An Act Regarding the Treatment of Forensic Patients
Maine Legislature, Session 127, LD 1391
Committee Amendment CA_A_H479 (House)

COMMITTEE AMENOMENT A" to H.P. 941, L.O. 1391, Bill, "An Act 
Regarding the Treatment of Forensic Patients" 
Amend the bill in section 1 by striking out all of the first line (page 1, line 2 in L.O.) 
and inserting the following: 
'Sec. 1. 15 MRSA §§106, 107 and 108 are enacted to read:' 
Amend the bill in section 1 in § 1 06 in subsection 2 in the 6th line (page 1, line 11 in 
L.O.) by striking out the following: "antipsychotic" and inserting the following: 
'psychiatric' 
Amend the bill in section 1 in § 1 06 in subsection 3 in paragraph B in subparagraph 
(2) in division (a) in the first line (page 2, line 1 in L.O.) by strildng out the following: 
"stand trial" and inserting the following: 'proceed' 
Amend the bill in section 1 in § 106 in subsection 3 in paragraph B in subparagraph 
(4) in the first line (page 2, line 7 in L.O.) by striking out the following: "likely" and 
inserting the following: 'unlikely' 
Amend the bill in section I in § 106 by striking out all of subsection 4 (page 2, lines 
to 15 in L.D.) 
Amend the bill in section 1 in § 1 06 in subsection 5 in the 2nd line (page 2, line 17 in 
L.O.) by striking out the following: "antipsychotic" and inserting the following: 
'psychiatric' 
Amend the bill in section 1 in § 1 06 in subsection 5 in the 5th line (page 2, line 20 in 
L.O.) by striking out the following: "antipsychotic" and inserting the following: 
'psychiatric' 
Amend the bill in section 1 in § 1 06 by renumbering the subsections to read 
consecutively. 
Amend the bill in section 1 in § 1 07 in subsection 1 by striking out all of paragraphs A 
to E (page 2, lines 31 to 37 in, L.O.) and inserting the following: 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ,A" to H.P. 941, L.O. 1391 
'A. "CommissiW,er" means th~ Commissioner_9f Heal~h and Hmnan Services or the 
cQmmissioner's designee. 
B. "D..martment" tneans the Department QfHeaIt,h ang H':lman S~rvices. 
C. "Patient" means a Qerson helq in a ~osnital under segtion 1 Ol-p oWQ1. 
D. "Psychiatrist" includes a physician assistant working under the sup(f,rvision of a 
psychiatrist and apsychiatric nurse practitioner.' 
Amend the bill in section 1 in § 1 07 in sUbsection 3 by striking out all of paragraph B 
(page 3, lines 14 to 16 in L.D.) and inserting the following: 
'B. A psychiatrist has determined that. as a result of tpe patient's mental illness or 
disorder, the patient poses a substantial risk of harm to self 9r others 9r there is a 
reasonable certainty that the patient will suffer severe physi~al or mental harm as 
manifested by recent behavior demonstrating an inability tg (ivgid risk or tg Protect 
the patient adeqyately from impairment or injury;' 
Amend the bill in section 1 in § 1 07 in subsection 3 in paragraph H by striking out all 
of subparagraph (2) (page 4, lines 15 to 17 in L.D.) and inserting the following: 
'(2) As a result of that illness or disorder the patient poses a substantial risk of 
harm to self or others or there is a reasonable certainty that the patient will suffer 
severe physical or mental harm as manifested by recent behavigr demonstrating 
an inability to avoid risk or to protect the patient adequately from impairment or 
injury ifnot medicated;' 
Amend the bill in section 1 in § 1 07 in subsection 3 by striking Q1Jt all of paragraph K 
(page 4, lines 29 to 33 in L.D.) and inserting the following: 
'\ 
'K. The historical course of the patient's mental illness or disorder, as detennined QY 
available relevant information about the course of tile patient's mental illness or 
disorder, is considered when it has direct bearing on the determination of whether the 
patient, as the result of a mental illness or disorder, poses a substantial riskofharm to 
self or others or there is a reasonable certainty that the patient will suffer severe 
physical or mental harm as manifested by recent behavior demonstrating an inability 
to avoid risk or to protect the patient adequately from impairment or injury.' 
Amend the bill in section 1 in § 107 in subsection 7 in paragraph A in the next to the 
last line (page 5, line 23 in L.D.) by striking out the following: "acts need be" and 
inserting the following: 'acts necessarily need to be' 
Amend the bill in section 1 in § 107 in subsection 7 by striking out all of paragraph B 
(page 5, lines 25 to 32 in L.D.) and inserting the following: 
'B. 
