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Last updated November 2003
Chapter 630
Department of Mental Health
Department created--state mental health commission--
630.003.
1. There is hereby created a department of mental health to be headed by a
mental health commission who shall appoint a director, by and with the advice
and consent of the senate. The director shall be the administrative head of the
department and shall serve at the pleasure of the commission and be compensated
as provided by law for the director, division of mental health. All employees
of the department shall be selected in accordance with chapter 36, RSMo.
2.
(1) The "State Mental Health Commission", composed of seven members,
is the successor to the former state mental health commission and it has all
the powers, duties and responsibilities of the former commission. All members
of the commission shall be appointed by the governor, by and with the advice
and consent of the senate. None of the members shall otherwise be employed by
the state of
(2) Three of the commission members first appointed shall be
appointed for terms of four years, and two shall be appointed for terms of
three years, and two shall be appointed for a term of two years. The governor
shall designate, at the time the appointments are made, the length of the term
of each member so appointed. Thereafter all terms shall be for four years.
(3) At least two of the members of the commission shall be
physicians, one of whom shall be recognized as an expert in the field of the
treatment of nervous and mental diseases, and one of whom shall be recognized
as an expert in the field of mental retardation or of other developmental
disabilities. At least two of the members of the commission shall be
representative of persons or groups who are consumers having substantial
interest in the services provided by the division, one of whom shall represent
the mentally retarded or developmentally disabled and one of whom shall
represent those persons being treated for nervous and mental diseases. Of the
other three members at least one must be recognized for his expertise in general
business management procedures, and two shall be
recognized for their interest and expertise in dealing with alcohol/drug abuse
problems, or community mental health services.
3.
The provisions of sections 191.120, 191.125, 191.130, 191.140, 191.150, 191.160,
191.170, 191.180, 191.190, 191.200, 191.210, RSMo,
and others as they relate to the division of mental health not previously
reassigned by executive reorganization plan number 2 of 1973 as submitted by
the governor under chapter 26, RSMo, are transferred
by specific type transfer from the department of public health and welfare to
the department of mental health. The division of mental health, department of
health and welfare, chapter 202, RSMo, and others are
abolished and all powers, duties and functions now assigned by law to the
division, the director of the divisions of mental health or any of the
institutions or officials of the division are transferred by type I transfer to
the department of mental health.
4.
The
5.
There is hereby established within the department of mental health a division
of mental retardation and developmental disabilities. The director of the
division shall be appointed by the director of the department. The division
shall administer all state facilities under the direction and authority of the
department director. The Marshall Habilitation Center, the Higginsville
Habilitation Center, the Bellefontaine Habilitation Center, the Nevada
Habilitation Center, the St. Louis Developmental Disabilities Treatment
Centers, and the regional centers located at Albany, Columbia, Hannibal,
Joplin, Kansas City, Kirksville, Poplar Bluff, Rolla, St. Louis, Sikeston and
Springfield and other similar facilities as may be established, are transferred
by type I transfer to the division of mental retardation and developmental
disabilities.
6.
All the duties, powers and functions of the advisory council on mental
retardation and community health centers, sections 202.664 to 202.666, RSMo, are hereby transferred by type I transfer to the
division of mental retardation and developmental disabilities of the department
of mental health. The advisory council on mental retardation and community
health centers shall be appointed by the division director.
7.
The advisory council on mental retardation and developmental disabilities
heretofore established by executive order and all of the duties, powers and
functions of the advisory council including the responsibilities of the
provision of the council in regard to the Federal Development Disabilities Law
(P.L. 91-517) and all amendments thereto are transferred by type I transfer to
the division of mental retardation and developmental disabilities. The advisory
council on mental retardation and developmental disabilities shall be appointed
by the director of the division of mental retardation and developmental
disabilities.
8.
The advisory council on alcoholism and drug abuse, chapter 202, RSMo, is transferred by type II transfer to the department
of mental health and the members of the advisory council shall be appointed by
the mental health director.
Definitions.
630.005.
As used in this chapter and chapters 631, 632, and 633, RSMo,
unless the context clearly requires otherwise, the following terms shall mean:
(1)
"Administrative entity", a provider of specialized services other
than transportation to clients of the department on behalf of a division of the
department;
(2)
"Alcohol abuse", the use of any alcoholic beverage, which use results
in intoxication or in a psychological or physiological dependency from
continued use, which dependency induces a mental, emotional or physical
impairment and which causes socially dysfunctional behavior;
(3)
"Chemical restraint", medication administered with the primary intent
of restraining a patient who presents a likelihood of serious physical injury
to himself or others, and not prescribed to treat a person's medical condition;
(4)
"Client", any person who is placed by the department in a facility or
program licensed and funded by the department or who is a recipient of services
from a regional center, as defined in section 633.005, RSMo;
(5)
"Commission", the state mental health commission;
(6)
"Consumer", a person:
(a) Who qualifies to receive department services; or
(b) Who is a parent, child or sibling of a person who
receives department services; or
(c) Who has a personal interest in services provided by the department. A person who provides services to persons
affected by mental retardation, developmental disabilities, mental disorders,
mental illness, or alcohol or drug abuse shall not be considered a consumer;
(7)
"Day program", a place conducted or maintained by any person who
advertises or holds himself out as providing prevention, evaluation, treatment,
habilitation or rehabilitation for persons affected by mental disorders, mental
illness, mental retardation, developmental disabilities or alcohol or drug
abuse for less than the full twenty-four hours comprising each daily period;
(8)
"Department", the department of mental health of the state of
(9)
"Developmental disability", a disability:
(a) Which is attributable to:
a. Mental retardation, cerebral palsy,
epilepsy, head injury or autism, or a learning disability related to a brain
dysfunction; or
b. Any other mental or physical
impairment or combination of mental or physical impairments; and
(b) Is manifested before the person attains age twenty-two; and
(c) Is likely to continue
indefinitely; and
(d) Results in substantial functional limitations in two or
more of the following areas of major life activities:
a. Self-care;
b. Receptive and expressive language
development and use;
c. Learning;
d. Self-direction;
e. Capacity for independent living
or economic self-sufficiency;
f. Mobility; and
(e) Reflects the person's need for a combination and
sequence of special, interdisciplinary, or generic care, habilitation or other
services which may be of lifelong or extended duration and are individually
planned and coordinated;
(10)
"Director", the director of the department of mental health, or his
designee;
(11)
"Domiciled in Missouri", a permanent connection between an individual
and the state of Missouri, which is more than mere residence in the state; it
may be established by the individual being physically present in Missouri with
the intention to abandon his previous domicile and to remain in Missouri
permanently or indefinitely;
(12)
"Drug abuse", the use of any drug without compelling medical reason,
which use results in a temporary mental, emotional or physical impairment and
causes socially dysfunctional behavior, or in psychological or physiological
dependency resulting from continued use, which dependency induces a mental,
emotional or physical impairment and causes socially dysfunctional behavior;
(13)
"Habilitation", a process of treatment, training, care or specialized
attention which seeks to enhance and maximize the mentally retarded or
developmentally disabled person's abilities to cope with the environment and to
live as normally as possible;
(14)
"Habilitation center", a residential facility operated by the
department and serving only persons who are mentally retarded, including developmentally
disabled;
(15)
"Head of the facility", the chief administrative officer, or his
designee, of any residential facility;
(16)
"Head of the program", the chief administrative officer, or his
designee, of any day program;
(17)
"Individualized habilitation plan", a document which sets forth
habilitation goals and objectives for mentally retarded or developmentally
disabled residents and clients, and which details the habilitation program as
required by law, rules and funding sources;
(18)
"Individualized rehabilitation plan", a document which sets forth the
care, treatment and rehabilitation goals and objectives for patients and
clients affected by alcohol or drug abuse, and which details the rehabilitation
program as required by law, rules and funding sources;
(19)
"Individualized treatment plan", a document which sets forth the
care, treatment and rehabilitation goals and objectives for mentally disordered
or mentally ill patients and clients, and which details the treatment program
as required by law, rules and funding sources;
(20)
"Investigator", an employee or contract agent of the department of
mental health who is performing an investigation regarding an allegation of abuse
or neglect or an investigation at the request of the director of the department
of mental health or his designee;
(21)
"Least restrictive environment", a reasonably available setting or
mental health program where care, treatment, habilitation or rehabilitation is
particularly suited to the level and quality of services necessary to implement
a person's individualized treatment, habilitation or rehabilitation plan and to
enable the person to maximize his functioning potential to participate as freely
as feasible in normal living activities, giving due consideration to
potentially harmful effects on the person and the safety of other facility or
program clients and public safety. For some mentally disordered or mentally
retarded persons, the least restrictive environment may be a facility operated
by the department, a private facility, a supported community living situation,
or an alternative community program designed for persons who are civilly
detained for outpatient treatment or who are conditionally released pursuant to
chapter 632, RSMo;
(22)
"Mental disorder", any organic, mental or emotional impairment which
has substantial adverse effects on a person's cognitive, volitional or
emotional function and which constitutes a substantial impairment in a person's
ability to participate in activities of normal living;
(23)
"Mental illness", a state of impaired mental processes, which
impairment results in a distortion of a person's capacity to recognize reality
due to hallucinations, delusions, faulty perceptions or alterations of mood,
and interferes with an individual's ability to reason, understand or exercise
conscious control over his actions. The term "mental illness" does
not include the following conditions unless they are accompanied by a mental
illness as otherwise defined in this subdivision:
(a) Mental retardation, developmental disability or
narcolepsy;
(b) Simple intoxication caused by substances such as alcohol
or drugs;
(c) Dependence upon or addiction to any substances such as
alcohol or drugs;
(d) Any other disorders such as senility, which are not of
an actively psychotic nature;
(24)
"Mental retardation", significantly subaverage
general intellectual functioning which:
(a) Originates before age eighteen; and
(b) Is associated with a
significant impairment in adaptive behavior;
(25)
"Minor", any person under the age of eighteen years;
(26)
"Patient", an individual under observation, care, treatment or
rehabilitation by any hospital or other mental health facility or mental health
program pursuant to the provisions of chapter 632, RSMo;
(27)
"Psychosurgery",
(a) Surgery on the normal brain tissue of an individual not
suffering from physical disease for the purpose of changing or controlling
behavior; or
(b) Surgery on diseased brain tissue of an individual if the
sole object of the surgery is to control, change or affect behavioral
disturbances, except seizure disorders;
(28)
"Rehabilitation", a process of restoration of a person's ability to
attain or maintain normal or optimum health or constructive activity through
care, treatment, training, counseling or specialized attention;
(29)
"Residence", the place where the patient has last generally lodged
prior to admission or, in case of a minor, where his family has so lodged; except,
that admission or detention in any facility of the department shall not be
deemed an absence from the place of residence and shall not constitute a change
in residence;
(30)
"Resident", a person receiving residential services from a facility,
other than mental health facility, operated, funded or licensed by the
department;
(31)
"Residential facility", any premises where residential prevention,
evaluation, care, treatment, habilitation or rehabilitation is provided for
persons affected by mental disorders, mental illness, mental retardation,
developmental disabilities or alcohol or drug abuse; except the person's
dwelling;
(32)
"Specialized service", an entity which provides prevention,
evaluation, transportation, care, treatment, habilitation or rehabilitation
services to persons affected by mental disorders, mental illness, mental
retardation, developmental disabilities or alcohol or drug abuse;
(33)
"Vendor", a person or entity under contract with the department,
other than as a department employee, who provides services to patients,
residents or clients.
Mental health commission--members,
terms, qualifications, appointment, vacancies, compensation--organization,
meetings.
630.010.
1. The state mental health commission, established by the omnibus
reorganization act of 1974, section 9, appendix B, RSMo,
shall be composed of seven members appointed by the governor, by and with the
advice and consent of the senate. The terms of members appointed under the
reorganization act before
2.
The commission shall be comprised of members who are not prohibited from
serving by sections 105.450 to 105.482, RSMo, as
amended, and who are not otherwise employed by the state. The commission shall
be composed of the following:
(1) A physician recognized as an expert in the treatment of
mental illness;
(2) A physician recognized as an expert in the evaluation or
habilitation of the mentally retarded and developmentally disabled;
(3) A representative of groups who are consumers or families
of consumers interested in the services provided by the department in the
treatment of mental illness;
(4) A representative of groups who are consumers or families
of consumers interested in the services provided by the department in the
habilitation of the mentally retarded;
(5) A person recognized for his expertise in general
business matters and procedures;
(6) A person recognized for his interest and expertise in
dealing with alcohol or drug abuse; and
(7) A person recognized for his interest or expertise in
community mental health services.
3.
Vacancies occurring on the commission shall be filled by appointment by the
governor, by and with the advice and consent of the senate, for the unexpired terms. In case of a vacancy when the senate is
not in session, the governor shall make a temporary appointment until the next
session of the general assembly, when he shall nominate someone to fill the
office.
4.
The commission shall elect from its members a chairman and a secretary.
Meetings shall be held at least once a month, and special meetings may be held
at the call of the chairman.
5.
The department shall pay the commission members one hundred dollars per day for
each day, or portion thereof, they actually spend in transacting the business
of the commission and shall reimburse the commission members for necessary
expenses actually incurred in the performance of their official duties.
Director, appointment--duties of
commission.
630.015.
1. The state mental health commission shall appoint the director of the
department by and with the advice and consent of the senate, and the director
shall serve at the pleasure of the commission.
2.
The commission shall advise the director of the department as to all phases of
department practices in order to make them compatible with professional
standards, including the following subjects:
(1) Care, treatment, habilitation and rehabilitation
facilities and programs;
(2) Manpower recruitment, development and training;
(3) Medical and statistical records;
(4) Operational policies;
(5) Accessibility of services.
3.
The commission shall advise the director in the initiation, approval and
guidance of research projects and distribution of research funds.
4.
The commission shall assist the director in establishing, maintaining and
reviewing the best possible plans, practices, rules and regulations,
facilities, programs and services which are operated, funded or licensed by the
department.
Departmental goals, duties.
630.020.
1. The department shall seek to do the following for the citizens of this
state:
(1) Reduce the incidence and prevalence of mental disorders,
developmental disabilities and alcohol or drug abuse through primary, secondary
and tertiary prevention;
(2) Maintain and enhance intellectual, interpersonal and
functional skills of individuals affected by mental disorders, developmental
disabilities or alcohol or drug abuse by operating, funding and licensing
modern treatment and habilitation programs provided in the least restrictive
environment possible;
(3) Improve public understanding of and attitudes toward
mental disorders, developmental disabilities and alcohol and drug abuse.
2.
The department shall make necessary orders, policies and procedures for the
government, administration, discipline and management of its facilities,
programs and operations.
Research activities by department.
630.055.
From funds appropriated by the general assembly for this purpose, the
department may conduct research into the causes of mental disorders,
developmental disabilities and alcohol or drug abuse, into improving methods of
care, treatment, habilitation and rehabilitation for persons affected by such
conditions, and the stigmatizing effects on persons presently or formerly
served in the department service delivery system. Insofar as practicable, the
department shall make use of and cooperate with the services and facilities of
the various state universities and state agencies to conduct its research.
Cooperation with other groups.
630.060.
The department shall seek and encourage cooperation and active participation of
communities, counties, organizations, agencies, private and not-for-profit
corporations and individuals in the effort to establish and maintain quality
programs and services for persons affected by mental disorders, developmental
disabilities or alcohol or drug abuse. The department shall develop programs of
public information and education for this purpose.
State auditor may examine records--personally identifiable
information not to be revealed.
630.080.
The state auditor shall have access to all records maintained and established
by the department. Any confidential records shall not be divulged in such a way
to reveal personally identifiable information.
Annual report by director, to whom,
when, contents.
630.085.
1. The director shall make an annual written report on behalf of the department
to the governor and the general assembly within ninety days of the end of each
fiscal year.
2.
The report shall include pertinent information as to the cost and benefit
effectiveness of activities, projects, plans and accomplishments of the
department and each of its divisions, together with statistics and summaries of
financial receipts and expenditures as the director may, with the advice of the
commission, deem necessary and expedient. The reports may be presented in sections
compiled on behalf of each respective division of the department.
3.
The department shall indicate every two years in every even-numbered year
whether each department facility is in compliance with standards applicable to
the facility, the deficiencies which cause the facility not to be in compliance
if it is not and the actions necessary for the facility to achieve compliance,
unless the report states the reasons for the facility not to attempt to achieve
compliance.
Patient's rights--limitations.
630.110.
1. Except as provided in subsection 5 of this section, each person admitted to
a residential facility or day program and each person admitted on a voluntary
or involuntary basis to any mental health facility or mental health program
where people are civilly detained pursuant to chapter 632, RSMo,
except to the extent that the head of the residential facility or day program
determines that it is inconsistent with the person's therapeutic care,
treatment, habilitation or rehabilitation and the safety of other facility or
program clients and public safety, shall be entitled to the following:
(1) To wear his own clothes and to keep and use his own
personal possessions;
(2) To keep and be allowed to spend a reasonable sum of his own money for canteen expenses and small purchases;
(3) To communicate by sealed mail or otherwise with persons
including agencies inside or outside the facility;
(4) To receive visitors of his own choosing at reasonable
times;
(5) To have reasonable access to a telephone both to make
and receive confidential calls;
(6) To have access to his mental and medical records;
(7) To have opportunities for physical exercise and outdoor
recreation;
(8) To have reasonable, prompt access to current newspapers,
magazines and radio and television programming.
2.
Any limitations imposed by the head of the residential facility or day program
or his designee on the exercise of the rights enumerated in subsection 1 of
this section by a patient, resident or client and the reasons for such
limitations shall be documented in his clinical record.
3.
Each patient, resident or client shall have an absolute right to receive visits
from his attorney, physician or clergyman, in private, at reasonable times.
4.
Notwithstanding any limitations authorized under this section on the right of
communication, every patient, resident or client shall be entitled to
communicate by sealed mail with the department, his legal counsel and with the
court, if any, which has jurisdiction over the person.
5.
Persons committed to a residential facility or day program operated, funded or
licensed by the department pursuant to section 552.040, RSMo,
shall not be entitled to the rights enumerated in subdivisions (1), (3) and (5)
of subsection 1 of this section unless the head of the residential facility or
day program determines that these rights are necessary for the person's
therapeutic care, treatment, habilitation or rehabilitation. In exercising the
discretion to grant any of the rights enumerated in subsection 1 of this
section to a patient, resident or client, the head of the residential facility
or day program shall consider the safety of the public.
Patient's
entitlements--administrative review of violations.
630.115.
1. Each patient, resident or client shall be entitled to the following without
limitation:
(1) To humane care and treatment;
(2) To the extent that the facilities, equipment and
personnel are available, to medical care and treatment in accordance with the
highest standards accepted in medical practice;
(3) To safe and sanitary housing;
(4) To not participate in nontherapeutic
labor;
(5) To attend or not attend religious services;
(6) To receive prompt evaluation and care, treatment,
habilitation or rehabilitation about which he is informed insofar as he is
capable of understanding;
(7) To be treated with dignity as a human being;
(8) To not be the subject of experimental research without
his prior written and informed consent or that of his parent, if a minor, or
his guardian; except that no involuntary patient shall be subject to experimental
research, except as provided within this chapter;
(9) To decide not to participate or may withdraw from any
research at any time for any reason*;
(10) To have access to consultation with a private physician
at his own expense;
(11) To be evaluated, treated or habilitated in the least
restrictive environment;
(12) To not be subjected to any hazardous treatment or
surgical procedure unless he, his parent, if he is a minor, or his guardian
consents; or unless such treatment or surgical procedure is ordered by a court
of competent jurisdiction;
(13) In the case of hazardous treatment or irreversible
surgical procedures, to have, upon request, an impartial review prior to
implementation, except in case of emergency procedures required for the preservation
of his life;
(14) To a nourishing, well-balanced and varied diet;
(15) To be free from verbal and physical abuse.
2.
Notwithstanding any other sections of this chapter, each patient, resident or
client shall have the right to an impartial administrative review of alleged
violations of the rights assured under this chapter. The impartial
administration review process shall be a mechanism for:
(1) Reporting alleged violations of rights assured under
this chapter;
(2) Investigating alleged violations of these rights;
(3) Presenting patient, resident or client grievances on the
record to a neutral decision maker; and
(4) Requiring that the neutral decision maker issue findings
of fact, conclusions and recommendations.
3.
The impartial administrative review process shall be completed within a timely
manner after the alleged violation is reported.
4.
This impartial review process shall not apply to investigations of alleged
patient, resident or client abuse or neglect conducted pursuant to section
630.167.
*Word
"season" appears in original rolls.
No presumptions.
630.120.
No patient or resident, either voluntary or involuntary, shall be presumed to
be incompetent, to forfeit any legal right, responsibility or obligation or to
suffer any legal disability as a citizen, unless otherwise prescribed by law,
as a consequence of receiving evaluation, care, treatment, habilitation or
rehabilitation for a mental disorder, mental illness, mental retardation,
developmental disability, alcohol problem or drug problem.
Explanation of rights and
entitlements.
630.125.
1. At the time of admission, either on a voluntary or involuntary basis, a
mental health facility or mental health program in which people may be civilly
detained pursuant to chapter 632, RSMo, or a
residential facility or day program operated, funded or licensed by the
department shall give each patient, resident or client written information
which sets forth, in lay language, the following:
(1) A description of the facility, its services and its
costs;
(2) Information as to how to seek conditional release or
discharge;
(3) A statement of rights assured by this chapter or the
department in its rules and regulations;
(4) A description of a patient grievance procedure.
2.
Unless the patient, resident or client can read the information with
understanding, the facility personnel shall explain it to him.
3.
The facility or program shall prominently post a list of patient or residential
rights in residential and activity areas.
Electroconvulsive therapy,
procedure--prohibitions.
630.130.
1. Every patient, whether voluntary or involuntary, in a public or private
mental health facility shall have the right to refuse electroconvulsive
therapy.
2.
Before electroconvulsive therapy may be administered
voluntarily to a patient, the patient shall be informed, both orally and in
writing, of the risks of the therapy and shall give his express written
voluntary consent to receiving the therapy.
3.
Involuntary electroconvulsive therapy may be
administered under a court order after a full evidentiary hearing where the
patient refusing such treatment is represented by counsel who shall advocate
his position. The therapy may be administered on an involuntary basis only if
it is shown, by clear and convincing evidence, that the therapy is necessary
under the following criteria:
(1) There is a strong likelihood that the therapy will
significantly improve or cure the patient's mental disorder for a substantial
period of time without causing him any serious functional harm; and
(2) There is no less drastic alternative form of therapy
which could lead to substantial improvement in the patient's condition. At the
conclusion of such hearing, if the petitioner has sustained his burden of*
proof, the court may order up to a specified number of involuntary electroconvulsive therapy treatments to be performed over a
specified period of time.
4.
Parents of minor patients or legal guardians of incompetent patients shall be
required to obtain court orders authorizing electroconvulsive
therapy under the procedures specified in subsection 3 of this section.
5.
Persons who are diagnosed solely as mentally retarded shall not be subject to electroconvulsive therapy.
*Word
"or" appears in original rolls.
Psychosurgery, consent required--not to be performed by
department.
630.133.
1. Psychosurgery shall not be performed involuntarily on any patient or
resident. A competent patient or resident shall be informed, both orally and in
writing, of the risks of the therapy and shall give his express written
voluntary consent before the surgery is performed. Parents of minor patients or
residents or legal guardians of incompetent patients or residents shall be
required to obtain court orders authorizing such surgery under the procedures
and criteria specified in subsection 3 of section 630.130.
2.
Psychosurgery shall not be performed by the department in any of its
facilities.
Rules regarding patient's rights.
630.135.
The department shall promulgate reasonable rules relative to the implementation
of patient, resident and client rights described in this chapter.
Records confidential, when--may be disclosed, to whom, how,
when --release to be documented--court records confidential, exceptions.
630.140.
