A3089

An Act concerning involuntary commitment and amending P.L.1987, c.116 and P.L.2023, c.139.

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

1. Section 2 of P.L.1987, c.116 (C.30:4-27.2) is amended to read as follows:

2. As used in P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.):

a. "Chief executive officer" means the person who is the chief administrative officer of an institution [or], psychiatric facility, or residential substance use disorder treatment facility.

b. "Clinical certificate" means a form prepared by the division and approved by the Administrative Office of the Courts, [that] which is completed by the psychiatrist or other physician who has examined the person [who is] subject to commitment, within three days of presenting the person for involuntary commitment to treatment, and which states that the person is in need of involuntary commitment to treatment. The form shall also state the specific facts upon which the examining physician has based his conclusion and shall be certified in accordance with the Rules of the Court. A clinical certificate may not be executed by a person who is a relative by blood or marriage to the person who is being screened.

c. "Clinical director" means the person who is designated by the director or chief executive officer to organize and supervise the clinical services provided in a screening service, short-term care facility, or psychiatric facility. The clinical director shall be a psychiatrist; however, those persons currently serving in the capacity will not be affected by this provision. This provision shall not alter any current civil service laws designating the qualifications of such position.

d. "Commissioner" means the Commissioner of Human Services.

e. "County counsel" means the chief legal officer or advisor of the governing body of a county.

f. "Court" means the Superior Court or a municipal court.

g. "Custody" means the right and responsibility to ensure the provision of care and supervision.

h. "Dangerous to self" means that, by reason of a person’s mental illness or substance use disorder, the person has threatened or attempted suicide or serious bodily harm, or has behaved in such a manner as to indicate that the person is unable to satisfy [his] the person's need for nourishment, essential medical care, or shelter, so that it is probable that substantial bodily injury, serious physical harm, or death will result within the reasonably foreseeable future; however, no person shall be deemed to be unable to satisfy [his] the person's need for nourishment, essential medical care, or shelter, if [he] the person is able to satisfy such needs with the supervision and assistance of others who are willing and available. This determination shall take into account a person's history, recent behavior, and any recent act, threat, or serious psychiatric deterioration. An individual who has recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose shall be determined to be dangerous to self.

i. "Dangerous to others or property" means that, by reason of a person’s mental illness, there is a substantial likelihood that the person will inflict serious bodily harm upon another person or cause serious property damage within the reasonably foreseeable future. This determination shall take into account a person's history, recent behavior, and any recent act, threat, or serious psychiatric deterioration.

j. "Department" means the Department of Human Services.

k. "Director" means the chief administrative officer of a screening service, short-term care facility, or special psychiatric hospital.

l. "Division" means the Division of Mental Health and Addiction Services in the Department of Human Services.

m. "In need of involuntary commitment" or "in need of involuntary commitment to treatment" means that an adult [with] :

(1) who has a mental illness, whose mental illness causes the person to be dangerous to self or dangerous to others or property; or

(2) who has recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose, which causes the person to be dangerous to self; and

(3) who is unwilling to accept appropriate treatment voluntarily after it has been offered, [needs] and is in need of residential substance use disorder treatment, outpatient mental health or substance use disorder treatment [or] , inpatient care at a short-term care facility or psychiatric facility, or special psychiatric hospital because other services are not appropriate or available to meet the person's mental health care or substance use disorder treatment needs.

n. "Institution" means any State or county facility providing inpatient care, supervision, and treatment for persons with developmental disabilities; except that with respect to the maintenance provisions of Title 30 of the Revised Statutes, "institution" also means any psychiatric facility for the treatment of persons with mental illness.

o. "Mental health agency or facility" means a legal entity which receives funds from the State, county, or federal government to provide mental health services.

p. "Mental health screener" means a psychiatrist, psychologist, social worker, registered professional nurse, licensed marriage and family therapist, or other individual who is trained to do outreach [only] for the purposes of psychological assessment [who], and is employed by a screening service and possesses the license, academic training, or experience, as required by the commissioner pursuant to regulation; except that a psychiatrist and a State licensed clinical psychologist who meet the requirements [for] necessary to act as a mental health screener, as specified in this definition, shall not have to comply with any additional requirements adopted by the commissioner.

q. "Mental hospital" means, for the purposes of the payment and maintenance provisions of Title 30 of the Revised Statutes, a psychiatric facility.

r. "Mental illness" means a current, substantial disturbance of thought, mood, perception, or orientation which significantly impairs a person’s judgment, capacity to control behavior, or capacity to recognize reality [, but] . "Mental illness" does not include simple alcohol intoxication, transitory reaction to drug ingestion, organic brain syndrome, or developmental disability, unless [it] such condition results in the severity of impairment described herein. [The term mental] “Mental illness” is not limited to ["]psychosis["] or ["]active psychosis,["] but shall include all conditions that result in the severity of impairment described herein.

s. "Patient" means a person over the age of 18 who has been admitted to, but not discharged from, a residential substance use disorder treatment facility, a short-term care facility, or a psychiatric facility, or who has been assigned to, but not discharged from, an outpatient treatment provider.

t. "Physician" means a person who is licensed to practice medicine in any one of the United States or its territories, or the District of Columbia.

u. "Psychiatric facility" means a State psychiatric hospital listed in R.S.30:1-7, a county psychiatric hospital, or a psychiatric unit of a county hospital.

v. "Psychiatrist" means a physician who has completed the training requirements of the American Board of Psychiatry and Neurology.

w. "Psychiatric unit of a general hospital" means an inpatient unit of a general hospital [that], which unit restricts its services to the care and treatment of persons with mental illness who are admitted on a voluntary basis.

x. "Psychologist" means a person who is licensed as a psychologist by the New Jersey Board of Psychological Examiners.

y. "Screening certificate" means a clinical certificate executed by a psychiatrist or other physician affiliated with a screening service.

z. "Screening service" means a public or private ambulatory care service, designated by the commissioner, which provides [mental health] services, including assessment, emergency, and referral services to persons with mental illness , or persons who have recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose, in a specified geographic area.

aa. "Screening outreach visit" means an evaluation [provided] of a person, which is conducted by a mental health screener wherever the person may be when clinically relevant information indicates that the person may need involuntary commitment to treatment and is unable or unwilling to come to a screening service.

bb. "Short-term care facility" means an inpatient, [community based] community-based mental health treatment facility that is designated to provide acute care and assessment services to a person with mental illness whose mental illness causes the person to be dangerous to self or dangerous to others or property. A short-term care facility is authorized to serve persons from a specified geographic area, may be a part of a general hospital or other appropriate health care facility, and shall meet certificate of need requirements and be licensed and inspected by the Department of Health pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.).

cc. "Special psychiatric hospital" means a public or private hospital licensed by the Department of Health to provide voluntary and involuntary mental health services, including assessment, care, supervision, treatment, and rehabilitation services to persons with mental illness.

dd. "Treatment team" means one or more persons, including at least one psychiatrist or physician, and may include a psychologist, social worker, nurse, licensed marriage and family therapist, and other appropriate services providers. A treatment team provides mental health services or substance use disorder treatment services, as appropriate, to a patient of a screening service, residential substance use disorder treatment facility, outpatient treatment provider, [or] short-term care facility, or psychiatric facility.

ee. "Voluntary admission" means that an adult [with mental illness,] whose mental illness or substance use disorder causes the person to be dangerous to self or dangerous to others or property [and] is willing to be voluntarily admitted to a residential substance use disorder treatment facility [voluntarily for care, needs care at] , a short-term care facility, or a psychiatric facility, because other facilities or services are not appropriate or available to meet the person's mental health or substance use disorder treatment needs. A person may also be voluntarily admitted to a psychiatric facility, if [his] the person’s mental illness presents a substantial likelihood of rapid deterioration in functioning in the near future, there are no appropriate community alternatives available, and the psychiatric facility can admit the person and remain within its rated capacity.

