Note:
Changes in
the laws, rules and regulations since the 2001 edition of the LSBEP
Directory and Statutory Reference book appear in boldface type in this
2002 edition.
Mental Health
Proceedings, Louisiana Children’s Code, Art. 1401-1471.
Art. 1401. Purpose
The purpose of this Title is to facilitate
the proper treatment of children suffering from mental illness or
substance abuse. The manner of treatment should be medically appropriate,
least restrictive of the child’s liberty, and respectful of the child’s
individual rights. A
preference for outpatient treatment should prevail unless the admission to
a treatment facility is determined necessary for the recovery of the child
from the mental illness or substance abuse.
Art. 1402. Declaration of policy
The underlying policy of this Title is as follows:
(1) That mentally ill minors and minors suffering
from substance abuse and their caretakers on their behalf be encouraged to
seek voluntary treatment.
(2) That any involuntary treatment or evaluation
be accomplished in a setting which is medically appropriate, most likely
to facilitate proper care and treatment that will return the minor patient
to the community as soon as possible, and is the least restrictive of the
minor’s liberty.
(3) That continuity of care for the mentally ill
and minors suffering from substance abuse be provided.
(4) That mental health and substance abuse
treatment services be delivered as near to the place of residence of the
minor receiving such services as is reasonably possible and medically
appropriate.
(5) That individual rights of minor patients be
safeguarded.
(6) That no minor solely as a result of mental
illness or alcoholism or incapacitation by alcohol shall be confined in
any jail, prison, correctional facility, or juvenile detention center.
(7) That no minor shall be denied treatment solely
because he has withdrawn from treatment against medical advice on a prior
occasion or because he has relapsed after an earlier treatment.
(8) That minors be protected from unnecessary
institutionalization and be afforded proper treatment for their special
mental health needs.
(9) That, in view of the liberty interest at issue
in any commitment decision, proper respect for the parental decisionmaking
role be balanced with the individual rights of the minor.
Art. 1403. General applicability
Except as otherwise specified in this Title, all
provisions of the Children’s Code remain applicable.
Art. 1404. Definitions as used in this title:
(1) “Caretaker” means any person legally obligated
to provide or secure adequate care for a child, including a parent, tutor,
guardian, legal custodian, foster home patient, or other person providing
a residence for the child.
(2) "Conditional discharge” means the physical
release of a judicially committed minor from a treatment facility by the
director or by the court.
(3) “Dangerous to others” means the condition of a
person whose behavior or significant threats support a reasonable
expectation that there is a substantial risk that he will inflict physical
harm upon another person in the near future.
(4) “Dangerous to self” means the condition of a
person whose behavior, significant threats, or inaction supports a
reasonable expectation that there is a substantial risk that he will
inflict physical or severe emotional harm upon his own person.
(5) “Department” means the Department of Health
and Hospitals.
(6) “Diagnosis” means the art and science of
determining the presence of disease in an individual and distinguishing
one disease from another.
(7) “Director” or “superintendent” means a person
in charge of a treatment facility or his deputy.
(8) “Discharge” means the full or conditional
release from a treatment facility of any minor admitted or otherwise
detained under this Title.
(9) “Formal voluntary admission” means the
admission of a minor suffering from mental illness or substance abuse
desiring admission to a treatment facility for diagnosis or treatment of
such conditions. or both, who may be formally admitted upon his written
request.
(10) “Grave disability” means the condition of a
person who is unable to provide for his own basic physical needs, such as
essential food, clothing, medical care, and shelter, as a result of
serious mental illness or substance abuse and is unable to survive safely
in freedom or protect himself from serious harm; the term also includes
incapacitation by alcohol, which means the condition of a person who, as a
result of the use of alcohol, is unconscious or whose judgment is
otherwise so impaired that he is incapable of realizing and making a
rational decision with respect to his need for treatment.
(11) “Informal voluntary admission” means the
admission of a minor suffering from mental illness or substance abuse,
desiring admission to a treatment facility for diagnosis or treatment of
such condition, or both, who may be admitted upon his request without
making formal application.
(12) “MHAS” means Mental Health Advocacy Service,
as established by R.S. 28:64.
(13) “Major surgical procedure” means an invasive
procedure of a serious nature with incision upon the body or parts thereof
under general, local, or spinal anesthesia, utilizing surgical
instruments, for the purpose of diagnosis or treatment of a mental
condition. Diagnostic procedures, including but not limited to the
following, shall not be considered as major surgical procedures:
(a) Endoscopy through natural body
openings, such as the mouth, anus, or urethra, to view the trachea,
bronchi, esophagus, stomach, pancreas, small or large intestine, urethra,
urinary bladder, or ureters, and to obtain from such organs
specimens of fluids or tissues for chemical or microscopic
analysis.
(b) Subcutaneous percutaneous liver biopsy.
(c) Punch biopsy of skeletal muscles.
(d) Bone marrow biopsy.
(e) Lumbar puncture.
(f) Myelogram.
(h) Abdominocentesis.
(i) Conization of the uterine cervix.
(j) Renal angiography.
(k) Femoral angiography.
(l) Carotid angiography.
(m) Vertebral angiography.
(14) “Mental Health Advocacy Service” means a
service established by the state of Louisiana for the purpose of providing
legal counsel and representation for mentally disabled persons and to
insure that their legal rights are protected.
(15) “Mentally ill
person” means any person with a psychiatric disorder which has substantial
adverse effects on his ability to function and who requires care and
treatment. It does not include a person suffering solely from mental
retardation, epilepsy, alcoholism, or drug abuse.
(16) “Patient” means any person detained and taken
care of as a mentally-ill person or person suffering from substance abuse.
(17) “Respondent” means a person alleged to be
mentally ill or suffering from substance abuse and for whom an application
for commitment to a treatment facility has been filed.
(18) “Restraint” means the partial or total
immobilization of any or all of the extremities or the torso by mechancial
means for psychiatric indications. Restraint does not include the use of
mechanisms usually and customarily used during medical or surgical
procedures, including but not limited to, body immobilization during
surgery and arm immobilization during intravenous administration.
Restraint does not include orthopedic appliances used to posturally
support the patient, such as posies.
(19) "Seclusion" means the involuntary
confinement of a patient alone in a room, which the patient is physically
prevented from leaving, for any period of time, except that seclusion does
not include the placement of a patient alone in a room or other area for
no more than thirty minutes at a time and no more than three hours in any
twenty-four hour time period pursuant to behavior-shaping techniques such
as "time-out".
(20) “Substance abuse” means the condition of a
person who uses narcotic, stimulant, depressant, soporific, tranquilizing,
or hallucinogenic drugs or alcohol to the extent that it renders the
person dangerous to himself or others or renders the person gravely
disabled.
(21) “Treatment” means an active effort to
accomplish an improvement in the mental condition or behavior of a patient
or to prevent deterioration in his condition or behavior. Treatment
includes, but is not limited to, hospitalization, partial hospitalization,
outpatient services, examination, diagnosis, training, the use of
pharmaceuticals, and other services provided for patients by a treatment
facility.
(22) “Treatment facility” means any public or
private hospital, retreat, institution, mental health center, or facility
licensed by the state of Louisiana in which any mentally ill minor or
minor suffering from substance abuse is received or detained as a patient
except a facility under the control or supervision of the Department of
Public Safety and Corrections unless otherwise provided in Title VIII of
this Code.
Art. 1405. Mental Health Advocacy Service (MHAS);
representation; fees
A. MHAS shall provide legal counsel to all
patients who request such service and who are admitted for treatment
pursuant to this Title, including but not limited to voluntary or
involuntary admission, commitment, legal competency, change of status,
transfer, and discharge.
B. MHAS shall provide legal counsel, as
availability is determined by its executive director, to minors admitted
for mental health or substance abuse treatment pursuant to the
dispositional alternatives as provided in the other Titles of this Code,
including but not limited to Titles VI and VIII.
C. Nothing in this Title shall be construed to
prohibit a mentally ill person or respondent from being represented by
privately retained counsel. If a MHAS attorney has been appointed by the
court and the mentally ill minor or respondent secures his own counsel,
the court shall discharge the MHAS attorney.
D. MHAS shall establish official rules and
regulations for evaluating a client’s financial resources, for the purpose
of determining whether a client has the ability to pay for services
received. A client found to have sufficient financial resources shall be
required to pay in accordance with standards established by the executive
director. An indigent client shall be provided legal counsel and
representation without charge.
