 days
following the date on which the appeal is filed with the clerk of the superior
court. The appeal from the order of the juvenile court to the Court of Appeals
and the Supreme Court shall be as provided by law but shall be heard as
expeditiously as possible. The patient must pay all costs upon filing any
appeal authorized under this Code section or must make an affidavit that he or
she is unable to pay costs. The patient shall retain all rights of review of
any order of the superior court, the Court of Appeals, and the Supreme Court,
as provided by law. The patient shall have a right to counsel or, if unable to
afford counsel, shall have counsel appointed for the patient by the court. The
appeal rights provided to the patient, the patientīs
representatives, or the patientīs attorney in this
Code section are in addition to any other appeal rights which the parties may
have, and the provision of the right for the patient, the patientīs
representatives, or the patientīs attorney to appeal
does not deny the right to the Department of Human Resources to appeal under
the general appeal provisions of Code Sections 5-3-2 and 5-3-3.
§ 37-3-160.
The patientīs dignity as an individual shall be
respected at all times and upon all occasions, including any occasion wherein
the patient is taken into custody, detained, or transported. Mentally ill
patients or those suspected of being mentally ill shall, to the maximum extent
reasonably possible, be treated at all times as medical patients. All patients
shall be treated by a physician or psychologist acting within the scope of his
or her license. Except where required under conditions of extreme urgency,
those procedures, facilities, vehicles, and restraining devices normally
utilized for criminals or those accused of crime shall not be used in
connection with the mentally ill.
§ 37-3-161.
It is the policy of the state that the least restrictive alternative placement be secured for every patient at every stage of his medical
treatment and care. It shall be the duty of the facility to assist the patient
in securing placement in noninstitutional community
facilities and programs.
§ 37-3-162.
(a) Each patient in a facility and each person receiving services for mental
illness shall receive care and treatment that is suited to his needs and is the
least restrictive appropriate care and treatment. Such care and treatment shall
be administered skillfully, safely, and humanely with full respect for the patientīs dignity and personal integrity.
(b) Each patient shall have the right to participate in his care and treatment.
The board shall issue regulations to ensure that each patient participates in
his care and treatment to the maximum extent possible. Unless the disclosure to
the patient is determined by the chief medical officer or the patientīs treating physician or psychologist to be
detrimental to the physical or mental health of the patient, and unless a
notation to that effect is made a part of the patientīs
record, the patient shall have the right to reasonable access to review his
medical file, to be told his diagnosis, to be consulted on the treatment
recommendation, and to be fully informed concerning his medication, including
its side effects and available treatment alternatives.
(c) It is the duty of the chief medical officer to ensure that each patient
receives such medical attention as is suitable to his condition and that no
treatment shall be given which is not recognized as standard psychiatric
treatment, except upon the written consent of the patient or, if applicable,
his guardian having capacity to give such consent. If such consent is given by
someone other than the patient or such guardian, court approval must be
obtained after a full and fair hearing.
(d) If a patient hospitalized under this chapter is able to secure the services
of a private physician or psychologist, he shall be allowed to see his
physician or psychologist at any reasonable time. The chief medical officer is
authorized and directed to establish regulations designed to facilitate
examination and treatment which a patient may request from such private
physician or psychologist.
(e) Every patient admitted to a facility under this chapter shall be examined
by the staff of the admitting facility as soon as possible after his admission.
§ 37-3-163.
(a) It shall be the policy of this state to recognize the personal physical
integrity of all patients.
(b) It shall be the policy of this state to protect, within reason, the right
of every individual to refuse medication except in cases where a physician
determines that refusal would be unsafe to the patient or others. If the
patient continues to refuse medication after such initial emergency treatment,
a concurring opinion from a second physician must be obtained before medication
can be continued without the patientīs consent.
Further, in connection with any hearing under this chapter, the patient has the
right to appear and testify as free from any side effects or adverse effects of
the medication as is reasonably possible.
(c) Any patient objecting to the treatment being administered to him shall have
a right to request a protective order pursuant to Code Section 37-3-148.
(d) Except as provided in subsections (b) and (e) of this Code section, consent
to medical treatment and surgery shall be obtained and regulated by Chapter 9
of Title 31.