ff. "County adjuster" means the person appointed pursuant to R.S.30:4-34.

gg "Least restrictive environment" means the available setting and form of treatment that appropriately addresses a person's need for care and the need to respond to dangers to the person, others, or property and respects, to the greatest extent practicable, the person's interests in freedom of movement and self-direction.

hh. "Outpatient treatment" means clinically appropriate care based on proven or promising treatments directed to wellness and recovery, provided by a member of the patient's treatment team to a person not in need of inpatient treatment. Outpatient treatment may include, but shall not be limited to, day treatment services, case management, residential services, outpatient counseling and psychotherapy, and medication treatment.

ii. "Outpatient treatment provider" means a community-based mental health treatment provider, designated [as an outpatient treatment provider] pursuant to section 8 of P.L.1987, c.116 (C.30:4-27.8), [that] or an outpatient substance use disorder treatment provider, designated pursuant to paragraph (2) of subsection b. of section 8 of P.L.1987, c.116 (C.30:4-27.8), which provides, or coordinates the provision of, outpatient mental health or substance use disorder treatment services, as appropriate, to persons who are in need of involuntary commitment to treatment.

jj. "Plan of outpatient treatment" means a plan [for recovery from] of treatment for a person with a mental illness or a substance use disorder who has a history of responding to treatment and does not require intensive inpatient or residential treatment, which plan is approved by a court pursuant to section 17 of P.L.2009, c.112 (C.30:4-27.15a) [that is], provides for treatment to be carried out in an outpatient setting, and is prepared by an outpatient treatment provider [for a patient who has a history of responding to treatment]. The plan may include medication as a component of the plan; however, medication shall not be involuntarily administered in an outpatient setting.

kk. "Reasonably foreseeable future" means a time frame that may be beyond the immediate or imminent, but which is not longer than a time frame as to which reasonably certain judgments about a person's likely behavior can be reached.

ll. "Geographic area" means a distinct area of the State that is designated by the commissioner to be served by a screening service and may be a county, portion of a county, or multi-county area.

mm. "Opioid antidote" means naloxone hydrochloride, or any other similarly acting drug approved by the United States Food and Drug Administration for the treatment of an opioid overdose.

nn. "Substance use disorder" means substance use disorder as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders.

(cf: P.L.2019, c.391, s.1)

2. Section 3 of P.L.1987, c.116 (C.30:4-27.3) is amended to read as follows:

3. a. The standards and procedures in [this act] P.L.1987, c.116 (C.30:4-27.1 et seq.) shall apply to:

(1) all adults with mental illness who are involuntarily committed to mental health treatment, including those who are assigned to an outpatient mental health treatment provider [or], and those who are admitted to a short-term care facility, psychiatric facility, or special psychiatric hospital [and];

(2) all adults who have recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose, and who are involuntarily committed to substance use disorder treatment, including those who are assigned to an outpatient substance use disorder treatment provider, and those who are admitted to a residential substance use disorder treatment facility;

(3) all adults with mental illness who are voluntarily admitted from a screening service to a short-term care facility or psychiatric facility; and

(4) all adults who have recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose, and who are voluntarily admitted from a screening service to a residential substance use disorder treatment facility.

b. The standards and procedures in [this act] P.L.1987, c.116 (C.30:4-27.1 et seq.) shall not apply to adults who are voluntarily admitted to psychiatric units in general hospitals or special psychiatric hospitals, except as provided in section 11 or 20 of P.L.1987, c.116 (C.30:4-27.11 or C.30:4-27.20).

(cf: P.L.2009, c.112, s.3)

3. Section 4 of P.L.1987, c.116 (C.30:4-27.4) is amended to read as follows:

4. The commissioner, in consultation with the appropriate county mental health board, and consistent with the approved county mental health plan, shall designate one or more mental health agencies or facilities in each county or multi-county region in the State as a screening service. The commissioner shall so designate an agency or facility only with the approval of the agency's or facility's governing body. In designating the screening services, the commissioner shall ensure that screening services are accessible to all persons in the State who need these services, and that screening service evaluation is the preferred process for entry into outpatient treatment, short-term care facilities, residential substance use disorder treatment facilities, or psychiatric facilities so that appropriate consideration is given to less restrictive treatment alternatives.

(cf: P.L.2009, c.112, s.4)

4. Section 5 of P.L.1987, c.116, s.5 (C.30:4-27.5) is amended to read as follows:

5. The commissioner shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) regarding a screening service and its staff [that], as necessary to effectuate the following purposes and procedures:

a. A screening service shall serve as the facility in the public mental health care and substance use disorder treatment system wherein a person who is believed to be in need of involuntary commitment [to outpatient treatment, a short-term care facility, psychiatric facility or special psychiatric hospital undergoes] will undergo an assessment to determine what mental health or substance use disorder treatment services are appropriate for the person, and where those services may be most appropriately provided in the least restrictive environment.

The screening service [may] conducting an assessment under this subsection shall provide emergency and consensual mental health or substance use disorder treatment, as appropriate, to the person receiving the assessment, and may transport the person, or detain the person for a period of up to 24 hours, for the purposes of conducting the assessment and providing the emergency treatment [and conducting the assessment].

b. When a person is assessed by a mental health screener and involuntary commitment to treatment seems necessary, the screener shall provide, on a screening document prescribed by the division, information regarding the person's history and available alternative facilities and services that are deemed inappropriate for the person. When appropriate and available, and as permitted by law, the screener shall make reasonable efforts to gather information from the person's family or significant others for the purposes of preparing the screening document. If a psychiatrist, in consideration of this document, and in conjunction with the psychiatrist's own complete assessment, concludes that the person is in need of commitment to treatment, the psychiatrist shall complete the screening certificate. The screening certificate shall be completed by a psychiatrist, except in those circumstances where the division's contract with the screening service provides that another physician may complete the certificate.

Upon completion of the screening certificate, screening service staff shall determine, in consultation with the psychiatrist or another physician, as appropriate, the least restrictive environment for [the] appropriate treatment to which the person shall be assigned or admitted, taking into account the person's prior history of hospitalization and treatment, and the person's current mental health condition or substance use disorder status. Screening service staff shall designate:

(1) inpatient mental health treatment or residential substance use disorder treatment for the person, if [he] the person is deemed to be immediately or imminently dangerous, or if outpatient treatment is deemed inadequate to render the person unlikely to be dangerous to self, others, or property within the reasonably foreseeable future; and

(2) outpatient mental health or substance use disorder treatment for the person when outpatient treatment is deemed sufficient to render the person unlikely to be dangerous to self, others, or property within the reasonably foreseeable future.

If the screening service staff determines that the person is in need of involuntary commitment to outpatient treatment, the screening service staff shall consult with an outpatient treatment provider to arrange, if possible, for an appropriate interim plan of outpatient treatment in accordance with section 9 of P.L.2009, c.112 (C.30:4-27.8a).

If a person has been admitted three times or has been an inpatient for 60 days at a short-term care facility during the preceding 12 months, consideration shall be given to not placing the person in a short-term care facility.