The commissioner may order an extension of an authorization under this 
subsection. An order extending an authorization that is in effect must be granted 
based on clear and convincing evidence that: 
(1) The patient has a mental illness or disorder; 
(2) As a result of that illness or disorder the patient poses a substantial risk of 
harm to self or others or there is a reasonable certainty that the patient will suffer 
severe physical or mental harm as manifested by recent behavior demonstrating 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 941, L.D. 1391 
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an inability to avoid risk or to protect the patient adequately from impairment Ot 
injury if not medicated; 
(3) There is no less intrusive alternative toinvoluntary mediill!!ion; am! 
(4) The need for treatment Qutweighs the risks and side effects.' 
Amend the bill in section 1 in § 1 07 in subsection 8 in the 5th line (page 5, line 39 in 
L.D.) by inserting after the following: "change to the" the following: 'conditions leading 
to the original order or the' 
Amend the bill in section 1 in §107 in subsection 8 in the 8th line (page 5, line 42 in 
L.D.) by inserting after the following: "change in" the following: 'the conqitions leading 
to the original order or the patient's' 
Amend the bill in section 1 in § 107 in subsection 8 in paragraph C in the last line 
(page 6, line 17 in L.D.) by inserting after the following: "proceeding." the following: 'If 
the hearing officer determines that a hearing is warranted, the patient must be provided 
pounsel at the department's expense at least 7 days prior to the hearing,: 
Amend the bill in section 1 in § 107 in subsection 8 in paragraph D by striking out all 
of the last sentence (page 6, lines 21 and 22 in L.D.) and inserting the following: 'The 
decision whether to terminate the authorization of involuntary treatment rests with the 
commissioner, who shall act within 48 hours upon the hearing officer's recommendation.' 
Amend the bill in section 1 by inserting at the enct the following: 
'.§lOS. Court-ordered independent examinations 
Before making a determination under section 106 or 107, a court may ord,er an 
independent psychiatric or medical examination of the patient. The Department of Health 
and Human Services, within 30 days after receiving. a request from the Administrative 
Office of the Courts, shall reimburse the Judicial Department for the full amount of fees 
paid by the Judicial Department to providers of psychiatric and medical examinations of 
forensic patients ordered by the court.' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment changes the references to 
"antipsychotic" medication to 
"psychiatric" medication to more accurately describe the type of medication that may be 
administered. 
The amendment changes the terminology from competency "to stand trial" to 
competency "to proceed" to be consistent throughout the bill. 
The amendment revises the definition of "Commissioner of Health and Human 
Services" to include the commissioner's designee. 
The amendment deletes the definition of "gravely disabled" and replaces it with the 
standard that the patient poses a substantial risk of harm to self or others or there is a 
reasonable certainty that the patient will suffer severe physical or mental harm as 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A 
"to H.P. 941, L.D. 1391 
manifested by recent behavior demonstrating an inability to avoid risk or to protect the 
patient adequately from impairment or injury if not medicated. 
The amendment revises the factors that the commissioner must consider in order to 
continue the ex;tension of the order allowing treatmynt without the patient's consent. The 
commissioner must find by clear and convincing evidence that: 
1. The patient has a mental illness or disorder; 
2. As a result of that illness or disorder the patient poses a substantial risk of hann to 
self or others or there is a reasonable certainty that the patient will suffer severe physical 
or mental harm as manifested by recent behavior demonstrating an inability to avoid risk 
or to protect the patient adequately from impairment or injury ifnot medicated; 
3. There is no less intrusive alternative to involuntary medication; and 
4. The need for treatment outweighs the risks and side effects. 
The amendment clarifies that the patient or the patient's designated representative 
may request that the treatment authorization be terminated early by filing a request with 
the department that demonstrates that there is a significant change to the conditions that 
led to the original order or the patient's medical condition. 
If the hearing officer 
determines that a hearing on the request is warranted, then the patient must be provided 
counsel at the Department of Health and Human Services'expense at least 7 days before 
the hearing. If the hearing officer recommends termination of the treatment authorization 
to the commissioner, the commissioner must either order the termination or deny the 
request for termination within 48 hours of the recommendation. 
This amendment adds a new section that clarifies that the court may order an 
independent psychiatric or medical examination to make a determination under the bill. 
The Administrative Office of the Courts is directed to request that the Department of 
Health and Human Services reimburse the full amount of fees paid to the providers of the 
examinations. The Department of Health and Human Services is directed to reimburse 
the Judicial Department within 30 days after the request. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Revised: 06/18115 
;tpae 
LD 1391 
LR 1977(02) 
An Act Regarding the Treatment of Forensic Patients 
Fiscal Note for Bill as Amended by Committee Amendment 11' (H -41 q ') 
Committee: Judiciary 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Any additional costs to the Department of Health and Human Services and to the Judicial Department to implement 
the provisions of this bill, including the cost of evaluations, are expected to be minor and can be absorbed within 
existing budgeted resources. 
LR1977(02) - Fiscal Note - Page 1 of 1