March 26 Update:

ACTION: Call or write your state legislators and urge them NOT to pass the Majority Report on LD 1360.

March 22 Update:

More developments, and unfortunately not for the better. On Thursday afternoon, March 18, the HHS Committee voted to reconsider LD 1360. Senators Mills and Nutting offered yet another amendment to the minority report for the Committee's consideration. A motion for a vote was quickly made and seconded to approve this amended version, and after relatively brief discussion of the amendment, they voted 8-4 to pass. This vote shifted the former minority report to become the majority report, adding to the likelihood of the bill passing when it reaches the full house and senate, though that is not a forgone conclusion by any means. The house and senate will consider both the majority and minority reports and may pass either or neither version. For details, see Majority Report and Minority Report, after voting on March 18.

Since last year to now, LD 1360 has undergone many changes, thanks in great part to the hard work of stakeholders opposed to the bill. The amendments considered in recent work sessions looks very little like the original bill, thankfully. However, this last amendment that is now the majority report does differ from the most previous amendment. Helen Bailey of the Disability Rights Center offers the following synopsis:

"In the new amendment, the provisions that would have allowed the court to appoint a guardian or conservator, have been removed.The new amendment also removes the provision that would have permitted the court to issue an order that would have permitted the agency supervising the PTP to forcibly administer medications.  These were two provisions that we objected to.  The amendment also fixes a few technical problems we pointed out and some ordering problems.  But otherwise there were no further amendments adopted that we suggested.

The new amendment also adds some troubling provisions.  The court now is only required to appoint one independent examiner in both inpatient and PTP commitment hearings.  Both the inpatient and PTP commitment hearing can also be continued for a period of 21 days, up from 10, extending the period of time a person could be hospitalized prior to hearing to 38 to 40 days.  That examiner could be the individual who initiated the blue paper and/or signed the certificate upon the person's being in the hospital for 24 hours because the provision requiring this independence has been removed.  The commitment period to the PTP has been increased from an initial 6 month period to 12 months.  The extension period in both amendments is 12 months.

The increase in the continuance period and the reduction in the number of examiners were apparently made after considering the financial implications."

For more details from Helen's analysis, please see her line-by-line comparison of the lastest amendment with the previous amendment HERE.

February 18 Update:

The Health & Human Services Committee held another work session on LD 1360 on February 17th. The majority of the committee voted only to approve Question 1 (see below), and repeal the "sunset" on the progressive treatment program [PTP] and continue it with a new sunset date of July 1, 2014. ("Sunset" is the date the legislation will "die" if not renewed again). They also emphasized that DHHS needs to provide adequate reporting and data on the progressive treatment program as it moves forward, including before and after (longitudinal) information and outcomes for those ordered to participate.

The majority agreed that changing Maine's involuntary commitment laws should be a thoughtful, comprehensive process that involves all stakeholders. It appeared from the discussion after the vote that Senator Mills intends to present another draft of the bill that either takes out certain highly problematic elements of the current version or addresses committee members' concerns raised during the discussion.

Another important part of the work session was around the costs associated ("fiscal note") with the proposed legislation. DHHS maintains there would be costs involved in services and the Administrative Office of the Courts also raised substantial concerns about increased court costs for the required independent examinations, as well as strains on District Court dockets. The proponents (people in favor) of LD 1360 raised questions about increased costs, emphasizing their intention that the proposed bill would not require any additional funding.

The committee discussed the major decision points of the bill outlined in the form of 5 questions:

Question 1: Whether to extend the progressive treatment program [PTP] past July 1, 2010?
Question 2: Whether to extend the progressive treatment program [PTP] to persons being discharged from Acadia Hospital and Spring Harbor Hospital?
Question 3: Whether to extend the progressive treatment program [PTP] to persons who are involuntarily committed (white paper) as an option for the Court instead of involuntary hospitalization?
Question 4: Whether to extend the length of time of an order of involuntary treatment [in hospital] from 120 days to 6 months, with an extension period of up to 1 year?
Question 5: Whether to revise the involuntary commitment laws: decreasing the number of examinations from 4 to 3, simplifying the definitions of "likelihood of serious harm" and providing a definition of "medical practitioner" and, with reagrd to the progressive treatment program [PTP], allowing applications to be filed by the ACT team or Commissioner, providing the Court authority to enter orders to ensure compliance with the treatment plan, and simplifying and shortening eligibility, notice and hearings provisions?