The person shall be admitted to [the] an appropriate inpatient or residential facility, or assigned to [the] an appropriate outpatient treatment provider, [as appropriate for treatment], as soon as possible, based on the person’s treatment needs. Screening service staff [are] shall be authorized to coordinate the initiation of outpatient treatment [or] services, or to transport [the person], or arrange for transportation of, the person to [the] an appropriate provider or facility.

c. If the mental health screener determines that the person is not in need of [assignment or commitment to an outpatient treatment provider, or admission or commitment to a short-term care facility, psychiatric facility or special psychiatric hospital] involuntary commitment to treatment, the screener shall refer the person to an appropriate community mental health or social services agency, to an appropriate substance use disorder treatment provider, or to appropriate professional or inpatient care in [a] the psychiatric unit of a general hospital.

d. A mental health screener shall make a screening outreach visit if the screener determines, based on clinically relevant information provided by an individual with personal knowledge of the person subject to screening, that the person may need involuntary commitment to treatment, and [the person] is unwilling or unable to come to the screening service for an assessment.

e. If the mental health screener [pursuant to this assessment] determines, as the result of an assessment, that there is reasonable cause to believe that a person is in need of involuntary commitment to treatment, the screener shall so certify the need on a form prepared by the division.

(cf: P.L.2009, c.112, s.5)

5. Section 6 of P.L.1987, c.116 (C.30:4-27.6) is amended to read as follows:

6. A State or local law enforcement officer shall take a person into custody [of a person], and [take] shall transport the person immediately and directly to a screening service for the purposes of assessment, if:

a. [On the basis of personal observation,] the law enforcement officer has reasonable cause to believe, on the basis of personal observation, that the person is in need of involuntary commitment to treatment;

b. [A] a mental health screener has certified, [on] in a form and manner prescribed by the division [that], and based on a screening outreach visit conducted pursuant to subsection d. of section 5 of P.L.1987, c.116 (C.30:4-27.5), that the person is in need of involuntary commitment to treatment, and the screener has requested that the person be taken to the screening service for a complete assessment;

c. [The court orders that a] the person is subject to, but has failed to adhere to the conditions of, an order of conditional discharge, issued by a court pursuant to subsection c. of section 15 of P.L.1987, c.116 (C.30:4-27.15) [who has failed to follow the conditions of the discharge], and the court has ordered the person to be taken to a screening service for an assessment; [or]

d. [An] an outpatient treatment provider has certified, [on] in a form and manner prescribed by the division, that the provider has reasonable cause to believe that the person is in need of [evaluation for] involuntary commitment to treatment;

e. the law enforcement officer has administered an opioid antidote, as defined in section 3 of P.L.2013, c.46 (C.24:6J-3), directly to the person, in order to revive the person, and prevent the person’s death, following the person’s overdose on opioid drugs; or a health care practitioner, emergency medical responder, or private individual has certified, in a form and manner prescribed by the division, that the person has overdosed on opioid drugs, and has been revived with an opioid antidote, within the preceding 48-hour period, thereby necessitating the belief by the health care practitioner, emergency medical responder, or private individual that the person is an imminent danger to self, and is in need of involuntary commitment to treatment; or

f. a health care practitioner, mental health care practitioner, or emergency medical responder has certified, in a form and manner prescribed by the division, that the person is currently undergoing a mental health or behavioral health crisis in which the person has caused, or attempted to cause, actual harm to self or others, thereby necessitating a belief by the practitioner or emergency medical responder that the person is in need of involuntary commitment to treatment.

The involvement of the law enforcement authority under this section shall continue at the screening service as long as necessary to protect the safety of the person in custody, and the safety of the community from which the person was taken.

(cf: P.L.2009, c.112, s.6)

6. Section 7 of P.L.1987, c.116 (C.30:4-27.7) is amended to read as follows:

7. a. A law enforcement officer, or a staff member designated by a screening service, outpatient treatment provider [or], residential substance use disorder treatment facility, short-term care facility [designated staff person or their respective employers], psychiatric facility, or special psychiatric hospital, acting in good faith pursuant to P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), who takes reasonable steps to assess, take custody of, detain, or transport an individual for the purposes of mental health or substance use disorder assessment or treatment [is], and the respective employers of such individuals, shall be immune from civil and criminal liability.

b. An emergency [services or medical transport person or their respective employers] medical responder or non-emergency medical transporter, acting in good faith pursuant to [this act] P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), and pursuant to the direction of a person designated in subsection a. of this section, who takes reasonable steps, in good faith, to take custody of, detain, or transport an individual for the purpose of mental health or substance use disorder assessment or treatment [is], and the respective employers of such individuals, shall be immune from civil and criminal liability.

[For the purposes of this subsection, "emergency services or medical transport person" means a member of a first aid, ambulance, rescue squad or fire department, whether paid or volunteer, auxiliary police officer or paramedic.]

(cf: P.L.2009, c.112, s.7)

7. Section 8 of P.L.1987, c.116 (C.30:4-27.8) is amended to read as follows:

8. a. The commissioner, in consultation with the Commissioner of Health [and Senior Services], shall designate one or more mental health agencies or facilities in each county or multi-county region in the State as short-term care facilities. [The commissioner shall so designate an agency or facility only with the approval of the agency's or facility's governing body.]

b. The commissioner shall:

(1) designate one or more mental health agencies, in each county or multi-county region in the State, as an outpatient mental health treatment provider, and [shall] authorize the designated [outpatient treatment] provider to provide services to persons with mental illness, from a specified geographic area , who are in need of involuntary commitment to outpatient mental health treatment; and

(2) designate one or more outpatient substance use disorder treatment facilities or clinics, in each county or multi-county region in the State, as an outpatient substance use disorder treatment provider, and authorize the designated provider to provide services to persons with substance use disorders, from a specified geographic area, who are in need of involuntary commitment to outpatient substance use disorder treatment.

c. The commissioner shall [so] designate an agency or facility, as provided by this section, only with the approval of the agency's or facility’s governing body.

(cf: P.L.2009, c.112, s.8)

8. Section 9 of P.L.2009, c.112 (C.30:4-27.8a) is amended to read as follows:

9. a. An outpatient treatment provider shall develop a plan of outpatient treatment, in cooperation with screening service or short term care facility staff, or the court, as applicable, for patients who are committed and assigned to outpatient treatment by screening service staff, or by order of a court, or both. When appropriate and available, and as permitted by law, the provider shall make reasonable efforts to gather information from the patient's family or significant others for the purposes of developing the plan of outpatient treatment.

b. During the time a patient is [assigned to the outpatient treatment provider for services pursuant to a commitment] committed to outpatient treatment, the outpatient treatment provider shall provide and coordinate the provision of care consistent with the plan of outpatient treatment.

c. If a patient fails to materially comply with the plan of outpatient treatment during the time the patient is [assigned by a screening service to the outpatient treatment provider for services pursuant to a commitment] committed to outpatient treatment, or, if the outpatient treatment provider determines that the plan of outpatient treatment is inadequate to meet the patient's mental health or substance use disorder treatment needs, the provider shall notify the screening service of the material noncompliance or plan inadequacy, as applicable, and the patient shall be referred to a screening service for an assessment to determine what mental health or substance use disorder treatment services are appropriate, and where those services may be provided, in accordance with section 5 of P.L.1987, c.116 (C.30:4-27.5). In such a case, the patient shall be afforded the protections and procedures provided for in P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.).

d. If a patient fails to materially comply with the plan of outpatient treatment during the time the patient is assigned by a court to the outpatient treatment provider for services pursuant to a commitment to outpatient treatment, or if the outpatient treatment provider determines that the plan of outpatient treatment is inadequate to meet the patient's mental health needs, the provider shall notify the court and screening service of the material noncompliance or plan inadequacy, as applicable, and the patient shall be referred to a screening service for an assessment to determine what mental health services are appropriate, and where those services may be provided, in accordance with section 5 of P.L.1987, c.116 (C.30:4-27.5). In such a case, the patient shall be afforded the protections and procedures provided for in P.L.1987, c.116 and P.L.2009, c.112.

e. If an outpatient treatment provider determines that a plan of outpatient treatment is inadequate and needs to be modified, but referral to a screening service is not necessary, the provider shall seek [court] judicial approval for such modification, and shall notify the court, the patient's attorney, and the county adjuster of the request for [court] judicial approval of such modification.