1. Information and records compiled, obtained, prepared or maintained by the residential
facility, day program operated, funded or licensed by the department or
otherwise, specialized service, or by any mental health facility or mental
health program in which people may be civilly detained pursuant to chapter 632,
RSMo, in the course of providing services to either
voluntary or involuntary patients, residents or clients shall be confidential.
2.
The facilities or programs shall disclose information and records including
medication given, dosage levels, and individual ordering such medication to the
following upon their request:
(1) The parent of a minor patient, resident or client;
(2) The guardian or other person having legal custody of the
patient, resident or client;
(3) The attorney of a patient, resident or client who is a ward
of the juvenile court, an alleged incompetent, an incompetent ward or a person
detained under chapter 632, RSMo, as evidenced by
court orders of the attorney's appointment;
(4) An attorney or personal physician as authorized by the
patient, resident or client;
(5) Law enforcement officers and agencies, information about
patients, residents or clients committed pursuant to chapter 552, RSMo, but only to the extent necessary to carry out the
responsibilities of their office, and all such law enforcement officers shall
be obligated to keep such information confidential;
(6) The entity or agency authorized to implement a system to
protect and advocate the rights of persons with developmental disabilities
under the provisions of 42 U.S.C. 6042. The entity or agency shall be able to
obtain access to the records of a person with developmental disabilities who is
a client of the entity or agency if such person has authorized the entity or
agency to have such access; and the records of any person with developmental
disabilities who, by reason of mental or physical condition is unable to
authorize the entity or agency to have such access, if such person does not
have a legal guardian, conservator or other legal representative, and a
complaint has been received by the entity or agency with respect to such person
or there is probable cause to believe that such person has been subject to
abuse or neglect. The entity or agency obtaining access to a person's records
shall meet all requirements for confidentiality as set out in this section;
(7) The entity or agency authorized to implement a system to
protect and advocate the rights of persons with mental illness under the
provisions of 42 U.S.C 10801 shall be able to obtain access to the records of a
patient, resident or client who by reason of mental or physical condition is
unable to authorize the system to have such access, who does not have a legal
guardian, conservator or other legal representative and with respect to whom a
complaint has been received by the system or there is probable cause to believe
that such individual has been subject to abuse or neglect. The entity or agency
obtaining access to a person's records shall meet all requirements for
confidentiality as set out in this section. The provisions of this subdivision
shall apply to a person who has a significant mental illness or impairment as
determined by a mental health professional qualified under the laws and
regulations of the state;
(8) To mental health coordinators, but only to the extent
necessary to carry out their duties under chapter 632, RSMo.
3.
The facilities or services may disclose information and records under any of
the following:
(1) As authorized by the patient, resident or client;
(2) To persons or agencies responsible for providing health
care services to such patients, residents or clients;
(3) To the extent necessary for a recipient to make a claim
or for a claim to be made on behalf of a recipient for aid or insurance;
(4) To qualified personnel for the purpose of conducting scientific
research, management audits, financial audits, program evaluations or similar
studies; provided, that such personnel shall not identify, directly or
indirectly, any individual patient, resident or client in any report of such
research, audit or evaluation, or otherwise disclose patient, resident or
client identities in any manner;
(5) To the courts as necessary for the administration of
chapter 211, RSMo, 475, RSMo,
552, RSMo, or 632, RSMo;
(6) To law enforcement officers or public health officers,
but only to the extent necessary to carry out the responsibilities of their
office, and all such law enforcement and public health officers shall be
obligated to keep such information confidential;
(7) Pursuant to an order of a court or administrative agency
of competent jurisdiction;
(8) To the attorney representing petitioners, but only to
the extent necessary to carry out their duties under chapter 632, RSMo;
(9) To the department of social services as necessary to
report or have investigated abuse, neglect, or rights violations of patients,
residents, or clients;
(10) To a county board established pursuant to sections
205.968 to 205.972, RSMo 1986, but only to the extent
necessary to carry out their statutory responsibilities. The county board shall
not identify, directly or indirectly, any individual patient, resident or
client.
4.
The facility or program shall document the dates, nature, purposes and
recipients of any records disclosed under this section and sections 630.145 and
630.150.
5.
The records and files maintained in any court proceeding under chapter 632, RSMo, shall be confidential and available only to the
patient, his attorney, guardian, or, in the case of a minor, to a parent or
other person having legal custody of the patient, and to the petitioner and his
attorney. In addition, the court may order the release or use of such records
or files only upon good cause shown, and the court may impose such restrictions
as the court deems appropriate.
6.
Nothing contained in this chapter shall limit the rights of discovery in
judicial or administrative procedures as otherwise provided for by statute or
rule.
7.
The fact of admission of a voluntary or involuntary patient to a mental health
facility under chapter 632, RSMo, may only be disclosed
as specified in subsections 2 and 3 of this section.
Department to release information to next of kin and persons
responsible for costs, when.
630.145.
1. Notwithstanding the provisions of section 630.140, a residential facility or
day program operated, funded or licensed by the department may release to a
patient's or resident's next of kin, attorney, guardian or conservator, if any,
the information that the person is presently a patient, resident or client in
the facility or program, or that the person is seriously physically ill, and
shall notify a voluntary patient's or resident's next of kin, attorney,
guardian, or conservator or any other person who may be responsible for the
costs incurred by such patient or resident, of the admittance of such patient
or resident.
2.
Upon the death of a patient or resident, the facility shall notify his next of
kin, guardian or conservator, if any, about the death and its cause.
3.
Next of kin shall be notified under this section in the following order unless
otherwise indicated by the patient or resident:
(1) Spouse;
(2) Parents;
(3) Children;
(4) Brothers and sisters;
(5) Other relatives according to the degree of relation.
4.
The patient or resident may indicate additional persons whom he wants notified
in the event of his death or serious injury or incapacity.
Disclosure of absence to be made, when,
to whom.
630.150.
1. Except as provided in subsection 2 of this section, when a patient, resident
or client is absent due to his unauthorized disappearance from a residential
facility or day program, or his whereabouts are unknown and disclosure is necessary
for the protection of the patient, resident or others, and the provisions of
section 630.140 would otherwise be applicable, notice of the disappearance,
along with relevant information, may be made to relatives, governmental law
enforcement agencies and other persons if necessary for the protection of the
patient, resident or other parties, as designated by the head of the facility
or program or physician in charge of the patient, resident or client.
2.
If the patient, resident or client was committed to the custody of the
department of mental health pursuant to chapter 552, RSMo,
and that patient, resident or client is absent due to an unauthorized
disappearance from a residential facility or day program, or such person's
whereabouts are unknown, the head of the mental health facility or a designee
shall immediately give notice of the disappearance, along with relevant
information, to the prosecutor and sheriff of the county wherein the committed
person is detained, the prosecutor and sheriff of the county wherein the
committed person was tried and acquitted, all known surviving victims as
defined in chapter 595, RSMo, any other agencies or
persons designated by the head of the facility as necessary for the protection
of the patient, resident or other parties.
Mistreatment of patient--defined--penalty.
630.155.
1. A person commits the crime of "patient, resident or client abuse or
neglect" against any person admitted on a voluntary or involuntary basis
to any mental health facility or mental health program in which people may be
civilly detained pursuant to chapter 632, RSMo, or
any patient, resident or client of any residential facility, day program or
specialized service operated, funded or licensed by the department if he
knowingly does any of the following:
(1) Beats, strikes or injures any person, patient,
resident or client;
(2) Mistreats or maltreats, handles
or treats any such person, patient, resident or client in a brutal or inhuman
manner;
(3) Uses any more force than is reasonably necessary for the
proper control, treatment or management of such person, patient, resident or
client;
(4) Fails to provide services which are reasonable and
necessary to maintain the physical and mental health of any person, patient,
resident or client when such failure presents either an imminent danger to the
health, safety or welfare of the person, patient, resident or client, or a substantial
probability that death or serious physical harm will result.
2.
Patient, resident or client abuse or neglect is a class A misdemeanor unless
committed under subdivision (2) or (4) of subsection 1 of this section in which
case such abuse or neglect shall be a class D felony.
Furnishing unfit food--defined--penalty.
630.160.
1. A person commits the crime of "furnishing unfit food to patients,
residents or clients" if he does any of the following:
(1) Knowingly furnishes or delivers any diseased, putrid or
otherwise unwholesome meat from any animal or fowl that was diseased or
otherwise unfit for food to any person admitted on a voluntary or involuntary
basis to any mental health facility or mental health program in which people
may be civilly detained pursuant to chapter 632, RSMo,
or to any residential facility or day program operated, funded or licensed by
the department;
(2) Knowingly furnishes or delivers any other unwholesome
food, vegetables or provisions whatsoever to such facilities or programs to be
used as food by the patients, residents, clients or employees thereof;
(3) Knowingly receives or consents to receive as an employee
of such facility or program any diseased or unwholesome meat, food or
provisions.
2.
Furnishing unfit food to patients, residents or clients is a class A misdemeanor.
Suspected abuse of patient, report, by whom
made, contents--effect of failure to report.
630.165.
1. When any physician, dentist, chiropractor, optometrist, podiatrist, intern,
nurse, medical examiner, social worker, psychologist, minister, Christian
Science practitioner, peace officer, pharmacist, physical therapist, facility
administrator, nurse's aide or orderly in a residential facility, day program
or specialized service operated, funded or licensed by the department or in a
mental health facility or mental health program in which people may be admitted
on a voluntary basis or are civilly detained pursuant to chapter 632, RSMo, or employee of the department has reasonable cause to
believe that a patient, resident or client of a facility, program or service
has been abused or neglected, he shall immediately report or cause a report to
be made to the department or the department of health and senior services, if
such facility or program is licensed pursuant to chapter 197, RSMo.
2.
The report shall contain the name and address of the residential facility, day
program or specialized service; the name of the patient, resident or client;
information regarding the nature of the abuse or neglect; the name of the
complainant, and any other information which might be helpful in an
investigation.
3.
Any person required in subsection 1 of this section to report or cause a report to be made to the department who fails to do
so within a reasonable time after the act of abuse or neglect is guilty of an
infraction.
4.
In addition to those persons required to report under subsection 1 of this
section, any other person having reasonable cause to believe that a resident
has been abused or neglected may report such information to the department.
Investigation of report, when made, by whom--abuse prevention
by removal, procedure--reports confidential, privileged, exceptions --immunity
of reporter, notification--retaliation prohibited --administrative discharge of
employee, appeal procedure.
630.167.
1. Upon receipt of a report, the department or its agents, contractors or
vendors or the department of health and senior services, if such facility or
program is licensed pursuant to chapter 197, RSMo,
shall initiate an investigation within twenty-four hours.
2.
If the investigation indicates possible abuse or neglect of a patient, resident
or client, the investigator shall refer the complaint together with the
investigator's report to the department director for appropriate action. If,
during the investigation or at its completion, the department has reasonable
cause to believe that immediate removal from a facility not operated or funded
by the department is necessary to protect the residents from abuse or neglect,
the department or the local prosecuting attorney may, or the attorney general
upon request of the department shall, file a petition for temporary care and
protection of the residents in a circuit court of competent jurisdiction. The
circuit court in which the petition is filed shall have equitable jurisdiction
to issue an ex parte order granting the department authority for the temporary
care and protection of the resident for a period not to exceed thirty days.
3.
(1) Reports referred to in section 630.165 and the investigative reports
referred to in this section shall be confidential, shall not be deemed a public
record, and shall not be subject to the provisions of section 109.180, RSMo, or chapter 610, RSMo;
except that: complete copies all such reports shall be open and available to
the parents or other guardian of the patient, resident, or client who is the
subject of such report, except that the names and any other descriptive
information of the complainant or other person mentioned in the reports shall
not be disclosed unless such complainant or person specifically consents to
such disclosure. All reports referred to in this section shall be admissible in
any judicial proceedings or hearing in accordance with section 36.390, RSMo, or any administrative hearing before the director of
the department of mental health, or the director's designee. All such reports
may be disclosed by the department of mental health to law enforcement officers
and public health officers, but only to the extent necessary to carry out the
responsibilities of their offices, and to the department of social services,
and to boards appointed pursuant to sections 205.968 to 205.990, RSMo, that are providing services to the patient, resident
or client as necessary to report or have investigated abuse, neglect, or rights
violations of patients, residents or clients provided that all such law
enforcement officers, public health officers, department of social services'
officers and boards shall be obligated to keep such information confidential;
(2) Except as otherwise provided in this section, the
proceedings, findings, deliberations, reports and minutes of committees of
health care professionals as defined in section 537.035, RSMo,
or mental health professionals as defined in section 632.005, RSMo, who have the responsibility to evaluate, maintain, or
monitor the quality and utilization of mental health services are privileged
and shall not be subject to the discovery, subpoena or other means of legal
compulsion for their release to any person or entity or be admissible into
evidence into any judicial or administrative action for failure to provide
adequate or appropriate care. Such committees may exist, either within
department facilities or its agents, contractors, or vendors, as applicable.
Except as otherwise provided in this section, no person who was in attendance at
any investigation or committee proceeding shall be permitted or required to
disclose any information acquired in connection with or in the course of such
proceeding or to disclose any opinion, recommendation or evaluation of the
committee or board or any member thereof; provided, however, that information
otherwise discoverable or admissible from original sources is not to be
construed as immune from discovery or use in any proceeding merely because it
was presented during proceedings before any committee or in the course of any
investigation, nor is any member, employee or agent of such committee or other
person appearing before it to be prevented from testifying as to matters within
their personal knowledge and in accordance with the other provisions of this
section, but such witness cannot be questioned about the testimony or other
proceedings before any investigation or before any committee;
(3) Nothing in this section shall limit authority otherwise
provided by law of a health care licensing board of the state of Missouri to
obtain information by subpoena or other authorized process from investigation
committees or to require disclosure of otherwise confidential information
relating to matters and investigations within the jurisdiction of such health care
licensing boards; provided, however, that such information, once obtained by
such board and associated persons, shall be governed in accordance with the
provisions of this subsection;
(4) Nothing in this section shall limit authority otherwise
provided by law in subdivisions (5) and (6) of subsection 2 of section 630.140
concerning access to records by the entity or agency authorized to implement a
system to protect and advocate the rights of persons with developmental
disabilities under the provisions of 42 U.S.C. 6042 and the entity or agency
authorized to implement a system to protect and advocate the rights of persons
with mental illness under the provisions of 42 U.S.C. 10801. In addition,
nothing in this section shall serve to negate assurances that have been given
by the governor of
4.
Anyone who makes a report pursuant to this section or who testifies in any
administrative or judicial proceeding arising from the report shall be immune
from any civil liability for making such a report or for testifying unless such
person acted in bad faith or with malicious purpose.
5.
Within five working days after a report required to be made pursuant to this
section is received, the person making the report shall be notified in writing
of its receipt and of the initiation of the investigation.
6.
No person who directs or exercises any authority in a residential facility, day
program or specialized service shall evict, harass, dismiss or retaliate
against a patient, resident or client or employee because he or she or any
member of his or her family has made a report of any violation or suspected
violation of laws, ordinances or regulations applying to the facility which he
or she has reasonable cause to believe has been committed or has occurred.
7.
Any person who is discharged as a result of an administrative substantiation of
allegations contained in a report of abuse or neglect may, after exhausting
administrative remedies as provided in chapter 36, RSMo,
appeal such decision to the circuit court of the county in which such person
resides within ninety days of such final administrative decision. The court may
accept an appeal up to twenty-four months after the party filing the appeal
received notice of the department's determination, upon a showing that:
(1) Good cause exists for the untimely commencement of the
request for the review;
(2) If the opportunity to appeal is not granted it will
adversely affect the party's opportunity for employment; and
(3) There is no other adequate remedy at law.
Suspected abuse to be reported.
630.168.
If it is alleged or suspected that any patient, resident or client who has been
admitted on a voluntary or involuntary basis to a mental health facility or
mental health program in which people are detained pursuant to chapter 632, RSMo, or any patient, resident or client in a residential
facility, day program or specialized service operated, funded or licensed by
the department is being or has been subjected to patient or resident abuse
which results in physical injury, and in cases of sexual abuse, the head of the
facility, program or service shall promptly notify local law enforcement
authorities and cooperate fully with any investigation by them.
Disqualification for employment because of
conviction--appeal process --registry maintained, when.
630.170.
1. A person convicted of any crime pursuant to section 630.155 or 630.160 shall
be disqualified from holding any position in any public or private facility or
day program operated, funded or licensed by the department or in any mental
health facility or mental health program in which people are admitted on a
voluntary or involuntary basis or are civilly detained pursuant to chapter 632,
RSMo.
2.
A person convicted of any felony offense against persons as defined in chapter
565, RSMo; of any felony sexual offense as defined in
chapter 566, RSMo; of any felony offense defined in
section 568.045, 568.050, 568.060, 569.020, 569.030, 569.040 or 569.050, RSMo, or of an equivalent felony offense shall be
disqualified from holding any direct-care position in any public or private
facility, day program, residential facility or specialized service operated,
funded or licensed by the department or any mental health facility or mental
health program in which people are admitted on a voluntary basis or are civilly
detained pursuant to chapter 632, RSMo.
3.
Any person disqualified pursuant to the provisions of subsection 1 or 2 of this
section may appeal the disqualification to the director of the department or
the director's designee. The request shall be written and may not be made more
than once every twelve months. The request may be granted by the director or
designee if in the judgment of the director or designee a clear showing has
been made by written submission only, that the person will not commit any
additional acts for which the person had originally been disqualified for or
any other acts that would be harmful to a patient, resident or client of a
facility, program or service. The director or designee may grant the appeal
subject to any conditions deemed appropriate and failure to comply with such
terms may result in the person again being disqualified. Decisions by the
director or designee pursuant to the provisions of this subsection shall not be
subject to appeal. The right to appeal pursuant to this subsection shall not
apply to persons convicted of any crime pursuant to the provisions of chapter
566 or 568, RSMo, or section 565.020 or 565.021, RSMo.
4.
The department may maintain a disqualification registry and place on the
registry the names of any persons who have been finally determined by the
department to be disqualified pursuant to this section, or who have had
administrative substantiations made against them for abuse or neglect pursuant
to department rule. Such list shall reflect that the person is barred from
holding any position in any public or private facility or day program operated,
funded or licensed by the department, or any mental
health facility or mental health program in which persons are admitted on a
voluntary basis or are civilly detained pursuant to chapter 632, RSMo.
Physical and chemical restraints prohibited,
exceptions.
630.175.
1. No person admitted on a voluntary or involuntary basis to any mental health
facility or mental health program in which people are civilly detained pursuant
to chapter 632, RSMo, and no patient, resident or
client of a residential facility or day program operated, funded or licensed by
the department shall be subject to physical or chemical restraint, isolation or
seclusion unless it is determined by the head of the facility or the attending
licensed physician that the chosen intervention is imminently necessary to
protect the health and safety of the patient, resident, client or others and that
it provides the least restrictive environment.
2.
Every use of physical or chemical restraint, isolation or seclusion and the
reasons therefor shall be made a part of the clinical
record of the patient, resident or client under the signature of the head of
the facility or the attending licensed physician.
3.
Physical or chemical restraint, isolation or seclusion shall not be considered
standard treatment or habilitation and shall cease as soon as the circumstances
causing the need for such action have ended.
Treatment by religious practice to
be permitted.
630.180.
The provisions of this chapter and chapters 631, 632 and 633, RSMo, shall not be construed as authorizing any form of
compulsory medical treatment of any person who is being treated by prayer in
the practice of the religion of any church which teaches reliance on spiritual
means for healing unless the person or his legal guardian, if any, consents to
such treatment.
Officers may authorize medical treatment for patient.
630.183.
Subject to other provisions of this chapter, the head of a mental health or
mental retardation facility may authorize the medical and surgical treatment of
a patient or resident under the following circumstances:
(1) Upon consent of a patient or resident who is competent;
(2) Upon consent of a parent or legal guardian of a patient
or resident who is a minor or legally incapacitated;
(3) Pursuant to the provisions of chapter 431, RSMo;
(4) Pursuant to an order of a court of competent
jurisdiction.
Purchase of food limited to that for use of patients.
630.186.
Any purchase of food in any institution under the control of the department,
other than the usual quantity purchased for the patients or residents thereof,
to be used by or for anyone other than the patients or residents of such
institution shall be charged directly to the individual responsible for such
purchase.
Limitations on research activities
in mental health facilities and programs.
630.192.
No biomedical or pharmacological research shall be conducted in any mental
health facility or mental health program in which people may be civilly
detained pursuant to chapter 632, RSMo, or in any
public or private residential facilities or day programs operated, funded or
licensed by the department for persons affected by mental retardation,
developmental disabilities, mental illness, mental disorders or alcohol or drug
abuse unless such research is intended to alleviate or prevent the disabling
conditions or is reasonably expected to be of direct therapeutic benefit to the
participants. Without a specific court order, no involuntary patient shall
consent to participate in any biomedical or pharmacological research. The
application for the order shall be filed in the court having probate
jurisdiction in the county in which the mental health facility is located,
provided, however, that if the patient requests that the hearing be held by the
court which has committed the patient, or if the court having probate
jurisdiction deems it appropriate, the hearing on the application shall be
transferred to the committing court.
Professional review committee to
make recommendations to director --committee members, appointment,
qualifications, terms, compensation --organization and meetings.
630.193.
1. A "Professional Review Committee", consisting of ten members
appointed by the director is hereby created to review, report, and recommend
approval or disapproval to the director of any research conducted by the
department. The committee shall consist of persons who reside in the state and
are not employed by the department and who have demonstrated recognized
competence in medicine, pharmacology, behavioral sciences, biomedical science,
philosophy of science, or bioethics. Each member of the committee shall serve
for a term of four years following his appointment, except one-half of the
members initially appointed after
2.
The department shall pay the members of the committee one hundred dollars per
day for each day, or portion thereof, they actually spend in the performance of
their official duties and shall reimburse the members for actual necessary
expenses incurred in the performance of their official duties.
3.
The committee shall elect a chairman annually. The committee shall meet at the
call of the director or the chairman and shall have a quorum when at least five
members are present.
Professional review committee to review proposals, make
report and recommendations--director to approve or disapprove--to review work
in progress.
630.194.
1. Persons seeking to initiate any research in residential facilities or day
programs funded, operated or licensed by the department shall submit their
research proposals to the professional review committee for review. The
committee shall prepare a report, which shall be available to the general
public, of each research proposal it reviews, stating its finding and
conclusions, and recommending either approval or disapproval of the project to
the director. The director shall state his decision in writing and the decision
shall be final.
2.
The committee shall review the conduct of the research during the progress of
the project. If during the research, harm or increased risk of harm to
participants occurs, or if deviations in research protocol occur without
approval of the committee, the committee shall investigate the project. The
committee shall suspend or halt the project if deemed appropriate to prevent
harm or the increased risk of harm.
3.
The professional review committee shall review each biomedical or
pharmacological research proposal according to, but not restricted to, the
following criteria:
(1) Need for the research;
(2) Methodological adequacy;
(3) Duplication with other projects;
(4) Sufficiency of scientific and theoretical justification;
(5) Competence of the researcher;
(6) Funding sufficiency;
(7) Weighing risks against potential benefits;
(8) Appropriateness of subject population;
(9) Adequacy of consent information.
4.
If the committee believes it lacks sufficient expertise in the subject area of
the proposed research, it may obtain outside experts to review the project and
recommend disposition.
Research review committee at
department facilities--committee members, appointment, qualifications, terms,
compensation--organization and meetings.
630.196.
1. A "Research Review Committee", consisting of five members, shall
be established at each department facility where research is proposed to be
conducted. The members of the committees shall be appointed by the head of the
facilities with the approval of the division director. The committee shall be
composed of persons who reside in the state and are not employed by the
department and shall be composed of the following:
(1) Three members shall be consumers, family members of
consumers, or representatives of consumer groups;
(2) One member shall be a licensed physician;
(3) One member shall be an attorney.
2.
The members of the committees shall serve for terms of four years each, except
that two of the members initially appointed shall serve a term of two years
each.
3.
The committee members shall not receive any compensation for their services but
they shall be reimbursed for the actual and necessary expenses they incur while
performing committee work.