E. MHAS shall be empowered with all of the same
rights and responsibilities to represent their clients whether appointed
through the provisions of this Code of Title 28 of the Louisiana Revised
Statutes of 1950. These rights include but are not limited to:
(1) A request for a judicial hearing
pursuant to Article 1411.
(2) An independent medical examination as
requested and approved by the MHAS executive director.
Art. 1406. Selection of facilities; judicial
commitments
A. Any treatment facility, except a forensic
facility, shall be selected with consideration for the following:
(1) Medical suitability.
(2) Least restriction of the minor’s
liberty.
(3) Nearness to the minor patient’s usual
residence.
(4) Financial status of the minor patient.
B. Treatment facilities include but are not
limited to the following:
(1) Community mental health centers.
(2) Private clinics.
(3) Public or private halfway houses.
(4) Public or private group homes.
(5) Residential facilities for children.
(6) Public or private general hospitals.
(7) Public or private mental hospitals.
(8) Detoxification centers.
(9) Substance abuse clinics.
(10) Substance abuse inpatient facilities.
(11) Forensic facilities.
C. Judicial commitments may be made to any
facility, except forensic facilities, which is listed in Paragraph B of
this Article.
Art. 1407. Facilities prohibited; emergency certificate
for mental health treatment
A. Minor patients involuntarily hospitalized by
emergency certificate for mental health treatment shall not be admitted to
the following facilities:
(1) Private clinics.
(2) Public or private halfway houses.
(3) Public or private group homes.
(4) Substance abuse clinics.
(5) Forensic facilities.
(6) Residential facilities for
children.
B. Minor patients in the custody of the Department
of Public Safety and Corrections may be admitted to forensic facilities by
emergency certificate provided that judical commitment proceedings are
initiated during the period of treatment at the forensic facility
authorized by emergency certificate.
Art. 1408. Facilities prohibited; emergency certificate
for substance abuse treatment
A. Minor patients involuntarily hospitalized by
emergency certificate for substance abuse treatment shall not be admitted
to the following facilities:
(1) Private clinics.
(2) Public or private halfway houses.
(3) Public or private group homes.
(4) Forensic facilities.
(5) Residential facilities for children.
B. Judicial commitment or hospitalization by
emergency certificate may be made to any facility listed in Article
1406(B), except forensic facilities, provided that such facility has a
substance abuse inpatient operation maintained separate and apart from any
mental health inpatient operation in such facility.
Chapter 3. Rights of
Minor Patients
Art. 1409. Rights guaranteed
A. Each minor patient has a right to care provided
in a dignified and humane manner, and to such privacy as is possible
consistent with the minor's treatment plan.
B. The confinement of a minor to an institution
shall not of itself cause him to lose any of the rights enjoyed by
citizens of Louisiana and of the Untied States. No minor patient shall be
deprived of these rights except when the determination is made by an
appropriate court.
C. (1) The minor patient in a treatment
facility shall be permitted unimpeded, private, and uncensored
communication with persons of his choice by mail, telephone, and
visitation. These rights may be restricted by the director of the
treatment facility if sufficient cause exists and is so documented in the
minor's medical records. The minor's legal counsel, as well as his next
of kin or responsible party, must be notified in writing of any such
restrictions and reasons therefor. When the cause for any restriction
ceases to exist, the minor's full rights shall be reinstated. A minor
shall have the right to communicate in any manner in private with his
attorney at all times.
(2) The director of the treatment facility
shall ensure that correspondence can be conveniently received and mailed,
that telephones are reasonably accessible, and that space for visits is
available. Writing materials, postage, and telephone usage funds shall be
provided in reasonable amounts to minor patients who are unable to procure
such items.
(3) Reasonable times and places for the
use of telephones and for visits may be established in writing by the
director of any treatment facility. However, the times and places
established by the director must allow patients, at a minimum, reasonable
daily communication by telephone and visitation. These rights may be
restricted by the director of the treatment facility if sufficient cause
exists and is so documented in the patient's medical records. The
patient's legal counsel, as well as his next of kin or responsible party
must be notified in writing of any such restrictions and the reasons
therefor. When the cause for any restriction ceases to exist, the
patient's full rights shall be reinstated.
(4) (a) The director of any substance
abuse treatment facility may restrict the visitation rights of a minor who
is voluntarily admitted to such treatment facility for substance abuse
treatment under provisions of this Title for the initial phase of
treatment but no longer than seven days unless good cause exists to extend
the restriction and is so documented in the patient's record. This
restriction shall not apply to visitation by the minor's attorney, or if
he is not represented by counsel, the MHAS attorney or the minor's
minister. This restriction shall also not apply to the parent or legal
guardian of a minor unless the director determines that good cause exists
that such restriction shall be in the best interests of the minor and is
so documented in the minor's record. When the facility director
determines the need to restrict visitation of new minor patients, he shall
post notice of such restriction in places prominent to all new admissions,
and shall inform each new patient of the restriction prior to his
admission and the length and duration thereof, and further that such
restriction may be extended on an individual basis as determined to be in
the minor's interest by the treatment staff with the concurrence of the
medical director.
(b) Nothing herein shall be
construed to further restrict other forms of patient communication by and
to minor patients as permitted in this Article nor shall this restriction
apply to mental health treatment facilities.
D. Physical restraints or seclusion shall only be
used to prevent a minor patient from physically injuring himself or
others. Physical restraints or seclusion may not be used to punish or
discipline a patient or used as a convenience to the staff of the
treatment facility. Restraint and seclusion shall be used only in
accordance with the following standards:
(1) Restraint or seclusion shall only be
used when verbal intervention or less restrictive measures fail. Use of
restraint or seclusion shall require documentation in the patient's record
of the clinical justification for such use as well as the inadequacy of
less restrictive intervention techniques.
(2) A written order from a physician or a
psychologist acting within the scope of his institutional privileges shall
be required for any use of restraint or seclusion. If, however, no
physician or psychologist is immediately available, a registered nurse who
has been trained in management of disturbed behavior may utilize restraint
or seclusion. The nurse or the nursing supervisor shall then immediately
notify a physician or a psychologist with institutional authority to order
seclusion and provide him with sufficient information to determine whether
restraints or seclusion are necessary and whether less restrictive
interventions have been tried or considered. The physician or
psychologist may then issue a telephone order for seclusion or restraint,
if such order is indicated.
(3) Written orders for the use of
restraint or seclusion shall be time limited and not more than twelve
hours in duration. The written order shall include the date and time of
the actual examination of the patient, the date and time that the patient
was placed in restraint or seclusion, and the date and time that the order
was signed.
(4) A renewal order for up to twelve hours
of restraint or seclusion may be
issued by a physician or a psychologist with institutional authority to
order seclusion or restraint after determining that there is no less
restrictive means of preventing injury to the patient or others. If any
patient is held in restraint or seclusion for twenty-four hours, the
physician or psychologist with institutional authority shall conduct an
actual examination of the patient and document the reason why the use of
seclusion or restraint beyond twenty-four hours is necessary, and the
parent, tutor, or caretaker shall be notified by the twenty-sixth hour.
(5) Staff who implement written orders for
restraints and seclusion shall have documented training in the proper use
of the procedure for which the order was written.
(6) Periodic monitoring and care of the
patient shall be provided by responsible staff. A patient in restraint or
seclusion shall be evaluated every fifteen minutes, especially in regard
to regular meals, water, and snacks, bathing, the need for motion and
exercise, and use of the bathroom, and documentation of these evaluations
shall be entered in the patient's record.
(7) Patients shall be released from
restraint or seclusion as soon as the reasons justifying the use of
restraints or seclusion subside. If at any time during the period of
restraint or seclusion a registered nurse determines that the emergency
which justified the seclusion or restraint has subsided and a physician or
psychologist is not immediately available, the patient shall be released.
At the end of the period of restraint or seclusion ordered by the
physician or psychologist the patient shall be released unless a renewal
order is issued.
(8) Mechanical restraints shall be
designed and used so as not to cause physical injury to the patient and so
as to cause the least possible discomfort.
(9) Facilities using seclusion or
restraint shall have written policies concerning their use. These
policies shall include standards and procedures for placing a patient in
seclusion or restraint, and for informing him of the reason he was put in
seclusion or restraint and the means of terminating such seclusion or
restraint.
