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_A_S512 (Senate)
Amends: 25 MRSA §1541, 34-B MRSA §3801, 34-B MRSA §380, 34-B MRSA §383, 34-B MRSA §3862, 34-B MRSA §3863, 34-B MRSA §3864, 34-B MRSA §3871, 34-B MRSA §3873-A

COMMITTEE AMENDMENT ,,4 " 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 celiain 
persons with mental illness will be repealed on July 1,2010; and 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 1, 
2010 unless enacted as 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 p~lrsual1t to an order of the District 
Court under Title 34-B, section 3864 because the person was found to present a 
COMMITTEE AMENDMENT 
~. 
~~. 
] 
]0 
1] 
]2 
]3 
]4 
COMMITIEE AMENDMENT "A " 
to S.P. 495, L.D. 1360 
likelihood of serious harm, as defined under Title 34-B, section 380], 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 MRSA §1541, sub-§3, ~C, 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: 
(l) 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 3801, subsection 
4- 4-A, paragraphs A to D; 
(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, 
§§ 1 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 injUlY; or 
D. For the purposes of section 3873-A, in view of the person's treatment histOlY, 
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 MRSA §3801, sub-§4-B is enacted to read: 
COMMITTEE AMENDMENT 
") 
') 
,.' 
) 
· .%. 
~. 
... '~-
( '\ 
COMMITTEE AMENDMENT" A" 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 §380l, 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 whleh that substantially impairs flts that person's mental health, induding or 
creates a substantial risk of suicide. "Mentally ill person" includes persons suffering fFem. 
tRe effects sf from the use of drugs, narcotics, hallucinogens or intoxicants, including 
alcohol, but not induding 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 §380l, 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 MRSA §380l, sub-§7-A, as enacted by PL 2005, c. 519, Pt. BBBB, 
§3 and affected by §20, is amended to read: 
7-A. 
Progressive treatment program. 
"Progressive treatment program" or 
"program" means a program of court-ordered services provided to participants under 
section ~ 
3873-A. 
. 
Sec. 9. 34-B MRSA §380l, sub-§7-B, as enacted by PL 2007, c. 319, §3, is 
amended to read: 
7-B. Psychiatric hospital. "Psychiatric hospital" means: 
A. A state mental health institute; er 
B. A nonstate mental health institution.~ 
C. A designated nonstate mental health institution. 
Sec. 10. 34-B MRSA §383l, sub-§6, as amended by PL 2007, c. 319, §6, is 
further amended to read: 
6. Adults with advance health care directives. An adult with an advance health 
care directive authorizing 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 
COMMITTEE AMENDMENT 
%. 
~.~ 
COMMITTEE AMENDMENT "A" to S.P. 495, L.D. 1360 
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-A. 
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. 11. 34-B MRSA §3862, sub-§I, as amended by PL 2007, c. 178, §1, is 
further amended to read: 
1. Law enforcement officer's power. If a law enforcement officer has reasonable 
grounds probable cause to believe, based upon probable cause, that a person may be 
mentally ill and that due to that condition the person presents a threat of imminent and 
substantial physical harm to that person or to other persons, or if a law enforcement 
officer knows that a person has an advance health care directive authorizing mental health 
treatment and the officer has reasonable grounds probable cause to believe, based upon 
nrobable cause. that the person lacks capacity, the law enforcement officer: 
A. May take the person into protective custody; and 
B. If the law enforcement officer does take the person into protective custody, shall 
deliver the person immediately for examination by a medical practitioner 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. 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. 
When,..-ifl formulating probable cause, the law enforcement officer relies may rely upon 
information provided by a 3rd-party informant, if the officer shall confirm confirms that 
the informant has reason to believe, based upon the informant's recent personal 
observations of or conversations 'i'lith a person, personallmowledge sufficient to justify a 
belief that the person may be mentally ill and that due to that condition the person 
presents a threat of imminent and substantial physical harm to that person or to other 
persons. 
