An Act Regarding the Mandatory Administration of Medication in Hospitals Serving Psychiatric Patients
Maine Legislature, Session 123, LD 1033
Committee: Health and Human Services
Sponsors: NUTTING, GROSE, MARRACHE, MILLS, HOLMAN, LEWIN
Amends: 34-B MRSA §1432-A, 8 MRSA §3864

Legislative Document 
No. 1033 
S.P.350 
March 6, 2007 
An Act Regarding the Mandatory Administration of Medication in 
Hospitals Serving Psychiatric Patients 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Senator NUTTING of Androscoggin. 
JOY J. O'BRIEN 
Secretary of the Senate 
Cosponsored by Representative GROSE of Woolwich and Senators: MARRACHE of 
Kennebec, MILLS of Somerset, Representatives: HOLMAN of Fayette, LEWIN of Eliot, 
PERR Y of Calais. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1: 34-B MRSA §1432-A is enacted to read: 
§1432-A. Mandatory administration of medication 
The mandatory administration of medication at the Dorothea Dix Psychiatric Center, 
the Riverview Psychiatric Center and other specialty psychiatric hospitals or hospitals 
that contain one or more units that provide inpatient psychiatric care is subject to the 
provisions of this section. 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Hospital" means a hospital in the State that is licensed as a specialty psychiatric 
hospital or a hospital that contains one or more units that are licensed for inpatient 
psychiatric care. 
B. "Lay advisor" means an individual who is employed at a psychiatric center or 
hospital who is knowledgeable about mental health practice and who assists patients 
with questions about patient rights and rights complaints. 
C. "Medication" means psychiatric medication prescribed by a psychiatrist for a 
patient for the treatment of a mental illness or disorder. 
D. "Panel" means a clinical review panel that determines whether to approve the 
mandatory administration of medication under this section. 
E. "Psychiatric center" means the Dorothea Dix Psychiatric Center or the Riverview 
Psychiatric Center. 
F. 
"Patient" means a person receiving inpatient care in a psychiatric center or 
hospital. 
2. 
Appointment of panel. A panel must consist of persons appointed by the 
superintendent of the psychiatric center or chief administrative officer of the hospital but 
may not include a person directly responsible for care of the patient refusing medication. 
The panel must consist of 2 psychiatrists and a mental health professional who is not a 
physician. 
At least one member of the panel must be employed on the unit of the 
psychiatric center or hospital on which the patient receives care but may not provide 
direct care for the patient. 
3. Limitation on mandatory administration of medication. Medication may not 
be administered to a patient who refuses medication except in the following 
circumstances: 
A. In an emergency, on the order of a physician when the patient presents a danger to 
the life or safety ofthe patient or other persons; or 
B. In a nonemergency, when the patient is involuntarily committed under chapter 3 
and the mandatory administration of medication is approved by a panel. 
4. Procedures for panel. The following requirements apply to the procedures for a 
panel considering mandatory administration of medication under subsection 3, paragraph 
B. 
A. 
Upon application of a member of the treatment team for a patient, the 
superintendent of the psychiatric center or chief administrative officer of the hospital 
shall provide notice pursuant to paragraph B to the patient and appoint a panel. 
B. Notice must be given to a patient who is the subject of a panel hearing under 
paragraph D at least 24 hours prior to the panel hearing and must include the date, 
time and location of the panel hearing; the purpose of the panel hearing; and a 
description of the rights of the patient that is consistent with the rights of patients 
described by rules adopted by the department. 
C. A patient who is the subject of a panel hearing under paragraph D has the right to 
the assistance of a lay advisor; to contact information for the lay advisor; to notice as 
provided in paragraph B; to attend the hearing of the panel and present information, 
including witnesses; to question witnesses presenting information to the panel; to 
information regarding the patient's diagnosis; and to information regarding the 
clinical need for the medication, including potential side effects and the material risks 
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and benefits of taking or refusing the medication. 
D. 
A panel shall hold a hearing to determine whether to order mandatory 
administration of medication to a patient when the patient has been involuntarily 
committed under chapter 3 and is refusing medication. 
Prior to making a 
determination the panel shall: 
(1) Review the patient's clinical record, as appropriate; 
(2) Assist the patient and the treating physician in their arriving at a mutually 
agreeable treatment plan; and 
(3) 
Meet for the purpose of holding the hearing, receiving information and 
clinically assessing the patient's need for the medication and shall: 
(a) Consult with the patient regarding the reason for the patient's refusing 
medication and any appropriate alternative treatment; 
(b) Consult with members of the patient's treatment team at the psychiatric 
center or hospital regarding the patient's diagnosis, treatment and 
medications and the medication that is the subject of the hearing; 
(c) Receive information presented by or on behalf of the patient and other 
persons participating in the panel hearing; 
(d) 
Provide the patient with an opportunity to ask questions of anyon~ 
presenting information to the panel; and 
(e) 
Review the potential consequences of approving the mandatory 
administration of medication. 
E. The panel shall make a determination whether to order mandatory administration 
of medication to a patient as provided in this paragraph. 
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(I) Notwithstanding the provisions of Title 1, chapter 13 and any other provision 
of law to the contrary, the panel may meet privately to make its determination. 