(10) Nothing in this Article shall be
construed to expand the scope of practice of psychology as defined in R.
S. 37:2351 et seq. to authorize the ordering, administering, or dispensing
of medications, or to authorize any practice not permitted under the
privileges granted by the institution.
(11) The department shall adopt rules and
regulations in accordance with the Administrative Procedures Act to govern
the use of seclusion and restraint. Such rules and regulations shall
respect the minor patient's individual rights, protect the minor patient's
health, safety, and welfare, and be the least restrictive of the minor
patient's liberty. The department shall adopt rules and regulations to
provide for enforcement procedures and penalties applicable to a person
who violates the requirements of this Section.
E. A patient may be placed alone in a room or
other area pursuant to behavior shaping techniques such as "time-out".
Such placement may only be used as part of a written treatment plan, shall
not be used for the convenience of staff, and may be used only according
to the following standards and procedures:
(1) Placement alone in a room or other
area shall be imposed only when less restrictive measures are inadequate.
(2) Placement alone in a room or other
area shall only be ordered by a qualified professional trained in
behavior-shaping techniques and authorized in accordance with written
policies and procedures of the facility to order the use of
behavior-shaping techniques.
(3) The period of placement alone in a
room or other area shall not exceed thirty minutes.
(4) The patient shall be observed and
supervised by a staff member.
(5) The period of placement alone in a
room or other area shall not exceed a total of three hours in any
twenty-four hour time period. If the placement alone in a room or other
area exceeds a total of three hours in any twenty-four hour time period,
it shall then be considered seclusion and shall be governed by the
procedures and standards set forth in Paragraph D of this Article.
(6) The date, time, and duration of the
placement shall be documented.
(7) In treatment facilities where patients
are placed alone in a room or other area as a behavior-shaping technique,
there shall be written policies and procedures governing use of such
behavior-shaping technique.
F. No minor patient confined by emergency
certificate, judicial commitment, court order, or noncontested status
shall receive major surgical procedures or electroshock therapy without
the written consent of a court of competent jurisdiction after a hearing.
However, if the director of the treatment facility, in consultation with
two physicians, determines that the condition of the minor is of such a
critical nature that it may be life threatening unless major surgical
procedures or electroshock therapy are administered, such emergency
measures may be performed without the consent otherwise provided for in
this Paragraph. No physician shall be liable for a good faith
determination that a medical emergency exists.
G. Every minor patient shall have the right to
wear his own clothes and keep and use his personal possessions, including
toilet articles, unless determined by a physician that these are medically
inappropriate and the reasons therefor are documented in his medical
record. The minor shall also be allowed to spend a reasonable sum of his
own money for canteen expenses and small purchases, and to have access to
individual storage spaces for his private use. If the minor is financially
unable to provide these articles for himself, the treatment facility shall
provide a reasonable supply of clothing and toiletries.
H. The following rules shall govern performance of
work by minor patients:
(1) No minor shall be required to perform
work of any kind that involves the operation and maintenance of an
institution, nor shall privileges or release from an institution be
conditioned upon performance of any work, except as follows:
(a) A minor patient may be required
to perform vocational training tasks, provided each task is:
(i) Part of the minor’s
individual treatment plan and has been approved as a program activity by a
professional responsible for supervising the program.
(ii) Supervised by a
qualified professional.
(iii) Not continued for
longer than six months, unless it is specifically reinstated by the
minor’s treatment plan.
(b) A minor patient may be required
to perform without compensation such housekeeping tasks as would be
performed by a minor in a natural home, foster home, or group home,
provided that nothing in the minor’s individual treatment plan forbids
such work. In no case, however, may a minor be required to perform
housekeep ing tasks for
more than twelve other people.
(2) A minor may voluntarily engage in work
during nonprogram hours, provided that:
(a) The minor’s individual
treatment plan does not forbid it.
(b) The particular work has been
approved by the qualified professional
responsible for supervising the implementation of the minor
treatment plan.
(c) The particular work is
supervised by qualified staff.
(d) The conditions of employment
and the compensation are in full compliance with all applicable federal
laws.
3) No minor patient shall be involved in
the care, feeding, clothing, training, or supervision of other minors
unless the qualified professional responsible for supervising the
implementation of the treatment plan certifies in writing in the minor’s
record that the particular task will not in any way endanger the life or
health or be detrimental to the development of the particular children who
receive such care or of the minor patient providing it.
I. Under appropriate supervision, each minor
patient shall be provided with suitable opportunities for interaction with
members of the opposite sex, except where a qualified professional
responsible for the formulation of a particular minor’s treatment plan
writes an order to the contrary and explains the reasons therefor.
J. Every minor patient shall have the right to be
discharged from a treatment facility when his condition has changed or
improved to the extent that confinement and treatment at the treatment
facility are no longer required. The director of the treatment facility
shall have the authority to discharge a patient admitted by judicial
commitment pursuant to Chapter 9 of this Title without the approval of the
court which committed him to the treatment facility. The court shall be
advised of any such discharge. The director shall not be legally
responsible to any person for the subsequent acts of behavior of a patient
discharged by him in good faith.
K. Every minor patient shall have the right to
engage a private attorney. If the minor is indigent, he shall be provided
an attorney by the MHAS, if he so requests. The attorneys provided by the
MHAS or appointed by a court shall be interested in and qualified by
training or experience, or both, in the field of mental health statutes
and jurisprudence.
L. Every minor patient shall have the right to
request a court hearing pursuant to Article 1411. The purpose of the
hearing shall be to determine whether or not he should be discharged from
the treatment facility or transferred to a less restrictive and medically
suitable treatment facility.
M. No provision hereof shall abridge or diminish
the right of any minor patient to avail himself of the right of habeas
corpus at any time.
N. Every minor patient shall have the right to be
visited and examined at his own expense by a physician designated by him,
a member of his family, or an interested party. The physician may consult
and confer with the medical staff of the treatment facility and have the
benefit of all information contained in the patient’s medical record.
O. Prefrontal 1obotomy shall be prohibited as a
treatment solely for medical or emotional illness of a minor patient.
P. No medication shall be administered to a minor
patient unless a written order of a physician prescribes it in writing.
The physician is responsible for all medications which he has ordered and
which are administered to a minor patient. The medication prescribed shall
be noted in the minor patient’s records. At least monthly, the attending
physician shall review the drug regimen of each minor patient under his
care. All prescriptions shall be written with a termination date, which
shall not exceed thirty days. The minor’s records shall state the effects
of psychoactive medication on him. Unnecessary or excessive medication
shall not be administered to any minor patient. Medication shall not be
used as punishment, for the convenience of staff, as a substitute for a
treatment program, or in quantities that interfere with the minor’s
treatment program. No medication shall be administered except by persons
who have been appropriately trained.
Q. A minor patient admitted to a treatment
facility has the right to an individualized treatment plan and periodic
review to determine his progress. The appropriate staff of the facility
shall review the minor’s progress at least at intervals of thirty, ninety,
one hundred eighty days, and every one hundred eighty days thereafter. The
staff shall enter into the minor’s medical record his response to medical
treatment, his current mental status, and specific reasons why continued
treatment is necessary in the current setting or whether a treatment
facility is available which is medically suitable and less restrictive of
the minor patient’s liberty.
R. A minor patient admitted to a treatment
facility has the right to have available such treatment as is medically
appropriate to his condition. Should the treatment facility be unable to
provide an active and appropriate medical treatment program, the minor
shall be discharged.
S. Each minor patient shall have the right to
receive prompt and adequate medical treatment for any physical ailments
and for the prevention of any illness or disability. Such medical
treatment shall meet the standards of medical practice in the community.
T. The institution shall prohibit the
mistreatment, neglect, or abuse of any minor child in any way.
Art. 1410. Violation of rights; reports; reports of
abuse or neglect
A. Alleged violations of the rights established by
Article 1409 shall be reported immediately to the superintendent and there
shall be a written record that:
(1) Each alleged violation has been
thoroughly investigated and findings stated.
(2) The results of such investigation were
reported to the superintendent within twenty-four hours of the report of
the incident.
B. Abuse or neglect of any child shall be reported
to a child protection agency in accordance with Chapter 5 of Title VI.