Sec. 12. 34-B MRSA §3862, sub-§3, as enacted by PL 1983, c. 459, §7, IS 
amended to read: 
COMMITTEE AMENDMENT 
') 
') 
" 
) 
· 
~~. 
~. 
,r"~, 
; 
\ 
( 
, 
COMMITTEE AMENDMENT 'A" to S.P. 495, L.D. 1360 
3. Certificate executed. If the certificate is executed by the exam iner under section 
3863, the officer shall undertake forthwith to secure the endorsement of ajudicial officer 
under section 3863 and may detain the person for a reasonable period of time, not to 
exceed 18 hours. oendine: as may be necessalY to obtain that endorsement. 
Sec. 13. 34-B MRSA §3863, sub-§I, as amended by PL 2007, c. 319, §9, is 
further amended to read: 
1. Application. Any health officer, law enforcement officer or other person may 
make a '""ritten application mm.!Y to admit a person to a psychiatric hospital, subject to the 
prohibitions and penalties of section 3805, stating: 
A. 
The person's applicant's belief that the person is mentally ill and, because of the 
person's illness, poses a likelihood of serious harm; and 
B. The grounds for this belief. 
Sec. 14. 34-B MRSA §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 
osvcholoe:ist. stating: 
A. The physiciml, physician's assistant, certified psychiatric clinical nurse specialist, 
ffilfSO That the practitioner or psychologist has examined the person on the date of the 
certificate; aOO 
B. The physician, physician's assistant, certified psychiatric clinical nurse specialist, 
ffilfSO That the medical 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:-.;. 
C. That adequate community resources are unavailable for care and treatment of the 
person's mental illness; and 
D. 
The grounds for the practitioner's opinion, which may be based on personal 
observation or on history and information from other sources considered reliable by 
the examiner. 
Sec. 15. 34-B MRSA §3863, sub-§5, as amended by PL 2007, c. 319, §9, is 
repealed. 
Sec. 16. 34-B MRSA §3863, sub-§5-A is enacted to read: 
5-A. Continuation of hospitalization. If there is need for fwiher hospitalization of 
the person as determined by the chief administrative officer of the hospital, the chief 
administrative officer shall first determine if the person may be informally admitted under 
section 3831. If informal admission is not suitable or is refused by the person, the chief 
administrative officer may seek involuntary commitment in accordance with this 
subsection. 
A. If the person is at a state mental health institute, the chief administrative officer 
may seek involuntary commitment by applying for an order under section 3864. 
COMMITTEE AMENDMENT 
~~. 
~. 
II 
COMMITTEE AMENDMENT "A" to S.P. 495, L.D. 1360 
B. 
If the person is at a designated nonstate mental health institution, the chief 
administrative officer may seek involuntary commitment only by requesting the 
commissioner to apply for an order under section 3864. 
C. An application under this subsection must be made to the District Court having 
territorial jurisdiction over the psychiatric hospital to which the person is admitted on 
an emergency basis and 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. If no application to the District Court is timely filed, the person must be 
promptly discharged. 
Sec. 17. 34-B MRSA §3863, sub-§6, ~, as enacted by PL 1983, c. 459, §7, is 
amended to read: 
E. One of Either the next of kin or a friend, if none of the listed persons e)dsts no 
guardian or immediate family member is known or can be quickly located. 
Sec. 18. 34-B MRSA §3863, sub-§7, as amended by PL 2007, c. 319, §9, is 
further amended to read: 
7. Post-admission examination. Every patient admitted to a psychiatric hospital 
under this section must be examined as soon as practicable after the patient's admission. 
If findings required for admission under subsection 2 are not certified in a 2nd opinion by 
a staff physician or licensed clinical psychologist within 24 hours after admission, the 
person must be immediately discharged. 
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 certifjling mmminer 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 the staff physician's or licensed clinical 
psychologist's opinion, the person is mentally ill and due to the person's mental 
illness poses a likelihood of serious harm, the person must be immediately 
discharged. 
