The Vermont Statutes Online

Title 18: Health

Chapter 181: Judicial Proceedings

• §§ 7601-7608. Repealed. 1977, No. 252 (Adj. Sess.), § 36.

• §§ 7609, 7610. [Reserved for future use.]

• § 7611. Involuntary treatment

  No person may be made subject to involuntary treatment unless he or she is found to be a person in need of treatment or a patient in need of further treatment. (Added 1977, No. 252 (Adj. Sess.), § 18.)

• § 7612. Application for involuntary treatment

  (a) An interested party may, by filing a written application, commence proceedings for the involuntary treatment of an individual by judicial process.

  (b) The application shall be filed in the Family Division of the Superior Court.

  (c) If the application is filed under section 7508 or 7620 of this title, it shall be filed in the unit of the Family Division of the Superior Court in which the hospital is located. In all other cases, it shall be filed in the unit in which the proposed patient resides. In the case of a nonresident, it may be filed in any unit. The court may change the venue of the proceeding to the unit in which the proposed patient is located at the time of the trial.

  (d) The application shall contain:

  (1) The name and address of the applicant.

  (2) A statement of the current and relevant facts upon which the allegation of mental illness and need for treatment is based. The application shall be signed by the applicant under penalty of perjury.

  (e) The application shall be accompanied by:

  (1) a certificate of a licensed physician, which shall be executed under penalty of perjury stating that the physician has examined the proposed patient within five days after the date the petition is filed and is of the opinion that the proposed patient is a person in need of treatment, including the current and relevant facts and circumstances upon which the physician’s opinion is based; or

  (2) a written statement by the applicant that the proposed patient refused to submit to an examination by a licensed physician.

  (f) Before an examining physician completes the certificate of examination, the examining physician shall consider available alternative forms of care and treatment that might be adequate to provide for the person’s needs without requiring hospitalization. The examining physician shall document on the certificate the specific alternative forms of care and treatment that the examining physician considered and why those alternatives were deemed inappropriate, including information on the availability of any appropriate alternatives.

  (g) If the Commissioner seeks to have the patient receive treatment in a secure residential recovery facility or a psychiatric residential treatment facility for youth, the application for an order authorizing treatment shall expressly state that such treatment is being sought. The application shall contain, in addition to the statements required by subsections (d) and (e) of this section, a statement setting forth the reasons for the Commissioner’s determination that clinically appropriate treatment for the patient’s condition can be provided safely only in a secure residential recovery facility or a psychiatric residential treatment facility for youth, respectively. (Added 1977, No. 252 (Adj. Sess.), § 19; amended 2009, No. 154 (Adj. Sess.), § 238; 2013, No. 192 (Adj. Sess.), § 9; 2023, No. 6, § 202, eff. July 1, 2023; 2023, No. 137 (Adj. Sess.), § 10, eff. July 1, 2024.)

• § 7612a. Probable cause review

  (a) Within three days after an application for involuntary treatment is filed, the Family Division of the Superior Court shall conduct a review to determine whether there is probable cause to believe that the person was a person in need of treatment at the time of his or her admission. The review shall be based solely on the application for an emergency examination and accompanying certificate by a licensed physician and the application for involuntary treatment.

  (b) If, based on a review conducted pursuant to subsection (a) of this section, the court finds probable cause to believe that the person was a person in need of treatment at the time of his or her admission, the person shall be ordered held in the temporary custody of the Commissioner for further proceedings in accordance with Part 8 of this title. If probable cause is not established, the person shall be ordered discharged or released from the hospital and returned to the place from which he or she was transported or to such place as the person may reasonably direct.

  (c) An application for involuntary treatment shall not be dismissed solely because the probable cause review is not completed within the time period required by this section if there is good cause for the delay. (Added 2013, No. 192 (Adj. Sess.), § 10.)

• § 7613. Notice—appointment of counsel

  (a) When the application is filed, the court shall appoint counsel for the proposed patient and transmit a copy of the application, the physician’s certificate, if any, and a notice of hearing to the proposed patient; his or her attorney, guardian, or any person having custody and control of the proposed patient; the State’s Attorney; or the Attorney General, and any other person the court believes has a concern for the proposed patient’s welfare. A copy of the notice of hearing shall also be transmitted to the applicant and certifying physician.

  (b) The notice of hearing shall set forth the date and time of the hearing and shall contain a list of the proposed patient’s rights at the hearing.

