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Title
34-B: BEHAVIORAL AND DEVELOPMENTAL SERVICES
Chapter 1: GENERAL PROVISIONS
Subchapter
1: DEFINITIONS
§1001. Definitions
As used in this Title, unless the context otherwise indicates, the
following terms have the following meanings.
1. Chief administrative officer. "Chief
administrative officer" means the head of a state institution or the head
of any other institution which provides services which fall under the
jurisdiction of the department.
2. Client. "Client" means a person receiving
services from the department, from any state institution or from any agency
licensed or funded to provide services falling under the jurisdiction of the
department.
3. Commissioner. "Commissioner" means the Commissioner
of Behavioral and Developmental Services or the commissioner's designee, except
that when the term "commissioner and only the commissioner" is used, the term applies only to the person appointed
Commissioner of Behavioral and Developmental Services and not to any
designee.
4. Department. "Department" means the Department of
Behavioral and Developmental Services.
5. Parking area. "Parking area" means land maintained by
the State at the state institutions under the jurisdiction of the department,
which may be designated as parking areas by the heads of the state
institutions.
6. Public way. "Public way" means a road or driveway
on land maintained by the State at the state institutions under the
jurisdiction of the department.
7. Resident. "Resident" means a person residing in
a state institution or in any other institution which provides services which
fall under the jurisdiction of the department.
8. State institution. "State institution" means:
A. The
B. The
D. The
E. The
9. Written political material. "Written political
material" means flyers, handbills or other nonperiodical
publications which are subject to the restrictions of Title 21-A, chapter
13.
Chapter 3: MENTAL
HEALTH
Subchapter
1: MENTAL HEALTH SERVICES
§3001. General
The Department of Behavioral and Developmental Services is
responsible for the direction of the mental health programs in the state
institutions and for the promotion and guidance of mental health programs
within the communities of the State.
§3002. Director (REPEALED)
§3003. Rules
1. Promulgation. The commissioner shall adopt rules, subject to
the Maine Administrative Procedure Act, Title 5, chapter 375, for the
enhancement and protection of the rights of clients receiving services from the
department, from any hospital pursuant to subchapter IV or from any program or
facility administered or licensed by the department under section 1203-A.
2. Requirements. The rules shall include, but are not limited
to:
A. Establishment of the right to
provision of treatment and related services in the least restrictive
appropriate setting;
B. Establishment of the right to an individualized treatment or
service plan, to be developed with the participation of the client;
C. Standards for informed consent to treatment, including
reasonable standards and procedural mechanisms for determining when to treat a
client absent his informed consent, consistent with applicable law;
D. Standards for participation in
experimentation and research;
E. Standards pertaining to the use of
seclusion and restraint;
F. Establishment of the right to
appropriate privacy and to a humane treatment environment;
G. Establishment of the right to confidentiality of records and
procedures pertaining to a person's right to access to his mental health care
records;
H. Establishment of the right to receive
visitors and to communicate by telephone and mail;
I. Procedures to ensure that clients are
notified of their rights;
J. The right to assistance in protecting
a right or advocacy service in the exercise or protection of a right;
K. Provisions for a fair, timely and impartial grievance procedure
for the purpose of ensuring appropriate administrative resolution of grievances
with respect to infringement of rights; and
L. To the extent that state and community resources are available,
establishment of the rights of long-term mentally ill clients containing the
following requirements:
(1) The right to a service system which
employs culturally normative and valued methods and settings;
(2) The right to coordination of the
disparate components of the community service system;
(3) The right to individualized developmental programming which
recognizes that each long-term mentally ill individual is capable of growth or
slowing of deterioration;
(4) The right to a continuum of community services allowing a
gradual transition from a more intense level of service; and
(5) The right to the maintenance of natural support systems, such as
family and friends of the long-term mentally ill individual and formal and
informal networks of mutual and self-help.
3. Public hearing. The commissioner shall hold a public hearing
before adopting these rules and shall give notice of the public hearing
pursuant to the Maine Administrative Procedure Act, Title 5, section
8053.
4. Legislative review. When a rule is proposed or adopted under
this section, a copy of the proposed or adopted rule shall be sent to the
legislative committee having jurisdiction over health and institutional
services.
