An Act To Allow Law Enforcement and Family Members To Petition the District Court To Initiate Assisted Outpatient Treatment
Maine Legislature, Session 124, LD 1360
Committee Amendment CA_B_S513 (Senate)
Amends: 15 MRSA §393, 34-B MRSA §3801, 34-B MRSA §3864, 34-B MRSA §3873

COMMITTEE AMENDMENT" /3" to S.P. 495, L.D. 1360, Bill, "An Act To 
Allow Law Enforcement and Family Members To Petition the District Court To Initiate 
Assisted Outpatient Treatment" 
Amend the bill by striking out the title and substituting the following: 
'An Act Regarding Mental Health Treatment' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, provisions of law related to progressive treatment programs for certain 
persons with mental illness will be repealed on July 1,20 10; and 
Whereas, it is necessary to extend the progressive treatment programs law and make 
related amendments to the laws; and 
Whereas, that extension and the related changes might not take effect on July I, 
I 0 unless enacted an emergency measures; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 15 MRSA §393, sub-§I, ~, as enacted by PL 2007, c. 670, §6, IS 
amended to read: 
E. Has been: 
(1) Committed involuntarily to a hospital pursuant to .an order of the District 
Court under Title 34-B, section 3864 because the person was found to present a 
COMMITTEE AMENDMENT 
.':\. 
I 
,~.,. 
II 
COMMITTEE AMENDMENT~' to S.P. 495, L.D. 1360 
likelihood of serious harm, as defined under Title 34-B, section 380 I, subsection 
4-- 4-A, paragraphs A to C; 
(2) Found not criminally responsible by reason of insanity with respect to a 
criminal charge; or 
(3) Found not competent to stand trial with respect to a criminal charge. 
Sec. 2. 25 MRS A §1541, sub-§3, cue, as enacted by PL 2007, c. 670, § 16, is 
amended to read: 
C. 
The commanding officer shall report to the Federal Bureau of Investigation, 
National Instant Criminal Background Check System a court's finding, upon the 
commanding officer's receipt of an abstract from a court that a person has been: 
(I) Committed involuntarily to a hospital pursuant to an order of the District 
Court under Title 34-B, section 3864 because the person was found to present a 
likelihood of serious harm, as defined under Title 34-B, section 380 I, subsection 
4-- 4-A, paragraphs A to 0; 
(2) Found not criminally responsible by reason of insanity with respect to a 
criminal charge; or 
(3) Found not competent to stand trial with respect to a criminal charge. 
The commanding officer may adopt rules to implement the requirements of this 
paragraph. Rules adopted pursuant to this paragraph are routine technical rules, as 
defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 3. 34-B MRSA §3801, sub-§4, as amended by PL 2005, c. 519, Pt. BBBB, 
§§ I and 2 and affected by §20, is repealed. 
Sec. 4. 34-B MRSA §3801, sub-§4-A is enacted to read: 
4-A. Likelihood of serious harm. "Likelihood of serious harm" means: 
A. A substantial risk of physical harm to the person as manifested by recent threats 
of, or attempts at, suicide or serious self-inflicted harm; 
B. 
A substantial risk of physical harm to other persons as manifested by recent 
homicidal or violent behavior or by recent conduct placing others in reasonable fear 
of serious physical harm; 
C. A reasonable certainty that the person will suffer severe physical or mental harm 
as manifested by recent behavior demonstrating an inability to avoid risk or to protect 
the person adequately from impairment or injury; or 
D. 
For the purposes of section 3873, in view of the person's treatment history, 
current behavior and inability to make an informed decision, a reasonable likelihood 
that the person's mental health will deteriorate and that the person will in the 
foreseeable future pose a likelihood of serious harm as defined in paragraphs A, B or 
C. 
Sec. 5. 34-B MRS A §3801, sub-§4-B is enacted to read: 
COMMITTEE AMENDMENT 
') 
) 
) 
"t,. 
'V". 
(~~\ 
I 
II 
( 
'. ~~--~ 
COMMITTEE AMENDMENT"!?" to S.P. 495, L.D. 1360 
4-B. 
Medical practitioner. 
"Medical practitioner" or "practitioner" means a 
licensed physician, registered physician assistant, certified psychiatric clinical nurse 
specialist, certified nurse practitioner or licensed clinical psychologist. 
Sec. 6. 
