An Act To Create a Secure, Therapeutic Mental Health Unit
Maine Legislature, Session 127, LD 0440
Committee Amendment CA_A_S458 (Senate)
Amends: 15 MRSA §101-D, 15 MRSA §103, 34-A MRSA §3069-A, 34-A MRSA §3069-B, 34-B MRSA §1207, 34-B MRSA §3863

COMMITTEE AMENDMENT" A" to S.P. 169, L.D. 440, Bill, "An Act To Create 
a Secure, Therapeutic Mental Health Unit" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 15 MRSA §101-D, sub-§4, as amended by PL 2013, c. 265, §1, is further 
amended to read: 
4. Commitment for observation. The court may commit the defendant to the 
custody of the Commissioner of Health and Human Services for placement in a secure, 
therapeutic mental health unit established pursuant to Title 34-B, chapter 3, subchapter 6 
if placement in the unit is determined by the court to be appropriate for the defendant and 
for the purpose of observation pursuant to this section. If the Commissioner of Health 
and Human Services determines that the defendant's placement in that unit is 
contraindicated, the commissioner shall so advise the court and the court may order that 
the defendant be placed in a state mental health institute as defined in Title 34-B, section 
3801, subsection 9, in an apf1F0flriate alternative institution that is appropriate for the care 
and treatment of people with mental illness or in an appropriate residential program that 
provides care and treatment for persons who have intellectual disabilities or autism, as set 
forth in this subsection. If the State Forensic Service determines that observation of the 
defendant will materially enhance its ability to perform an examination ordered pursuant 
to subsection 1, 2, 3 or 9 and the defendant is incarcerated, the observation may take 
place at the correctional facility where the defendant is incarcerated if the State Forensic 
Service determines that the correctional facility can provide an appropriate setting for the 
observation. If the ebservatiea is te take f1laee ia a eerreetieaal faeility, the 001:111 may aet 
eeHHBft the eefeaeaat te the e1:1st0ey efthe Cemmissieaer ef Health aae Ht:imaa Serviees. 
A. If the State Forensic Service determines that observation of the defendant in !!: 
secure, therapeutic mental health unit, in a state mental health institute, in an 
af1f1F0f1riate alternative institution that is appropriate for the care of people with 
mental illness or in an appropriate residential program that provides care and 
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treatment for persons who have intellectual disabilities or autism will materially 
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COMMITTEE AMENDMENT" A" to S.P. 169, L.D. 440 
enhance its ability to perform an examination ordered pursuant to subsection 1, 2, 3 
or 9, the State Forensic Service shall so advise the court. The State Forensic Service 
may make this determination based upon consultation with the defendant's attorney 
and the attorney for the State and the court and upon such other information as it 
determines appropriate. In addition, the State Forensic Service may include such a 
determination in a report to the court that recommends further evaluation of the 
defendant. 
B. Upon a determination by the State Forensic Service under paragraph A, a court 
having jurisdiction in a criminal case may commit the defendant to the custody of the 
Commissioner of Health and Human Services for placement in a secure, therapeutic 
mental health unit, in a state mental health institute, in an appropria-te alternative 
institution that is appropriate for the care and treatment of people with mental illness 
or in an appropriate residential program that provides care and treatment for persons 
who have intellectual disabilities or autism for observation for a period not to exceed 
days. If the State Forensic Service requires additional time for observation, it 
shall communicate its request and the reasons for that request to the court and to 
counsel for the parties. The court shall accommodate a party's request to be heard on 
the issue of whether an extension should be granted and may extend the commitment 
for up to an additional 90 days. Unless the defendant objects, an order under this 
paragraph must authorize the secure, therapeutic mental health unit, state mental 
health institute, institution or residential program where the defendant is placed by 
the Commissioner of Health and Human Services to provide treatment to the 
defendant. 
When further observation of the defendant is determined no longer 
necessary by the State Forensic Service, the commissioner shall report that 
determination to the court and the court shall terminate the commitment. If the 
defendant had been incarcerated prior to the commitment for observation and if, 
during the period of observation, the defendant presents a substantial risk of causing 
bodily injury to staff or others that cannot be managed in an appropriate state mental 
health institute, in an institution for the care and treatment of people with mental 
illness or in an appropriate residential program that provides care and treatment for 
persons who have intellectual disabilities or autism, the commissioner ma-y remm the 
Ele:ieaaaat to the eorreetioaal faeility shall commit the defendant to a secure, 
therapeutic mental health unit. The commissioner shall report the risk management 
issues to the court. Upon receiving the report, the court shall review the report and 
may enter any order authorized by this section, including termination of the 
commitment. 
