Amendment SSA1-SB391

SB391-SSA1, s. 119 Section 119. 55.06 (14) of the statutes is amended to read:

SB391-SSA1,115,4 55.06 (14) Prior to discharge of an individual from a protective placement, the appropriate board which county department that is responsible for protective placement shall review the need for provision of continuing protective services or for, continuation of full or limited guardianship, or provision for such guardianship, if the individual has no guardian, guardianship. Recommendation shall be made to the court if If the county department's recommendation includes a course of action for which court approval would be required, the county department shall make the recommendation to the court. Prior to discharge of the individual from any state mental health institute or center for the developmentally disabled, the department shall make such the review under s. 51.35.

SB391-SSA1, s. 120 Section 120. 55.06 (17) (b) of the statutes is amended to read:

SB391-SSA1,115,11 55.06 (17) (b) If the subject is an adult who has been adjudged incompetent under ch. 880 or is a minor, consent for release of information from and access to the court records may be given only as provided in s. 51.30 (5) . If the subject is an adult who has been adjudicated incompetent in this state, consent for release of information from and access to court records may be given only as provided in s. 54.75.

SB391-SSA1, s. 121 Section 121. 55.14 of the statutes is created to read:

SB391-SSA1,115,14 55.14 Involuntary administration of psychotropic medication. (1) In this section:

SB391-SSA1,115,16 (a) "Involuntary administration of psychotropic medication" means any of the following:

SB391-SSA1,115,18 1. Placing psychotropic medication in an individual's food or drink with knowledge that the individual protests receipt of the psychotropic medication.

SB391-SSA1,115,20 2. Forcibly restraining an individual to enable administration of psychotropic medication.

SB391-SSA1,115,22 3. Requiring an individual to take psychotropic medication as a condition of receiving privileges or benefits.

SB391-SSA1,116,2 (c) "Protest" means make more than one discernible negative response, other than mere silence, to the offer of, recommendation for, or other proffering of voluntary receipt of psychotropic medication. "Protest" does not mean a discernible negative response to a proposed method of administration of the psychotropic medication.

SB391-SSA1,116,4 (d) "Psychotropic medication" means a prescription drug, as defined in s. 450.01 (20), that is used to treat or manage a psychiatric symptom or challenging behavior.

SB391-SSA1,116,7 (2) Involuntary administration of psychotropic medication, with consent of a guardian, may be ordered as a protective service only under the requirements of this section.

SB391-SSA1,116,10 (3) In addition to the other requirements of this chapter pertaining to petitions for protective services, a petition under this section shall allege that all of the following are true:

SB391-SSA1,116,11 (a) A physician has prescribed psychotropic medication for the individual.

SB391-SSA1,116,12 (b) The individual is not competent to refuse psychotropic medication.

SB391-SSA1,116,13 (c) One of the following is true:

SB391-SSA1,116,20 1. The individual has refused to take the psychotropic medication voluntarily. If this is alleged, the petition shall identify, if known, the reasons the individual refuses to take psychotropic medication voluntarily and shall provide evidence showing that a reasonable number of documented attempts to administer psychotropic medication voluntarily using appropriate interventions that could reasonably be expected to increase the individual's willingness to take psychotropic medication voluntarily have been made and have been unsuccessful.

SB391-SSA1,116,23 2. Attempting to administer psychotropic medications to the individual voluntarily is not feasible or is not in the best interests of the individual. If this is alleged, the petition must identify specific reasons supporting that allegation.

SB391-SSA1,117,3 (d) The individual's condition for which psychotropic medication has been prescribed is likely to be improved by administration of psychotropic medication and the individual is likely to respond positively to psychotropic medication.

SB391-SSA1,117,8 (e) Unless psychotropic medication is administered involuntarily, the individual will incur a substantial probability of physical harm, impairment, injury, or debilitation or will present a substantial probability of physical harm to others. The substantial probability of physical harm, impairment, injury, or debilitation shall be evidenced by one of the following:

SB391-SSA1,117,14 1. The individual's history of at least 2 episodes, one of which has occurred within the previous 24 months, that indicate a pattern of overt activity, attempts, threats to act, or omissions that resulted from the individual's failure to participate in treatment, including psychotropic medication, and that resulted in a finding of probable cause for commitment under s. 51.20 (7), a settlement agreement approved by a court under s. 51.20 (8) (b), or commitment ordered under s. 51.20 (13).

SB391-SSA1,117,16 2. Evidence that the individual meets one of the dangerousness criteria set forth in s. 51.20 (1) (a) 2. a. to e.

SB391-SSA1,117,21 (4) A petition under this section must include a written statement signed by a physician who has personal knowledge of the individual that provides general clinical information regarding the appropriate use of psychotropic medication for the individual's condition and specific data that indicates that the individual's current condition necessitates the use of psychotropic medication.

