ASSEMBLY, No. 828

STATE OF NEW JERSEY

Introduced Pending Technical Review by Legislative Counsel

PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

By Assemblyman ARNONE

An Act concerning conditional discharge of persons involuntarily committed and amending and supplementing P.L.1987, c.116 (C.30:4-27.1 et al.).

    Be It Enacted by the Senate and General Assembly of the State of New Jersey:

    1. Section 15 of P.L.1987, c.116 (C.30:4-27.15) is amended to read as follows:

    15. a. If the court finds by clear and convincing evidence that the patient needs continued involuntary commitment, it shall issue an order authorizing the involuntary commitment of the patient and shall schedule a subsequent court hearing in the event the patient is not administratively discharged pursuant to section 17 of [this act] P.L.1987, c.116 (C.30:4-27.17) prior thereto.

    b. If the court finds that the patient does not need continued involuntary commitment, the court shall so order and the facility shall discharge the patient within 48 hours of the court's verbal order or by the end of the next working day, whichever is longer, with a discharge plan prepared pursuant to section 18 of [this act] P.L.1987, c.116 (C.30:4-27.18).

    c. If the court finds that the patient's history indicates a high risk of rehospitalization because of the patient's failure to comply with discharge plans, the court [may] shall discharge the patient subject to conditions recommended by the facility and coordinated with the mental health agency [staff] which will provide services to the patient and developed with the participation of the patient. The mental health agency shall provide follow-up care to the patient which shall include, but not be limited to, therapy, counseling, medications, daily living skills, and referral services, as appropriate. Conditions imposed on the patient shall be specific and their duration shall not exceed [90 days] six months. If the patient complies with the conditional discharge and has had no readmissions, the patient shall be finally discharged.

    The designated mental health agency [staff person] providing services to the patient shall notify the court if the patient fails to meet the conditions of the discharge plan within 48 hours of that failure. The court shall determine, in conjunction with the [findings of a screening service, if the patient needs to be] recommendations of the mental health agency providing services to the patient, if the terms of the conditional discharge can be complied with or modified to ensure compliance. If so, the court shall order the continuance of the conditional discharge with revised conditions for a period of 90 days. If it is determined that the terms cannot be modified to ensure compliance or if the patient has demonstrated a pattern of noncompliance, the court shall order the patient rehospitalized and[, if so,]the patient shall be returned to the discharging facility. The court shall hold a hearing within 20 days of the day the patient was returned to the facility to determine if the [order of conditional discharge should be vacated] involuntary commitment should be continued.

(cf: P.L.1987, c.116, s.15)

    2. Section 17 of P.L.1987, c.116 (C.30:4-27.17) is amended to read as follows:

    17. a. The treatment team at a short-term care or psychiatric facility or special psychiatric hospital shall administratively discharge a patient from involuntary commitment status with a discharge plan prepared pursuant to section 18 of P.L.1987, c.116 (C.30:4-27.18) if the treatment team determines that the patient no longer needs involuntary commitment. [If a discharge plan has not been developed pursuant to section 18 of this act, it shall be developed forthwith.]

    b. The treatment team at a short-term care or psychiatric facility or special psychiatric hospital shall administratively conditionally discharge a patient if the treatment team determines that the patient no longer needs involuntary commitment although the patient may be at risk of rehospitalization because of previous failure to comply with discharge plans. The conditions of discharge shall be based on recommendations of the treatment team and coordinated with the mental health agency which will provide services to the patient and developed with the participation of the patient. The mental health agency shall provide follow-up care to the patient which shall include, but not be limited to therapy, counseling, medications, daily living skills, and referral services, as appropriate. Conditions imposed on the patient shall be specific and their duration shall not exceed six months. If the patient complies with the conditional discharge and has had no readmissions, the patient shall be finally discharged.