34-B MRSA §3801, sub-§5, as enacted by PL 1983, c. 459, §7, is 
amended to read: 
5. Mentally ill person. "Mentally ill person" means a person having a psychiatric or 
other disease wIti€ft that substantially impairs fl.i.s that person's mental health, including or 
creates a substantial risk of suicide. "Mentally ill person" includes persons suffering.frem. 
tfte effects e.f from the use of drugs, narcotics, hallucinogens or intoxicants, including 
alcohol, but not including mentally retarded or sociopathic persons. 
A person with 
developmental disabilities or a person diagnosed as a sociopath is not for those reasons 
alone a mentally ill person. 
Sec. 7. 34-B MRSA §3801, sub-§7, as amended by PL 2007, c. 319, §2, is 
further 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, a person 
receiving services from an assertive community treatment team, a person receiving 
intensive mental health management services from the department or a person being 
evaluated for emergency admission' under section 3863 in a hospital emergency 
department. 
Sec. 8. 34-B MRS A §3863, sub-§2, as amended by PL 2007, c. 319, §9, is 
further amended to read: 
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 medical practitioner or licensed clinical 
psychologist, stating: 
A. The physician, physician's assistant, certified psychiatric clinical nurse specialist, 
fltIfSe That the 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, 
fltIfSe That the 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 opin ion7; and 
C. That adequate community resources are unavailable for care and treatment of the 
person's mental illness. 
Sec. 9. 34-B MRSA §3864, sub-§4, ~, as amended by PL 2007, c. 446, §3 and 
affected by § 7, is further amended to read: 
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; 
COMMITTEE AMENDMENT 
~\ 
'{\. tt.\ • 
I 
II 
IS 
COMMITTEE AMENDMENTib" to S.P. 495, L.D. 1360 
(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 380 I, subsection 4- 4-A; and 
(4) When involuntary treatment is at issue, whether the need for such treatment 
meets the criteria of subsection 7-A, paragraphs A and B7; and 
(5) Whether adequate community resources are available for care and treatment 
of the person's mental illness. 
Sec. 10. 34-B MRSA §3864, sub-§6, as amended by PL 2007, c. 319, § 10, is 
further amended to read: 
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: 
" 
(I) 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; 
(I-A) That adequate community resources for care and treatment of the person's 
mental illness are unavailable; 
(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 
+ (I), (I-A) and ~ ill, 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. 
Sec. 11. 34-B MRSA §3873, sub-§2, as amended by PL 2009, c. 321, § I, is 
further amended to read: 
2. Criteria for participation. The following criteria apply to participation in the 
progressive treatment program. 
A. Participation in the program must be ordered by the District Court in accordance 
with this paragraph. 
(I) The superintendent of a state mental health institute may file an application 
for an order of admission to the progressive treatment program with the District 
Court. 
COMMITTEE AMENDMENT 
" 
') 
) 
') 
.,.' 
~i\." '-
,r .... , 
( 
'\ 
I 
. 
I 
II 
IS 
COMMITTEE AMENDMENT:£;" to S.P, 495, L.D. 1360 
(2) The procedures for commitment under section 3864 apply, except that an 
order of admission to the progressive treatment program requires the following: 
(a) A finding that the person meets the criteria of paragraph B; 
(b) A finding that an assertive community treatment team is available to 
provide treatment and care for the person; and 
(c) A provision in the order that requires the person to return to the state 
mental health institute pursuant to subsection 5 in the event of failure to fully 
participate and deterioration of the person's mental health so that 
hospitalization is in the person's best interest and the person poses a 
likelihood of serious harm as defined in section 380 I, subsection 4- 4-A, 
paragraph D, 
B. The person must: 
(I) Be 18 years of age or older; 
(2) Have been clinically determined to be suffering from a severe and persistent 
mental illness; 
(3) Have been under an order of involuntary commitment to a state mental health 
institute at the time of filing of the application for progressive treatment; and 
(4) Have been clinically determined to be in need of the progressive treatment 
program in order to prevent interruptions in treatment, relapse and deterioration 
of mental health and to enable the person to survive safely in a community setting 
in the reasonably foreseeable future without posing a likelihood of serious harm 
as defined in section 380 I, subsection 4- 4-A, paragraph D. A determination 
under this subparagraph must be based on current behavior, treatment history, 
documented history of positive responses to treatment while hospitalized, relapse 
and deterioration of mental health after discharge and inability to make informed 
decisions regarding treatment. 