SB391-SSA1,117,25 (5) The guardian ad litem appointed under s. 55.06 (6) for an individual who is the subject of a petition under this section shall report to the court whether the allegations in the petition required under sub. (3) are true, and whether involuntary administration of psychotropic medication is in the best interests of the individual.

SB391-SSA1,118,8 (6) If requested by an individual who is the subject of a petition under this section or anyone on his or her behalf, the individual has the right at his or her own expense, or if indigent at the expense of the county in which the petition is filed, to secure an independent medical or psychological examination relevant to the issue of whether the allegations in the petition required under sub. (3) are true and whether involuntary administration of psychotropic medication is in the best interest of the individual, and to present a report of this independent evaluation or the evaluator's personal testimony as evidence at the hearing.

SB391-SSA1,118,11 (7) Upon the filing of a petition under this section, the court shall appoint counsel. A petition under this section shall be heard under s. 55.06 within 30 days after it is filed.

SB391-SSA1,118,21 (8) The court may issue an order authorizing an individual's guardian to consent to involuntary administration of psychotropic medication to the individual and may order involuntary administration of psychotropic medication to the individual as a protective service, with the guardian's consent if the court or jury finds by clear and convincing evidence that the allegations in the petition required under sub. (3) are true, all other requirements for involuntary administration of psychotropic medication under this section have been met, psychotropic medication is necessary for treating the condition described in the statement under sub. (4), and all other requirements of this chapter for ordering protective services have been met. An order under this section shall do all of the following:

SB391-SSA1,119,8 (a) Direct the development of a treatment plan for the individual specifying the protective services, including psychotropic medication as ordered by the treating physician, that the individual should receive. If the individual resides in a nursing home or hospital, the nursing home or hospital shall develop the treatment plan. If the individual resides elsewhere, the county department or an agency with which it contracts shall develop the treatment plan. The treatment plan shall include a plan for the involuntary administration of psychotropic medication to the individual. The treatment plan is subject to the approval of the guardian and to review and approval by the court. If the court approves the plan, the court shall order the county department or an agency with which it contracts to ensure that protective services, including psychotropic medication, are administered in accordance with the treatment plan.

SB391-SSA1,119,19 (b) Order the individual to comply with the treatment plan under par. (a). The order shall provide that if the individual fails to comply with provisions of the treatment plan that require the individual to take psychotropic medications, the medications may be administered involuntarily with consent of the guardian. The order shall specify the methods of involuntary administration of psychotropic medication to which the guardian may consent. An order authorizing the forcible restraint of an individual shall specify that a person licensed under s. 441.06, 441.10, or 448.05 (2) or (5) shall be present at all times that psychotropic medication is administered in this manner and shall require the person or facility using forcible restraint to maintain records stating the date of each administration, the medication administered, and the method of forcible restraint utilized.

SB391-SSA1,120,12 (9) If an individual who is subject to an order under this section is not in compliance with the order because he or she refuses to take psychotropic medication as ordered under the treatment plan, and it is necessary for the individual to be transported to an appropriate facility for forcible restraint for administration of psychotropic medication, the corporation counsel shall file with the court a statement of the facts which constitute basis for the noncompliance of the individual. The statement shall be sworn to be true and shall be based upon the information and belief of the person filing the statement. The statement shall be signed by the individual's guardian and by the director or designee of the county department or an agency with which it contracts to develop and administer the treatment plan. Upon receipt of the statement of noncompliance, if the court finds by clear and convincing evidence that the individual has substantially failed to comply with the administration of psychotropic medication as ordered under the treatment plan, the court may issue an order authorizing the sheriff or any other law enforcement agency in the county in which the individual is found or in which it is believed that the individual may be present to take the individual into custody and transport him or her to an appropriate facility for administration of psychotropic medication using forcible restraint, with consent of the guardian.

SB391-SSA1,120,14 (10) Nothing in this section prohibits the involuntary administration of psychotropic medication as an emergency protective service under this chapter.

SB391-SSA1,120,17 (11) The county department or an agency with which it contracts shall provide to the department a copy of any order issued under this section that applies to any protectively placed individual in the county.

SB391-SSA1,120,19 (12) The department shall annually submit to the legislature under s. 13.172 (2) a report regarding orders under this section.

SB391-SSA1,120,20 (13) An order under this section is subject to annual review under s. 55.19.

