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CHAPTER 1. MENTAL HEALTH LAW
§1. Short title
This
Chapter may be cited as the Mental Health Law.
§2. Definitions
Whenever
used in this Title, the masculine shall include the feminine, the singular
shall include the plural, and the following definitions shall apply:
(1)
"Conditional discharge" means the physical release of a judicially
committed person from a treatment facility by the director or by the court. The
patient may be required to report for outpatient treatment as a condition of
his release. The judicial commitment of such persons shall remain in effect for
a period of up to one hundred twenty days and during this time the person may
be hospitalized involuntarily for appropriate medical reasons upon court order.
(2)
"Court" means any duly constituted district court or court having
family or juvenile jurisdiction. "Court" does not include a city
court, which shall have no jurisdiction to commit persons to mental health
treatment facilities in civil or criminal proceedings, except when exercising
juvenile jurisdiction.
(3)
"Dangerous to others" means the condition of a person whose behavior
or significant threats support a reasonable expectation that there is a
substantial risk that he will inflict physical harm upon another person in the
near future.
(4)
"Dangerous to self" means the condition of a person whose behavior,
significant threats or inaction supports a reasonable expectation that there is
a substantial risk that he will inflict physical or severe emotional harm upon
his own person.
(5)
"Diagnosis" means the art and science of determining the presence of
disease in an individual and distinguishing one disease from another.
(6)
"Director" or "superintendent" means a person in charge of
a treatment facility or his deputy.
(7)
"Discharge" means the full or conditional release from a treatment
facility of any person admitted or otherwise detained under this Chapter.
(8)
"Department" means the Department of Health and Hospitals.
(9)
"Formal voluntary admission" means the admission of a person
suffering from mental illness or substance abuse desiring admission to a
treatment facility for diagnosis and/or treatment of such condition who may be
formally admitted upon his written request. Such persons may be detained
following a request for discharge pursuant to R.S. 28:52.2.
(10)
"Gravely disabled" means the condition of a person who is unable to
provide for his own basic physical needs, such as essential food, clothing,
medical care, and shelter, as a result of serious mental illness or substance
abuse and is unable to survive safely in freedom or protect himself from
serious harm; the term also includes incapacitation by alcohol, which means the
condition of a person who, as a result of the use of alcohol, is unconscious or
whose judgment is otherwise so impaired that he is incapable of realizing and
making a rational decision with respect to his need for treatment.
(11)
"Informal voluntary admission" means the admission of a person
suffering from mental illness or substance abuse, desiring admission to a
treatment facility for diagnosis and/or treatment of such condition who may be
admitted upon his request without making formal application.
(12)
"Major surgical procedure" means an invasive procedure of a serious
nature with incision upon the body or parts thereof under general, local or
spinal anesthesia, utilizing surgical instruments, for the purpose of diagnosis
or treatment of a medical condition. Diagnostic procedures, including, but not limited
to, the following, shall not be considered as major surgical procedures:
(a) Endoscopy through natural body
openings, such as the mouth, anus, or urethra, to view the trachea, bronchi,
esophagus, stomach, pancreas, small or large intestine, urethra, urinary
bladder, or ureters, and to obtain from such organs
specimens of fluids or tissues for chemical or microscopic analysis.
(b) Sub-cutaneous percutaneous liver biopsy.
(c) Punch biopsy of skeletal muscles.
(d) Bone marrow biopsy.
(e) Lumbar puncture.
(f) Myelogram.
(g) Thoracocentesis.
(h) Abdominocentesis.
(i) Conization
of the uterine cervix.
(j) Renal angiography.
(k) Femoral angiography.
(l) Carotid angiography.
(m) Vertebral angiography.
(13)
"Mental health advocacy service" means a service established by the
state of
(14)
"Mentally ill person" means any person with a psychiatric disorder
which has substantial adverse effects on his ability to function and who
requires care and treatment. It does not refer to a person suffering solely
from mental retardation, epilepsy, alcoholism, or drug abuse.
(15)
"Minor" means a person under eighteen years
of age.
(16)
"Parent" means a person who is the biological mother or father of an
individual or the legally adoptive mother or father of an individual.
(17)
"Patient" means any person detained and taken care of as a mentally
ill person or person suffering from substance abuse.
(18)
"Peace officer" means any sheriff, police officer, or other person
deputized by proper authority to serve as a peace officer.
(19)
"Person of legal age" means any person eighteen years of age or
older.
(20)
"Petition" means a written civil complaint filed by a person of legal
age alleging that a person is mentally ill or suffering from substance abuse
and requires judicial commitment to a treatment facility.
(21)
"Physician" means a person permitted to practice and in active
practice as a physician under the laws of
(22)(a)
"Psychiatrist" means a physician who has at least three years of
formal training or primary experience in the diagnosis and treatment of mental
illness.
(b) "Psychologist" means a person licensed to
practice psychology in
(23)
"Respondent" means a person alleged to be mentally ill or suffering
from substance abuse and for whom an application for commitment to a treatment
facility has been filed.
(24)
"Restraint" means the partial or total immobilization of any or all
of the extremities or the torso by mechanical means for psychiatric
indications. Restraint does not include the use of mechanisms usually and
customarily used during medical or surgical procedures, including but not
limited to body immobilization during surgery and arm immobilization during
intravenous administration. Restraint does not include orthopedic appliances
used to posturally support the patient, such as
posies.
(25)
"Seclusion" means the involuntary confinement of a patient alone in a
room where the patient is physically prevented from leaving for any period of
time, except that seclusion does not include the placement of a patient alone
in a room or other area for no more than thirty minutes at a time and no more
than three hours in any twenty-four-hour period pursuant to behavior-shaping
techniques, such as "time-out".
(26)
"Substance abuse" means the condition of a person who uses narcotic,
stimulant, depressant, soporific, tranquilizing, or hallucinogenic drugs or
alcohol to the extent that it renders the person dangerous to himself or others
or renders the person gravely disabled.
(27)
"Transfer" means the removal of a patient from one mental institution
to another without any procedure for admission other than is prescribed by the
department.
(28)
"Treatment" means an active effort to accomplish an improvement in
the mental condition or behavior of a patient or to prevent deterioration in
his condition or behavior. Treatment includes but is not limited to
hospitalization, partial hospitalization, outpatient services, examination,
diagnosis, training, the use of pharmaceuticals, and other services provided
for patients by a treatment facility.
(29)(a)
"Treatment facility" means any public or private hospital, retreat,
institution, mental health center, or facility licensed by the state in which
any mentally ill person or person suffering from substance abuse is received or
detained as a patient. The term includes Veterans Administration and public
health hospitals and forensic facilities. "Treatment facility"
includes but is not limited to the following, and shall be selected with
consideration of first, medical suitability; second, least restriction of the
person's liberty; third, nearness to the patient's usual residence; and fourth,
financial or other status of the patient, except that such considerations shall
not apply to forensic facilities:
(i) Community mental health
centers.
(ii) Private clinics.
(iii) Public or private halfway houses.
(iv) Public or private nursing homes.
(v) Public or private general hospitals.
(vi) Public or private mental hospitals.