(cf: P.L.2009, c.112, s.9)

9. Section 9 of P.L.1987, c.116 (C.30:4-27.9) is amended to read as follows:

9. a. Outpatient treatment providers, residential substance use disorder treatment facilities, short-term care facilities, psychiatric facilities, and special psychiatric hospitals shall effectuate the following purposes and procedures:

[a.] (1) An outpatient treatment provider to which a person has been assigned, pursuant to an order of continued involuntary commitment to treatment [pursuant to] issued under section 15 of P.L.1987, c.116 (C.30:4-27.15), shall [maintain] adhere to the plan of outpatient treatment approved by the court pursuant to section 17 of P.L.2009, c.112 (C.30:4-27.15a), and shall notify the court, the [person's] patient’s attorney, and the county adjuster of any material non-compliance with the plan by the [person] patient, and of the inadequacy of the plan of outpatient treatment to meet the [person's] patient’s mental health or substance use disorder treatment needs, if applicable, and shall seek [court] approval from the court for [a] any modification to a plan of outpatient treatment, as provided for in section 9 of P.L.2009, c.112 (C.30:4-27.8a). [The director or chief executive officer of a]

(2) A residential substance use disorder treatment facility, short-term care facility, psychiatric facility, or special psychiatric hospital shall be authorized to detain any person who is involuntarily committed to the facility. The director or chief executive officer of the facility shall have custody of a person while that person is detained in the facility, and shall notify: [(1)] (a) appropriate public or private agencies to arrange for the care of any dependents of the person, and to ensure the protection of the person's property; [and (2)] (b) appropriate [ambulatory] outpatient mental health treatment providers or outpatient substance use disorder treatment providers, for the purposes of beginning discharge planning[. If a person is admitted to]; and (c) in the case of a psychiatric facility, [the chief executive officer of the facility shall promptly notify] the county adjuster of the person's county of residence, in order to ensure that the county adjuster is aware that the person has been admitted to the facility. [The]

(3) Each facility [is] and provider identified under this subsection shall be authorized to provide assessment, treatment, and rehabilitation services, as appropriate, to persons who are involuntarily committed thereto pursuant to P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), and shall provide discharge planning services as required [pursuant to] by section 18 of P.L.1987, c.116 (C.30:4-27.18). The facility is authorized to detain persons involuntarily committed to the facility.

b. A person shall not be involuntarily committed to treatment at an outpatient treatment provider, short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital, unless the person is determined, pursuant to P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), to be in need of involuntary commitment to treatment.

[The] A person shall be assigned involuntarily to an outpatient treatment provider, or admitted involuntarily to a facility, only by referral from a screening service, or by temporary court order. The person may be admitted voluntarily to a short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital only after the person has been advised orally and in writing of the discharge provisions established pursuant to P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), and of the subsequent possibility that the facility may initiate involuntary commitment proceedings for the person.

c. A short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital may detain a person[,] who is involuntarily admitted to the facility [involuntarily by] through a screening service referral [from a screening service], without a temporary court order, for no more than 72 hours from the time the screening certificate was executed. During this period of time, the facility shall initiate court proceedings for the involuntary commitment of the person pursuant to section 10 of P.L.1987, c.116 (C.30:4-27.10).

d. A person shall not be involuntarily assigned to an outpatient treatment provider by referral from a screening service, and without a temporary court order, for more than 72 hours from the time the screening certificate was executed. During this period of time the provider shall initiate court proceedings for the involuntary commitment of the person, pursuant to section 10 of P.L.1987, c.116 (C.30:4-27.10).

(cf: P.L.2009, c.112, s.10)

10. Section 1 of P.L.2023, c.139 (C.30:4-27.9a) is amended to read as follows:

1. a. Notwithstanding the provisions of section 9 of P.L.1987, c.116 (C.30:4-27.9) or any other law, rule, or regulation to the contrary, commencing on the effective date of P.L.2023, c.139 (C.30:4-27.9a et al.) and ending on the last day of the 24th calendar month following that effective date, a short-term care [or] facility, psychiatric facility, residential substance use disorder treatment facility, or a special psychiatric hospital, may detain a person admitted to the facility involuntarily by referral from a screening service without a temporary court order for no more than 72 hours from the time the screening certificate was executed.

Except in the event a general hospital was granted a temporary court order permitting the continued hold of the person pursuant to subsection b. of this section, which delayed a person's admission to the short-term care [or] facility, psychiatric facility, residential substance use disorder treatment facility, or special psychiatric hospital, a short-term care [or] facility, psychiatric facility, residential substance use disorder treatment facility, or special psychiatric hospital shall not detain a person admitted to the facility involuntarily by referral from a screening service without a temporary court order for more than 72 hours from the time the screening certificate was executed.

Within 24 hours of admission, the admitting facility shall initiate court proceedings for the involuntary commitment of the person pursuant to section 10 of P.L.1987, c.116 (C.30:4-27.10) and request a temporary court order permitting the continued hold of the person pending the return date of the involuntary commitment hearing, which shall take place no later than 20 days from initial commitment.

b. (1) Notwithstanding the provisions of section 9 of P.L.1987, c.116 (C.30:4-27.9) or any other law, rule, or regulation to the contrary, commencing on the effective date of P.L.2023, c.139 (C.30:4-27.9a et al.) and ending on the last day of the 24th calendar month following that effective date, a general hospital, including any satellite emergency department of a general hospital, where a person is located during a screening outreach visit, may not detain the person for more than 72 hours from the time a screening certificate is executed, unless the hospital or emergency department obtains a temporary court order permitting the continued hold of the person for up to 72 additional hours, as determined by the court. The hospital or emergency department may submit an emergent application for such order and continue to hold the person during the pendency of the application, provided that appropriate treatment that meets the standard of care is being rendered to the person. The Office of the Public Defender shall be notified of the emergent application, provided with a copy of the application and all supporting documents, and shall be appointed as counsel to represent the patient. The application may be decided by the court on documentary presentations relevant to the standards established under paragraph (2) of this subsection. At the request of counsel, the court may conduct a hearing on the record, at which hearing the court shall consider the arguments of counsel and all relevant evidence submitted. The court shall determine the format of the hearing based on the apparent complexity of the matter and the extent of doubt as to the merits of the application, and may, at its discretion, rely on certifications from witnesses or require live testimony.

(2) The court may grant a temporary order granting the continued hold of a person upon an application submitted pursuant to paragraph (1) of this subsection if the hospital or emergency department:

(a) exhausted all reasonable efforts to place the individual in a short-term care [or] facility, psychiatric facility, residential substance use disorder treatment facility, or special psychiatric hospital, depending on which facility is appropriate for the person's condition and is the least restrictive environment; and

(b) demonstrates that there is a substantial likelihood that [, by reason of mental illness,] the person will be dangerous to the person's own self or others based upon the certification of two psychiatrists who have examined the patient and deemed the patient is in need of involuntary commitment.

The court shall include such conditions in the temporary order as the court deems appropriate to promote diligent efforts to locate an available facility to accommodate the patient's needs and protect the rights of the person detained pending commitment. The Office of the Public Defender shall be notified and provided with a copy of any temporary court order granted pursuant to this paragraph. The patient shall receive a court hearing with respect to the issue of continued need for involuntary commitment within 20 days from the date of initial commitment or within 20 days from the date an application was filed pursuant to paragraph (1) of this subsection, whichever date occurs first, unless the patient has been administratively discharged pursuant to section 17 of P.L.1987, c.116 (C.30:4-27.17).

