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Judges’ Quick Reference Guideto the New Jersey

Involuntary Commitment Codeand Related Rule of Court

(2014 Revisions)

AUGUST 2015 UPDATE

A Publication of theTreatment Advocacy Center

2015

For additional copies or more information200 N. Glebe Road, Suite 801

Arlington, Virginia703-294-6001

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JUDGES’ QUICK REFERENCE GUIDE TO THE NJ INVOLUNTARY COMMITMENT CODE

INTRODUCTION

This guide is designed to assist New Jersey judges in applying the state’s involuntary commitment code (N.J. Rev Stat § 30.4-27.1 et. seq.) and the related Rule of Court (Rule 4:74-7) in cases where individuals are alleged to be men-tally ill and in need of involuntary treatment (whether on an inpatient or outpatient basis) to avert danger to self, others or property. We hope it will prove useful on the bench and in chambers as a quick reference to the applicable statutory requirements.

Our goal was to present the relevant law in outline form that is easier to navigate than the code itself. This is not intended to substitute for consultation of the annotated code in judicial decision-making. (On the contrary, statutory citations are included throughout to aid judges in access-ing the relevant law.) We have not attempted to integrate decisional notes that may address statutory ambiguities nor to provide definitions of all terms defined in N.J. Rev. Stat § 30.4-27.2.

This guide was made possible through the generous support of The Bodman Foundation.

Treatment Advocacy Center June 2015


WHO MAY INITIATE A PROCEEDING FOR COMMITMENT?

• GENERALRULE:Anyonemay,byfollowingcourtrule and statutory procedure §30:4-27.10(b),Rule4:74-7(b)

• EXCEPTION:Ifthesubjectofthepetitionis“aninmatewhoisscheduledforreleaseuponexpirationofamaximumtermofincarceration,”proceedingmustbeinitiatedbytheAttorneyGeneralorcountyprosecutor §30:4-27.10(c)

HOW IS A COMMITMENT PROCEEDING INITIATED? Rule4:74-7(b)

• GENERALRULE:Apartyinitiatesaproceedingbysubmittingtothecourttwoclinicalcertificates

u CertificatesmustbeintheformprescribedbytheDivisionofMentalHealthandAddictionServicesandapprovedbytheAdministrativeDirectoroftheCourtsRule4:74-7(b)

u Atleastonecertificatemustbeexecutedbyapsychiatrist§30:4-27.10(b),(c)

u Neithercertificatemaybeexecutedbyarelativebybloodormarriageoftheperson §30:4-27.10(c),Rule4:74-7(b)(3)(B)

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u Neithercertificatemaybemotivatedotherthanforpurposesofcare,treatmentandconfinement §30:4-27.10(c)

u CertificatesmuststateRule4:74-7(b)(3)(A)n Personismentallyilln Personpresentsdangertoself,othersorpropertyn Personisunwillingtoaccepttreatmentvoluntarilyn Whetherpersonrequiresinpatientoroutpatientcare

w ifinpatientcareisrecommended,thatthedangerposedbythepersonis“immediateorimminent”

w ifoutpatientcareisrecommendedthat,withsuchcare,thepersonisunlikelytobedangerouswithinthereasonablyforeseeablefuture

n Thatthereisnoavailableorappropriatelessrestrictive alternative

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• EXCEPTION:Certainparties…§30:4-27.10(a),Rule4:74-7(b)(1)

u Ashort-termcarefacility

u Aspecialpsychiatrichospital

u Ascreeningservice(whenseekingoutpatientcommitment)or

u Anoutpatienttreatmentprovider(whenseekingoutpatientcommitment)

…initiateproceedingbysubmittingtothecourt:u Oneclinicalcertificateand

u Thescreeningcertificatethatauthorizedadmission/assignmentofthepatienttotheinitiatingpartyn MustbecompletedbypsychiatristonformprescribedbytheDivisionofMentalHealthandAddiction Services §30:4-27.5

n Givesperson’shistoryandbackground,includingprior admissions to inpatient care §30:4-27.5

n Recommends least restrictive environment §30:4-27.5

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• LIMITATIONSONEXCEPTION:

u Theclinicalcertificateandthescreeningcertificateshallnotbesignedbythesamepsychiatristunlessthepsychiatristhasmadea“reasonablebutunsuccessful”attempttoenlistanotherpsychiatrist §30:4-27.10(a),Rule4:74-7(b)(3)(B)

u Ifthepatientisadmittedtoinvoluntaryhospitaltreatmentwithoutacourtorder,facilitymustinitiateproceedingswithin72hours§30:4-27.9(c),Rule4:74-7(b)(1)

u Ifthepatientisassignedtooutpatienttreatmentbyascreeningservicewithoutacourtorder,providermustinitiatecourtproceedingswithin72hours §30:4-27.9(d),Rule4:74-7(b)(1)