(vii) Detoxification centers.
(viii) Substance abuse clinics.
(ix) Substance abuse in-patient facility.
(x) Forensic facilities.
(b) Patients involuntarily hospitalized by emergency
certificate or mental health treatment shall not be admitted to the facilities
listed in Items (ii), (iii), (iv), (viii), or (x) of Subparagraph (a), except
that patients in custody of the Department of Public Safety and Corrections may
be admitted to forensic facilities by emergency certificate provided that
judicial commitment proceedings are initiated during the period of treatment at
the forensic facility authorized by emergency certificate. Patients
involuntarily hospitalized by emergency certificate for substance abuse
treatment shall not be admitted to the facilities listed in Items (ii), (iii),
(iv), or (x) of Subparagraph (a). Judicial commitments, however, may be made to
any of the above facilities except forensic facilities. However, in the case of
any involuntary hospitalization as a result of such emergency certificate for
substance abuse or in the case of any judicial commitment as the result of
substance abuse, such commitment or hospitalization may be made to any of the
above facilities, except forensic facilities, provided that such facility has a
substance abuse in-patient operation maintained separate and apart from any
mental health in-patient operation at such facility.
(c) "Treatment facility" shall not include a jail
or prison of any kind, or any facility under the control or supervision of the
Department of Public Safety and Corrections unless the facility has been
designated by the Department of Health and Hospitals and the Department of
Public Safety and Corrections as a treatment facility pursuant to R.S.
15:830.1(B); however, a jail or prison shall not be construed as a forensic
facility. Only adult inmates sentenced to the Department of Public Safety and
Corrections may be admitted to a treatment facility designated pursuant to R.S.
15:830.1(B).
§3. Application of
Chapter; costs
The
provisions of this Chapter apply to persons who are suffering from mental
illness or substance abuse. Nothing in this Chapter referring to costs shall be
construed to defer or prevent the care of a person in a
state mental institution, nor their release therefrom.
PART II. INSTITUTIONS AND PLACES FOR MENTAL
PATIENTS
§21. State hospitals for the
mentally ill and inebriate
A.
The hospital at
B.
The assistant secretary of the office of mental health of the department may
establish community cottages as satellite facilities to these institutions from
funds presently allocated or to be allocated to these institutions by the
legislature.
C.
Any site designated under this Section shall comply with any applicable local
and state building or zoning ordinances and laws.
D.
Any site selected by the assistant secretary must be approved by the local
governing authority.
E.
The assistant secretary for the office of mental health is authorized to
reorganize the office of mental health into an area management structure to
consist of areas A, B, and C, which are meant to include both hospital and
community resources which previously existed in these areas, excluding
Jefferson Parish Human Services Authority and Capital Area Human Services
District.
(1) Area A shall consist of the following:
(a) The parishes of Assumption, Lafourche,
Livingston, Orleans, Plaquemines, St. Bernard, St.
Charles, St. Helena, St. James, St. John the Baptist, St. Mary, St. Tammany, Tangipahoa, Terrebonne,
Washington, and Jefferson, except the Jefferson Parish Human Services
Authority.
(b)
(c)
(d) The acute psychiatric units operated by the office of
mental health in the parishes listed in Subparagraph (a) of this Paragraph.
(2) Area B shall include the following:
(a) Except the services provided by the Capital Area Human
Services District, the parishes of Acadia, Allen, Ascension, Beauregard, Calcasieu, Cameron,
East Baton Rouge, East Feliciana, Evangeline, Iberia,
Iberville, Jefferson Davis, Lafayette, Pointe Coupee, St. Landry, St. Martin, Vermilion, West Baton
Rouge, and West Feliciana.
(b) The
(i)
(ii) Feliciana Forensic Facility.
(iii)
(c) The acute psychiatric units operated by the office of
mental health in the parishes listed in Subparagraph (a) of this Paragraph.
(3) Area C shall include the following:
(a) The parishes of Avoyelles, Bienville, Bossier, Caddo, Catahoula,
Caldwell, Claiborne, Concordia, DeSoto, East Carroll,
Franklin, Grant, Jackson, LaSalle, Lincoln, Madison, Morehouse,
Natchitoches, Ouachita, Rapides,
Red River, Richland, Sabine, Tensas, Union, Webster,
West Carroll, Vernon, and Winn.
(b)
(c) The acute psychiatric units operated by the office of
mental health in the parishes listed in Subparagraph (a) of this Paragraph.
§22.4. Guidance
centers
The
guidance centers heretofore established by the department are recognized,
created, and continued as units of the department under its supervision;
provided the department may enter into contracts with any voluntary
association, nonprofit corporation, police jury, school board, municipality, or
other public agency in the area served by a guidance center or mental health
center, providing for the administration of such center out of funds
contributed in whole or in part by local groups, corporations, or public
agencies or out of joint state and local funds, or joint state, federal, and
local funds.
§22.5. Community
mental health centers
The
community mental health centers located in Lafayette, Pineville, Lake Charles,
Baton Rouge, New Orleans, Crowley, Shreveport, and Monroe for the care,
treatment, and rehabilitation at the community level of the mentally ill and
the mentally defective as defined in R.S. 28:2(3) and R.S. 28:2(4) are created
and continued as units of the department under its supervision and
administration. Guidance centers heretofore established may be converted to
mental health centers by the department or two or more of them may be merged
and consolidated into a mental health center by the department.
§22.6. Payment for
maintenance or treatment
Persons
or their responsible relatives who are able to pay all or a part of the cost of
their maintenance or treatment or both at the units named in R.S. 28:22 through
R.S. 28:22.5 shall reimburse the department to the extent of their ability to
pay at rates to be fixed by the department.
§22.7. Geriatric
hospitals and units
A.
The department may establish and administer geriatric hospitals or units to
receive and care for elderly and infirm persons who have been discharged by a
hospital for the mentally ill and for other elderly and infirm persons who are
in need of nursing and medical care. Such hospitals or units may be established
on sites designated by the department, provided that no such geriatric hospital
or unit may be established on any site located more than five air miles from
the administrative office of
B.
The geriatric hospital at
§23. Psychiatric
inpatient units in state general hospitals
The
department shall establish psychiatric inpatient units in state-owned general
hospitals for the emergency and temporary care of cases of acute mental
illness.
§25. Provisions for
close confinement of certain mental patients
At
institutions that it may designate, the department may provide facilities for
the care and confinement of mental patients who require close confinement in
the interest of themselves and of the public.
The
department shall designate places of confinement for patients of dangerous
tendencies and for those charged with or convicted of a crime or misdemeanor
who require special protection and restraint.
§25.1. Establishment
of Feliciana Forensic Facility; authorization to
establish forensic facilities in New Orleans, Baton Rouge, Shreveport, and
A.
The forensic unit at
B.
The department may establish additional forensic facilities for the treatment
of forensic patients in
C.(1)(a) The superintendent of any such facility shall admit only those
persons:
(i) Determined to be incompetent
prior to trial and committed on recommendation of a sanity commission.
(ii) Found
not guilty by reason of insanity.
(iii) Transferred from state
correctional institutions.
