mental health law reform office of the vice president for government relations and health policy
TRANSCRIPT
Mental Health Law Reform
Office of the Vice President for Government Relations and Health
Policy
Background
Virginia Tech Panel Supreme Court Commission Legislation and process during the 2008
General Assembly- HB 499 (Hamilton) and SB 246 (Howell)
First steps in ongoing process
Budget - $417 million Investment
2009 ndash 2010 MH InitiativesBiennium
Budget
Increase CSB Capacity forEmergency ServicesCase ManagementOutpatient CliniciansTherapists
$283M
Jail Diversion $6M
Provide Outpatient Services to Children $58M
Expansion Monitoring and Accountability of CSBs $600K
Crisis Intervention Training Program $600K
Expand Licensing Staff $345K
Presentation Overview
Commitment Criteria Emergency Custody Orders Temporary Detention Orders Independent Examiners Hearing Procedural Changes Next Steps
Commitment Criteria
(i) has a mental illness (ii) presents an imminentdanger to himself or others as a result of mental
illness or is so seriously mentally ill as to besubstantially unable to care for himself and that there
exists a substantial likelihood that as a result ofmental illness the person will in the near future (a)cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting orthreatening harm and other relevant information ifany or (b) suffer serious harm due to his lack of
capacity to protect himself from harm or to providefor his basic human needshellip
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Background
Virginia Tech Panel Supreme Court Commission Legislation and process during the 2008
General Assembly- HB 499 (Hamilton) and SB 246 (Howell)
First steps in ongoing process
Budget - $417 million Investment
2009 ndash 2010 MH InitiativesBiennium
Budget
Increase CSB Capacity forEmergency ServicesCase ManagementOutpatient CliniciansTherapists
$283M
Jail Diversion $6M
Provide Outpatient Services to Children $58M
Expansion Monitoring and Accountability of CSBs $600K
Crisis Intervention Training Program $600K
Expand Licensing Staff $345K
Presentation Overview
Commitment Criteria Emergency Custody Orders Temporary Detention Orders Independent Examiners Hearing Procedural Changes Next Steps
Commitment Criteria
(i) has a mental illness (ii) presents an imminentdanger to himself or others as a result of mental
illness or is so seriously mentally ill as to besubstantially unable to care for himself and that there
exists a substantial likelihood that as a result ofmental illness the person will in the near future (a)cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting orthreatening harm and other relevant information ifany or (b) suffer serious harm due to his lack of
capacity to protect himself from harm or to providefor his basic human needshellip
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Budget - $417 million Investment
2009 ndash 2010 MH InitiativesBiennium
Budget
Increase CSB Capacity forEmergency ServicesCase ManagementOutpatient CliniciansTherapists
$283M
Jail Diversion $6M
Provide Outpatient Services to Children $58M
Expansion Monitoring and Accountability of CSBs $600K
Crisis Intervention Training Program $600K
Expand Licensing Staff $345K
Presentation Overview
Commitment Criteria Emergency Custody Orders Temporary Detention Orders Independent Examiners Hearing Procedural Changes Next Steps
Commitment Criteria
(i) has a mental illness (ii) presents an imminentdanger to himself or others as a result of mental
illness or is so seriously mentally ill as to besubstantially unable to care for himself and that there
exists a substantial likelihood that as a result ofmental illness the person will in the near future (a)cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting orthreatening harm and other relevant information ifany or (b) suffer serious harm due to his lack of
capacity to protect himself from harm or to providefor his basic human needshellip
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Presentation Overview
Commitment Criteria Emergency Custody Orders Temporary Detention Orders Independent Examiners Hearing Procedural Changes Next Steps
Commitment Criteria
(i) has a mental illness (ii) presents an imminentdanger to himself or others as a result of mental
illness or is so seriously mentally ill as to besubstantially unable to care for himself and that there
exists a substantial likelihood that as a result ofmental illness the person will in the near future (a)cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting orthreatening harm and other relevant information ifany or (b) suffer serious harm due to his lack of
capacity to protect himself from harm or to providefor his basic human needshellip
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Commitment Criteria
(i) has a mental illness (ii) presents an imminentdanger to himself or others as a result of mental
illness or is so seriously mentally ill as to besubstantially unable to care for himself and that there
exists a substantial likelihood that as a result ofmental illness the person will in the near future (a)cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting orthreatening harm and other relevant information ifany or (b) suffer serious harm due to his lack of
capacity to protect himself from harm or to providefor his basic human needshellip
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
1st prong ndash Dangerousness
ldquoImminentrdquo Removed from Dangerous Criteria
ldquothe person has a mental illness and there is a substantial likelihood that as a result of mental
illness the person will in the near future (1) cause serious physical harm to himself or others as
evidenced by recent behavior causing attempting or threatening harm and other relevant information if
anyrdquo
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
Substantial Likelihood- ldquoSubstantial likelihoodrdquo replaces ldquoimminent
dangerrdquo- But substantial likelihood is limited by ldquonear
futurerdquo- And must be evidenced by a recent act or
behavior or other relevant evidence (ie future is tied to recent past)
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
Near Future- 28 states have a temporal requirement- 22 states have none- Case law interpreting ldquonear futurerdquo based upon
facts of each case- Illinois interprets ldquonear futurerdquo to be equivalent
to ldquowithin a reasonable timerdquo
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
Recent Behavior- Recitation of past acts not sufficient in
absence of prediction of future dangerousness- 34 states require an act or some behavior to
