The county of residence of an individual who is subject to an order authorizing
involuntary administration of psychotropic medication and whose placement is in a
different county may enter into an agreement under which the county of placement
performs all or a part of the county duties specified in the bill.
The county review must include a written evaluation of the physical, mental, and
social condition of the individual that are relevant to the continued need for the order for
involuntary administration of psychotropic medication. The review must be made part
of the individual's permanent record. The county department must inform the
individual's guardian of the review and invite the individual and his or her guardian to
submit comments concerning the individual's need for protective placement or protective
services. In performing the review, the county department or contractual agency staff
member performing the review must visit the individual and must contact the
individual's guardian. The review 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.
By the first day of the 11th month after the initial order is made, and annually
thereafter, the county must do all of the following:
1. File a report of the review with the court that issued the order.
2. File with the court a petition for annual review of the order.
3. Provide the report to the individual and the individual's guardian.
The report must contain information on all of the following:
1. Whether the individual continues to meet the standards for protective services.
2. Whether the individual is not competent to refuse psychotropic medication as
set forth in s. 55.14 (1) (b).
3. Whether the individual continues to refuse to take psychotropic medication
voluntarily or attempting to administer psychotropic medication to the individual
voluntarily is not in the best interests of the individual as set forth in s. 55.14 (3) (c).
4. Whether the individual's condition for which psychotropic medication has been
prescribed has been improved by psychotropic medication and the person has responded
positively to psychotropic medication.
5. Whether the individual continues to meet the dangerousness criteria set forth
in s. 51.20 (1) (a) 2. a. to e.
6. A summary of the comments of the individual and the individual's guardian and
the county's response to those comments.
7. The comments, if any, of any staff member at any facility at which the individual
is placed or receives services or at which psychotropic medication is administered to the
individual which are relevant to the continued need for the order.
Responsibilities of the Guardian Ad Litem
The court is required to appoint a guardian ad litem after it receives the report from
the county described above. The guardian ad litem is required to do all of the following:
1. Review the report filed by the county, the annual report of the guardian, and any
other reports on the individual's condition that are relevant to the continued need for
involuntary administration of psychotropic medication.
2. Meet with the individual and contact the individual's guardian and orally
explain to the individual and guardian all of the following:
a. The procedure for review of the order for involuntary administration of
psychotropic medication.
b. The right to appointment of legal counsel.
c. The right to request performance of an independent evaluation.
d. The contents of the report submitted to the court by the county.
e. That a termination or modification of the order may be ordered by the court.
f. The right to a hearing and an explanation that the individual or the individual's
guardian may request a full due process hearing.
The guardian ad litem must provide all of the information described above to the
individual and the individual's guardian in writing.
3. Review the individual's condition and rights with the individual's guardian.
4. Ascertain whether the individual wishes to exercise any of his or her rights (the
right to appointment of legal counsel, to request an independent evaluation, and to a full
due process hearing).
5. File a written report with the court within 30 days after appointment that
includes a discussion of whether the individual appears to continue to meet the standards
for the order. The report must also state whether any of the following applies:
a. The guardian ad litem, the individual, or the individual's guardian request an
independent evaluation.
b. The individual or the individual's guardian requests termination of the order.
c. The individual or the individual's guardian requests, or the guardian ad litem
recommends, that legal counsel be appointed for the individual.
d. The individual or his or her guardian or guardian ad litem requests a full due
process hearing.
6. Certify to the court that he or she has complied with the requirements described
under items 1., 2., 3., and 4., above.
Court Review of Reports, Hearing, and Order
The bill requires the court that issues an order for involuntary administration of
psychotropic medication to review, not more than 12 months after the initial order and
annually thereafter, the reports of the county and the guardian ad litem, described above,
and the annual report filed by the guardian under s. 880.38 (3), stats. In its review, the
court must determine whether any of the following is necessary:
1. Performance of an independent evaluation of the physical, mental, and social
condition of the individual that are relevant to the issue of the continued need for the
order. If the court determines that an independent evaluation is necessary, the
evaluation shall be performed at the expense of the individual unless the individual is
indigent. If the individual is indigent, the evaluation is performed at the expense of the
responsible county department. The court must order the performance of an independent
evaluation if any of the following applies:
a. The report submitted by the county is not timely filed or the court determines
that the report fails to meet the statutory requirements.
b. Following review of the guardian ad litem's report, the court determines that
independent evaluation is necessary.
c. The individual or the individual's guardian or guardian ad litem requests an
independent evaluation.