A. The committee may review the rule and, if it determines that an
adopted rule should be stricken or amended, the committee may prepare
legislation to accomplish that purpose and submit the legislation to the full
Legislature in accordance with legislative rules.
B. The adopted rule shall remain in effect unless the full
Legislature acts to strike or amend it, or it is
repealed or amended by the director in accordance with the Maine Administrative
Procedure Act, Title 5, chapter 375.
§3004. Community Support Systems
1. Definition. As used in this section, unless the context
otherwise indicates, the term "community support system" means the
entire complex of mental health, rehabilitative, residential and other support
services in the community to ensure community integration and the maintenance
of a decent quality of life for persons with chronic mental illness.
2. General policy. The department shall develop programs to:
A. Promote and support the development and implementation of
comprehensive community support systems to ensure community integration and the
maintenance of a decent quality of life for persons with chronic mental illness
in each of the mental health service areas in the State; and
B. Strengthen the capacity of families, natural networks,
self-help groups and other community resources in order to improve the support
for persons with chronic mental illness.
3. Duties. The
department shall:
A. Provide technical assistance for program development, promote
effective coordination with health and other human services and develop new
resources in order to improve the availability and accessibility of
comprehensive community support services to persons with chronic mental
illness;
B. Assess service needs, monitor service delivery related to these
needs and evaluate the outcome of programs designed to meet these needs in
order to enhance the quality and effectiveness of community support
services;
C. Prepare a report that describes the system of community support
services in each of the mental health service regions and statewide.
(1) The report must include both existing
service resources and deficiencies in the system of services.
(2) The report must include an assessment of the roles and
responsibilities of mental health agencies, human services agencies, health
agencies and involved state departments and must suggest ways in which these
agencies and departments can better cooperate to improve the service system for
people with chronic mental illness.
(3) The report must be prepared biennially and must be submitted
to the joint standing committee of the Legislature having jurisdiction over
human resources by December 15th of every even-numbered year.
(4) The committee shall review the report and make recommendations
with respect to administrative and funding improvements in the system of
community support services to persons with chronic mental illness; and
D. Participate in the coordination of services
for persons with chronic mental illnesses with local transitional services
coordination projects for handicapped youth, as established in Title 20-A,
chapter 308, assigning appropriate regional staff and resources as available
and necessary in each region to be served by a project.
§3005. Services to persons who are deaf or hearing-impaired
(REPEALED)
§3006. State Mental Health Plan (REPEALED)
§3006-A. State mental health plan (REPEALED)
§3007. Teenage Suicide Prevention Program
The department shall, in cooperation with the Department of
Education, the Department of Human Services and the "local action
councils" funded in Public Law 1987, chapter 349, Part A under the heading
"Human Services, Department of," develop a teenage suicide prevention
strategy and a model suicide prevention program to be presented in the
secondary schools of the State. Development of such a program must include
preparation of relevant educational materials that must be distributed in the
schools.
§3008. Sexual activity with recipient of services prohibited
A person who owns, operates or is an employee of an organization,
program or residence that is operated, administered, licensed or funded by the
Department of Behavioral and Developmental Services or the Department of Human Services
may not engage in a sexual act, as defined in Title 17-A, section 251,
subsection 1, paragraph C, with another person or subject another person to
sexual contact, as defined in Title 17-A, section 251, subsection 1, paragraph
D, if the other person, not the actor's spouse, is a person with mental illness
who receives therapeutic, residential or habilitative
services from the organization, program or residence. [
§3010. Access to mental health services (REALLOCATED FROM
TITLE 34-B, SECTION 3009)
Any money that is identified as net General Fund savings through
legislative actions or through departmental administrative actions due to the
closure of or diminution of services at a state mental health institution or to
lowered administrative costs within the department must be used to provide
mental health services to persons in need of those services in other
appropriate settings and programs, including, but not limited to,
community-based mental health programs. For the purposes of this section, "net
General Fund savings" means total savings in the General Fund projected to
be available due to a series of specific actions less any cost or liability
resulting from implementing those actions.