Sec. 19. 34-B MRSA §3863, sub-§8, as amended by PL 2009, c. 276, § 1, is 
fmiher amended to read: 
8. 
Rehospitalization from progressive treatment program. 
The assertive 
community treatment An ACT team physician, psychologist, certified psychiatric clinical 
nurse specialist or nurse practitioner or the commissioner may make a ',witten application 
.rum.!Y under this section to admit to a state mental health institute a persen patient who 
fails to fully participate in the progressive treatment program in accordance with section 
3873, subsection 5 3873-A. The provisions of this section apply to that application. 
mwept that the standard for admission is governed by section 3873, subsection 5, 
naraeanh B. 
COMMITTEE AMENDMENT 
') 
.' 
.') 
,,' " 
) 
'to-
.~-
(~''; 
COMMITTEE AMENDMENT "A "to S.P. 495, L.D. 1360 
Sec. 20. 34-B MRSA §3864, sub-§l, as amended by PL 2007, c. 319, §10, is 
further amended to read: 
1. 
Application. 
An application to the District Court to admit a person to a 
psychiatric hospital, filed under section 3863, subsection ,) 5-A, oarmuaoh B. must be 
accompanied by: 
A. The emergency application under section 3863, subsection 1; 
B. 
The accompanying celiificate of the physician or psychologist medical 
practitioner under section 3863, subsection 2; 
C. The certificate of the physician or psychologist under section 3863, subsection 7 
.. I.~ .... 
ttfttt;".>. 
(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, if any, 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 hmv 
to contact the District Court; and~ 
(1) The patient's right to retain an attorney or to have an attorney appointed; 
(2) 
The patient's right to select or to have the patient's attorney select an 
independent examiner; and 
(3) How to contact the District Court; and 
E. A copy of the notice and instructions given to the patient. 
Sec. 21. 34-B MRSA §3864, sub-§4, as amended by PL 2007, c. 472, §1, is 
further amended to read: 
4. Examination. Examinations under this section are governed as follows. 
A. 
Upon receipt by the District COlui 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 a medical practitioner. 
If the 
application includes a request for an order for involuntalY treatment under subsection 
7-A, the practitioner must be a medical practitioner who is qualified to prescribe 
medication relevant to the patient's care. If the person under examination or the 
counsel for that person selects a qualified examiner who is reasonably available, the 
court shall give preference to choosing that examiner. 
(1) Except as provided in subparagraph (1 A), each eJwminer must be either a 
licensed nhvsician or a licensed clinical nsvcholo2'ist. 
COMMITTEE AMENDMENT 
~., 
~ 
~" 
I 
COMMITTEE AMENDMENT "A" to S.P. 495, L.D. 1360 
(1 A) If the application requests an order for involuntal)' treatment pursuant to 
subsection 1 A, one examiner must be a licensed physician or a licensed e1inical 
psychologist and one examiner must be a person 'Nho is qualified to prescribe 
medication relevant to the patient's care as a licensed physician, certified nurse 
practitioner or registered physician assistant. 
(2 A) If the person under examination or the counsel for that person selects a 
qualified examiner ',vho is reasonably available, then the court shall choose that 
examiner as one of the 2 designated by the court. 
(3) Neither e](aminer appointed by the court may be the certifying examiner 
under section 3863. subsection 2 or 7. 
B. The examination must be held at the f! psychiatric hospital or at any other suitable 
place not likely to have a harmful effect on the mental health of the person. 
E. The eKaminers examiner shall report to the court on: 
(1) Whether the person is a mentally ill person within the meaning of section 
3801, subsection 5; 
(2) When the establishment of a progressive treatment plan under section 3-8-H-
3873-A is at issue, whether a person is suffering from a severe and persistent 
mental illness within the mean ing of section 380 I, subsection 8-A; 
(3) Whether the person poses a likelihood of serious harm within the meaning of 
section 3801, subsection -4- 4-A; ana 
(4) When involuntary treatment is at issue, whether the need for such treatment 
meets the criteria of subsection 7-A, paragraphs A and B-,,~ 
(5) Whether adequate community resources are available for care and treatment 
of the person's mental illness; and 
(6) Whether the person's clinical needs may be met by an order under section 
3873-A to participate in a progressive treatment program. 
