An Act To Clarify Involuntary Admissions for Psychiatric Hospitalizations No. 1855 April 12,2007
Maine Legislature, Session 123, LD 1855
Committee: Judiciary
Sponsors: NUTTING
Amends: 34-B MRSA §3801, 34-B MRSA §3802, 34-B MRSA §3831, 34-B MRSA §3861, 34-B MRSA §3865, 34-B MRSA §3871

Legislative Document 
S.P.669 
An Act To Clarify Involuntary Admissions for Psychiatric 
Hospitalizations 
No. 1855 
April 12,2007 
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204. 
Received by the Secretary of the Senate on April 11, 2007. Referred to the Committee on 
Judiciary pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint Rule 401. 
Presented by Senator NUTTING of Androscoggin. 
Cosponsored by Representative CANA V AN of Waterville. 
Printed on recycled paper 
JOY J. O'BRIEN 
Secretary of the Senate 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 34-B MRSA §3801, sub-§l, as enacted by PL 1983, c. 459, §7, IS 
repealed. 
Sec. 2. 34-B MRSA §3801, sub-§7, as enacted by PL 1983, c. 459, §7, IS 
amended to read: 
7. Patient. "Patient" means a person under observation, care or treatment in a 
psychiatric hospital or residential care facility pursuant to this subchapter or a person 
being evaluated for emergency admission under section 3863 in a hospital emergency 
department. 
Sec.3. 34-B MRSA §3801, sub-§7-B is enacted to read: 
7-B. Psychiatric hospital. "Psychiatric hospital" means: 
A. A state mental health institute: or 
B. A nonstate mental health institution. 
Sec. 4. 34-B MRSA §3802, sub-§3, as enacted by PL 1983, c. 459, §7, IS 
amended to read: 
3. Visitation. Visit each psychiatric hospital or residential care facility regularly to 
review the commitment procedures of all new patients admitted between visits and visit 
other hospitals as necessary to review protocols and procedures related to certification of 
patients under section 3863; 
Sec. 5. 34-B MRS A §3803, as enacted by PL 1983, c. 459, §7, is amended to 
read: 
§3803. Patient's rights 
A patient in a psychiatric hospital or residential care facility under this subchapter has 
the following rights. 
1. Civil rights. Every patient is entitled to exercise all civil rights, including, but not 
limited to, the right to civil service status, the right to vote, rights relating to the granting, 
renewal, forfeiture or denial of a license, permit, privilege or benefit pursuant to any law, 
the right to enter into contractual relationships and the right to manage hH; the patient's 
property, unless: 
A. 
The chief administrative officer of the psychiatric hospital or residential care 
facility determines that it is necessary for the medical welfare of the patient to impose 
restrictions on the exercise of these rights and, if restrictions are imposed, the 
restrictions and the reasons for them shall must be made a part of the clinical record 
of the patient; 
B. 
A patient has been adjudicated incompetent and has not been restored to legal 
capacity; or 
Page I -123LRI058(Ol)-1 
C: 
The exercise of these rights is specifically restricted by other statute or rule, but 
not solely because of the fact of admission to a psychiatric hospital or residential .::.re 
facility. 
2. Humane care and treatment. Every patient is entitled to humane care and 
treatment and, to the extent that facilities, equipment and personnel are available, to 
medical care and treatment in accordance with the highest standards accepted in medical 
practice. 
3. 
Restraints and seclusion. 
Restraint, including any mechanical means of 
restricting movement, and seclusion, including isolation by means of doors wffieft that 
cannot be opened by the patient, may not be used on a patient, unless the chief 
administrative officer of the psychiatric hospital or residential care facility or his the chief 
administrative officer's designee determines that either is required by the medical needs 
of the patient. 
A. 
The chief administrative officer of the psychiatric hospital or facility shall record 
and make available for inspection every use of mechanical restraint or seclusion and 
the reasons for its use. 
B. 
The limitation of the use of seclusion in this section does not apply to maximum 
security installations. 
4. Communication. Patient communication rights are as follows. 
A. 
Every patient is entitled to communicate by sealed envelopes with the 
department, a member of the clergy of his the patient's choice, his the patient's 
attorney and the court wffieft that ordered his the patient's hospitalization, if any. 
B. 
Every patient is entitled to communicate by mail in accordance with the rules of 
the psychiatric hospital. 
5. 
Visitors. 
Every patient is entitled to receive VISItors unless definitely 
contraindicated by his the patient's medical condition, except that he the patient may be 
visited by a member of the clergy of his the patient's choice or his the patient's attorney at 
any reasonable time. 
6. Sterilization. A patient may not be sterilized except in accordance with chapter 7. 
Sec. 6. 34-B MRSA §3831, as amended by PL 1999, c. 423, §3, is further 
amended to read: 
§3831. Admission 
A psychiatric hospital for the meatally ill may admit on an infonnal voluntary basis 
for care and treatment of a mental illness any person desiring admission or the adult ward 
of a legally appointed guardian, subject to the following conditions. 
1. 
Availability of accommodations. 
Except in cases of medical emergency, 
voluntary admission is subject to the availability of suitable accommodations. 
., 
StiaJluard hospital information. Standard hospital information may be elicited 
from the person if, after examination, the chief administrative officer of the psychiatric 
hospital deems determines the person suitable for admission, care and treatment. 
3. Persons under 18 years of age. Any person under 18 years of age must have the 
const:ni of ffis the person's parent or guardian. 
4. State mental health institute. Any person under 18 years of age must have the 
consent of the commissioner for admission to a state mental health institute. 
5. Adults under guardianship. An adult ward may be admitted on an informal 
voluntary basis only if fti.s the adult ward's legally appointed guardian consents to the 
admission and the ward makes no objection to the admission. 