Subchapter 2: STATE
MENTAL HEALTH INSTITUTES
§3201. Maintenance
The commissioner shall maintain 2 state mental health institutes
for the mentally ill, one at
§3202. Superintendent
1. Chief administrative officer. The chief
administrative officer of each state mental health institute is called the
superintendent.
2. Qualifications. To be eligible to be appointed superintendent,
a person shall be a qualified psychiatrist, qualified hospital administrator,
qualified psychologist or a person with a master's degree in social work,
public administration or public health.
3. Appointment. The commissioner shall appoint the
superintendent of each state mental health institute. The Governor shall
establish the salary of each superintendent.
A. The commissioner shall give due consideration to the
appointee's qualifications and experience in administration and to the
appointee's qualifications and experience in health matters.
4. Duties. The superintendents of the state mental health
institutes have the following duties.
A. The Superintendent of the Bangor Mental Health Institute has
general superintendence of the Bangor Mental Health Institute and its grounds
under the direction of the commissioner and shall receive all persons legally
sent to the Bangor Mental Health Institute who are in need of special care and
treatment, if accommodations permit.
B. The Superintendent of the Augusta Mental Health Institute has
general superintendence of the Augusta Mental Health Institute and its grounds
under the direction of the commissioner and shall receive all persons legally
sent to the Augusta Mental Health Institute who are in need of special care and
treatment, if accommodations permit.
Subchapter
3: COMMUNITY MENTAL HEALTH SERVICES
Article 1: GENERAL
PROVISIONS
§3601. Definitions
As used in this subchapter, unless the context otherwise
indicates, the following terms have the following meanings.
1. Agency. "Agency" means a person, firm,
association or corporation, but does not include the individual or corporate
professional practice of one or more psychologists or psychiatrists.
1-A. Case management services. "Case management
services" means those services which assist an individual in gaining
access to and making effective use of the range of medical, psychological and
other related services available to them.
1-B. Long-term mentally ill. "Long-term
mentally ill" means persons who suffer certain mental or emotional
disorders, such as organic brain syndrome, schizophrenia, recurrent depressive
and manic-depressive disorders, paranoid and other psychoses, plus other
disorders which may become chronic, that erode or prevent the capacities in
relation to 3 or more of the primary aspects of daily life, such as personal
hygiene and self-care, self-direction, interpersonal relationships, social
transactions, learning, recreation and economic self-sufficiency. While these
persons may be at risk of institutionalization, there is no requirement that
these persons are or have been residents of institutions providing mental
health services.
2. Mental health services. "Mental health services"
means out-patient counseling, other psychological, psychiatric, diagnostic or
therapeutic services and other allied services.
§3602. Purpose
The purpose of this subchapter is to expand community mental
health services, encourage participation in a program of community mental
health services by persons in local communities, obtain better understanding of
the need for those services and secure aid for programs of community mental
health services by state aid and local financial support.
§3603. Commissioner's duties
The commissioner shall promulgate rules, according to the Maine
Administrative Procedure Act, Title 5, chapter 375,
relating to the administration of the services authorized by this subchapter
and to licensing under this subchapter.
§3604. Commissioner's powers
1. Provision of services. The commissioner may provide mental
health services throughout the State and for that purpose may cooperate with
other state agencies, municipalities, persons, unincorporated associations and nonstock corporations.
2. Funding sources. The commissioner may receive and use for the
purpose of this subchapter money appropriated by the State, grants by the
Federal Government, gifts from individuals and gifts from any other
sources.
3. Grants. The commissioner may make grants of funds to
any state or local governmental unit, or branch of a governmental unit, or to a
person, unincorporated association or nonstock
corporation, which applies for the funds, to be used in the conduct of its
mental health services.
A. The programs administered by the person or entity shall provide
for adequate standards of professional services in accordance with state
statutes.
B. The commissioner may require the person or entity applying for
funds to produce evidence that appropriate local, governmental and other
funding sources have been sought to assist in the financing of its mental
health services.
C. After negotiation with the person or entity applying for funds,
the commissioner may execute a contract or agreement for the provision of
mental health services which reflects the commitment by the person or entity of
local, governmental and other funds to assist in the financing of its mental
health services.