(3) Notwithstanding the provisions of any other law, rule, or regulation to the contrary, commencing on the effective date of P.L.2023, c.139 (C.30:4-27.9a et al.) and ending on the last day of the 24th calendar month following that effective date, each general hospital and emergency department shall prepare and submit to the Department of Human Services a quarterly report, which report shall include, but not be limited to, information on:

(a) the number of applications submitted to the court for a temporary court order permitting the continued hold of a person beyond 72 hours pursuant to paragraph (1) of this subsection;

(b) the number of temporary court orders granted pursuant to paragraph (2) of this subsection permitting the continued hold of a person beyond 72 hours;

(c) whether a person detained for longer than 72 hours: has a criminal history; has a co-occurring substance use disorder; has a co-occurring intellectual or developmental disability; or is unable to be released because the 72-hour timeframe falls on a weekend and either admission to treatment facilities are not provided on weekends, or discharges from the facility do not occur on weekends;

(d) the length of time each individual was held beyond 72 hours before finding appropriate placement in a treatment facility; and

(e) the number of individuals placed in an appropriate treatment facility within 72 hours.

Any information included in a report concerning specific individuals shall be de-identified. Each report shall be made available to the public within 60 days of the date the Department of Human Services receives the report.

c. (1) Notwithstanding the provisions of any other law, rule, or regulation to the contrary, the Commissioner of Health may, to the extent the commissioner finds necessary, commencing 120 days following the effective date of P.L.2023, c.139 (C.30:4-27.9a et al.) and ending on the last day of the 15th calendar month following that effective date, allow a general acute care hospital that is licensed for acute care hospital psychiatric beds to apply to the Department of Health for temporary licenses for beds for the involuntary commitment of patients. The department may issue temporary licenses pursuant to this paragraph if the hospital demonstrates in its application a need for such beds based on retrospective data demonstrating the need for involuntary commitment beds, a showing that the hospital continually exhausts all reasonable efforts to place individuals in short-term care [or] facilities, psychiatric facilities, residential substance use disorder treatment facilities, or special psychiatric hospitals, and any other factors as determined by the Commissioner of Health. Any temporary license granted pursuant to this paragraph, unless otherwise confirmed at the next certificate of need review, as required pursuant to N.J.A.C.8:33-4.4 or its successor regulation, shall expire within 90 days of the Commissioner of Health's decision rendered pursuant to that full review process.

(2) The Department of Health shall make available on its Internet website and continuously update information concerning the total number of temporary licenses granted pursuant to paragraph (1) of this subsection, as well as the number of temporary licenses granted to each hospital that submitted an application pursuant to paragraph (1) of this subsection.

(3) The department shall submit information concerning the total number of temporary licenses granted pursuant to paragraph (1) of this subsection, as well as the number of temporary licenses granted to each hospital that submitted an application pursuant to paragraph (1) of this subsection, to the Commissioner of Human Services, which information shall: (a) be submitted in a manner that allows the Commissioner of Human Services sufficient time to include the information in the report required pursuant to subsection b. of section 2 of this act; and (b) reflect the number of temporary licenses granted as of the date the information is submitted.

(cf: P.L.2023, c.139, s.1)

11. Section 10 of P.L.1987, c.116 (C.30:4-27.10) is amended to read as follows:

10. a. (1) A short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or [a] special psychiatric hospital shall initiate court proceedings for involuntary commitment to inpatient or outpatient treatment by submitting to the court a clinical certificate completed by a psychiatrist on the patient's treatment team, or an electronically scanned clinical certificate in lieu of the original certificate, and the screening certificate, or an electronically scanned screening certificate in lieu of the original certificate, which authorized admission of the patient to the facility; provided, however, that both certificates shall not be signed by the same psychiatrist, unless the psychiatrist has made a reasonable but unsuccessful attempt to have another psychiatrist conduct the evaluation and execute the certificate.

(2) A screening service or outpatient treatment provider shall initiate court proceedings for commitment to outpatient treatment by submitting to the court a clinical certificate completed by a psychiatrist on the patient's treatment team, or an electronically scanned clinical certificate in lieu of the original certificate, and the screening certificate, or an electronically scanned screening certificate in lieu of the original certificate, which authorized assignment of the patient to outpatient treatment with the outpatient treatment provider; provided, however, that both certificates shall not be signed by the same psychiatrist, unless the psychiatrist has made a reasonable but unsuccessful attempt to have another psychiatrist conduct the evaluation and execute the certificate.

b. Court proceedings for the involuntary commitment to treatment of any person not referred by a screening service may be initiated by the submission to the court of two clinical certificates, at least one of which is prepared by a psychiatrist. The person shall not be involuntarily committed before the court issues a temporary court order.

c. A court proceeding for involuntary commitment to treatment of an inmate who is scheduled for release upon expiration of a maximum term of incarceration shall be initiated by the Attorney General or county prosecutor by submission to the court of two clinical certificates, at least one of which is prepared by a psychiatrist.

d. The Attorney General, in exercise of the State's authority as parens patriae, may initiate a court proceeding for the involuntary commitment to treatment of any person, in accordance with the procedures set forth in subsection a. or b. of this section. When the Attorney General determines that the public safety requires the initiation of a proceeding pursuant to subsection b. of this section, the Attorney General may apply to the court for an order compelling the [psychiatric evaluation of the] person to undergo a psychiatric evaluation or substance use disorder assessment. The court shall grant the Attorney General's application, if the court finds that there is reasonable cause to believe that the person may be in need of involuntary commitment to treatment. The Attorney General may delegate the authority granted pursuant to this subsection, on a case by case basis, to the county prosecutor.

e. Any person who is a relative, by blood or marriage, of the person being screened, and who executes a clinical certificate, or any person who signs a clinical certificate for any purpose or motive other than for purposes of care, treatment, and confinement of a person in need of involuntary commitment to treatment, shall be guilty of a crime of the fourth degree.

f. Upon receiving [these] the documents required by this section, the court shall immediately review [them] the documents, in order to determine whether there is probable cause to believe that the person is in need of involuntary commitment to treatment.

g. If the court finds, pursuant to a documentary review conducted pursuant to subsection f. of this section, that there is probable cause to believe that the person, other than a person whose commitment is sought pursuant to subsection c. of this section, is in need of involuntary commitment to treatment, [it] the court shall issue a temporary order authorizing the temporary assignment of the person to an outpatient treatment provider, or the temporary admission to, or retention of the person in the custody of [the] , a facility, that is both appropriate to the person's condition and [is] provides the least restrictive environment for treatment, pending [a final] the court’s final determination on the matter, which final determination shall be issued at a formal commitment hearing held pursuant to section 12 of P.L.1987, c.116 (C.30:4-27.12).

h. If the court finds that there is probable cause to believe that a person whose commitment is sought pursuant to subsection c. of this section is in need of involuntary commitment to treatment, it shall issue an order setting a date for a [final] commitment hearing under section 12 of P.L.1987, c.116 (C.30:4-27.12), and authorizing the Commissioner of [the Department of] Corrections to arrange for temporary commitment pursuant to section 2 of P.L.1986, c.71 (C.30:4-82.2) to the Ann Klein Forensic Center in Trenton or other facility designated for the criminally insane, pending the final hearing, and prior to the expiration of the person's term of incarceration. The order shall specifically provide for transfer of custody to the Ann Klein Forensic Center in Trenton or other facility designated for the criminally insane, if the person's maximum term will expire prior to the final hearing.

i. In the case of a person committed to treatment at a short-term care facility or special psychiatric hospital, after the facility's treatment team conducts a mental and physical examination, administers appropriate treatment, and prepares a discharge assessment, the facility may transfer the patient to a psychiatric facility prior to the final hearing; provided that:

(1) the patient, [his] and the patient’s family and [his] attorney are given 24 hours' advance notice of the pending transfer; and

(2) the transfer is accomplished in a manner which will give the receiving facility adequate time to examine the patient, become familiar with [his] the patient’s behavior and condition, and prepare for the hearing. In no event shall the transfer be made less than five days prior to the date of the hearing, unless an unexpected transfer is dictated by a change in the person's clinical condition.

j. A clinical certificate or screening certificate that is electronically scanned pursuant to subsection a. or b. of this section shall be transmitted in accordance with the Rules of Court.