Art. 1411. Right to hearing
A minor or his attorney shall have the right to
demand a hearing to determine whether the minor should receive treatment
on an inpatient basis, be discharged from the treatment facility, or
placed in a less restrictive setting.
Art. 1412. Petition; venue
A. The petition shall be filed in the court of the
jurisdiction in which the patient is
confined or, if the minor is currently under a disposition by a juvenile
court, the hearing shall be held in that juvenile court.
B. The hearing shall be held in that court and no
other except for good cause shown.
C. The judge of the court where the petition was
filed may hold the hearing at the treatment facility where the minor is
confined, if in the opinion of the director of the treatment facility it
will be detrimental to the patient’s health, welfare, or dignity to travel
to the court where the petition was filed.
Art. 1413. Time for hearing
The hearing shall be held within ten days of the
filing of the petition.
Art. 1414. Order of hearing
A. Witnesses and evidence tending to show that the
child needs to be in a treatment facility shall be presented first.
B. Counsel for the child shall have the
opportunity to present evidence and to cross-examine witnesses.
Art. 1415. Burden of proof; order
If the court finds by clear and convincing
evidence that the minor has a mental illness or suffers from substance
abuse of such severity that hospitalization is necessary and that he can
benefit from inpatient treatment, it shall order his continued confinement
in a designated treatment facility which is medically suitable and least
restrictive of his liberty.
Art. 1416. Facility records; confidentiality;
disclosure; destruction
A. Complete records for each minor shall be
maintained and all information contained in a minor patient’s records
shall be considered privileged and confidential and shall not be disclosed
except as provided herein.
B. A minor patient’s record shall be readily
available to both the qualified professionals and the residential care
workers who are directly involved with the minor.
C. The parent or tutor of the minor shall be
permitted access to his records. These records shall include:
(1) Identification data, including the
minor’s legal status.
(2) The minor’s history, including but not
limited to:
(a) Family data, educational
background, and employment record.
(b) Prior medical history, both
physical and mental, including prior institutionalization.
(3) The minor patient’s grievances if any.
(4) An inventory of the minor’s life
skills.
(5) A record of each physical examination
describing the results of the examination.
(6) A copy of the minor’s individual plan
and any modifications thereto and an appropriate Summary to guide and
assist resident care workers in implementing the minor’s program.
(7) The findings made in periodic reviews
of the plan, including an analysis of the successes and failures of the
minor patient’s program and recommendations for any modifications deemed
necessary.
(8) A copy of the post-institutionalization
plan and any modification there-
to, and a summary of the steps that have been taken to
implement that plan.
(9) History and present status with
respect to medication.
(10) A summary of each significant contact
with the minor by a qualified professional.
(11) A summary of the minor patient’s
response to his program, prepared by a qualified professional involved in
his treatment and recorded at least monthly. Such response wherever
possible, shall be scientifically documented.
(12) A signed order by a qualified
professional for any physical restraints or seclusion, and documentation
of the clinical justification for the use of restraints, seclusion, and
placement as required by Articles 1409(D) and (E).
(13) A description of any extraordinary
incident or accident in the institution involving the minor, to be entered
by a staff member noting personal knowledge of the incident or accident or
other source of information, including any reports of investigations of
mistreatment of the child, as required by Article 1410.
(14) A summary of family visits and
contacts.
(15) A summary of attendance and leaves
from the institution.
(16) A record of any seizures, illnesses,
treatments thereof, and immunizations.
D. Any attorney representing a mentally ill minor
or a respondent as defined herein shall have ready access to view and copy
all mental health and developmental disability records pertaining to his
client unless the client objects. The attorney shall return all copies of
his client’s medical record to the treatment facility upon completion of
their use. If the patient or respondent later retains a private attorney
to represent him, the MHAS shall destroy all copies of records pertaining
to his case.
E. Any respondent or mentally disabled minor shall
have the right to demand that the records in the possession of his
attorney regarding his mental condition be destroyed or returned to the
treatment facility and he shall have the right to assurance by the
director that such records have been so destroyed by the MHAS attorney.
Art. 1417. Court records
A. Each court shall keep a record of the cases
relating to mentally ill minors coming before it under this Title and the
disposition of them. It shall also keep on file the original petition and
certificates of physicians required by this Chapter, or a microfilm
duplicate of such records.
B. All records maintained in the courts under the
provisions of this Article shall be sealed and available only to the
respondent or his attorney unless the court, after a hearing held with
notice to the respondent, determines such, records should be disclosed to
a petitioner for cause shown.
Art. 1418. Physician’s standard of care
Any licensed physician who acts pursuant to the
provisions of this Title, including execution of an emergency certificate,
shall be held to that degree of skill and care ordinarily employed under
similar circumstances by members of his profession in good standing in the
same community or locality and using reasonable care and diligence with
his best judgment in the application of his skill.
Art. 1419. Immunity
A. Any licensed physician exercising that degree
of skill and care ordinarily employed under similar circumstances by
members of his profession in good standing in the same community or
locality and using reasonable care and diligence with his best judgment in
the application of his skill, shall not be held civilly liable or subject
to criminal prosecution for acts arising from his medical opinions,
judgments, actions, or duties pursuant to any of the provisions of this
Title.
B. Any person who acts in good faith to assist in
the apprehension or taking into protective custody and examination of a
minor patient will not be subject to civil or criminal penalties. However,
a person who willfully advises or participates in the making of a false
application or certificate shall be imprisoned with or without hard labor
for not more than two years or fined not more than ten thousand dollars,
or both.
C. Any apprehension or taking into protective
custody and confinement made by law enforcement officers, ordered by a
court or upon the certificate of a physician under the procedures provided
in this Title, is hereby declared to be an administrative act relative to
the functions of their office, as required by law, and for which act they
are specifically granted personal immunity, but not thereby relieved of
their official responsibilities.
Art. 1420. Admission by emergency certificate;
extension
A. A mentally ill minor or a minor suffering from
substance abuse may be admitted and detained at a treatment facility for
observation, diagnosis, and treatment for a period not to exceed fifteen
days under an emergency certificate.
B. A minor suffering from substance abuse may be
detained at a treatment facility for one additional period, not to exceed
fifteen days, provided that a second emergency certificate is executed. A
second certificate may be executed only if and when a physician at the
treatment facility and any other physician have examined the detained
minor within seventy-two hours prior to the termination of the initial
fifteen-day period and certified in writing on the second certificate that
the minor remains dangerous to himself or others or gravely disabled, and
that his condition is likely to improve during the extended period. The
director shall inform the minor patient of the execution of the second
certificate, the length of the extended period, and the specific reasons
therefor, and shall also give notice of the same to the minor’s nearest
relative or other designated responsible party initially notified pursuant
to Article 1428.
Art. 1421. Examination required
Any physician may execute an emergency certificate
only after an actual examination of a minor alleged to be mentally ill or
suffering from substance abuse who is determined to be in need of
immediate medical treatment in a treatment facility because the examining
physician determines him to be dangerous to himself or others or to be
gravely disabled. Failure to conduct an examination prior to the execution
of the certificate will be evidence of gross negligence.
Art. 1422. Certificate; contents
A. The emergency certificate shall state all of
the following:
(1) The date of the physician’s examination
of the minor, which shall not be more than seventy-two hours prior to the
date of the signature of the certificate.
(2) The objective findings of the physician
relative to the physical and mental condition of the minor, leading to the
conclusion that he is dangerous to him-
self or others or is gravely disabled as a result of
substance abuse or mental illness.
(3) The history of the case, if known.
(4) The determination of whether the minor
examined is in need of immedi-
ate psychiatric treatment in a treatment facility because
he is either:
(a) Dangerous to himself.
(b) Dangerous to others.
(c) Gravely disabled.
(5) A statement that the minor is unwilling
or unable to seek voluntary admission.
B. The certificate shall be dated and executed
under the penalty of perjury, but need not be notarized. The certificate
shall be valid for seventy-two hours and shall be delivered to the
director of the treatment facility where the person is to be further
evaluated and treated.
Art. 1423. Coroner; notice; independent examination;
discharge
A. Upon admission of any minor by emergency
certificate to a treatment facility, it shall be the duty of the director
of the treatment facility immediately to notify the coroner of the parish
in which the treatment facility is located of the admission, giving the
following information if known:
(1) The minor’s name, address, date of
birth.