D. Beyond the commissioner's assuring through program monitoring
and auditing activities that an equitable distribution of the funds committed
by contract or agreement to assist in the financing of mental health services
are actually provided, it shall be the prerogative of the person or entity
providing services to apportion other nonstate funds
in an appropriate manner in accordance with its priorities, service contracts
and applicable provisions of law.
E. Any new contract must be awarded through a request-for-proposal
procedure and any contract of $500,000 per year or more that is renewed must be
awarded through a request-for-proposal procedure at least every 8 years, except
for the following.
(1) A renewal contract with a provider is not subject to the
request-for-proposal procedure requirement if the contract granted under this
subsection is performance based.
(2) Notwithstanding subparagraph (1), the department shall subject
a contract to a request-for-proposal procedure when necessary to comply with
paragraph G.
F. The commissioner shall establish a procedure to obtain
assistance and advice from consumers of mental health services regarding the
selection of contractors when requests for proposals are issued.
G. A contract under this subsection that is subject to renewal
must be awarded through a request-for-proposal procedure if the department
determines that:
(1) The provider has breached the
existing contract;
(2) The provider has failed to correct
deficiencies cited by the department;
(3) The provider is inefficient or ineffective in the delivery of
services and is unable or unwilling to improve its performance within a reasonable
time; or
(4) The provider can not or will not respond to a reconfiguration
of service delivery requested by the department.
4. Cooperative planning required; grant recipients and
correctional authorities. As a condition for receipt of state mental health funding,
providers of community mental health services to persons with serious mental
illness shall develop with state and local correctional authorities
cooperative plans for the provision of services to those persons. These plans
must include at least the following:
A. Procedures for timely referral of
persons with serious mental illness to community-based mental health
services;
B. Provision for the treatment and support of persons with serious
mental illness in correctional facilities and commitment of funds within
available resources; and
C. Procedures for referrals of individuals with serious mental
illness to local providers of comprehensive mental health services following
release from correctional facilities, including mechanisms for developing
comprehensive treatment plans before the release from correctional facilities
of persons with serious mental illness.
Providers of community mental health services and other public
providers of comprehensive services to persons with serious mental illness that
fail to participate in the development of plans to serve this population are
not eligible for state funding for the provision of mental health services.
5. Exclusion. Beginning October 1, 1996, an entity that
applies for the award or renewal of a grant or contract for the provision of
mental health services must be a participating member of the quality
improvement council or the local service network, as defined in section 3607,
for the region of the State subject to that grant or contract or an interested
party assisting a council pursuant to section 3607, subsection 8.
§3605. Governmental agencies (REPEALED)
§3606. Licenses (REPEALED)
§3607. Quality improvement councils
The department
shall establish 7 quality improvement councils, called area councils, to
evaluate the delivery of mental health services to children and adults under
the authority of the department or who have a major mental illness, and to
advise the department regarding quality assurance, systems development and the
delivery of mental health services to children and adults under the authority
of the department. The department shall also establish 2 institute councils to
evaluate the delivery of mental health services at the 2 state mental health
institutes and advise the department regarding quality assurance, operations
and functions of the mental health institutes.
1. Definitions. As used in this section and sections 3608 and 3609,
unless the context otherwise indicates, the following terms have the following
meanings.
A. "Community members" means
persons who represent the composition of the community at large.
B. "Consumer" means a recipient or former recipient of
publicly funded mental health services or an adult who has or had a major
mental illness.
C. "Council" means a quality improvement council
approved by the commissioner pursuant to subsection 2, paragraph D.
D. "Family member" means a
relative, guardian or household member of an adult consumer.
D-1. "Major mental illness" means a diagnosis of mental
illness as defined by the department. Rules adopted pursuant to this paragraph
are routine technical rules as defined by Title 5, chapter 375, subchapter
II-A.
E. "Network" means a local
service network established pursuant to section 3608.
F. "Parent" means a parent or a person who has acted in
that capacity or assumed that role for a consumer under
18 years of age.
G. "Regional director" means a regional director
appointed pursuant to section 1204, subsection 2, paragraph C, subparagraph (10).
H. "Service provider" or "provider" means a
person or organization providing publicly funded mental health services to
consumers or family members.