G. Opinions of the examiner may be based on personal observation or on history and 
information from other sources considered reliable by the examiner. 
Sec. 22. 34-B MRSA §3864, sub-§S, ~A, as amended by PL 2009, c. 281, §3, is 
further amended to read: 
A. The District Court sha.ll hold a hearing on the application not later than 14 days 
from the date of the application. The District Court may separate the hearing on 
commitment from the hearing on involuntary treatment. 
(1) Gil For good cause shown, on a motion by any party or by the court on its 
own motion, the hearing on commitment or on involuntary treatment may be 
continued for cause for a period not to exceed -W Zl additional days. 
(1 A) On a motion by any party or by the court on its own motion, the hem'ing on 
involuntUl)' treatment may be continued for cause for a period not to exceed 21 
davs from the date of entrv of the order on the annlication for commitment. 
COMMITTEE AMENDMENT 
,) 
) 
) 
~. 
-:t-
~. 
/,..-",~, 
( 
'. 
...., 
COMMITTEE AMENDMENT·A" to S.P. 495, L.D. 1360 
(2) If the hearing on commitment 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. 
(2-A) If the hearing on involuntary treatment is not held within the time 
specified, or within the specified continuance period, the COllli shall dismiss the 
application for involuntary treatment. 
(3) In computing the time periods set forth in this paragraph, the Maine Rules of 
Civil Procedure apply. 
Sec. 23. 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: 
(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; 
(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 
+- (1), (I-A) and ~ 0, 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. 
C. If the District COUli makes the findings in section 3873-A, subsection 1, the COllli 
may issue an order under section 3873-A requiring the person to participate in a 
progressive treatment program. 
Sec. 24. 34-B MRS A §3864, sub-§7, as amended by PL 2007, c. 319, § 1 0, is 
further amended to read: 
7. Commitment. Upon making the findings described in subsection 6, paragraph A, 
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 24 
hours of the hearing. 
COMMITTEE AMENDMENT 
.~ 
~ 
COMMITTEE AMENDMENT" ~, to S.P. 495, L.D. 1360 
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 immediately. 
Sec. 25. 34-B MRSA §3864, sub-§7-A, f[C, as enacted by PL 2007, c. 446, §4 
and affected by § 7, is amended to read: 
C. The hospital and person parties may agree to changes in change, terminate or 
extend the treatment plan during the time period of an order for involuntary 
treatment. 
Sec. 26. 34-B MRSA §3864, sub-§7-A, enD, as enacted by PL 2007, c. 446, §4 
and affected by § 7, is amended to read: 
D. If a change in the treatment plan is needed and the hospital and patient do not 
agree on the change, the hospital shall For good cause shown, any party may apply to 
the court fer.-a to change .ffi or terminate the treatment plan. 
Sec. 27. 34-B MRSA §3871, sub-§6, as enacted by PL 2005, c. 519, Pt. BBBB, 
§ 13 and affected by §20, is amended to read: 
6. Discharge to progressive treatment program. If a person participates in the 
progressive treatment program under section ~ 
3873-A, the time period of a 
commitment under this section terminates on entry into the progressive treatment 
program. 
Sec. 28. 34-B MRS A §3873, as amended by PL 2009, c. 276, §2 and c. 321, §§1 
to 4, is repealed. 
Sec. 29. 34-B MRSA §3873-A is enacted to read: 
§3873-A. Progressive treatment program 
1. Application. The superintendent or chief administrative officer of a psychiatric 
hospital, the commissioner or the director of an ACT team, except as limited by 
subsection 10, may obtain an order from the District COlllt to admit a patient to a 
progressive treatment program upon the following conditions: 
A. The patient suffers from a severe and persistent mental illness; 
B. The patient poses a likelihood of serious harm; 
C. The patient has the benefit of a suitable individualized treatment plan; 
D. Community resources are available to support the treatment plan; 
E. The patient is unlikely to follow the treatment plan voluntarily; 
F. Court-ordered compliance will help to protect the patient from interruptions in 
treatment, relapses or deterioration of mental health; and 
G. Compliance will enable the patient to survive more safely in a community setting 
without posing a likelihood of serious harm. 