  (c) If the court has reason to believe that notice to the proposed patient will be likely to cause injury to the proposed patient or others, it shall direct the proposed patient’s counsel to give the proposed patient oral notice prior to written notice under circumstances most likely to reduce likelihood of injury. (Added 1977, No. 252 (Adj. Sess.), § 20.)

• § 7614. Psychiatric examination

  As soon as practicable after notice of the commencement of proceedings is given, the court on its own motion or upon the motion of the proposed patient or his or her attorney or the State of Vermont shall authorize examination of the proposed patient by a psychiatrist other than the physician making the original certification. The examination and subsequent report or reports shall be paid for by the State of Vermont. The physician shall report his or her finding to the party requesting the report or to the court if it requested the examination. (Added 1977, No. 252 (Adj. Sess.), § 21.)

• § 7615. Hearing on application for involuntary treatment

  (a)(1) Upon receipt of the application, the court shall set a date for the hearing to be held within 10 days from the date of the receipt of the application or 20 days from the date of the receipt of the application if a psychiatric examination is ordered under section 7614 of this title unless the hearing is continued by the court pursuant to subsection (b) of this section.

  (2)(A) The applicant or a person who is certified as a person in need of treatment pursuant to section 7508 of this title may file a motion to expedite the hearing. The motion shall be supported by an affidavit, and the court shall rule on the motion on the basis of the filings without holding a hearing. The court:

  (i) shall grant the motion if it finds that the person demonstrates a significant risk of causing the person or others serious bodily injury as defined in 13 V.S.A. § 1021 even while hospitalized, and clinical interventions have failed to address the risk of harm to the person or others;

  (ii) may grant the motion if it finds that the person has received involuntary medication pursuant to section 7624 of this title during the past two years and, based upon the person’s response to previous and ongoing treatment, there is good cause to believe that additional time will not result in the person establishing a therapeutic relationship with providers or regaining competence.

  (B) If the court grants the motion for expedited hearing pursuant to this subdivision, the hearing shall be held within 10 days from the date of the order for expedited hearing.

  (3) If a hearing on the application for involuntary treatment has not occurred within 60 days from the date of the court’s receipt of the application, the Commissioner shall request that the court and both parties’ attorneys provide the reasons for the delay. The Commissioner shall submit a report to the court, the Secretary of Human Services, and the patient’s attorney that either explains why the delay was warranted or makes recommendations as to how delays of this type can be avoided in the future.

  (b)(1) For hearings held pursuant to subdivision (a)(1) of this section, the court may grant each party a onetime extension of up to seven days for good cause.

  (2) The court may grant one or more additional seven-day continuances if:

  (A) the court finds that the proceeding or parties would be substantially prejudiced without a continuance; or

  (B) the parties stipulate to the continuance.

  (c) The hearing shall be conducted according to the Vermont Rules of Evidence, and to an extent not inconsistent with this part, the Vermont Rules of Civil Procedure shall be applicable.

  (d) The applicant and the proposed patient shall have a right to appear at the hearing to testify. The attorney for the State and the proposed patient shall have the right to subpoena, present, and cross-examine witnesses, and present oral arguments. The court may, at its discretion, receive the testimony of any other person.

  (e) The proposed patient may at his or her election attend the hearing, subject to reasonable rules of conduct, and the court may exclude all persons, except a peer or other support person designated by the proposed patient, not necessary for the conduct of the hearing. (Added 1977, No. 252 (Adj. Sess.), § 22; amended 2009, No. 154 (Adj. Sess.), § 238; 2013, No. 192 (Adj. Sess.), § 11.)

• § 7616. Appearance by State; burden of proof

  (a) The State shall appear and be represented by the State’s Attorney for the county in which the hearing takes place or by the Attorney General at his or her discretion.

  (b) The State shall have the burden of proving its case by clear and convincing evidence.

  (c) The Attorney for the State shall have the authority to dismiss the application at any stage of the proceeding. (Added 1977, No. 252 (Adj. Sess.), § 23.)

• § 7617. Findings; order

  (a) If the court finds that the proposed patient was not a person in need of treatment at the time of admission or application or is not a patient in need of further treatment at the time of the hearing, the court shall enter a finding to that effect and shall dismiss the application.