(cf: P.L.2014, c.43, s.1)

12. Section 11 of P.L.1987, c.116 (C.30:4-27.11) is amended to read as follows:

11. A patient who is admitted to a short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital, either on a voluntary or involuntary basis, or who is assigned to an outpatient treatment provider [has], shall have the following rights:

a. The right to have examinations and services provided in the patient's primary means of communication, including, as soon as possible, with the aid of an interpreter if needed because the patient is of limited English-speaking ability or suffers from a speech or hearing impairment;

b. The right to a verbal explanation of the reasons for admission to the facility or assignment to the provider, as applicable, the availability of an attorney, and the rights provided in P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112 (C.30:4-27.8 et al.); and

c. The right to be represented by an attorney, and, if unrepresented or unable to afford an attorney, the right to be provided with an attorney paid for by the appropriate government agency. An attorney representing a patient [has] shall have the right to inspect and copy the patient's clinical chart.

The clinical director of the facility[,] or [the outpatient treatment] provider, as appropriate, shall ensure that a written statement of the rights [provided in P.L.1987, c.116 (C.30:4-27.1 et seq.) and P.L.2009, c.112] established under this section is provided to patients [at the time of] as soon as possible after their admission to the facility or assignment to the provider, as applicable, [as soon as possible thereafter,] and to patients and their families, upon request.

(cf: P.L.2009, c.112, s.12)

13. Section 12 of P.L.1987, c.116 (C.30:4-27.12) is amended to read as follows:

12. a. A patient who is involuntarily committed to treatment [and assigned to an outpatient treatment provider or involuntarily committed to treatment and admitted to a short-term care or psychiatric facility or special psychiatric hospital] shall receive a court hearing with respect to the issue of continued need for involuntary commitment within 20 days [from] after the date of initial commitment, unless the patient has been administratively discharged pursuant to section 17 of P.L.1987, c.116 (C.30:4-27.17). However, if a person is involuntarily committed pursuant to subsection c. or d. of section 10 of P.L.1987, c.116 (C.30:4-27.10), that person shall immediately [shall] be committed to the Ann Klein Forensic Center in Trenton, or [other] to another facility designated for the criminally insane, for the duration of the 20-day waiting period.

b. Except as provided in subsection c. of this section, the assigned county counsel [is] shall be responsible for presenting the case for the patient's involuntary commitment to the court, unless the county adjuster is licensed to practice law in this State, in which case, the county adjuster shall present the case for the patient's involuntary commitment to the court.

c. Notwithstanding the provisions of subsection b. of this section, and upon notice to the county adjuster:

(1) The Attorney General, or the county prosecutor acting at the request of the Attorney General, may supersede the county counsel or county adjuster and assume responsibility for presenting any case for involuntary commitment to treatment, or may elect to participate with the county counsel or county adjuster in presenting any such case; and

(2) The county prosecutor may supersede the county counsel or county adjuster and assume responsibility for presenting any case for involuntary commitment to treatment, which has been initiated by the county prosecutor pursuant to subsection c. of section 10 of P.L.1987, c.116 (C.30:4-27.10), or may elect to participate with the county counsel in the presentation of any such case.

d. A patient subject to involuntary commitment to treatment shall have counsel present at [the] any hearing held pursuant to this section, and shall not be permitted to appear at [the] any such hearing without counsel.

(cf: P.L.2009, c.112, s.13)

14. 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 to treatment, it shall issue an order authorizing the involuntary commitment of the patient and the assignment or admission of the patient pursuant to section 17 of P.L.2009, c.112 (C.30:4-27.15a) and shall schedule a subsequent court hearing in the event the patient is not administratively discharged pursuant to section 17 of 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 to treatment, the court shall so order. A patient who is serving a term of incarceration shall be returned to the appropriate State, county or local authority to complete service of the term of incarceration imposed until released in accordance with law, and any other patient shall be discharged by the facility 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 P.L.1987, c.116 (C.30:4-27.18).

c. (1) The court may discharge the patient subject to conditions, if the court finds that the person does not need involuntary or continued involuntary commitment to treatment and the court finds:

(a) that the patient's history indicates a high risk of rehospitalization because of the patient's failure to comply with discharge plans; or

(b) that there is substantial likelihood that [by reason of mental illness] the patient will be dangerous to himself, others or property if the patient does not receive other appropriate and available services that render involuntary commitment to treatment unnecessary.

(2) Conditions imposed pursuant to this section shall include those recommended by the facility and mental health agency and developed with the participation of the patient. Conditions imposed on the patient shall be specific and their duration shall not exceed 90 days unless the court determines, in a case in which the Attorney General or a county prosecutor participated, that the conditions should be imposed for a longer period. If the court imposes conditions for a period exceeding six months, the court shall provide for a review hearing on a date the court deems appropriate but in no event later than six months from the date of the order. The review hearing shall be conducted in the manner provided in this section, and the court may impose any order authorized pursuant to this section.

(3) The designated mental health agency staff person shall notify the court if the patient fails to meet the conditions of the discharge plan, and the court shall issue an order directing that the person be taken to a screening service for an assessment. The court shall determine, in conjunction with the findings of a screening service, if the patient needs to be rehospitalized and, if so, the patient shall be returned to the 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.

d. Notwithstanding subsection a. of this section, or any provision of section 16, 17 or 18 of P.L.1987, c.116 (C.30:4-27.16, 30:4-27.17 or 30:4-27.18), no person committed while serving a term of incarceration shall be discharged by the court or administratively discharged prior to the date on which the person's maximum term would have expired had he not been committed. If the person is no longer in need of involuntary commitment to treatment, the person shall be returned to the appropriate State, county or local authority to complete service of the term of incarceration imposed until released in accordance with law, and the person shall be given day for day credit for all time during which the person was committed.

e. Notwithstanding subsection a. of this section, or any provision of section 16, 17 or 18 of P.L.1987, c.116 (C.30:4-27.16, 30:4-27.17 or 30:4-27.18), no person committed pursuant to N.J.S.2C:4-8 concerning acquittal of a criminal charge by reason of insanity or pursuant to N.J.S.2C:4-6 concerning lack of mental competence to stand trial shall be discharged by the court or administratively discharged unless the prosecuting attorney in the case receives prior notice and an opportunity to be heard.