(e) In cases of grave emergency where the medical staff of the facility in
which a mentally ill individual has been accepted for treatment determines that
immediate surgical or other intervention is necessary to prevent serious
physical consequences or death and where delay in obtaining consent would
create a grave danger to the physical health of such person, as determined by at
least two physicians, then essential surgery or other intervention may be
administered without the consent of the person, the spouse, next of kin,
attorney, guardian, or any other person. In such cases, a record of the
determination of the physicians shall be entered into the medical records of
the patient and this will be proper consent for such surgery or other
intervention. Such consent will be valid notwithstanding the type of admission
of the patient and it shall also be valid whether or not the patient has been
adjudged incompetent. This Code section is intended to apply to those
individuals who, as a result of their advanced age, impaired thinking, or other
disability, cannot reasonably understand the consequences of withholding
consent to surgery or other intervention as contemplated by this Code section.
Any physician, agent, employee, or official who obtains consent or relies on
such consent, as authorized by this Code section, and who acts in good faith
and within the provisions of this chapter shall be immune from civil or
criminal liability for his actions in connection with the obtaining of or the
relying upon such consent. Actual notice of any action taken pursuant to this
Code section shall be given to the patient and the spouse, next of kin, attorney,
guardian, or representative of the patient as soon as practicably possible.
§ 37-3-164.
(a) As used in this Code section, the term:
(1) 'Representative' means the representative designated by the patient or, in
the absence of such designation, the person selected as a representative in the
order of listing under subsection (b) of Code Section 37-3-147 but shall not
mean the patientīs legal guardian. At the time of
designation or selection, such representative shall be notified of his right to
notice and to consultation under this Code section. In order to exercise such
rights, the representative shall notify the department on a form supplied by
the department of his election to exercise such rights. Upon receiving such
notice, the department shall thereafter provide that representative the
notification and consultation required by this Code section until that
representative notifies the department to the contrary. A patient need not be
notified of his representativeīs rights under this
Code section unless such representative has elected to exercise such rights.
(2) 'Substantial change' means a significant change including, but not limited
to, the transfer within a facility of a patient from a unit primarily serving
patients under 18 years of age to a unit primarily serving patients 18 years of
age or over or the transfer of a patient from one facility to another but shall
not include:
(A) Changes in the routine day-to-day care of the patient;
(B) Routine or periodic changes or adjustments in patient medication;
(C) Changes relating to routine or necessary medical care needs of the patient;
(D) Formulation of the patientīs initial
individualized service plan;
(E) Changes specifically contemplated in a service plan regarding which the
representative has already received notification; or
(F) Discharge of the patient from the facility.
(b) At the time an adult patientīs representative is
designated or selected under Code Section 37-3-147 and at least every 12 months
thereafter, such patient shall be notified that, unless objected to by the
patient, such representative will be permitted to consult with the facility
regarding the development of the patientīs
individualized service plan and the patientīs
treatment under such plan. The representative of a minor patient and the
representative of an adult patient not objecting to consultation as authorized
by this Code section may consult with the facility regarding the development of
such patientīs individualized service plan and the patientīs treatment under such plan.
(c) At least seven days prior to any substantial change in the individualized
service plan or treatment thereunder of an adult
patient, the facility to which the patient has been admitted shall notify the
patient that it will notify his representative of such change, unless the
patient objects to such notification within 24 hours. A patientīs
representative shall be notified at least five days prior to any substantial
change in such patientīs individualized service plan
or the treatment under such plan unless such patient is an adult and objects to
such notification.
(d) In an emergency where the delay due to providing prior notification under
subsection (c) of this Code section would create serious damage to the health
of the patient, such a substantial change may be made without such prior
notification. The patientīs record shall specify the
circumstances surrounding the emergency. Within 48 hours after the change, an
adult patient shall be notified of his right to object within 24 hours to his representativeīs being notified of such change. A patientīs representative shall be notified of such change
within five days after such change occurs unless the patient is an adult and
objects to such notification pursuant to subsection (c) of this Code section.
(e) Notification to representatives under subsections (c) and (d) of this Code
section may be made by telephone if the date and time of such notification is
entered on the patientīs clinical record and if such
notification is followed within 15 days by written notification.
(f) A patientīs legal guardian shall have the
consultation and notification rights of a patientīs
representative under subsections (b) through (d) of this Code section
regardless of whether the patient is a minor or whether the patient objects to
such consultation or notification. A patient for whom a legal guardian has been
appointed shall not be notified of any right to object under this Code section.