  (b) If the proposed patient is found to have been a person in need of treatment at the time of admission or application and a patient in need of further treatment at the time of the hearing, the court may order the person:

  (1) hospitalized in a designated hospital;

  (2) hospitalized in any other public or private hospital if he or she and the hospital agree; or

  (3) to undergo a program of treatment other than hospitalization.

  (c) Prior to ordering any course of treatment, the court shall determine whether there exists an available program of treatment for the person that is an appropriate alternative to hospitalization. The court shall not order hospitalization without a thorough consideration of available alternatives.

  (d) Before making its decision, the court shall order testimony by an appropriate representative of a hospital, a community mental health agency, public or private entity or agency, or a suitable person, who shall assess the availability and appropriateness for the individual of treatment programs other than hospitalization.

  (e) Prior to ordering the hospitalization of a person, the court shall inquire into the adequacy of treatment to be provided to the person by the hospital. Hospitalization shall not be ordered unless the hospital in which the person is to be hospitalized can provide him or her with treatment that is adequate and appropriate to his or her condition.

  (f) Preference between available hospitals shall be given to the hospital that is located nearest to the person’s residence, except when the person requests otherwise or there are other compelling reasons for not following the preference. (Added 1977, No. 252 (Adj. Sess.), § 24.)

• § 7617a. Reporting; National Instant Criminal Background Check System

  (a) If the court issues a hospitalization order pursuant to subdivision 7617(b)(1) or (2) of this title or a nonhospitalization order pursuant to subdivision 7617(b)(3), the Court Administrator shall within 48 hours report the name of the person subject to the order to the National Instant Criminal Background Check System, established by Section 103 of the Brady Handgun Violence Prevention Act of 1993. The report shall include only information sufficient to identify the person, the reason for the report, and a statement that the report is made in accordance with 18 U.S.C. § 922(g)(4).

  (b) A report required by this section shall be submitted notwithstanding section 7103 of this title or any other provision of law.

  (c) A report required by this section is confidential and exempt from public inspection and copying under the Public Records Act except as provided in subsection (d) of this section. The report shall not be used for any purpose other than for submission to the National Instant Criminal Background Check System pursuant to this section, where it may be used for any purpose permitted by federal law, including in connection with the issuance of a firearm-related permit or license.

  (d) A copy of the report required by this section shall be provided to the person who is the subject of the report. The report shall include written notice to the person who is the subject of the report that the person is not permitted to possess a firearm. (Added 2015, No. 14, § 6, eff. Oct. 1, 2015.)

• § 7618. Order; nonhospitalization

  (a) If the court finds that a treatment program other than hospitalization is adequate to meet the person’s treatment needs, the court shall order the person to receive whatever treatment other than hospitalization is appropriate for a period of 90 days. If the treatment plan proposed by the Commissioner is for a secure residential recovery facility or a psychiatric residential treatment facility for youth, the court may at any time, on its own motion or on a motion of an interested party, review the need for treatment at the secure residential recovery facility or the psychiatric residential treatment facility for youth, respectively.

  (b) If at any time during the specified period it comes to the attention of the court either that the patient is not complying with the order or that the alternative treatment has not been adequate to meet the patient’s treatment needs, the court may, after proper hearing:

  (1) consider other alternatives, modify its original order, and direct the patient to undergo another program of alternative treatment for the remainder of the 90-day period; or

  (2) enter a new order directing that the patient be hospitalized for the remainder of the 90-day period. (Added 1977, No. 252 (Adj. Sess.), § 25; amended 2023, No. 137 (Adj. Sess.), § 11, eff. July 1, 2024.)

• § 7619. Order; hospitalization

  An initial order of hospitalization shall be for a period of 90 days from the date of the hearing. (Added 1977, No. 252 (Adj. Sess.), § 26.)

• § 7620. Application for continued treatment

  (a) If, prior to the expiration of any order issued in accordance with section 7623 of this title, the Commissioner believes that the condition of the patient is such that the patient continues to require treatment, the Commissioner shall apply to the court for a determination that the patient is a patient in need of further treatment and for an order of continued treatment.

  (b) An application for an order authorizing continuing treatment shall contain a statement setting forth the reasons for the Commissioner’s determination that the patient is a patient in need of further treatment, a statement describing the treatment program provided to the patient, and the results of that course of treatment.

  (c) Any order of treatment issued in accordance with section 7623 of this title shall remain in force pending the court’s decision on the application.