    If the patient fails to meet the conditions of the conditional discharge, the mental health agency providing services to the patient shall notify the Division of Mental Health and Hospitals in the Division of Human Services within 48 hours of that failure. The division and the mental health agency shall determine, as soon as practicable, whether the patient can comply with the terms of the conditional discharge or whether the terms can be modified to ensure compliance by the patient. If so, the conditions shall be continued and modified, as appropriate, for a period of 90 days. If it is determined that the terms cannot be modified to ensure compliance, or if the patient has indicated a pattern of noncompliance, the patient shall be rehospitalized and returned to the discharging facility.

(cf: P.L.1987, c.116, s.17)

    3. Section 18 of P.L.1987, c.116 (C.30:4-27.18) is amended to read as follows:

    18. [A] a. Except in the case of conditional discharge, a person discharged either by the court or administratively from a short-term care or psychiatric facility or special psychiatric hospital shall have a discharge plan prepared by the treatment team at the facility pursuant to this section. The treatment team shall give the patient an opportunity to participate in the formulation of the discharge plan. In the case of patients committed to short-term care or psychiatric facilities, a community agency designated by the commissioner shall participate in the formulation of the plan. The facility shall advise the mental health agency of the date of the patient's discharge. The mental health agency shall provide follow-up care to the patient pursuant to regulations adopted by the commissioner. This section does not preclude discharging a patient to an appropriate professional who shall provide services in accordance with the discharge plan.

    b. Psychiatric facilities shall give notice of the conditional or final discharge to the county adjuster of the county in which the patient has legal settlement.

(cf: P.L.1987, c.116, s.18)

    4. (New section) The Department of Human Services shall ensure that a person who is conditionally discharged either by the court or administratively shall be visited at least monthly by a case manager employed by the department.

    5. (New section) a. The Division of Mental Health and Hospitals in the Department of Human Services shall monitor the mental health agencies which provide services to patients who are conditionally discharged. The division shall provide an annual performance report to the commissioner regarding the effectiveness of these agencies in caring for conditionally discharged patients.

    b. The mental health agency providing services to patients who are conditionally discharged shall file a quarterly report with the division which shall include, but not be limited to, an indication of the number of conditionally discharged patients served by the agency; the number of patients who have successfully completed the conditions of discharge and have been finally discharged; and the number of patients who have been unsuccessful in their conditional discharge and the reasons therefor.

    c. Any funding to a mental health agency which provides services to patients who are conditionally discharged shall be contingent upon the demonstrated success of the agency in providing services to these patients.

    6. This act shall take effect immediately.

STATEMENT

    This bill provides for the conditional discharge, by a court or administratively, of persons who are involuntarily committed. The bill provides that a person who is no longer in need of involuntary commitment but has a high risk of rehospitalization shall be discharged subject to certain conditions for a period of six months. If the patient complies with the conditions of discharge and has had no readmissions, the bill provides that the patient shall be finally discharged.

    The bill also provides that if the patient fails to meet the conditions of the discharge, the mental health agency providing services to the patient shall notify the court or the Division of Mental Health and Hospitals (DMHH), as appropriate, within 48 hours. The court or the division and the mental health agency shall then determine whether the patient can comply with the terms of the conditional discharge or whether the terms could be modified to ensure compliance by the patient. If so, the conditions shall be continued and modified, as appropriate, for a period of 90 days. If not, or if the patient has indicated a pattern of noncompliance, he shall be rehospitalized and returned to the discharging facility.

    The bill requires the Department of Human Services to ensure that a person conditionally discharged shall be visited at least monthly by a department case manager. The bill also requires the DMHH to monitor the mental health agencies which provide services to conditionally discharged patients and to provide an annual report to the commissioner regarding the effectiveness of these agencies in caring for conditionally discharged patients.

    The bill also requires the mental health agencies to file quarterly reports with the division which shall include, but not be limited to, an indication of the number of patients served; the number who have successfully completed the conditions of discharge and have been finally discharged; and the number who have been unsuccessful and the reasons therefor. Finally, the bill directs that any funding to these agencies shall be contingent upon their demonstrated success in providing services to conditionally discharged patients.

Provides for conditional discharge of persons involuntarily committed.