2. Councils established. There is established an approved quality
improvement council in each area designated in subsection 3, referred to in
this section as "area council," and for the Augusta Mental Health
Institute and the Bangor Mental Health Institute, referred to in this section
as "institute council." The councils operate under the authority of
the department. Each council consists of the initial members chosen pursuant to
paragraph B, the members subsequently chosen pursuant to council bylaws, the
members of the network established pursuant to section 3608 and any advisory
committees established pursuant to subsection 8.
A. The councils shall assist the department and providers with
systems planning and needs assessment at the local level and community
education and quality improvement activities that must be implemented at the
local level. Through the program evaluation teams the councils shall perform
program assessment.
B. Each area council consists of 24 members whose membership takes
into consideration local geographic factors. The membership on each council
consists of 4 adult consumers, 4 family members, 4 parents, 6 community members
and 6 service providers. Any resident of a council area may make
recommendations regarding initial membership on the local area council to the
commissioner, who shall make the appointments by
C. Each institute council consists of 16 members whose membership
takes into consideration local geographic factors. The membership on each
council consists of 4 consumers, 4 family members, 4 community members and 4
providers. Any resident or former resident of the Augusta Mental Health
Institute or the Bangor Mental Health Institute, any family member of a
resident or former resident, any community member in the Augusta or Bangor
region and any service provider at those institutes may make recommendations
regarding membership on the institute councils to the commissioner, who shall
make the initial appointments by June 1, 1996. The commissioner or a designee
of the commissioner shall convene the first meeting of each council by
D. The councils shall adopt bylaws that establish the terms and qualifications
of membership, the selection of members succeeding the initial members and the
internal governance and rules. The commissioner shall approve the bylaws of
each council prior to designating it as an approved council.
E. Under the supervision of each council, a program evaluation
team of nonprovider members shall review each program
funded by the department on a periodic basis. The results of the review must be
reported to the council and the regional director for the department and must
be considered in funding decisions by the department.
3. Areas. An area council shall operate in each of the
following geographic areas:
A.
B.
C.
D.
E.
F.
G.
4. Accountability. Each area council is accountable to the
regional director. The institute councils are accountable to the director of
facility management within the department.
5. Duties. By
A. Case management, including advocacy activities and techniques
for identifying and providing services to consumers at risk. Case management
services must be independent of providers whenever possible;
B. Medication management, outpatient
therapy, substance abuse treatment and other outpatient services;
C. In-home flexible supports, home-based crisis assistance, mobile
outreach, respite and inpatient capacity and other crisis prevention and
resolution services
D. Housing, in-home support services, tenant training and support
services, home ownership options and supported housing; and
E. Rehabilitation and vocational services, including transitional
employment, supported education and job finding and coaching.
6. Regional directors; responsibilities. Each regional director
is responsible for the operation of the area councils within the region and for
dispute resolution within those area councils. Each regional director shall receive
reports from the councils, consider the recommendations of the councils and
report periodically to the commissioner on their performance.
7. Institute council directors; responsibilities. The director of
facility management within the department is responsible for the operation of
the councils of the Augusta Mental Health Institute and the Bangor Mental
Health Institute and for dispute resolution within those institute councils.
The director shall receive reports from the councils, consider the recommendations
of the councils and report periodically to the commissioner on their
performance.
8. Public outreach. Each council shall solicit the participation of
interested consumers, families, parents, community members and service
providers to serve on the council, the network or advisory committees.
9. Participation. State-operated direct service programs shall
participate in the activities of the councils.
10. Institute councils. Within the limitations of state and
federal law, adequate information must be provided by the mental health
institutes and the department to the institute councils to perform their
duties, including but not limited to:
A. Input into the annual budgets of the
mental health institutes;
B. Achievement of the goals and
objectives of the department as they pertain to the mental health
institutes;
C. Compliance with all professional
accreditation standards applicable to the mental health institutes;
D. Review, oversight and assessment of services and programs
provided to residents of the mental health institutes and their families;
E. Review of personnel policies and employment patterns, including
staffing requirements and patterns, the use of overtime assignments and
training and job development;
F. Input into public relations efforts of the department and the
mental health institutes and community education initiatives; and
G. Monitoring building and grounds maintenance and safety and risk
management on the campuses of the mental health institutes.