  (d) If the Commissioner seeks to have the patient receive the further treatment in a secure residential recovery facility or a psychiatric residential treatment facility for youth, the application for an order authorizing continuing treatment shall expressly state that such treatment is being sought. The application shall contain, in addition to the statements required by subsection (b) of this section, a statement setting forth the reasons for the Commissioner’s determination that clinically appropriate treatment for the patient’s condition can be provided safely only in a secure residential recovery facility or a psychiatric residential treatment facility for youth, respectively. (Added 1977, No. 252 (Adj. Sess.), § 27; amended 1997, No. 114 (Adj. Sess.), § 2; 2011, No. 160 (Adj. Sess.), § 3, eff. May 17, 2012; 2023, No. 137 (Adj. Sess.), § 12, eff. July 1, 2024.)

• § 7621. Hearing on application for continued treatment; orders

  (a) The hearing on the application for continued treatment shall be held in accordance with the procedures set forth in sections 7613, 7614, 7615, and 7616 of this title.

  (b) If the court finds that the patient is a patient in need of further treatment and requires hospitalization, it shall order hospitalization for up to one year.

  (c) If the court finds that the patient is a patient in need of further treatment but does not require hospitalization, it shall order nonhospitalization for up to one year. If the treatment plan proposed by the Commissioner for a patient in need of further treatment includes admission to a secure residential recovery facility or a psychiatric residential treatment facility for youth, the court may at any time, on its own motion or on motion of an interested party, review the need for treatment at the secure residential recovery facility or the psychiatric residential treatment facility for youth, respectively.

  (d) If at any time during the period of nonhospitalization ordered under subsection (c) of this section, it comes to the attention of the court that the person is not complying with the order or that the alternative treatment has not been adequate to meet the patient’s treatment needs, the court may, after proper hearing:

  (1) consider other treatments not involving hospitalization, modify its original order, and direct the patient to undergo another program of alternative treatment for an indeterminate period, up to the expiration date of the original order; or

  (2) order that the patient be hospitalized, up to the expiration date of the original order.

  (e) If the court finds that the patient is not a patient in need of further treatment, it shall order the patient discharged.

  (f) This section shall not be construed to prohibit the court from issuing subsequent orders after a new application is filed pursuant to section 7620 of this title. (Added 1977, No. 252 (Adj. Sess.), § 28; amended 1997, No. 114 (Adj. Sess.), § 3; 2011, No. 160 (Adj. Sess.), § 4, eff. May 17, 2012; 2023, No. 137 (Adj. Sess.), § 13, eff. July 1, 2024.)

• § 7622. Expert testimony

  (a) A mental health professional testifying at hearings conducted under this part may, if appropriately qualified, give opinion testimony and, notwithstanding 12 V.S.A. § 1612, describe any information that he or she acquired in attending the patient.

  (b) The facts or data in the particular case, upon which an expert bases an opinion or inference, may be those perceived by or made known to him or her at or before the hearing. If of a type reasonably relied upon by experts in the particular field in forming opinions or inferences upon the subject, the facts or data need not be admissible in evidence. (Added 1977, No. 252 (Adj. Sess.), § 29.)

• § 7623. Orders; custody

  All court orders of hospitalization, nonhospitalization, and continued treatment shall be directed to the Commissioner and shall admit the patient to his or her care and custody for the period specified. (Added 1977, No. 252 (Adj. Sess.), § 30.)

• § 7624. Application for involuntary medication

  (a) The Commissioner may commence an action for the involuntary medication of a person who is refusing to accept psychiatric medication and meets any one of the following conditions:

  (1) has been placed in the Commissioner’s care and custody pursuant to section 7619 of this title or subsection 7621(b) of this title;

  (2) has previously received treatment under an order of hospitalization and is currently under an order of nonhospitalization;

  (3) has been committed to the custody of the Commissioner on an order of nonhospitalization and has been placed at a secure residential recovery facility;

  (4) has been committed to the custody of the Commissioner of Corrections as a convicted felon and is being held in a correctional facility that is a designated facility pursuant to section 7628 of this title and for whom the Departments of Corrections and of Mental Health have determined jointly that involuntary medication would be appropriate pursuant to 28 V.S.A. § 907(4)(H);

  (5) has an application for involuntary treatment pending for which the court has granted a motion to expedite pursuant to subdivision 7615(a)(2)(A)(i) of this title;

  (6)(A) has an application for involuntary treatment pending;

  (B) waives the right to a hearing on the application for involuntary treatment until a later date; and

  (C) agrees to proceed with an involuntary medication hearing without a ruling on whether the person is a person in need of treatment; or

  (7) has had an application for involuntary treatment pending pursuant to subdivision 7615(a)(1) of this title for more than 26 days without a hearing having occurred and the treating psychiatrist certifies, based on specific behaviors and facts set forth in the certification, that in the psychiatrist’s professional judgment there is good cause to believe that:

  (A) additional time will not result in the person establishing a therapeutic relationship with providers or regaining competence; and

  (B) serious deterioration of the person’s mental condition is occurring.