6. Adults with advance health care directives. An adult with an advance health 
care directive authorizing meatal health psychiatric hospital treatment may be admitted 
on an informal voluntary basis if the conditions specified in the advance health care 
directive for the directive to be effective are met in accordance with the method stated in 
the advance health care directive or, if no such method is stated, as determined by a 
physician or a psychologist. If no conditions are specified in the advance health care 
directive as to how the directive becomes effective, the person may be admitted on an 
informal voluntary basis if the person has been determined to be incapacitated pursuant to 
Title 18-A, Article 5, Part 8. A person may be admitted only if the person does not at the 
time object to the admission or, if the person does object, if the person has directed in the 
advance health care directive that admission to the psychiatric hospital may occur despite 
that person's objections. The duration of the stay in the psychiatric hospital of a person 
under this subsection may not exceed 5 working days. If at the end of that time the chief 
administrative officer of the psychiatric hospital recommends further hospitalization of 
the person, the chief administrative officer shall proceed in accordance with section 3863, 
subsection 5. 
This subsection does not create an affirmative obligation of a psychiatric hospital to 
admit a person consistent with the person's advance health care directive. This subsection 
does not create an affirmative obligation on the part of the psychiatric hospital or 
treatment provider to provide the treatment consented to in the person's advance health 
care directive if the physician or psychologist evaluating or treating the person or the 
chief administrative officer of the psychiatric hospital determines that the treatment is not 
in the best interest of the person. 
Sec. 7. 34-B MRS A §3832, as amended by PL 2005, c. 519, Pt. BBBB, §4 and 
affected by §20, is further amended to read: 
§3832. Freedom to leave 
1. 
Patientts right. A patient admitted under section 3831 is free to leave the 
psychiatric hospital at any time after admission within 16 hours of the patient's request 
unless application for admission of the person under section 3863 is initiated within that 
time. 
2.' Notice. The chief administrative officer of the psychiatric hospital shall cause 
every patient admitted under section 3831 to be informed, at the time of admission, of: 
A. His The patient's status as an informally admitted patient; and 
B. 
His The patient's freedom to leave the psychiatric hospital under this section. 
Sec. 8. 34-B MRSA §3861, sub-§2, as amended by PL 1997, c. 422, §5, is 
further amended to read: 
2. State mental health institute. The chief administrative officer of a state mental 
health institute: 
A. 
May receive for observation, diagnosis, care and treatment in the hospital state 
mental health institute any person whose admission is applied for under section 3831 
or 3863 if the certifying examination conducted pursuant to section 3863, subsection 
was completed no more than 2 days before the date of admission; and 
B. 
May receive for observation, diagnosis, care and treatment in the hospital state 
mental health institute any person whose admission is applied for under section 3864 
or is ordered by a court. 
Any business entity contracting with the department for psychiatric physician services or 
any person contracting with a state mental health institute or the department to provide 
services pertaining to the admission, treatment or discharge of patients under sections 
3863 and 3864 within a state mental health institute or any person contracting with a 
business entity to provide those services within a state mental health institute is deemed 
to be a governmental entity or an employee of a governmental entity for purposes of civil 
liability under the Maine Tort Claims Act, Title 14, chapter 741, with respect to the 
admission, treatment or discharge of patients within a state mental health institute under 
sections 3863 and 3864. 
Sec. 9. 34-B MRS A §3862, sub-§I, ~, as amended by PL 1999, c. 423, §4, is 
further amended to read: 
B. 
If the law enforcement officer does take the person into protective custody, shall 
deliver the person immediately for examination as provided in section 3863 or, for a 
person taken into protective custody who has an advance health care directive 
authorizing mental health treatment, for examination as provided in Title 18-A, 
section 5-802, subsection (d) to determine the individual's capacity and the existence 
of conditions specified in the advance health care directive for the directive to be 
effective. 
If the e*aR'l-iI'latioI'l ooours ia a hospital emergeI'loy room, the The 
examination may be performed by a licensed physician, a licensed clinical 
psychologist, a physician's assistant, a nurse practitioner or a certified psychiatric 
clinical nurse specialist. If the e*amiI'latioI'l does I'lot ooour ia a hospital emergeI'loy 
room, the e*amiI'latioI'l may ae performed Oaly ay a lioeased physician or liceased 
eliaieal psyohologist. 
Sec. 10. 34-B MRS A §3863, as amended by PL 2005, c. 519, Pt. BBBB, §§5 to 8 
and affected by §20, is further amended to read: 
§3863. Emergency procedure 
A person may be admitted to a meatal psychiatric hospital on an emergency basis 
according to the following procedures. 
1. Application. Any health officer, law enforcement officer or other person may 
make a written application to admit a person to a meatal psychiatric hospital, subject to 
the prohibitions and peaalities penalties of section 3805, stating: 
A. 
Hi5 The person's belief that the person is mentally ill and, because of his the 
person's illness, poses a likelihood of serious harm; and 
B. 
The grounds for this belief. 
2. Certifying examination. The written application must be accompanied by a 
dated certificate, signed by a licensed physician, physician's assistant, certified 
psychiatric clinical nurse specialist, nurse practitioner or -it- licensed clinical psychologist, 
B 
stating: 
A. 
The physician, physician's assistant, certified psychiatric clinical nurse 
specialist, nurse practitioner or psychologist has examined the person on the date of 
the certificate; and 
B. 
The physician, physician's assistant, certified psychiatric clinical nurse specialist, 
nurse practitioner or psychologist is of the opinion that the person is mentally ill and, 
because of that illness, poses a likelihood of serious harm. The written certificate 
must include a description of the grounds for that opinion. 
