The Vermont Statutes Online

Title 18 : Health

Chapter 181 : Judicial Proceedings

• § 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.)