(2) Name of certifying physician.
(3) Date and time of admission.
(4) The name and address of the treatment
facility.
B. Within seventy-two hours of admission, the
minor patient shall be independently examined by the coroner or his deputy
who shall execute an emergency certificate pursuant to Article 1422, which
shall be a necessary precondition to the person’s continued confinement.
C. However, in the event that the coroner has made
the initial examination and executed the first emergency commitment
certificate, then a second examination shall be
made within the seventy-two hour period set forth in this Article by any
physician at the treatment facility where the minor patient is confined.
D. If from his examination the coroner concludes
that the minor is not a proper subject for emergency admission, then the
minor shall not be further detained in the treatment facility and shall be
discharged by the director forthwith.
Art. 1424. Coroner; fees; records
A. in making either the initial examination or the
second examination, when the coroner or his deputy examines the patient
and executes an emergency certificate and a reexamination of the minor and
reexecution of a certificate is necessary for any reason to insure the
validity of the certificate, both the first examiner and the reexaminer
shall be entitled to a fee for the service, unless they are one and the
same.
B. When a minor patient is confined in a treatment
facility other than a state mental institution, the examining coroner in
the parish where the minor is confined shall be entitled to the usual fee
paid for this service to the coroner of the parish in which the patient is
domiciled or residing.
C. When a minor patient is confined in a state
mental institution in a parish other than his parish of domicile or
residence, the examining coroner shall be entitled to the fee authorized
by law in his parish for the service.
D. In either case, the fee shall be paid and
accurate records of such payments kept by the governing authority of the
parish in which the minor patient is domiciled or residing from parish
funds designated for the purpose of payment to the coroner.
E. All coroners shall keep accurate records
showing the number of patients confined in their parishes pursuant to this
Article.
Art. 1425. Request for MHAS representation
Upon admission by emergency certificate, a patient
may request the director of the treatment facility to advise the executive
director of MHAS of his admission and may request representation.
Art. 1426. Right to hearing
A. Prior to or during confinement under the
provisions of this Title, any minor or his attorney shall have the right
to demand a judicial hearing to determine if
probable cause exists for his continued confinement under
an emergency certificate.
B. The hearing shall be held within five days of
the filing of the petition.
C. Pending the decision of the court, the minor
patient shall remain confined unless the court orders release or a less
restrictive status.
Art. 1427. Authority to transport and detain
A. An emergency certificate shall constitute legal
authority to transport a patient to a treatment facility and shall permit
the director of such treatment facility to detain the minor patient for
diagnosis and treatment for a period not to exceed fifteen days, and to
return him to the facility if he is absent with or without permission
during authorized periods of detention.
B. If necessary, peace officers shall apprehend
and transport, or ambulance services, under appropriate circumstances, may
locate and transport a minor patient on whom an emergency certificate has
been completed to a treatment facility at the request of either the
director of the facility, the certifying physician, the minor’s next of
kin or tutor, or the agency legally responsible for his welfare.
Art. 1428. Notice of admission
The director of the treatment facility shall
notify the minor patient’s nearest relative, if known, or designated
responsible party, if any, in writing of the minor’s admission by
emergency certificate as soon as reasonably possible.
Art. 1429. Application for judicial commitment
A. If the minor patient admitted to a treatment
facility pursuant to this Chapter is a proper candidate for judicial
commitment pursuant to Chapter 9 of this Title, the director of the
treatment facility, or any interested party, may apply for such commitment
under provisions of Chapter 9 of this Title.
B. Such a minor patient, hospitalized on an
emergency certificate, for whom a patient for judicial commitment has been
filed in court may continue to be detained for a further period on order
of the court.
Art. 1430. Advice of rights
A. Every minor patient admitted by emergency
certificate shall be informed in writing at the time of his admission of
the procedures of requesting release from the treatment facility, the
availability of counsel, information about MHAS, the rights enumerated in
Chapter 3 of this Title, and the rules and regulations applicable to or
concerning his conduct while a patient is in the treatment facility.
B. If the minor is illiterate or does not read or
understand English, appropriate provisions should be made to supply him
this information.
C. In addition, a copy of the information
mentioned in this Article must be posted in any area where patients are
confined and treated.
Art. 1431. Coroner’s examination; emergency certificate
A. Upon the request of a credible adult who is
financially unable to afford a private physician or who cannot immediately
obtain an examination by a physician, the parish coroner may render, or
the coroner or a judge of a court of competent jurisdiction may cause to
be rendered by a physician, an actual examination of a minor alleged to be
mentally ill or suffering from substance abuse and in need of immediate
medical treatment because he is dangerous to self or others or gravely
disabled. If the coroner is not a physician he may deputize a physician to
perform this examination.
B. Failure to render an actual examination prior
to execution of the emergency
certificate shall be evidence of gross negligence.
C. To accomplish the examination authorized by
this Article, if the coroner or the judge is apprehensive that his own
safety or that of the deputy or other physician may be endangered thereby,
he shall issue a protective custody order pursuant to Chapter 8 of this
Title.
D. If the examining physician determines that the
provisions of this Article are met, he shall execute an emergency
certificate and shall transport or cause to be transported the minor named
in the emergency certificate to a treatment facility.
Art. 1432. Order for custody; grounds
A. Any parish coroner or judge of a court of
competent jurisdiction may order a minor to be taken into protective
custody and transported to a treatment facility or the office of the
coroner for immediate examination when a peace officer or other credible
person executes a statement under private signature specifying that, to
the best of his knowledge and belief, the minor is mentally ill or
suffering from substance abuse and is in need of immediate treatment to
protect the minor patient or others from physical harm. The statement may
include the following information:
(1) A statement of facts, including the
affiant’s observations leading to the conclusion that the minor is
mentally ill or suffering from substance abuse and dangerous to himself or
others or gravely disabled.
(2) The date and place of any dangerous
acts or threats.
(3) The name and surname, if known, of any
other person who is in danger.
(4) Facts showing that the minor sought has
been encouraged to seek treatment and is unwilling to be evaluated on a
voluntary basis.
(5) Facts showing that the affiant has
attempted to contact a specific treatment facility or a specific physician
in order to obtain an examination of the minor sought to be treated.
B. The order for custody shall be in writing, in
the name of the state of Louisiana, signed by the judge or parish coroner,
and shall state all of the following:
(1) The date and hour of issuance and the
municipality or parish where issued. (2) The name
of the minor to be taken into custody or, if his name is not known, a
designation of the minor by any name or description by which he can be
identified with reasonable certainty.
(3) A description of the acts or threats
which have led to the belief that the minor is mentally ill or suffering
from substance abuse and is in need of immediate hospitalization to
protect the person or others from physical harm.
(4) That the minor shall be taken to a
community mental health center, a public or private general hospital, a
public or private mental hospital, coroner’s office, or a detoxification
center.
C. The order for custody shall be effective for
seventy-two hours from its issuance and shall be delivered to the coroner
or director of the treatment facility by the individual who has
transported the minor. The date and hour that the minor is taken into
protective custody shall be written on the order. Without delay, and in no
event more than twelve hours after being taken into protective custody,
the minor shall be delivered to a treatment facility or the office of the
coroner or he shall be released. Upon arrival, the minor in custody shall
be examined immediately by the coroner or, if at a treatment facility, by
a physician, preferably a psychiatrist, who shall determine if the minor
shall be voluntarily admitted, admitted by emergency certificate, admitted
as a noncontested admission, or discharged. The minor in custody shall be
examined within eight hours of his arrival at the treatment facility or
coroner’s office or he shall be released.
Art. 1433. Protective custody without court order
A. A peace officer or a peace officer accompanied
by an emergency medical service trained technician may take a minor into
protective custody and transport him to a treatment facility for a medical
evaluation when, as a result of his personal observation, the peace
officer or emergency medical service technician has reasonable grounds to
believe the minor is a proper subject for involuntary admission to a
treatment facility because he is acting in a manner dangerous to himself
or dangerous to others, is gravely disabled, and is in need of immediate
hospitalization to protect the minor or others from physical harm.
B. The minor may only be transported to one of the
following:
(1) A community mental health center.
(2) A public or private general hospital.
(3) A public or private mental hospital.
(4) A detoxification center.
(5) A substance abuse clinic.
(6) A substance abuse inpatient facility.