2. 
Contents of the application. 
The application must be accompanied by a 
certificate of a medical practitioner providing the facts and opinions necessary to support 
COMMITTEE AMENDMENT 
) 
') 
:) 
."e' 
" 
.,-~ .. 
( 
) 
1 "- •• , 
,/ 
I 
COMMITTEE AMENDMENT,./r" to S.P. 495, L.D. 1360 
the application. 
The certificate must indicate that the examiner's opinions are based on 
one or more recent examinations of the patient or upon the examiner's recent personal 
treatment of the patient. Opinions of the examiner may be based on personal observation 
or on history and information from other sources considered reliable by the examiner. 
The applicant must also provide a written statement 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, if any, have been notified of: 
A. The patient's right to retain an attorney or to have an attorney appointed; 
B. The patient's right to select or to have the patient's attorney select an independent 
examiner; and 
II 
C. How to contact the District Court. 
3. Notice of hearing. Upon receipt by the District Court of the application or any 
motion relating to the application, the court shall cause written notice of hearing to be 
mailed within 2 days to the applicant, to the patient and to the following persons if 
known: to anyone serving as the patient's guardian and to the patient's spouse, a parent or 
an adult child, if any. If no immediate relatives are known or can be located, notice must 
be mailed to a person identified as the patient's next of kin or a friend, if any are known. 
If the applicant has reason to believe that notice to any individual would pose risk of 
harm to the patient, notice to that individual may not be given. 
A docket entry is 
sufficient evidence that notice under this subsection has been given. 
4. Examinations. 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 I and at least 3 days after the person who is the 
subject of the examination is notified by the applicant 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 a medical practitioner. If the person under examination or 
the counsel for that person selects a qualified examiner who is reasonably available, 
the court shall give preference to choosing that examiner. 
B. The examination must be held at a psychiatric hospital, a crisis center, an ACT 
team facility or at another suitable place not likely to have a harmful effect on the 
mental health of the patient. 
C. The examiner shall report to the COllli on: 
(I) Whether the patient is a mentally ill person within the meaning of section 
I, subsection 5; 
(2) Whether the patient is suffering from a severe and persistent mental illness 
within the meaning of section 380 I, subsection 8-A; and 
(3) Whether the patient poses a likelihood of serious harm within the meaning of 
section 380 I, subsection 4-A. 
5. Hearings. Hearings under this section are governed as follows. 
COMMITTEE AMENDMENT 
e,. 
~. 
Q 
COMMITTEE AMENDMENT "A" to S.P. 495, L.D. 1360 
A. The District Court shall hold a hearing on the application or any subsequent 
motion not later than 14 days from the date when the application or motion is filed. 
For good cause shown, on a motion by any party or by the court on its own motion, 
the hearing may be continued for a period not to exceed 21 additional days. If the 
hearing is not held within the time specified, or within the specified continuance 
period, the court shall dismiss the application or motion. 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 harm the mental health of the 
patient. The applicant shall transport the patient to and from the place of hearing. If 
the patient is released following the hearing, the patient must be transpOlied to the 
patient's place of residence if the patient so requests. 
C. 
The court shall conduct the hearing in accordance with accepted rules of 
evidence. The patient, the applicant and all other persons to whom notice is required 
to be sent must be afforded an 0ppOliunity to appear at the hearing to testifY and to 
present and cross-examine witnesses. The court may, in its discretion, receive the 
testimony of any other person and may subpoena any witness. 
D. The patient must be afforded an opportunity to be represented by counsel, and, if 
neither the patient nor others provide counsel, the court shall appoint counsel for the 
patient. 