2-A. Custody agreement. A state, county or municipal law enforcement agency 
may meet with representatives of those public and private health practitioners and health 
care facilities that are willing and qualified to perform the certifying examination required 
by this section in order to attempt to work out a procedure for the custody of the person 
who is to be examined while that person is waiting for that examination. Any agreement 
must be written and signed by and filed with all participating parties. In the event of 
failure to work out an agreement that is satisfactory to all participating parties, the 
procedures of section 3862 and this section continue to apply. 
As part of an agreement the law enforcement officer requesting certification may transfer 
protective custody of the person for whom the certification is requested to another law 
enforcement officer, a health officer if that officer agrees or the chief administrative 
officer of a public or private health practitioner or health facility or the chief 
administrative officer's designee. Any arrangement of this sort must be part of the written 
agreement between the law enforcement agency and the health practitioner or health care 
facility. In the event of a transfer, the law enforcement officer seeking the transfer shall 
provide the written application required by this section. 
A person with mental illness may not be detained or confined in any jailor local 
correctional or detention facility, whether pursuant to the procedures described in section 
3862, pursuant to a custody agreement, or under any other circumstances, unless that 
person is being lawfully detained in relation'to or is serving a sentence for commission of 
a crime. 
3: Judicial review. The application and accompanying certificate must be reviewed 
by a Justice of the Superior Court, Judge of the District Court, Judge of Probate nr a 
justice of the peace, who may review the original application and accompanying 
certificate or a facsimile transmission of them. 
A. 
If the judge or justice finds the application and accompanying certificate to be 
regular and in accordance with the law, the judge or justice shall endorse them and 
promptly send them to the admitting ffi@ffial psychiatric hospital. For purposes of 
carrying out the provisions of this section, an endorsement transmitted by facsimile 
machine has the same legal effect and validity as the original endorsement signed by 
the judge or justice. 
B. 
A person may not be held against the person's will in the ~ hospital under this 
section, whether infunnally admitted under section 3831 or sought to be iI¥loluntarily 
admitted under this section, unless the application and certificate have beee eedorsed 
by a judge or justice, except that a person for whom an examiner has executed the 
certificate under subsection 2 may be detained in a hospital for a reasonable period of 
time, not to exceed +& 24 hours, pending endorsement by a judge or justice, if: 
(l) For a person informally admitted under section 3831, the chief administrative 
officer of the psychiatric hospital undertakes to secure the endorsement 
immediately upon execution of the certificate by the examiner; and 
(2) For a person sought to be involuntarily admitted under this section, the 
person or persons transporting the person sought to be imroluntarily admitted to 
the hospital seeking the involuntary admission undertake to secure the 
endorsement immediately upon execution of the certificate by the examiner. 
C. 
Notwithstanding paragraph B, subparagraphs (1) and (2), a person sought to be 
admitted informally under section 3831 or involuntarily under this section may be 
transported to a psychiatric hospital and held there for evaluation and treatment at-a 
hospital pending judicial endorsement of the application and certificate if the 
endorsement is obtained between the soonest available hours of 7:00 a.m. and 11 :00 
p.m. 
4. Custody and transportation. Custody and transportation under this section are 
governed as follows. 
A. 
Upon endorsement of the application and certificate by the judge or justice, a 
law enforcement officer or other person designated by the judge or justice may take 
the person into custody and transport that person to the psychiatric hospital 
designated in the application. 
Transportation of an individual to' a psychiatric 
hospital under these circum5tances must involve the least restrictive fomi of 
transportation available that meets the clinical needs of that individual. 
B. 
The Department of Health and Human Services is responsible for any 
transportation expenses under this section, including return from the psychiatric 
hospital if admission is declinerl. The department shall utilize any 3rd-party payment 
sources that are available. 
C 
When a person who 1S under a sentence or lawful detention related to 
43:-(}mrnission of a crime and who is incarcerated in a jailor local correctional or 
P.n'ltC 6 - lZ3LRlOS8(Ol)-1 
detention facility is admitted to a psychiatric hospital under any of the procedures in 
this subchapter, the county where the incarceration originated shall pay all expenses 
incident to transportation of the person between the psychiatric hospital and the jailor 
local correctional or detention facility. 
5. 
Continuation of hospitalization. 
If the chief administrative officer of the 
psychiatric hospital recommends further hospitalization of the person, the chief 
administrative officer shall determine the suitability of admission, care and treatment of 
the patient as an informally admitted patient, as described in section 3831. 
A. 
If the chief administrative officer of the hospital determines that admission of 
the person as an informally admitted patient is suitable, the chief administrative 
officer shall admit the person on this basis, if the person so desires. 
B. 
If the chief administrative officer ofthe hospital determines that admission of the 
person as an informally admitted patient is not suitable, or if the person declines 
admission as an informally adlnitted patient, the chief administrative officer ef....tbe 
hospital may seek involuntary commitment of the patieHt person by filing an 
application for the issuance of an order for hospitalization under section 3864, except 
that if the psychiatric hospital is a designated nonstate mental health institution and if 
the patient was admitted under the contract between the psychiatric hospital and the 
department for receipt by the psychiatric hospital of involuntary patients, then the 
chief administrative officer may seek involuntary commitment only by requesting the 
commissioner to file an application for the issuance of an order for hospitalization 
under section 3864. 
(1) 
The application must be made to the District Court having territorial 
jurisdiction over the psychiatric hospital to which the person was admitted on an 
emergency basis. 
(2) The application must be filed within 3 days from the date of admission of the 
patient under this section, except that, if the 3rd day falls on a weekend or 
holiday, the application must be filed on the next business day following that 
weekend or holiday. 
C. 
If neither readmission on an informal voluntary basis nor application to the 
District Court is effected under this subsection, the chief administrative officer of the 
psychiatric hospital to which the person was admitted on an emergency basis shall 
discharge the person immediately. 
D. 