(iv) Who were judicially committed after
being charged with a criminal offense and found incompetent to stand trial.
(v) Judicially committed to and transferred from any state
hospital for the mentally ill and inebriant.
(b) A transfer from any other state hospital shall be had
only after the director of the transferring facility, in concurrence with two
psychiatrists, has determined and certified in writing to such forensic
facility that the person to be transferred is dangerous to others and that the
transferring facility cannot adequately protect its staff and patients from
such person.
(c) The decision to transfer shall not be made until after
the person who is proposed to be transferred has had an opportunity to be heard
regarding his actions upon which the proposed transfer is based by the director
and two concurring psychiatrists.
(d) For purposes of this Section, a person shall be
determined "dangerous to others" when said person has attempted to
cause serious injury or harm to a patient or staff person on at least one
occasion and the likelihood is that said person will cause such injury again if
he is allowed to remain in the facility requesting the transfer.
(2)(a) The administrator of the Feliciana
Forensic Facility shall refuse admission to any person if:
(i) Admission of the person would
cause overcrowding of the facility.
(ii) The facility is unable to provide appropriate care or
treatment for the person.
(iii) The person is not accompanied by a file containing a
history of the person's mental and physical health and documents required
pursuant to Articles 648.1 and 654.1 of the Code of Criminal Procedure.
(iv) The person from a state hospital or
correctional institution is not accompanied by a summary of the facts presented
at the hearing at which the person objected to his transfer to the forensic
facility and a summary of the person's objections.
(b) If the person refused admission is being held in a
parish jail, the Department of Health and Hospitals shall pay to the parish
sheriff, or to the parish governing authority of any parish in which the
governing authority operates the parish jail, an amount equal to the sum paid
to the parishes by the Department of Public Safety and Corrections for keeping
and feeding state inmates under the provisions of R.S. 15:824(B)(1). This sum shall be paid from the day the inmate is
committed to the facility until the person is accepted by the facility or the
order of commitment is rescinded by the court. The department shall, in
addition, reimburse the sheriff or parish governing authority for the cost of
any medical treatment occasioned by the reasons for the commitment, provided
the treatment is not provided by a state operated facility. The payments
required by this Subparagraph shall be made monthly based upon reports filed by
the sheriff.
(3) The Feliciana Forensic
Facility shall be free to return a patient to the original institution when, in
the opinion of the Feliciana Forensic Facility
administrator, the patient has received the maximum benefit of treatment at the
Feliciana Forensic Facility.
(4) When the administrator of Feliciana
Forensic Facility fails to obey an order or judgment of a court committing a
person to said facility, the court shall consider the following before it holds
him in contempt: whether the failure is (a) due to the inability to comply with
the order or judgment because of inability to offer adequate or appropriate
care or treatment, (b) because of overcrowding at the facility, or (c) because
obeying the order or judgment would cause the administrator to violate an
outstanding court order or judgment.
D.
The department may contract with local law enforcement agencies and the
Department of Corrections to provide security personnel for mental health
patients placed in such forensic units, or other
facilities to which such patients may be temporarily referred for medical
treatment.
§25.2. Granting of
passes to patients
A.
Notwithstanding any other provision of law to the contrary, including any
provision of the Code of Criminal Procedure, the administrator of the Feliciana Forensic Facility, in his discretion, may grant
any patient committed to his custody a pass or furlough from the facility,
except those patients who are under commitment to the Department of Public
Safety and Corrections.
B.
The administrator shall not grant any patient a pass or furlough for release
from the facility except upon the recommendation of the patient's treating
psychiatrist and with prior approval of the committing court. The administrator
may impose conditions on a pass or furlough. Any pass or furlough granted shall
be for a fixed period of time.
PART III. EXAMINATION, ADMISSION, COMMITMENT,
AND TREATMENT OF PERSONS SUFFERING FROM MENTAL ILLNESS AND SUBSTANCE ABUSE
§50. Declaration of policy
The
underlying policy of this Chapter is as follows:
(1)
That mentally ill persons and persons suffering from substance abuse be
encouraged to seek voluntary treatment.
(2)
That any involuntary treatment or evaluation be accomplished in a setting which
is medically appropriate, most likely to facilitate proper care and treatment
that will return the patient to the community as soon as possible, and is the
least restrictive of the patient's liberty.
(3)
That continuity of care for the mentally ill and persons suffering from
substance abuse be provided.
(4)
That mental health and substance abuse treatment services be delivered as near
to the place of residence of the person receiving such services as is
reasonably possible and medically appropriate.
(5)
That individual rights of patients be safeguarded.
(6)
That no person solely as a result of mental illness or alcoholism or
incapacitation by alcohol shall be confined in any jail, prison, correctional
facility, or criminal detention center. This shall not apply to persons
arrested, charged, or convicted under Title 14 of the Louisiana Revised
Statutes of 1950.
(7)
That no person shall be denied treatment solely because he has withdrawn from
treatment against medical advice on a prior occasion or because he has relapsed
after an earlier treatment.
§51. Procedures for
admission
A.
The director of a treatment facility, subject to the availability of suitable
accommodations, shall receive for observation, diagnosis, care, and treatment,
any person whose admission is authorized under any of the procedures provided
for in R.S. 28:52 through R.S. 28:54 and R.S. 28:64.
B.
The failure by any director to obey an order or judgment committing a patient
to a treatment facility shall not be construed as contempt of any court, if it
appears that the failure to obey is due to the inability to comply with the
order or judgment because medically suitable accommodations for the patient are
unavailable.
C.
The Department of Health and Hospitals, through its
hospitals, mental health clinics and similar institutions, shall have the duty
to assist petitioners and other persons in the preparation of petitions for
commitment, requests for protective custody orders and requests for emergency
certificates, upon request of such persons.
§52. Voluntary
admissions; general provisions
A.
Any mentally ill person or person suffering from substance abuse may apply for
voluntary admission to a treatment facility. The admitting physician may admit
the person on either a formal or informal basis, as hereinafter provided.
B.
Admitting physicians are encouraged to admit mentally ill persons or persons
suffering from substance abuse to treatment facilities on voluntary admission
status whenever medically feasible.
C.
No director of a treatment facility shall prohibit any mentally ill person or
person suffering from substance abuse from applying for conversion of
involuntary or emergency admission status to voluntary admission status. Any
patient on an involuntary admission status shall have the right to apply for a
writ of habeas corpus in order to have his admission status changed to
voluntary status.
D.
No employee of a mental health care program or treatment facility, peace
officer, or physician shall state to any person that involuntary admission may
result if such person does not voluntarily admit himself to a mental health
care program or treatment facility unless the employee, peace officer, or
physician is prepared to execute a certificate pursuant to R.S. 28:53 or a
petition pursuant to R.S. 28:54.
E.
Each person admitted on a voluntary basis shall be informed of any other
medically appropriate alternative treatment programs and treatment facilities
known to the admitting physician and be given an opportunity to seek admission
to alternative treatment programs or facilities.
F.