C. Upon arrival at the treatment facility, the
escorting peace officer shall then be relieved of any further
responsibility and the minor shall be immediately examined by a physician,
preferably a psychiatrist, who shall determine if the minor shall be
voluntarily admitted, admitted by emergency certificate, or discharged.
D. In the case of a minor suffering from substance
abuse and where any of the facilities stated in Paragraph B of this
Article are unavailable, the peace officer and emergency medical service
technician may use whatever means or facilities available to protect the
health and safety of the minor suffering from substance abuse until such
time as any of the above facilities become available. In taking a minor
into protective custody, the peace office and emergency medical service
technician may take reasonable steps to protect themselves. A peace
officer or emergency medical service technician who acts in compliance
with this Article is acting in the course of his official duty and cannot
be subjected to criminal or civil liability as a result thereof.
E. Under the provisions of this Article no minor
shall be placed in protective custody for a period in excess of
seventy-two hours. Any minor placed in protective custody under the
provisions of this Article shall be considered as an inmate for
maintenance purposes only.
Art. 1434. Judicial commitment; petition
A. Any adult may file with the court a petition
which asserts his belief that a minor is suffering from mental illness
which contributes or causes him to be a danger to himself or others or to
be gravely disabled, or is suffering from substance abuse which contributes
or causes the minor to be a danger to himself or others or to be gravely
disabled, and may thereby request a hearing.
B. The petition shall contain the facts which are
the basis of the assertion and provide the minor respondent with adequate
notice and knowledge relative to the nature of the proceedings.
C. A petitioner who is unable to afford an
attorney may seek the assistance of any legal aid society or similar
agency if available.
Art. 1435. Filing; venue
A. The petition may be filed in the judicial
district in which the minor respondent is confined or, if not confined, in
the judicial district where he resides or may be found.
B. Before the hearing, the minor respondent may
move for a change of venue to the parish of his domicile, which motion
shall be granted only for compelling reasons. If the minor respondent is
confined to a hospital, the judge of the court where the petition was
filed may hold the hearing on such commitment at the treatment facility
where his is confined, if in the opinion of at least one of the physicians
appointed by the court to examine him, it will be detrimental to the
minor’s health, welfare, or dignity to travel to the court where the
petition was filed.
Art. 1436. Hearing; notice
A. Upon the filing of the petition, the court
shall assign a time, not later than eighteen calendar days thereafter,
shall assign a place for a hearing upon the petition, and shall cause
reasonable notice thereof to be given to the minor, his attorney, and the
petitioner.
B. The notice shall inform the minor respondent
that he has a right to be present at the hearing, that he has a right to
counsel, that he, if indigent or otherwise qualified has the right to have
counsel appointed to represent him by the MHAS, and that he has the right
to cross examine witnesses testifying at any hearing on such application.
Art. 1437. Probable cause; order for examination
A. As soon as practical after the filing of the
petition, the court shall review the petition and supporting documents and
determine whether there exists probable cause to believe that the minor
respondent is suffering from mental illness which contributes or causes
him to be a danger to himself or others, or to be gravely disabled, or is
suffering from substance abuse which contributes or causes him to be a
danger to himself or others or to be gravely disabled.
B. If the court determines that probable cause
exists, the court may appoint the minor respondent’s treating physician if
available or, if none, then another physician, preferably a psychiatrist,
to examine the minor and make a written report to the court and
respondent’s attorney on the form provided by the office of human services
of the Department of Health and Hospitals.
Art. 1438. Report of examination
A. Any report ordered pursuant to Article 1437
shall set forth specifically the objective factors leading to the
conclusion that the minor has a mental illness or suffers from substance
abuse, the actions or statements by the person leading to the conclusion
that the mental illness or substance abuse causes the minor to be
dangerous to himself or others or to be gravely disabled and in need of
immediate treatment as a result of such illness or abuse, and why
involuntary confinement and treatment are indicated.
B. The following criteria should be considered by
the physician:
(1) The minor is suffering from serious
mental illness which contributes or causes him to be dangerous to himself
or others or to be gravely disabled or from substance abuse which
contributes or causes him to be dangerous to himself or others or to be
gravely disabled.
(2) The minor’s condition is likely to
deteriorate needlessly unless he is provided appropriate medical
treatment.
(3) The minor’s condition is likely to
improve if he is provided appropriate medical treatment.
Art. 1439. Independent examination
A. The minor respondent or his attorney shall have
the right to seek an additional independent medical opinion, when
necessary, in their discretion.
B. If the respondent is indigent, this opinion may
be paid for by the MHAS, upon the approval of its executive director.
C. Reasonable compensation of the appointed
examining physicians and all court costs shall be established by the court
and ordered paid by the minor respondent or the petitioner in the
discretion of the court. If it is determined by the court that the costs
shall not be borne by the minor respondent or the petitioner, then
compensation to the physicians and all court costs shall be paid from
funds appropriated to the judiciary, but such court costs shall not exceed
the sum of seventy-five dollars.
Art. 1440. Order for custody and detention
A. If the minor respondent refuses to be examined
by the court appointed physician as herein provided or if the judge, after
reviewing the petition and an affidavit filed pursuant to Article 1432,
the report of the treating physician, or the court-appointed physician,
finds that the minor is mentally ill or suffering from substance abuse and
is in need of immediate hospitalization to protect himself or others from
physical harm, or that the minor respondent’s condition may be markedly
worsened by delay, then the court may issue a court order for custody of
the minor and a peace officer shall deliver him to a treatment facility
designated by the court.
B. The court shall also issue an order to the
treatment facility authorizing detention of the minor until the commitment
hearing is completed, unless he is discharged by the director.
Art. 1441. Placement pending hearing
A. Unless the minor is currently hospitalized or
under an emergency certificate, he shall be allowed to remain in his home
or other place of residence pending an ordered examination and to return
to his home or other place of residence upon completion of the
examination.
B. An examining physician may execute an emergency
certificate pursuant to Article 1422 if he deems that action appropriate.
In such a case, the respondent shall be admitted pursuant to Article 1420
pending the hearing on the petition.
Art. 1442. Right to counsel
A. The court shall provide the minor respondent a
reasonable opportunity to select his own counsel. In the event he does not
select counsel and is unable to pay for counsel or in the event counsel
selected by him refuses to represent said minor or is not available for
such representation, then the court shall appoint counsel for him provided
by the MHAS.
B. Reasonable compensation of appointed counsel
shall be established by the court and may be ordered paid by the minor
respondent or petitioner in the discretion of the court if either is found
financially capable. If it is determined by the court that the costs
shall not be borne by the respondent or the petitioner, then compensation
to the attorney shall be paid from funds appropriated to the judiciary.
C. The minor respondent shall have the right to
privately retained and paid counsel at any time. However, all minor
respondents must be represented by counsel as early as possible in every
proceeding. If attorneys are available through the MHAS, the court shall
contact the MHAS and request the assignment of an attorney who will be
appointed.
D. In cases where the service is unable to provide
representation, the court shall select and appoint an attorney to
represent the minor respondent, whose fee shall be set by the court.
E. An attorney appointed by a court to represent a
minor respondent pursuant to this Chapter has a continuing duty toward
that minor even after admission. That duty shall include but not be
limited to follow-up investigation of the circumstances of the person and
representation in subsequent proceedings relating to admission, status,
and discharge. The duty shall continue until it is terminated by the court
making the appointment.
Art. 1443. Hearing; priority
On the day appointed, the hearing shall take
precedence over all other matters, except pending cases of the same type.
Art. 1444. Nature of hearing; evidence
The court shall conduct the hearing in as formal a
manner as is possible under the circumstances and shall admit evidence
according to the usual rules of evidence.
Art. 1445. Order of hearing
A. Witnesses and evidence tending to show that the
minor who is the subject of the petition is a proper subject-for judicial
commitment shall be presented first.
B. The minor respondent or his counsel shall have
the right to present evidence and cross-examine witnesses who may testify
at the hearing.
C. If the minor respondent or his attorney
notified the court not less than three days before the hearing that he
wishes to cross-examine the examining physicians, the court shall order
such physicians to appear in person or by deposition.
D. If the minor respondent is present at the
hearing and is medicated, the court shall be informed of the medication
and its common effects.
Art. 1446. Record; transcription
A. The court shall cause a recording of the
testimony of the hearing to be made, which shall be transcribed only in
the event of an appeal from the judgment.