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• ATTORNEYGENERALHASMULTIPLEOPTIONSTOINITIATE:TheAttorneyGeneral(oracountyprosecutortowhomtheA.G.hasdelegatedauthority)mayinitiateacommitmentproceedinginanyofthreeways: §30:4-27.10(d)

u Bytwoclinicalcertificates(see “General Rule,” pp. 1-2)

u Byclinicalcertificateandscreeningcertificate (see “Exception,” pp. 3-4)

u ByapplicationtothecourtforanordercompellingpsychiatricevaluationofthepersonuponA.G.’sdeterminationthatpublicsafetyrequiresinitiationofaproceeding.Courtshallgrantorderuponfindingof“reasonablecausetobelievethepersonmaybeinneedoftreatment”

• EXCEPTIONTOA.G.CHOICE:Ifthepersonisaninmatescheduledforrelease,A.G.mustinitiatebytwoclinicalcertificates§30:4-27.10(c)

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WHAT MUST COURT DO UPON RECEIVING A SUFFICIENT APPLICATION FOR COMMITMENT?

• Courtdetermineswhetherpersonallegedtorequirecommitment is a minor or an adult

u Ifpersonisaminor,followproceduresstatedin RuleofCourt4:74-7a

• Courtimmediatelyreviewsapplicationtodeterminewhetherthereisprobablecausetocommit§30:4-27.10(f) (see pp. 13-15 for criteria)

• Uponfindingprobablecause,courtsetsadateforacourthearingwithin20daysandissuesatemporaryorder,assigningthepersontotheleastrestrictiveenvironmentthatisappropriate,pendingfinaldisposition §§30:4-27.10(g),30:4-27.12(a),Rule4:74-7(c)

u “Leastrestrictiveenvironment”requireseither §30:4-27.10(g)

n Retention in a facility orn Assignment to an outpatient treatment provider

u Ifpersoniscurrentlyaninmatescheduledforreleasefromincarcerationpriortothecommitmenthearingdate,thetemporaryordershalldirectthat,priortoreleasefromincarceration,thepersonbetransferredtotheAnnKleinForensicCenterinTrenton(orother

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facility“designatedforthecriminallyinsane”) andretainedtherependingdisposition§30:4-27.10(h)

u TemporaryorderidentifiesRule4:74-7(c)n Thehearingdateandlocationn Counseltopresentthecaseforcommitment (see p. 11)

n Counseltorepresentthepatient,ifpresentlyunrepresented(see p. 11)

n Partiestobenotified(see “Who Must Receive Notice” below)

n Modeofservice(see p. 9)n Datebywhichnoticemustbeserved(see p. 9)

WHO MUST RECEIVE NOTICE OF THE SCHEDULED HEARING?

§30:4-27.13(a),Rule4:74-7(c)(4)

• Thepatient

• Patient’snext-of-kinandguardian,ifany

• Patient’scounsel

• Facilitydirector/outpatientproviderresponsibleforpatientunderthetemporaryorder

• Adjusterofpatient’scountyoflegalsettlement

• Anyotherindividualidentifiedbythecourt

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WHO SERVES NOTICE? §30:4-27.13(a),Rule4:74-7(c)(4)

• Theattorneypresentingthecaseinfavorofcommitment

WHEN MUST NOTICE BE SERVED? §30:4-27.13(a),Rule4:74-7(c)(4)

• Atleast10dayspriortothehearingdate

ARE THERE LIMITATIONS ON MODE OF SERVICE? Rule4:74-7(c)(4)

• Patientmustreceivepersonalservice

WHAT MUST NOTICE INCLUDE? §30:4-27.13(a),Rule4:74-7(c)(4)

• Date,time,locationofhearing

• Topatientandcounselonly,copiesof:

u Clinicalcertificatesandsupportingdocuments

u Temporary court order

u Statementofpatient’srightsathearing(see p. 12)

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WHAT DISCOVERY IS ALLOWED? Rule4:74-7(d)

• Notwithstandinganyrule,policyorregulationonconfidentiality,patient’scounselorguardianadlitem hasrighttoinspectorcopyallmedicalrecordsrelated to patient’s mental condition

• Courtmayorderindependentexamofpatient

u Costsbornebythepartychargedwithpatient’s legal settlement

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AT THE HEARING, WHO PRESENTS THE CASE IN FAVOR OF COMMITMENT?