(c.f: P.L.2009, c.112, s.16)

15. Section 17 of P.L.2009, c.112 (C.30:4-27.15a) is amended to read as follows:

17. a. The court shall determine whether a patient who has been found to be in need of continued involuntary commitment to treatment, pursuant to section 15 of P.L.1987, c.116 (C.30:4-27.15), should be assigned to an outpatient setting or admitted to an inpatient setting for treatment, and shall issue [the] an order authorizing such placement, pursuant to section 15 of P.L.1987, c.116 (C.30:4-27.15), in accordance with this section. In determining the appropriate place for commitment [placement], the court shall [consider] select the least restrictive environment for the patient to receive clinically appropriate treatment that would ameliorate the danger posed by the patient and provide the patient with appropriate treatment.

b. If the court determines that the least restrictive environment for the patient to receive clinically appropriate treatment would be in an outpatient setting, and that there is a likelihood [of] that the patient [responding] will respond to outpatient treatment, the court shall obtain, from a designated outpatient treatment provider, a proposed plan of outpatient treatment for the patient, which the court shall review and approve. [The plan of outpatient treatment shall be approved by the court.]

c. If the court determines that the least restrictive environment for the patient to receive clinically appropriate treatment would be in an inpatient setting, the court shall issue an order [for admission] providing for the patient to be admitted to a psychiatric facility or residential substance use disorder treatment facility, as appropriate for the patient’s condition.

d. [Between] During the intervening time periods [for] between periodic court review hearings, scheduled pursuant to section 16 of P.L.1987, c.116 (C.30:4-27.16), the chief executive officer of a psychiatric facility or residential substance use disorder treatment facility may recommend [changing] that the court order a change in the placement of the patient from an inpatient to outpatient setting, in order to ensure that the patient receives clinically appropriate treatment in the least restrictive environment. The chief executive officer of the facility shall notify the court of the recommendation for the change in placement.

e. At the time that the court sets the date for a hearing on [the] a proposed change in placement, which has been recommended pursuant to subsection d. of this section, notice of the hearing shall be served upon the patient, the patient's guardian, if any, the patient's next-of-kin, the patient's attorney, and the county adjuster of the county in which the patient has legal settlement.

f. The provisions of section 14 of P.L.1987, c.116 (C.30:4-27.14), concerning patient rights at a hearing, shall apply to [the] any hearing that is held pursuant to this [subsection] section.

(cf: P.L.2009, c.112, s.17)

16. Section 16 of P.L.1987, c.116 (C.30:4-27.16) is amended to read as follows:

16. a. A patient who is committed pursuant to a court order [who is], and who has not been administratively discharged pursuant to section 17 of P.L.1987, c.116 (C.30:4-27.17), shall be afforded periodic court review hearings [of the] to evaluate whether there is a continued need for involuntary commitment to treatment, and [of the] to determine whether the patient is being provided with services in the least restrictive environment [for that commitment]. [The] Each such periodic review hearing shall be conducted in the manner provided [in section] by sections 12 through 15 of P.L.1987, c.116 (C.30:4-27.12 through C.30:4-27.15). If the court determines, at a periodic review hearing, that involuntary commitment to treatment shall be continued, it shall execute a new order to that effect, which order shall specify the least restrictive environment for continued commitment.

(1) In the case of a patient who has been admitted to a short-term care facility, [the court shall conduct] a psychiatric facility, or a special psychiatric hospital for the treatment of a mental illness, the first periodic review hearing under this section shall be held three months [from] after the date of the [first] initial commitment hearing under section 12 of P.L.1987, c.116 (C.30:4-27.12), the [next] second review hearing shall be held nine months [from] after the date of the [first] initial commitment hearing [and subsequent], the third periodic review [hearings] hearing shall be held 12 months [from] after the date of the [first] initial commitment hearing, and subsequent periodic review hearings shall be held annually thereafter. The court may schedule additional review hearings, but, except in extraordinary circumstances, such hearings shall not be held more often than once every 30 days.

(2) In the case of a patient who has been assigned to an outpatient treatment provider [, the court shall conduct] for the treatment of a mental illness, the first periodic review hearing under this section shall be held six months [from] after the date of the [first] initial commitment hearing under section 12 of P.L.1987, c.116 (C.30:4-27.12), the [next] second periodic review hearing shall be held nine months [from] after the date of the [first] initial commitment hearing [and subsequent], the third periodic review [hearings] hearing shall be held 12 months [from] after the date of the [first] initial commitment hearing, and subsequent periodic review hearings shall be held annually thereafter. The court may schedule additional review hearings, as deemed to be appropriate, but, except in extraordinary circumstances, such hearings shall not be held more often than once every 30 days.

(3) In the case of a patient who has been admitted to a residential substance use disorder treatment facility, or assigned to an outpatient treatment provider for treatment of a substance use disorder, the first periodic review hearing under this section shall be held 30 days after the date of the initial commitment hearing under section 12 of P.L.1987, c.116 (C.30:4-27.12), and subsequent periodic review hearings shall be held every 30 days thereafter. The court may schedule additional periodic review hearings, as deemed to be necessary, but, except in extraordinary circumstances, such hearings shall not be held more often than once every 21 days.

(4) If the date of a periodic review hearing under this section will fall on a holiday or weekend, the court shall order the hearing to be held on the business day that immediately proceeds the holiday or weekend.

b. At [a court] any periodic review hearing held pursuant to this section, when the advanced age of the patient, or the cause or nature of the patient’s mental illness or substance use disorder renders it appropriate, and when it would be impractical to obtain the testimony of a psychiatrist as required [in] by section 13 of P.L.1987, c.116 (C.30:4-27.13), the court may permit a physician on the patient's treatment team, who has personally conducted an examination of the patient as close to the hearing date as possible, but in no event more than five days prior to the hearing date, to testify at the hearing as to the clinical basis for the determination that the patient is still in need [for] of involuntary commitment to treatment.

(cf: P.L.2009, c.112, s.18)

17. 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 an outpatient treatment provider, short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital shall, subject to the limitations set forth in subsections b. and c. of this section, administratively discharge a patient from involuntary commitment status, if, at any time, the treatment team determines that the patient is no longer [needs] in need of involuntary commitment to treatment. If a discharge plan has not been developed pursuant to section 18 of P.L.1987, c.116 (C.30:4-27.18), [it] such discharge plan shall be developed forthwith.

b. If the patient is confined pursuant to an order entered under section 15 of P.L.1987, c.116 (C.30:4-27.15) in a case in which the Attorney General or a county prosecutor participated, the treatment team shall, [no] not less than 10 days prior to the proposed date of administrative discharge, provide written notice of the discharge to the committing court, and to the person or persons who presented the case for involuntary commitment to treatment. If, within five days [of] after receipt of such notice, a person who presented the case for commitment files a request for a hearing on the issue of the patient’s continued need for commitment, and serves notice of that request, in accordance with the provisions of section 13 of P.L.1987, c.116 (C.30:4-27.13), the treatment team shall delay the administrative discharge, and the court shall schedule a hearing on the issue. The hearing shall be conducted in the same manner as the initial commitment hearing, as provided [in section] by sections 12 through 15 of P.L.1987, c.116 (C.30:4-27.12 through C.30:4-27.15).

c. If the patient is confined pursuant to an order entered under N.J.S.2C:4-8, concerning acquittal of a criminal charge by reason of insanity, or under N.J.S.2C:4-6, concerning lack of mental competence to stand trial, the treatment team shall, [no] not less than 10 days prior to the proposed date of administrative discharge, provide written notice of the discharge to the committing court, and to the prosecutor. If, within five days of receipt of such notice, the prosecutor files a request for a hearing on the issue of the patient’s continued need for commitment, and serves notice of that request, in accordance with the provisions of section 13 of P.L.1987, c.116 (C.30:4-27.13), the treatment team shall delay the administrative discharge, and the court shall schedule a hearing on the issue. The hearing shall be conducted in the same manner as the initial commitment hearing, as provided [in section] by sections 12 through 15 of P.L.1987, c.116 (C.30:4-27.12 through C.30:4-27.15).

(cf: P.L.2009, c.112, s.19)

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

18. a. A person who is discharged, either administratively or by order of the court [or administratively], from an outpatient treatment provider, short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital shall have a discharge plan prepared by the treatment team at the facility or provider, as appropriate, 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] b. (1) If the patient has been [committed to treatment at] admitted to a short-term care facility, a residential substance use disorder treatment facility, or a psychiatric [facilities] facility, a community mental health agency designated by the commissioner shall participate in the formulation of [the] a discharge plan under this subsection. The facility shall advise the mental health agency of the date of the patient's discharge[. The mental health], and the agency shall provide follow-up care to the patient, pursuant to regulations adopted by the commissioner.