SB391-SSA1, s. 122 Section 122. 55.19 of the statutes is created to read:

SB391-SSA1,121,2 55.19 Annual review of order authorizing involuntary administration of psychotropic medication. In addition to or in conjunction with the annual review required under s. 55.06 (10), all of the following shall be performed with respect to any individual who is subject to an order under s. 55.14 or an order initially issued under s. 880.33 (4r), 2003 stats., authorizing involuntary administration of psychotropic medication:

SB391-SSA1,121,16 (1) County department performance of review. (a) The county department of the individual's county of residence shall, except as provided in sub. (1m), review, in compliance with the requirements of this section, the status of each individual who is the subject of the order. The review shall include a visit to the individual and a written evaluation of the physical, mental, and social condition of the individual that is relevant to the issue of the continued need for the order. The review shall be made a part of the permanent record of the individual. The county department shall inform the guardian of the individual of the review at the time the review is made and shall invite the individual and the guardian to submit comments or information concerning the individual's need for involuntary administration of psychotropic medication or other protective services before completing a report of the review. Not later than the first day of the 11th month after the initial order is made for an individual, except as provided in par. (b), and at least annually thereafter, the county department shall do all of the following:

SB391-SSA1,121,17 1. File a report of the review with the court that issued the order.

SB391-SSA1,121,19 2. File with the court under subd. 1. a petition for annual review by the court of the order.

SB391-SSA1,121,21 3. Provide the report under subd. 1. to the individual and the guardian of the individual.

SB391-SSA1,122,3 (b) If, in an annual review of an individual's status under par. (a), the individual or the individual's guardian or guardian ad litem requests termination of the order and a full due process hearing is provided, or if a full due process hearing is provided under a petition for modification or termination of the order, the county department is not required to initiate a subsequent review under par. (a) until the first day of the 11th month after the date that the court issues a final order after the full due process hearing.

SB391-SSA1,122,6 (bm) If the individual is subject to a protective placement order, the review under par. (a) shall be conducted simultaneously with any review of the individual's protective placement.

SB391-SSA1,122,10 (c) The review under par. (a) may not be conducted by a person who is an employee of a facility in which the individual resides or from which the individual receives services. The report of the review shall include information on all of the following:

SB391-SSA1,122,12 1. Whether the individual continues to meet the standards for protective services.

SB391-SSA1,122,14 2. Whether the individual is not competent to refuse psychotropic medication, as defined in s. 55.14 (1) (b).

SB391-SSA1,122,18 3. Whether the individual continues to refuse to take psychotropic medication voluntarily or attempting to administer psychotropic medication to the individual voluntarily is not feasible or is not in the best interests of the individual, as specified in s. 55.14 (3) (c).

SB391-SSA1,122,21 4. Whether the individual's condition for which psychotropic medication has been prescribed has been improved by psychotropic medication and the individual has responded positively to psychotropic medication.

SB391-SSA1,122,24 5. If the petitioner alleged under s. 55.14 (3) (e) 2. that the individual meet one of the dangerousness criteria set forth in s. 51.20 (1) (a) 2. a. to e., whether the individual continues to meet the criterion.

SB391-SSA1,123,3 6. The comments of the individual and the individual's guardian during the performance of the review, as summarized by the county department, and the response of the county department to the comments.

SB391-SSA1,123,6 7. The comments, if any, of a staff member at the facility at which the individual is placed or receives services or at which psychotropic medication is administered to the individual that are relevant to the review of the continued need for the order.

SB391-SSA1,123,11 (1m) County agreement. The county of residence of an individual who is subject to an order under s. 55.14 and is protectively placed in a different county may enter into an agreement with that county under which the county of the individual's placement performs all or part of the duties of the county of residence under this section.

SB391-SSA1,123,15 (2) Guardian ad litem appointment and report. After a county department has filed a report with a court under sub. (1) (a) 1., the court shall appoint a guardian ad litem in accordance with s. 757.48 (1). The guardian ad litem shall do all of the following:

SB391-SSA1,123,17 (a) Review the report filed under sub. (1) (a) 1. and any other relevant reports on the individual's condition and continued need for the order under s. 55.14.

SB391-SSA1,123,19 (b) Meet with the individual and contact the individual's guardian and orally explain to the individual and guardian all of the following:

SB391-SSA1,123,21 1. The procedure for review of an order for involuntary administration of psychotropic medication.

SB391-SSA1,123,22 2. The right of the individual to appointment of legal counsel under sub. (3) (c).

SB391-SSA1,123,23 3. That the court may under sub. (3) (b) 1. order performance of an evaluation.

SB391-SSA1,123,24 4. The contents of the report under sub. (1) (a) 1.

SB391-SSA1,124,2 5. That a termination of the order for involuntary administration of psychotropic medication may be ordered by the court.

SB391-SSA1,124,3 6. The right to a full due process hearing under sub. (3) (d).

SB391-SSA1,124,4 (c) Provide the information required under par. (b) to the individual in writing.

SB391-SSA1,124,5 (d) Review the individual's condition and rights with the individual's guardian.