2. Obtaining any other information with respect to the individual.
3. Appointment of legal counsel. If the court appoints legal counsel and it appears
that the individual is indigent, the court shall refer the individual to the authority for
indigency determinations under s. 977.07 (1). The court must order legal counsel for an
individual if any of the following applies:
a. Following review of the guardian ad litem's report, the court determines that
legal counsel for the individual is necessary.
b. The individual or the individual's guardian or guardian ad litem requests
appointment of legal counsel.
4. Holding of a full due process hearing.
Upon completion of its review, the court must 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 such as by telephone or by a videoconference. The court must hold a full due
process hearing if any of the following applies:
a. The individual or the individual's guardian or guardian ad litem requests a full
due process hearing.
b. The report of the guardian ad litem indicates that the individual no longer meets
standards for the order.
c. The report of the guardian ad litem indicates that the individual objects to the
order.
Following the summary hearing or the full due process hearing, the court must do
one of the following:
1. Order the continuation of the order. The court shall make this order if it finds
that the individual continues to meet the standards for involuntary administration of
psychotropic medication. The court must include the information relied upon as a basis
for the order and make findings based on the factors set forth in s. 55.14 (3) in support
of the need for continuation of the order.
2. Terminate the order. The court shall make this order if it determines that the
individual no longer meets the standards for involuntary administration of psychotropic
medication. If the court terminates an order, it must review the needs of the individual
with respect to protective services and order protective services if it determines the
individual meets the standards for protective services that are not currently being
provided.
The bill requires the court to provide a copy of its order to the individual, the
individual's guardian, guardian ad litem and legal counsel, the residential facility in
which the individual is protectively placed, if any, and the county department.
Other Provisions
The bill repeals the following statutory provisions in ch. 880, relating to a
guardian's authority to consent to administration, including forcible administration, of
psychotropic medication to a ward: (1) s. 880.01 (7m), which defines "not competent to
refuse psychotropic medication" for purposes of ch. 880; (2) s. 880.07 (1m), which sets
forth required contents of a petition alleging that a person for whom guardianship is
sought is not competent to refuse psychotropic medication; and (3) s. 880.33 (4m) and (4r),
which set forth procedures under which the guardian may consent to or refuse
psychotropic medication on behalf of the ward, including consent to forcible
administration of psychotropic medication.
The bill specifies that any orders issued under those provisions remain in effect
until modified or terminated by the court. The bill also specifies that orders authorizing
involuntary administration of psychotropic medication originally issued under s. 880.33
(4r), which is repealed by the bill, are subject to annual review as described above.
These provisions are replaced by the procedures created by the bill.
The bill specifies that involuntary administration of psychotropic medication may
be ordered as an emergency protective service.
The bill requires counties to provide to the department a copy of any order for
involuntary administration of psychotropic medications to any protectively placed person
in the county.
The bill requires the DHFS to annually submit to the legislature a report regarding
orders for involuntary administration of psychotropic medication.
Involuntary Administration of Medication and Involuntary Medical Treatment
Other Than Psychotropic Medication
The bill authorizes a guardian to consent, without further court involvement, to
involuntary administration of medication, other than psychotropic medication, and
involuntary medical treatment that is in the ward's best interest. In determining
whether medication or medical treatment is in the ward's best interest, the guardian
shall consider the invasiveness of the medication or treatment and the likely benefits and
side effects of the medication or treatment. A guardian may not consent to involuntary
administration of psychotropic medication unless the guardian has been authorized to do
so under s. 55.14.
Transfers of Protectively Placed Persons
Under current law, a person who is protectively placed in a facility may be
transferred between placement units or from a placement unit to a medical facility (other
than a locked unit or a facility providing acute psychiatric treatment) by a guardian or
placement facility without approval by a court. When a transfer is made by a placement
facility, 24 hours' prior written notice of the transfer shall be provided to the guardian,
when feasible. If it is not feasible to notify the guardian in advance, written notice must
be provided immediately upon transfer, and notice must also be provided to the court and
the board under s. 55.02, or the board's designated agency, within a reasonable period of
time not to exceed 48 hours from the time of transfer.