  (b)(1) Except as provided in subdivisions (2), (4), and (5) of this subsection, an application for involuntary medication shall be filed in the Family Division of the Superior Court in the county in which the person is receiving treatment.

  (2) If the application for involuntary medication is filed pursuant to subdivision (a)(5) of this section:

  (A) the application shall be filed in the county in which the application for involuntary treatment is pending; and

  (B) the court shall consolidate the application for involuntary treatment with the application for involuntary medication and rule on the application for involuntary treatment before ruling on the application for involuntary medication.

  (3) If the application for involuntary medication is filed pursuant to subdivision (a)(6) or (a)(7) of this section, the application shall be filed in the county in which the application for involuntary treatment is pending.

  (4) Within 72 hours of the filing of an application for involuntary medication pursuant to subdivision (a)(7) of this section, the court shall determine, based solely upon a review of the psychiatrist’s certification and any other filings, whether the requirements of that subdivision have been established. If the court determines that the requirements of subdivision (a)(7) of this section have been established, the court shall consolidate the application for involuntary treatment with the application for involuntary medication and hear both applications within 10 days after the date that the application for involuntary medication is filed. The court shall rule on the application for involuntary treatment before ruling on the application for involuntary medication. Subsection 7615(b) of this title shall apply to applications consolidated pursuant to this subdivision.

  (c) The application shall include a certification from the treating physician, executed under penalty of perjury, that includes the following information:

  (1) the nature of the person’s mental illness;

  (2) that the person is refusing medication proposed by the physician;

  (3) that the person lacks the competence to decide to accept or refuse medication and appreciate the consequences of that decision;

  (4) the necessity for involuntary medication;

  (5) any proposed medication, including the method, dosage range, and length of administration for each specific medication;

  (6) a statement of the risks and benefits of the proposed medications, including the likelihood and severity of adverse side effects and its effect on:

  (A) the person’s prognosis with and without the proposed medications; and

  (B) the person’s health and safety, including any pregnancy;

  (7) the current relevant facts and circumstances, including any history of psychiatric treatment and medication, upon which the physician’s opinion is based;

  (8) what alternate treatments have been proposed by the doctor, the patient, or others, and the reasons for ruling out those alternatives, including information on the availability of any appropriate alternatives; and

  (9) whether the person has executed an advance directive in accordance with the provisions of chapter 231 of this title and the identity of the agent or agents designated by the advance directive.

  (d) A copy of the advance directive, if available, shall be attached to the application. (Added 1997, No. 114 (Adj. Sess.), § 4; amended 2005, No. 174 (Adj. Sess.), § 40; 2007, No. 15, § 22; 2009, No. 154 (Adj. Sess.), § 238; 2011, No. 160 (Adj. Sess.), § 5, eff. May 17, 2012; 2013, No. 192 (Adj. Sess.), §§ 12, 25; 2023, No. 6, § 203, eff. July 1, 2023; 2023, No. 137 (Adj. Sess.), § 14, eff. July 1, 2024.)

• § 7625. Hearing on application for involuntary medication; burden of proof

  (a) Unless consolidated with an application for involuntary treatment pursuant to subdivision 7624(b)(2) or (b)(4) of this title, a hearing on an application for involuntary medication shall be held within seven days after filing and shall be conducted in accordance with sections 7613, 7614, and 7616 and subsections 7615(b)–(e) of this title.

  (b) In a hearing conducted pursuant to this section, section 7626, or section 7627 of this title, the Commissioner has the burden of proof by clear and convincing evidence.

  (c) In determining whether or not the person is competent to make a decision regarding the proposed treatment, the court shall consider whether the person is able to make a decision and appreciate the consequences of that decision. (Added 1997, No. 114 (Adj. Sess.), § 4; amended 2013, No. 192 (Adj. Sess.), §§ 13, 25; 2023, No. 6, § 204, eff. July 1, 2023.)