B. A copy of such transcript shall be furnished
without charge, to any appellant whom the court finds unable to pay for
the same.
C. The cost of such transcript shall be paid from
funds appropriated to the judicial department.
Art. 1447. Burden of proof; order
A. If the court finds by clear and convincing
evidence that the minor respondent is dangerous to himself or others or is
gravely disabled as a result of substance abuse or mental illness, it
shall render a judgment for his commitment to a designated treatment
facility which is medically suitable and least restrictive of his liberty.
B. The court order shall order a suitable person
to convey the minor to the treatment facility and deliver respondent,
together with a copy of the judgment and certificates, to the director.
C. In appointing a person to execute the order,
the court should give preference to a near relative or friend of the
minor.
Art. 1448. Discharge; revocation
A. The director shall notify the court in writing
when a minor patient has been discharged or conditionally discharged.
B. The court may, if it finds it to be in the best
interests of the minor, revoke the certificate or judgment of commitment.
Art. 1449. Notice of court action
Notice of any action taken by the court shall be
given to the minor respondent and his attorney as well as to the director
of the designated treatment facility in such manner as the court concludes
would be appropriate under the circumstances.
Art. 1450. Advisement of rights
A. Every minor patient admitted by judicial
commitment shall be informed in writing at the time of his admission of
the procedures for requesting release from the treatment facility, the
availability of counsel, information about the MHAS, the rights enumerated
in Article 1409, and the rules and regulations applicable to or concerning
his conduct while a patient in the treatment facility.
B. If the minor patient is illiterate or does not
read or understand English, appropriate provisions should be made to
supply him this information.
C. In addition, a copy of the information listed
in this Article must be posted in any area where patients are confined and
treated.
Art. 1451. Conversion to voluntary status
A. No director of a treatment facility shall
prohibit any mentally ill minor or minor suffering from substance abuse
from applying for conversion of involuntary or emergency admission status
to voluntary admission status.
B. Any minor patient on an involuntary admission
status shall have the right to apply for a writ of habeas corpus to have
his admission status changed to voluntary status.
Art. 1452. Mandatory review of commitments
A. All judicial commitments, except those for
alcoholism, shall be reviewed by the court issuing the order for
commitment after the first sixty and after one hundred twenty days of
commitment and every one hundred eighty days thereafter.
B. A commitment for alcoholism shall expire after
forty-five days and the minor patient, if not converted to a voluntary
status, shall be discharged, unless the court, upon application by the
director of the treatment facility, finds that continued involuntary
treatment is necessary and orders the minor patient recommitted for a
period not to exceed sixty days; provided, that not more than two such
sixty day recommitments may be ordered in connection with the same
continuous confinement.
C. All judicial commitments involving a minor
patient who has been found not guilty by reason of insanity or who has
been found to lack the capacity to proceed, shall be reviewed in the
manner as set forth in Title VIII.
Art. 1453. Reports to court
A. The director of the treatment facility to which
the minor has been judicially committed shall issue reports to the court
at the intervals provided in Article 1452, setting forth the minor
patient’s response to the treatment, his current condition, and the
reasons why continued involuntary treatment is necessary to improve his
condition or to prevent it from deteriorating.
B. These reports shall be treated by the court as
confidential and shall not be available for public examination, nor shall
they be subject to discovery in any proceedings other than those initiated
pursuant to this Title.
Art. 1454. Hearing to determine continued involuntary
commitment
A. The court may at any time upon application or
upon its own motion order a new hearing to be held in order to determine
whether the involuntary status of the minor patient should be continued.
B. Minor patients committed judicially shall have
their cases reviewed in a hearing semiannually.
C. The semiannually hearing shall be conducted
according to the procedures and standards set forth in this Chapter and
may be held by the juvenile court in the parish in which the minor patient
is being confined or, if not confined, by the juvenile court in the parish
in which he resides or may be found. The hearing shall not be transferred
to another district except for good cause shown.
Art. 1455. Discretion of director
A. Notwithstanding an order of judicial
commitment, the director of the treatment facility to which the minor
patient is committed is encouraged to explore treatment measures that are
medically appropriate and less restrictive.
B. The director may at any time convert an
involuntary commitment to a voluntary one should he deem that action
medically appropriate. He shall inform the court of any action in that
regard.
C. The director may discharge any minor patient if
in his opinion discharge is appropriate. The director shall not be legally
responsible to any person for the subsequent acts of behavior of a patient
discharged in good faith.
Art. 1456. Appeal; writs
A. A minor who is judicially committed shall be
allowed to appeal devolutively from the order to the court of appeal. If
the lower court finds the minor indigent, it shall allow the appeal to be
taken in forma pauperis.
B. Upon perfection of an appeal, it shall be heard
in a summary manner, taking preference over all other cases except similar
matters.
C. Upon affirmation of the order of commitment,
the minor may apply for appropriate writs from the supreme court which
shall be heard in a summary manner.
Art. 1457. Right of habeas corpus
Nothing in this Title shall deny the right of
habeas corpus, including an application based upon a change of
circumstances.
Art. 1458. Conditional discharge
A. A minor who is judicially committed may be
conditionally discharged for a period of up to one year by the director or
by the court during which time the judicial commitment of the minor shall
remain in effect. The minor patient may be required to report for
outpatient treatment as a condition of his release. The terms and
conditions of the
conditional discharge shall be specifically set forth in writing and
signed by the minor patient. A copy of the conditional discharge shall be
given to him and explained to him before he is discharged.
B. If the minor patient is conditionally
discharged by the director, a copy of the conditional discharge shall be
sent to the court which judicially committed him. If the minor patient is
conditionally discharged by the court, a copy of the conditional discharge
shall be sent to the facility to which he has been committed.
C. If a minor patient does not comply with the
terms and conditions of his conditional discharge, he is subject to any of
the procedures for involuntary treatment, including but not limited to the
issuance of an order for custody and the execution of an emergency
certificate. A conditionally discharged minor patient who is confined
pursuant to any of these involuntary procedures shall have all rights of
an involuntary patient, including the right to demand a probable cause
hearing, the right to periodic reports and review, and a semiannual
hearing pursuant to Article 2454.
D. An extension of a conditional discharge may be
granted upon application by the director of the treatment facility to the
court and notification to the minor’s counsel of record. The court may
grant the extension of the conditional discharge for a period of up to two
years. No further extension may be made without a constradictory hearing.
The burden of proof is on the director of the treatment facility to show
why continued treatment is necessary.
Art. 1459. Review by MHAS
All minor patients presently unrepresented by
privately retained counsel and who are the subject of involuntary
commitment under any prior statute shall have their cases reviewed by
attorneys provided by the MHAS within one year from the effective date of
this Code, or be discharged or be committed again according to the
provisions of this Chapter.
Art. 1460. Parental admission of minor
A. Any minor may be admitted to a treatment
facility for inpatient care and treatment upon application of a parent,
tutor, or, in the absence of a parent or tutor, of a caretaker to the
director of a treatment facility if the director finds that the minor has
a mental illness which has a substantial adverse effect on his ability to
function and requires care and treatment in an institution. Within
twenty-four hours of admission, the minor shall be examined by a physician
who shall set forth in detail in the patient’s medical record the reasons
for the continued need of confinement and treatment of the minor. The
parent, tutor, or caretaker may request the minor’s discharge pursuant to
the provisions of Article 1462(C).
B. A minor who is eligible for admission pursuant
to Paragraph A of this Article and who is in such a condition that
immediate hospitalization is necessary may be admitted upon the
application of any interested adult, when after diligent effort the
minor’s parent, tutor, or caretaker cannot be located. Following the
admission of the minor, the director of the treatment facility shall
continue efforts to locate the minor’s parent, tutor, or caretaker. If
such person is located and consents in writing to the admission, the minor
may be continued to be hospitalized. However, upon notification of the
admission, the parent, tutor, or caretaker may request the minor’s
discharge pursuant to the provisions of Article 1462(C).
Art. 1461. Advice of rights
A. On admission to a treatment facility, the minor
shall be informed in writing of the procedures for requesting release and
of the availability of counsel, information about the MHAS, the rights
enumerated in Article 1409, and the rules and regulations applicable to or
concerning his conduct while a patient in the program or facility.
B. This information shall also be posted in a
prominent place.