C. If the eollft hati proviEleEl for remaaa to a eorreetioaal faeility follo•i'tiftg the 
eommitmeat lHKier paragFB:f)a B, the eorreetioaal faeility saa:ll e1 .. eel:lte tae remaaa 
orEler l:lpoa a<:l-viee fi:om the CoH!:missioaer of Health aaa Hl:H.Haa Serviees ts.at 
eommitmeat is Eletenmaea ao loager aeeessary. 
Sec. 2. 15 MRSA §101-D, sub-§5, ,A, as amended by PL 2013, c. 434, §1 and 
affected by § 15, is further amended to read: 
A. Commit the defendant to the custody of the Commissioner of Health and Human 
Services for placement in a secure, therapeutic mental health unit established in Title 
34-B, chapter 3, subchapter 6 if placement in the unit is determined to be appropriate 
for the defendant by the court. If the Commissioner of Health and Human Services 
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COMMITTEE AMENDMENT" Pt" to S.P. 169, L.D. 440 
determines the defendant's placement in that unit is contraindicated, the 
commissioner shall so advise the court and the court may order that the defendant be 
placed in a state mental health institute as defined in Title 34-B, section 3801, 
subsection 9 or an a~repriat:e alternative program that is appropriate for observation, 
care and treatment of people with mental illness or persons with intellectual 
disabilities or autism. An appropriate program may be in an institution for the care 
and treatment of people with mental illness, an intermediate care facility for persons 
who have intellectual disabilities or autism, a crisis stabilization unit, a nursing home, 
a residential care facility, an assisted living facility, a hospice, a hospital, an intensive 
outpatient treatment program or any program specifically approved by the court. At 
the end of 30 days or sooner, and again in the event of recommitment, at the end of 
days and 180 days, the State Forensic Service or other appropriate office of the 
Department of Health and Human Services shall forward a report to the 
Commissioner of Health and Human Services relative to the defendant's competence 
to stand trial and its reasons. The Commissioner of Health and Human Services shall 
without delay file the report with the court having jurisdiction of the case. The court 
shall hold a hearing on the question of the defendant's competence to stand trial and 
receive all relevant testimony bearing on the question. If the State Forensic Service's 
report or the report of another appropriate office of the Department of Health and 
Human Services to the court states that the defendant is either now competent or not 
restorable, the court shall within 30 days hold a hearing. If the court determines that 
the defendant is not competent to stand trial, but there does exist a substantial 
probability that the defendant will be competent to stand trial in the foreseeable 
future, the court shall recommit the defendant to the custody of the Commissioner of 
Health and Human Services for placement in a secure, therapeutic mental health unit 
if placement in the unit is determined by the court to be appropriate for the defendant. 
If the Commissioner of Health and Human Services determines the defendant's 
placement in that unit is contraindicated. the commissioner shall so advise the court 
and the court may order that the defendant be placed in a state mental health institute 
or an af)pFepriat:e alternative program that is appropriate for observation, care and 
treatment of people with mental illness or persons with intellectual disabilities or 
autism. An appropriate program may be in an institution for the care and treatment of 
people with mental illness, an intermediate care facility for persons who have 
intellectual disabilities or autism, a crisis stabilization unit, a nursing home, a 
residential care facility, an assisted living facility, a hospice, a hospital, an intensive 
outpatient treatment program or any program specifically approved by the court. 