If the chief administrative officer of the psychiatric hospital has filed an 
application in the District Court for an order of hospitalization under section 3864 but 
the hearing on the application has not yet been conducted, the t;hief administrative 
officer may also submit in the interim a request for an administrative hearing before a 
hearing officer employed by or under contract with the department to administer 
medication on an involuntary basis to the patient if the court orders such 
commitment. In such cases, the administrative hearing to consider the request for 
involuntary treatment must be held within 4 business days of the date of the court's 
order permitting involuntary hospitalization under section 3864 
6.' Notice. Upon admission of a person under this section, and after consultation 
with the person, the chief administrative officer of the psychiatric hospital shall notify, as 
soon as possible regarding the fact of admission, the person's: 
A. 
Guardian, if known; 
B. 
Spouse; 
C. 
Parent; 
D. 
Adult child; or 
E. 
One of next of kin or a friend, if none of the listed persons exists. 
If the chief administrative officer has redson to believe that notice to any individual in 
paragraphs A to E would pose risk of harm to the person admitted, then notice may not be 
given to that individual. 
7. Post-admission examination. Every patient admitted to a psychiatric hospital 
shall must be examined as soon as practicable after his the patient's admission. 
A. 
The chief administrative officer of the psychiatric hospital shall arrange for 
examination by a staff physician or licensed clinical psychologist of every patient 
hospitalized under this section. 
B. 
The examiner may not be the certifying examiner under this section or under 
section 3864. 
C. 
If the post-admission examination is not held within 24 hours after the time of 
admission, or if a staff physician or licensed clinical psychologist fails or refuses after 
the examination to certify that, in his the staff physician's or licensed clinical 
psychologist's opinion, the person is mentally ill and due to his the person's mental 
illness poses a likelihood of serious harm, the person shall must be immediately 
discharged. 
8. 
Rehospitalization from progressive treatment program. 
The assertive 
community treatment team physician or psychologist may make a written application 
under this section to admit to a state mental health institute a person who fails to fully 
participate in the progressive treatment program in accordance with section 3873, 
subsection 5. The provisions of this section apply to that application, except that the 
standard for admission is governed by section 3873, subsection 5, paragraph B. 
Sec. 11. 34-B MRS A §3864, as amended by PL 2005, c. 519, Pt. BBBB, §§9 and 
and affected by §20, is further amended to read: 
§3864. Judicial procedure and commitment 
1. Application. An application to the District Court to admit a person to a meAtal 
psychiatric hospital, filed under section 3863, subsection 5, paragraph B, shall must be 
accompanied by: 
A. 
The emergency application under section 3863, subsection 1; 
I 
B. 
The accompanying certificate of the physician or psychologist under section 
3863, subsection 2; 
C. 
The certificate of the physician or psychologist under section 3863, subsection 7 
that: 
(1) The physician or psychologist has examined the patient; and 
(2) It is the opinion of the physician or psychologist that the patient is a mentally 
ill person and, because of that patient's illness, poses a likelihood of serious harm; 
D. 
A written statement, signed by the chief administrative officer of the psychiatric 
hospital, certifying that a copy of the application and the accompanying documents 
have been given personally to the patient and that the patient and the patient's 
guardian or next of kin have been notified of the patient's right to retain an attorney or 
to have an attorney appointed, of the patient's right to select or to have the patient's 
attorney select an independent examiner and regarding instructions on how to contact 
the District Court; and 
E. 
A copy of the notice and instructions given to the patient. 
2. 
Detention pending judicial determination. 
Notwithstanding any other 
provisions of this subchapter, a person, with respect to whom an application for the 
issuance of an order for hospitalization has been filed, may not be released or discharged 
during the pendency of the proceedings, unless: 
A. 
The District Court orders release or discharge upon the request of the patient, or 
the patient's guardian, parent, spouse or next of kin; 
B. 
The District Court orders release or discharge upon the report of the applicant 
that the person may be discharged with safety; 
C. 
A court orders release or discharge upon a writ of habeas corpus under section 
3804; or 
D. 
Upon request of the commissioner, the District Court orders the transfer of a 
patient in need of more specialized treatment to another psychiatric hospital. In the 
event of a transfer, the court shall transfer its file to the District Court having 
territorial jurisdiction over the receiving psychiatric hospital. 
3. Notice of receipt of application. The giving of notice of receipt of application 
and date of hearing under this section is governed as follows. 
A. 
Upon receipt by the District Court of the application and accompanying 
documents specified in subsection 1, the court shall cause written notice of the 
application and date of hearing: 
(1) To be mailed within 2 days of filing to the person; and 
(2) To be mailed to the person's guardian, if known, and to the person's spouse, 
parent or one of the person's adult children or, if none of these persons exist or if 
none of those persons can be located, to one of the person's next of kin or a 
friend, except that if the chief adniinistrative officer has reason to believe that 
'-
notice to any of these individuals would pose risk of hann to the person Wh0 is 
the subject of the application, notice to that individual may not be given. 
B. 
A docket entry is sufficient evidence that notice under this subsection has been 
given. 
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 counsel or to select an examiner, the court shall 
cause the person to be examined by 2 examiners. 
(1) Each examiner must be either a licensed physician or a licensed clinical 
psychologist. 
(2) One of the examiners must be a physician or psychologist chosen by the 
person or by that person's counsel, if the chosen physician or psychologist is 
reasonably available. 
(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 hannful effect on the mental health of the person. 
C. If the report of the examiners is to the effect that the person is not mentally ill or 
does not pose a likelihood of serious harm, the application shall 9@ oFa@F@d 
dischaFgea furthwith. 
D. 
If the report of the examiners is to the effect that the person is mentally ill OF 
poses tt likelihooa of serious hann, the hearing shall ge hela on the aate, OF an the 
eontinuea aate, 'Nruch the court has set for the hearing. 
E. 