Art. 1462. Objection to admission by the minor who has
been admitted
A. Objection may be made by the minor who has been
admitted if the minor is sixteen years of age or older.
B. If the minor informs any staff person of his
desire to object to the admission, a staff person shall assist him in
preparing and submitting his objection.
C. Upon receipt of an objection, the director of
the treatment facility shall release such minor within seventy-two hours
unless proceedings are begun pursuant to Chapter 7 or 9 of this Title.
Art. 1463. Physician’s certificate for a minor
A. A minor shall not be detained at a treatment
facility pursuant to parental admission more than seventy-two hours unless
a physician’s certificate for a minor has been executed and delivered to
the MHAS.
B. The certificate may be executed by any licensed
physician after an actual examination.
C. Failure to conduct an actual examination prior
to the execution of the certificate will be evidence of gross negligence.
D. The certificate shall be dated and executed
under penalty of perjury, but need not be notarized. The certificate shall
state:
(1) The date and time of the physician’s
examination of the minor, which
shall not be more than seventy-two hours prior to the
signature of the certificate.
(2) The name and age of the minor, if
known.
(3) The date and time of admission.
(4) The name and address of the parent,
tutor, caretaker, or responsible person admitting the minor.
(5) The objective findings of the physician
relative to the physical and mental condition of the minor leading to the
determination of whether the minor examined is in need of inpatient
psychiatric treatment because he suffers from mental illness or substance
abuse which has a substantial adverse effect on his ability to function
and requires care and treatment in an institution, that he can benefit
from inpatient treatment, and that the treatment facility where the minor
is confined is medically appropriate.
(6) The history of the case, if known.
(7) A statement
as to whether the minor wishes to remain in the treatment facility.
E. The certificate shall be delivered to the MHAS
located nearest to the treatment facility. Delivery may be accomplished
either by:
(1) Personal delivery to any MHAS employee.
(2) Mailing a copy of the certificate to
the nearest MHAS, certified mail, return receipt requested.
F. MHAS shall have the authority to represent the
interests of any minor they suspect has been inappropriately placed or who
had requested their services. Services may be rendered as deemed necessary
including but not limited to the provisions of Article 1405.
Art. 1464. Voluntary admission of minors
A. Any minor sixteen years of age or older may
apply for voluntary admission to a treatment facility pursuant to this
Chapter.
B. A minor so admitted shall have the same rights
as an adult patient.
C. The admitting physician may admit the person on
either a formal or informal basis, as hereinafter provided.
Art. 1465. Voluntary admissions favored
A. Admitting physicians are encouraged to admit
mentally ill minors or minors suffering from substance abuse to treatment
facilities on voluntary admission status whenever medically feasible.
B. No director of a treatment facility shall
prohibit any mentally ill minor or minor suffering from substance abuse
from applying for conversion of involuntary or emergency admission status
to voluntary admission status. Any minor patient on an involuntary
admission status shall have the right to apply for a writ of habeas corpus
in order to have his admission status changed to voluntary status.
C. No employee of a mental health care program or
treatment facility, peace officer, or physician shall state to any person
that involuntary admission may result if the minor does not voluntarily
admit himself to a mental health care program or treatment facility unless
the employee, peace officer, or physician is prepared to execute a
certificate pursuant to Chapter 7 or a petition pursuant to Chapter 9 of
this Title.
Art. 1466. Advisement of rights
A. Each minor admitted on a voluntary basis shall
be informed of any other medically appropriate alternative treatment
programs and treatment facilities known to the admitting physician and be
given an opportunity to seek admission to alternative treatment programs
or facilities.
B. Every minor patient admitted on a voluntary
admission status shall be informed in writing at the time of admission of
the procedures for requesting release from the treatment facility, the
availability of counsel, information about the mental health advocacy
service, the rights enumerated in Article 1409, and rules and regulations
applicable to or concerning his conduct while a patient in the treatment
facility.
C. If the minor is illiterate or does not read or
understand English, appropriate provisions should be made to supply him
this information.
D. In addition, a copy of the information listed
in this Article must be posted in any area where minor patients are
confined and treated.
Art. 1467. Capacity required
A. No admission may be deemed voluntary unless the
admitting physician determines that the minor to be admitted has the
capacity to make a knowing and voluntary consent to the admission.
B. Knowing and voluntary consent shall be
determined by the ability of the minor to understand:
(1) That the treatment facility to which
the minor patient is requesting admission is one for mentally ill persons
or persons suffering from substance abuse.
(2) That he is making an application for
admission.
(3) The nature of his status and the
provisions governing discharge or conversion to an involuntary status.
Art. 1468. Informal voluntary admission
A. In the discretion of the director, any mentally
ill minor or minor suffering from substance abuse, who is sixteen years of
age or older and who desires admission to a treatment facility for
diagnosis or treatment of a psychiatric disorder or substance abuse, may
be admitted upon the minor patient’s request without a formal application.
B. Any minor patient admitted pursuant to this
Article shall have the right to leave the treatment facility at any time
during the normal day-shift hours of operation, which shall include but
not be limited to nine a.m. to five p.m.
Art. 1469. Formal voluntary admission
A. Any mentally ill minor or minor suffering from
substance abuse who is sixteen years old or older and who desires
admission to a treatment facility for diagnosis and/or treatment of a
psychiatric disorder or substanance abuse and who is deemed suitable for
formal voluntary admission by the admitting physician may be so admitted
upon his written request.
B. A minor patient admitted under the provisions
of this Article shall not be detained in the treatment facility for longer
than seventy-two hours after making a valid written request for discharge
to the director of the treatment facility unless an emergency certificate
is executed pursuant to Article 1422 or unless judicial commitment is
instituted pursuant to Chapter 9 of this Title.
Art. 1470. Admission by parent
A. A minor suffering from substance abuse may be
admitted and detained at a public or private general hospital or a
substance abuse inpatient facility for observation,
diagnosis, and treatment for a period not to exceed twenty-eight days,
when a parent has admitted the person or caused him to be admitted
pursuant to the provisions of Chapter 8 of this Title.
B. At the time of admission, the parent shall
execute or provide a written statement of facts, including personal
observations, leading to the conclusion that the minor is suffering from
substance abuse and is dangerous to himself or others or is gravely
disabled, specifically describing any dangerous acts or threats, and
stating that the minor has been encouraged to seek treatment but is
unwilling to be evaluated on a voluntary basis.
C. As soon as practicable, but in no event more
than eight hours after admission to the hospital or inpatient facility, a
physician shall examine the minor and either execute an emergency
certificate in accordance with Article 1422 or order the minor discharged.
If an emergency certificate is executed, the physician or the director of
the hospital or inpatient facility shall immediately notify the coroner
and the coroner or his deputy shall conduct an independent examination in
accordance with Article 1423. If the coroner or his deputy executes a
second emergency certificate, the minor patient may be detained for
treatment for a period not to exceed twenty-eight days from the date of
his admission. Otherwise, he shall be discharged.
D. Except as inconsistent with the provisions of
this Article, all other provisions of the Title applicable to persons
admitted by emergency certificate shall be applicable.
Art. 1471. Transfer of patients between institutions
A. Except as otherwise provided in this Article,
the department may transfer any patient from one mental institution to
another. Moreover, the superintendent of an institution may request the
department to transfer a patient when he believes that a transfer is
necessary.
(1) A patient may be transferred to or from
a private mental institution only upon the joint application of the
superintendent of that institution and of the legal or natural guardian or
the person liable for the support of the minor patient. However, no
private mental institution shall be obligated to retain a minor patient
because of the refusal to sign the application by the guardian or the
person liable for support.
(2) A person under an order of commitment
or acquitted of a delinquent act on the ground of mental illness shall be
transferred only upon authority of the committing court.
(3) A minor patient voluntarily admitted
pursuant to Article 1464 shall be transferred only with his written
consent.
(4) A minor patient admitted by a parental
commitment pursuant to Article 1460 shall be transferred only upon the
written consent of the parent, tutor, or caretaker who originally sought
his admission.
B. The following documents, as applicable, shall
accompany a minor patient upon his transfer.
(1) The transfer order of the department.
(2) Certified copies of the application for
admission, the physician’s certificate, the report of the commission, and
the order of the committing court.
(3) All of the minor patient’s clinical
records or a full abstract thereof, including the results of medical,
physical, and laboratory examinations.