[In the case of patients] (2) If the patient has been assigned to an outpatient treatment [providers] provider, the outpatient treatment provider shall participate in the formulation of [the] a discharge plan under this subsection.

[This] c. Nothing in this section [does not] shall preclude a facility or provider from discharging a patient to the care of an appropriate professional.

[Psychiatric facilities] d. A psychiatric facility discharging a patient who was committed thereto, pursuant to P.L.1987, c.116 (C.30:4:27-1 et seq.) and P.L.2009, c.112 (C.30:4-27.8a et al.), shall [give] provide notice of the discharge to the county adjuster of the county in which the patient has legal settlement.

(cf: P.L.2009, c.112, s.20)

19. Section 20 of P.L.1987, c.116 (C.30:4-27.20) is amended to read as follows:

20. A voluntary patient at a short-term care [or] facility, residential substance use disorder treatment facility, psychiatric facility, or special psychiatric hospital shall be discharged by the treatment team at the patient's request. The treatment team shall document all requests for discharge, whether oral or written, in the patient's clinical record. The facility shall discharge the patient as soon as possible, but in every case, within 48 hours, or at the end of the next working day, from the time of the request, whichever is longer, except that, if the treatment team determines that the patient [needs] is in need of involuntary commitment, the treatment team shall initiate court proceedings pursuant to section 10 of [this act] P.L.1987, c.116 (C.30:4-27.10). The facility shall detain the patient beyond 48 hours or the end of the next working day [from the time] following receipt of the request for discharge, only if the court has issued a temporary court order authorizing such detainment.

(cf: P.L.1987, c.116, s.20)

20. Section 20 of P.L.1987, c.116 (C.30:4-27.20) is amended to read as follows:

(cf: P.L.1987, c.116, s.20)

21. R.S.30:4-34 is amended to read as follows:

30:4-34. In each county where the county counsel, county solicitor, county clerk, county physician, [or] county probation officer, or any of their assistants is in charge [and supervision] of, and supervises, the preparation of papers relating to the commitment of persons with mental illness or substance use disorders, such person shall be known as "county adjuster," and such duties shall, except as otherwise provided in section 2 of P.L.1981, c.403 (C.30:4-34.1), continue to pertain to the office of such county counsel, county solicitor, county clerk, county physician, or county probation officer, or their successors in office[, but]. However, notwithstanding the foregoing, [in case] if any other county official or employee [shall be] is, at the time of the [adoption of this act] enactment of R.S.30:4-34, in charge [and supervision] of, and supervising, the preparation of papers relating to the commitment of persons with mental illness, the governing body of the county may designate that county official or employee as county adjuster. In all other counties, the county governing body shall designate some county official or employee as county adjuster.

The county adjuster shall [have] be in charge [and supervision] of, and shall supervise, the preparation of papers relating to the commitment of persons with mental illness or substance use disorders in such county, [and] as well as in cases arising in other counties in which the legal settlement appears to be in [his] the county adjuster’s county. Classification under civil service rules shall not be affected by reason of such designation or additional duties, and additional compensation, if any, for such services may be fixed by the county governing body and paid in the same manner as other county employees are paid. Each county governing body shall notify the various facilities and institutions that are available for the treatment of persons with mental illness or substance use disorders of the name and address of the county adjuster.

[The] A judge of the Superior Court within the county may appoint the county adjuster to act as referee for the purpose of taking testimony bearing solely on the question of legal settlement and the financial ability of the person with mental illness, or the parent of [the person with mental illness] thereof, if the person is under the age of 18, to pay the cost of maintenance, in accordance with the provisions of R.S.30:4-60[, and shall make return to]. A county adjuster appointed to act as a referee, pursuant to this section, shall provide the court [of his] with the county adjuster’s findings, conclusions, and recommendations, which are developed pursuant to this section. Such findings, conclusions, and recommendations shall be subject to the approval of the court, and shall not [be] become effective until incorporated in an appropriate order or judgment of the court. The county adjuster, acting as such referee, may [subpena] subpoena witnesses and compel their attendance on forms approved by the court.

(cf: P.L.2005, c.55, s.2)

22. The Commissioner of Human Services shall adopt rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.

23. This act shall take effect on the first day of the fourth month next following enactment, except that the Commissioner of Human Services may take anticipatory administrative action, in advance of the effective date, as may be necessary to implement the provisions of this act.

STATEMENT

This bill would amend the State's existing involuntary commitment laws at P.L.1987, c.116 (C.30:4-27.1 et seq.), in order to clarify the circumstances under which a person may be involuntarily committed to treatment, including substance use disorder treatment. The bill extends the various provisions of the State's involuntary commitment laws to individuals who have recently been admitted to a hospital for a substance use overdose or administered an opioid antidote for the emergency treatment of an apparent opioid overdose. Under the bill, these individuals can be determined to be "dangerous to self" and to be "in need of involuntary commitment" to substance use disorder treatment at a residential substance use disorder treatment facility.

The bill would provide for persons committed for a substance use disorder to be provided with treatment at a residential substance use disorder treatment facility or an outpatient substance use disorder treatment provider, rather than at a psychiatric facility, hospital, or other mental health provider.

The bill would clarify that the court is to provide for more frequent periodic judicial review hearings in cases where a person is committed for a substance use disorder than in cases where a person is committed for a mental illness. In particular, when a person is committed to substance use disorder treatment, the first periodic review hearing is to be conducted 30 days after the date of the initial commitment hearing (as opposed to three months after the date of initial commitment, in the case of inpatient commitment for mental illness, and six months after the date of initial commitment, in the case of outpatient commitment for mental illness), and subsequent review hearings are to be held every 30 days thereafter (as opposed to nine months, 12 months, and every year thereafter for both inpatient and outpatient commitment for mental illness). The court may schedule additional periodic review hearings for a person who is committed for a substance use disorder, as determined to be necessary, but such hearings are not to be held more often than once every 21 days, except in extraordinary circumstances. The bill would further clarify that a substance use treatment provider or facility will be required to administratively discharge a person committed thereto, if, at any time, the treatment team determines that the person is no longer in need of involuntary commitment to treatment.

The bill would require a law enforcement officer to take a person into custody, and transport the person immediately and directly to a screening service for an assessment to evaluate the need for involuntary commitment, and for the commencement of involuntary commitment proceedings, if necessary, in any case where the law enforcement officer has administered naloxone or another opioid antidote to the person, in order to revive the person, and prevent the person’s death, following the person’s overdose on opioid drugs; or in any case where a health care practitioner, emergency medical responder, or private individual has certified, in a form and manner prescribed by the Division of Mental Health and Addiction Services, that the person has overdosed on opioid drugs, and has been revived with an opioid antidote, within the preceding 48-hour period, thereby necessitating the belief by the health care practitioner, emergency medical responder, or private individual that the person is an imminent danger to himself, and is in need of involuntary commitment to treatment.

In a related vein, the bill would also amend the existing commitment law to clarify that a law enforcement officer is to take a person directly to a screening service for a mental health evaluation, and for the commencement of mental health commitment proceedings under the existing law, if necessary, in any case where a health care practitioner, mental health care practitioner, or emergency medical responder has certified, in a form and manner prescribed by the division, that the person is currently undergoing a mental health or behavioral health crisis in which the person has caused, or attempted to cause, actual harm to self or others, thereby necessitating a belief by the practitioner or emergency medical responder that the person is in need of involuntary commitment to treatment for a mental illness.

The bill makes various changes to the State's existing involuntary commitment laws to reflect these changes and make various technical changes to P.L.1987, c.116 (C.30:4-27.1 et seq.) concerning grammar, style, and syntax.