Every patient admitted on a voluntary admission status shall be informed in
writing at the time of admission of the procedures for requesting release from
the treatment facility, the availability of counsel, information about the
mental health advocacy service, the rights enumerated in R.S. 28:171 and rules
and regulations applicable to or concerning his conduct while a patient in the
treatment facility. If the person is illiterate or does not read or understand
English, appropriate provisions should be made to supply him this information.
In addition, a copy of the information listed in this Subsection must be posted
in any area where patients are confined and treated.
G.
No admission may be deemed voluntary unless the admitting physician determines
that the person to be admitted has the capacity to make a knowing and voluntary
consent to the admission.
Knowing
and voluntary consent shall be determined by the ability of the individual to
understand:
(1) That the treatment facility to which the patient is
requesting admission is one for mentally ill persons or persons suffering from
substance abuse;
(2) That he is making an application for admission, and
(3) The nature of his status and the provisions governing
discharge or conversion to an involuntary status.
H.(1)
Voluntary patients may receive medications or treatment, but no major surgical
procedure or electroshock therapy may be performed upon such patient, without
the patient's written and informed consent. If it is determined by the director
of the treatment facility that a voluntary patient has become incapable of
making an informed consent for such procedure, he shall apply to a court of
competent jurisdiction for a determination of the patient's specific incompetence
to give informed consent for the procedure. If the director, in consultation
with two physicians, determines that the condition of a voluntary patient who
is incapable of informed consent is of such critical nature that it may be
life-threatening unless major surgical procedures or electroshock treatment is
administered, the emergency measures may be taken without the consent otherwise
provided for in this Section.
(2)(a) Notwithstanding the provision of Paragraph (1) of this
Subsection, any licensed physician may administer medication to a patient
without his consent and against his wishes in a situation which, in the
reasonable judgment of the physician who is observing the patient during the
emergency, constitutes a psychiatric or behavioral emergency. For purposes of
this Paragraph a "psychiatric or behavioral emergency" occurs when a
patient, as a result of mental illness, substance abuse, or intoxication
engages in behavior which, in the clinical judgment of the physician, places
the patient or others at significant and imminent risk of damage to life or
limb. The emergency administration of medication may be continued until the
emergency subsides, but in no event shall it exceed forty-eight hours, except
on weekends or holidays when it may be extended for an additional twenty-four
hours.
(b) The physician shall make a reasonable effort to consult
with the primary physician outside the facility that has previously treated the
patient for his mental condition at the earliest possible time, but in no event
more than forty-eight hours after the emergency administration of medication
has begun, except on weekends or holidays when the time period may be extended
an additional twenty-four hours. The physician shall record in the patient's
file either the date and time of the consultation and
a summary of the comments of the primary physician or, if the physician is
unable to consult with the primary physician, the date and time that a
consultation with the primary physician was attempted.
§52.1. Informal
voluntary admission
A.
In the discretion of the director, any mentally ill person or person suffering
from substance abuse desiring admission to a treatment facility for diagnosis
or treatment of a psychiatric disorder or substance abuse may be admitted upon
the patient's request without a formal application.
B.
Any patient admitted pursuant to this Section shall have the right to leave the
treatment facility at any time during the normal day-shift hours of operation,
which shall include but not be limited to
§52.2. Formal
voluntary admission
A.
Any mentally ill person or person suffering from substance abuse desiring
admission to a treatment facility for diagnosis and/or treatment of a
psychiatric disorder or substance abuse and who is deemed suitable for formal
voluntary admission by the admitting physician may be so admitted upon his
written request.
B.
A patient admitted under the provisions of this Section shall not be detained
in the treatment facility for longer than seventy-two hours after making a
valid written request for discharge to the director unless an emergency
certificate is executed pursuant to R.S. 28:53, or unless judicial commitment
is instituted pursuant to R.S. 28:54, after making a valid written request for
discharge to the director of the treatment facility.
§52.3. Noncontested admission
A.
A mentally ill person or person suffering from substance abuse who does not
have the capacity to make a knowing and voluntary consent to a voluntary
admission status and who does not object to his admission to a treatment
facility may be admitted to a treatment facility as a noncontested
admission. Such person shall be subject to the same rules and regulations as a
person admitted on a voluntary admission status and his treatment shall be
governed by the provisions of R.S. 28:52H.
B.
A noncontested admission may be made by a physician
to a treatment facility in order to initiate a complete diagnostic and
evaluative study. The diagnosis and evaluation shall include complete medical,
social, and psychological studies and, when medically indicated, any other
scientific study which may be necessary in order to make decisions relative to
the treatment needs of the patient. In the absence of specified medical
reasons, the diagnostic studies shall be completed in fourteen days.
Alternative community-based services shall be thoroughly considered.
Following
a review of the diagnostic evaluation study, the director of the treatment
facility shall determine if the person is to remain on noncontested
status, is to be discharged, is to be converted to formal or informal voluntary
status, or is to be involuntarily hospitalized pursuant to R.S. 28:53 or R.S.
28:54. Nothing in this Section shall be interpreted to prohibit the director of
a treatment facility from transferring the patient to another treatment
facility when it is medically indicated.
C.
A person admitted pursuant to this Section may object to his admission at any
time. If the person informs a staff member of his desire to object to his
admission, a staff member shall assist him in preparing and submitting a valid
written objection to the director. Upon receipt of a valid objection, the
director shall release the person within seventy-two hours unless proceedings
are instituted pursuant to R.S. 28:53 or R.S. 28:54.
D.
In no case shall a patient remain on noncontested
status longer than three months. Within that time, the patient must be
converted to either a formal or an informal voluntary status, or be
involuntarily hospitalized pursuant to R.S. 28:53 or R.S. 28:54, or be
discharged.
§52.4. Admission by
relative
A.
A person suffering from substance abuse may be admitted and detained at a
public or private general hospital or a substance abuse in-patient facility for
observation, diagnosis, and treatment for a period not to exceed twenty-eight
days, when a parent, spouse, or the major child of the person if that child has
attained the age of 18 years has admitted the person or caused him to be admitted
pursuant to the provisions of R.S. 28:53.2.
B.
At the time of admission of the person, the parent, spouse, or the major child
of the person if that child has attained the age of 18 years shall execute or
provide a written statement of facts, including personal observations, leading
to the conclusion that the person is suffering from substance abuse and is
dangerous to himself or others or is gravely disabled, specifically describing
any dangerous acts or threats, and stating that the person has been encouraged
to seek treatment but is unwilling to be evaluated on a voluntary basis.
C.
As soon as practicable, but in no event more than twelve hours after admission
to the hospital or in-patient facility, a physician shall examine the person
and either execute an emergency certificate in accordance with R.S. 28:53(B) or
order the person discharged. If an emergency certificate is executed, the
physician or the director of the hospital or in-patient facility shall
immediately notify the coroner, and the coroner or his deputy shall conduct an
independent examination, in accordance with R.S. 28:53(G). If the coroner or
his deputy executes a second emergency certificate, the person may be detained
for treatment for a period not to exceed twenty-eight days from the date of his
admission. Otherwise, he shall be discharged.
D.
Except as inconsistent with the provisions of this Section, all other
provisions of this Part applicable to persons admitted by emergency certificate
shall be applicable to persons admitted pursuant to this Section.
§53. Admission by
emergency certificate; extension
A.(1)
A mentally ill person or a person suffering from substance abuse may be
admitted and detained at a treatment facility for observation, diagnosis, and
treatment for a period not to exceed fifteen days under an emergency
certificate.
(2) A person suffering from substance abuse may be detained
at a treatment facility for one additional period, not to exceed fifteen days,
provided that a second emergency certificate is executed. A second certificate
may be executed only if and when a physician at the treatment facility and any
other physician have examined the detained person within seventy-two hours
prior to the termination of the initial fifteen day period and certified in writing
on the second certificate that the person remains dangerous to himself or
others or gravely disabled, and that his condition is likely to improve during
the extended period. The director shall inform the patient of the execution of
the second certificate, the length of the extended period, and the specific
reasons therefor, and shall also give notice of the
same to the patient's nearest relative or other designated responsible party
initially notified pursuant to Subsection F.
B.(1) Any physician or psychologist may execute an emergency certificate
only after an actual examination of a person alleged to be mentally ill or
suffering from substance abuse who is determined to be in need of immediate
care and treatment in a treatment facility because the examining physician or
psychologist determines the person to be dangerous to self or others or to be
gravely disabled. Failure to conduct an examination prior to the execution of
the certificate will be evidence of gross negligence.
(2) The certificate shall state:
(a) The date of the physician's or psychologist's
examination of the person, which shall not be more than seventy-two hours prior
to the date of the signature of the certificate.
(b) The objective findings of the physician or psychologist relative
to the physical or mental condition of the person, leading to the conclusion
that the person is dangerous to self or others or is gravely disabled as a
result of substance abuse or mental illness.
(c) The history of the case, if known.
(d) The determination of whether the person examined is in
need of immediate care and treatment in a treatment facility because the
patient is either:
(i)
Dangerous to himself.
(ii) Dangerous to others.
(iii) Gravely disabled.
(e) That the person is unwilling or
unable to seek voluntary admission.
(3) The certificate shall be dated and executed under the
penalty of perjury, but need not be notarized. The certificate shall be valid
for seventy- two hours and shall be delivered to the director of the treatment
facility where the person is to be further evaluated and treated.
C.
A patient may request the director of the treatment facility to advise the
executive director of the mental health advocacy service of his admission and
may request representation.
D.
Prior to or during confinement, under the provisions of this Title, any person
or his attorney shall have the right to demand a judicial hearing to determine
if probable cause exists for his continued confinement under an emergency
certificate. The hearing shall be held within five days of the filing of the
petition. The petition shall be filed in the court of the jurisdiction in which
the patient is confined. The hearing shall be held in that court and no other
except for good cause shown. If the person is confined, the judge of the court
where the petition was filed may hold the hearing at the treatment facility
where the person is confined, if in the opinion of the director of the
treatment facility it will be detrimental to the patient's health, welfare or dignity,
to travel to the court where the petition was filed. Pending the decision of
the court, the patient shall remain confined unless the court orders release or
a less restrictive status.
E.
The attorney of any patient in a treatment facility may review his client's
medical record. If deemed essential by the attorney, portions of the record
specifically required for proper representation pursuant to this Title, may be
copied and given to the patient's attorney. The attorney shall return all
copies of his client's medical record to the treatment facility upon completion
of their use.
F.
An emergency certificate shall constitute legal authority to transport a
patient to a treatment facility and shall permit the director of such treatment
facility to detain the patient for diagnosis and treatment for a period not to
exceed fifteen days, and to return the patient to the facility if he is absent
with or without permission during authorized periods of detention. If
necessary, peace officers shall apprehend and transport, or ambulance services,
under appropriate circumstances, may locate and transport, a patient on whom an
emergency certificate has been completed to a treatment facility at the request
of either the director of the facility, the certifying physician or
psychologist, the patient's next of kin, the patient's curator, or the agency
legally responsible for his welfare. The director of the treatment facility
shall notify the patient's nearest relative, if known, or designated
responsible party, if any, in writing, of the patient's admission by emergency
certificate as soon as reasonably possible.
G.(1)
Upon admission of any person by emergency certificate to a treatment facility,
the director of the treatment facility shall immediately notify the coroner of
the parish in which the treatment facility is located of the admission, giving
the following information if known:
(a) The person's name.
(b) Address.
(c) Date of birth.
(d) Name of certifying physician or psychologist.
(e) Date and time of admission.
(f) The name and address of the treatment facility.
(2) Within seventy-two hours of admission, the person shall
be independently examined by the coroner or his deputy who shall execute an
emergency certificate, pursuant to Subsection B, which shall be a necessary
precondition to the person's continued confinement.
(3) However, in the event that the coroner has made the
initial examination and executed the first emergency commitment certificate
then a second examination shall be made within the seventy-two hour period set
forth in this Part by any physician at the treatment facility where the person
is confined.
(4) In making either the initial examination or the second
examination, when the coroner or his deputy examines the person and executes an
emergency certificate and a reexamination of the person and reexecution
of a certificate is necessary for any reason to insure the validity of the
certificate, both the first examiner and the reexaminer
shall be entitled to the fee for the service, unless they are one and the same.
(5) If, from his examination, the coroner concludes that the
person is not a proper subject for emergency admission, then the person shall
not be further detained in the treatment facility and shall be discharged by
the director forthwith.
(6) When a person is confined in a treatment facility other
than a state mental institution, the examining coroner in the parish where the
patient is confined shall be entitled to the usual fee paid for this service to
the coroner of the parish in which the patient is domiciled or residing. When a
person is confined in a state mental institution in a parish other than his
parish of domicile or residence, the examining coroner shall be entitled to the
fee authorized by law in his parish for the service. In either case, the fee
shall be paid and accurate records of such payments kept by the governing
authority of the parish in which the patient is domiciled or residing from
parish funds designated for the purpose of payment to the coroner. All coroners
shall keep accurate records showing the number of patients confined in their
parishes pursuant to this Section.
H.
If the patient admitted to a treatment facility pursuant to this Section is a proper
candidate for judicial commitment pursuant to R.S. 28:54, the director of the
treatment facility, or any interested party, may apply for such commitment
under provisions of that Section. Such a patient, hospitalized on an emergency
certificate, for whom a petition for judicial
commitment has been filed in court may continue to be detained for a further
period on order of the court.
I.
Every patient admitted by emergency certificate shall be informed in writing at
the time of his admission of the procedures of requesting release from the
treatment facility, the availability of counsel, information about the mental
health advocacy service, the rights enumerated in R.S. 28:171 and the rules and
regulations applicable to or concerning his conduct while a patient in the
treatment facility. If the person is illiterate or does not read or understand
English, appropriate provisions should be made to supply him this information.
In addition, a copy of the information mentioned in this Subsection must be
posted in any area where patients are confined and treated.
J.(1)
Upon the request of a credible person of legal age who is financially unable to
afford a private physician or who cannot immediately obtain an examination by a
physician, the parish coroner may render, or the coroner or a judge of a court
of competent jurisdiction may cause to be rendered by a physician, an actual
examination of a person alleged to be mentally ill or suffering from substance
abuse and in need of immediate medical treatment because he is dangerous to
himself or others or is gravely disabled. If the coroner is not a physician he
may deputize a physician to perform this examination. To accomplish the
examination authorized by this Subsection, if the coroner or the judge is
apprehensive that his own safety or that of the deputy or other physician may
be endangered thereby, he shall issue a protective custody order pursuant to
R.S. 28:53.2.
(2) If the examining physician determines that the above
standard is met, he shall execute an emergency certificate and shall transport
or cause to be transported the person named in the emergency certificate to a
treatment facility. Failure to render an actual examination prior to execution
of the emergency certificate shall be evidence of gross negligence.
(3) In any instance where the coroner or his deputy executes
the first emergency certificate, the second emergency certificate shall not be
executed by the coroner or his deputy, but the second emergency certificate may
be executed by any other physician including a physician at the treatment
center.
K.(1)(a)
Patients admitted by emergency certificate may receive medication and treatment
without their consent, but no major surgical procedure or electroshock therapy
may be performed without the written consent of a court of competent
jurisdiction after a hearing. With regard to the administration of medicine, if
the patient objects to being medicated, prior to making a final decision, the
treating physician shall make a reasonable effort to consult with the primary
physician outside of the facility that has previously treated the patient for
his mental condition. The treating physician shall, prior to the administration
of such medication, record in the patient's file either the date and time of the
consultation and a summary of the comments of the primary physician or, if the
treating physician is unable to consult with the primary physician, the date
and time that a consultation with the primary physician was attempted.
(b) Notwithstanding the provisions of Subparagraph (a) of
this Paragraph, any licensed physician may administer medication to a patient
without his consent and against his wishes in a situation which, in the
reasonable judgment of the physician who is observing the patient during the
emergency, constitutes a psychiatric or behavioral emergency. For purposes of
this Paragraph a "psychiatric or behavioral emergency" occurs when a
patient, as a result of mental illness, substance abuse, or intoxication
engages in behavior which, in the clinical judgment of the physician, places
the patient or others at significant and imminent risk of damage to life or
limb. The emergency administration of medication may be continued until the
emergency subsides, but in no event shall it exceed forty-eight hours, except
on weekends or holidays when it may be extended for an additional twenty-four
hours.
(c) The physician shall make a reasonable effort to consult
with the primary physician outside the facility that has previously treated the
patient for his mental condition at the earliest possible time, but in no event
more than forty-eight hours after the emergency administration of medication
has begun, except on weekends or holidays when the time period may be extended
an additional twenty-four hours. The physician shall record in the patient's
file either the date and time of the consultation and
a summary of the comments of the primary physician or, if the physician is
unable to consult with the primary physician, the date and time that a
consultation with the primary physician was attempted.
(2) If the director of the treatment facility, in
consultation with two physicians, determines that the condition of such a
patient is of such a critical nature that it may be life-threatening unless
major surgical procedures or electroshock treatment is administered, such
emergency measures may be performed without the consent otherwise provided for
in this Section.
L.(1)
A peace officer or a peace officer accompanied by an emergency medical service
trained technician may take a person into protective custody and transport him
to a treatment facility for a medical evaluation when, as a result of his
personal observation, the peace officer or emergency medical service technician
has reasonable grounds to believe the person is a proper subject for
involuntary admission to a treatment facility because the person is acting in a
manner dangerous to himself or dangerous to others, is gravely disabled, and is
in need of immediate hospitalization to protect such a person or others from
physical harm. The person may only be transported to one of the following:
(a) A community mental health center.
(b) A public or private general hospital.
(c) A public or private mental hospital.
(d) A detoxification center.
(e) A substance abuse clinic.
(f) A substance abuse in-patient facility.
(2) Upon arrival at the treatment facility, the escorting
peace officer shall then be relieved of any further responsibility and the
person shall be immediately examined by a physician, preferably a psychiatrist,
who shall determine if the person shall be voluntarily admitted, admitted by
emergency certificate, or discharged.
(3) In the case of a person suffering from substance abuse
and where any of the above facilities are unavailable, the peace officer and
emergency medical service technician may use whatever means or facilities
available to protect the health and safety of the person suffering from
substance abuse until such time as any of the above facilities become
available. In taking a person into protective custody the peace officer and
emergency medical service technician may take reasonable steps to protect
themselves. A peace officer or emergency medical service technician who acts in
compliance with this section is acting in the course of his official duty and
cannot be subjected to criminal or civil liability as a result thereof.
M.
Under the provisions of this Part no person shall be placed in protective
custody for a period in excess of seventy-two hours. Any person placed in protective
custody under the provisions of this Part shall be considered as an inmate for
maintenance purposes only.
§53.2. Order for
custody; grounds; civil liability; criminal penalty for making a false
statement
A.
Any parish coroner or judge of a court of competent jurisdiction may order a
person to be taken into protective custody and transported to a treatment
facility or the office of the coroner for immediate examination when a peace
officer or other credible person executes a statement under private signature
specifying that, to the best of his knowledge and belief, the person is
mentally ill or suffering from substance abuse and is in need of immediate
treatment to protect the person or others from physical harm. The statement may
include the following information:
(1) A statement of facts, including the affiant's
observations, leading to the conclusion that the person is mentally ill or
suffering from substance abuse and dangerous to himself or others or gravely
disabled.
(2) The date and place of any dangerous acts or threats.
(3) The name and surname, if known, of any other person who
is in danger.
(4) Facts showing that the person sought has been encouraged
to seek treatment and is unwilling to be evaluated on a voluntary basis, and
(5) Facts showing that the affiant
has attempted to contact a specific treatment facility or a specific physician
in order to obtain an examination of the person sought to be treated.
B.
The order for custody shall be in writing, in the name of the state of
(1) The date and hour of issuance and the municipality or
parish where issued.
(2) The name of the person to be taken into custody, or if
his name is not known a designation of the person by any name or description by
which he can be identified with reasonable certainty.
(3) A description of the acts or threats which have led to
the belief that the person is mentally ill or suffering from substance abuse
and is in need of immediate hospitalization to protect the person or others
from physical harm, and
(4) That the person shall be taken to a community mental
health center, a public or private general hospital, a public or private mental
hospital, coroner's office or a detoxification center.
C.
The order for custody shall be effective for seventy-two hours from its
issuance and shall be delivered to the coroner or director of the treatment
facility by the individual who has transported the person. The date and hour that
the person is taken into protective custody shall be written on the order.
Without delay, and in no event more than twelve hours after being taken into
protective custody, the person shall be delivered to a treatment facility or
the office of the coroner or he shall be released. Upon arrival, the person in
custody shall be examined immediately by the coroner or, if at a treatment
facility, by a physician, preferably a psychiatrist, who shall determine if the
person shall be voluntarily admitted, admitted by emergency certificate,
admitted as a noncontested admission, or discharged.
The person in custody shall be examined within twelve hours of his arrival at
the treatment facility or coroner's office or he shall be released.
D.
Coroners and assistant coroners who act in good faith to order persons to be
taken into protective custody and transported for examination in accordance
with this Section shall not be civilly liable for damages to such persons
resulting from those actions.
E.
Any person who is found guilty of executing a statement that another person is
mentally ill or suffering from substance abuse and is in need of immediate
treatment to protect the person or others that the affiant
knows or should know is false may be imprisoned, with or without hard labor,
for not more than one year, or fined not more than one thousand dollars.
§54. Judicial
commitment; procedure
A.
Any person of legal age may file with the court a petition which asserts his
belief that a person is suffering from mental illness which contributes or
causes that person to be a danger to himself or others or to be gravely
disabled, or is suffering from substance abuse which contributes or causes that
person to be a danger to himself or others or to be gravely disabled and may thereby
request a hearing. The petition may be filed in the judicial district in which
the respondent is confined, or if not confined, in the judicial district where
he resides or may be found. The hearing shall not be transferred to another
district except for good cause shown. A petitioner who is unable to afford an
attorney may seek the assistance of any legal aid society or similar agency if
available.
B.
The petition shall contain the facts which are the basis of the assertion and
provide the respondent with adequate notice and knowledge relative to the
nature of the proceedings.
C.
Upon the filing of the petition, the court shall assign a time, not later than
eighteen calendar days thereafter, shall assign a place for a hearing upon the
petition, and shall cause reasonable notice thereof to be given to the
respondent, respondent's attorney and the petitioner. The notice shall inform
such respondent that he has a right to be present at the hearing; that he has a
right to counsel; that he, if indigent or otherwise qualified, has the right to
have counsel appointed to represent him by the Mental Health Advocacy Service,
and that he has the right to cross examine witnesses testifying at any hearing
on such application.
D.(1) As soon as practical after the filing of the petition, the court
shall review the petition and supporting documents, and determine whether there
exists probable cause to believe that the respondent is suffering from mental
illness which contributes to his being or causes him to be a danger to himself
or others or gravely disabled, or is suffering from substance abuse which
contributes to his being or causes him to be a danger to himself or others or
gravely disabled. If the court determines that probable cause exists, the court
shall appoint a physician, preferably a psychiatrist, to examine the respondent
and make a written report to the court and the respondent's attorney on the
form provided by the office of human services of the Department of Health and
Hospitals. The court-appointed physician may be the respondent's treating
physician. The written report shall be made available to counsel for the
respondent at least three days before the hearing. This report shall set forth
specifically the objective factors leading to the conclusion that the person
has a mental illness or suffers from substance abuse, the actions or statements
by the person leading to the conclusion that the mental illness or substance
abuse causes the person to be dangerous to himself or others or to be gravely
disabled and in need of immediate treatment as a result of such illness or
abuse, and why involuntary confinement and treatment are indicated. The
following criteria should be considered by the physician:
(a) The respondent is suffering from serious mental illness
which contributes or causes him to be dangerous to himself or others or to be
gravely disabled or from substance abuse which contributes or causes him to be
dangerous to himself or others or to be gravely disabled.
(b) The respondent's condition is likely to deteriorate
needlessly unless he is provided appropriate medical treatment.
(c) The respondent's condition is likely to improve if he is
provided appropriate medical treatment.
(2) The respondent or his attorney shall have the right to
seek an additional independent medical opinion, when necessary, in their
discretion. If the respondent is indigent, this opinion may be paid for by the
Mental Health Advocacy Service, upon the approval of its executive director.
Reasonable compensation of the appointed examining physicians and all court
costs shall be established by the court and ordered paid by respondent or
petitioner in the discretion of the court. If it is determined by the court
that the costs shall not be borne by the respondent or the petitioner, then
compensation to the physicians and all court costs shall be paid from funds
appropriated to the judiciary, but such court costs shall not exceed the sum of
seventy-five dollars.
(3) If the respondent refuses to be examined by the court
appointed physician as herein provided, or if the judge, after reviewing the
petition and an affidavit filed pursuant to R.S. 28:53.2 or the report of the
treating physician or the court appointed physician, finds that the respondent
is mentally ill or suffering from substance abuse and is in need of immediate
hospitalization to protect the person or others from physical harm, or that the
respondent's condition may be markedly worsened by delay, then the court may
issue a court order for custody of the respondent, and a peace officer shall
deliver the respondent to a treatment facility designated by the court. The
court shall also issue an order to the treatment facility authorizing detention
of the respondent until the commitment hearing is completed, unless he is discharged
by the director.
(4) Unless the individual is currently hospitalized or under
an emergency certificate, he shall be allowed to remain in his home or other
place of residence pending an ordered examination and to return to his home or
other place of residence upon completion of the examination. An examining
physician may execute an emergency certificate pursuant to R.S. 28:53 if he
deems that action appropriate. In such a case, the respondent shall be admitted
pursuant to R.S. 28:53 pending the hearing on the petition.
§55. Judicial hearings
A.
At the appointed time, the court shall conduct a hearing on the petition.
Before the hearing, the respondent may move for a change of venue to the parish
of his domicile, which motion shall be granted only for compelling reasons. If
the respondent is confined to a hospital, the judge of the court where the
petition was filed may hold the hearing on such commitment at the treatment
facility where the person is confined, if in the opinion of at least one of the
physicians appointed by the court to examine him, it will be detrimental to his
health, welfare, or dignity to travel to the court where the petition was
filed.
B.
The court shall provide respondent a reasonable opportunity to select his own
counsel. In the event the respondent does not select counsel and is unable to
pay for counsel, or in the event counsel selected by respondent refuses to
represent said respondent or is not available for such representation, then the
court shall appoint counsel for respondent provided by the mental health
advocacy service. Reasonable compensation of appointed counsel shall be
established by the court and may be ordered paid by respondent or petitioner in
the discretion of the court if either is found financially capable. If it is
determined by the court that the costs shall not be borne by the respondent or
the petitioner, then compensation to the attorney shall be paid from funds
appropriated to the judiciary.
C.
The respondent shall have the right to privately retained and paid counsel at
any time. However, all respondents must be represented by counsel as early as
possible in every proceeding. If attorneys are available through the mental
health advocacy service, the court shall contact the office of the service and
request the assignment of an attorney who will be appointed. In cases where the
service is unable to provide representation, the court shall select and appoint
an attorney to represent the respondent, whose fee shall be set by the court.
An attorney appointed to represent a person by a court pursuant to this Title
has a continuing duty toward that person even after admission. That duty shall
include, but not be limited to, follow-up investigation of the circumstances of
the person and representation in subsequent proceedings relating to admission,
status, and discharge. The duty shall continue until it is terminated by the
court making the appointment.
D.