Sec. 12. 34-B MRSA §3873, sub-§S, as amended by PL 2009, c. 276, §2, IS 
further amended to read: 
5. Termination of participation. Failure of a person to fully participate in the 
program and follow the individualized treatment plan may result in termination of 
paliicipation in the program and rehospitalization under this subsection. 
A. 
If the person does not fully participate in the program and follow the 
individualized treatment plan and if the assertive community treatment team 
physician, psychologist, certified psychiatric clinical nurse specialist or nurse 
practitioner determines, based on clinical findings, that as a result of failure to fully 
participate or follow the individualized treatment plan the person's mental health has 
deteriorated so that hospitalization is in the person's best interest and the person poses 
a likelihood of serious harm as defined in section 3801, subsection 4- 4-A, paragraph 
D, the assertive community treatment team physician, psychologist, certified 
psychiatric clinical nurse specialist or nurse practitioner shall complete a certificate 
stating that the person requires hospitalization and the grounds for that belief The 
COMMITTEE AMENDMENT 
~\. 
~.f. 
I 
II 
IS 
COMMITTEE AMENDMENT "i?" to S.P. 495, L.D. 1360 
person may agree to hospitalization or may be subject to an application for 
readmission under paragraph B. 
B. 
A person who participates in the progressive treatment program may be 
rehospitalized on an emergency basis under the provisions of section 3863 if the 
judicial officer reviewing the certificate under section 3863, subsection 3 finds that 
rehospitalization is in the person's best interest and that the person poses a likelihood 
of serious harm as defined in section 3801, subsection 4- 4-A, paragraph D. This 
paragraph does not preclude the use of protective custody by law enforcement 
officers pursuant to section 3862. 
C. 
A person who participates in the progressive treatment program may be 
committed under section 3864 if the court reviewing the application finds that 
hospitalization is in the person's best interest and that the person poses a likelihood of 
serious harm as defined in section 380 I, subsection 4- 4-A, paragraph D. 
D. If the person has an advance directive or durable power of attorney or a guardian, 
the advance directive may be admitted into evidence and the attorney in fact or 
guardian may provide testimony and evidence to the court in any proceeding under 
this subsection. The court shall consider but is not required to follow any directions 
within the advance directive or durable power of attorney document or testimony 
from the attorney or guardian. 
Sec. 13. 34-B MRSA §3873, sub-§6, as enacted by PL 2005, c. 519, Pt. BBBB, 
§ 14 and affected by §20, is amended to read: 
6. Repeal. This section is repealed July I,;mw 2014. 
Sec. 14. Report. The Department of Health and Human Services shall conduct a 
review and analysis of the progressive treatment program established under the Maine 
Revised Statutes, Title 34-B, section 3873 and shall report to the joint standing committee 
of the Legislature having jurisdiction over health and human services matters by January 
I, 2012. The review process must include the collection and analysis of data regarding 
participants in the progressive treatment program over periods of time prior to, during and 
after participation in the program. The review process must include work with a broad 
group of stakeholders to compile a list of resources that would be needed if the State were 
to implement assisted outpatient mental health treatment for persons who have been 
ordered by a court to receive mental health treatment outside of a psychiatric hospital. 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment is the minority report of the committee. The amendment replaces 
the bill. The amendment adds an emergency preamble and emergency clause to the bill. 
It provides a definition for "medical practitioner" in the laws on commitment for mental 
illness. It redefines "likelihood of serious harm," "mentally ill person" and "patient." It 
extends the repeal provision on the progressive treatment program under the Maine 
COMMITTEE AMENDMENT 
.t 
) 
0) 
.. ') 
.,,' 
,~ 
~ .• " 
('-"\ 
I 
COMMITTEE AMENDMENT ~" 
to S.P. 495, L.D. 1360 
Revised Statutes, Title 34-B, section 3873 for 4 years and requ ires a comprehensive 
report from the Department of Health and Human Services by January I, 2012. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/23/10 .:'k?ac:.. 
LD 1360 
LR 1770(02) 
An Act To Allow Law Enforcement and Family Members To Petition the District Court To Initiate 
Assisted Outpatient Treatment 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment 'iJ" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
The additional costs to the Judicial Branch and the Department of Health and Human Services can be absorbed 
1\ 
) 
utilizing existing budgeted resources.') 
,./ 
',',) 
LRI770(02) - Fiscal Note - Page 1 of 1