An Act Regarding the Mandatory Administration of Medication in Hospitals Serving Psychiatric Patients
Maine Legislature, Session 123, LD 1033
Committee Amendment CA_A_S332 (Senate)
Amends: 34-B MRSA §3003, 34-B MRSA §3864

COMMITTEE AMENDMENT ''A'' to S.P. 350, L.D. 1033, Bill, "An Act 
Regarding the Mandatory Administration of Medication in Hospitals Serving Psychiatric 
Patients" 
Amend the bill by striking out the title and substituting the following: 
'An Act Regarding Involuntary Treatment of Mental Health Patients' 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 34-B MRSA §3003, sub-§2, ~C, as amended by PL 1985, c. 645, §4, is 
further amended to read: 
C. Standards for informed consent to treatment, including reasonable standards and 
procedural mechanisms for determining when to treat a client absent his informed 
consent, consistent with applicable lawt. 
The rules must include the following 
process: 
(1) 
The primary treating physician may request an order for involuntary 
treatment of a patient from a clinical review panel; 
(2) A clinical review panel that consists of 2 or more professional staff who do 
not provide direct care to the patient is convened. At least one member of the 
panel must be a professional licensed to prescribe the medications relevant to the 
patient's care; 
(3) The clinical review panel conducts the review and makes a decision on the 
request of the primary treating physician within 4 days of the request based on 
the criteria in section 3864, subsection 7-A, paragraph B; 
(4) If the clinical review panel decides to approve the request for involuntary 
treatment, the panel enters an order of involuntary treatment in the patient's 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to S.P. 350, L.D. 1033 
hospital records. An order for involuntary treatment may be made for as long as 
the period of commitment and pending any appeal; and 
(5) At any hearings or meetings pertaining to involuntary treatment, the patient is 
offered the assistance of a lay advisor, rather than legal counsel; 
Sec. 2. 34-B MRSA §3864, sub-§l-A is enacted to read: 
I-A. Involuntary treatment. An application under this section may also include a 
request for an order of involuntary treatment under subsection 7-A. 
Sec. 3. 34-B MRSA §3864, sub-§4, as amended by PL 1997, c. 422, §16, is 
further amended to read: 
4. Examination. Examinations under this section are governed as follows. 
A. Upon receipt by the District Court of the application and the accompanying 
documents specified in subsection 1 and at least 3 days after the person who is the 
subject of the examination was notified by the psychiatric hospital of the proceedings 
and of that person's right to retain counselor to select an examiner, the court shall 
cause the person to be examined by 2 examiners. 
(I) Each examiner must be either a licensed physician or a licensed clinical 
psychologist. 
When involuntary treatment under subsection 1 -A has been 
requested, one of the examiners must be a professional who is licensed to 
prescribe medications relevant to the patient's care. 
(2) ORe of the eKlHf.liRefS fRl:lst be a physician or psychologist choseR by the 
perSOR or by that person's COl:lflSel, if the chosen physician Of ps~'chologist is 
reasonably a'lailable. 
(2-A) If the person under examination or the counsel for that person selects a 
qualified examiner who is reasonably available., then the court shaH choose that 
examiner as one of the 2 designated by the court. 
(3) Neither examiner appointed by the court may be the certifying examiner 
under section 3863, subsection 2 or 7. 
B. The examination shall must be held at the psychiatric hospital or at any other 
suitable place not likely to have a harmful effect on the mental health of the person. 
C. If the report of the eKaminers is to the effect that the person is not mentally ill or 
does not pose a likelihood of seriotls haffR, the application shall be ordered 
discharged forthvlith. 
D. If the report of the eKlHf.liners is to the effect that the person is mentally ill Of 
poses a likeJihood of seriOlfs haffR, the hearing shall be held on the date, or on the 
continl:led date, 'Nhieh the eOl:lrt has set for the hearing. 
E. The examiners shall report to the court on: 
(1) Whether the person is a mentally ill person within the meaning of section 
3801, subsection 5; 
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COMMITTEE AMENDMENT "A " to S.P. 350, L.D. 1033 
(2) When the establishment of a progressive treatment plan under section 3873 is 
at issue, whether a person is suffering from a severe and persistent mental illness 
within the meaning of section 3801, subsection 8-A; 
(3) Whether the person poses a likelihood of serious harm within the meaning of 
section 3801, subsection 4; and 
(4) When involuntary treatment is at issue, whether the need for such treatment 
meets the criteria of subsection 7-A, paragraphs A and B. 