§ 37-3-165.
(a) Mistreatment, neglect, or abuse in any form of any patient is prohibited.
Medication in quantities that interfere with the patientīs
treatment program is prohibited. All medication, seclusion, or physical
restraints are to be used solely for the purposes of providing effective
treatment and protecting the safety of the patient and other persons.
(b) Physical restraints shall not be applied unless they are determined by an
attending physician, a psychologist involved in the care and treatment of a
patient, or a clinical nurse specialist in psychiatric/mental health involved
in the care and treatment of the patient to be absolutely necessary in order to
prevent a patient from seriously injuring himself or herself or others and are
required by the patientīs medical needs. Such
determination shall expire after 24 hours. An attending physician, a
psychologist involved in the care and treatment of a patient, or a clinical
nurse specialist in psychiatric/mental health involved in the care and
treatment of the patient must then make a new determination before the restraint
may be continued. Every use of a restraint and the reasons therefor
shall be made a part of the clinical record of the patient. A copy of each such
entry or a summary of such entries shall be forwarded to the chief medical
officer for review. A patient placed in physical restraint shall be checked at
least every 30 minutes by staff trained in the use of restraints and a written
record of such checks shall be made. When the application of a restraint is
necessary in emergency situations to protect the patient from immediate injury
to himself or herself or to others, restraints may be authorized by attending
staff who must immediately report the action taken to the physician and any
psychologist involved in the care and treatment of the patient. The facility
shall have written policies and procedures which govern the use of restraints
and which clearly delineate, in descending order, the personnel who can
authorize the use of restraints in emergency situations.
(c) For the purposes of this Code section, those devices which restrain
movement, but are applied for protection from accidental injury or required for
the medical treatment of the patientīs physical
condition or for supportive or corrective needs of the patient, shall not be
considered physical restraints. However, devices used in such situations must
be authorized and applied in compliance with the facilityīs
policies and procedures. The use of such devices shall be a part of the patientīs individualized service plan.
§ 37-3-166.
(a) A clinical record for each patient shall be maintained. Authorized release
of the record shall include but not be limited to examination of the original
record, copies of all or any portion of the record, or disclosure of
information from the record, except for matters privileged under the laws of
this state. Such examination shall be conducted on hospital premises at
reasonable times determined by the facility. The clinical record shall not be a
public record and no part of it shall be released except:
(1) When the chief medical officer of the facility where the record is kept
deems it essential for continued treatment, a copy of the record or parts
thereof may be released to physicians or psychologists when and as necessary
for the treatment of the patient;
(2) A copy of the record may be released to any person or entity designated in
writing by the patient or, if appropriate, the parent of a minor, the legal
guardian of an adult or minor, or a person to whom legal custody of a minor
patient has been given by order of a court;
(2.1) A copy of the record of a deceased patient or deceased former patient may
be released to or in response to a valid subpoena of a coroner or medical
examiner under Chapter 16 of Title 45, except for matters privileged under the
laws of this state;
(3) When a patient is admitted to a facility, a copy of the record or
information contained in the record from another facility, community mental
health center, or private practitioner may be released to the admitting
facility. When the service plan of a patient involves transfer of that patient
to another facility, community mental health center, or private practitioner, a
copy of the record or information contained in the record may be released to
that facility, community mental health center, or private practitioner;
(4) A copy of the record or any part thereof may be disclosed to any employee
or staff member of the facility when it is necessary for the proper treatment
of the patient;
(5) A copy of the record shall be released to the patientīs
attorney if the attorney so requests and the patient, or the patientīs legal guardian, consents to the release;
(6) In a bona fide medical emergency, as determined by a physician treating the
patient, the chief medical officer may release a copy of the record to the
treating physician or to the patientīs psychologist;
(7) At the request of the patient, the patientīs
legal guardian, or the patientīs attorney, the record
shall be produced by the entity having custody thereof at any hearing held
under this chapter;
(8) A copy of the record shall be produced in response to a valid subpoena or
order of any court of competent jurisdiction, except for matters privileged
under the laws of this state;
(8.1) A copy of the record may be released to the
legal representative of a deceased patientīs estate,
except for matters privileged under the laws of this state;
(9) Notwithstanding any other provision of law to the contrary, a law
enforcement officer in the course of a criminal investigation may be informed
as to whether a person is or has been a patient in a state facility, as well as
the patientīs current address, if known; and
(10) Notwithstanding any other provision of law to the contrary, a law
enforcement officer in the course of investigating the commission of a crime on
the premises of a facility covered by this chapter or against facility
personnel or a threat to commit such a crime may be informed as to the
circumstances of the incident, including whether the individual allegedly
committing or threatening to commit a crime is or has been a patient in the
facility, and the name, address, and last known whereabouts of any alleged
patient perpetrator.