Currently, if a guardian, ward or attorney, or other interested person objects to the
transfer by petition, the court must order a hearing within 96 hours after filing of the
petition, to determine whether the transfer is consistent with the requirements in s. 55.06
(9) (a) and is necessary for the best interests of the ward.
This bill creates definitions of "protective placement facility" and "protective
placement unit". A "protective placement facility" is defined as a facility to which a court
may order a person to be protectively placed under s. 55.12 for the primary purpose of
residential care and custody. A "protective placement unit" is defined as a ward, wing,
or other designated part of a placement facility.
This bill provides that transfers between placement units, between placement
facilities, or from a placement facility to a medical facility (provided that the medical
facility is not a psychiatric facility), may be made by a county department that placed the
individual or the DHFS, in addition to a guardian or placement facility. However, if such
a transfer is made, 10 days' prior written notice must be given by the transferring entity
to the guardian, the county department, the department, and the placement facility.
Further, this bill requires that the county department, the department, or a
placement facility making such a transfer must obtain the prior written consent of the
guardian. If an emergency precludes providing the required prior written notice, or
precludes obtaining the guardian's prior written consent, written notice must be provided
immediately upon transfer.
Also, the bill requires an entity who seeks a transfer of a protective placement to
obtain the prior written consent of the county department if the transfer is to a facility
that is more costly to the county. This requirement does not apply in the case of an
emergency transfer.
Under the bill, if an individual under protective placement, the individual's
guardian or attorney, or other interested person files a petition specifying objections to
a transfer, the court must order a hearing within 10 days after filing the petition.
For transfers, the purpose of the hearing is to determine whether the proposed
placement meets the standards of s. 55.12; is in the least restrictive environment
consistent with the person's needs and with the factors in s. 55.12 (3), (4), and (5) or, if
the transfer is to an intermediate facility or nursing facility, is in the most integrated
setting; and is in the best interests of the ward.
The bill also sets forth the options for a court order on a transfer petition.
Modification and Termination of Protective Placements
Current law, under s. 55.06 (10) (b), sets forth limited procedures for modification
and termination of a protective placement. That statute allows the department, an
agency, a guardian or ward, or any other interested person to petition the court for
modification or termination of a protective placement at any time. The petition must be
heard if a hearing has not been held within the previous 6 months but a hearing may be
held at any time in the discretion of the court. The petition must be heard within 21 days
of its receipt by the court.
This bill provides more detailed procedures for modification or termination of a
protective placement or an order for protective services.
The bill requires the following:
Modification of Protective Placement
1. A petition for modification of an order for protective placement may be filed by
an individual subject to a protective placement; the individual's guardian or guardian ad
litem; the DHFS; the county department that placed the individual; a contractual agency;
or any interested person.
2. The petition must be served on the individual; the individual's guardian; the
individual's legal counsel and guardian ad litem, if any; and the county department.
3. The petition must contain specific allegations, depending on whether the
individual is under a protective placement order or court-ordered protective services.
4. A hearing on the petition must be held within 21 days after the filing of the
petition, if a hearing on a protective placement petition or transfer has not been held
within the previous 6 months.
5. The hearing must comply with the requirements of s. 55.10 (4), which sets forth
rights in a protective placement proceeding.
6. The order must contain specific findings regarding whether the person currently
meets the standard for protective placement or court-ordered protective services.
7. If the person continues to meet the standard for protective placement or
court-ordered protective services, the court must either continue the order or modify the
order so that the placement or services are consistent with the person's needs if the
person's needs have changed.
8. Orders for continuation or modification of protective services must be consistent
with the factors in s. 55.12 (3), (4), and (5).
9. If the person does not meet the standard for protective placement or protective
services, the order must require termination of the protective placement or court-ordered
protective services.
10. Notice of the order must be provided to the individual; the individual's
guardian, guardian ad litem, and legal counsel, if any; and the residential facility, if the
person receives services in such a facility.
11. The transfer provisions may be used if the modification sought is a transfer of
an individual between placement units, between placement facilities, or from a
placement unit to a medical facility, and if the petitioner is an entity authorized to initiate
such a transfer under s. 55.15.
Termination of Protective Placement or Court-Ordered Protective Services
The provisions described above pertaining to who may petition, the contents of the
petition, service of the petition, and requirement for conducting the hearing for
modification of protective placement or court-ordered protective services apply to
petitions for termination of placement or services.