The examiners shall report to the court as to whether the person is a mentaily 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 perfonned. 
F. 
The examiners shall report to the court as to whether the person presellts a 
likelihood of serious hann within the meaning of section 3801, subsection 4. 
5. Hearing, Hearings under this section are governed as follows. 
A. 
The District Court shall hold a hearing on the application not later than 14 days 
from the date of the application. 
(l) On a motion by any party, the hearing may be continued for cause for a 
period not to exceed 10 additional days. 
(2) If the hearing is not held within the time specified, or within the specified 
continuance period, the court shall dismiss the application and order the person 
discharged forthwith. 
Pa~ to - 123LRl958(OI)-1 
"d 
"'"
(3) In computing the time periods set forth in this paragraph, the Maine Rules of 
Civil Procedure apply. 
B. 
The hearing must be conducted in as informal a manner as may be consistent 
with orderly procedure and in a physical setting not likely to have harmful effect on 
the mental health of the person. If the setting is outside the psychiatric hospital to 
which the patient is currently admitted, the Department of Health and Human 
Services shall bear the responsibility and expense of transporting the patient to and 
from the hearing. If the patient is to be admitted to a psychiatric hospital following 
the hearing, then the responsible hospital from which the Datient came shall transport 
the patient to the admitting psychiatric hospital. If the patient is to be released 
following the hearing, then the responsible hospital from which the patient came shall 
return the patient to the that hospital or, at the patient's request, return the patient to 
the patient's place of residence. 
C. 
The court shall receive all relevant and material evidence wlOOh that may be 
offered in accordance with accepted rules of evidence and accepted judicial 
dispositions. A hearing must be held on every application, even if the examiners' 
report indicates that the person is not mentally ill or does not pose a likelihood of 
serious harm. 
(1) The person, the applicant and all other persons to whom notice is required to 
be sent sbaR must be afforded an opportunity to appear at the hearing to testify 
and to present and cross-examine witnesses. 
(2) The court may, in its discretion, receive the testimony of any other person 
and may subpoena any witness. 
D. 
The person sbaR must be afforded an opportunity to be represented by counsel, 
and, if neither the person nor others provide counsel, the court shall appoint counsel 
for the person. 
E. 
In addition to proving that the patient is a mentally ill individual, the applicant 
must show: 
(1) By evidence of the patient's recent actions and behavior, that due to the 
patient's mental illness the patient poses a likelihood of serious harm; and 
(2) 
That, after full consideration of less restlictive treatment settings and 
modalities, inpatient hospitalization is the best available means for the treatment 
of the person. 
F. 
In each case, the applicant shall submit to the court, at the time of the hearing, 
testimony, including expert psychiatric testimony, indicating the individual treatment 
plan to be followed by the Qsyc:liatric h03pilal staff, if the person is committed under 
this section, and shall bear any expense for witnesses for this purpose. 
G. 
A stenographic or electronic record shall must be made of the proceedings in all 
judicial hospitalization hearings. 
(1) 
The record and all notes, txhibits and other evidence sha!l 00 il~ 
confidential. 
(2) The record and all notes, exhibits and other evidence 5hall must be retained 
as part of the District Court records for a period of 2 years from the date of the 
hearing. 
H. 
The hearing shall be i.§ confidential and He ~ report of the proceedings may not 
be released to the public or press, except by permission of the person or hit; the 
person's counsel and with approval of the presiding District Court Judge, except that 
the court may order a public hearing on the request of the person or hit; the person's 
counsel. 
6. Court findings. Procedures dealing with the District Court's findings under this 
section are as follows. 
A. 
The District Court shall so state in the record, if it finds upon completion of the 
hearing and consideration of the record: 
(l) Clear and convincing evidence that the person is mentally ill and that the 
person's recent actions and behavior demonstrate that the person's illness poses a 
likelihood of serious harm; 
(2) That inpatient hospitalization is the best available means for treatment of the 
patient; and 
(3) 
That it is satisfied with the individual treatment plan offered by the 
psychiatric hospital to which the applicant seeks the patient's involuntary 
commitment. 
B. 
If the District Court makes the findings described in paragraph A, subparagraphs 
and 2, but is not satisfied with the individual treatment plan as offered, it may 
continue the case for not longer than 10 days, pending reconsideration and 
resubmission of an individual treatment plan by the psychiatric hospital. 
7. Commitment. Upon making the findings described in subsection 6, the court 
may order commitment to a psychiatric hospital for a period not to exceed 4 months in 
the first instance and not to exceed one year after the first and all subsequent hearings. 
A. 
The court may issue an order of commitment immediately after the completion 
of the hearing, or it may take the matter under advisement and issue an order within 
hours of the hearing. 
B. 
If the court does not issue an order of commitment within 24 hours of the 
completion of the hearing, it shall dismiss the application and order the patient 
discharged inunediatdy. 
8. Continued involuntary hospitalization. If the chief administrative officer of the 
psychiatric hospital to which a person has been committed involuntarily by the District 
Court recommends that continued involuntary hospitalization is necessary for that person, 
the chief administrative officer shall notifY the commissioner. The commissioner may 
then, not later than 31) days prior to the expiration of a period of cornmitment ordered by 
the court, make application in accordance with this section to the District Court that has 
territorial jurisdiction over the psychiatric hospital designated for treatment in the 
application by the comrllissioner for a hearing to be held under this section. 
P&ge 12 -123LRI058(Ol)-1 
9. Transportation. Except for transportation expenses paid by the District Court 
pursuant to subsection 10, a continued involuntary hospitalization hearing that requires 
transportation of the patient to and from any psychiatric hospital to a court that has 
committed the person must be provided at the expense of the Department of Health and 
Human Services. Transportation of an individual to a psychiatric hospital under these 
circumstances must involve the least restrictive form of transportation available that 
meets the clinical needs of that individual and be in compliance with departmental 
regulations. 