(b) In connection with any hearing held under this chapter, any physician,
including any psychiatrist, or any psychologist who is
treating or who has treated the patient shall be authorized to give evidence as
to any matter concerning the patient, including evidence as to communications
otherwise privileged under Code Section
(c) Any disclosure authorized by this Code section or any unauthorized
disclosure of confidential or privileged patient information or communications
shall not in any way abridge or destroy the confidential or privileged
character thereof, except for the purpose for which such authorized disclosure
is made. Any person making a disclosure authorized by this Code section shall
not be liable to the patient or any other person, notwithstanding any contrary
provision of Code Section
(d) When a sheriff transports an adult involuntary patient to a facility, that
sheriff may request in writing that a notice of such patientīs
discharge be given to the sheriff; and such notice shall be provided if such
patient or the patientīs guardian consents in writing
to the disclosure or if, in its discretion, the court ordering the involuntary
treatment provides for such notice in the order issued pursuant to Code Section
37-3-81.1.
§ 37-3-167.
(a) Except as provided in subsection (b) of Code Section 37-3-162, every
patient shall have the right to examine all medical records kept in the patientīs name by the department or the facility where the
patient was hospitalized or treated.
(b) Every patient shall have the right to request that any inaccurate information
found in his medical record be corrected.
(c) The board shall promulgate reasonable rules and regulations to implement
subsections (a) and (b) of this Code section. Nothing contained in this Code
section shall be construed to require the deletion of
information by the department nor constrain the department from destroying
patient records after a reasonable passage of time.
(d)(1) Notwithstanding paragraphs (7) and (8) of Code Section 15-9-37 or any
provisions of Article 4 of Chapter 18 of Title 50, all files and records of a
court in a proceeding under this chapter since September 1, 1978, shall remain
sealed and shall be open to inspection only upon order of the court issued
after petition by, or notice to, the patient and subject to the provisions of
Code Section 37-3-166 pertaining to the medical portions of the record.
(2) If any official or employee of
any court or archival facility assists a person who is not an official or
employee of that court or facility in attempting to gain access to any court
record which the official or employee knows concerns examination, evaluation,
treatment, or commitment for mental illness, such record was created prior to
September 1, 1978, and such record contains no information concerning the
patient which is ordinarily public, such as the fact that a guardianship was
created, such official or employee shall seal the record if it is in the
possession of the court or facility and shall inform the person seeking access
that if such a record exists it is open to inspection only upon order of the
court issued after petition by, or notice to, the patient and subject to the
provisions of Code Section 37-3-166 pertaining to the medical portions of the
record.
(3) Upon a petition for access to such files or records referred to in
paragraphs (1) and (2) of this subsection, the court should allow inspection by
the person who is the subject of a record unless there are compelling reasons
why it should not but should require anyone other than the person who is the
subject of a court record to show compelling reasons why the record should be
opened. If access is granted, the court order shall restrict dissemination of
the information to certain persons or for certain purposes or both.
(4) The court may refer to such files and records referred to in paragraphs (1)
and (2) of this subsection in any subsequent proceeding under this chapter
concerning the same patient on condition that the files and records of such
subsequent proceeding will then be sealed in accordance with this subsection.
The court may permit authorized representatives of recognized organizations
compiling statistics for proper purposes to inspect and make abstracts from
official records, but without personal identifying information and under
whatever conditions upon their use and distribution the court may deem proper.
The court may punish by contempt any violations of any such conditions.
§ 37-3-168.
The patientīs attorney shall have the right, at
reasonable times, to interview the physician or psychologist and staff who have
attended or are now attending the patient in any facility and to have the patientīs records interpreted by them. The chief medical
officer is authorized and directed to establish reasonable regulations to make
available to the patientīs attorney all such
information in the possession of the facility as the attorney requires in order to advise and represent the patient concerning his
hospitalization.
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