§3608. Local service networks
The department shall establish and oversee networks to participate
with the area councils, as defined in section 3607, subsection 2, in the
delivery of mental health services to children and adults under the authority of
the department. A network consists of organizations providing mental health
services funded by the General Fund and Medicaid in the corresponding area
specified in section 3607, subsection 3. The local service networks must be
established and operated in accordance with standards that are consistent with
standards adopted by accredited health care organizations and other standards
adopted by the department to establish and operate networks. Oversight must
include, but is not limited to, establishing and overseeing protocols, quality
assurance, writing and monitoring contracts for service, establishing outcome
measures and ensuring that each network provides an integrated system of care.
The department may adopt rules to carry out this section. Rules adopted
pursuant to this section are major substantive rules as defined in Title 5,
chapter 375, subchapter II-A. This section may not be construed to supersede
the authority of the Department of Human Services as the single state Medicaid
agency under the Social Security Act, Title XII or to affect the professional
standards and practices of nonnetwork
providers.
1. Responsibilities. Each network shall perform the following
responsibilities:
A. Deliver and coordinate 24-hour crisis response services accessible
through a single point of entry to adults with mental illness and to children
and adolescents with severe emotional disturbance and their families;
B. Ensure continuity, accountability and
coordination regarding service delivery;
C. Participate in a uniform client data
base;
D. In conjunction with the regional
director and the area council, conduct planning activities; and
E. Develop techniques for identifying and
providing services to consumers at risk.
2. Accountability. Each network is accountable to the area council
and the regional director.
3. Public outreach. Each network shall solicit the participation of
interested providers to serve on the area council, the network or advisory
committees.
4. Participation. State-operated direct service programs shall
participate in the activities of the networks.
5. Data collection. The department shall collect data to assess the
capacity of the local service networks, including, but not limited to, analyses
of utilization of mental health services and the unmet needs of persons
receiving publicly funded mental health services.
§3609. Statewide quality improvement council
Each council shall designate a member and an alternate to serve on
a statewide quality improvement council to advise the commissioner on issues of
system implementation that have statewide impact. The commissioner shall
appoint other members to serve on the council.
§3610. Safety net services
The department is responsible for providing a safety net of adult
mental health services for people with major mental illness who the department
or its designee determines can not otherwise be served by the local service
networks. The department may develop contracts to deliver safety net services
if the department determines contracts to be appropriate and cost-effective.
The state-operated safety net must include, but is not limited to:
1. Beds. Backup emergency hospital beds for people requiring medical
stabilization, assessment or treatment;
2. Treatment. Intermediate and long-term treatment for people
who need long-term structured care;
3. Forensic services. Forensic services;
4. Intensive case management. Intensive case
management; and
5. Other services. Other services determined by the commissioner
to be needed.
Article 2: CRISIS
INTERVENTION PROGRAM
§3621. Crisis Intervention Program established
The department shall establish the Crisis Intervention Program to
serve Penobscot, Hancock, Piscataquis
and
1. Emergency room services. Crisis intervention and
psychiatric emergency services based in a hospital emergency room;
2. Outreach services. Outreach services and crisis intervention
beyond the hospital setting; and
3. Telephone hot-line services. A community-based
telephone crisis intervention hot-line offering 24-hour, 7-days-a-week
counseling, consultation, evaluation, treatment and referral services.
§3622. Crisis intervention team
1. Established. A community-based crisis intervention team
shall be established to provide crisis intervention on a 24-hour, 7-days-a-week
basis to mentally ill people and to provide crisis intervention training for
emergency room personnel.
2. Qualifications. The team shall be comprised of qualified mental
health professionals with training and experience in assessment and
intervention with mentally ill people in a crisis. In addition, the team
members shall have a working knowledge of case management, the mental health
system and area resources.
§3623. Region II Crisis Intervention Program Advisory Board
(REPEALED)
§3624. Region III Crisis Intervention Program Advisory Board
(REPEALED)
Subchapter
4: HOSPITALIZATION
Article 1: GENERAL
PROVISIONS
§3801. Definitions
As used in this subchapter, unless the context otherwise
indicates, the following terms have the following meanings.
1. Hospital. "Hospital" means:
A. A state mental health institute;
or
B. A nonstate
mental health institution.