10. Expenses. With the exception of expenses incurred by the applicant pursuant to 
subsection 5, paragraph F, the District Court shall be ~ responsible for any expenses 
incurred under this section, including fees of appointed counsel, witness and notice fees 
and expenses of transportation for the person. 
11. 
Appeals. 
A person ordered by the District Court to be committed to a 
psychiatric hospital may appeal from that order to the Superior Court. 
A. 
The appeal is on questions of law only. 
B. 
Any findings of fact of the District Court may not be set aside unless clearly 
erroneous. 
C. 
The order of the District Court shall remain remains in effect pending the appeal. 
D. 
The District Court Civil Rules and the Maine Rules of Civil Procedure apply to 
the conduct of the appeals, except as otherwise specified in this subsection. 
Sec. 12. 34-B MRSA §3865, as enacted by PL 1983, c. 459, §7, is amended to 
read: 
§3865. Hospitalization by federal agency 
If a person ordered to be hospitalized under section 3864 is eligible for hospital care 
or treatment by any agency of the United States, the court, upon receipt of a certificate 
from the agency showing that facilities are available and that the person is eligible for 
care or treatment in the facilities, may order fHm the person to be placed in the custody of 
the agency for hospitalization. 
1. Rules and rights. A person admitted under this section to any psychiatric 
hospital or institution operated by any agency of the United States, inside or outside the 
State, is subject to the rules of the agency, but retains ail rights to release and periodic 
court review granted by this subchapter. 
2. Powers of chief administrative officer. The chief administrative officer of a.'1y 
psychiatric hospital or institution operated by a federal agency in which the person is 
hospitalized has, with respect to dIe person, the same powers as the chief administrative 
officer of psychiatric hospitals or the commissioner within this State with respect to 
detention, custody, transfer, conditionai release or discharge of patients. 
3. Court jurisdiction. Every order of hospitalization issued under this section is 
conditioned on the retention of jurisdiction in the courts of this State to, at any time: 
Page n - IlJLRI0Sl(tl)-t 
A. 
Inquire into the mental condition of a person hospitalized; and 
B. 
Determine the necessity for continuance of lH5 the person's hospitalization. 
Sec. 13. 34-B MRS A §3866, as enacted by PL 1983, c. 459, §7, is amended to 
read: 
§3866. Members of the Armed Forces 
1. Admission to psychiatric hospital. Any member of the Armed Forces of the 
United States who was a resident of the State at the time of lH5 the member's induction 
into the service and who is determined by a federal board of medical officers to have a 
mental disease not incurred in line of duty shall must be received, at the discretion of the 
commissioner and without formal commitment, at either of the state hospitals for the 
mentally ill mental health institutes, upon delivery at the hospital institute designated by 
the commissioner of: 
A. 
The member of the Armed Forces; and 
B. 
The findings of the board of medical officers that he the member is mentally ill. 
2. Status. After delivery of the member of the Armed Forces at the hospital state 
mental health institute designated by the commissioner, lH5 the member's status shall be ~ 
the same as if he the member had been committed to the hospital institute under section 
3864. 
Sec. 14. 34-B MRS A §3867, as amended by PL 1997, c. 422, §20, is further 
amended to read: 
§3867. Transfer from out-of-state institutions 
1. Commissioner's authority. The commissioner may, upon request of a competent 
authority of the District of Columbia or of a state that is not a member of the Interstate 
Compact on Mental Health, authorize the transfer of a mentally ill patient person directly 
to a hospital state mental health institute in Maine, if: 
A. 
The patient person has resided in this State for a consecutive period of one year 
during the 3-year period immediately preceding commitment in the other state or the 
District of Columbia; 
B. 
The patient person is currently confined in a recognized institution for the care 
of the mentally ill as the result of proceedings considered legal by that state or by the 
District of Columbia; 
C. 
A duly certified copy of the original commitment proceedings and a copy of the 
patient's person's case history is supplied; 
D. 
The commissioner, after investigation, considers the transfer justifiable; and 
E. 
All expenses of the transfer are borne by the agency requesting It. 
2. Receipt of patient. When the commissioner has authorized a transfer under this 
section, the superintendent of the hospital state mental health institute designated by the 
commissioner shall receive the patient as having been regularly committed to the state 
mental health institute under section 3864. 
Sec. 15. 34":B MRSA §3868, as amended by PL 1997, c. 422, §21, is further 
amended to read: 
§3868. Transfer to other institutions 
1. To other hospitals. The commissioner may transfer, or authorize the transfer of, 
a patient from one hospital to another, either inside or outside the State, if the 
commissioner determines that it would be consistent with the medical or psychiatric 
needs of the patient to do so. 
lOA. Before a patient is transferred, the commissioner shall give written notice of the 
transfer to the patient's guardian, the patient's parents or spouse or, if none of these 
persons exists or can be located, to the patient's next of kin or friend, except that if the 
chief administrative officer of the hospital to which the patient is currently admitted 
has reason to believe that notice to any of these individuals would pose risk of harm 
to the person, then notice may not be given to that individual. 
B. 
In making all such transfers, the commissioner shall give due consideration to 
the relationship of the patient to his the patient's family, guardian or friends, in order 
to maintain relationships and encourage visits beneficial to the patient. 
2. To federal agency. Upon receipt of a certificate of an agency of the United States 
that facilities are available for the care or treatment of any involuntarily hospitalized 
person and that the person is eligible for care and treatment in a hospital or institution of 
the agency, the chief administrative officer of the psychiatric hospital may cause his the 
person's transfer to the agency of the United States for hospitalization. 
A. 
Upon making such a transfer, the chief administrator of the hospital 
administrative officer shall notify the court whi€h that ordered hospitalization and the 
persons specified in subsection 1, paragraph A. 