• Countyadjuster,iflicensedtopracticelaw.Ifnot,case for commitment presented by assigned county counsel §30:4-27.12(b)

• TheAttorneyGeneralorcountyprosecutor,actingatA.G.’srequest,maysupersedeorco-counselwiththecountyadjuster/countycounsel§30:4-27.12(c)(1)

• Countyprosecutormayindependentlysupersedeor co-counselwiththecountyadjusterorcountycounsel §30:4-27.12(c)(2)

WHO REPRESENTS THE PATIENT? §§30:4-27.12(d),30:4-27.14(a)

• Patientmaynotappearwithoutcounsel

• Counselappointedifpatientisindigent

WHAT EVIDENCE MUST BE PRESENTED AT THE HEARING?

§30:4-27.13(b),Rule4:74-7(e)

• Psychiatristonthepatient’streatmentteamshalltestify onfindingsofexamination

u Exammusthavebeenconductedwithin5daysprior tocourthearing

u Testimonymustincludeclinicalbasisforfindingneed to commit

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WHAT ADDITIONAL EVIDENCE MAY BE PRESENTED AT THE

HEARING? Rule4:74-7(e)

• Treatmentteammembersshallbepermittedtotestify §30:4-27.13(b)

• Witnesseswithrelevantinformationshallbepermitted totestify,ifofferedbyeitherparty§30:4-27.13(b)

• Patient’snext-of-kinmayattendandtestifyatcourt’sdiscretion §30:4-27.13(c)

WHAT ARE OTHER COURT RESPONSIBILITIES? §30:4-27.13(d)

• Courtshalltranscribehearing

• Courtshallarrangepaymentofexpensesinsamemannerasothercourtproceedings

WHAT ARE THE PATIENT’S RIGHTS AT THE HEARING?

§30:4-27.14,Rule4:74-7(e)

• Righttoberepresentedbycounsel(appointedifpatient isindigent)

• Righttobepresentunlesscourtdeterminesconductorcircumstancesjustifypatient’sabsence

• Righttopresentevidence

• Righttocross-examinewitnesses

• Righttohearingincamera

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WHAT IS THE BURDEN OF PROOF? §30:4-27.15(a)

• Clearandconvincingevidence

WHAT MUST THE COURT FIND TO ORDER INVOLUNTARY

COMMITMENT? §§30:4-27.2(m),30:4-27.15(a),Rule4:74-7(f)

Thatthepatientis:

• Anadultwithmentalillness

u “Mentalillness”definedas§30:4-27.2(r)n Acurrentsubstantialdisturbanceofthought,mood,

perception or orientation,n whichsignificantlyimpairsjudgmentorcapacitytocontrolbehaviororrecognizereality,

n butdoesnotincludesimplealcoholintoxication,transitory reaction to drug ingestion, organic brain syndrome or developmental disability, unless resulting in severe impairment,

n andisnotlimitedtopsychosis

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• Adangertoself,othersorproperty

u “Dangertoself”definedas§30:4-27.2(h)n Takingintoaccounttheperson’s:

w historyw recentbehaviorw seriouspsychiatricdeterioration

n Theperson’smentalillnesshascausedeither:w threatsorattemptsatsuicideorbodilyharmorw inabilitytosatisfyneedsfornourishment,essentialmedicalcareorshelterD “inabilitytosatisfyneeds”shallnotbefoundifthepersonisabletosatisfysuchneedswithsupervisionandassistanceofwillingandavailableothers

n Probabilitythatthepersonwillsustainsubstantialbodilyinjury,seriousphysicalharmordeathinthereasonably foreseeable future

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u “Dangertoothersorproperty”definedas§30:4-27.2(i)n Takingintoaccounttheperson’s:

w historyw recentbehaviorw seriouspsychiatricdeterioration

n Thepersonis:w substantiallylikelytoinflictseriousbodilyharmorcauseseriouspropertydamageinthenearfuture

w unwillingtovoluntarilyacceptappropriatetreatmentthathasbeenoffered

w in need of inpatient or outpatient care because otherservicesarenotappropriateoravailabletomeettheperson’smentalhealthcareneeds

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WHAT HAPPENS IF THE COURT FINDS THE NEED FOR INVOLUNTARY COMMITMENT ESTABLISHED?

