House lawmakers are considering significant changes to a Senate-passed bill that aims to streamline the judicial process for involuntary medication of psychiatric patients.
Bill Lippert, D-Hinesburg, chair of the House Judiciary Committee, said the draft language released this week is not a final product.
“This is not a draft of the new bill by the Judiciary Committee, this is some ideas put forward that legislative counsel put in draft form,” he said.
The House Judiciary version of the bill strips out a provision that would allow simultaneous hearings for involuntary treatment and medication.
The Senate-passed bill, S.287, would allow clinicians working with severely mentally ill patients to seek a judge’s order to hold a patient against his or her will and at the same time request that the judge allow that patient to undergo involuntarily prescription treatment.
Under current law it can takes weeks for a judge to rule on what is known as an involuntary treatment application. Once a patient is ordered into treatment, a separate judicial order is required to involuntarily medicate the patient.
The hospital association and the clinicians they represent support the streamlined hearing process as outlined in the Senate bill. They say that the change is crucial for a small cohort of patients who are a threat to themselves or others.
In many cases patients are already being held and treated against their will, but continue to refuse prescribed medications, according to testimony from clinicians and other hospital representatives. Medication can be a key part of a treatment strategy. Advocates say delays in involuntary medication can prolong recovery for certain patients.
The average time between a ruling on involuntary treatment and involuntary medication is two weeks on average, according to the latest figures from the Department of Mental Health.
The time from when a patient is admitted to the psychiatric facility to when a judge rules on the involuntary medication request is closer to 35 days.
That waiting period can hurt a patient’s recovery and ultimately increase the time they must be held in a secure psychiatric facility, proponents of the Senate bill argue.
At a public hearing held earlier in the session, family members of psychiatric patients shared how painful it can be to see their loved ones go unmedicated in a psychotic state, and how, in many instances, they were able to return home once they began taking medication.
However, none of the people who had experienced involuntary medication testified that they felt it was in their best interest. Many say the process caused lasting trauma.
Opponents say consolidating the involuntary medication and treatment hearings would give patients less opportunity to voluntarily accept medication. In addition they fear psychiatrists will routinely file both applications together, resulting in more patients subjected to forced medication.
The House Judiciary Committee’s draft also changes the definition of a patient admission for psychiatric care from when they receive a bed at an inpatient facility to when they begin receiving inpatient services.
Acutely psychotic patients often wind up in hospital emergency rooms, in many cases for significantly longer than allowed by law.
Windham County Sheriff Keith Clark testified in favor of the change.
When patients experiencing psychotic episodes are taken to an emergency department, sheriff’s deputies must accompany them until they receive a psychiatric evaluation and are admitted to a secure facility.
“We’re holding people in these rooms that essentially become jail cells,” he said. “Armed guards, my deputies watching people that are not getting care.”
Clark acknowledged it won’t solve the problem, but formally making admission correspond to when a patient arrives in an emergency room is a good start, he said.
Both the House Judiciary and House Health and Human Service committees have taken testimony on S.287, and the two committees will work together to bring a bill to the House floor, Lippert said.
The House is expected to wrap up all committee work by Friday, and a final House version of the bill could hit the floor next week, in order to leave time for the bill to be reconciled with the Senate version before the session ends.