 

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The latest amendments to LD 1360 in part reflect the "4th option" for involuntary commitment (described below), but does so by changing existing laws for involuntary commitment to psychiatric hospitals and the Progressive Treatment Program (PTP) law. In addition to allowing for limited involuntary outpatient commitment (which the vast majority of Maine consumers stand firmly against), changes in wording and other things included in the amendments give rise for concerns and objections.

Helen Bailey, attorney with the Disability Rights Center, submitted a line-by-line analysis of those concerns and objections to the legislature's Joint Committee on Health & Human Services (HHS) on February 8th in preparation for their work session scheduled for February 11th. Helen also prepared, in collaboration with and signed by the Advocacy Initiative Network (AIN) and the CCSM, a position paper detailing some of our most substantive concerns about these amendments. "Read Position Paper" (Please feel free to provide feedback using the Comment section below.)

The HHS work session on LD 1360 happens at 1 p.m. on February 11th in Room 209 of the Cross Building, just behind the Capitol Building in Augusta.

LD 1360 Information 2009

During the January - June 2009 legislative session, Senator John Nutting introduced LD 1360, a bill entitled "An Act to Allow Law Enforcement and Family Members to Petition the District Court to Initiate Assisted Outpatient Treatment." The vast majority of the consumer community, including the CCSM, stood firmly in opposition to the bill. The Joint Committee on Health and Human Services (HHS) decided to "carry-over" LD 1360 to their next session, rather than decide pass or fail at that time. HHS asked Senator Nutting to convene stakeholder meetings before the next session begins in January 2010 in an attempt to find common ground on which to move forward.

Those stakeholder meetings were held on November 29 and December 7. The CCSM was invited as one of the opponents to the bill. Senator Mills presided over the meetings and seemed most interested in finding some small movement that all parties could agree upon. No actual agreement was reached, but the discussion indicated that Senator Nutting will draft language to amend the current involuntary commitment law to give judges another decision option in involuntary commitment hearings. That additional option would be involuntary commitment to “community treatment.”

The following points were stressed by the proponents in the discussion:

• The criteria for involuntary commitment will not change. In order words, the person would have to meet conditions already established by law to be involuntarily committed to a psychiatric hospital. The idea for involuntary commitment to community treatment in these circumstances would be to provide the judge with a “less restrictive” option than hospitalization.
• A comprehensive treatment plan must be presented at the hearing and approved by the judge. The details of how and by whom the treatment plan would be prepared have not been worked out. (Most likely, a person involuntarily committed to community treatment would be ordered to participate in an ACT Team or the PTP programs currently operating through Riverview and Dorothea Dix.)

Basic explanation of involuntary commitment process:

The first step in involuntary commitment is commonly known as being “blue-papered.” Blue papers can be initiated by anyone, but is most commonly done by crisis providers and hospital Emergency Room doctors when people they believe need hospitalization don’t agree to do so voluntarily. Blue papers remain in effect for three days during which time the person is involuntarily hospitalized. During those three days a “white paper” hearing in a court of law must be scheduled to be held within 14 days. At that court hearing, the judge decides whether or not the person should continue be hospitalized involuntarily. Sometimes before the hearing date, the “blue papered” person decides to continue hospitalization voluntarily. So, the judge has three possible findings or decision options under current law: 1) order involuntary commitment; 2) dismiss, due to findings; or 3) dismiss, due to change to voluntary. The proposed amendment, as noted above, would add a fourth option: 4) order involuntary commitment to community (or outpatient) treatment.