E. At the time of hearing, the applicant shall submit to the court expert testimony to 
support the application and to describe the proposed individual treatment plan. The 
applicant shall bear the expense of providing witnesses for this purpose. 
F. The court may consider, but is not bound by, an advance directive or durable 
power of attorney executed by the patient and may receive testimony from the 
patient's guardian or attorney in fact. 
G. A stenographic or electronic record must be made of the proceedings. The record 
and all notes, exhibits and other evidence are confidential and must be retained as 
part of the District Court records for a period of2 years from the date of the hearing. 
H. The hearing is confidential and a repoli of the proceedings may not be released to 
the public or press, except by permission of the patient or the patient's counsel and 
with approval of the presiding District Court Judge, except that the cOUli may order a 
public hearing on the request of the patient or patient's counsel. 
1. Except as provided in this subsection, the provisions of section 3864, subsections 
and 11 apply to expenses and the right of appeal. 
6. Order. After notice, examination and hearing, the couli may issue an order 
effective for a period of up to 12 months directing the patient to follow an individualized 
treatment plan and identirying incentives for compliance and potential consequences for 
noncompliance. 
7. Compliance. To ensure compliance with the treatment plan, the cOllli may: 
COMMITTEE AMEND 'ENT 
:) 
) 
') 
· ~. 
~ 
«--. 
(''''') 
COMMITTEE AMENDMENT"JI" to S.P. 495, L.D. 1360 
A. Order that the patient be committed to the care and supervision of an ACT team 
or other outpatient facility with such restrictions or conditions as may be reasonable 
and necessary to ensure plan compliance; 
B. Issue an order of emergency commitment under section 3863 conditioned on 
receiving a certificate from a medical practitioner that the patient has failed to comply 
with an essential requirement of the treatment plan; and 
C. Order that any present or conditional restrictions on the patient's liberty or control 
over the patient's assets or affairs be suspended or ended upon achievement of the 
designated goals under the treatment plan. 
S. Consequences. In addition to any conditional remedies contained in the court's 
order, if the patient fails to comply with the treatment plan, the applicant may file with 
the court a motion for enforcement supported by a certificate from a medical practitioner 
identifYing the circumstances of noncompliance. If after notice and hearing the cOllli 
finds that the patient has been noncompliant and that the patient presents a likelihood of 
serious harm, the court may authorize emergency hospitalization under section 3863 if 
the practitioner's certificate supporting the motion complies with section 3863, subsection 
2. Nothing in this section precludes the use of protective custody by law enforcement 
officers under section 3862. 
9. Motion to dissolve, modify or extend. For good cause shown, any party to the 
application may move to dissolve or modifY an order or to extend the term of the 
treatment plan for an additional term of up to one year. 
10. Limitation. The director of an ACT team may apply to the District COllli to 
obtain an order under subsection 1 to admit a patient to a progressive treatment program 
only if: 
A. The ACT team was in existence on the effective date of this section; 
B. The ACT team complies with nationally recognized essential standards and basic 
principles for the provision of mental health services at the ACT team level as 
identified in rules adopted by the department; and 
C. 
The ACT team meets the criteria for ACT teams set forth in section 3801, 
subsection 11 and applicable state rules and federal laws and regulations. 
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
Sec. 30. Application. All progressive treatment plans in effect July 1,2010 must 
be continued under the provisions of the Maine Revised Statutes, Title 34-B, section 
3873-A. 
Sec. 31. 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-A and shall repOli to the joint standing 
committee of the Legislature having jurisdiction over health and human services matters 
by January 1,2012. 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 
COMMITTEE AMENDMENT 
~. 
rh-%. 
COMMITTEE AMENDMENT"k "to S.P. 495, L.D. 1360 
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. 