1-A. Designated nonstate mental
health institution. "Designated nonstate mental health
institution" means a nonstate mental health
institution that is under contract with the department for receipt by the
hospital of involuntary patients.
1-B. Least restrictive form of transportation. "Least restrictive
form of transportation" means the vehicle used for transportation and any
restraining devices that may be used during transportation that impose the
least amount of restriction, taking into consideration the stigmatizing impact
upon the individual being transported.
2. Licensed physician. "Licensed physician" means a
person licensed under the laws of the State to practice medicine or osteopathy
or a medical officer of the Federal Government while in this State in the
performance of his official duties.
3. Licensed clinical psychologist. "Licensed clinical
psychologist" means a person licensed under the laws of the State as a
psychologist and who practices clinical psychology.
4. Likelihood of serious harm. "Likelihood of
serious harm" means:
A. A substantial risk of physical harm to the person himself as
manifested by evidence of recent threats of, or attempts at, suicide or serious
bodily harm to himself and, after consideration of less restrictive treatment
settings and modalities, a determination that community resources for his care
and treatment are unavailable;
B. A substantial risk of physical harm to other persons as
manifested by recent evidence of homicidal or other violent behavior or recent
evidence that others are placed in reasonable fear of violent behavior and
serious physical harm to them and, after consideration of less restrictive
treatment settings and modalities, a determination that community resources for
his care and treatment are unavailable; or
C. A reasonable certainty that severe physical or mental impairment
or injury will result to the person alleged to be mentally ill as manifested by
recent evidence of his actions or behavior which demonstrate his inability to
avoid or protect himself from such impairment or injury, and, after
consideration of less restrictive treatment settings and modalities, a
determination that suitable community resources for his care are
unavailable.
5. Mentally ill person. "Mentally ill person" means a
person having a psychiatric or other disease which substantially impairs his
mental health, including persons suffering from the effects of the use of
drugs, narcotics, hallucinogens or intoxicants, including alcohol, but not
including mentally retarded or sociopathic persons.
6. Nonstate mental health
institution. "Nonstate mental health
institution" means a public institution, a private institution or a mental
health center, which is administered by an entity other than the State and
which is equipped to provide inpatient care and treatment for the mentally ill.
7. Patient. "Patient" means a person under
observation, care or treatment in a hospital or residential care facility
pursuant to this subchapter.
8. Residential care facility. "Residential care
facility" means a licensed or approved boarding care, nursing care or
foster care facility which supplies supportive residential care to individuals
due to their mental illness.
9. State mental health institute. "State mental
health institute" means the Augusta Mental Health Institute or the Bangor
Mental Health Institute.
§3802. Commissioner's powers
The commissioner may:
1. Rules. Promulgate such rules, not inconsistent with
this subchapter, as he may find to be reasonably necessary for proper and
efficient hospitalization of the mentally ill;
2. Investigation. Investigate, by personal visit, complaints made
by any patient or by any person on behalf of a patient;
3. Visitation. Visit each hospital or residential care
facility regularly to review the commitment procedures of all new patients
admitted between visits;
4. Reports. Require reports from the chief administrative
officer of any hospital or residential care facility relating to the admission,
examination, diagnosis, release or discharge of any patient; and
5. Forms. Prescribe the form of applications, records,
reports and medical certificates provided for under this subchapter and
prescribe the information required to be contained in them.
§3803. Patient's rights
A patient in a hospital or residential care facility under this
subchapter has the following rights.
1. Civil rights. Every patient is entitled to exercise all civil
rights, including, but not limited to, the right to civil service status, the
right to vote, rights relating to the granting, renewal, forfeiture or denial of
a license, permit, privilege or benefit pursuant to any law, the right to enter
into contractual relationships and the right to manage his property, unless:
A. The chief administrative officer of the hospital or residential
care facility determines that it is necessary for the medical welfare of the
patient to impose restrictions on the exercise of these rights and, if
restrictions are imposed, the restrictions and the reasons for them shall be
made a part of the clinical record of the patient;
B. A patient has been adjudicated
incompetent and has not been restored to legal capacity; or
C. The exercise of these rights is specifically restricted by
other statute or rule, but not solely because of the fact of admission to a hospital
or residential care facility.