• § 7626. Advance directive

  (a) If a person who is the subject of an application filed under section 7624 of this title has executed an advance directive in accordance with the provisions of chapter 231 of this title, the court shall suspend the hearing and enter an order pursuant to subsection (b) of this section, if the court determines that:

  (1) the person is refusing to accept psychiatric medication;

  (2) the person is not competent to make a decision regarding the proposed treatment; and

  (3) the decision regarding the proposed treatment is within the scope of the valid, duly executed advance directive.

  (b) An order entered under subsection (a) of this section shall authorize the Commissioner to administer treatment to the person, including involuntary medication in accordance with the direction set forth in the advance directive or provided by the agent or agents acting within the scope of authority granted by the advance directive. If hospitalization is necessary to effectuate the proposed treatment, the court may order the person to be hospitalized.

  (c) [Repealed.]

  (d)(1) The Commissioner of Mental Health shall develop a protocol for use by designated hospitals for the purpose of educating hospital staff on the use and applicability of advance directives pursuant to chapter 231 of this title and other written or oral expressions of treatment preferences pursuant to subsection 7627(b) of this title.

  (2) Prior to a patient’s discharge or release, a hospital shall provide information to a patient in the custody or temporary custody of the Commissioner regarding advance directives, including relevant information developed by the Vermont Ethics Network and Office of the Mental Health Care Ombudsman. (Added 1997, No. 114 (Adj. Sess.), § 4; amended 2013, No. 192 (Adj. Sess.), §§ 14, 25.)

• § 7627. Court findings; orders

  (a) The court shall issue an order regarding all possible findings pursuant to this section, and for persons subject to an application pursuant to subdivision 7624(a)(3) of this title, the court shall first find that the person is a person in need of treatment as defined by subdivision 7101(17) of this title.

  (b) If a person who is the subject of an application filed under section 7625 of this title has not executed an advance directive, the court shall follow the person’s competently expressed written or oral preferences regarding medication, if any, unless the Commissioner demonstrates that the person’s medication preferences have not led to a significant clinical improvement in the person’s mental state in the past within an appropriate period of time.

  (c) If the court finds that there are no medication preferences or that the person’s medication preferences have not led to a significant clinical improvement in the person’s mental state in the past within an appropriate period of time, the court shall consider at a minimum, in addition to the person’s expressed preferences, the following factors:

  (1) the person’s religious convictions and whether they contribute to the person’s refusal to accept medication;

  (2) the impact of receiving medication or not receiving medication on the person’s relationship with his or her family or household members whose opinion the court finds relevant and credible based on the nature of the relationship;

  (3) the likelihood and severity of possible adverse side effects from the proposed medication;

  (4) the risks and benefits of the proposed medication and its effect on:

  (A) the person’s prognosis; and

  (B) the person’s health and safety, including any pregnancy; and

  (5) the various treatment alternatives available, which may or may not include medication.

  (d) As a threshold matter, the court shall consider the person’s competency. If the court finds that the person is competent to make a decision regarding the proposed treatment or that involuntary medication is not supported by the factors in subsection (c) of this section, the court shall enter a finding to that effect and deny the application.

  (e) As a threshold matter, the court shall consider the person’s competency. If the court finds that the person is incompetent to make a decision regarding the proposed treatment and that involuntary medication is supported by the factors in subsection (c) of this section, the court shall make specific findings stating the reasons for the involuntary medication by referencing those supporting factors.

  (f)(1) If the court grants the application, in whole or in part, the court shall enter an order authorizing the Commissioner to administer involuntary medication to the person. The order shall specify the types of medication, the permitted dosage range, length of administration, and method of administration for each. The order for involuntary medication shall not include electroconvulsive therapy, surgery, or experimental medications. A long-acting injection shall not be ordered without clear and convincing evidence, particular to the patient, that this treatment is the most appropriate under the circumstances.

  (2) The order shall require the person’s treatment provider to conduct weekly reviews of the medication to assess the continued need for involuntary medication, the effectiveness of the medication, the existence of any side effects, and whether the patient has become competent pursuant to subsection 7625(c) of this title and shall also require the person’s treatment provider to document this review in detail in the patient’s chart. The person’s treatment provider shall notify the Department when he or she determines that the patient has regained competence. Within two days of receipt, the Department shall provide a copy of the notice to the patient’s attorney.