4.
Each committee shall annually elect a chairman. Each committee shall meet at
the call of the head of the facility or the committee chairman and shall have a
quorum when at least three members are* present.
*Word
"are" does not appear in original rolls.
Duties of research review committee.
630.198.
1. After a project has been approved by the professional review committee, the
research review committees shall determine that the persons selected to
participate in biomedical or pharmacological research or their parents or
guardians have given informed consent as to whether or not they wish to
participate. Before any person participates in such research, the committees
shall screen the research and recommend approval or disapproval to the
director. The decision of the director shall be final.
2.
The committees shall assure that the following criteria are met in giving
informed consent:
(1) The person has the capacity to understand the risks,
benefits and procedures with respect to the project he or she is asked to
engage in;
(2) The person has been given sufficient information to
understand the risks, benefits and procedures; and
(3) The person is acting of his own free volition without
coercive influence.
3.
Persons may decide not to participate or may withdraw from the research at any
time for any reasons.
4.
Persons who are subjects of the research shall be compensated for their time
spent in the research projects to the same extent that persons who are not
department patients, residents or clients are typically compensated.
Research involving persons civilly detained,
sections applicable.
630.199.
Sections 630.194, 630.196 and 630.198 shall apply to all proposed biomedical or
pharmacological research that involves persons civilly detained.
Discrimination prohibited.
630.200.
In accordance with state and federal law, no mental health facility or mental
health program in which people may be civilly detained pursuant to chapter 632,
RSMo, and no residential facility, day program or
specialized service operated, funded or licensed by the department shall deny
admission or other services to any person because of his race, sex, creed,
marital status, national origin, disability or age.
Patient or representative liable for costs of services
rendered --parents not liable, when--denial of services for inability to pay
prohibited, when--department subrogated to rights of patient, parent, or
recipient, when.
630.205.
1. The person receiving services and the person's estate, spouse, parents, if
the person is a minor, and any fiduciary or representative payee holding assets
for the person or on the person's behalf are jointly and severally liable for
the fees for services rendered to the person by a residential facility, day
program or specialized service operated or funded by the department. The
department shall not charge parents for services it renders to persons who are
eighteen years of age or older and who are residents of this state. If any
person, firm, corporation, or public or private agency is liable, either
pursuant to contract or otherwise, to the parents or a recipient of services on
account of personal injury to or disability or disease of the recipient of
services, the department is subrogated to the right of the parent or recipient
to recover from that part of the award or settlement an amount equal to the
amount expended by the service for services which are not otherwise recoverable
from the parent or recipient. The acceptance of services from the department
constitutes acknowledgment of subrogation rights by the department, and the
department may take any and all action necessary to enforce the subrogation
rights.
2.
Parents of minors who are domiciled in this state, as defined in section
162.970, RSMo, shall not be liable for the cost of
education or special education and related services. If, as a result of a
comprehensive evaluation and such conclusion in the minor's individualized
education program, admission to a department facility or placement program is
necessary for such minor to receive an appropriate education, the parents of
minors who are domiciled in this state under section 162.970, RSMo, shall not be liable for the cost of nonmedical care and room and board.
3.
For purposes of subsection 2 of this section, "special education" and
"related services" are defined pursuant to the Federal Education of
the Handicapped Act (20 U.S.C. {1401, et seq.), as amended, and the rules and
regulations promulgated in furtherance thereof.
4.
No person who is domiciled in
5.
Nothing in this section shall be construed to relieve an insurer or other third
party from an otherwise valid obligation.
Charges for pay patients--each facility considered a
separate unit --director to determine rules for means test and domicile
verification --failure to pay, effect--exceptions, emergency treatment for
transients.
630.210.
1. The director shall determine the maximum amount for services which shall be
charged in each of the residential facilities, day programs or specialized
services operated or funded by the department for full-time or part-time
inpatient, resident or outpatient evaluation, care, treatment, habilitation,
rehabilitation or other service rendered to persons affected by mental
disorder, mental illness, mental retardation, developmental disability or drug
or alcohol abuse. The maximum charge shall be related to the per capita
inpatient cost or actual outpatient evaluation or other service costs of each
facility, program or service, which may vary from one locality to another. The
director shall promulgate rules setting forth a reasonable standard means test
which shall be applied by all facilities, programs and services operated or
funded by the department in determining the amount to be charged to persons
receiving services. The department shall pay, out of funds appropriated to it
for such purpose, all or part of the costs for the evaluation, care, treatment,
habilitation, rehabilitation or room and board provided or arranged by the
department for any patient, resident or client who is domiciled in Missouri and
who is unable to pay fully for services.
2.
The director shall apply the standard means test annually and may make
application of the test upon his own initiative or upon request of an
interested party whenever evidence is offered tending to show that the current
support status of any patient, resident or client is no longer proper. Any
change of support status shall be retroactive to the date of application or
request for review. If the persons responsible to pay under section 630.205 or
552.080, RSMo, refuse to cooperate in providing
information necessary to properly apply the test or if retroactive benefits are
paid on behalf of the patient, resident or client, the charges may be
retroactive to a date prior to the date of application or request for review.
The decision of the director in determining the amount to be charged for
services to a patient, resident or client shall be final. Appeals from the
determination may be taken to the circuit court of
3.
The department shall not pay for services provided to a patient, resident or
client who is not domiciled in Missouri unless the state is fully reimbursed
for the services; except that the department may pay for services provided to a
transient person for up to thirty days pending verification of his domiciliary
state, and for services provided for up to thirty days in an emergency
situation. The director shall promulgate rules for determination of the
domiciliary state of any patient, resident or client receiving services from a
facility, program or service operated or funded by the department.
4.
Whenever a patient, resident or client is receiving services from a residential
facility, day program or specialized service operated or funded by the
department, and the state, county, municipality, parent, guardian or other
person responsible for support of the patient, resident or client fails to pay
any installment required to be paid for support, the department or the
residential facility, day program or specialized service may discharge the
patient, resident or client as provided by chapter 31, RSMo.
The patient, resident or client shall not be discharged under this subsection until
the final disposition of any appeal filed under subsection 2 of this section.
Pay patient, how determined--estate
of patient, court to notify director and conservator--failure to pay, may
discharge--appeal.
630.215.
1. Any probate division of the circuit court having knowledge of the existence
of an estate of a patient, resident or client receiving services from
residential facilities or day programs operated or funded by the department
shall promptly notify the director of the nature and extent of the estate and
the identity of the attorney of record and conservator. The director shall then
apply the standard means test contained in the rules of the department to determine
if the estate shall be charged for services rendered by the department.
2.
If the director determines that the estate should be charged for the
evaluation, care, treatment, habilitation, rehabilitation or room and board
provided or funded by the department, and notifies the conservator, the
conservator shall pay the charges. If the conservator fails to pay for the
charges, after reasonable delay, the head of the department, residential
facility or day program may discharge the patient as provided by chapter 31, RSMo.
3.
The decision of the director shall be final, and appeal may be made to the
circuit court of
Court actions by department on behalf of institutions--interest
on accounts of patients.
630.220.
For all debts and demands whatsoever to any of the residential facilities or
day programs subject to the control of the department, and for all damages for
failure of contract, for trespass and other wrongs to a facility operated by
the department, or any of its property thereof, real or personal, actions in
any court of competent jurisdiction may be maintained in the name of the
director. Interest shall be recovered on any and all sums due any facility or
program operated or funded by the department on account of any patient or
resident thereof, the account therefor, certified by
the head of the facility, with the seal of the institution attached, shall be
prima facie evidence of the amount due.
Pay patient to be provided suitable clothing before
admission--may receive gifts of clothing.
630.225.
Before any patient who can support himself is admitted into any facility
operated by the department, he shall be furnished, by those responsible for his
support, with suitable changes of clothing. If patients who are able to support
themselves as determined under section 630.210 are in need of clothing, the
business manager, under the direction of the head of the facility, shall furnish
the same. The department shall calculate expenditures for such clothing as part
of the per diem expense. Nothing in this section shall be construed as
prohibiting the purchase of clothing by, or gifts of
clothing to, a patient or resident by his family or friends.
Funds of patient, control,
expenditure, return, safekeeping.
630.305.
1. For purposes of this section, the term "money" includes any legal
tender, note, draft, certificate of deposit, stock, bond, check or credit card.
2.
A department residential facility may require that all money which is on the
person of a patient or resident, which comes to a patient or resident, or which
the facility receives in place of the patient or resident under a benefit
arrangement or otherwise be turned over to the facility for safekeeping. The
money shall be accounted for in the name of the patient or resident and
recorded periodically in the records of the patient or resident. Upon request,
money accounted for in the name of the patient or resident shall be turned over
to a conservator of the patient or resident, if the conservator has such
authority, or to the parent of the patient or resident if the patient or
resident is a minor; except the facility shall hold money it received as
representative payee under terms of public or private benefit arrangements as
authorized by section 630.315.
3.
A patient or resident of a department facility shall have easy access to the
money in his account and may keep and be allowed to spend a reasonable sum for
canteen expenses and small purchases. He may spend or otherwise use the money
as he chooses, except as provided in subsection 4 of this section. With the
approval of the department, the facility shall establish written policies and
procedures giving patients and residents easy access to the money in their
accounts and allowing the money to be spent or otherwise used as the patients
or residents choose.
4.
A department facility may deny a patient or resident the access to and ability
to spend or otherwise use the money in his account if it determines that the
denial is essential in order to prevent the patient or resident from
significantly dissipating his assets or that reasonable restrictions are
necessary to protect the patient, resident or others. The department shall
establish policies and procedures governing such determinations, including the
evidence necessary to support a denial of the patient's or resident's rights.
If a denial is made, the patient or resident may continue to spend or otherwise
use the money in ways which would not constitute significant dissipation of the
assets and which would sufficiently protect himself or
others.
5.
The department facility shall deposit money accounted for in the name of a
patient or resident with a financial institution. Any earnings attributable to
money in the account of a patient or resident shall be credited to that
account. Under sections 110.070 to 110.110, RSMo, the
department shall receive bids from banking corporations, associations or trust
companies which desire to be selected as depositaries of the department for
patients' and residents' moneys.
6.
The department shall deliver to the patient or resident, his conservator, if he
is legally disabled, or his parent, if he is a minor, all money, including any
earnings, in the patient's or resident's account upon release from the
facility; except that the department may continue to serve as a depositary for
the money in the account of a patient or resident who is placed through the
department's placement program.
7.
The department shall establish policies and procedures designed to insure that
money in the accounts of patients and residents is safeguarded against theft,
loss or misappropriation. The department shall guarantee against theft, loss or
misappropriation the principal amounts in any patient's or resident's account.
Receipt of funds of patient, procedure.
630.310.
A department residential facility may accept funds which a parent, guardian or
other person wishes to provide for the use or benefit of a patient or resident
of the facility. The possession and use of such funds shall be governed by section
630.305 and by any additional directions given by the provider of the funds.
Department may become payee for patient, procedure.
630.315.
A department residential facility may accept an appointment to serve as
representative payee or fiduciary, or in a similar
capacity for payments to a patient or resident under a public or private
benefit arrangement. Funds so received shall be governed by section 630.305,
except to the extent that laws or regulations governing payment of the benefits
provide otherwise.
Disposition of unclaimed funds of
patient--escheats, procedure.
630.320.
1. If any patient or resident dies, is released, escapes or otherwise leaves
the care of the department, and leaves any personal funds in the custody of a
department facility, the head of the facility shall use all proper diligence to
refund such moneys. All reasonable means shall be used to contact the patient
or resident if living, or if deceased, the patient's or resident's heirs to
refund such moneys. If the patient or resident is deceased, the facility may
dispose of these moneys through the probate court or otherwise release these
moneys to the heirs, if located. The facility may also make claim for these
moneys for unmet costs of care in accordance with procedures established by the
director of the department.
2.
After one year from the date of such death, release, escape or other departure,
if there shall remain in the custody of a facility any money, the owner of
which is unknown, or if known, cannot be located, in each and every such
instance, the money shall be disposed of in the following manner:
(1) Amounts less than one hundred dollars shall be deposited
into the state treasury to the credit of the mental health trust fund. Such
money shall escheat and vest absolutely in the state of
(2) Amounts of one hundred dollars or more shall be
deposited into the state treasury to the credit of the general revenue fund in
a special account designated as escheat. Claims may be made, as provided in
this section, for such moneys for a period of two years after deposit into the
escheat account. After remaining therein unclaimed for two years such moneys
shall escheat and vest absolutely in the state of
3.
Within two years after such money in amounts of one hundred dollars or more has
been transmitted into the escheats account, any person who appears and claims
the same may file his petition in the circuit court of Cole County, Missouri,
stating the nature of his claim and asking to be paid such money. A copy of the
petition shall be served upon the director who shall file an answer to the
same. If the court finds that such person is entitled to any money so paid into
the state treasury, it shall order the commissioner of administration to issue
a warrant for the amount of such claim, but without interest or costs;
provided, that either party may appeal from the decision of the court in the
same manner as provided by law in other civil actions.
4.
Nothing in this section shall be deemed to apply to funds regularly due the
state of
Disposition of unclaimed personal property
of patient.
630.325.
If any patient or resident dies, is released, escapes, or otherwise leaves the
care of the department, and leaves any article or articles of tangible personal
property in the custody of a department facility, the head of the facility may,
in his discretion, after the lapse of one year from the date of such death,
release, escape, or other departure, if no claim therefor
has been made, transfer the personal property to the state agency for surplus
property for public or private sale. If such sale or sales are made, the
commissioner of administration shall transmit the net proceeds thereof to the
director of revenue for deposit in the general revenue fund.
Department may receive gifts--disposal of gift
property--mental health trust fund created.
630.330.
1. The director may for the benefit of the department or any residential
facility operated by the department take, receive, administer and hold in trust
all grants, gifts, donations, moneys escheated under section 630.320, devises
or bequests of money or other personal property, or any real property on behalf
and in the name of the governor, and the income or interest received or earned
on any property or funds so acquired from any person whether individual, body
politic, corporate, partnership, unincorporated association or from any other
source. If any grant, gift, donation, devise or bequest is made for a specified
use or purpose, it shall not be applied either wholly or in part for any other
use or purpose. The director may, if so authorized by the general assembly,
convey or lease any real property so acquired. The director or the governor
shall deposit the funds derived from such sale or conveyance or lease and any
other funds derived from grants, gifts, donations, moneys escheated, devises or
bequests of money or other property, whether real or personal or income or
interest therefrom, in the state treasury where it
shall be credited to a special fund known as the "Mental Health Trust
Fund", which is hereby created. The state treasurer shall credit to the
fund any interest earned from investing the moneys in the fund. The mental
health trust fund shall not lapse biennally and,
accordingly, shall be exempt from the provisions of section 33.080, RSMo, relating to the transfer of funds to the general
revenue fund of the state by the state treasurer.
2.
The moneys in the mental health trust fund shall not be appropriated for the
support of the facilities of the department in lieu of general state revenues
but shall be appropriated only for the purposes of carrying out the objects for
which the grants, gifts, donations, devises or bequests were made, or for
purposes of funding special projects or purchasing special equipment from
moneys escheated under section 630.320.
3.
The director shall make an annual written report to the governor, the
commissioner of administration and the general assembly within ninety days
after the close of each fiscal year of the moneys in the mental health trust fund.
Inventory of facilities--plan for new facilities.
630.510.
At least once every three years, the department shall conduct a complete
statewide inventory of its existing facilities and a survey of needs for
persons affected by mental disorders, mental illness, mental retardation,
developmental disabilities and alcohol or drug abuse, and shall make a public
report of its inventory and survey and recommend a state plan for the
construction of additional facilities.
Destruction of obsolete
structures--procedure.
630.525.
If any major building standing on property under the supervision and control of
the department is in such a state of dilapidation or disrepair as to be, in the
opinion of the director, dangerous to patients or residents, employees of the
department or other persons frequenting such property, the department may, with
the approval of the division of design and construction and, if necessary, with
appropriations for this purpose from the general assembly, cause such building
to be torn down or razed. For such purpose, the department may contract with
any person under the rules and regulations of the division of purchasing, and
may sell or otherwise dispose of the materials composing such building.
Unneeded property may be transferred to another state agency
--procedure.
630.535.
1. If the department discontinues the use of any building or real property on
any of the grounds of a residential facility operated by it and determines it
has no future use for the building or grounds, the department may inform the
commissioner of administration that the unused building or property is vacant.
The governor may, consistent with appropriations, transfer the control and
management of the building or property to another state agency.
2.
The governor shall obtain the approval of the director before making any such
transfer.
Placement programs to be maintained.
630.605.
The department shall establish a placement program for persons affected by a
mental disorder, mental illness, mental retardation, developmental disability
or alcohol or drug abuse. The department may utilize residential facilities,
day programs and specialized services which are designed to maintain a person
who is accepted in the placement program in the least restrictive environment
in accordance with the person's individualized treatment, habilitation or
rehabilitation plan. The department shall license, certify and fund, subject to
appropriations, a continuum of facilities, programs and services short of
admission to a department facility to accomplish this purpose.
Applications for placement--criteria
to be considered.
630.610.
1. If the head of a facility operated by the department determines that
placement out of the facility would be appropriate for any patient or resident,
the head of the facility shall refer the patient or resident for placement
according to the department's rules. If a patient or resident is accepted and
placed under this chapter, then the patient or resident shall be considered as
discharged as a patient or resident of the facility and reclassified as a
client of the department.
2.
Any person, his authorized representative, his parent, if the person is a
minor, his guardian, a court of competent jurisdiction or a state or private
facility or agency having custody of the person may apply for placement of the
person under this chapter.
3.
If the department finds the application to be appropriate after review, it
shall provide for or arrange for a comprehensive evaluation, and the
preparation of an individualized treatment, habilitation or rehabilitation plan
of the person seeking to be placed, whether from a department facility or
directly, to determine if he meets the following criteria:
(1) The person is affected by a mental disorder, mental
illness, mental retardation, developmental disability or alcohol or drug abuse;
and
(2) The person is in need of special care, treatment,
habilitation or rehabilitation services as described in this chapter, including
room or board, or both; provided, however, that no person shall be accepted for
placement if the sole reason for the application or referral is that
residential placement is necessary for a school-aged child, as defined in
chapter 162, RSMo, to receive an appropriate special
education.
Program standards to be
considered--prior to placement.
630.615.
Before placing any client in a particular residential facility or day program,
the department shall consider each of the following criteria:
(1) The best interests of the patient or resident;
(2) Except as provided in subdivision (5) of this section,
the least restrictive environment for providing care and treatment consistent
with the needs and conditions of the patient or resident;
(3) The ability to provide to the patient or resident that
individual degree of care and treatment which is required for that patient or resident
and which is of comparable quality to the existing care and treatment based
upon investigation of the alternative place and its program of care and
treatment;
(4) The relationship of the patient or resident to his
family, guardian or friends, so as to maintain relationships and encourage
visits beneficial to the patient or resident;
(5) Whether the facility will provide the security necessary
to protect the public safety and any crime victim or other witnesses if the
client was committed to the department of mental health pursuant to chapter
552, RSMo, based on an accepted plea of not guilty by
reason of a mental disease or defect excluding responsibility or an acquittal
on that basis as provided in section 552.030, RSMo,
for a dangerous felony as defined in section 556.061, RSMo,
or a violation of section 565.020 or 566.040, RSMo,
or an attempt to commit one of the preceding crimes.
Facilities and programs to be
utilized in making placements.
630.620.
1. Except as provided in subsection 2 of this section, the department may place
any patient or resident referred by a department facility or any person
applying directly or referred under section 630.610 who is accepted for
placement, in one or more of the following facilities or programs as soon as
practicable after consultation with the person, patient or resident, if
competent, or his parents, if he is a minor, or his guardian:
(1) A facility licensed by the department of social services
under chapter 198, RSMo, and licensed or certified,
or both, by the department under this chapter;
(2) A facility or program licensed or certified, or both, by
the department;
(3) The home of the client.
2.
If the person was committed to the department of mental health pursuant to
chapter 552, RSMo, based on an accepted plea of not
guilty by reason of a mental disease or defect excluding responsibility or an
acquittal on that basis as provided in section 552.030, RSMo,
for a dangerous felony as defined in section 556.061, RSMo,
or a violation of section 565.020 or 566.040, RSMo,
or an attempt to commit one of the preceding crimes, the placement shall be to
a secure facility as defined in section 552.040, RSMo,
unless a court order is entered allowing placement in a nonsecure
facility.
3.
The department shall provide a written statement to the client, the client's
parent, if the client is a minor, the client's legal guardian, the referring
court or the referring state or private agency or facility, and to the client's
next of kin specifying reasons why a proposed placement is appropriate pursuant
to section 630.615. If the client was originally committed pursuant to chapter
552, RSMo, the written statement shall also be
provided to the prosecuting attorney in the jurisdiction where the person was
tried and acquitted.
Consent required for placement.
630.625.
If the client is competent to give informed consent, the department shall allow
ten days to obtain his consent before making a placement. If the client is a
minor or has a legal guardian, the department shall obtain the consent of the
parent or guardian before placement. If the client is an involuntary patient or
resident under chapter 211, 552 or 632, RSMo, the
department shall notify the court of competent jurisdiction of the proposed
placement and allow ten days for the court to object.
Alternative proposals to be
prepared.
630.630.
If a patient or resident, parent, if the patient or resident is a minor, or legal guardian does not consent to transfer of the
patient or resident from a facility operated by the department, then the
department shall propose other appropriate placement alternatives, if
available, and seek to obtain consent under section 630.625 until the
alternatives are exhausted.
Procedure when consent not given--review panel to be
named--notice and hearing required--appeal--emergency transfers may be made.
630.635.
1. If a resident in a mental retardation facility, or his parent if he is a
minor, or his legal guardian refuses to consent to the proposed placement, the
head of the mental retardation facility may petition, under the procedures in section
633.135, RSMo, the director of the division of mental
retardation and developmental disabilities to determine whether the proposed
placement is appropriate under chapter 633, RSMo.
2.
If a patient in a mental health facility, or his parent if he is a minor, or
his legal guardian refuses to consent to the proposed placement, the head of
the mental health facility may petition the director of the division of
comprehensive psychiatric services to determine whether the proposed placement
is appropriate under sections 630.610, 630.615 and 630.620.
3.
The director of the division of comprehensive psychiatric services shall refer
the petition to the chairman of the state advisory council for his division who
shall appoint and convene a review panel composed of three members. At least
one member of the panel shall be a family member or guardian of a patient who
resides in a mental health facility operated by the department. The remaining
members of the panel shall be persons who are from nongovernmental organizations
or groups concerned with the prevention of mental disorders, evaluation, care,
treatment or rehabilitation of persons affected by the same conditions as the
patient the department seeks to place and who are familiar with services and
service needs of persons in mental health facilities operated by the
department. No member of the panel shall be an officer or employee of the
department.
4.
After prompt notice and hearing, the panel shall determine whether the proposed
placement is appropriate under sections 630.610, 630.615 and 630.620. The
hearing shall be electronically recorded for purposes of obtaining a
transcript. The council shall forward the tape recording, recommended findings
of fact, conclusions of law, and decision to the director who shall enter
findings of fact, conclusions of law, and the final decision. Notice of the
director's decision shall be sent to the patient, or his parent if he is a
minor, or his guardian by registered mail, return receipt requested. The
director shall expedite this review in all respects.
5.
If the patient, or his parent if he is a minor, or his guardian disagrees with
the decision of the director, he may appeal the decision, within thirty days
after notice of the decision is sent, to the circuit court of the county where
the patient or resident, or his parent if he is a minor, or his guardian
resides. The court shall review the record, proceedings and decision of the
director not only under the provisions of chapter 536, RSMo,
but also as to whether or not the head of the facility or the department
sustained its burden of proof that the proposed placement is appropriate under
sections 630.110, 630.115 and 630.120. The court shall expedite this review in
all respects. Notwithstanding the provisions of section 536.140, RSMo, a court may, for good cause shown, hear and consider
additional competent and material evidence.