(2) The panel shall make its determination based on its clinical assessment of the 
patient's record at the psychiatric center or hospital and information presented to 
the panel. 
(3) The panel shall dismiss an application for mandatory medication if since the 
filing of the application for mandatory administration of medication the patient 
and the patient's treatment team have agreed on the medication or an alternative 
treatment. 
(4) The panel shall document its consideration of the issues and the basis for its 
decision and issue a written decision. 
ill The panel may approve mandatory administration of medication if the panel 
determines that the medication represents a reasonable exercise of professional 
judgment for treatment of the patient and that without the medication the patient 
is at substantial risk of continued hospitalization because of the patient's: 
(a) Remaining seriously mentally ill with no significant relief of the mental 
illness symptoms that cause the patient to be a danger to the patient or others; 
(b) Remaining seriously mentally ill for a significantly longer period of time 
with symptoms that cause the patient to be a danger to the patient or others; 
or 
(c) Relapsing into a condition in which the patient is in danger of serious 
physical harm resulting from the patient's inability to provide for essential 
human needs of health and safety. 
(6) A determination to approve mandatory administration of medication must 
include the following: 
(a) The name of any medication approved, with dosage and frequency range; 
(b) The date for beginning the medication, which may not be sooner than 48 
hours from the date that the determination is received by the patient, and the 
duration of the approval, which may not exceed 90 days, except if extended 
pursuant to a separate determination of approval under this section; 
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Cc) If an alternative medication or treatment was rejected by the panel, the 
reason for that rejection; and 
Cd) Notice of the right to appeal the approval to the Superior Court under the 
Maine Administrative Procedure Act as final agency action under Title 5, 
chapter 375, subchapter 7. 
5. 
Appeal. 
Within 30 days of receipt by the patient of the notice of the 
determination of approval of mandatory administration of medication under this section, 
the patient may appeal the approval to the Superior Court as final agency action under 
Title 5, chapter 375, subchapter 7. 
A. Unless otherwise ordered by the Superior Court, the filing of a petition of appeal 
as provided in Title 5, section 11002 does not suspend the determination of approval 
of mandatory administration of medication issued by the panel. 
B. A patient who has filed a petition of appeal in the Superior Court may file a 
motion requesting a stay of judgment of approval of mandatory administration of 
medication. The court may grant a stay of a judgment of approval of mandatory 
administration of medication pending the disposition of the motion or the taking of 
such an appeal or during the pendency of an appeal. 
6. Lay advisor duties. A lay advisor shall assist a patient who is the subject of a 
panel hearing in preparing for the panel hearing and, if the panel approves mandatory 
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administration of medication, shall discuss the determination with the patient; inform the 
patient of the right to appeal and the appeal procedures, including how to request a stay of 
the judgment of approval of mandatory administration of medication and the assistance of 
counsel for an appeal; assist the patient with filing the petition of appeal if appropriate; 
and notify the superintendent of the psychiatric center or chief administrative officer of 
the hospital if the patient decides to appeal. 
Sec. 2. 34-8 MRSA §3864, sub-§4, ~C, as enacted by PL 1983, c. 459, §7, is 
repealed. 
Sec. 3. 34-8 MRS A §3864, sub-§4, ~, as enacted by PL 1983, c. 459, §7, is 
repealed. 
Sec. 4. 34-8 MRSA §3864, sub-§4, ~ 
is enacted to read: 
E. 
The examiners shall report to the court as to whether the person is a mentally ill 
person within the meaning of section 3801, subsection 5 or is a person with severe 
and persistent mental illness, as appropriate to the proceedings for which the 
examination was performed. 
Sec. 5. 34-8 MRS A §3864, sub-§4, W is enacted to read: 
F. 
The examiners shall report to the court as to whether the person presents a 
likelihood of serious harm within the meaning of section 380 I, subsection 4. 
Sec. 6. 
Rulemaking regarding rights of recipients of mental health 
services. By October 15, 2007, the Department of Health and Human Services shall 
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amend its rules entitled "Chapter 1, Rights of Recipients of Mental Health Services" to 
amend those rules to reflect the mandatory administration of medication procedures 
established in the Maine Revised Statutes, Title 34-B, section 1432-A. Rules adopted 
pursuant to this section are routine technical rules as defined by Title 5, chapter 375, 
subchapter 2-A. 
SUMMARY 
This bill amends the law with regard to inpatient psychiatric treatment as follows. 
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I . 
It ensures that a full District Court hearing is held before a person can be 
involuntarily committed to a psychiatric hospital. At this hearing the examiners report to 
the District Court as to whether the person is a mentally ill person or is a person with a 
serious and persistent mental illness, as appropriate to the proceeding, and as to whether 
the person poses a likelihood of serious harm and the hospital staff and family are able to 
testify. 
2. 
It enacts new law on mandatory administration of medication that provides 
protections for the person through a hearing process that uses a panel of 2 psychiatrists 
and I mental health professional. The process also includes a written decision by the 
panel and an appeal to the Superior Court under the Maine Administrative Procedure Act. 
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3. It directs the Department of Health and Human Services to amend its rules entitled 
"Rights of Recipients of Mental Health Services" to reflect the new law on mandatory 
administration of medication.