• Courtmustdeterminetheleastrestrictiveenvironmentappropriateforthepatient§30:4-27.15a(a)

u “Leastrestrictiveenvironment”isthatwhichbestaddresses §30:4-27.2(gg)n Theneedforcaren Theneedtoaddressdangerstoself,othersor

propertyn Thepatient’sinterestinfreedomofmovement

and self-direction

• Ifinpatient(hospital)careisfoundtobetheleastrestrictiveenvironment,thecourtshallissueanorder foradmissiontoapsychiatricfacility§30:4-27.15a(c)

• Ifoutpatientcareisfoundtobetheleastrestrictiveenvironment,thecourtshallissueanorderapproving a plan of outpatient treatment §30:4-27.15a(b)

u “Planofoutpatienttreatment”definedasaplan §30:4-27.2(hh),(ii),(jj)

n Forapatientwithahistoryofrespondingtomentalhealthtreatment§30:4-27.2(jj)

n Consisting of clinically appropriate care directed to wellnessandrecoveryfrommentalillness§30:4-27.2(hh)


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n Basedonprovenorpromisingtreatments §30:4-27.2(hh)

u Planmayincludebutisnotlimitedto§30:4-27.2(hh)n Day treatment servicesn Case managementn Residential servicesn Outpatientcounselingandpsychotherapyn Medication(maynotbeinvoluntarilyadministered)

u Planmustbeprepared:n ByanoutpatienttreatmentproviderdesignatedbytheCommissionerofHumanServices §§30:4-27.2(ii),(jj),30:4-27.8(b)

n Incooperationwithfacilityorcourt§30:4-27.8a(a)n Withreasonableandappropriateeffortstogatherrelevantinformationfromfamilyorsignificantothers§30:4-27.8a(a)


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WHAT HAPPENS IF THE COURT FINDS NEED FOR COMMITMENT NOT ESTABLISHED?

• Courtdischargesthepatient

u Ifnocriminalchargeorsentenceispending,andthepatienthadbeentemporarilycommittedtothecustodyofafacility,thepatientshallbereleasedfromthefacilitywithadischargeplanwithin48hoursofthecourt’sverbalorderorbytheendofthenextworkingday,whicheverislater§30:4-27.15(b)n EXCEPTION:Ifthepatienthasbeenacquittedby

reason of insanity or found incompetent to stand trialonacriminalcharge,thepatientmaynotbedischargedwithouttheprosecutingattorneyreceivingnoticeandopportunitytobeheard §30:4-27.15(e)

u Ifthedischargedpatientisaninmatewithapendingcriminalsentenceofincarceration,thepatientshallbereturnedtotheappropriateauthoritytocompletethesentence §30:4-27.15(d)


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• Notwithstandingthelackofbasisforafinalcommitmentorder,thecourtmaydischargethetemporarilycommittedpatientsubjecttoconditions,ifthecourtfinds §30:4-27.15(c)(1)

u Thepatient’shistoryindicateshighriskofre-hospitalizationduetofailuretofollowdischarge plans or

u Substantiallikelihoodofdangertoself,othersorproperty(see pp. 13-15)ifthepatientdoesnotreceivenecessary services

• Dischargeconditionsshall§30:4-27.15(c)(2)

u Bespecific

u Includerecommendationsbythefacilityoroutpatientprovidertowhichthepatienthadbeentemporarilycommitted

u Bedevelopedwithparticipationofpatient

u Notexceed90daysunlesscourtdeterminesotherwiseinacaseinwhichtheAttorneyGeneralorcountyprosecutor participatedn Ifconditionsexceed6months,courtshallseta reviewhearingdate


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HOW OFTEN MUST THE COURT REVIEW AN INVOLUNTARY

COMMITMENT ORDER? §30:4-27.16(a),Rule4:74-7(f)(2)

• Reviewsofinpatientcommitmentordersmustbeheldatleast3,9and12monthsfromfirsthearingandannuallythereafterbutnotmoreoftenthanevery30days

• Reviewsofoutpatientcommitmentordersmustbeheldatleast6,9and12monthsfromfirsthearingandannuallythereafterbutnotmoreoftenthanevery30days

WHAT OCCURS AT A REVIEW HEARING? §30:4-27.16,Rule4:74-7(f)(2)

• Thecourtmustdeterminetheleastrestrictiveenvironmentthatisappropriateforthepatientatthe timeofthereviewhearing

• Allnoticeandevidencerulesapplicableattheinitialcommitmenthearingapplytoreviews

u EXCEPTION:Ifthetestimonyofpsychiatristisimpractical, and patient’s advanced age or mental illnessrendersitappropriate,atreatingphysicianwhohasexaminedthepatientwithin5daysofthehearingmay testify