When a l?erson who has been evaluated on behalf of the court by the State Forensic 
Service or other appropriate office of the Department of Health and Human Services 
is committed into the custody of the Commissioner of Health and Human Services 
under this paragraph, the court shall order that the State Forensic Service or other 
appropriate office of the Department of Health and Human Services share any 
information that it has collected or generated with respect to the person with the state 
mental health institute. institution or residential program in which the person is 
placed. If the defendant is charged with an offense under Title 17 -A, chapter 9, 11 or 
or Title 17-A, section 506-A, 802 or 803-A and the court determines that the 
defendant is not competent to stand trial and there does not exist a substantial 
probability that the defendant can be competent in the foreseeable future, the court 
shall dismiss all charges against the defendant and, unless the defendant is subject to 
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COMMITTEE AMENDMENT" A,, to S.P. 169, L.D. 440 
an undischarged term of imprisonment, order the Commissioner of Health and 
Human Services to commence proceedings pursuant to Title 34-B, chapter 3, 
subchapter 4. If the defendant is charged with an offense other than an offense under 
Title 17-A, chapter 9, 11 or 13 or Title 17-A, section 506-A, 802 or 803-A and the 
court determines that the defendant is not competent to stand trial and there does not 
exist a substantial probability that the defendant can be competent in the foreseeable 
future, the court shall dismiss all charges against the defendant and, unless the 
defendant is subject to an undischarged term of imprisonment, notify the appropriate 
authorities who may institute civil commitment proceedings for the individual. If the 
defendant is subject to an undischarged term of imprisonment, the court shall order 
the defendant into execution of that sentence and the correctional facility to which the 
defendant must be transported shall execute the court's order; or 
Sec. 3. 15 MRSA §103, first ,r, as amended by PL 2011, c. 542, Pt. A, §10, is 
further amended to read: 
When a court accepts a negotiated plea of not criminally responsible by reason of 
insanity or when a defendant is found not criminally responsible by reason of insanity by 
jury verdict or court finding, the judgment must so state. In those cases the court shall 
order the person committed to the custody of the Commissioner of Health and Human 
Services to be placed in a secure. therapeutic mental health unit established pursuant to 
Title 34-B, chapter 3, subchapter 6. if placement in the unit is determined by the court to 
be appropriate for the defendant. If the Commissioner of Health and Human Services 
determines the person's placement in that unit is contraindicated, the commissioner shall 
so advise the court and the court may order that the defendant be placed in a state mental 
health institute as defined in Title 34-B, section 3801, subsection 9 or an a_f)f)ropriate 
alternative institution that is appropriate for the care and treatment of persons with mental 
illness or in an appropriate residential program that provides care and treatment for 
persons who have intellectual disabilities or autism for care and treatment. 
Upon 
placement in the state mental health institution. appropriate institution or residential 
program and in the event of transfer from one institution or residential program to another 
of persons committed under this section, notice of the placement or transfer must be 
given by the commissioner to the committing court. 
Sec. 4. 34-A MRSA §3069-A, sub-§§1 and 2, as enacted by PL 2013, c. 434, 
§5, are amended to read: 
1. Eligible inmates. The commissioner may transfer from a jail to a correctional 
facility or. by agreement with the Commissioner of Health and Human Services, to a 
secure, therapeutic mental health unit established pursuant to Title 34-B, chapter 3, 
subchapter 6 an adult inmate who the chief administrative officer of the Riverview 
Psychiatric Center confirms is eligible for admission to a state mental health institute 
under Title 34-B, section 3863, but for whom no suitable bed is available, for the purpose 
of providing to the inmate mental health services in a mental health unit of a correctional 
facility or a secure, therapeutic mental health unit that provides intensive mental health 
care and treatment. The commissioner may not transfer pursuant to this section a person 
who has been found not criminally responsible by reason of insanity. The commissioner 
may return an inmate transferred pursuant to this subsection back to the sending facility. 
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COMMITTEE AMENDMENT" A" to S.P. 169, L.D. 440 
For purposes of this subsection, "intensive mental health care and treatment" has the same 
meaning as in section 3049, subsection 1. 
2. Evaluation. The commissioner may transfer from a jail to a correctional facility 
or, by agreement with the Commissioner of Health and Human Services, to a secure, 
therapeutic mental health unit established pursuant to Title 34-B, chapter 3, subchapter 6 
an adult inmate whom the court orders to be examined or further evaluated by the State 
Forensic Service under Title 15, section 101-D, subsection 1, 2, 3 or 9 if the State 
Forensic Service determines that the jail where the inmate is incarcerated cannot provide 
an appropriate setting for the examination but that a mental health unit in a correctional 
facility or a secure, therapeutic mental health unit can provide an appropriate setting for 
the examination. The commissioner shall return an inmate transferred pursuant to this 
subsection back to the sending facility upon the completion of the examination ordered, 
including any further evaluation ordered, unless the commissioner transferred the inmate 
for another reason in addition to the examination. 
Sec. 5. 34-A MRSA §3069-B, sub-§1, ,rB, as enacted by PL 2013, c. 434, §6, is 
amended to read: 
B. There is not sufficient security at a state mental health institute to address the 
likelihood of serious harm; aaa 
Sec. 6. 34-A MRSA §3069-B, sub-§1, ,rB-1 is enacted to read: 
B-1. There is not a suitable bed available at a secure, therapeutic mental health unit 
established pursuant to Title 34-B, chapter 3, subchapter 6; and 
Sec. 7. 34-B MRSA §1207, sub-§1, ,rB, as repealed and replaced by PL 2015, c. 