2. Humane care and treatment. Every patient is
entitled to humane care and treatment and, to the extent that facilities,
equipment and personnel are available, to medical care and treatment in
accordance with the highest standards accepted in medical practice.
3. Restraints and seclusion. Restraint, including
any mechanical means of restricting movement, and seclusion, including
isolation by means of doors which cannot be opened by the patient, may not be
used on a patient, unless the chief administrative officer of the hospital or
residential care facility or his designee determines that either is required by
the medical needs of the patient.
A. The chief administrative officer of the hospital or facility
shall record and make available for inspection every use of mechanical
restraint or seclusion and the reasons for its use.
B. The limitation of the use of seclusion
in this section does not apply to maximum security installations.
4. Communication. Patient communication rights are as follows.
A. Every patient is entitled to communicate by sealed envelopes
with the department, a member of the clergy of his choice, his attorney and the
court which ordered his hospitalization, if any.
B. Every patient is entitled to
communicate by mail in accordance with the rules of the hospital.
5. Visitors. Every patient is entitled to receive visitors
unless definitely contraindicated by his medical condition, except that he may
be visited by a member of the clergy of his choice or his attorney at any
reasonable time.
6. Sterilization. A patient may not be sterilized except in
accordance with chapter 7.
§3804. Habeas corpus
Any person detained pursuant to this subchapter is entitled to the
writ of habeas corpus, upon proper petition by himself or by a friend to any
justice generally empowered to issue the writ of habeas corpus in the county in
which the person is detained.
§3805. Prohibited acts; penalty
1. Unwarranted hospitalization. A person is guilty of causing
unwarranted hospitalization, if he willfully causes the unwarranted
hospitalization of any person under this subchapter.
2. Denial of rights. A person is guilty of causing a denial of
rights if he willfully causes the denial to any person of any of the rights
accorded to him by this subchapter.
3. Penalty. Causing unwarranted hopitalization
or causing a denial of rights is a Class C crime.
Article
2: VOLUNTARY HOSPITALIZATION
§3831. Admission
A hospital for the mentally ill may admit on an informal voluntary
basis for care and treatment of a mental illness any person desiring admission
or the adult ward of a legally appointed guardian, subject to the following
conditions.
1. Availability of accommodations. Except in cases of
medical emergency, voluntary admission is subject to the availability of
suitable accommodations.
2. Standard hospital information. Standard hospital
information may be elicited from the person if, after examination, the chief
administrative officer of the hospital deems the person suitable for admission,
care and treatment.
3. Persons under 18 years of age. Any person under 18
years of age must have the consent of his parent or guardian.
4. State mental health institute. Any person under 18 years
of age must have the consent of the commissioner for admission to a state
mental health institute.
5. Adults under guardianship. An adult ward may be
admitted on an informal voluntary basis only if his legally appointed guardian
consents to the admission and the ward makes no objection to the
admission.
6. Adults with advance health care directives. An adult with an
advance health care directive authorizing mental health hospital treatment may
be admitted on an informal voluntary basis if the conditions specified in the
advance health care directive for the directive to be effective are met in
accordance with the method stated in the advance health care directive or, if
no such method is stated, as determined by a physician or a psychologist. If no
conditions are specified in the advance health care directive as to how the
directive becomes effective, the person may be admitted on an informal
voluntary basis if the person has been determined to be incapacitated pursuant
to Title 18-A, Article 5, Part 8. A person may be admitted only if the person
does not at the time object to the admission or, if the person does object, if
the person has directed in the advance health care directive that admission to
the hospital may occur despite that person's objections. The duration of the
stay in the hospital of a person under this subsection may not exceed 5 working
days. If at the end of that time the chief administrative officer of the
hospital recommends further hospitalization of the person, the chief administrative
officer shall proceed in accordance with section 3863, subsection 5.
This subsection does not create an affirmative obligation of a
hospital to admit a person consistent with the person's advance health care
directive. This subsection does not create an affirmative obligation on the
part of the hospital or treatment provider to provide the treatment consented
to in the person's advance health care directive if the physician or
psychologist evaluating or treating the person or the chief administrative
officer of the hospital determines that the treatment is not in the best
interest of the person.