  (g) For a person receiving treatment pursuant to an order of hospitalization, the Commissioner may administer involuntary medication as authorized by this section to the person for up to 90 days, unless the court finds that an order is necessary for a longer period of time. Such an order shall not be longer than the duration of the current order of hospitalization. If at any time the treating psychiatrist finds that a person subject to an order for involuntary medication has become competent pursuant to subsection 7625(c) of this title, the order shall no longer be in effect.

  (h) For a person who had received treatment under an order of hospitalization and is currently receiving treatment pursuant to an order of nonhospitalization, if the court finds that without an order for involuntary medication there is a substantial probability that the person would continue to refuse medication and as a result would pose a danger of harm to self or others, the court may order hospitalization of the person for up to 72 hours to administer involuntary medication as ordered under this section.

  (i) The court may authorize future 72-hour hospitalizations of a person subject to an order under subsection (h) of this section to administer involuntary medication for 90 days following the initial hospitalization, unless the court finds that an involuntary medication order is necessary for a longer period of time. Such an order shall not be longer than the duration of the current order of nonhospitalization.

  (j) A future administration of involuntary medication authorized by the court under subsection (i) of this section shall occur as follows:

  (1) The treating physician shall execute and file with the Commissioner a certification executed under penalty of perjury that states all the following:

  (A) the person has refused medication;

  (B) the person is not competent to make a decision regarding medication and to appreciate the consequences;

  (C) the proposed medications, the dosage range, length of administration, and method of administration; and

  (D) the substantial probability that in the near future the person will pose a danger of harm to self or others if not hospitalized and involuntarily medicated.

  (2) Depending on the type of medication ordered, the Commissioner shall provide two to 14 days’ notice, as set forth in the initial court order, to the court, the person, and the person’s attorney. The notice shall be given within 24 hours of receipt by the Commissioner of the physician’s certification and shall state that the person may request an immediate hearing to contest the order. The person may be hospitalized in a designated hospital on the date specified in the notice for up to 72 hours in order to administer involuntary medication.

  (k) An order for involuntary medication issued under this section shall be effective concurrently with the current order of commitment issued pursuant to section 7623 of this title.

  (l) The treating physician shall provide written notice to the court to terminate the order when involuntary medication is no longer necessary.

  (m) At any time, the person may petition the court for review of the order.

  (n) As used in this section, “household members” means persons living together or sharing occupancy. (Added 1997, No. 114 (Adj. Sess.), § 4; amended 2013, No. 192 (Adj. Sess.), §§ 15, 25.)

• § 7628. Protocol

  The Department of Mental Health shall develop and adopt by rule a strict protocol to ensure the health, safety, dignity, and respect of patients subject to administration of involuntary psychiatric medications in any designated hospital or secure residential recovery facility. This protocol shall be followed by all designated hospitals and secure residential recovery facilities administering involuntary psychiatric medications. (Added 1997, No. 114 (Adj. Sess.), § 4; amended 2023, No. 137 (Adj. Sess.), § 15, eff. July 1, 2024.)

• § 7629. Legislative intent

  (a) It is the intention of the General Assembly to recognize the right of a legally competent person to determine whether or not to accept medical treatment absent an emergency or a determination that the person is incompetent and lacks the ability to make a decision and appreciate the consequences.

  (b) The General Assembly adopts the goal of high-quality, patient-centered health care, which the Institute of Medicine defines as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” A substitute decision-maker is sometimes necessary to make a decision about care when a person is incompetent and lacks the ability to make a decision and appreciate the consequences. Even when a person lacks competence, health care that a person is opposing should be avoided whenever possible because the distress and insult to human dignity that result from compelling a person to participate in medical treatment against his or her will are real, regardless of how poorly the person may understand the decision.

  (c) It is the policy of the General Assembly to work toward a mental health system that does not require coercion or the use of involuntary medication.

  (d) This chapter protects the rights and values described in this section through a judicial process to determine competence prior to an order for nonemergency involuntary medication and by limiting the duration of an order for involuntary treatment to no more than one year. The least restrictive order consistent with the person’s right to adequate treatment shall be provided in all cases. (Added 1997, No. 114 (Adj. Sess.), § 1; amended 2013, No. 192 (Adj. Sess.), § 16.)