Sec. 32. Emergency rule-malting authority. The Department of Health and 
Human Services shall adopt emergency rules on or before October 1, 2010 under the 
Maine Revised Statutes, Title 5, sections 8054 and 8073 in order to implement 
rulemaking under Title 34-B, section 3873-A, subsection 10 relating to ACT team 
compliance with nationally recognized essential standards and basic principles for the 
provision of mental health services at the ACT team level. The department may adopt the 
rules without having to demonstrate that immediate adoption is necessary to avoid a 
threat to public health, safety or general welfare. The rules must identify nationally 
recognized essential standards and basic principles for ACT teams providing mental 
health services under the progressive treatment program pursuant to Title 34-B, section 
3873-A. 
Sec. 33. Delayed implementation. Notwithstanding the Maine Revised Statutes, 
Title 34-B, section 3873-A, subsection I, the director of an ACT team may not apply to 
the District Court to obtain an order to admit a patient to a progressive treatment program 
until the Department of Health and Human Services adopts rules pursuant to Title 34-B, 
section 3873-B, subsection 10 identifying nationally recognized essential standards and 
basic principles for the provision of mental health services by ACT teams and until the 
transition of claims processing under the Department of Health and Human Services 
MaineCare program to the department's new system in fiscal year 2010-11. 
Sec. 34. Appropriations and allocations. The following appropriations and 
allocations are made. 
JUDICIAL DEPARTMENT 
Courts - Supreme, Superior and District 0063 
Initiative: Deappropriates funds due to an anticipated reduction in the number of 
psychological examinations. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2009-10 
$0 
$0 
2010-11 
($87,600) 
($87,600) 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment is the majority report of the committee. The amendment replaces 
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 decreases the number of examiners for the purposes of mental health 
COMMITTEE AMENDMENT 
) 
') 
"') 
,.,.1 
.~. 
~. 
(---\, 
COMMITTEE AMENDMENT" A" to S.P. 495, L.D. 1360 
commitment from 4 to 2. It increases the time period, with an extension, for a hearing on 
court commitment from 24 days total to 35 days total. It establishes a new option for the 
court in a civil commitment hearing, the option of ordering the person to paJiicipate in a 
program of outpatient treatment, and provides for compliance and consequences for 
noncompliance with the treatment program. It allows an alternative community treatment 
team or the Commissioner of Health and Human Services to petition the court for an 
order that an alternative community treatment team participant be ordered to participate 
in outpatient treatment. It extends the time period in which the District Court must hold a 
hearing under the progressive treatment program from 14 to 21 days. It decreases the 
examiners for civil commitment under the Maine Revised Statutes, Title 34-B, section 
3864 from 2 examiners to one and gives preference to the patients' choice of examiner. It 
extends the time period for the progressive treatment program from 6 months to 12 
months. It requires a comprehensive report from the Department of Health and Human 
Services by January 1, 2012. It delays implementation of the provisions that authorize an 
ACT team director to apply for a COllli order to admit a patient to a progressive treatment 
program until rulemaking has been completed and the new MaineCare claims 
management process is functioning. The amendment authorizes emergency rulemaking 
to adopt rules regarding nationally recognized essential standards and basic principles for 
ACT teams. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04/01110 .?dac 
LD 1360 
LR 1770(03) 
An Act To Allow Law Enforcement and Family Members To Petition the District Court To Initiate 
Assisted Outpatient Treatment 
Fiscal Note for Bill as Amended by Committee Amendment ,A" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
2009-10 
2010-11 
Projections 
2011-12 
Projections 
2012-13 
) 
Net Cost (Savings) 
General Fund 
$0 
($87,600) 
($87,600) 
($87,600) .', 
') 
Appropriations/Allocations 
General Fund 
Fiscal Detail and Notes 
$0 
($87,600) 
($87,600) 
($87,600) 
This bill includes a General Fund deappropriation of$87,600 in fiscal year 2010-11 from the Judicial Department due 
to an anticipated decrease in the number of psychological examinations. The additional costs to the Department of 
Health and Human Services can be absorbed utilizing existing budgeted resources. 
LR1770(03) - Fiscal Note - Page 1 of 1 
,. 
)