SB391-SSA1,124,7 (e) Ascertain whether the individual wishes to exercise any of his or her rights under sub. (3) (b), (c), or (d).

SB391-SSA1,124,12 (f) Within 30 days after appointment, file with the court a written report based on information obtained under this subsection and any other evaluations or records of the individual. The report shall discuss whether the individual appears to continue to meet the standards for an order under s. 55.14. The report shall also state whether any of the following apply:

SB391-SSA1,124,14 1. An evaluation under sub. (3) (b) is requested by the guardian ad litem, the individual, or the individual's guardian.

SB391-SSA1,124,16 2. The individual or the individual's guardian requests termination of the order under s. 55.14.

SB391-SSA1,124,18 3. The individual or the individual's guardian requests or the guardian ad litem recommends that legal counsel be appointed for the individual.

SB391-SSA1,124,20 4. The individual or his or her guardian or guardian ad litem requests a full due process hearing under this section for the individual.

SB391-SSA1,124,22 (g) Certify to the court that he or she has complied with the requirements of pars. (b), (c), and (d).

SB391-SSA1,124,25 (3) Court review of reports; hearing; order. (a) The court that issued the order under s. 55.14 shall review the report of the guardian ad litem under sub. (2) (f) and the report filed under sub. (1) (a) 1.

SB391-SSA1,125,5 (b) The court shall order performance, by a person who is not an employee of the county department, of an evaluation of the physical, mental, and social condition of the individual that is relevant to the issue of the continued need for the order under s. 55.14 that is independent of the review performed under sub. (1) (a) if any of the following apply:

SB391-SSA1,125,7 1. The report required under sub. (1) (a) 1. is not timely filed, or the court determines that the report fails to meet the requirements of sub. (1) (c).

SB391-SSA1,125,9 2. Following review of the guardian ad litem's report under sub. (2) (f), the court determines that an independent evaluation for the individual is necessary.

SB391-SSA1,125,10 3. The individual or the individual's guardian or guardian ad litem so requests.

SB391-SSA1,125,13 (bm) If an evaluation is ordered under par. (b), it shall be performed at the expense of the individual or, if the individual is indigent, at the expense of the county of residence under sub. (1) (a).

SB391-SSA1,125,15 (br) The court may order that the county department obtain any other necessary information with respect to the individual.

SB391-SSA1,125,18 (c) The court shall order legal counsel for an individual and, if the individual appears to be indigent, refer him or her to the authority for indigency determinations under s. 977.07 (1) if any of the following apply:

SB391-SSA1,125,20 1. Following review of the guardian ad litem's report under sub. (2) (f), the court determines that legal counsel for the individual is necessary.

SB391-SSA1,125,21 2. The individual or the individual's guardian or guardian ad litem so requests.

SB391-SSA1,125,25 (d) The court shall order either a summary hearing or a full due process hearing. A summary hearing may be held in court or may be held by other means including by telephone or video conference. The court shall hold a full due process hearing if any of the following apply:

SB391-SSA1,126,1 1. The individual or the individual's guardian or guardian ad litem so requests.

SB391-SSA1,126,3 2. The report under sub. (2) (f) indicates that the individual no longer meets the standards for an order under s. 55.14 (8).

SB391-SSA1,126,4 3. The report under sub. (2) (f) indicates that the individual objects to the order.

SB391-SSA1,126,5 (e) Following the hearing under par. (d), the court shall do one of the following:

SB391-SSA1,126,10 1. If the court finds that the individual continues to meet the standards for an order under s. 55.14 (8), the court shall order the continuation of the order. The court shall include in the decision the information relied upon as a basis for continuation of the order and shall make findings based on the requirements for allegations of a petition under s. 55.14 (3) in support of the need for continuation of the order.

SB391-SSA1,126,19 2. If the court finds that the individual continues to meet the standards for an order under s. 55.14 (8) but that modification of the order or the treatment plan would be in the best interests of the individual, the court shall modify the order, order modifications to the individual's treatment plan, or both. Any modifications to the treatment plan are subject to the approval of the guardian. The court shall include in the decision the information relied upon as a basis for continuation of the order and shall make findings based on the requirements for allegations of a petition under s. 55.14 (3) in support of the need for authorizing the guardian to consent to involuntary administration of psychotropic medication.

SB391-SSA1,126,25 3. If the court finds that the individual no longer meets the standards for an order under s. 55.14 (8), the court shall terminate the order. If the order is terminated, the court shall review the needs of the individual with respect to other protective services. If the court determines that the individual meets the standards for other protective services under this chapter that are not currently being provided to the individual, the court may order those protective services for the individual.

SB391-SSA1,127,2 (f) The court shall provide a copy of the order made under par. (e) to all of the following: