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Last updated January 2004
Chapter 253 – HOSPITALS FOR
PERSONS WITH MENTAL ILLNESS
§ 253.015 Location; management; commitment; chief executive
officer.
Subdivision 1. State-operated services for persons with
mental illness. The state-operated services facilities
located at
Subd. 2. Repealed, 1Sp2003 c 14 art 6 s 68
Subd. 3. Repealed, 1Sp2003 c 14 art 6 s 68
Subd. 4. Services for persons with
traumatic brain injury. By
§ 253.016 Purpose of regional treatment centers.
The primary mission of the regional treatment centers for
persons with major mental illness is to provide inpatient psychiatric hospital
services. The regional treatment centers
are part of a comprehensive mental health system. Regional treatment center services must be
integrated into an array of services based on assessment of individual needs.
§ 253.017 Treatment provided by state-operated services.
Subdivision 1. Active psychiatric treatment.
The state-operated services shall provide active psychiatric treatment
according to contemporary professional standards. Treatment must be designed to:
(1) stabilize
the individual and the symptoms that required hospital admission;
(2) restore individual functioning
to a level permitting return to the community;
(3) strengthen
family and community support; and
(4) facilitate
discharge, after care, and follow-up as patients return to the community.
Subd. 2. Need for services.
The commissioner shall determine the need for the psychiatric services
provided by the department based upon individual needs assessments of persons
in the state-operated services as required by section 245.474, subdivision 2,
and an evaluation of: (1) state-operated
services programs, (2) programs needed in the region for persons who require
hospitalization, and (3) available epidemiologic
data. Throughout its planning and
implementation, the assessment process must be discussed with the State
Advisory Council on Mental Health in accordance with its duties under section
245.697. Continuing assessment of this
information must be considered in planning for and implementing changes in
state-operated programs and facilities for persons with mental illness. Expansion may be considered only after a
thorough analysis of need and in conjunction with a comprehensive mental health
plan.
Subd. 3.
Dissemination of admission and stay criteria. The commissioner shall
periodically disseminate criteria for admission and continued stay in a state-operated
services facility. The commissioner
shall disseminate the criteria to the courts of the state and counties.
253.018 Persons served.
The regional treatment centers shall primarily serve adults.
Programs treating children and adolescents who require the clinical support
available in a psychiatric hospital may be maintained on present campuses until
adequate state-operated alternatives are developed off campus according to the
criteria of section 253.28, subdivision 2.
§ 253.13 Notice of escape.
When a convict from the
§ 253.20
The commissioner of human services shall erect, equip, and
maintain in St. Peter a suitable building to be known as the Minnesota Security
Hospital, for the purpose of providing a secure treatment facility as defined
in section 253B.02, subdivision 18a, for persons who may be committed there by
courts, or otherwise, or transferred there by the commissioner of human
services, and for persons who are found to be mentally ill while confined in
any correctional facility, or who may be found to be mentally ill and
dangerous, and the commissioner shall supervise and manage the same as in the
case of other state hospitals.
§ 253.21 Commitment; proceedings; restoration of mental
health.
When any person confined in the Minnesota correctional
facility-Stillwater or the Minnesota correctional facility-St. Cloud is alleged
to be mentally ill, the chief executive officer or other person in charge shall
forthwith notify the commissioner of human services, who shall cause the
prisoner to be examined by the court exercising probate jurisdiction of the
county where the prisoner is confined, as in the case of other persons who are
mentally ill. In case the prisoner is
found to be mentally ill, the prisoner shall be transferred by the order of the
court to the
§ 253.22 Allowances.
When any convict is discharged from the
§ 253.23 Transfer proceedings.
When any criminal shall be transferred to the
§ 253.24 Terms of sentence.
A prisoner who is
removed or returned under sections 253.20 to 253.26 shall be held in the place
to which the prisoner is so removed or returned in accordance with the terms of
the prisoner's original sentence unless sooner discharged and the period of
removal shall be counted as a part of the term of the confinement.
§ 253.26 Transfers of patients or residents.
The commissioner of human services may transfer a committed
patient to the
§ 253.28 State-operated, community-based programs for
persons with mental illness.
Subdivision 1. Programs for persons with mental illness.
Beginning
Subd. 2. Location of programs for
persons with mental illness. In determining the location of
state-operated, community-based programs, the needs of the individual clients
shall be paramount. The commissioner
shall take into account:
(1) the
personal preferences of the persons being served and their families;
(2) location
of the support services needed by the persons being served as established by an
individual service plan;
(3) the
appropriate grouping of the persons served;
(4) the
availability of qualified staff;
(5) the need
for state-operated, community-based programs in the geographical region of the
state; and
(6) a
reasonable commuting distance from a regional treatment center or the
residences of the program staff.
Subd. 3. Evaluation of community-based
services development. The commissioner shall develop an integrated
approach to assessing and improving the quality of community-based services
including state-operated programs to persons with mental illness. The commissioner shall evaluate the progress
of the development and quality of the community-based services to determine if
further development can proceed. The
commissioner shall report results of the evaluation to the legislature by
Chapter
253B – CIVIL COMMITMENT
§ 253B.01 Citation.
This chapter may be cited as the "Minnesota Commitment
and Treatment Act."
§ 253B.02 Definitions.
Subdivision 1. Definitions.
For purposes of this chapter, the terms defined in this section have the
meanings given them.
Subd. 1a. Case manager.
"Case manager" has the definition given in section 245.462,
subdivision 4, for persons with mental illness.
Subd. 2. Chemically dependent person.
"Chemically dependent person" means any person (a) determined
as being incapable of self-management or management of personal affairs by
reason of the habitual and excessive use of alcohol, drugs, or other
mind-altering substances; and (b) whose recent conduct as a result of habitual
and excessive use of alcohol, drugs, or other mind-altering substances poses a substantial
likelihood of physical harm to self or others as demonstrated by (i) a recent attempt or threat to physically harm self or
others, (ii) evidence of recent serious physical problems, or (iii) a failure
to obtain necessary food, clothing, shelter, or medical care.
"Chemically dependent person" also means a
pregnant woman who has engaged during the pregnancy in habitual or excessive
use, for a nonmedical purpose, of any of the
following controlled substances or their derivatives: cocaine, heroin, phencyclidine, methamphetamine, or amphetamine.
Subd. 3. Commissioner. "Commissioner" means the
commissioner of human services or the commissioner's designee.
Subd. 4. Committing court.
"Committing court" means the district court where a petition
for commitment was decided. In a case
where commitment proceedings are commenced following an acquittal of a crime or
offense under section 611.026, "committing court" means the district
court in which the acquittal took place.
Subd. 4a. Crime against the person.
"Crime against the person" means a violation of or attempt to
violate any of the following provisions:
sections 609.185 (murder in the first degree); 609.19 (murder in the
second degree); 609.195 (murder in the third degree); 609.20 (manslaughter in
the first degree); 609.205 (manslaughter in the second degree); 609.21
(criminal vehicular homicide and injury); 609.215 (suicide); 609.221 (assault
in the first degree); 609.222 (assault in the second degree); 609.223 (assault
in the third degree); 609.224 (assault in the fifth degree); 609.2242 (domestic
assault); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of
residents or patients); 609.2325 (criminal abuse); 609.233 (criminal neglect);
609.2335 (financial exploitation of a vulnerable adult); 609.235 (use of drugs
to injure or facilitate crime); 609.24 (simple robbery); 609.245 (aggravated
robbery); 609.25 (kidnapping); 609.255 (false imprisonment); 609.265
(abduction); 609.27, subdivision 1, clause (1) or (2) (coercion); 609.28
(interfering with religious observance) if
violence or threats of violence were used; 609.322, subdivision 1,
clause (2) (solicitation); 609.342 (criminal sexual conduct in the first
degree); 609.343 (criminal sexual conduct in the second degree); 609.344
(criminal sexual conduct in the third degree); 609.345 (criminal sexual conduct
in the fourth degree); 609.365 (incest);
609.498, subdivision 1 (tampering with a witness); 609.50, clause (1)
(obstructing legal process, arrest, and firefighting); 609.561 (arson in the
first degree); 609.562 (arson in the second degree); 609.595 (damage to
property); and 609.72, subdivision 3 (disorderly conduct by a caregiver).
Subd. 4b. Community-based treatment. "Community-based
treatment" means community support services programs defined in section
245.462, subdivision 6; day treatment services defined in section 245.462,
subdivision 8; outpatient services defined in section 245.462, subdivision 21;
and residential treatment services as defined in section 245.462, subdivision
23.
Subd. 5. Designated agency.
"Designated agency" means an agency selected by the county
board to provide the social services required under this chapter.
Subd. 6. Emergency treatment.
"Emergency treatment" means the treatment of a patient
pursuant to section 253B.05 which is necessary to protect the patient or others
from immediate harm.
Subd. 7. Examiner.
"Examiner" means a person who is knowledgeable, trained, and
practicing in the diagnosis and assessment or in the treatment of the alleged
impairment, and who is:
(1) a
licensed physician; or
(2) a
licensed psychologist who has a doctoral degree in psychology or who became a
licensed consulting psychologist before
Subd. 7a. Harmful sexual conduct.
(a) "Harmful sexual conduct" means sexual conduct
that creates a substantial likelihood of serious physical or emotional harm to
another.
(b) There is a rebuttable
presumption that conduct described in the following provisions creates a
substantial likelihood that a victim will suffer serious physical or emotional
harm: section 609.342 (CRIMINAL SEXUAL
CONDUCT IN THE FIRST DEGREE), 609.343 (CRIMINAL SEXUAL CONDUCT IN THE SECOND
DEGREE), 609.344 (CRIMINAL SEXUAL CONDUCT IN THE THIRD DEGREE), or 609.345 (CRIMINAL
SEXUAL CONDUCT IN THE FOURTH DEGREE). If
the conduct was motivated by the person's sexual impulses or was part of a
pattern of behavior that had criminal sexual conduct as a goal, the presumption
also applies to conduct described in section 609.185 (MURDER IN THE FIRST
DEGREE), 609.19 (MURDER IN THE SECOND DEGREE), 609.195 (MURDER IN THE THIRD
DEGREE), 609.20 (MANSLAUGHTER IN THE FIRST DEGREE), 609.205 (MANSLAUGHTER IN
THE SECOND DEGREE), 609.221 (ASSAULT IN THE FIRST DEGREE), 609.222 (ASSAULT IN
THE SECOND DEGREE), 609.223 (ASSAULT IN THE THIRD DEGREE), 609.24 (SIMPLE
ROBBERY), 609.245 (AGGRAVATED ROBBERY), 609.25 (KIDNAPPING), 609.255 (FALSE
IMPRISONMENT), 609.365 (INCEST), 609.498 (TAMPERING WITH A WITNESS), 609.561
(ARSON IN THE FIRST DEGREE), 609.582, subdivision 1 (BURGLARY IN THE FIRST
DEGREE), 609.713 (TERRORISTIC THREATS), or 609.749, subdivision 3 or 5
(HARASSMENT AND STALKING).
Subd. 8. Head of the treatment facility.
"Head of the treatment facility" means the person who is
charged with overall responsibility for the professional program of care and
treatment of the facility or the person's designee.
Subd. 9. Health officer.
"Health officer" means a licensed physician, licensed
psychologist, licensed social worker, registered nurse working in an emergency
room of a hospital, or psychiatric or public health nurse as defined in section
145A.02, subdivision 18, and formally designated members of a prepetition screening unit established by section 253B.07.
Subd. 10. Interested person.
"Interested person" means:
(1) an adult, including but not
limited to, a public official, including a local welfare agency acting under
section 626.5561, and the legal guardian, spouse, parent, legal counsel, adult
child, next of kin, or other person designated by a proposed patient; or
(2) a
health plan company that is providing coverage for a proposed patient.
Subd. 11. Licensed psychologist.
"Licensed psychologist" means a person licensed by the Board
of Psychology and possessing the qualifications for licensure provided in
section 148.907.
Subd. 12. Licensed physician.
"Licensed physician" means a person licensed in
Subd. 12a. Mental illness.
"Mental illness" has the meaning given in section 245.462,
subdivision 20.
Subd. 13. Person who is mentally ill.
(a) A "person who is mentally ill" means any
person who has an organic disorder of the brain or a substantial psychiatric
disorder of thought, mood, perception, orientation, or memory which grossly
impairs judgment, behavior, capacity to recognize reality, or to reason or
understand, which is manifested by instances of grossly disturbed behavior or
faulty perceptions and poses a substantial likelihood of physical harm to self
or others as demonstrated by:
(1) a
failure to obtain necessary food, clothing, shelter, or medical care as a
result of the impairment;
(2) an inability for reasons other
than indigence to obtain necessary food, clothing, shelter, or medical care as
a result of the impairment and it is more probable than not that the person
will suffer substantial harm, significant psychiatric deterioration or
debilitation, or serious illness, unless appropriate treatment and services are
provided;
(3) a
recent attempt or threat to physically harm self or others; or
(4) recent
and volitional conduct involving significant damage to substantial property.
(b) A person is not mentally ill under this section if the
impairment is solely due to:
(1) epilepsy;
(2) mental
retardation;
(3) brief
periods of intoxication caused by alcohol, drugs, or other mind-altering
substances; or
(4) dependence
upon or addiction to any alcohol, drugs, or other mind-altering substances.
Subd. 14. Mentally retarded person.
"Mentally retarded person" means any person:
(a) who has been diagnosed as having significantly subaverage intellectual functioning existing concurrently
with demonstrated deficits in adaptive behavior and who manifests these
conditions prior to the person's 22nd birthday; and
(b) whose recent conduct is a
result of mental retardation and poses a substantial likelihood of physical
harm to self or others in that there has been (i) a
recent attempt or threat to physically harm self or others, or (ii) a failure
and inability to obtain necessary food, clothing, shelter, safety, or medical
care.
Subd. 15. Patient.
"Patient" means any person who is receiving treatment or committed
under this chapter.
Subd. 16. Peace officer.
"Peace officer" means a sheriff, or municipal or other local
police officer, or a State Patrol officer when engaged in the authorized duties
of office.
Subd. 17. Person who is mentally ill and
dangerous to the public. A "person who is mentally
ill and dangerous to the public" is a person (a) who is mentally ill; and
(b) who as a result of that mental illness presents a clear danger to the
safety of others as demonstrated by the facts that (i)
the person has engaged in an overt act causing or attempting to cause serious
physical harm to another and (ii) there is a substantial likelihood that the
person will engage in acts capable of inflicting serious physical harm on
another. A person committed as a sexual
psychopathic personality or sexually dangerous person as defined in
subdivisions 18a and 18b is subject to the provisions of this chapter that
apply to persons who are mentally ill and dangerous to the public.
Subd. 18. Regional treatment center.
"Regional treatment center" means any state-operated facility
for persons who are mentally ill, mentally retarded, or chemically dependent
under the direct administrative authority of the commissioner.
Subd. 18a. Secure
treatment facility. "Secure treatment facility" means
the Minnesota Security Hospital and the Minnesota sex offender program facility
in Moose Lake and any portion of the Minnesota sex offender program operated by
the Minnesota sex offender program at the Minnesota Security Hospital, but does
not include services or programs administered by the secure treatment facility
outside a secure environment.
Subd. 18b. Sexual psychopathic
personality. "Sexual psychopathic personality"
means the existence in any person of such conditions of emotional instability,
or impulsiveness of behavior, or lack of customary standards of good judgment,
or failure to appreciate the consequences of personal acts, or a combination of
any of these conditions, which render the person irresponsible for personal
conduct with respect to sexual matters, if the person has evidenced, by a
habitual course of misconduct in sexual matters, an utter lack of power to
control the person's sexual impulses and, as a result, is dangerous to other
persons.
Subd. 18c. Sexually
dangerous person.
(a) A "sexually dangerous person" means a person
who:
(1) has
engaged in a course of harmful sexual conduct as defined in subdivision 7a;
(2) has
manifested a sexual, personality, or other mental disorder or dysfunction; and
(3) as a
result, is likely to engage in acts of harmful sexual conduct as defined in
subdivision 7a.
(b) For purposes of this provision, it is not necessary to
prove that the person has an inability to control the person's sexual impulses.
Subd. 19. Treatment facility.
"Treatment facility" means a hospital, community mental health
center, or other treatment provider qualified to provide care and treatment for
persons who are mentally ill, mentally retarded, or chemically dependent.
Subd. 20. Verdict.
"Verdict" means a jury verdict or a general finding by the
trial court sitting without a jury pursuant to the rules of criminal
procedure.
Subd. 21. Pass.
"Pass" means any authorized temporary, unsupervised absence
from a treatment facility.
Subd. 22. Pass plan.
"Pass plan" means the part of a treatment plan for a person
who has been committed as mentally ill and dangerous that specifies the terms
and conditions under which the patient may be released on a pass.
Subd. 23. Pass-eligible status.
"Pass-eligible status" means the status under which a person
committed as mentally ill and dangerous may be released on passes after
approval of a pass plan by the head of a treatment facility.
§ 253B.03 Rights of
patients.
Subdivision 1.
Restraints.
(a) A patient has the right to be free from restraints. Restraints shall not be applied to a patient
in a treatment facility unless the head of the treatment facility, a member of
the medical staff, or a licensed peace officer who has custody of the patient
determines that they are necessary for the safety of the patient or others.
(b) Restraints shall not be applied to patients with mental
retardation except as permitted under section 245.825 and rules of the
commissioner of human services. Consent
must be obtained from the person or person's guardian except for emergency
procedures as permitted under rules of the commissioner adopted under section 245.825.
(c) Each use of a restraint and reason for it shall be made
part of the clinical record of the patient under the signature of the head of
the treatment facility.
Subd. 2. Correspondence.
A patient has the right to correspond freely without censorship. The head of the treatment facility may
restrict correspondence if the patient's medical welfare requires this
restriction. For patients in regional
treatment centers, that determination may be reviewed by the commissioner. Any limitation imposed on the exercise of a
patient's correspondence rights and the reason for it shall be made a part of
the clinical record of the patient. Any
communication which is not delivered to a patient shall be immediately returned
to the sender.
Subd. 3. Visitors and phone calls.
Subject to the general rules of the treatment facility, a patient has
the right to receive visitors and make phone calls. The head of the treatment facility may
restrict visits and phone calls on determining that the medical welfare of the
patient requires it. Any limitation
imposed on the exercise of the patient's visitation and phone call rights and
the reason for it shall be made a part of the clinical record of the
patient.
Subd. 4. Special visitation; religion.
A patient has the right to meet with or call a personal physician,
spiritual advisor, and counsel at all reasonable times. The patient has the right to continue the
practice of religion.
Subd. 4a. Disclosure of patient's
admission. Upon admission to a facility where federal
law prohibits unauthorized disclosure of patient or resident identifying
information to callers and visitors, the patient or resident, or the legal
guardian or conservator of the patient or resident, shall be given the
opportunity to authorize disclosure of the patient's or resident's presence in
the facility to callers and visitors who may seek to communicate with the
patient or resident. To the extent
possible, the legal guardian or conservator of a patient or resident shall
consider the opinions of the patient or resident regarding the disclosure of
the patient's or resident's presence in the facility.
Subd. 5. Periodic assessment.
A patient has the right to periodic medical assessment, including
assessment of the medical necessity of continuing care and, if the treatment
facility declines to provide continuing care, the right to receive specific
written reasons why continuing care is declined at the time of the
assessment. The treatment facility shall
assess the physical and mental condition of every patient as frequently as
necessary, but not less often than annually.
If the patient refuses to be examined, the facility shall document in
the patient's chart its attempts to examine the patient. If a person is committed as mentally retarded
for an indeterminate period of time, the three-year judicial review must
include the annual reviews for each year as outlined in Minnesota Rules, part
9525.0075, subpart 6.
Subd. 6. Consent for medical procedure.
A patient has the right to prior consent to any medical or surgical
treatment, other than treatment for chemical dependency or nonintrusive
treatment for mental illness.
The following procedures shall be used to obtain consent for
any treatment necessary to preserve the life or health of any committed
patient:
(a) The written, informed consent of
a competent adult patient for the treatment is sufficient.
(b) If the patient is subject to
guardianship or conservatorship which includes the
provision of medical care, the written, informed consent of the guardian or
conservator for the treatment is sufficient.
(c) If the head of the treatment
facility determines that the patient is not competent to consent to the
treatment and the patient has not been adjudicated incompetent, written,
informed consent for the surgery or medical treatment shall be obtained from
the nearest proper relative. For this
purpose, the following persons are proper relatives, in the order listed: the patient's spouse, parent, adult child, or
adult sibling. If the nearest proper
relatives cannot be located, refuse to consent to the procedure, or are unable
to consent, the head of the treatment facility or an interested person may
petition the committing court for approval for the treatment or may petition a
court of competent jurisdiction for the appointment of a guardian or
conservator. The determination that the
patient is not competent, and the reasons for the determination, shall be
documented in the patient's clinical record.
(d) Consent to treatment of any
minor patient shall be secured in accordance with sections 144.341 to
144.346. A minor 16 years of age or
older may consent to hospitalization, routine diagnostic evaluation, and
emergency or short-term acute care.
(e) In the case of an emergency when
the persons ordinarily qualified to give consent cannot be located, the head of
the treatment facility may give consent.
No person who consents to treatment pursuant to the
provisions of this subdivision shall be civilly or criminally liable for the
performance or the manner of performing the treatment. No person shall be liable for performing
treatment without consent if written, informed consent
was given pursuant to this subdivision.
This provision shall not affect any other liability which may result
from the manner in which the treatment is performed.
Subd. 6a. Consent for treatment for
mental retardation. A patient with mental retardation, or the
patient's guardian or conservator, has the right to give or withhold consent
before:
(1) the
implementation of any aversive or deprivation procedure except for emergency
procedures permitted in rules of the commissioner adopted under section
245.825; or
(2) the
administration of psychotropic medication.
Subd. 6b. Consent for mental health
treatment. A competent person admitted voluntarily to a
treatment facility may be subjected to intrusive mental health treatment only
with the person's written informed consent.
For purposes of this section, "intrusive mental health
treatment" means electroshock therapy and neuroleptic
medication and does not include treatment for mental retardation. An incompetent person who has prepared a
directive under subdivision 6d regarding treatment with intrusive therapies
must be treated in accordance with this section, except in cases of
emergencies.
Subd. 6c. Repealed, 1997 c 217 art 1 s 118
Subd. 6d. Adult mental health treatment.
(a) A competent adult may make a declaration of preferences
or instructions regarding intrusive mental health treatment. These preferences or instructions may
include, but are not limited to, consent to or refusal of these treatments.
(b) A declaration may designate a proxy to make decisions
about intrusive mental health treatment.
A proxy designated to make decisions about intrusive mental health
treatments and who agrees to serve as proxy may make decisions on behalf of a
declarant consistent with any desires the declarant expresses in the
declaration.
(c) A declaration is effective only if it is signed by the
declarant and two witnesses. The
witnesses must include a statement that they believe the declarant understands
the nature and significance of the declaration.
A declaration becomes operative when it is delivered to the declarant's physician or other mental health treatment
provider. The physician or provider must
comply with it to the fullest extent possible, consistent with reasonable
medical practice, the availability of treatments requested, and applicable
law. The physician or provider shall
continue to obtain the declarant's informed consent
to all intrusive mental health treatment decisions if the declarant is capable
of informed consent. A treatment
provider may not require a person to make a declaration under this subdivision
as a condition of receiving services.
(d) The physician or other provider shall make the
declaration a part of the declarant's medical
record. If the
physician
or other provider is unwilling at any time to comply with the declaration, the
physician or provider must promptly notify the declarant and document the
notification in the declarant's medical record. If the declarant has been committed as a
patient under this chapter, the physician or provider may subject a declarant
to intrusive treatment in a manner contrary to the declarant's
expressed wishes, only upon order of the committing court. If the declarant is not a committed patient
under this chapter, the physician or provider may subject the declarant to
intrusive treatment in a manner contrary to the declarant's
expressed wishes, only if the declarant is committed as mentally ill or
mentally ill and dangerous to the public and a court order authorizing the
treatment has been issued.
(e) A declaration under this subdivision may be revoked in
whole or in part at any time and in any manner by the declarant if the
declarant is competent at the time of revocation. A revocation is effective when a competent
declarant communicates the revocation to the attending physician or other
provider. The attending physician or other provider shall note the revocation
as part of the declarant's medical record.
(f) A provider who administers intrusive mental health
treatment according to and in good faith reliance upon the validity of a
declaration under this subdivision is held harmless from any liability
resulting from a subsequent finding of invalidity.
(g) In addition to making a declaration under this
subdivision, a competent adult may delegate parental powers under section
524.5-505 or may nominate a guardian or conservator under section 525.544.
Subd. 7. Program plan.
A person receiving services under this chapter has the right to receive
proper care and treatment, best adapted, according to contemporary professional
standards, to rendering further supervision unnecessary. The treatment facility shall devise a written
program plan for each person which describes in behavioral terms the case
problems, the precise goals, including the expected period of time for treatment,
and the specific measures to be employed.
Each plan shall be reviewed at least quarterly to determine progress
toward the goals, and to modify the program plan as necessary. The program plan shall be devised and
reviewed with the designated agency and with the patient. The clinical record shall reflect the program
plan review. If the designated agency or
the patient does not participate in the planning and review, the clinical
record shall include reasons for nonparticipation and the plans for future
involvement. The commissioner shall
monitor the program plan and review process for regional centers to insure
compliance with the provisions of this subdivision.
Subd. 8. Medical records.
A patient has the right to access to personal medical records. Notwithstanding the provisions of section
144.335, subdivision 2, every person subject to a proceeding or receiving
services pursuant to this chapter and the patient's attorney shall have
complete access to all medical records relevant to the person's
commitment. A provider may require an
attorney to provide evidence of representation of the patient or an authorization
signed by the patient.
Subd. 9. Repealed, 1997 c 217 art 1 s 118
Subd. 10. Notification.
All persons admitted or committed to a treatment facility shall be
notified in writing of their rights regarding hospitalization and other treatment
at the time of admission. This
notification must include:
(1) patient
rights specified in this section and section 144.651, including nursing home
discharge rights;
(2) the
right to obtain treatment and services voluntarily under this chapter;
(3) the
right to voluntary admission and release under section 253B.04;
(4) rights
in case of an emergency admission under section 253B.05, including the right to
documentation in support of an emergency hold and the right to a summary
hearing before a judge if the patient believes an emergency hold is improper;
(5) the
right to request expedited review under section 62M.05 if additional days of
inpatient stay are denied;
(6) the right to continuing benefits
pending appeal and to an expedited administrative hearing under section 256.045
if the patient is a recipient of medical assistance, general assistance medical
care, or MinnesotaCare; and
(7) the
right to an external appeal process under section 62Q.73, including the right to a second
opinion.
Subd. 11. Proxy.
A legally authorized health care proxy, agent, guardian, or conservator
may exercise the patient's rights on the patient's behalf.
§ 253B.04 Voluntary
treatment and admission procedures.
Subdivision 1.
Voluntary admission and treatment.
(a) Voluntary admission is preferred over involuntary
commitment and treatment. Any person 16
years of age or older may request to be admitted to a treatment facility as a
voluntary patient for observation, evaluation, diagnosis, care and treatment
without making formal written application.
Any person under the age of 16 years may be admitted as a patient with
the consent of a parent or legal guardian if it is determined by independent
examination that there is reasonable evidence that (1) the proposed patient has
a mental illness, or is mentally retarded or chemically dependent; and (2) the
proposed patient is suitable for treatment.
The head of the treatment facility shall not arbitrarily refuse any
person seeking admission as a voluntary patient. In making decisions regarding admissions, the
facility shall use clinical admission criteria consistent with the current
applicable inpatient admission standards established by the American
Psychiatric Association or the
(b) In addition to the consent provisions of paragraph (a),
a person who is 16 or 17 years of age who refuses to consent personally to
admission may be admitted as a patient for mental illness or chemical
dependency treatment with the consent of a parent or legal guardian if it is
determined by an independent examination that there is reasonable evidence that
the proposed patient is chemically dependent or has a mental illness and is
suitable for treatment. The person
conducting the examination shall notify the proposed patient and the parent or
legal guardian of this determination.
(c) A person who is voluntarily participating in treatment
for a mental illness is not subject to civil commitment under this chapter if
the person:
(1) has
given informed consent or, if lacking capacity, is a person for whom legally
valid substitute consent has been given; and
(2) is
participating in a medically appropriate course of treatment, including
clinically appropriate and lawful use of neuroleptic
medication and electroconvulsive therapy. The limitation on commitment in this
paragraph does not apply if, based on clinical assessment, the court finds that
it is unlikely that the person will remain in and cooperate with a medically
appropriate course of treatment absent commitment and the standards for commitment are otherwise
met. This paragraph does not apply to a
person for whom commitment proceedings are initiated pursuant to rule 20.01 or
20.02 of the Rules of Criminal Procedure, or a person found by the court to
meet the requirements under section 253B.02, subdivision 17.
Legally valid substitute consent may be provided by a proxy
under a health care directive, a guardian or conservator with authority to
consent to mental health treatment, or consent to admission under subdivision
1a or 1b.
Subd. 1a. Voluntary treatment or
admission for persons with mental illness.
(a) A person with a mental illness may seek or voluntarily
agree to accept treatment or admission to a facility. If the mental health provider determines that
the person lacks the capacity to give informed consent for the treatment or
admission, and in the absence of a health care power of attorney that
authorizes consent, the designated agency or its designee may give informed
consent for mental health treatment or admission to a treatment facility on
behalf of the person.
(b) The designated agency shall apply the following criteria
in determining the person's ability to give informed consent:
(1) whether the person demonstrates
an awareness of the person's illness, and the reasons for treatment, its risks,
benefits and alternatives, and the possible consequences of refusing treatment;
and
(2) whether
the person communicates verbally or nonverbally a clear choice concerning
treatment that is a reasoned one, not based on delusion, even though it may not
be in the person's best interests.
(c) The basis for the designated agency's decision that the
person lacks the capacity to give informed consent for treatment or admission,
and that the patient has voluntarily accepted treatment or admission, must be
documented in writing.
(d) A mental health provider that provides treatment in
reliance on the written consent given by the designated agency under this
subdivision or by a substitute decision maker appointed by the court is not
civilly or criminally liable for performing treatment without consent. This paragraph does not affect any other
liability that may result from the manner in which the treatment is performed.
(e) A person who receives treatment or is admitted to a
facility under this subdivision or subdivision 1b has the right to refuse
treatment at any time or to be released from a facility as provided under
subdivision 2. The person or any
interested person acting on the person's behalf may seek court review within
five days for a determination of whether the person's agreement to accept treatment
or admission is voluntary. At the time a
person agrees to treatment or admission to a facility under this subdivision,
the designated agency or its designee shall inform the person in writing of the
person's rights under this paragraph.
(f) This subdivision does not authorize the administration of
neuroleptic medications. Neuroleptic
medications may be administered only as provided in section 253B.092.