• Ifcourtdeterminestreatmentshouldbecontinued,courtshallissueaneworder


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HOW IS A PATIENT DISCHARGED FROM INVOLUNTARY

COMMITMENT? §30:4-27.17,Rule4:74-7(h)

• If,atanypointduringtheperiodofcommitment,thetreatmentteamdeterminesthatthepatientnolongerrequiresinvoluntarycommitment,theteamshall:

u Developadischargeplan

u Notifytheprosecutingagencyandthecourtatleast 10dayspriortodischarge

u Dischargethepatientwithin48hours,iftheprosecutingagencydeclinestofileforcontinuedcommitment Rule4:74-7(h)(1)

• If,within5daysofreceivingnoticeoftheplanneddischarge,theprosecutingagencyfilesforhearingontheneedforcontinuedcommitment,thedischargeshallbestayedpendinghearinganddispositionbythecourt

• Ifappropriateplacementisunavailable,courtshallconditionallyextendhospitalizationandscheduleahearingwithin60daysRule4:74-7(h)(2)

• Ifpatientisnotsoonerdischarged,furtherplacementreviewsshallbeheldnolessfrequentlythanevery 6monthsRule4:74-7(h)(2)

• Ifappropriateplacementbecomesavailableinintervalbetweenhearings,patientmaybeadministrativelydischargedtosuchplacementRule4:74-7(h)(2)


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HOW MAY A PATIENT CONVERT HIS/HER OWN INPATIENT COMMITMENT STATUS FROM INVOLUNTARY TO VOLUNTARY?

Rule4:74-7(g)

• Uponreceivingpatient’srequest,courtsetsdateforhearingwithin20days

• Standardnoticerulesapply(see pp. 8-9)

• Counselpreviouslyappointedrepresentspatient

• Patientshallbepresentathearingunlesscourtissatisfiedthatpatientdoesnotwishtoattend

• Athearing,courtdetermineswhetherpatient:

u Hascapacitytomakeinformeddecision

u Madedecisionknowingly/voluntarily

HOW MAY THE TREATMENT TEAM EFFECT TRANSFER FROM INPATIENT COMMITMENT TO OUTPATIENT COMMITMENT?

• IfatanypointduringaninpatientcommitmentthetreatmentfacilityCEOdeterminesthatthepatient wouldbebetterservedbyanoutpatientcommitment, theCEOshallnotifythecourtofitsrecommendation §30:4-27.15a(d)

• UponreceivingtheCEO’srecommendation,thecourtshallsetahearingonchangeinplacement,withstandardnoticerules(see pp. 8-9)§30:4-27.15a(e)


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WHAT HAPPENS IF A PATIENT COMMITTED TO OUTPATIENT TREATMENT FAILS TO COMPLY WITH THE COURT ORDER OR THE PROVIDER BELIEVES THE ORDER REQUIRES

MODIFICATION? §§30:4-27.9,30:4-27.17

• Theoutpatienttreatmentproviderwillnotifythecourt,thepatient’sattorneyandthecountyadjusterandinitiatemodificationoftheorder,iftheoutpatienttreatmentproviderfindsthat:

u Theplanofoutpatienttreatmentisnotadequate to meet patient’s needs or

u Patienthasfailedtomateriallycomplywiththeplan of outpatient treatment

• Theoutpatienttreatmentprovidershallseekanadditionalassessment to determine appropriate services

• Theoutpatienttreatmentprovidershallseekcourtapprovalofthemodification,withstandardrequirementsofnotice(see pp. 8-9)


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WHAT HAPPENS IF A TEMPORARILY COMMITTED PATIENT SUBJECT TO DISCHARGE CONDITIONS (see p. 18) FAILS TO

COMPLY? §30:4-27.15(c)(3)

• Thedesignatedmentalhealthagencystaffpersonshallnotifythecourt,andthecourtshallissueanorderdirectingthatthepatientbetakentoascreeningservicefor assessment

• Alawenforcementofficershalltakethepatientintocustodyandtransportthepatienttoascreeningfacilityforsuchpurpose§30:4-27.6(c)

• Thepatientshallbereturnedtoafacilityifthe courtdetermines,inconjunctionwiththefindings ofthescreeningservice,thatthepatientneedsto bere-hospitalized

• Thecourtshallholdahearingwithin20daysofthe daythepatientwasreturnedtothefacilitytodetermine iftheorderofconditionaldischargeshouldbevacated

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