B. 
Ne A person may not be transferred to an agency of the United States if he the 
person is confined pursuant to conviction of any felony or misdemeanor or if he the 
person has been acquitted of the charge solely on the ground of mental illness, unless 
before the transfer the court originally ordering confinement of the person enters an 
order for transfer after appropriate motion and hearing. 
C. 
Any person transferred under this section to an agency of the United States is 
deemed to be hospitalized by the agency pursuant to the original order of 
hospitalization. 
Sec. 16. 34-B MRS A §3869, as enacted by PL 1983, c. 459, §7, is amended to 
read: 
§3869. Return from unauthorized absence 
If any patient committed under section 3864 leaves the grounds of the psychiatric 
hospital without authorization of the chief administrative officer of the psychiatric 
hospital or his the chief administrative officer's designee, or refuses to return to the 
psychiatric hospital from a community pass when requested to do so by the chief 
administrative officer or his the chief administrative officer's designee, law enforcement 
personnel of the State or of any of its subdivisions may, upon request of the chief 
administrative officer or his the chief administrative officer's designee, assist in the return 
of the patient to the psychiatric hospital. 
Sec. 17. 34-B MRS A §3870, as amended by PL 2005, c. 519, Pt. BBBB, §§11 
and 12 and affected by §20, is further amended to read: 
§3870. Convalescent status 
1. Authority. The chief administrative officer of a state mental health institute may 
release an improved patient on convalescent status when the chief administrative officer 
believes that the release is in the best interest of the patient and that the patient does not 
pose a likelihood of serious harm. The chief administrative officer of a nonstate mental 
health institute may release an improved patient on convalescent status when the chief 
administrative officer believes that the release is in the best interest of the patient, the 
patient does not pose a likelihood of serious harm and, when releasing an involuntarily 
committed patient, the chief administrative officer has obtained the approval of the 
commissioner after submitting a plan for continued responsibility. 
A. 
Release on convalescent status may include provisions for continuing 
responsibility to and by the psychiatric hospital, including a plan of treatment on an 
outpatient or nonhospital basis. 
B. 
Before release on convalescent status under this section, the chief administrative 
officer of a psychiatric hospital shall make a good faith attempt to notify, by 
telephone, personal communication or letter, of the intent to release the patient on 
convalescent status and of the plan of treatment, if any: 
(1) The parent or guardian of a minor patient; 
(2) The iegal guardian of an adult incompetent patient, if any is known; or 
(3) The spouse or adult next of kin of an adult competent patient, if any is 
IUlOwn, unless the patient requests in writing that the notice not be given. 
If the chief administrative officer of the psychiatric hospital to which the patient is 
currently admitted has reason to believe that notice to any of the individuals listed in 
this paragraph would pose risk of hann to the Pef5efl patient, then notice may not be 
given to that individu;;.;l. 
C. 
The .Q§ychiatric hospital is not liable when good faith attempts to notify the 
parents, spouse or guardian have failed. 
D. 
Before releasing a patient on convalescent status, the chief administrative officer 
of the p...§ychiattiQ hospital shall advise the patient, orally and in writing, of the terms 
of the patient's convalescent status, the treatment available while the patient is on 
convalescent status and, if the patient is a voluntary patient, of the patient's right to 
request tennination of the status and, if involuntarily committed, the means by which 
and conditions undt:r \vhich rehospitalization may occur. 
2. Reexamination. Before a patient has spent a year on convalescent status, and at 
least once a year thereafter, the chief administrative officer of the psychiatric hospital 
shall reexamine the facts relating to the hospitalization of the patient on convalescent 
status. 
3. Discharge. Discharge from convalescent status is governed as follows. 
A. 
If the chief administrative officer of the psychiatric hospital deterrnines that, in 
view of the condition of the patient, convalescent status is no longer necessary, the 
chief administrative officer shall discharge the patient and make a report of the 
discharge to the commissioner. 
B. 
The chief administrative officer shall terminate the convalescent status of a 
voluntary patient within 10 days after the day the chief administrative officer receives 
from the patient a request for discharge from convalescent status. 
C. 
Discharge from convalescent status occurs upon expiration of the period of 
involuntary commitment. 
4. Rehospitalization. Rehospitalization of patients under this section is governed as 
follows. 
A. 
If, prior to discharge, there is reason to believe that it is in the best interest of an 
involuntarily committed patient on convalescent status to be rehospitalized, or if an 
iRyoluRtary involuntarily cornmitted patient on convalescent status poses a likelihood 
of serious harm~ the commissioner~ or the chief administrative officer of the 
psychiatric hospital, with the approval of the connnissioner, may issue an order for 
the immediate rehospitalization of the patient. 
C. 
If the order is not voluntarily complied with, an involuntarily committed patient 
on convalescent leave may be returned to the psychiatric hospital if the following 
conditions are met: 
(1) An order is issued pursuant to paragraph A; 
(2) The order is brought before a District Court Judge or justice of the peace; 
and 
(3) Based upon clear and convincing evidence that return to the psychiatric 
hospital is in the patient's best interest or that the patient poses a likelihood of 
serious harm, the District Court Judge or justice of the peace approves return to 
the psychiatric hospital. 
After approval by the District Court Judge or justice of the peace, a law enforcement 
officer may take the patient into custody and arrange for transportation of the patient 
in accordance with the provisions of section 3863, subsection 4. 
This paragraph does not preclude the use of protective custody by iaw enforcement 
officers pursuant to section 3862. 
5. Notice of change of status. Notice of the change of convalescent status of 
patients is governed as follows. 
A. 