329, Pt. A, §21, is repealed and the following enacted in its place: 
B. Information may be disclosed as may be applicable to the department if necessary 
to carry out the statutory functions of the department; the provisions of chapter 3, 
subchapter 4 or subchapter 6; the provisions of section 1931; the purposes of section 
3608; the purposes of Title 5, section 19506; the purposes of United States Public 
Law 99-319, dealing with the investigatory function of the independent agency 
designated with advocacy and investigatory functions under United States Public 
Law 88-164, Title I, Part C or United States Public Law 99-319; the investigation and 
hearing pursuant to Title 15, section 393, subsection 4-A; the provision of therapeutic 
mental health care by the Department of Health and Human Services pursuant to 
chapter 3, subchapter 6; or the provision of mental health services by the department 
pursuant to Title 34-A, section 3031, 3069-A or 3069-B. 
This paragraph is repealed August 1, 2017; 
Sec. 8. 34-B MRSA §1207, sub-§1, ,rB-3, as amended by PL 2015, c. 329, Pt. 
A, §22, is further amended to read: 
B-3. Information may be disclosed if necessary to carry out the statutory functions of 
the department; the hospitalization provisions of chapter 3, subchapter 4; the 
provisions of section 1931; the purposes of section 3608; the purposes of Title 5, 
section 19506; the purposes of United States Public Law 99-319, dealing with the 
investigatory function of the independent agency designated with advocacy and 
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COMMITTEE AMENDMENT" A" to S.P. 169, L.D. 440 
investigatory functions under United States Public Law 88-164, Title I, Part C or 
United States Public Law 99-319; 0f the investigation and hearing pursuant to Title 
15, section 393, subsection 4-A: or the provision of therapeutic mental health care by 
the Department of Health and Human Services pursuant to chapter 3, subchapter 6. 
This paragraph takes effect August 1, 201 7; 
Sec. 9. 34-B MRSA §3863, sub-§2-A, as amended by PL 2007, c. 319, §9, is 
further amended to read: 
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 ofthis 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 Except for placement in a secure, therapeutic mental health unit established pursuant to 
chapter 3, subchapter 6, a person with mental illness may not be detained or confined in 
any jail or 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. 
Sec. 10. 34-B MRSA c. 3, sub-c. 6 is enacted to read: 
SUBCHAPTER 6 
SECURE, THERAPEUTIC MENTAL HEALTH UNIT 
§3910. Secure, therapeutic mental health unit 
The department shall establish one or more secure, therapeutic mental health units in 
accordance with this subchapter. 
§3911. Definitions 
As used in this subchapter, unless the context otherwise indicates, the following 
terms have the following meanings. 
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COMMITTEE AMENDMENT" 4,, to S.P. 169, L.D. 440 
1. Eligible person or person. "Eligible person" or "person" means a person who 
meets the criteria to be ordered to a secure, therapeutic mental health unit by a court 
pursuant to Title 15, section 101-D, subsection 4; section 101-D, subsection 5, paragraph 
A; or section 103 or transferred from a jail pursuant to Title 34-A, section 3069-A, 
subsection I or 2. 
2. Secure, therapeutic mental health unit or unit. "Secure, therapeutic mental 
health unit" or "unit" means the secure, therapeutic mental health unit established 
pursuant to section 3912. 
§3912. Unit establishment 
The department shall enter into an agreement with one or more sheriffs of one or 
more county jails or a regional jail to establish one or more secure, therapeutic mental 
health units within the county jail or regional jail for the purposes of providing 
observation, mental health evaluation for the purposes of determining competency or 
criminal responsibility, risk assessments and therapeutic mental health care for eligible 
persons. 
1. Staffing. The department shall provide: 
A. Full staffing for a unit for the purposes of operation of the unit, observation, 
evaluation, treatment, risk assessment. therapeutic care and health care of persons in 
the unit, security for the unit and transportation of persons to and from the unit. Staff 
must be dedicated to the unit and trained to provide health care and mental health 
treatment and care and patient management and security in a mental health treatment 
environment. The agreement between the department and a sheriff must require staff 
training appropriate to the unit and the persons placed in the unit by court order. 
Staff training must be provided by a nongovernmental advocacy organization for 
persons with mental illness or by the private entity that contracts to provide 
therapeutic mental health care under paragraph B: and 
B. Therapeutic mental health care that meets or exceeds the accreditation or quality 
standards for mental health services as established by a national organization 
involved with accreditation for mental health services in a facility that provides the 
services in paragraph A. 
The department shall contract with a private entity to 
provide therapeutic mental health care. 
2. Sight and sound separation. The persons in a unit must be separated by sight 
and sound from the general jail population at all times. 
3. Admittance to a unit. An eligible person who is ordered to a unit by a court 
under Title 15, section 101-D or 103 must be placed into the unit unless there is not a 
suitable bed in the unit available for the person. 