6.
The notice and procedure for the hearing by the panel shall be in accordance
with chapter 536, RSMo.
7.
In all proceedings either before the panel or before the circuit court, the
burden of proof shall be upon the head of the facility to demonstrate by a
preponderance of evidence that the proposed placement is appropriate under the
criteria set forth in sections 630.610, 630.615 and 630.120.
8.
Pending the convening of the hearing panel and the final decision of the
director or the court if the director's decision is appealed, the department
shall not place or discharge the patient from a facility except that the
department may temporarily transfer such patient in the case of a medical
emergency.
9.
There shall be no retaliation against any state employee as the result of a
good faith decision to place the patient which is appealed and who testifies
during a hearing or otherwise provides information or evidence in regard to a
proposed placement.
Costs of benefits may be paid by department--recovery.
630.640.
1. If a client receiving services under this chapter is ineligible for public
assistance benefits from any source, or such benefits are inadequate to meet
the costs of such services, his monthly costs may be paid or supplemented out
of funds appropriated for that purpose to the department.
2.
If payments for the support and maintenance of the client are made from funds
appropriated to the department, the department shall charge the client or those
responsible for his support under this chapter for his support and maintenance
pursuant to sections 630.205 to 630.215.
Follow-up care.
630.645.
The department shall provide or shall arrange for follow-up care and aftercare
and shall make or arrange for reviews and visits with the client at least
quarterly to the residential facility or day program in which the client has
been placed to determine whether the client is receiving care, treatment,
habilitation and rehabilitation, including medical care, consistent with his
needs and condition. The department shall identify the facilities, programs or
specialized services operated or funded by the department which shall provide
necessary levels of follow-up care, aftercare, habilitation or medical
treatment to clients in certain geographic areas where they are placed. After a
client has been placed through the placement program, the department shall, for
a period of four months following the initial placement, evaluate and review
the progress of the client in the placement at least once a month.
Cooperation with department of
social services.
630.650.
The department of social services shall cooperate with the department of mental
health and its facilities in locating licensed residential facilities, day
programs and specialized services, in visiting and inspecting them, and in
submitting inspection and other reports regarding them and the department
clients placed therein.
Rules for standards for placement
facilities and programs--required standards.
630.655.
1. The department shall promulgate rules which set forth reasonable standards
for residential facilities, day programs or specialized services such that each
program's level of service, treatment, habilitation or rehabilitation may be
certified and funded accordingly by the department for its placement program
clients or as necessary for the facilities or programs, to meet conditions of
third-party reimbursement.
2.
The rules shall provide for the facilities, programs or services to be
reasonably classified as to resident or client population, size, type of
services or other classification.
3.
The standards contained in the rules shall particularly provide for the
following:
(1) The admission and commitment criteria, which shall be
based upon diagnoses;
(2) The care, treatment, habilitation or rehabilitation;
(3) The general medical and health care;
(4) Adequate physical plant facilities, including fire
safety, housekeeping and maintenance standards;
(5) Food service facilities;
(6) Safety precautions;
(7) Drugs and medications;
(8) A uniform system of record keeping;
(9) Resident or client rights and grievance procedures;
(10) Adequate staff.
4.
The department shall certify the facilities, programs or services which meet
the standards without the requirement of a fee.
Waiver or exception request of
administrative rule or standard, procedure.
630.656.
Notwithstanding any rule to the contrary, any request for a waiver or exception
of administrative rule or standard shall be approved by an exceptions committee
created by the filing agency and such committee shall be considered a public
governmental body operating under chapter 610, RSMo.
Written contracts required.
630.660.
The department shall require residential facilities, day programs and
specialized services to enter into written contracts to receive funding for
services rendered to clients placed by the department.
Rules for standards for facilities
and programs for persons affected by mental disorder, mental illness, mental retardation
or developmental disability--classification of facilities and programs
--certain facilities and programs not to be licensed.
630.705.
1. The department shall promulgate rules setting forth reasonable standards for
residential facilities and day programs for persons who are affected by a
mental disorder, mental illness, mental retardation or developmental
disability.
2.
The rules shall provide for the facilities and programs to be reasonably
classified as to resident or client population, size, type of services or other
reasonable classification. The department shall design the rules to promote and
regulate safe, humane and adequate facilities and programs for the care,
treatment, habilitation and rehabilitation of persons described in subsection 1
of this section.
3.
The following residential facilities and day programs shall not be licensed by
the department:
(1) Any facility or program which relies solely upon the use
of prayer or spiritual healing;
(2) Any educational, special educational or vocational
program operated, certified or approved by the state board of education
pursuant to chapters 161, 162 and 178, RSMo, and
regulations promulgated by the board;
(3) Any hospital, facility, program or entity operated by
this state or the
(4) Any hospital, facility or other entity, excluding those
with persons who are mentally retarded and developmentally disabled as defined
in section 630.005 otherwise licensed by the state and operating under such
license and within the limits of such license, unless the majority of the
persons served receive activities and services normally provided by a licensed
facility pursuant to this chapter;
(5) Any hospital licensed by the department of social
services as a psychiatric hospital pursuant to chapter 197, RSMo;
(6) Any facility or program accredited by the Joint
Commission on Accreditation of Hospitals, the American Osteopathic Association,
Accreditation Council for Services for Mentally Retarded or other
Developmentally Disabled Persons, Council on Accreditation of Services for
Children and Families, Inc., or the Commission on Accreditation of
Rehabilitation Facilities;
(7) Any facility or program caring for less than four
persons whose care is not funded by the department.
Required standards.
630.710.
1. The standards contained in the rules shall particularly provide for the
following:
(1) Admission and commitment criteria, which shall be based
upon diagnoses;
(2) Care, treatment, habilitation or rehabilitation;
(3) General medical and health care;
(4) Adequate physical plant facilities, including fire
safety, housekeeping and maintenance standards;
(5) Food service facilities;
(6) Safety precautions;
(7) Drugs and medications;
(8) Uniform system of record keeping;
(9) Resident or client rights and grievance procedures;
(10) Adequate staff.
2.
The rules containing the standards for living units within facilities or homes
shall provide for such classifications of the living units as are small enough
to ensure programs based upon the personal needs of the resident as determined
by individualized habilitation or treatment plans. The units may include
distinct parts of other facilities such as wards, wings or floors.
Licensing of residential facilities
and day programs--fee--affidavit.
630.715.
1. The department shall establish a procedure for the licensing of residential
facilities and day programs for persons described in section 630.705, which
procedure shall provide for the acceptance of a license, a temporary operating
permit or a probationary license issued by the department of social services
under sections 198.006 to 198.096, RSMo, as regards
the licensing requirements in the following areas:
(1) General medical and health care;
(2) Adequate physical plant facilities including fire
safety, housekeeping and maintenance standards;
(3) Food service facilities;
(4) Safety precautions;
(5) Drugs and medications;
(6) Uniform system of recordkeeping;
(7) Resident and client rights and grievance procedures.
However, the department shall require annually that any facilities and programs
already licensed by the department of social services under chapter 198, RSMo, which desire to provide services to persons diagnosed
as mentally disordered, mentally ill, mentally retarded or developmentally
disabled in accordance with sections 630.705 to 630.760 meet the department's
requirements in excess of those required for licensure or certification under
chapter 198, RSMo, which are appropriate to admission
criteria and care, treatment, habilitation and rehabilitation needs of such
persons.
2.
Applications for licenses shall be made to the department upon forms provided
by it and shall contain such information and documents as the department
requires, including, but not limited to, affirmative evidence of ability to
comply with the rules adopted by the department. Each application for a
license, except applications from a governmental unit or a facility caring for less
than four persons, which shall not pay any fee, shall be accompanied by a
license fee of ten dollars for establishments which accept more than three but
less than ten persons and fifty dollars from establishments which accept ten or
more. The license fee shall be paid to the director of revenue for deposit to
the general revenue fund of the state treasury.
3.
An applicant for a license shall submit an affidavit under oath that all
documents required by the department to be filed pursuant to this section are
true and correct to the best of his knowledge and belief, that the statements
contained in the application are true and correct to the best of his knowledge
and belief and that all required documents are either included with the
application or are currently on file with the department.
Issuance of license, term--temporary permits, when--may be
transferable--posting.
630.720.
1. Upon receipt of an application for a license, the department shall issue a
license if the applicant demonstrates that his residential facility or day
program meets the requirements established in the department rules and
regulations. A license, unless sooner revoked, shall be issued for a period of
one year.
2.
The department shall notify the holder of a valid license at least sixty days
prior to the expiration of such license of the date that the license
application is due. Application for a license shall be made to the department
at least thirty days prior to the expiration of an existing, valid license.
3.
The department shall grant a temporary operating permit in order to allow for
state inspection for the purposes of relicensure if
the inspection process has not been completed prior to the expiration of a
license and the applicant is not at fault for the failure to complete the
inspection process.
4.
Each license shall be issued only for the premises and persons or governmental
units named in the application and shall not be transferable or assignable
except with the written approval of the department. The department shall grant
a temporary operating permit of sufficient duration to allow the department to
evaluate any application for a license submitted as a result of any change of
ownership.
5.
Licenses shall be posted in a conspicuous place on the licensed premises.
Denial or revocation--appeal--determination
by administrative hearing commission.
630.725.
1. The department shall revoke a license or deny an application for a license
in any case in which it finds a substantial failure to comply with the
standards established under its rules or the requirements established under
sections 630.705 to 630.760.
2.
Any person aggrieved by the action of the department to deny or revoke a
license under the provisions of sections 630.705 to 630.760 may seek a
determination of the department director's decision by the administrative
hearing commission pursuant to the provisions of section 621.045, RSMo. It shall not be a condition to such determination
that the person aggrieved seek a reconsideration, a
rehearing or exhaust any other procedure within the department.
3.
The administrative hearing commission may stay the revocation of such license,
pending the commission's finding and determination in the cause, upon such
conditions as the commission deems necessary and appropriate including the posting
of bond or other security except that the commission shall not grant a stay or
if a stay has already been entered shall set aside its stay, if upon
application of the department the commission finds reason to believe that
continued operation of a residential facility or day program pending the
commission's final determination would present an imminent danger to the
health, safety or welfare of any resident or a substantial probability that
death or serious physical harm would result. In any case in which the
department has refused to issue a license, the commission shall have no
authority to stay or to require the issuance of a license pending final
determination by the commission.
4.
The administrative hearing commission shall make the final decision as to the
issuance or revocation of a license. Any person aggrieved by a final decision
of the administrative hearing commission, including the department, may seek
judicial review of such decision by filing a petition for review in the court
of appeals for the district in which the facility or program is located. Review
shall be had, except as modified herein, in accordance with the provisions of
sections 621.189 and 621.193, RSMo.
Inspection by department and others, when--may be ordered,
when.
630.730.
1. The department may inspect any residential facility or day program for
persons described in section 630.705, RSMo, at any
time if a license has been issued to or an application for a license has been
filed by the head of such facility or program. The department shall make or
cause to be made at least one inspection per year. The department may make such
other inspections, announced or unannounced, as it deems necessary to carry out
the provisions of sections 630.705 to 630.760. The department may delegate its
powers and duties to investigate and inspect residential facilities and day
programs licensed by it to determine compliance with all or part of its
standards, to another governmental agency, where practicable, if the department
feels such other agency is qualified to inspect and license such facilities or
programs. The governmental unit shall submit a written report of its findings
to the department. The department may accept the recommendations of the
governmental unit for issuance or revocation of a license.
2.
If the department has reasonable grounds to believe that a residential facility
or day program required to be licensed under sections 630.705 to 630.760 is
operating without a license, and the department is not permitted access to
inspect the facility or program, or when the head of such facility or program
refuses to permit access to the department to inspect the facility or program,
the department shall apply to the circuit court of the county in which the
premises is located for an order authorizing entry for such inspection, and the
court shall issue the order if it finds that the head of the facility or
program has refused to permit the department access to inspect such facility or
program.
License required.
630.735.
1. No person or governmental unit, acting separately or jointly with any other
person or governmental unit, shall establish, conduct or maintain any
residential facility in this state for the care, treatment, habilitation or rehabilitation
of mentally retarded or developmentally disabled persons without a valid
license issued by the department. Licenses in effect on
2.
After October 1, 1983, no person or governmental unit, acting separately or
jointly with any other person or governmental unit, shall establish, conduct or
maintain any residential facility or day program in this state for care,
treatment, habilitation or rehabilitation of persons diagnosed as mentally
disordered or mentally ill or day program for mentally retarded or
developmentally disabled persons unless the facilities or programs are licensed
by the department.
Penalty for failure to obtain
license--attorney general to represent department--relief to be granted.
630.740.
1. Any person establishing, conducting, managing or operating any residential
facility or day program without a license as provided for in sections 630.705
to 630.760 is guilty of a class C misdemeanor.
2.
The attorney general shall represent the department, which may institute an
action in the name of the state for an injunction or other process against any
person or governmental unit to restrain or prevent the establishment, conduct,
management or operation of a residential facility or day program without a
license as required under this law.
Noncompliance with law revealed by
inspection--procedure--corrective measures, time limit--reinspection,
when--probationary license --posting of noncompliance notices.
630.745.
1. If a duly authorized representative of the department finds upon inspection
of a residential facility or day program that it is not in compliance with the
provisions of sections 630.705 to 630.760, and the standards established thereunder, the head of the facility or program shall be
informed of the deficiencies in an exit interview conducted with him. A written
report shall be prepared of any deficiency for which there has not been prompt
remedial action, and a copy of such report and a written correction order shall
be sent to the head of the facility or program by certified mail, return
receipt requested, at the facility or program address within twenty working
days after the inspection, stating separately each deficiency and the specific
statute or regulation violated.
2.
The head of the facility or program shall have twenty working days following
receipt of the report and correction order to request any conference and to
submit a plan of correction for the department's approval which contains
specific dates for achieving compliance. Within ten working days after
receiving a plan of correction, the department shall give its written approval
or rejection of the plan.
3.
A reinspection shall be conducted within fifty-five
days after the original inspection to determine if deficiencies are being
corrected as required in the approved correction plan or any subsequent
authorized modification. If the facility or program is not in substantial
compliance and the head of the facility or program is not correcting the
noncompliance in accordance with the time schedules in his approved plan of
correction, the department shall issue a notice of noncompliance, which shall
be sent by certified mail, return receipt requested, to the head of the
facility or program.
4.
The notice of noncompliance shall inform the head of the facility or program
that the department may seek the imposition of any of the sanctions and
remedies provided for in section 630.755, or any other action authorized by
law.
5.
At any time after an inspection is conducted, the head of the facility or
program may choose to enter into a consent agreement with the department to
obtain a probationary license. The consent agreement shall include a provision
that the head of the facility or program will voluntarily surrender the license
if substantial compliance is not reached in accordance with the terms and
deadlines established under the agreement. The agreement shall specify the
stages, actions and time span to achieve substantial compliance.
6.
If a notice of noncompliance has been issued, the head of the facility or
program shall post a copy of the notice of noncompliance and a copy of the most
recent inspection report in a conspicuous location in the facility or program,
and the department shall send a copy of the notice of noncompliance to any concerned
federal, state or local governmental agencies.
Procedure upon finding of
noncompliance which may present health or safety dangers.
630.750.
The provisions of section 630.745 notwithstanding, if a duly authorized
representative of the department finds upon inspection of a licensed
residential facility or day program, and the director finds upon review, that
the facility or program is not in substantial compliance with a standard or
standards the violations of which would present either an imminent danger to
the health, safety or welfare of any resident or a substantial probability that
death or serious physical harm would result and which is not immediately
corrected, the department shall:
(1) Give immediate written notice of the noncompliance to
the head of the facility or program;
(2) Make public the fact that a notice of noncompliance has
been issued to the facility or program. Copies of the notice shall be sent to
appropriate hospitals and social service agencies;
(3) Send a copy of the notice of noncompliance to any
concerned federal, state or local government agencies. The facility or program
shall post in a conspicuous location in the facility or program a copy of the
notice of noncompliance and a copy of the most recent inspection report.
Injunctive relief may be requested--action to have
priority--civil penalties may be assessed, procedure.
630.755.
1. An action may be brought by the department, or by the attorney general on
his own volition or at the request of the department or any other appropriate
state agency, to temporarily or permanently enjoin or restrain any violation of
sections 630.705 to 630.760, to enjoin the acceptance of new residents until
substantial compliance with sections 630.705 to 630.760 is achieved, or to
enjoin any specific action or practice of the residential facility or day
program. Any action brought under the provisions of this section shall be
placed at the head of the docket by the court and the court shall hold a hearing
on any action brought under the provisions of this section no less than fifteen
days after the filing of the action.
2.
Any facility or program which has received a notice of noncompliance as
provided by sections 630.745 to 630.750 is liable to the state for civil
penalties of up to one hundred dollars for each day that noncompliance
continues after the notice of noncompliance is received. The attorney general
shall, upon the request of the department, bring an action in a circuit court
of competent jurisdiction to recover the civil penalty. The court shall have
the authority to determine the amount of civil penalty to be assessed.
Patients to have same rights as
those for residents of nursing homes.
630.760.
In addition to rights provided for patients, residents or clients of
residential facilities licensed by the department under this chapter, residents
or clients in facilities and programs licensed by the department shall have the
same rights as residents as defined in chapter 198, RSMo,
have under section 198.088, RSMo.
Receiver may be requested, by whom, when.
630.763.
The attorney general, either on his own initiative or upon the request of the
department or of any other state governmental agency having an interest in the
matter, a resident or residents or the guardian of a resident of a residential
facility or the head of a facility may petition for appointment of a receiver
for such facility when any of the following conditions exist:
(1) The facility is being operated without a license;
(2) The department has revoked the license of the facility
or refused to grant an application for a license for the facility;
(3) The department has initiated revocation procedures and
has determined that the lives, health, safety, or welfare of the residents
cannot be adequately assured pending a full hearing on license revocation;
(4) The facility is closing or intends to close and adequate
arrangements for relocation of residents have not been made at least thirty
days prior to closure;
(5) An emergency exists in the facility;
(6) The licensee is insolvent; or
(7) An owner of the land or structure is insolvent and such
insolvency substantially affects the operation of the facility.
Monitor may be assigned by department--to advise operator as
to compliance--report to department.
630.766.
In any situation described in section 630.763 the department may place a person
to act as a monitor in the facility. The monitor shall observe operation of the
residential facility and shall advise it on how to comply with state laws and
regulations, and shall submit a written report periodically to the department
on the operation of the facility.
Venue for appointment of receiver--copy of petition to be
provided --hearing thereon within five days, determination within fifteen
--court to appoint receiver if grounds exist.
630.769.
Any petition for appointment of a receiver shall be verified and shall be
accompanied by an affidavit or affidavits setting forth material facts showing
there exists one or more of the conditions specified in section 198.099, RSMo. The petition shall be filed in the circuit court of
Emergency procedure.
630.772.
If it appears from the petition filed under section 198.105, RSMo, or from an affidavit or affidavits filed with the
petition, or from testimony of witnesses under oath when the court determines
that this is necessary, that there is probable cause to believe that an
emergency exists in the residential facility, the court shall immediately issue
the requested order for appointment of a receiver, ex parte and without further
hearing. Notice of the petition and order shall be served on the head of the
facility or, if personal service is impossible, shall be posted in a
conspicuous place in the facility within twenty-four hours after issuance of
the order. If the petition is not filed by the attorney general, a copy of the
petition shall be served on the department and upon the attorney general. A
hearing on the petition shall be held within three days after notice is served
or posted unless the head of the facility consents to a later date. After the
hearing, the court may terminate, continue or modify the temporary order.
Powers and duties of receiver.
630.775.
A receiver appointed under this section:
(1) May exercise those powers and shall perform those duties
set out by the court;
(2) May, in his discretion, either:
(a) Take control of all day-to-day operations of the
residential facility;
(b) Name an individual to conduct the day-to-day operations
of the facility subject to the supervision and direction of the receiver;
(3) May upgrade deficient facilities by any methods,
procedures or actions he deems necessary; provided, however, that expenditures
in excess of three thousand dollars, or in excess of any amount set by the
court, be first approved by the court;
(4) Shall have the same rights to possession of the building
in which the facility is located and of all goods and fixtures in the building
at the time the petition for receivership is filed as the head of the facility
would have had if the receiver had not been appointed. The receiver shall take
such action as is reasonably necessary to protect and conserve the assets or
property of which the receiver takes possession, or the proceeds of any
transfer thereof, and may use them only in the performance of the powers and
duties set forth in this section and by order of the court;
(5) May use the building, fixtures, furnishings and any
accompanying consumable goods in the provision of care and services to
residents and to any other persons receiving services from the facility at the
time the petition for receivership was filed. The receiver shall collect
payments for all goods and services provided to residents or others during the
period of receivership, at the same rate of payment as was charged by the head
of the facility at the time the petition for receivership was filed, unless a
different rate is set by the court;
(6) May let contracts and hire agents and employees,
including legal counsel, to carry out the powers and duties created under this
section or by the court;
(7) May hire or discharge any employees;
(8) Shall receive and expend in a reasonable manner the
revenues of the facility due on the date of the order of appointment as
receiver, and to become due during the receivership;
(9) Shall do all acts necessary or appropriate to conserve
the property and promote the health, safety or care of the residents of the
facility;
(10) Except as hereinafter specified in section 630.790,
shall honor all leases, mortgages, secured transactions or other wholly or
partially executory contracts entered into on behalf
of the facility, but only to the extent of payments which become due or are for
the use of the property during the period of the receivership;
(11) Shall be responsible, to the same extent as the
licensee would have been, for taxes which accrue during the period of the
receivership;
(12) Shall be entitled to and shall take possession of all
property or assets of residents which are in possession of the head of the
facility. The receiver shall preserve all property, assets and records of
residents of which the receiver takes possession and shall provide for the
prompt transfer of the property, assets and records to the alternative
placement of any transferred or discharged resident;
(13) Shall provide, if upgrading of the facility or
correction of the deficiencies is not possible, for the orderly transfer of all
residents in the facility to other suitable facilities, or make other
provisions for their continued health, safety and welfare;
(14) Shall, if any resident is transferred or discharged,
provide for:
(a) Transportation of the resident and the resident's
belongings and medical records to the place to which the resident is being
transferred or discharged;
(b) Aid in locating an alternative placement and in
discharge planning;
(c) If the resident is being transferred, preparation for
transfer to mitigate transfer trauma;
(15) Shall, if any resident is to be transferred, permit
participation by the resident or the resident's guardian in the selection of
the resident's alternative placement;
(16) Shall, unless emergency transfer is necessary, prepare
a resident under subdivisions (14)(c) and (15) by
explaining alternative placements, and by providing orientation to the placement
chosen by the resident or the resident's guardian.
Receiver may disregard certain contracts--factors to be
considered --court may order temporary noncompliance.
630.778.
1. A receiver may not be required to honor any lease, mortgage, secured
transaction or other wholly or partially executory
contract entered into on behalf of the facility if the agreement is
unconscionable. Factors which shall be considered in determining the unconscionability include, but are not limited to, the following:
(1) The person seeking payment under the agreement was an
affiliate of the individual contracting on behalf of the facility at the time
the agreement was made;
(2) The rental, price, or rate of interest required to be
paid under the agreement was substantially in excess of a reasonable rental,
price or rate of interest at the time the agreement was entered into.
2.
If the receiver is in possession of real estate or goods subject to a lease,
mortgage or security interest which the receiver is permitted to avoid under
subsection 1 of this section, and if the real estate or goods are necessary for
the continued operation of the facility, the receiver may apply to the court to
set a reasonable rental, price or rate of interest to be paid by the receiver
during the duration of the receivership. The court shall hold a hearing on the
application within fifteen days. The receiver shall send notice of the
application to any known owners of the property involved at least ten working
days prior to the hearing. Payment by the receiver of the amount determined by
the court to be reasonable is a defense to any action against the receiver for
payment or for possession of person who received such notice, but the payment
does not relieve the licensee or head of the facility of any liability for the
difference between the amount paid by the receiver and the amount due under the
original lease or mortgage involved.
Compensation of receiver.
630.781.
1. The court shall set the compensation of the receiver, which shall be
considered a necessary expense of a receivership.
2.
A receiver may be required by the court to post a bond, which shall be
considered a necessary expense of the receivership.
Receiver may receive license.
630.784.
Other provisions of section 630.705 to 630.760 notwithstanding, the department
may issue a license to a residential facility being operated by a receiver
under sections 630.763 to 630.793. The duration of a license issued under this
section is limited to the duration of the receivership.
Receivership may be terminated by court, when.
630.787.
The court may terminate a receivership:
(1) Upon a motion by any party to the petition, by the
department, or by the receiver, and a finding by the court that the
deficiencies and violations in the residential facility have been substantially
eliminated or remedied; or
(2) If all residents in the facility have been provided
alternative modes of health care, either in another facility or otherwise. The
court may immediately terminate the receivership, or may terminate the
receivership subject to such terms as the court deems necessary or appropriate
to prevent the conditions complained of from recurring.
Accounting of receiver, when--judgment for
deficiencies--priority of receiver's claim.
630.790.
1. Within thirty days after termination or such other time as the court may
set, the receiver shall give the court a complete accounting of all property of
which the receiver has taken possession, of all funds collected under section
630.772 and of the expenses of the receivership.
2.
If the operating funds collected by the receiver under section 630.775 exceed
the reasonable expenses of the receivership, the court shall order the payment
of the surplus to the licensee. If the operating funds are insufficient to
cover reasonable expenses of the receivership, the licensee shall be liable for
the deficiency. The licensee may apply to the court to determine the reasonableness
of any expense of the receivership. The licensee shall not be responsible for
expenses in excess of what the court finds to be reasonable.
3.
If a deficiency exists under subsection 2 of this section, the receiver may
apply to the court for such a determination. If after notice to all interested
parties and a hearing the court finds that in fact a deficiency does exist,
then the court shall enter judgment in favor of the receiver and against the
appropriate party or parties as set forth in subsection 2 of this section for
the amount of such deficiency. Any judgment obtained under this subsection
shall be treated as any other judgment and may be enforced according to law.
4.
Any judgment for a deficiency obtained in accordance with this section by the
receiver or any portion thereof may be assigned wholly or in part upon approval
of the court.
5.
The judgment shall have priority over any other judgment or lien or other
interest which originates subsequent to the filing of a petition for receivership
under the provisions of sections 630.763 to 630.793 except for a construction
or mechanic's lien arising out of work performed with the express consent of
the receiver.
Liabilities of receivers and
licensees.
630.793.
No licensee may be held liable for acts or omissions of the receiver or the
receiver's employees during the term of the receivership. Nothing in sections
630.763 to 630.793 shall be deemed to relieve any licensee or affiliate of a
licensee of a facility placed in receivership of any civil or criminal
liability incurred, or any duty imposed by law, by reason of acts or omissions
of the licensee or affiliates of the licensee prior to the appointment of a
receiver under section 630.763 or 630.793, nor shall anything contained in
sections 630.763 to 630.793 be construed to suspend during the receivership any
obligation of the licensee or any affiliate of a licensee for payment of taxes
or other operating and maintenance expenses of the facility, nor of the
licensee or affiliates of the licensee for the payment of mortgages or liens.
Nonresidents may be returned to place of residence,
when--reciprocal agreements authorized--transportation costs.
630.805.
1. Except for those persons committed to the department of mental health
pursuant to chapter 552, RSMo, a person who is not a
resident of this state who is committed to the department of mental health for
care, treatment, detention or training in a state hospital or institution by
order of a court may be returned by the department, either before or after such
person's admission to a state hospital or institution, to the state of such
person's residence, except that no person shall be so returned unless proper
arrangements to receive the patient have been made with the state to which the
person is to be returned.
2.
The director of the department of mental health may enter into reciprocal
agreements with other states or political subdivisions thereof for the
interstate transportation or transfer of mentally ill or mentally deficient
persons, or persons who are in need of mental treatment, to the state of their
residence.
3.
The cost of transporting a nonresident patient to the state of the patient's
residence is payable out of funds appropriated to the department of mental
health.
Compact enacted--form.
630.810.
The "Interstate Compact on Mental Health" is hereby enacted into law
and entered into by this state with all other states legally joining therein in
the form substantially as follows:
THE
INTERSTATE COMPACT ON MENTAL HEALTH
The
contracting states solemnly agree that:
ARTICLE
I
The
party states find that the proper and expeditious treatment of the mentally ill
and mentally deficient can be facilitated by cooperative action, to the benefit
of the patients, their families, and society as a whole. Further, the party
states find that the necessity of and desirability for furnishing such care and
treatment bears no primary relation to the residence or citizenship of the
patient but that, on the contrary, the controlling factors of community safety
and humanitarianism require that facilities and services be made available for
all who are in need of them. Consequently, it is the purpose of this compact
and of the party states to provide the necessary legal basis for the
institutionalization or other appropriate care and treatment of the mentally
ill and mentally deficient under a system that recognizes the paramount
importance of patient welfare and to establish the responsibilities of the
party states in terms of such welfare.
ARTICLE
II
As
used in this compact:
(a)
"Sending state" shall mean a party state from which a patient is
transported pursuant to the provisions of the compact or from which it is
contemplated that a patient may be so sent.
(b)
"Receiving state" shall mean a party state to which a patient is
transported pursuant to the provisions of the compact or to which it is
contemplated that a patient may be so sent.
(c)
"Institution" shall mean any hospital or other facility maintained by
a party state or political subdivision thereof for the care and treatment of
mental illness or mental deficiency.
(d)
"Patient" shall mean any person subject to or eligible as determined
by the laws of the sending state, for institutionalization or other care,
treatment, or supervision pursuant to the provisions of this compact.
(e)
"Aftercare" shall mean care, treatment and
services provided a patient, as defined herein, on convalescent status or conditional
release.
(f)
"Mental illness" shall mean mental disease to such extent that a
person so afflicted requires care and treatment for his own welfare, or the
welfare of others, or of the community.
(g)
"Mental deficiency" shall mean mental deficiency as defined by
appropriate clinical authorities to such extent that a person so afflicted is
incapable of managing himself and his affairs, but shall not include mental
illness as defined herein.
(h)
"State" shall mean any state, territory or possession of the
ARTICLE
III
(a)
Whenever a person physically present in any party state shall be in need of
institutionalization by reason of mental illness or mental deficiency, he shall
be eligible for care and treatment in an institution in that state irrespective
of his residence, settlement or citizenship qualifications.
(b)
The provisions of paragraph (a) of this article to the contrary
notwithstanding, any patient may be transferred to an institution in another
state whenever there are factors based upon clinical determinations indicating
that the care and treatment of said patient would be facilitated or improved
thereby. Any such institutionalization may be for the entire period of care and
treatment or for any portion or portions thereof. The factors referred to in
this paragraph shall include the patient's full record with due regard for the
location of the patient's family, character of the illness and probable
duration thereof, and such other factors as shall be considered appropriate.
(c)
No state shall be obliged to receive any patient pursuant to the provisions of
paragraph (b) of this article unless the sending state has given advance notice
of its intention to send the patient; furnished all available medical and other
pertinent records concerning the patient; given the qualified medical or other
appropriate clinical authorities of the receiving state an opportunity to examine
the patient if said authorities so wish; and unless the receiving state shall
agree to accept the patient.
(d)
In the event that the laws of the receiving state establish a system of
priorities for the admission of patients, an interstate patient under this
compact shall receive the same priority as a local patient and shall be taken
in the same order and at the same time that he would be taken if he were a
local patient.
(e)
Pursuant to this compact, the determination as to the suitable place of institutionalization
for a patient may be reviewed at any time and such further transfer of the
patient may be made as seems likely to be in the best interest of the patient.
ARTICLE
IV
(a)
Whenever, pursuant to the laws of the state in which a patient is physically
present, it shall be determined that the patient should receive aftercare or
supervision, such care or supervision may be provided in a receiving state. If
the medical or other appropriate clinical authorities having responsibility for
the care and treatment of the patient in the sending state shall have reason to
believe that aftercare in another state would be in the best interest of the
patient and would not jeopardize the public safety, they shall request the
appropriate authorities in the receiving state to investigate the desirability
of affording the patient such aftercare in said receiving state, and such
investigation shall be made with all reasonable speed. The request for
investigation shall be accompanied by complete information concerning the
patient's intended place of residence and the identity of the person in whose
charge it is proposed to place the patient, the complete medical history of the
patient, and such other documents as may be pertinent.
(b)
If the medical or other appropriate clinical authorities having responsibility
for the care and treatment of the patient in the sending state and the
appropriate authorities in the receiving state find that the best interest of
the patient would be served thereby, and if the public safety would not be
jeopardized thereby, the patient may receive aftercare or supervision in the
receiving state.
(c)
In supervising, treating, or caring for a patient on aftercare pursuant to the
terms of this article, a receiving state shall employ the same standards of
visitation, examination, care, and treatment that it employs for similar local
patients.
ARTICLE
V
Whenever a dangerous or potentially dangerous patient
escapes from an institution in any party state, that state shall promptly
notify all appropriate authorities within and out the jurisdiction of the
escape in a manner reasonably calculated to facilitate the speedy apprehension
of the escapee.
Immediately upon the apprehension and identification of any such dangerous or
potentially dangerous patient, he shall be detained in the state where found
pending disposition in accordance with law.
ARTICLE
VI
The
duly accredited officers of any state party to this compact, upon the
establishment of their authority and the identity of the patient, shall be
permitted to transport any patient being moved pursuant to this compact through
any and all states party to this compact, without interference.
ARTICLE
VII
(a)
No person shall be deemed a patient of more than one institution at any given
time. Completion of transfer of any patient to an institution in a receiving
state shall have the effect of making the person a patient of the institution
in the receiving state.
(b)
The sending state shall pay all costs of and incidental to the transportation
of any patient pursuant to this compact, but any two or more party states may,
by making a specific agreement for that purpose, arrange for a different
allocation of costs as among themselves.
(c)
No provision of this compact shall be construed to alter or affect any internal
relationships among the departments, agencies and officers of and in the
government of a party state, or between a party state and its subdivisions, as
to the payment of costs, or responsibilities therefor.
(d)
Nothing in this compact shall be construed to prevent any party state or
subdivision thereof from asserting any right against any person, agency or
other entity in regard to costs for which such party state or subdivision
thereof may be responsible pursuant to any provision of this compact.
(e)
Nothing in this compact shall be construed to invalidate any reciprocal
agreement between a party state and a nonparty state relating to
institutionalization, care or treatment of the mentally ill or mentally
deficient, or any statutory authority pursuant to which such agreements may be
made.
ARTICLE
VIII
(a)
Nothing in this compact shall be construed to abridge, diminish, or in any way
impair the rights, duties, and responsibilities of any patient's guardian on
his own behalf or in respect of any patient for whom he may serve, except that
where the transfer of any patient to another jurisdiction makes advisable the
appointment of a supplemental or substitute guardian, any court of competent
jurisdiction in the receiving state may make such supplemental or substitute
appointment and the court which appointed the previous guardian shall upon
being duly advised of the new appointment, and upon the satisfactory completion
of such accounting and other acts as such court may by law require, relieve the
previous guardian of power and responsibility to whatever extent shall be
appropriate in the circumstances; provided, however, that in the case of any
patient having settlement in the sending state, the court of competent
jurisdiction in the sending state shall have the sole discretion to relieve a
guardian appointed by it or continue his power and responsibility, whichever it
shall deem advisable. The court in the receiving state may, in its discretion,
confirm or reappoint the person or persons previously serving as guardian in
the sending state in lieu of making a supplemental or substitute appointment.
(b)
The term "guardian" as used in paragraph (a) of this article shall
include any guardian, trustee, legal committee, conservator, or other person or
agency however denominated who is charged by law with power to act for or
responsibility for the person or property of a patient.
ARTICLE
IX
(a)
No provision of this compact except Article V shall apply to any person
institutionalized while under sentence in a penal or correctional institution
or while subject to trial on a criminal charge, or whose institutionalization
is due to the commission of an offense for which, in the absence of mental
illness or mental deficiency, said person would be subject to incarceration in
a penal or correctional institution.
(b)
To every extent possible, it shall be the policy of states party to this
compact that no patient shall be placed or detained in any prison, jail or
lockup, but such patient shall, with all expedition, be taken to a suitable
institutional facility for mental illness or mental deficiency.
ARTICLE
X
(a)
Each party state shall appoint a "compact administrator" who, on
behalf of his state, shall act as general coordinator of activities under the
compact in his state and who shall receive copies of all reports,
correspondence, and other documents relating to any patient processed under the
compact by his state either in the capacity of sending or receiving state. The
compact administrator or his duly designated representative shall be the
official with whom other party states shall deal in any matter relating to the
compact or any patient processed thereunder.
(b)
The compact administrators of the respective party states shall have power to
promulgate reasonable rules and regulations to carry out more effectively the
terms and provisions of this compact.
ARTICLE
XI
The
duly constituted administrative authorities of any two or more party states may
enter into supplementary agreements for the provision of any service or
facility or for the maintenance of any institution on a joint or cooperative
basis whenever the states concerned shall find that such agreements will
improve services, facilities, or institutional care and treatment in the fields
of mental illness or mental deficiency. No such supplementary agreement shall
be construed so as to relieve any party state of any obligation which it
otherwise would have under other provisions of this compact.
ARTICLE
XII
This
compact shall enter into full force and effect as to any state when enacted by
it into law and such state shall thereafter be a party thereto with any and all
states legally joining therein.
ARTICLE
XIII
(a)
A state party to this compact may withdraw therefrom
by enacting a statute repealing the same. Such withdrawal shall take effect one
year after notice thereof has been communicated officially and in writing to
the governors and compact administrators of all other party states. However,
the withdrawal of any state shall not change the status of any patient who has
been sent to said state or sent out of said state
pursuant to the provisions of the compact.
(b)
Withdrawal from any agreement permitted by Article VII(b) as to costs or from
any supplementary agreement made pursuant to Article XI shall be in accordance
with the terms of such agreement and paragraph (a) hereof.
ARTICLE
XIV
This
compact shall be liberally construed so as to effectuate the purposes thereof.
The provisions of this compact shall be severable and
if any phrase, clause, sentence or provision of this compact is declared to be
contrary to the constitution of any party state or of the United States or the
applicability thereof to any government, agency, person or circumstance is held
invalid, the validity of the remainder of this compact and the applicability
thereof to any government, agency, person or circumstance shall not be affected
thereby. If this compact shall be held contrary to the constitution of any
state party thereto, the compact shall remain in full force and effect as to
the remaining states and in full force and effect as to the state affected as
to all severable matters.
Director of department to make rules--cooperate in
administration.
630.815.
The director of the department of mental health shall be the compact
administrator who, acting jointly with like officers of other party states,
shall have power to promulgate rules and regulations to carry out more
effectively the terms of the compact. The compact administrator is hereby
authorized, empowered and directed to cooperate with all departments, agencies
and officers of and in the government of this state and its subdivisions in
facilitating the proper administration of the compact or any supplementary
agreement or agreements entered into by this state thereunder.
Supplementary agreements authorized, when effective.
630.820.
The compact administrator is hereby authorized and empowered to enter into
supplementary agreements with appropriate officials of other states pursuant to
Articles VII and XI of the compact. In the event that such supplementary
agreements shall require or contemplate the use of any institution or facility
of this state or require or contemplate the provision of any service by this
state, no such agreement shall have force or effect until approved by the head
of the department or agency under whose jurisdiction the institution or
facility is operated or whose department or agency will be charged with the
rendering of the service.
Expenses, how paid.
630.825.
All expenditures necessitated under the provisions of sections 630.810 to
630.835 shall be paid out of appropriations made to the department of mental
health.
Transfer of patient, duty of administrator.
630.830.
The compact administrator is hereby directed to consult with the immediate
family of any proposed transferee and, in the case of a proposed transferee
from an institution in this state to an institution in another party state, to
take no final action without approval of the court which committed the proposed
transferee.
Copies of law furnished other states.
630.835.
Duly authorized copies of sections 630.810 to 630.835 shall, upon its approval,
be transmitted by the secretary of state to the governor of each state, the
Attorney General and the Secretary of State of the
Compact enacted--form.
630.850.
The "Interstate Compact on the Mentally Disordered Offender",
hereinafter called "the compact", is hereby enacted into law and
entered into with all other jurisdictions legally joining therein, in the form
substantially as contained in section 630.855.
Contracts authorized, limitations.
630.855.
The department of mental health and the department of corrections may negotiate
and enter into contracts on behalf of this state pursuant to Article III of the
compact and may perform such contracts; provided, that no funds, personnel,
facilities, equipment, supplies or materials shall be pledged for, committed or
used on account of any such contract, unless legally available therefor.
THE
INTERSTATE COMPACT ON
MENTALLY
DISORDERED OFFENDERS
ARTICLE
I
(a)
The party states, desiring by common action to improve their programs for the
care and treatment of mentally disordered offenders, declare that it is the
policy of each of the party states to:
1.
Strengthen their own programs and laws for the care and treatment of the
mentally disordered offender.
2.
Encourage and provide for such care and treatment in the most appropriate locations,
giving due recognition to the need to achieve adequacy of diagnosis, care,
treatment, aftercare and auxiliary services and facilities and, to every extent
practicable, to do so in geographic locations convenient for providing a
therapeutic environment.
3.
Authorize cooperation among the party states in providing services and
facilities, when it is found that cooperative programs can be more effective
and efficient than programs separately pursued.
4.
Place each mentally disordered offender in a legal status which will facilitate
his care, treatment and rehabilitation.
5.
Authorize research and training of personnel on a cooperative basis, in order
to improve the quality or quantity of personnel available for the proper
staffing programs, services and facilities for mentally disordered offenders.
6.
Care for and treat mentally disordered offenders under conditions which will
improve the public safety.
(b)
Within the policies set forth in this Article, it is the purpose of this
compact to:
1.
Authorize negotiation, entry into and operations under contractual arrangements
among any two or more of the party states for the establishment and maintenance
of cooperative programs in any one or more of the fields for which specific
provision is made in the several articles of this compact.
2.
Set the limits within which such contracts may operate, so as to assure
protection of the civil rights of mentally disordered offenders and protection
of the rights and obligations of the public and of the party states.
3.
Facilitate the proper disposition of criminal charges pending against mentally
disordered offenders, so that programs for their care, treatment and
rehabilitation may be carried on efficiently.
ARTICLE
II
As
used in this compact:
(a)
"Mentally disordered offender" means a person who has been
determined, by adjudication or other method legally sufficient for the purpose
in the party state where the determination is made, to be mentally ill and:
1.
Is under sentence for the commission of crime; or
2.
Who is confined or committed on account of the commission of an offense for
which, in the absence of mental illness, said person would be subject to
incarceration in a penal or correctional facility.
(b)
"Patient" means a mentally disordered offender who is cared for,
treated, or transferred pursuant to this compact.
(c)
"Sending state" means a state party to this compact in which the
mentally disordered offender was convicted; or the state in which he would be
subject to trial on or conviction of an offense, except for his mental
condition; or, within the meaning of Article V of this compact, the state whose
authorities have filed a petition in connection with an untried indictment,
information or complaint.
(d)
"Receiving state" means a state party to this compact to which a
mentally disordered offender is sent for care, aftercare, treatment or
rehabilitation, or within the meaning of Article V of this compact, the state
in which a petition in connection with an untried indictment, information or complaint
has been filed.
ARTICLE
III
(a)
Each party state may make one or more contracts with any one or more of the
other party states for the care and treatment of mentally disordered offenders
on behalf of a sending state in facilities situated in receiving states, or for
the participation of such mentally disordered offenders in programs of
aftercare on conditional release administered by the receiving state. Any such
contract shall provide for:
1.
Its duration.
2.
Payments to be made to the receiving state by the sending state for patient
care, treatment, and extraordinary services, if any.
3.
Determination of responsibility for ordering or permitting the furnishing of
extraordinary services, if any.
4.
Participation in compensated activities, if any, available to patients; the
disposition or crediting of any payment received by patients on account
thereof; and the crediting of proceeds from or disposal of any products
resulting therefrom.
5.
Delivery and retaking of mentally disordered offenders.
6.
Such other matters as may be necessary and appropriate to fix the obligations,
responsibilities and rights of the sending and receiving states.
(b)
Prior to the construction or completion of construction of any facility for
mentally disordered offenders or addition to such facility by a party state,
any other party state or states may contract therewith for the enlargement of
the planned capacity of the facility or addition thereto, or for the inclusion
therein of particular equipment or structures, and for the reservation of a
specific percentum of the capacity of the facility to
be kept available for use by patients of the sending state or states so
contracting. Any sending state so contracting may, to the extent that moneys
are legally available therefor, pay to the receiving
state, a reasonable sum as consideration for such enlargement of capacity, or
provision of equipment or structures, and reservation of capacity. Such payment
may be in a lump sum or in installments as provided in the contract.
(c)
A party state may contract with any one or more other party states for the
training of professional or other personnel whose services, by reason of such
training, would become available for or be improved in respect of ability to
participate in the care and treatment of mentally disordered offenders. Such
contracts may provide for such training to take place at any facility being
operated or to be operated for the care and treatment of mentally disordered
offenders; at any institution or facility having resources suitable for the
offering of such training; or may provide for the separate establishment of
training facilities, provided that no such separate establishment shall be
undertaken, unless it is determined that an appropriate existing facility or
institution cannot be found at which to conduct the contemplated program. Any
contract entered into pursuant to this paragraph shall provide for:
1.
The administration, financing, and precise nature of the program.
2.
The status and employment or other rights of the trainees.
3.
All other necessary matters.
(d)
No contract entered into pursuant to this compact shall be inconsistent with
any provision thereof.
ARTICLE
IV
(a)
Whenever the duly constituted judicial or administrative authorities in a state
party to this compact, and which has entered into a contract pursuant to
Article III, shall decide that custody, care and treatment in, or transfer of a
patient to, a facility within the territory of another party state, or
conditional release for aftercare in another party state is necessary in order
to provide adequate care and treatment or is desirable in order to provide an
appropriate program of therapy or other treatment, or is desirable for clinical
reasons, said officials may direct that the custody, care and treatment be
within a facility or in a program of aftercare within the territory of said
other party state, the receiving state to act in that regard solely as agent
for the sending state.
(b)
The appropriate officials of any state party to this compact shall have access,
at all reasonable times, to any facility in which it has a contractual right to
secure care or treatment of patients for the purpose of inspection and visiting
such of its patients as may be in the facility or served by it.
(c)
Except as otherwise provided in Article VI, patients in a facility pursuant to
the terms of this compact shall at all times be subject to the jurisdiction of
the sending state and may at any time be removed for transfer to a facility
within the sending state, for transfer to another facility in which the sending
state may have a contractual or other right to secure care and treatment of
patients, for release on aftercare or other conditional status, for discharge, or
for any other purpose permitted by the laws of the sending state; provided that
the sending state shall continue to be obligated to such payments as may be
required pursuant to the terms of any contract entered into under the terms of
Article III.
(d)
Each receiving state shall provide regular reports to each sending state on the
patients of that sending state in facilities pursuant to this compact including
a psychiatric and behavioral record of each patient and certify said record to
the official designated by the sending state, in order that each patient may
have the benefit of his or her record in determining and altering the
disposition of said patient in accordance with the law which may obtain in the
sending state and in order that the same may be a source of information for the
sending state.
(e)
All patients who may be in a facility or receiving aftercare from a facility
pursuant to the provisions of this compact shall be treated in a reasonable and
humane manner and shall be cared for, treated and supervised in accordance with
the standards pertaining to the program administered at the facility. The fact
of presence in a receiving state shall not deprive any patient of any legal
rights which said patient would have had if in custody or receiving care,
treatment or supervision as appropriate in the sending state.
(f)
Any hearing or hearings to which a patient present in a receiving state
pursuant to this compact may be entitled by the laws of the sending state shall
be had before the appropriate authorities of the sending state, or of the
receiving state if authorized by the sending state. The receiving state shall
provide adequate facilities for such hearings as may be conducted by the
appropriate officials of a sending state. In the event such hearing or hearings
are had before officials of the receiving state, the governing law shall be
that of the sending state and a record of the hearing or hearings as prescribed
by the sending state shall be made. Said record together with any
recommendations of the hearing officials shall be transmitted forthwith to the
official or officials before whom the hearing would have been had if it had
taken place in the sending state. In any and all proceedings had pursuant to
the provisions of this paragraph, the officials of the receiving state shall
act solely as agents of the sending state and no final determination shall be
made in any matter except by the appropriate officials of the sending state.
Costs of records made pursuant to this paragraph shall be borne by the sending
state.
(g)
Patient confined pursuant to this compact shall be released within the
territory of the sending state unless the patient, and the sending and
receiving states, shall agree upon release in some other place. The sending
state shall bear the cost of such return to its territory.
(h)
Any patient pursuant to the terms of this compact shall be subject to civil
process and shall have any and all rights to sue, be sued and participate in
and derive any benefits or incur or be relieved of any obligations or have such
obligation modified or his status changed on account of any action or
proceeding in which he could have participated if in any appropriate facility
of the sending state or being supervised therefrom,
as the case may be, located within such state.
(i) The parent, guardian, trustee, or other person or
persons entitled under the laws of the sending state to act for, advise, or
otherwise function with respect to any patient shall not be deprived of or
restricted in his exercise of any power in respect of any patient pursuant to
the terms of this compact.
ARTICLE
V
(a)
Whenever the authorities responsible for the care and treatment of a mentally
disordered offender, whether convicted or adjudicated in the state or subject
to care, aftercare, treatment or rehabilitation pursuant to a contract, are of
the opinion that charges based on untried indictments, informations
or complaints in another party state present obstacles to the proper care and
treatment of a mentally disordered offender or to the planning or execution of
a suitable program for him, such authorities may petition the appropriate court
in the state where the untried indictment, information or complaint is pending
for prompt disposition thereof. If the mentally disordered offender is a
patient in a receiving state, the appropriate authorities of the sending state,
upon recommendation of the appropriate authorities in the receiving state,
shall, if they concur in the recommendation, file the petition contemplated by
this paragraph.
(b)
The court shall hold a hearing on the petition within thirty days of the filing
thereof. Such hearing shall be only to determine whether the proper
safeguarding and advancement of the public interest; the condition of the
mentally disordered offender; and the prospects for more satisfactory care,
treatment and rehabilitation of him warrant disposition of the untried
indictment, information or complaint prior to termination of the defendant's
status as a mentally disordered offender in the sending state. The prosecuting
officer of the jurisdiction from which the untried indictment, information or
complaint is pending, the petitioning authorities, and such other persons as
the court may determine shall be entitled to be heard.
(c)
Upon any hearing pursuant to this Article, the court may order such
adjournments or continuances as may be necessary for the examination or
observation of the mentally disordered offender or for the securing of
necessary evidence. In granting or denying any such adjournment or continuance,
the court shall give primary consideration to the purposes of this compact, and
more particularly to the need for expeditious determination of the legal and
mental status of a mentally disordered offender so that his care, treatment and
discharge to the community only under conditions which will be consonant with
the public safety may be implemented.
(d)
The presence of a mentally disordered offender within a state wherein a
petition is pending or being heard pursuant to this Article, or his presence
within any other state through which he is being transported in connection with
such petition or hearing, shall be only for the purposes of this compact, and
no court, agency or person shall have or obtain jurisdiction over such mentally
disordered offender for any other purpose by reason of his presence pursuant to
this Article. The mentally disordered offender shall, at all times, remain in
the custody of the sending state. Any acts of officers, employees, or agencies
of the receiving state in providing or facilitating detention, housing or
transportation for the mentally disordered offender shall be only as agents for
the sending state.
(e)
Promptly upon conclusion of the hearing the court shall dismiss the untried
indictment, information or complaint, if it finds that the purposes enumerated
in paragraph (b) of this Article would be served thereby. Otherwise, the court
shall make such order with respect to the petition and the untried indictment,
information or complaint as may be appropriate in the circumstances and
consistent with the status of the defendant as a mentally disordered offender
in the custody of and subject to the jurisdiction of the sending state.
(f)
No fact or other matter established or adjudicated at any hearing pursuant to
this Article, or in connection therewith, shall be deemed established or
adjudicated, nor shall the same be admissible in evidence, in any subsequent
prosecution of the untried indictment, information or complaint concerned in a
petition filed pursuant to this Article unless:
1.
The defendant or his duly empowered legal representative requested or expressly
acquiesced in the making of the petition, and was afforded an opportunity to
participate in person in the hearing; or
2.
The defendant himself offers or consents to the introduction of the
determination or adjudication at such subsequent proceedings.
ARTICLE
VI
(a)
Any decision of the sending state in respect of any matter over which it
retains jurisdiction pursuant to this compact shall be conclusive upon and not reviewable within the receiving state, but if at the time
the sending state seeks to remove a patient from the receiving state there is
pending against the patient within such state any criminal charge or if the
patient is suspected of having committed within such state a criminal offense,
the patient shall not be returned without the consent of the receiving state
until discharged from prosecution or other form of proceeding, imprisonment or
detention for such offense. The duly accredited officers of the sending state
shall be permitted to transport patients pursuant to this compact through any
and all states party to this compact without interference.
(b)
A patient who escapes while receiving care and treatment or who violates
provisions of aftercare by leaving the jurisdiction, or while being detained or
transported pursuant to this compact shall be deemed an escapee from the
sending state and from the state in which the facility is situated or the
aftercare was being provided. In the case of an escape to a jurisdiction other
than the sending or receiving state, the responsibility for return shall be
that of the sending state, but nothing contained herein shall be construed to
prevent or affect the activities of officers and agencies of any jurisdiction
directed toward the apprehension and return of an escapee.
ARTICLE
VII
Any
state party to this compact may accept federal aid for use in connection with
any facility or program, the use of which is or may be affected by this compact
or any contract pursuant thereto and any patient in a receiving state pursuant
to this compact may participate in any such federally aided program or activity
for which the sending and receiving states have made contractual provision;
provided that if such program or activity is not part of the customary regimen
of the facility or program the express consent of the appropriate official of
the sending state shall be required therefor.
ARTICLE
VIII
This
compact shall enter into force and become effective and binding upon the states
so acting when it has been enacted into law by any two states from among the
states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri,
Nebraska, North Dakota, Ohio, South Dakota and Wisconsin. Thereafter, this
compact shall enter into force and become effective and binding as to any other
of said states, or any other state upon similar action by such state.
ARTICLE
IX
This
compact shall continue in force and remain binding upon a party state until it
shall have enacted a statute repealing the same and providing for the sending
of formal written notice of withdrawal from the compact to the appropriate
officials of all other party states. An actual withdrawal shall not take effect
until two years after the notices provided in said statute have been sent. Such
withdrawal shall not relieve the withdrawing state from its obligations assumed
hereunder prior to the effective date of withdrawal. Before the effective date
of withdrawal, a withdrawing state shall remove to its territory, at its own
expense, such patients as it may have in other party states pursuant to the
provisions of this compact.
ARTICLE
X
Nothing
contained in this compact shall be construed to abrogate or impair any
agreement or other arrangement which a party state may have with a nonparty
state for the custody, care, treatment, rehabilitation or aftercare of patients
nor to repeal any other laws of a party state authorizing the making of
cooperative arrangements.
ARTICLE
XI
The
provisions of this compact shall be liberally construed and shall be severable. If any phrase, clause, sentence or provision of
this compact is declared to be contrary to the constitution of any
participating state or of the United States or the applicability thereof to any
government, agency, person or circumstance is held invalid, the validity of the
remainder of this compact and the applicability thereof to any government,
agency, person or circumstance shall not be affected thereby. If this compact shall
be held contrary to the constitution of any state participating therein, the
compact shall remain in full force and effect as to the remaining states and in
full force and effect as to the state affected as to all severable
matters.
Chapter 632
Comprehensive Psychiatric Services
Definitions.
632.005.
As used in chapter 631, RSMo, and this chapter,
unless the context clearly requires otherwise, the following terms shall mean:
(1)
"Comprehensive psychiatric services", any one, or any combination of
two or more, of the following services to persons affected by mental disorders
other than mental retardation or developmental disabilities: inpatient,
outpatient, day program or other partial hospitalization, emergency,
diagnostic, treatment, liaison, follow-up, consultation, education,
rehabilitation, prevention, screening, transitional living, medical prevention
and treatment for alcohol abuse, and medical prevention and treatment for drug
abuse;
(2)
"Council", the
(3)
"Court", the court which has jurisdiction over the respondent or
patient;
(4)
"Division", the division of comprehensive psychiatric services of the
department of mental health;
(5)
"Division director", director of the division of comprehensive
psychiatric services of the department of mental health, or his designee;
(6)
"Head of mental health facility", superintendent or other chief
administrative officer of a mental health facility, or his designee;
(7)
"Judicial day", any Monday, Tuesday, Wednesday, Thursday or Friday
when the court is open for business, but excluding Saturdays, Sundays and legal
holidays;
(8)
"Licensed physician", a physician licensed pursuant to the provisions
of chapter 334, RSMo, or a person authorized to
practice medicine in this state pursuant to the provisions of section 334.150, RSMo;
(9)
"Likelihood of serious harm" means any one or more of the following
but does not require actual physical injury to have occurred:
(a) A substantial risk that serious physical harm will be
inflicted by a person upon his own person, as evidenced by recent threats,
including verbal threats, or attempts to commit suicide or inflict physical
harm on himself. Evidence of substantial risk may also
include information about patterns of behavior that historically have resulted
in serious harm previously being inflicted by a person upon himself;
(b) A substantial risk that serious physical harm to a
person will result or is occurring because of an impairment in his capacity to
make decisions with respect to his hospitalization and need for treatment as
evidenced by his current mental disorder or mental illness which results in an
inability to provide for his own basic necessities of food, clothing, shelter,
safety or medical care or his inability to provide for his own mental health
care which may result in a substantial risk of serious physical harm. Evidence
of that substantial risk may also include information about patterns of
behavior that historically have resulted in serious harm to the person
previously taking place because of a mental disorder or mental illness which
resulted in his inability to provide for his basic necessities of food,
clothing, shelter, safety or medical or mental health care; or
(c) A substantial risk that serious physical harm will be
inflicted by a person upon another as evidenced by recent overt acts, behavior
or threats, including verbal threats, which have caused such harm or which
would place a reasonable person in reasonable fear of sustaining such harm.
Evidence of that substantial risk may also include information about patterns
of behavior that historically have resulted in physical harm previously being
inflicted by a person upon another person;
(10)
"Mental health coordinator", a mental health professional employed by
the state of Missouri who has knowledge of the laws relating to hospital admissions
and civil commitment and who is appointed by the director of the department, or
his designee, to serve a designated geographic area or mental health facility
and who has the powers, duties and responsibilities provided in this chapter;
(11)
"Mental health facility", any residential facility, public or
private, or any public or private hospital, which can provide evaluation,
treatment and, inpatient care to persons suffering from a mental disorder or
mental illness and which is recognized as such by the department or any
outpatient treatment program certified by the department of mental health. No
correctional institution or facility, jail, regional center or mental
retardation facility shall be a mental health facility within the meaning of
this chapter;
(12)
"Mental health professional", a psychiatrist, resident in psychiatry,
psychologist, psychiatric nurse or psychiatric social worker;
(13)
"Mental health program", any public or private residential facility,
public or private hospital, public or private specialized service or public or
private day program that can provide care, treatment, rehabilitation or
services, either through its own staff or through contracted providers, in an
inpatient or outpatient setting to persons with a mental disorder or mental
illness or with a diagnosis of alcohol abuse or drug abuse which is recognized
as such by the department. No correctional institution or facility or jail may
be a mental health program within the meaning of this chapter;
(14)
"Ninety-six hours" shall be construed and computed to exclude
Saturdays, Sundays and legal holidays which are observed either by the court or
by the mental health facility where the respondent is detained;
(15)
"Peace officer", a sheriff, deputy sheriff, county or municipal
police officer or highway patrolman;
(16)
"Psychiatric nurse", a registered professional nurse who is licensed
under chapter 335, RSMo, and who has had at least two
years of experience as a registered professional nurse in providing psychiatric
nursing treatment to individuals suffering from mental disorders;
(17)
"Psychiatric social worker", a person with a master's or further
advanced degree from an accredited school of social work, practicing pursuant
to chapter 337, RSMo, and with a minimum of one year
training or experience in providing psychiatric care, treatment or services in
a psychiatric setting to individuals suffering from a mental disorder;
(18)
"Psychiatrist", a licensed physician who in addition has successfully
completed a training program in psychiatry approved by the American Medical
Association, the American Osteopathic Association or other training program
certified as equivalent by the department;
(19)
"Psychologist", a person licensed to practice psychology under
chapter 337, RSMo, with a minimum of one year
training or experience in providing treatment or services to mentally
disordered or mentally ill individuals;
(20)
"Resident in psychiatry", a licensed physician who is in a training
program in psychiatry approved by the American Medical Association, the
American Osteopathic Association or other training program certified as
equivalent by the department;
(21)
"Respondent", an individual against whom involuntary civil detention
proceedings are instituted pursuant to this chapter;
(22)
"Treatment", any effort to accomplish a significant change in the
mental or emotional conditions or the behavior of the patient consistent with
generally recognized principles or standards in the mental health professions.
Responsibilities, powers, functions
and duties of division.
632.010.
1. The "Division of Comprehensive Psychiatric Services" is hereby
created within the department of mental health. The division shall have the
responsibility of insuring that division prevention, evaluation, treatment and
rehabilitation services are accessible, wherever possible. The division shall
have and exercise supervision of division residential facilities, day programs
and other specialized services operated by the department and oversight over
facilities, programs and services funded or licensed by the department.
2.
The powers, functions and duties of the division shall include the following:
(1) Provision of funds for the planning and implementation
of accessible programs to prevent and alleviate mental disorders and mental
illness;
(2) Review of comprehensive psychiatric service plans
submitted to receive state and federal funds allocated by the department;
(3) Provision of technical assistance and training to
community-based programs to assist in planning and implementing quality
services;
(4) Assurance of program quality in compliance with such appropriate
standards as may be established by the department;
(5) Sponsorship and encouragement of research into the
causes, effects, prevention, treatment and rehabilitation of mental disorders
and mental illness;
(6) Provision of public information relating to mental
disorders and mental illness;
(7) Cooperation with nonstate
governmental agencies and the private sector in establishing, conducting,
integrating and coordinating facilities, programs, projects and services for
persons affected by mental disorders or mental illness;
(8) Participation in developing and implementing a statewide
plan to prevent and alleviate mental disorders and mental illness and to
overcome the barriers to the treatment and rehabilitation of persons
chronically affected by mental disorders or mental illness;
(9) Encouragement of coordination of division services with
other divisions of the department and other state agencies, where appropriate;
(10) Encouragement of the utilization, support, assistance
and dedication of volunteers to participate in the treatment and rehabilitation
of persons affected by mental disorders or mental illness or to persuade such
persons to voluntarily seek appropriate services to alleviate their disorders
or illness;
(11) Evaluation, or the requirement
of the evaluation, including the collection of appropriate and necessary
information, of division programs to determine their cost-and-benefit effectiveness;
(12) Participation in developing standards for residential
facilities, day programs and specialized services operated, funded or licensed
by the department for persons affected by mental disorders or mental illness.
Division director to be chief
administrative officer.
632.015.
The division director, subject to the supervision of the director, shall be the
chief administrative officer of his division and shall exercise for the
division the powers and duties of an appointing authority under chapter 36, RSMo, to employ such administrative, technical and other
personnel, except employees of department facilities, as may be necessary for
the performance of the powers and duties of the division.
Advisory council for comprehensive psychiatric
services--members, number, terms, qualifications, appointment--organization,
meetings --duties.
632.020.
1. The
2.
The members of the council shall be appointed by the director. Members shall
serve for overlapping terms of three years each. The members of the existing
council appointed under the provisions of the executive order shall serve the
remainder of their appointed terms. At the expiration of the term of each such
member, the director shall appoint an individual who shall hold office for a
term of three years. Each member shall hold office until a successor has been
appointed. Members shall have professional, research or personal interest in
the prevention, evaluation, care, treatment and rehabilitation of persons
affected by mental disorders and mental illness. The council shall include
representatives from the following:
(1) Nongovernment organization or
groups and state agencies concerned with the planning, operation or use of
comprehensive psychiatric services;
(2) Representatives of consumers and providers of
comprehensive psychiatric services who are familiar with the need for such
services. At least one-half of the members shall be consumers. No more than
one-fourth of the members shall be vendors or members of boards of directors,
employees or officers of vendors, or any of their spouses, if such vendors
receive more than fifteen hundred dollars under contract with the department;
except that members of boards of directors of not-for-profit corporations shall
not be considered members of board of directors of vendors under this
subsection.
3.
A vacancy occurring on the council shall be filled by appointment of the
director.
4.
Meetings shall be held at least every ninety days at the call of the division
director or the council chairman, who shall be elected by the council.
5.
Each member shall be reimbursed for reasonable and necessary expenses,
including travel expenses pursuant to the travel regulations for employees of
the department, actually incurred in the performance of his official duties.
6.
The council may be divided into subcouncils in
accordance with its bylaws. The council shall study, plan and make
recommendations on the prevention, evaluation, care, treatment, rehabilitation,
housing and facilities for persons affected by mental disorders and mental
illness.
7.
No member of a state advisory council may participate in or seek to influence a
decision or vote of the council if the member would be directly involved with
the matter or if he would derive income from it. A violation of the prohibition
contained herein shall be grounds for a person to be removed as a member of the
council by the director.
8.
The council shall collaborate with the department in developing and
administering a state plan for comprehensive psychiatric services. The council
shall be advisory and shall:
(1) Promote meetings and programs for the discussion of
reducing the debilitating effects of mental disorders and mental illness and
disseminate information in cooperation with any other department, agency or
entity on the prevention, evaluation, care, treatment and rehabilitation for
persons affected by mental disorders or mental illness;
(2) Study and review current prevention, evaluation, care,
treatment and rehabilitation technologies and recommend appropriate
preparation, training, retraining and distribution of manpower and resources in
the provision of services to persons affected by mental disorders or mental
illness through private and public residential facilities, day programs and other
specialized services;
(3) Recommend what specific methods, means and procedures
should be adopted to improve and upgrade the department comprehensive
psychiatric service delivery system for citizens of this state;
(4) Participate in developing and disseminating criteria and
standards to qualify comprehensive psychiatric service residential facilities,
day programs and other specialized services in this state for funding or
licensing, or both, by the department.
Services to be provided.
632.025.
The division may provide prevention, evaluation, care, treatment,
rehabilitation and such related services directly or through performance
contracts with appropriate residential facilities, day programs or specialized
services licensed and funded by the department.
Department to develop state plan,
contents.
632.030.
1. The department shall prepare a state plan to secure coordinated prevention,
evaluation, care, treatment and rehabilitation services accessible to persons
in need of them in defined geographic areas, which plan shall be reviewed and
revised annually.
2.
The state plan shall include, but need not be limited to, the following:
(1) A needs-assessment of the state to determine
underserved, unserved and inappropriately served
populations and areas;
(2) Statements of short-term and long-term goals for meeting
the needs of the currently served, unserved,
underserved or inappropriately served populations and areas of the state;
(3) An inventory of existing private or community-based
public residential facilities, clinics, day programs and other specialized
service providers offering mental disorder or mental illness services;
(4) Evaluations of the effects of prevention, evaluation,
care, treatment and rehabilitation programs;
(5) Descriptions of the following:
(a) Methods for assuring active, consumer-oriented citizen
participation throughout the system;
(b) Strategies and procedures for encouraging, coordinating
and integrating community-based services wherever practicable to avoid
duplication by private, not-for-profit and public state and community-based
providers of services;
(c) Methods for monitoring the quality of prevention,
evaluation, care, treatment and rehabilitation services funded by the state;
(d) Rules which set standards for construction, staffing,
operations and programs, as appropriate, for any public or private entity to
meet before receiving state licensing, certification or funding; and
(e) Plans for addressing the particular mental disorder and
mental illness service needs of each region, including special strategies for
rural and urban unserved, underserved or
inappropriately served populations and areas of the state.
3.
In preparing the state plan, the department shall take into consideration its
regional plans.
Department director to establish
regions.
632.035.
The department director shall divide the state into regions. The boundaries of
such regions shall, to the extent practicable, be contiguous with relevant
boundaries of political subdivisions and health service areas.
Department director may establish regional
councils--division director to appoint members--terms and qualifications of
members.
632.040.
1. The director may establish regional councils in any of the regions. If a
regional council is established in a region, the division director shall
appoint up to twenty members who reside in the region to serve staggered
three-year terms on the councils.
2.
At least one-half of the members shall be consumers and no more than one-fourth
of the members shall be vendors, or employees, members of boards of directors
or officers of vendors, or their spouses, if such vendors receive more than
fifteen hundred dollars under contract with the department; except that members
of boards of directors of not-for-profit corporations shall not be subject to
the one-fourth limitation on the membership under this subsection.
3.
No member of a regional advisory council may participate in or seek to
influence a decision or vote of the council if the member would be directly
involved with the matter or if he would derive income from it. A violation of
the prohibition contained herein shall be grounds for a person to be removed as
a member of the council by the director.
Duties of regional advisory
councils--plans--employment of staff.
632.045.
1. Any regional advisory councils established under section 632.040 shall
participate in the preparation of regional plans and annually review, advise on and recommend them before they are transmitted to
the state advisory council and the division director. The plans shall include
at least the following:
(1) An inventory of existing private or community-based
public residential facilities, clinics, day programs and other specialized
service providers offering mental disorder or mental illness services;
(2) An assessment of needs, including any special target
populations, of unserved, underserved or
inappropriately served persons;
(3) A statement of specific goals for the region.
*2.
Any staff of such regional advisory councils shall be provided only from funds
appropriated specifically for that purpose. This subsection shall become
effective
Division to identify community-based
services.
632.050.
The division shall identify community-based services in each geographic area as
entry and exit points into and from the state mental health delivery system
offering a continuum of comprehensive mental health services.
Division to provide services.
632.055.
The division shall provide or arrange for the provision of services in the
least restrictive environment to mentally disordered and mentally ill persons
based upon their diagnoses and individualized treatment plans on a continuum of
services.
Department may establish outpatient clinics--cooperation
with others.
632.060.
The department may establish clinics for the evaluation, care, treatment or
rehabilitation, on an outpatient basis, of persons affected by mental disorders
or mental illness. The department shall cooperate with political subdivisions,
schools and other organizations in the geographic area where it locates its
clinic to establish and further programs of education and training for the
prevention of mental disorders and mental illness.
Family services division to cooperate with mental health
department --consent for minors required.
632.070.
The division of family services of the department of social services through
its county family service offices shall cooperate with the facilities, programs
and services operated or funded by the department in locating, referring and
interviewing any persons who are in need of comprehensive psychiatric services.
The parents or legal custodians of any minors shall consent to the treatment of
the minors, and they shall be advised that they have the right to consult their
regular physicians before giving their consent to any treatment.
Adults to be accepted for evaluation, when, by whom--may
then be admitted to mental health facility--consent required.
632.105.
1. The head of a private mental health facility may, and the head of a
department mental health facility shall, except in the case of a medical
emergency and subject to the availability of suitable programs and
accommodations, accept for evaluation, on an outpatient basis if practicable,
any person eighteen years of age or over who applies for his admission. The
department may require that a community-based service where the person resides
perform the evaluation pursuant to an affiliation agreement and contract with
the department.
2.
If a person is diagnosed as having a mental disorder, other than mental
retardation or developmental disability without another accompanying mental
disorder, and is determined to be in need of inpatient treatment, the person
may be admitted by a private mental health facility and shall be admitted by a
department mental health facility, if suitable accommodations are available,
for care and treatment as an inpatient for such periods and under such
conditions as authorized by law. The department may require that a
community-based service where the patient resides admit the person for
inpatient care and treatment pursuant to an affiliation agreement and contract
with the department.
3.
A person who is admitted under this section is a voluntary patient and shall
have the right to consent to evaluation, care, treatment and rehabilitation and
shall not be medicated without his prior voluntary and informed consent; except
that medication may be given in emergency situations.
Minors to be accepted for evaluation, when, by whom--may
then be admitted to mental health facility--parent or guardian to consent
--peace officer may transport to facility, when.
632.110.
1. The head of a private mental health facility may, and the head of a
department mental health facility shall, except in the case of a medical
emergency and subject to the availability of suitable programs and
accommodations, accept for evaluation, on an outpatient basis if practicable,
any minor for whom an application for voluntary admission is made by his parent
or other legal custodian. The department may require that a community-based
service where the minor resides perform the evaluation pursuant to an
affiliation agreement or contract with the department.
2.
If the minor is diagnosed as having a mental disorder, other than mental
retardation or developmental disability without another accompanying mental
disorder, and found suitable for inpatient treatment as a result of the
evaluation, the minor may be admitted by a private mental health facility or
shall be admitted by a department mental health facility, if suitable
accommodations are available, for care, treatment and rehabilitation as an
inpatient for such periods and under such conditions as authorized by law. The
department may require that a community-based service where the patient resides
admit the person for inpatient care, treatment and rehabilitation pursuant to
an affiliation agreement and contract with the department.
3.
The parent or legal custodian who applied for the admission of the minor shall
have the right to authorize his evaluation, care, treatment and rehabilitation
and the right to refuse permission to medicate the minor; except that
medication may be given in emergency situations.
4.
The parent or legal custodian may request a peace officer to take a minor into
custody and transport him to the mental health facility for evaluation if the
parent or legal custodian applies for such evaluation under subsection 1 of
this section.
Juveniles to be admitted by heads of
facilities when committed.
632.115.
The head of a private mental health facility may, and the head of a public
mental health facility shall, except in the case of medical emergency and
subject to the availability of suitable programs and accommodations, admit any
minor who has symptoms of mental disorder other than mental retardation or
developmental disability, who is under the jurisdiction of a juvenile court and
who is committed to a facility not operated by the state of Missouri under
section 211.181, RSMo, or to the custody of the
director pursuant to sections 211.201 to 211.207, RSMo,
for assignment by the director to an appropriate facility.
Incompetents to be accepted by heads of facilities upon
application --duration of admission for evaluation--consent may be authorized.
632.120.
1. The head of a private mental health facility may, and the head of a
department facility shall, except in the case of a medical emergency and
subject to the availability of suitable programs and accommodations, accept for
evaluation and treatment, on an outpatient basis if practicable, any person who
has been declared incapacitated by a court of competent jurisdiction and for
whom an application for voluntary admission is made by his guardian. The
department may require that a community-based service where the person resides
perform the evaluation pursuant to an affiliation agreement and contract with
the department.
2.
If the person is diagnosed as having a mental disorder, other than mental
retardation or developmental disability without another accompanying mental
disorder, and the person is found suitable for inpatient treatment as a result
of the evaluation, the person may be admitted by a private mental health
facility or shall be admitted by a public mental health facility, if suitable
accommodations are available, for care, treatment and rehabilitation as an
inpatient for up to thirty days after admission for evaluation and treatment.
3.
If further inpatient services are recommended, the person may remain in the
facility only if his guardian is authorized by the court to continue the
inpatient hospitalization. The court may authorize the guardian to consent to
evaluation, care, treatment, including medication, and rehabilitation on an
inpatient basis.
Release of voluntary patients--voluntary patient may be
involuntarily detained, procedure.
632.150.
1. A voluntary patient who has applied for his own admission may request his
release either orally or in writing to the head of the mental health facility
and shall be released immediately; except, that if the head of the facility
determines that he is mentally disordered and, as a result, presents a
likelihood of serious physical harm to himself or others, the head of the
facility may refuse the request for release.
2.
If the request for release is refused, the mental health facility may detain
the person only if a mental health coordinator, a licensed physician, a
registered professional nurse designated by the facility and approved by the
department, a mental health professional or a peace officer completes an
application for detention for evaluation and treatment to begin the involuntary
detention of the patient under this chapter.
Release of voluntary minor patients, consent required--may
be involuntarily detained, when, procedure.
632.155.
1. A voluntary patient who is a minor and who requests his release either
orally or in writing, or whose release is requested in writing to the head of
the facility by his parent, spouse, adult next of kin, or person entitled to
his custody, shall be released immediately; except, that if the patient was
admitted on the application of another person, his release shall be conditioned
upon receiving the consent of the person applying for his admission.
2.
If the head of the mental health facility determines that the minor is mentally
disordered and, as a result, presents a likelihood of serious physical harm to himself or others, the head of the facility may refuse the
release. The mental health facility may detain the minor only if a mental
health coordinator, a licensed physician, a mental health professional or a
registered professional nurse designated by the facility and approved by the
department completes an application for detention for evaluation and treatment
to begin the involuntary detention of the minor under this chapter or, if
appropriate, the minor is detained in the facility under the provisions of
chapter 211, RSMo.
Review of patient's condition, by whom,
when--release or placement --copy of review to be given.
632.175.
1. At least once every one hundred eighty days, the head of each mental health
facility shall cause the condition of each patient to be reviewed for the
purpose of determining whether the patient needs further hospitalization or
should be released. If, as a result of such review, it is determined that
inpatient care, treatment and rehabilitation are no longer appropriate, the
head of the facility shall discharge, or initiate proceedings to discharge, the
patient. If a patient meets the criteria for placement, the head of the
facility shall refer him for placement.
2.
In making the review required by this section, the head of the facility shall
satisfy himself that the patient is receiving care,
treatment or rehabilitation in the least restrictive environment available.
3.
If the patient has a guardian, copies of this review and the person's
individualized treatment plan shall be sent to the guardian and the court.
Procedure when a likelihood of serious harm is alleged.
632.300.
1. When a mental health coordinator receives information alleging that a
person, as the result of a mental disorder, presents a likelihood of serious
harm to himself or others, he shall:
(1) Conduct an investigation;
(2) Evaluate the allegations and the data developed by
investigation; and
(3) Evaluate the reliability and credibility of all sources
of information.
2.
If, as the result of personal observation or investigation, the mental health
coordinator has reasonable cause to believe that such person is mentally
disordered and, as a result, presents a likelihood of serious harm to himself
or others, the mental health coordinator may file an application with the court
having probate jurisdiction pursuant to the provisions of section 632.305;
provided, however, that should the mental health coordinator have reasonable
cause to believe, as the result of personal observation or investigation, that
the likelihood of serious harm by such person to himself or others as a result
of a mental disorder is imminent unless the person is immediately taken into
custody, the mental health coordinator shall request a peace officer to take or
cause such person to be taken into custody and transported to a mental health
facility in accordance with the provisions of subsection 3 of section 632.305.
3.
If the mental health coordinator determines that involuntary commitment is not
appropriate, he should inform either the person, his
family or friends about those public and private agencies and courts which
might be of assistance.
Detention for evaluation and
treatment, who may request--procedure --duration--disposition after
application.
632.305.
1. An application for detention for evaluation and treatment may be executed by
any adult person, who need not be an attorney or represented by an attorney,
including the mental health coordinator, on a form provided by the court for
such purpose, and must allege under oath that the applicant has reason to
believe that the respondent is suffering from a mental disorder and presents a
likelihood of serious harm to himself or to others. The application must
specify the factual information on which such belief is based and should
contain the names and addresses of all persons known to the applicant who have
knowledge of such facts through personal observation.
2.
The filing of a written application in court by any adult person, who need not
be an attorney or represented by an attorney, including the mental health
coordinator, shall authorize the applicant to bring the matter before the court
on an ex parte basis to determine whether the respondent should be taken into
custody and transported to a mental health facility. The application may be
filed in the court having probate jurisdiction in any county where the
respondent may be found. If the court finds that there is probable cause,
either upon testimony under oath or upon a review of affidavits, to believe
that the respondent may be suffering from a mental disorder and presents a
likelihood of serious harm to himself or others, it shall direct a peace
officer to take the respondent into custody and transport him to a mental
health facility for detention for evaluation and treatment for a period not to
exceed ninety-six hours unless further detention and treatment is authorized
pursuant to this chapter. Nothing herein shall be construed to prohibit the
court, in the exercise of its discretion, from giving the respondent an
opportunity to be heard.
3.
A mental health coordinator may request a peace officer to take or a peace
officer may take a person into custody for detention for evaluation and
treatment for a period not to exceed ninety-six hours only when such mental health
coordinator or peace officer has reasonable cause to believe that such person
is suffering from a mental disorder and that the likelihood of serious harm by
such person to himself or others is imminent unless such person is immediately
taken into custody. Upon arrival at the mental health facility, the peace
officer or mental health coordinator who conveyed such person or caused him to
be conveyed shall either present the application for detention for evaluation
and treatment upon which the court has issued a finding of probable cause and
the respondent was taken into custody or complete an application for initial
detention for evaluation and treatment for a period not to exceed ninety-six
hours which shall be based upon his own personal observations or investigations
and shall contain the information required in subsection 1 of this section.
4.
If a person presents himself or is presented by others to a mental health
facility and a licensed physician, a registered professional nurse or a mental
health professional designated by the head of the facility and approved by the
department for such purpose has reasonable cause to believe that the person is
mentally disordered and presents an imminent likelihood of serious harm to
himself or others unless he is accepted for detention, the licensed physician,
the mental health professional or the registered professional nurse designated
by the facility and approved by the department may complete an application for
detention for evaluation and treatment for a period not to exceed ninety-six
hours. The application shall be based on his own
personal observations or investigation and shall contain the information
required in subsection 1 of this section.
Facilities to accept certain
applicants--evaluation to follow --transportation back to place of residence.
632.310.
1. Whenever a court has authorized the initial detention and evaluation of a
respondent pursuant to subsection 2 of section 632.305, or whenever a mental health
coordinator submits an application for initial detention and evaluation
pursuant to subsection 3 of section 632.305, or whenever a licensed physician,
a registered professional nurse designated by the facility and approved by the
department, or a mental health professional submits an application for initial
detention and evaluation pursuant to subsection 4 of section 632.305, a public
mental health facility shall, and a private mental health facility may
immediately accept such application and the respondent on a provisional basis,
and the facility shall then evaluate the respondent's condition and admit him
for treatment or release him in accordance with the provisions of this chapter.
2.
Whenever a peace officer applies for initial detention and evaluation pursuant
to subsection 3 of section 632.305, the mental health facility may, but is not
required to, accept the application and the respondent. If the facility accepts
the application and the respondent, the facility shall evaluate the respondent's
condition and admit him for treatment or release him in accordance with the
provisions of this chapter.
3.
If the respondent is not accepted for admission by a facility providing ninety-six-hour
evaluation and treatment, the facility shall immediately furnish
transportation, if not otherwise available, to return the respondent to his
place of residence or other appropriate place; provided, that in the case of a
person transported to the facility by a peace officer or other governmental
agency, such peace officer or agency shall furnish or arrange for such
transportation.
4.
The department may require, pursuant to an affiliation agreement and contract
with a community-based service certified by the department to serve the catchment area where a respondent whose mental disorder
consists of alcohol or drug abuse resides, that the service immediately accept
the application and respondent engaging in alcohol or drug abuse on a
provisional basis and that the service then evaluate such respondent's
condition and admit him for treatment for up to ninety-six hours, petition for
further detention and treatment, or release him in accordance with the
provisions of chapter 631, RSMo.
Copies of admission application to
be furnished.
632.315.
Any mental health facility accepting a respondent pursuant to section 632.310
shall be furnished a copy of the application for initial detention and
evaluation. If a person is involuntarily detained in a mental health facility
pursuant to section 632.310, no later than twenty-four hours after his arrival,
excluding Saturdays, Sundays and legal holidays, the head of the mental health
facility or the mental health coordinator shall file with the court the
application, a copy of the notice required by section 632.325 and proof that
the notice was given. The person's designated attorney shall receive a copy of
all documents. The head of the mental health facility shall send copies of all
completed applications, whether accepted for admission or not, to the
designated mental health coordinator for the region.
Time limits for certain procedures.
632.320.
1. Within three hours of the time at which the respondent arrives at a mental
health facility he shall:
(1) Be seen by a mental health professional or registered
professional nurse; and
(2) Be given a copy of the application for initial detention
and evaluation, a notice of rights pursuant to section 632.325 and a notice
giving the name, business address and telephone number of the attorney
appointed to represent him; and
(3) Be provided assistance in contacting the appointed
attorney or an attorney of his own choosing, if so
requested.
2.
Within eighteen hours after the respondent arrives at the mental health
facility, he shall be examined by a licensed physician.
3.
Within four days after the respondent arrives at the mental health facility,
unless sooner released, the mental health coordinator shall meet with the
respondent and explain his statutory rights under this chapter.
Information to be furnished to patient and others, when.
632.325.
If the respondent is accepted for evaluation or for evaluation and treatment
pursuant to this chapter, he shall be advised, orally and in writing, of the
information contained in subdivisions (1) through (11) of this section. The respondent's
guardian and, if possible and the respondent consents, a responsible member of
his immediate family shall be advised, within eight hours either orally or in
writing, of the information contained in subdivisions (1) through (11) of this
section. The personnel of the mental health facility to which the respondent is
taken or the mental health coordinator shall advise the aforementioned
individuals that unless the respondent is released or voluntarily admits
himself within ninety-six hours of the initial detention:
(1) He may be detained for ninety-six hours from the time of
his initial detention to be evaluated and treated;
(2) Within the ninety-six hours, the head of the mental
health facility or the mental health coordinator may file a petition to have
him detained for an additional period not to exceed twenty-one days, after a
court hearing;
(3) He will be given a judicial hearing within two judicial
days after the day the petition for additional detention is filed;
(4) An attorney has been appointed who will represent him
before and after the hearing and who will be notified as soon as possible;
provided, however, that he also has the right to private counsel of his own
choosing and at his own expense;
(5) He has the right to communicate with counsel at all
reasonable times and to have assistance in contacting such counsel;
(6) The purpose of the evaluation is to determine whether he
meets the criteria for civil detention under this chapter and that anything he
says to personnel at the mental health facility may be used in making that
determination, may result in involuntary detention proceedings being filed
against him and may be used at the court hearing;
(7) He has the right to present evidence and to
cross-examine witnesses who testify against him at the hearing;
(8) During the period prior to being examined by a licensed
physician, he may refuse medication unless he presents an imminent likelihood
of serious physical injury to himself or others;
(9) He has the right to refuse medication except for
lifesaving treatment beginning twenty-four hours prior to the hearing for
twenty-one-day detention;
(10) He has the right to request that the hearing be held in
his county of residence if he is a resident of this state;
(11) He has the right to have an interpreter assist him to
communicate, at the facility or during the hearing, or both, if he has impaired
hearing or does not speak English.
Additional detention and treatment may be
requested--contents of petition.
632.330.
1. At the expiration of the ninety-six hour period, the respondent may be
detained and treated involuntarily for an additional two judicial days only if
the head of the mental health facility or a mental health coordinator either
has filed a petition for additional inpatient detention and treatment not to
exceed twenty-one days or has filed a petition for outpatient detention and
treatment for a period not to exceed one hundred eighty days.
2.
Within ninety-six hours following initial detention, the head of the facility
or the mental health coordinator may file or cause to be filed either a
petition for a twenty-one-day inpatient involuntary detention and treatment
period or a petition for outpatient detention and treatment for a period not to
exceed one hundred eighty days, provided he has reasonable cause to believe
that the person is mentally ill and as a result presents a likelihood of
serious harm to himself or others. The court shall serve the petition and list
of prospective witnesses for the petitioner upon the respondent and his
attorney at least twenty-four hours before the hearing. The head of the
facility shall also notify the mental health coordinator if the petition is not
filed by the mental health coordinator. The petition shall:
(1) Allege that the respondent, by reason of mental illness,
presents a likelihood of serious harm to himself or to others;
(2) Allege that the respondent is in need of continued
detention and treatment either on an inpatient basis or on an outpatient basis;
(3) Allege the specific behavior of
the respondent or the facts which support such conclusion;
(4) Affirm that attempts were made to provide necessary
care, treatment and services in the least restrictive environment to the
respondent on a voluntary basis, but either the petitioner believes that the
respondent lacks the capacity to voluntarily consent to care, treatment and
services or the respondent refuses to voluntarily consent to care, treatment
and services such that proceeding with a petition for the respondent's civil
detention in the least restrictive environment is necessary;
(5) Allege that there will be appropriate support from
family, friends, case managers or others during the period of outpatient detention
and treatment in the community if such commitment is sought;
(6) Specify the mental health program that is appropriate to
handle the respondent's condition and that has agreed to accept the respondent;
(7) Specify the range of care, treatment and services that
shall be provided to the respondent if the petition for further detention is
sustained by the court;
(8) Name the entities that have agreed to fund and provide
the specified interventions; and
(9) Be verified by a psychiatrist or by a licensed physician
and a mental health professional who have examined the respondent.
3.
The petitioner shall consider whether based on the respondent's condition and
treatment history, the respondent meets the criteria in chapter 475, RSMo, so that appointment of a full or limited guardian or
conservator is appropriate for the court to consider, and if deemed so, the
petitioner then shall proceed as specified in subsection 4 of this section.
4.
If the head of the mental health facility, or his designee, or the mental
health coordinator believes that the respondent, because of a mental illness or
mental disorder, may be incapacitated or disabled as defined in chapter 475, RSMo, the head of the mental health facility or mental
health coordinator shall cause a petition to be filed pursuant to section
475.060, RSMo, and section 475.061, RSMo, if applicable, with the court having probate
jurisdiction as determined by section 475.035, RSMo.
In addition, if the head of the mental health facility, his designee or the mental
health coordinator believes it appropriate, he shall proceed with obtaining an
order for the respondent's temporary emergency detention as provided for in
section 475.355, RSMo. Furthermore, the hearing on
the petition filed pursuant to chapter 475, RSMo,
shall be conducted pursuant to the requirements of section 475.075, RSMo, and other appropriate sections of chapter 475, RSMo, and shall be held within two judicial days after
termination of the ninety-six-hour civil detention period unless continued for
good cause shown. Nothing contained in this subsection shall restrict or
prohibit the head of the mental health facility, his designee or the mental
health coordinator from proceeding under the appropriate provisions of this
chapter if the petition for guardianship or conservatorship
is denied.
Court procedures relating to continued detention or
outpatient detention and treatment--continued detention may be
ordered--patient's rights relating thereto.
632.335.
1. The petition for additional inpatient detention and treatment not to exceed
twenty-one days or the petition for outpatient detention and treatment not to
exceed one hundred eighty days shall be filed with the court having probate
jurisdiction. At the time of filing the petition, the court clerk shall set a
date and time for the hearing which shall take place within two judicial days
of the filing of the petition. The clerk shall promptly notify the respondent,
his attorney, the petitioner and the petitioner's attorney of the date and time
for the hearing. The court shall not grant continuances except upon a showing
of good and sufficient cause. If a continuance is granted, the court, in its
discretion, may order the person released pending the hearing upon conditions
prescribed by the court. The court may order the continued detention and
treatment of the person at a mental health facility pending the continued
hearing, and a copy of such order shall be furnished to the facility.
2.
The hearing shall be conducted in as informal a manner as may be consistent
with orderly procedure and in a physical setting not likely to have a harmful
effect on the respondent. Due consideration shall be given by the court to
holding a hearing at the mental health facility. The respondent shall have the
following rights in addition to those specified elsewhere:
(1) To be represented by an attorney;
(2) To present evidence on his own behalf;
(3) To cross-examine witnesses who testify against him;
(4) To remain silent;
(5) To view and copy all petitions and reports in the court
file of his case;
(6) To have the hearing open or closed to the public as he
elects;
(7) To be proceeded against according to the rules of
evidence applicable to civil judicial proceedings;
(8) A hearing before a jury if requested by the patient or
his attorney.
3.
The respondent shall be present at the hearing, unless the respondent's
physical condition is such that he cannot be present in the courtroom or if the
court determines that the respondent's conduct in the courtroom is so
disruptive that the proceedings cannot reasonably continue.
4.
At the conclusion of the hearing, if the court finds, based upon clear and
convincing evidence, that respondent, as the result of mental illness, presents
a likelihood of serious harm to himself or to others, and that a mental health
program appropriate to handle the respondent's condition has agreed to accept
him, the court shall order either that the respondent be detained for inpatient
involuntary treatment in the least restrictive environment for a period not to
exceed twenty-one days or be detained for outpatient detention and treatment
under the supervision of a mental health program in the least restrictive
environment for a period not to exceed one hundred eighty days.
Immediate inpatient detention during
court-ordered outpatient detention and treatment, procedure.
632.337.
1. When the court has ordered up to one hundred eighty days of outpatient
detention and treatment pursuant to section 632.335 or 632.350 or 632.355, and
the supervisory mental health program has good cause to believe that immediate
detention in a more appropriate least restrictive environment is required
because the respondent presents a likelihood of serious harm due to mental
illness, the supervisory mental health program may direct that the respondent
be detained for up to ninety- six hours at an appropriate mental health program
that has agreed to accept the respondent and may authorize the sheriff to
detain and transport the respondent to that mental health program. Detention
for more than ninety- six hours shall be pursuant to section 632.330.
2.
Evidence of detention for ninety-six-hour periods during the one hundred
eighty-day outpatient detention and treatment may be considered by the court in
determining additional periods of detention and treatment.
Further additional detention or outpatient detention and
treatment may be requested--hearing to be held, when--treatment plan to be
presented.
632.340.
1. Before the expiration of the twenty-one-day inpatient detention and
treatment period ordered pursuant to section 632.335, the court may order the
respondent to be detained and treated involuntarily for an additional period
not to exceed ninety inpatient days or may order the respondent to be detained
for outpatient detention and treatment for a period not to exceed one hundred
eighty days; provided, that:
(1) The respondent is mentally ill and continues to present
a likelihood of serious harm to himself or others; and
(2) The court, after a hearing, orders the respondent
detained and treated for the additional period.
2.
If, within seventeen days of the court hearing described in section 632.335,
the head of the mental health program or the mental health coordinator has
reasonable cause to believe that the respondent is mentally ill and as a result
presents a likelihood of serious harm to himself or others, and believes that
further detention and treatment is necessary, he shall file, or cause to be
filed, with the court a petition for ninety days additional detention and
treatment or a petition for outpatient detention and treatment for a period not
to exceed one hundred eighty days. The court shall immediately set a date and
time for a hearing on the petition, which shall take place within four judicial
days of the date of the filing of the petition. The court shall serve a copy of
the petition and the notice of the date and time of the hearing upon the
petitioner, the respondent, and their attorneys as promptly as possible, but
not later than two judicial days after the filing of the petition. The
petitioner shall also file with the court, for the court to serve upon the
respondent's attorney not later than two judicial days after the filing of the
petition, a list of the proposed witnesses for the petitioner. The head of the
mental health program shall notify the mental health coordinator if the
petition is not filed by the mental health coordinator. The petition shall
comply with the requirements of section 632.330, and an individualized
treatment plan for the respondent shall be attached thereto.
Physician or licensed psychologist
to be appointed, qualifications --detention to be continued, how long.
632.345.
1. If requested by the respondent, the court shall appoint an available
licensed physician or licensed psychologist to examine him and testify at the
respondent's request. If the respondent or his counsel so request, the court
shall not appoint a physician or licensed psychologist who is on the staff of
the program wherein the person is detained, and if the respondent is detained
in a program operated by the department and respondent or his counsel so
request, the court shall not appoint a physician or licensed psychologist who
is an employee of the department.
2.
The court may grant continuances but shall do so only upon a showing of good and
sufficient cause.
3.
The respondent shall continue to be detained and treated pending the hearing
unless released by order of the court. If a continuance is granted, the court,
in its discretion, may order respondent released upon conditions described by
the court pending the hearing. If no order has been made within thirty days
after the filing of the petition, not including extensions of time requested by
the respondent and granted, the respondent shall be
released.
Conduct of hearing--jury question--result.
632.350.
1. The hearing for a ninety-day inpatient detention and treatment period or for
outpatient detention and treatment for a period not to exceed one hundred
eighty days shall be conducted in as informal a manner as may be consistent
with orderly procedure and in a physical setting not likely to have a harmful
effect on the mental health of the respondent. If a jury trial is not
requested, due consideration shall be given by the court to holding a hearing
at the mental health program. The hearing shall be held in accordance with the
provisions set forth in section 632.335.
2.
The burden of proof at the hearing shall be by clear and convincing evidence
and shall be upon the petitioner.
3.
If the matter is tried before a jury, the jury shall determine and shall be
instructed only upon the issues of whether or not the respondent is mentally
ill and, as a result, presents a likelihood of serious harm to himself or others. The remaining procedures for the jury
trial shall be as in other civil matters.
4.
The respondent shall not be required to file an answer or other responsive
pleading.
5.
At the conclusion of the hearing, if the court or jury finds that the
respondent, as the result of mental illness, presents a likelihood of serious
harm to himself or to others, and the court finds that a program appropriate to
handle the respondent's condition has agreed to accept him, the court shall
order the respondent to be detained for involuntary treatment in the least
restrictive environment for a period not to exceed ninety days or for
outpatient detention and treatment under the supervision of a mental health
program in the least restrictive environment for a period not to exceed one
hundred eighty days.
Additional detention or period of outpatient detention and
treatment may be ordered, when.
632.355.
1. At the expiration of the ninety-day inpatient commitment period ordered by
the court pursuant to section 632.350, the respondent may be detained and
treated as an involuntarily inpatient for an additional period of time not to
exceed one year or such lesser period of time as determined by the court or may
be detained for outpatient detention and treatment for a period of time not to
exceed one hundred eighty days; provided, that:
(1) The respondent is mentally ill and continues to present
a likelihood of serious harm to himself or to others; and
(2) The court after a hearing orders the person detained and
treated for the additional period.
2.
Within the ninety-day commitment period, the head of the mental health program
or the mental health coordinator may file or cause to be filed, in compliance
with the requirements of section 632.330, a petition for a one-year inpatient
detention and treatment period or a petition for outpatient detention and
treatment for a period not to exceed one hundred eighty days if he has
reasonable cause to believe that the respondent is mentally ill and as a result
presents a likelihood of serious harm to himself or others, and that further
detention and treatment is necessary pursuant to an individualized treatment
plan prepared by the program and filed with the court. Procedures specified in
sections 632.340, 632.345 and 632.350 shall be followed.
3.
At the conclusion of the hearing, if the court or jury finds that the
respondent, as the result of mental illness, presents a likelihood of serious
harm to himself or others, and the court finds that a program appropriate to
handle the respondent's condition has agreed to accept him, the court shall
order that the respondent be detained for involuntary treatment in the least
restrictive environment for a period not to exceed one year or for outpatient
detention and treatment under the supervision of a mental health program in the
least restrictive environment for a period not to exceed one hundred eighty
days.
Discharge of patient,
when--procedure.
632.360.
At the end of any detention period ordered by the court under this chapter, the
respondent shall be discharged unless a petition for further detention is filed
and heard in the same manner as provided herein. Successive one-year detention
periods, or successive one hundred eighty-day outpatient detention periods, are
permissible on the same grounds and pursuant to the same procedures as the
initial detention period. No order of civil detention under this chapter may
exceed one year for an inpatient detention period or one hundred eighty days
for an outpatient detention period.
Where detention to take place.
632.365.
Notwithstanding any other provision of the law to the contrary, whenever a
court orders a person detained for involuntary treatment in a mental health
program operated by the department, the order of detention shall be to the
custody of the director of the department, who shall determine where detention
and involuntary treatment shall take place in the least restrictive
environment, be it an inpatient or outpatient setting.
Transfer of patient by department--hearing on transfer of
minor to adult ward--consent required--notice to be given--considerations
--transfer to federal facility, notice, restrictions.
632.370.
1. The department may transfer, or authorize the transfer of, an involuntary
patient detained under this chapter, chapter 211, RSMo,
chapter 475, RSMo, or chapter 552, RSMo, from one mental health program to another if the
department determines that it would be consistent with the medical needs of the
patient to do so. If a minor is transferred from a ward for minors to an adult
ward, the department shall conduct a due process hearing within six days of
such transfer during which hearing the head of the program shall have the
burden to show that the transfer is appropriate for the medical needs of the
minor. Whenever a patient is transferred, written notice thereof shall be given
after obtaining the consent of the patient, his parent if he is a minor or his
legal guardian to his legal guardian, parents and spouse, or, if none be known,
his nearest known relative or friend. In all such transfers, due consideration
shall be given to the relationship of the patient to his family, legal guardian
or friends, so as to maintain relationships and encourage visits beneficial to
the patient. The head of the mental health program shall notify the court
ordering detention or commitment, the patient's last known attorney of record
and the mental health coordinator for the region, and if the person was
committed pursuant to chapter 552, RSMo, to the
prosecuting attorney of the jurisdiction where the person was tried and
acquitted, of any transfer from one mental health facility to another. The
prosecutor of the jurisdiction where the person was tried and acquitted shall
use their best efforts to notify the victims of dangerous felonies.
Notification by the appropriate person or agency by certified mail to the most
current address provided by the victim shall constitute compliance with the
victim notification requirement of this section. In the case of a patient
committed under chapter 211, RSMo, the court, on its
own motion, may hold a hearing on the transfer to determine whether such
transfer is appropriate to the medical needs of the patient.
2.
Upon receipt of a certificate of an agency of the United States that facilities
are available for the care or treatment of any individual heretofore ordered
involuntarily detained, treated and evaluated pursuant to this chapter in any
facility for the care or treatment of the mentally ill, mentally retarded or
developmentally disabled and that such individual is eligible for care or
treatment in a hospital or institution of such agency, the department may cause
his transfer to such agency of the United States for hospitalization. Upon
effecting any such transfer, the court ordering hospitalization, the legal
guardian, spouse and parents, or, if none be known, his nearest known relative
or friend shall be notified thereof immediately by the department. No person
shall be transferred to an agency of the United States if he is confined
pursuant to a conviction for any felony or misdemeanor or if he has been acquitted
of any felony or misdemeanor solely on the ground of mental illness, unless
prior to transfer the court originally ordering confinement of such person
enters an order for the transfer after appropriate motion and hearing. Any
person transferred to an agency of the
Patient to be evaluated,
when--report to certain persons--court may consider continuation of detention.
632.375.
1. At least once every one hundred eighty days, the head of each mental health
program shall have each respondent who is detained at the program for a
one-year period under this chapter examined and evaluated to determine if the
respondent continues to be mentally ill, and as a result presents a likelihood
of serious harm to himself or others. The court, the mental health coordinator
for the region, the respondent and the respondent's attorney shall be provided
copies of the report of the examination and evaluation described by this
section and the respondent's individualized treatment plan.
2.
Upon receipt of the report, the court may, upon its own motion, or shall, upon
the motion of the respondent, order a hearing to be held as to the need for
continued detention and involuntary treatment. At the conclusion of the
hearing, the court may order:
(1) The discharge of the respondent; or
(2) An appropriate least restrictive course of detention and
involuntary treatment; or
(3) The respondent to be remanded to the mental health
program for the unexpired portion of the original
commitment order.
Provisions of chapter not to apply
to certain persons.
632.380.
Persons who are mentally retarded, developmentally disabled, senile or impaired
by alcoholism or drug abuse shall not be detained judicially under this
chapter, unless they are also mentally ill and as a result present likelihood
of serious harm to themselves or to others. Such persons may, however, be
committed upon court order under this chapter and the provisions of chapter
475, RSMo, relating to incapacitated persons,
pursuant to chapter 211, RSMo, relating to juveniles,
or may be admitted as voluntary patients under section 632.105 or 632.120.
Patient to be placed outside
facility, when--conditions--duration --furloughs--modification of
orders--notice requirements.
632.385.
1. The head of a mental health facility shall release a patient, whether
voluntary or involuntary, from the facility to the least restrictive
environment, including referral to and subsequent placement in the placement
program of the department, when he believes that such release is in the best
interests of the patient. Release to the least restrictive environment shall
include provisions for continuing responsibility to and by the facility.
2.
Release to the least restrictive environment may be conditioned on the patient
receiving outpatient care as prescribed by the head of the mental health
facility from which the patient is being released. The period of treatment in
the least restrictive environment shall not exceed the period of one year.
3.
The facility or agency which is to provide treatment in the least restrictive
environment must agree in writing to assume such responsibility. A copy of the
conditions for release shall be given to the patient, to the probate division
of the circuit court having jurisdiction and the mental health facility
providing treatment.
4.
The head of a mental health facility may permit a respondent detained for
treatment to leave the facility for prescribed short periods on trial visit
during his detention subject to conditions prescribed by the head of the mental
health facility.
5.
The head of the mental health facility providing treatment may modify the
conditions for continued release from the facility to the least restrictive
environment when such modification is in the best interest of the patient.
Notification of any changes shall be sent to the patient and to the court
within ninety-six hours if the patient is involuntarily detained under this
chapter. Upon a receipt of a notification returning the patient to the facility
as an inpatient, the committing court shall, if necessary, order the sheriff or
other law enforcement official to apprehend and transport the patient to the
facility. The committing court may, on its own motion or shall upon the
respondent's motion, order a hearing to be held on the need for such change.
Head of program to release certain patients--notification to
interested parties--involuntary patient may become voluntary, notification to
interested parties.
632.390.
1. The head of a mental health program shall release any person who is
involuntarily detained under this chapter when, in his opinion, the person is
no longer mentally ill or, although mentally ill, does not present a likelihood
of serious harm to himself or others, even though the detention period has not
expired.
2.
Whenever the head of a mental health program discharges a person prior to the
expiration of the detention order, he shall notify in writing the court and the
mental health coordinator.
3.
Whenever a respondent voluntarily admits himself and
the head of a mental health program accepts the admission application submitted
by respondent in good faith under section 632.105, the respondent's involuntary
detention shall cease, and the head of the program shall notify, in writing,
the court and the mental health coordinator.
Release of patient involuntarily detained, duties of
department --educational materials--disclosure of confidential information
--"care provider" defined.
632.392.
1. Notwithstanding the provisions of subsection 1 of section 630.140, RSMo, a mental health program and any treating physician,
upon release of a patient who was committed or who is civilly detained and
consents to voluntary treatment during the course of the inpatient stay
pursuant to section 632.150, 632.155, 632.300, 632.305, 632.330, 632.335,
632.340, 632.350, 632.355 or 632.375:
(1) Shall provide to the patient and his care provider a
written packet of educational information developed and supplied by the
department of mental health describing symptoms of common mental illnesses,
early warning signs of decompensation, and availability of other education,
community and statewide services. The packet shall also include the telephone
number of the department of mental health information line and information
specific to the laws and procedures addressing civil detention and
guardianship;
(2) May disclose confidential treatment information to the
primary care provider or care providers, when such information is medically
necessary for the provision of appropriate health care or treatment by the care
provider or is related to the safety of the patient or care provider.
2.
Prior to disclosure of the information specified under subdivision (2) of
subsection 1 of this section, the mental health facility shall provide written
notice to the patient; request in writing the consent of the patient; work with
the patient and care provider to encourage and secure appropriate patient
authorization; function as a mediator, negotiating the boundaries of
confidentiality to meet the needs of the client and care provider; and work
with the client to stress the importance of keeping the care provider informed
and involved with his treatment process. If the patient refuses to consent and
the treating physician deems the information is medically necessary for the
appropriate provision of health care or treatment by the care provider or is
related to the safety of the patient or care provider, the information may
still be released to the appropriate care provider. The reason for the intended
disclosure, the specific information to be released and the persons
to whom the disclosure is to be made, even if consent has not been obtained,
will be provided to the client and care provider. All these procedures shall be
documented by the treating physician in the client record, including a specific
notation as to whether client consent was given.
3.
As used in this section, the term "care provider" means the person or
persons who can demonstrate that they are primarily responsible for the health
care of the person with a mental illness. The term does not apply to any person
providing care through hospitals, nursing homes, group homes or any other such
facility.
Court may order transfer of custody to federal facility,
when--head of federal facility to be successor administrator--court to retain
jurisdiction--orders from courts of other states to be observed in this state.
632.395.
1. If an individual ordered to be involuntarily detained or committed, treated
and evaluated pursuant to this chapter is eligible for hospital care or
treatment by any agency of the United States, the court, upon receipt of a
certificate from such agency showing that facilities are available and that the
individual is eligible for care or treatment therein, may order him to be
placed in the custody of such agency for hospitalization. When any individual
is admitted pursuant to the order of the court to any hospital or institution
operated by any agency of the
2.
An order of a court of competent jurisdiction of another state, or of the
District of Columbia, authorizing hospitalization of an individual by any
agency of the United States shall have the same force and effect as to the
individual while in this state as in the jurisdiction in which is situated the
court entering the order, and the courts of the state or District of Columbia
issuing the order shall be deemed to have retained jurisdiction of the individual
so hospitalized for the purpose of inquiring into his mental condition and of
determining the necessity for continuance of his hospitalization, as is
provided in subsection 1 of this section with respect to individuals ordered
hospitalized by the courts of this state. Consent is hereby given to the
application of the law of the state or District of Columbia in which is located
the court issuing the order for hospitalization with respect to the authority
of the chief officer of any hospital or institution operated in this state by
any agency of the United States to retain custody, transfer, conditional
release or discharge the individual hospitalized.
Reexamination of detained person.
632.400.
Any respondent ordered detained for ninety-day or one-year periods of
involuntary inpatient treatment or ordered detained for a period of up to one
hundred eighty days of outpatient detention and treatment under this chapter
shall be entitled to a reexamination of the order for his detention on his own
motion, or that of his legal guardian, parent, spouse, relative, friend or
attorney to the court. Upon receipt of the motion, the court shall conduct or
cause to be conducted by a special commissioner proceedings
in accordance with section 632.340.
Prosecutor's duties.
632.405.
It shall be the duty of the prosecuting attorney of the county wherein a
hearing described under this chapter takes place to represent the petitioner
and to file and prosecute in court all petitions for detention, evaluation and
treatment pursuant to this chapter. Such duty shall be fulfilled by the county
counselor in counties having a county counselor and by the circuit attorney in
any city not within a county.
Venue--change of jurisdiction.
632.410.
Venue for proceedings for involuntary detentions pursuant to the provisions of
this chapter shall be in the court having probate jurisdiction in the county in
which the mental health program is located wherein the respondent is detained;
provided, however, that if the respondent is a resident of this state and makes
application for the hearing to be held in his county of residence, the court
shall order the proceedings, with all papers, files and transcripts of the
proceedings, to be transferred to the court having probate jurisdiction in the
respondent's county of residence. Once a court has assumed jurisdiction with
respect to involuntary detention proceedings, no other court shall assume
jurisdiction until the court having prior jurisdiction has transferred
jurisdiction and all papers, files, and transcripts. If the court having
jurisdiction receives notice that a respondent has been transferred to a mental
health program in another county, the court shall transfer jurisdiction, along
with all papers, files and transcripts, to the court in the county where the
respondent has been transferred.
Court to maintain register of attorneys available to
represent patients--state to pay certain attorney's fees.
632.415.
1. The judge having probate jurisdiction in each county where a mental health
program is located shall prepare and maintain a current register of attorneys
who have agreed to be appointed to represent respondents against whom
involuntary civil detention proceedings have been instituted in such county.
The judge may choose lawyers who are paid by any public or private agency or
other lawyers who are appointed to the register. The register shall be provided
to the mental health coordinator for the area which includes the county for
which the list was prepared. A new register shall be provided to the mental
health coordinator each time a new attorney is added.
2.
If the judge finds that the respondent is unable to pay attorney's fees for the
services rendered in the proceedings, the judge shall allow a reasonable
attorney's fee for the services, which fee shall be assessed as costs and paid
together with all other costs in the proceeding by the state, in accordance
with rules and regulations promulgated by the state court administrator, from
funds appropriated to the office of administration for such purposes provided
that no attorney's fees shall be allowed for services rendered by any attorney
who is a salaried employee of a public agency or a private agency which
receives public funds.
Certain examining physicians to be
paid by state.
632.420.
The court having probate jurisdiction in appointing licensed physicians
pursuant to section 632.345 shall choose, if available, physicians who have
agreed to serve without fee or physicians paid by any private or public agency,
if they are found suitable; provided, that if the court finds no suitable
physicians from such sources, the court shall appoint an available licensed
physician and he shall be paid a reasonable fee, as determined by the court, by
the state from funds appropriated to the office of administration for this
purpose.
Physician-patient, psychologist-patient privileges waived in
detention proceedings.
632.425.
The physician-patient privilege recognized by section 491.060, RSMo, and the psychologist-patient privilege recognized by
section 337.055, RSMo, shall be deemed waived in
detention proceedings under this chapter. The fact that such privileges have
been waived pursuant to this section does not by itself waive the privileges in
any other proceeding, civil or criminal. The waiver of the privileges shall
extend only to that evidence which is directly material and relevant to
detention proceedings.
Appeals--to have priority--attorney
general to be notified and to represent state.
632.430.
1. Appeals from court orders made under this chapter may be made by the
respondent or by the petitioner to the appropriate appellate court pursuant to
the rules of civil procedure of the supreme court of
2.
A motion to stay any order restricting an individual's liberty may be filed in
either the court or the appropriate appellate court. A stay order shall not be
granted in any case where the court finds that the person is so mentally ill
that there is an imminent likelihood of serious physical harm to himself or others if he is not detained or treated pending
appeal. Any refusal to grant a stay by the court may be reviewed by the
appropriate appellate court on motion.
Habeas corpus.
632.435.
Any person detained under this chapter shall be entitled to apply for a writ of
habeas corpus.
No liability for health care professionals, public officials
and certain peace officers.
632.440.
No officer of a public or private agency, mental health facility or mental
health program; no head, attending staff or consultant of any such agency,
facility or mental health program; no mental health coordinator, registered
professional nurse, licensed physician, mental health professional nor any
other public official performing functions necessary for the administration of
this chapter; no peace officer responsible for detaining a person pursuant to
this chapter; and no peace officer responsible for detaining or transporting,
or both, any person upon the request of any mental health coordinator pursuant
to section 632.300 or 632.305 or acting pursuant to the request of a guardian
who is acting pursuant to chapter 475, RSMo, or upon
the request of the head of any supervisory mental health program who is acting
pursuant to section 632.337, regardless of whether such peace officer is
outside the jurisdiction for which he serves as a peace officer during the
course of such detention or transportation, or both, shall be civilly liable
for detaining, transporting, conditionally releasing or discharging a person
pursuant to this chapter or chapter 475, RSMo, at or
before the end of the period for which the person was admitted or detained for
evaluation or treatment so long as such duties were performed in good faith and
without gross negligence.
No liability for petitioners.
632.445.
No person making or filing an application alleging that a person should be
involuntarily detained, certified or committed, treated or evaluated pursuant
to this chapter shall be rendered civilly or criminally liable if the
application was made and filed in good faith.
Representation by attorney required--duties of attorney.
632.450.
1. An attorney shall be appointed to represent the respondent in all judicial
proceedings under this chapter, including appeal, unless relieved by the courts
for good cause shown.
2.
The attorneys shall personally contact the respondent within two days of the
appointment and meet with the respondent in person as soon as is reasonably
possible after the appointment to advise the respondent regarding the
proceedings.
3.
The attorney shall fully advise the respondent, if the respondent is not fully
discharged by the courts, of the right to appeal and regarding the respondent's
rights and interests after detention.
Patient, absent without permission, return may be requested,
when.
632.455.
1. If requested to do so by the head of a mental health program, the sheriff of
the county where a patient absent without authorization is found shall
apprehend and return him to the program.
2.
The head of the program may request the return of an absent patient under
subsection 1 of this section only under one or more of the following
circumstances:
(1) The patient is a minor whose admission was applied for
by his parent or legal custodian, who has not requested the minor patient's
release;
(2) The patient is a minor under jurisdiction of the
juvenile court;
(3) The patient has been declared legally incapacitated and
his guardian has not requested his release;
(4) The patient was committed to the department under
chapter 552, RSMo, or this chapter;
(5) The patient's condition is of such a nature that, for
the protection of the patient or others, the head of the program determines
that the patient's return to the program is necessary as noted in the patient's
records, in which case civil detention procedures shall be initiated upon
return to the program.
Definitions.
632.550.
As used in sections 632.550 to 632.557, the following terms mean:
(1) "Board", the governing board established in
section 632.555;
(2) "Child", a person under the age of eighteen
years;
(3) "Demonstration project", the project established
in section 632.553;
(4) "Department", the department of mental health;
(5) "Severely emotionally disturbed child", a
child who exhibits substantial impairment in his ability to function at a
developmentally appropriate level due to the presence of a serious psychiatric
disorder.
Department to designate county for
demonstration project--advisory board, members, duties--project goals.
632.553.
1. Subject to appropriations, the department of mental health shall designate a
county in which to establish a three-year demonstration project to design and
implement a community-based inter-agency treatment system to serve severely
emotionally disturbed children who receive services through public funding.
Such county shall be required to fund ten percent of the cost of the project.
The director of the department of mental health shall assemble an advisory
board, consisting of members who are residents of such county, to plan the
demonstration project. It is the intent of the general assembly that the
demonstration project provide services that enable
severely emotionally disturbed children to remain with their families, attend
and make academic progress in public schools and not commit crimes or be
incarcerated.
2.
The demonstration project shall accomplish the following goals:
(1) Provide services in a manner that gives priority to
permitting a child to reside safely in his usual family setting if that is in
the best interests of the child;
(2) Ensure that when a joint evaluation indicates that
out-of-home care and treatment are required, services are provided for as brief
a time as possible, in the least restrictive setting consistent with effective
services, and in as close proximity as possible to the child's usual residence;
(3) Develop appropriate services for difficult to place
children;
(4) Conduct research into children's mental health service
system in order that the system may be evaluated for effectiveness of treatment
and cost benefit on an ongoing basis; and
(5) Provide for other counties or regions a replicable model
for a comprehensive, coordinated children's mental health service system.
Governing board for project,
members, terms, duties.
632.555.
1. There is hereby established within the department of mental health a
"Governing Board" for the demonstration project established pursuant
to section 632.553. The board shall be composed of seven members who are
residents of the county selected for the demonstration project. Such members
shall be appointed by the director of the department of mental health with the
advice and consent of the state mental health commission.
2.
Board members shall serve for the three-year duration of the demonstration
project. The board members shall receive no compensation, but shall be
reimbursed for necessary expenses in the performance of their duties.
3.
The board shall be responsible for the direct implementation of the
demonstration project and shall monitor and direct the treatment of the
severely emotionally disturbed children within the project, evaluating the
treatment effectiveness and the cost effectiveness of the program. The board
shall make quarterly reports to the department of mental health regarding such
effectiveness of treatment and cost benefit.
4.
The department shall provide clerical and administrative support to the board.
Reports to governor and general
assembly.
632.557.
The department shall file annual progress reports concerning the demonstration
project to the governor and to the general assembly.
Mental health care provider
requirements.
632.560.
1. As used in this section, "mental health care provider" means any
person licensed pursuant to chapter 334, RSMo,
chapter 335, RSMo, or chapter 337, RSMo.
2.
To provide repressed memory therapy, recovered memory therapy, reparenting therapy or multiple personality disorder
treatment, a person shall be a mental health care provider as defined in subsection
1 of this section.
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