meet commitment criteria- 8 states use Virginiarsquos new standard
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
2nd prong ndash Lack of Capacity
1048708 Substantially Unable to Care for Self changed to
ldquothe person has a mental illness and there is asubstantial likelihood that as a result of mental
illness the person will in the near future (2)suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for hisbasic human needsrdquo
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
New Commitment Criteria
Lack of Capacity- More specificity added- Substantial likelihoodNear future- Will suffer serious harm- Due to lack of capacity to protect himself from harm
- Not limited to physical harm - Can encompass serious financial harm
- Due to lack of capacity to provide for his basic human needs- 1048708 Not limited to food clothing or shelter- 1048708 Includes medically necessary treatment
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Positive changes directly affecting physicians Treating physician may petition for a TDO Treating physician may ask for an extension of an ECO for
an additional 2 hours Recommendations of treating or examining physician or
psychologist is to be used as evidence in commitment process
Any provider disclosing information pursuant to the new provision shall be immune from liability for any harm resulting from the disclosure unless it was intended to harm or if they acted in bad faith
Health care provider or CSB shall not be required to encrypt any email containing medical records or information sent to a magistrate unless there is reason to believe that a third party will attempt to intercept
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Emergency Custody Orders
Evidentiary Considerations Magistrate may consider
- Recommendations of treating or examining physician or psychologist
- Past actions of the person- Past mental health treatment- Any medical records available
-Affidavits if the witness is unavailable- Relevant hearsay
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Emergency Custody Orders
ECO can now be extended for an additional 2 hours
ECO request for renewal can be requested by- Family Member- CSB- Treating physician- Law enforcement officer
Magistrate may also renew ECO one time for up to 2 more hours if the magistrate finds good cause to grant the extension- Good cause includes CSB needing time to identify a
facility or a medical evaluation
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Temporary Detention Orders
Procedural Changes- Electronic Evaluation- CSB notice that the person not subject to TDO
- Must notify petitioner and on-site treating physician- Evidentiary Considerations
- Recommendations of treating physician- Past actions- Past mental health treatment- Medical Records available- Affidavits if the witness is unavailable- Any other relevant information
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Temporary Detention Orders
TDO Duration- Shall be sufficient to allow for
-Completion of independent examination-Completion of pre-admission screening- Initiation of treatment to stabilize personrsquos
psychiatric condition to avoid involuntary commitment where possible
- Shall not exceed 48 hours or until close of business on the next day that is not a weekend or holiday
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Independent Examiners
Qualifications of examiner- Psychiatrist or Psychologist
licensed in Virginia and qualified to diagnose mental illness
- If not available- Licensed Clinical Social Worker- Licensed Professional
Counselor- Psychiatric Nurse Practitioner- Clinical Nurse Specialist
Will need to be qualified in
assessing mental illness and complete
a certification program by DMHMRSAS
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Independent Examiners
Requirements- Comprehensive evaluation conducted in
person- If not practicable by two way electronic video- Translator if needed
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Independent Examiners Clinical assessment includes
- Mental status exam- Determination of current use of psychotropic meds- Medical and psychiatric history- Substance use or abuse- Determination of whether person meets 2nd prong of
commitment criteria (lack of capacity)- Determination of personrsquos capacity to consent to treatment- Review of temporary detention facilityrsquos records including
- Treating physician eval- Lab or toxicology results- Any collateral information- All admission forms and nursesrsquo notes
- Recommendation for the placement care and treatment
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Hearing Procedural Changes
Attendance- CSB- Independent Examiner and treating physician
Evidentiary considerations- Recommendations of any treating physician or
psychologist licensed in Va- IErsquos certification- Past actions of the person- Past mental health treatment- Any health records available- Preadmission screening report- Any other relevant evidence admitted
may be reached telephonically
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Hearing Procedural Changes
Removal of IE positive certification requirement- Judge or special justice must still consider the
IErsquos certification but law no long requires positive certification
Duration of inpatient treatment- Shall not exceed 30 days- Subsequent orders not to exceed 180 days
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Other Changes
New Definitions (sect 372 -800)- Responsible person includes a family member CSB
any treating physician or law enforcement officer- The term ldquocommunity services boardrdquo includes
ldquobehavioral health authorityrdquo HB 707 Execution of a TDO
- Person shall remain in law enforcement custody until detained in secure facility or accepted by appropriate person at TDO facility
HB 1323 Specifies that a treating physician may petition to obtain a TDO
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Next Steps
Supreme Court Commission
Workgroup with MSV VHHA AGrsquos Office CSBs etc
Carry over bills
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Further Information
We are looking for feedback as these new laws are implemented To submit comments or suggestions please visit our website
httpwwwgovrelvcuedu
Also please visit our website to get copies of the materials and the presentation
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Our Website
Mental Health Law Reform Website
Mental Health Law Reform
Mental Health Law Reform Website
Mental Health Law Reform
Mental Health Law Reform