Subd. 1b. Court appointment of
substitute decision maker. If the designated agency or its
designee declines or refuses to give informed consent under subdivision 1a, the
person who is seeking treatment or admission, or an interested person acting on
behalf of the person, may petition the court for appointment of a substitute
decision maker who may give informed consent for voluntary treatment and
services. In making this determination,
the court shall apply the criteria in subdivision 1a, paragraph (b).
Subd. 2. Release.
Every patient admitted for mental illness or mental retardation under
this section shall be informed in writing at the time of admission that the
patient has a right to leave the facility within 12 hours of making a request,
unless held under another provision of this chapter. Every patient admitted for chemical
dependency under this section shall be informed in writing at the time of
admission that the patient has a right to leave the facility within 72 hours,
exclusive of Saturdays, Sundays, and holidays, of making a request, unless held
under another provision of this chapter.
The request shall be submitted in writing to the head of the treatment
facility or the person's designee.
§ 253B.045 Temporary
confinement.
Subdivision 1.
Restriction. Except when ordered by the court pursuant to
a finding of necessity to protect the life of the proposed patient or others,
no person subject to the provisions of this chapter shall be confined in a jail
or correctional institution, except pursuant to chapter 242 or 244.
Subd. 2. Facilities.
Each county or a group of counties shall maintain or provide by contract
a facility for confinement of persons held temporarily for observation,
evaluation, diagnosis, treatment, and care.
When the temporary confinement is provided at a regional center, the
commissioner shall charge the county of financial responsibility for the costs
of confinement of persons hospitalized under section 253B.05, subdivisions 1
and 2, and section 253B.07, subdivision 2b, except that the commissioner shall
bill the responsible health plan first.
If the person has health plan coverage, but the hospitalization does not
meet the criteria in subdivision 6 or section 62M.07, 62Q.53, or 62Q.535, the
county is responsible.
"County of financial responsibility" means the
county in which the person resides at the time of confinement or, if the person
has no residence in this state, the county which initiated the
confinement. The charge shall be based
on the commissioner's determination of the cost of care pursuant to section
246.50, subdivision 5. When there is a
dispute as to which county is the county of financial responsibility, the
county charged for the
costs of confinement shall pay for them pending final determination of the
dispute over financial responsibility.
Disputes about the county of financial responsibility shall
be submitted to the commissioner to be settled in the manner prescribed in
section 256G.09.
Subd. 3. Cost of care.
Notwithstanding subdivision 2, a county shall be responsible for the
cost of care as specified under section 246.54 for persons hospitalized at a
regional treatment center in accordance with section 253B.09 and the person's
legal status has been changed to a court hold under section 253B.07,
subdivision 2b, pending a judicial determination regarding continued commitment
pursuant to sections 253B.12 and 253B.13.
Subd. 4. Treatment.
The designated agency shall take reasonable measures to assure proper
care and treatment of a person temporarily confined pursuant to this
section.
Subd. 5. Health plan
company; definition. For purposes of this section,
"health plan company" has the meaning given it in section 62Q.01,
subdivision 4, and also includes a demonstration provider as defined in section
256B.69, subdivision 2, paragraph (b), a county or group of counties participating
in county-based purchasing according to section 256B.692, and a children's
mental health collaborative under contract to provide medical assistance for
individuals enrolled in the prepaid medical assistance and MinnesotaCare
programs according to sections 245.493 to 245.495.
Subd. 6. Coverage.
(a) For purposes of this section, "mental health
services" means all covered services that are intended to treat or
ameliorate an emotional, behavioral, or psychiatric condition and that are
covered by the policy, contract, or certificate of coverage of the enrollee's
health plan company or by law.
(b) All health plan companies that provide coverage for
mental health services must cover or provide mental health services ordered by
a court of competent jurisdiction under a court order that is issued on the
basis of a behavioral care evaluation performed by a licensed psychiatrist or a
doctoral level licensed psychologist, which includes a diagnosis and an
individual treatment plan for care in the most appropriate, least restrictive
environment. The health plan company
must be given a copy of the court order and the behavioral care
evaluation. The health plan company
shall be financially liable for the evaluation if performed by a participating
provider of the health plan company and shall be financially liable for the
care included in the court-ordered individual treatment plan if the care is
covered by the health plan company and ordered to be provided by a
participating provider or another provider as required by rule or law. This court-ordered coverage must not be
subject to a separate medical necessity determination by a health plan company
under its utilization procedures.
§ 253B.05 Emergency
admission.
Subdivision 1.
Emergency hold.
(a) Any person may be admitted or held for emergency care and treatment in a treatment facility with the consent of the head of the