On the day appointed, the hearing shall take precedence over all other matters,
except pending cases of the same type. The court shall conduct the hearing in
as formal a manner as is possible under the circumstances and shall admit
evidence according to the usual rules of evidence. Witnesses and evidence
tending to show that the person who is the subject of the petition is a proper
subject for judicial commitment shall be presented first. The respondent has a
right to be present unless the court finds that he knowingly, voluntarily, and
intelligently waives his presence. The respondent or his counsel shall have the
right to present evidence and cross examine witnesses who may testify at the
hearing. If the respondent is present at the hearing and is medicated, the
court shall be informed of the medication and its common effects. If the
respondent or his attorney notifies the court not less than three days before
the hearing that he wishes to cross examine the examining physicians, the court
shall order such physicians to appear in person or by deposition. The court
shall cause a recording of the testimony of the hearing to be made, which shall
be transcribed only in the event of an appeal from the judgment. A copy of such
transcript shall be furnished without charge, to any appellant whom the court
finds unable to pay for the same. The cost of such transcript shall be paid
from funds appropriated to the judicial department.
E.(1)
If the court finds by clear and convincing evidence that the respondent is
dangerous to self or others or is gravely disabled, as a result of substance
abuse or mental illness, it shall render a judgment for his commitment. After
considering all relevant circumstances, including any preference of the
respondent or his family, the court shall determine whether the respondent
should be committed to a treatment facility which is medically suitable and
least restrictive of the respondent's liberty. However, if the placement
determined by the court is unavailable, the court shall commit the respondent
to the Department of Health and Hospitals for placement in a state treatment
facility until such time as an opening is available for transfer to the
treatment center determined by the court, unless the respondent waives the
requirement for such transfer. Within fifteen days following an alternative
placement, the department shall submit a report to the court stating the
reasons for such placement and seeking court approval of the placement.
(2) Following commitment of the respondent to the
department, the department shall consider all of the following in determining
the appropriate state treatment facility in which to place the respondent:
(a) The medical needs of the
respondent.
(b) The treatment programs available
at each treatment facility.
(c) The facility which would be
least restrictive of the respondent's liberty.
(d) The availability of space at the
respective treatment facilities.
(e) The preference of the respondent and the proximity of
the respondent's family to the location of the facility.
(3) Unless prohibited by the respondent, the department
shall notify the respondent's family of his placement at and/or transfer to a
state treatment facility.
(4) The director shall notify the court in writing when a
patient has been discharged or conditionally discharged.
(5) The court order shall order a suitable person to convey
such person to the treatment facility and deliver respondent, together with a
copy of the judgment and certificates, to the director. In appointing a person
to execute the order, the court should give preference to a near relative or
friend of the respondent.
(6) The court may, if it finds it to be in the best interest
of the respondent, revoke the certificate or judgment of commitment.
F.
Notice of any action taken by the court shall be given to the respondent and
his attorney as well as to the director of the designated treatment facility in
such manner as the court concludes would be appropriate under the
circumstances.
G.
Each court shall keep a record of the cases relating to mentally ill persons
coming before it under this Title and the disposition of them. It shall also
keep on file the original petition and certificates of physicians required by
this Section, or a microfilm duplicate of such records. All records maintained
in the courts under the provisions of this Section shall be sealed and
available only to the respondent or his attorney, unless the court, after
hearing held with notice to the respondent, determines such records should be
disclosed to a petitioner for cause shown.
H.
Every patient admitted by judicial commitment shall be informed in writing at
the time of admission of the procedures for requesting release from the
treatment facility, the availability of counsel, information about the mental
health advocacy service, the rights enumerated in R.S. 28:171, and the rules and
regulations applicable to or concerning his conduct while a patient in the
treatment facility. If the person is illiterate or does not read or understand
English, appropriate provisions should be made to supply him this information.
In addition a copy of the information listed in this Subsection must be posted
in any area where patients are confined and treated.
I.(1)(a)
A patient confined to a treatment facility by judicial commitment may receive
medication and treatment without his consent, but no major surgical procedures
or electroshock therapy may be performed without the written authority of a
court of competent jurisdiction after a hearing. With regard to the
administration of medicine, if the patient objects to being medicated, prior to
making a final decision, the treating physician shall make a reasonable effort
to consult with the primary physician outside of the facility that has
previously treated the patient for his mental condition. The treating physician
shall, prior to the administration of such medication, record in the patient's
file either the date and time of the consultation and a summary of the comments
of the primary physician or, if the treating physician is unable to consult
with the primary physician, the date and time that a consultation with the
primary physician was attempted.
(b) Notwithstanding the provisions of Subparagraph (a) of
this Paragraph, any licensed physician may administer medication to a patient
without his consent and against his wishes in situations which, in the
reasonable judgment of the physician who is observing the patient during the
emergency, constitutes a psychiatric or behavioral emergency. For purposes of
this Paragraph, a "psychiatric or behavioral emergency" occurs when a
patient, as a result of mental illness, substance abuse, or intoxication
engages in behavior which, in the clinical judgment of the physician, places
the patient or others at significant and imminent risk of damage to life or
limb. The emergency administration of medication may be continued until the
emergency subsides, but in no event shall it exceed forty-eight hours, except
on weekends or holidays when it may be extended for an additional twenty-four
hours.
(c) The physician shall make a reasonable effort to consult
with the primary physician outside the facility that has previously treated the
patient for his mental condition at the earliest possible time, but in no event
more than forty-eight hours after the emergency administration of medication
has begun, except on weekends or holidays, when the time period may be extended
an additional twenty-four hours. The physician shall record in the patient's
file either the date and time of the consultation and
a summary of the comments of the primary physician or, if the physician is unable
to consult with the primary physician, the date and time that a consultation
with the primary physician was attempted.
(2) If the director of the hospital, in consultation with
two physicians, determines that the condition of a committed patient is of such
critical nature that it may be life-threatening unless major surgical
procedures or electroshock treatment is administered, such measures may be
performed without the consent otherwise provided for in this Section.
J.
No director of a treatment facility shall prohibit any mentally ill person or
person suffering from substance abuse from applying for conversion of
involuntary or emergency admission status to voluntary admission status. Any
patient on an involuntary admission status shall have the right to apply for a
writ of habeas corpus to have his admission status changed to voluntary status.
§56. Judicial
commitment; review; appeals
A.(1)(a)
Except as provided in Subparagraph (b) of this Paragraph, all judicial
commitments except those for alcoholism shall be for a period not to exceed one
hundred eighty days. The period of commitment shall expire at the end of the
judicial commitment period, and the patient, if not converted to a voluntary
status, shall be discharged unless a petition for judicial commitment has been
filed prior to the expiration of the commitment period. If the court finds by
clear and convincing evidence that the patient is dangerous to self or others
or is gravely disabled as a result of mental illness, it shall render a
judgment for his commitment for an additional period. Except as provided in
Subparagraph (b) of this Paragraph, each additional judicial commitment shall
expire at the end of one hundred eighty days.
(b) If a person has been judicially committed for four
consecutive one- hundred-eighty-day periods pursuant to the provisions of
Subparagraph (a) of this Paragraph and during this time has not been
conditionally discharged, the period of a subsequent judicial commitment may
exceed one hundred eighty days but shall not exceed one year.
(2)(a) The hearing on the petition shall be conducted according to the procedures and standards set forth in R.S. 28:54 and 55, and this Section. The hearing may be held by the district court for the judicial district in which the patient is being confined, or if not confined, by the district court for the judicial district where he resides or may be found. The hearing shall not be transferred to another district except for good cause s