If the convalescent status of a patient in a psychiatric hospital is to be changed, 
either because of a decision of the chief administrative officer of the psychiatric 
hospital or because of a request made by a voluntary patient, the chief administrative 
officer of the psychiatric hospital shall immediately make a good faith attempt to 
notify, by telephone, personal communication or letter, ofthe contemplated change: 
(1) The parent or guardian of a minor patient; 
(2) The guardian of an adult incompetent patient, if any is known; or 
(3) The spouse or adult next of kin of an adult competent patient, unless the 
patient requests in writing that the notice not be given. 
If the chief administrative officer of the psychiatric hospital to which the patient is 
currently admitted has reason to believe that notice to any of the individuals listed in 
this paragraph would pose risk of harm to the person, then notice may not be given to 
that individual. 
B. 
If the change in convalescent status is due to the request of a voluntary patient, 
the chief administrative officer of the psychiatric hospital shall give the required 
notice within 10 days after the day the chief administrative officer receives the 
request. 
C. 
The psychiatric hospital is not liable when good faith attempts to notify the 
parents, spouse or guardian have failed. 
Sec. 18. 34-B MRSA §3871, as amended by PL 2005, c. 519, Pt. BBBB, §13 and 
affected by §20, is further amended to read: 
§3871. Discharge 
1. Examination. The chief administrative officer of a psychiatric hospital shall, as 
often as practicable, but no less often than every 30 days, examine or cause to be 
examined every patient to determine that patient's mental status and need for continuing 
hospitalization. 
2. 
Conditions for discharge. The chief administrative officer of a psychiatric 
hospital shall discharge, or cause to be discharged, any patient when: 
A. 
Conditions justifying hospitalization no longer obtain; 
B. 
The patient is transferred to another hospital for treatment for that patient's 
mental or physical condition; 
C. 
The patient is absent from the psychiatric hospital unlawfully for a period of 90 
days; 
D. 
Notice is received that the patient has been admitted to another hospital, inside 
or outside the State, for treatment for that patient's mental or physical condition; or 
E. 
Although lawfully absent from the psychiatric hospital, the patient is admitted to 
another hospital, inside or outside the State, for treatment of that patient's mental or 
physical condition, except that, if the patient is directly admitted to another hospital 
and it is the opinion of the chief administrative officer of the psychiatric hospital that 
the patient will directly reenter the psychiatric hospital within the foreseeable future, 
the patient need not be discharged. 
3. 
Discharge against medical advice. 
The chief administrative officer of a 
psychiatric hospital may discharge, or cause to be discharged, any patient even though the 
patient is mentally ill and appropriately hospitalized in the psychiatric hospital, if: 
A. 
The patient and either the guardian, spouse or adult next of kin of the patient 
request that patient's discharge; and 
B. 
In the opinion of the chief administrative officer of the psychiatric hospital, the 
patient does not pose a likelihood of serious harm due to that patient's mental illness. 
5. Notice. Notice of discharge is governed as follows. 
A. 
When a patient is discharged under this section, the chief administrative officer 
of the psychiatric hospital shall immediately make a good faith attempt to notify the 
following people, by telephone, personal communication or letter, that the discharge 
has taken or will take place: 
(1) The parent or guardian of a minor patient; 
(2) The guardian of an adult incompetent patient, if any is known; or 
(3) The spouse or adult next of kin of an adult competent patient, if any is 
known, unless the patient requests in writing that the notice not be given or 
unless the patient was transferred from or will be returned to a state correctional 
facility. 
If the chief administrative officer of the psychiatric hospital to which the patient is 
currently admitted has reason to believe that notice to any of the individuals listed in 
this paragraph would pose a risk of harm to the person, then notice may not be given 
to that individual. 
B. 
The psychiatric hospital is not liable when good faith attempts to notify the 
parents, spouse or guardian have failed. 
6. Discharge to progressive treatment program. If a person participates in the 
progressive treatment program under section 3873, the time period of a commitment 
under this section terminates on entry into the progressive treatment program. 
SUMMARY 
This bill makes the following changes to the Maine Revised Statutes, Title 34-B 
provisions governing hospitalization of psychiatric patients. 
1. 
It deletes the definition of "hospital," and adds the definition of "psychiatric 
hospital." The definition of "patient" is also expanded so that it describes not only 
persons receiving care in inpatient beds, but also persons being assessed in hospital 
emergency departments. 
2. It gives the Commissioner of Health and Human Services power to investigate 
complaints not only of patients in psychiatric hospitals but also of patients in general 
hospital emergency rooms who are being evaluated for certification for commitment. It 
gives the commissioner clear authority to visit nonpsychiatric hospitals that are involved 
in the certification process in order to review procedures related to the early steps of 
commitment. 
3. It places the phrase "psychiatric hospital" where the word "hospital" was used in 
the past to retain the meaning under the new definitions. 
4. It amends the law concerning a certification outside the hospital emergency room 
to permit a physician's assistant, certified psychiatric clinical nurse specialist or nurse 
practitioner, as well as a licensed physician or licensed clinical psychologist, to make the 
certification. 
5. It clarifies that a judicial officer can review a faxed certification. It clarifies that a 
patient may be held in any hospital for up to 18 hours while a placement and judicial 
endorsement are being sought. It amends the law so that the person seeking a patient's 
admission, rather than the law enforcement officer or ambulance service transporting the 
patient, is responsible for ensuring that the certification is judicially endorsed. 
6. It clarifies that a regular hospital may see a person in the emergency room and 
decide that the person needs to be involuntarily committed to a psychiatric hospital to 
receive the best care for that person. It clarifies that both kinds of hospitals are involved 
in this commitment process. 
7. It deletes the requirement that an application be dismissed if the 2 examiners 
report that the person is not mentally ill or does not pose a likelihood of serious harm. 
Instead, it provides that a hearing must be held on every application to give others a 
chance to testify, even if the examiners do not support the application.