4. Federal certification. The department and the county sheriff for the county in 
which a unit is located shall work to obtain and maintain for the unit any federal 
certification that is required for the unit or that is available on a voluntary basis and 
through which federal funding may be secured for the unit. 
Sec. 11. Report of Department of Health and Human Services. By January 
15, 2017, the Department of Health and Human Services, after consultation with the 
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COMMITTEE AMENDMENT"A "to S.P. 169, L.D. 440 
county sheriff of a county in which a secure, therapeutic mental health unit established 
pursuant to the Maine Revised Statutes, Title 34-B, chapter 3, subchapter 6 is located, 
shall submit for each unit a report to the joint standing committee of the Legislature 
having jurisdiction over criminal justice matters regarding the operations of the unit. The 
report must include the following information regarding the unit: the average daily 
population of the unit, the average daily staffing patterns, the average length of stay in the 
unit, a description of services provided and the number of persons placed in the unit. The 
report must also include recommendations regarding the reallocation of resources for the 
unit; the design of the unit; the provisions of forensic services at the Riverview 
Psychiatric Center and the unit; and the transfer provisions of Title 34-A, sections 3069, 
3069-A and 3069-B.' 
SUMMARY 
This amendment is the minority report of the committee. The amendment does the 
following. 
1. It retains the provisions of the bill that establish a secure, therapeutic mental health 
unit for defendants undergoing court-ordered assessments to determine their competency 
to stand trial or their criminal culpability, to provide therapeutic care for forensic patients 
and to provide care for jail inmates who meet the criteria for involuntary civil 
commitment under the Maine Revised Statutes, Title 34-B, chapter 3. The amendment 
directs the Department of Health and Human Services to establish one or more units. 
2. 
It adds to the laws governing the placement process a requirement for a 
determination by a court that a secure, therapeutic mental health unit is appropriate for 
the defendant. 
3. It assigns responsibility for operation of a secure, therapeutic mental health unit to 
the Commissioner of Health and Human Services and allows contracts with multiple jails 
for multiple secure, therapeutic mental health units. It specifies that staffing must be 
dedicated to the units, that staff must be trained, who may provide the training, that a unit 
must be separated from the general jail population at all times and that the Department of 
Health and Human Services and the county sheriff for the county in which a unit is 
located must work to obtain and maintain any federal certification that is required or 
available and through which funding may be secured for the unit. 
4. It directs the Department of Health and Human Services, by January 15, 2017, 
after consultation with the county sheriff of a county in which a secure, therapeutic 
mental health unit is located, to submit a report to the joint standing committee of the 
Legislature having jurisdiction over criminal justice matters regarding the operations of 
the units. The report must include data on population, length of stay, staffing and 
services. The report must also include recommendations regarding the reallocation of 
resources for the units, the designs of the units, the provisions of forensic services at the 
Riverview Psychiatric Center and the units and the transfer provisions of Title 34-A, 
sections 3069, 3069-A and 3069-B. 
FISCAL NOTE REQUIRlW 
(See attaehed) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Approved: 03/30/16 feac 
LD440 
LR 1147(02) 
An Act To Create a Secure, Therapeutic Mental Health Unit 
Fiscal Note for Bill as Amended by Committee Amendment "A' r~-£...(5'3\ 
Committee: Criminal Justice and Public Safety 
Lv 
J } 
Fiscal Note Required: Yes 
Fiscal Note 
CmTent biennium cost increase - General Fund 
Current biennium cost increase - Other Special Revenue Funds 
Ctment biennium revenue increase - Other Special Revenue Funds 
This bill requires the Department of Health and Human Services (DHHS) to establish one or more Secure Mental 
Health Units within county jails or regional jails for the purpose of providing observation, mental health evaluation 
for the purposes of detennining competency or criminal responsibility, risk assessments and therapeutic mental health 
care for certain eligible individuals. For comparison, the DHHS ctmently has a contract with an out of state provider 
to provide this service to similar individuals at a cost of $494 per bed per day. It is not !mown at this time how many 
units would be created, how many total beds would be needed, what staffing levels would be or when these units 
would be created. Thus, no estimate of the increased cost can be made at this time. 
The bill also requires the DHHS, in consultation with any county sheriffs impacted, to submit a report to the 
legislature regarding the current operations of the units and reconm1endations for optimal operations of the units. Any 
additional costs to the DHHS to consult with the Sheriffs and create and submit the report and recommendations are 
expected to be minor and can be absorbed within existing budgeted resources. 
LRl 147(02) - Fiscal Note - Page 1 of 1