Sec. 4. 34-B MRSA §3864, sub-§7-A is enacted to read: 
7-A. Involuntary treatment. This subsection governs involuntary treatment. 
A. The court may grant a psychiatric hospital power to implement a recommended 
treatment plan without a person's consent for up to 120 days or until the end of the 
commitment, whichever is sooner, if upon application the court finds: 
(1) That the person lacks the capacity to make an informed decision regarding 
treatment; 
(2) 
That the person is unable or unwilling to comply with recommended 
treatment; 
(3) That the need for the treatment outweighs the risks and side effects: and 
(4) That the recommended treatment is the least intrusive appropriate treatment 
option. 
Alternatively, the court may appoint a surrogate to make treatment decisions on the 
person's behalf for the duration of the commitment if the court is satisfied that the 
surrogate is suitable. willing and reasonably available to act in the person's best 
interests. 
B. The need for involuntary treatment under paragraph A may be based on findings 
that include, but are not limited to. the following: 
0) That a failure to treat the illness is likely to produce lasting or irreparable 
harm to the person; or 
(2) That without the recommended treatment the person's illness or involuntary 
commitment may be significantly extended without addressing the symptoms that 
cause the person to pose a likelihood of serious harm. 
C. The hospital and person may agree to changes in the treatment plan during the 
time period of an order for involuntary treatment. 
D. If a change in the treatment plan is needed and the hospital and patient do not 
agree on the change, the hospital shall apply to the court for a change in the treatment 
plan. 
Sec. 5. Commissioner to adopt rules. The Commissioner of Health and Human 
Services shall adopt rules to implement the Maine Revised Statutes, Title 34-B, section 
3003, subsection 2, paragraph C, subparagraphs 1 to 5 no later than January 1, 2008 for 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A " to S.P. 350, L.D. 1033 
use beginning on that date. The rules must include amendment of Rule 14-198 Chapter I: 
"Rights of Recipients of Mental Health Services." Rules adopted pursuant to this section 
are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A and are not 
subject to the provisions of Title 34-B, section 3003, subsection 4. 
Sec. 6. Appropriations and allocations. The following appropriations and 
allocations are made. 
JUDICIAL DEPARTMENT 
Courts - Supreme, Superior, District and Administrative 0063 
Initiative: Provides funds for additional physician services related to certain involuntary 
treatment examinations. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2007-08 
$40,000 
$40,000 
2008-09 
$40,000 
$40,000 
Sec. 7. Effective date. Those sections of this Act that enact the Maine Revised 
Statutes, Title 34-B, section 3864, subsections I-A and 7-A and amend section 3003, 
subsection 2, paragraph C and section 3864, subsection 4 take effect January 1,2008.' 
SUMMARY 
This amendment replaces the bill. The amendment adds to the court procedure for 
involuntary commitment the option of a request for involuntary treatment. 
The 
amendment amends the law on rules adopted by the Department of Health and Human 
Services regarding standards for treatment of a client absent informed consent. The 
amendment requires the department to amend those rules to include a clinical review and 
decision within 4 days of a request by the primary treating physician by a clinical review 
panel, to specify that orders for involuntary treatment are for the term of commitment and 
pending any appeal where appropriate and to require the offer of the assistance of a lay 
advisor and to amend the rules regarding the rights of recipients of mental health services. 
The rules, which are designated routine technical rules, must be adopted by January 1, 
2008 for use beginning on that date. The amendment provides an effective date of 
January 1, 2008, except that rulemaking begins prior to that date. This amendment also 
adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 06/14/07 
fra~ 
LD 1033 
LR48(02) 
An Act Regarding the Mandatory Administration of Medication in Hospitals Serving Psychiatric 
Patients 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment ')1 " 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor savings (JUD) - General Fund 
Minor cost increase (DHHS) - General Fund 
This amendment may result in minor savings to the Judicial Department. Any additional costs to the Department of 
Health and Human Services can be absorbed by the department utilizing existing budget resources. 
LR0048(02) - Fiscal Note - Page 1 of 1