2. Evidence of the facility's response to the individual's acts, attempts, omissions,
or threats described above, as documented in records maintained by the facility.
(e) The protective placement facility has made reasonable efforts to address or
accommodate the behavior or condition for which behavioral or psychiatric evaluation,
diagnosis, services, or treatment in a dementia crisis unit is sought and these steps are
documented in the individual's plan of care.
(f) The proposed placement is in an environment that is appropriate for the
individual.
(g) The protective placement facility has prepared detailed documentation of the
behaviors or condition of the individual that necessitate inpatient behavioral or
psychiatric evaluation, diagnosis, services, or treatment, including detailed information
regarding the physical examination conducted and efforts taken by the facility to address
or accommodate the individual's behavior, and provides this documentation to the
dementia crisis unit.
(h) One of the following is true:
1. The protective placement facility has a plan in place for the orderly return of the
individual upon discharge from the dementia crisis unit, which specifies the conditions
under which the individual will be readmitted to the facility, and a copy of the plan is
included with the petition.
2. The protective placement facility has determined that readmission of the
individual to the facility upon discharge from the dementia crisis unit is not in the best
interests of the individual, and includes, with the petition, specific factual information
supporting this conclusion.
Consent of Guardian and County Department Required. Under the bill, the
written consent of the individual's guardian and the county department are required in
order to carry out a transfer to a dementia crisis unit, except in the case of an emergency
transfer, as described below.
Hearing; Order to Transfer. The court must hold a hearing within 72 hours after
the filing of a petition for transfer. At the request of the individual, or his or her counsel
or guardian ad litem, the hearing may be postponed for up to 7 days from the date of
emergency transfer.
At the hearing, the court must consider whether the standards for transfer
described above have been met and whether the proposed transfer to a dementia crisis
unit is in the best interests of the person under protective placement.
Following the hearing, the court must do one of the following:
(a) If the court finds that the individual continues to meet the standards for
protective placement and the proposed transfer to a dementia crisis unit does not meet
the standards for transfer, the court must issue an order prohibiting the transfer. The
court must include the information relied upon as a basis for the order and make findings
based on those standards in support of the denial of the transfer.
(b) If the court finds that the individual continues to meet the standards for
protective placement and the proposed transfer to a dementia crisis unit meets the
standards for transfer, the court must order the transfer of the individual to a dementia
crisis unit for a period not to exceed 45 days.
(c) If the court finds that the individual no longer meets the standards for protective
placement the court must terminate the protective placement.
Emergency Transfer of Placement of an Individual With Dementia to
Dementia Crisis Unit; Probable Cause Hearing; Order
If an emergency makes it impossible to file a petition prior to transfer to a dementia
crisis unit or to obtain the prior written consent of the guardian, the individual may be
transferred without the prior written consent of the guardian and without a prior court
order. A petition containing all of the allegations required for temporary transfer to a
dementia crisis unit, and identification of the specific facts and circumstances which
made it impossible to carry out the transfer under the nonemergency procedures, must
be filed immediately upon transfer.
The court must hold a hearing within 72 hours of the transfer. At the request of
the subject individual, or his or her counsel or guardian ad litem, the probable cause
hearing may be postponed for up to 7 days from the date of the emergency transfer.
After the hearing, the court must issue an order based upon its findings, as set forth
above in the description of nonemergency temporary transfer procedures. In addition to
the factors that must be considered for nonemergency transfers, the court must also
consider whether there is probable cause to believe the allegations that an emergency
made it impossible to file a petition and carry out the transfer as a nonemergency transfer.
Transportation Upon Discharge. The order for transfer to a dementia crisis
unit, and any subsequent extension of the order, must state that the county in which the
original order for protective placement of the individual was issued is responsible for
transportation of the individual to any facility to which placement of the individual is
ordered upon discharge of the individual from the dementia crisis unit.
Extension of Temporary Transfer to a Dementia Crisis Unit
The order for temporary transfer to a dementia crisis unit may be extended for 60
days beyond the initial 45-day period of transfer if a petition for extension of the
temporary placement is filed before expiration of the order for temporary placement, and
the court orders the extension after a hearing. If requested, a jury trial must be held.
Allegations similar to those required to be proven at the probable cause hearing must be
proven. The court must also appoint 2 examiners, as is required for involuntary
commitments under ch. 51, to examine the individual and provide a report to the court
before the hearing or trial.
Subsequent Extensions of Temporary Transfer to a Dementia Crisis Unit
Temporary transfer to a dementia crisis unit may be subsequently extended in
increments of no more than 60 days. For each such extension, a petition alleging that the
individual meets the standards for temporary transfer to the dementia crisis unit must
be filed no later than 10 days prior to the expiration of the most-recently issued order for
temporary transfer. If an emergency makes it impossible to file a petition sooner, a
petition may be filed up to 72 hours prior to expiration of the period of temporary transfer.
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.
Examination by 2 experts must be conducted and a hearing must be held. The examiner's
reports must be made available 72 hours in advance of the hearing. A trial by a jury must
be provided if demanded by the individual sought to be protected or his or her attorney
or guardian ad litem. After the hearing, if grounds for continued transfer to the dementia
crisis unit are proven, the court must issue an order extending the temporary placement
for up to 60 days.
Medication and Treatment of an Individual With Dementia in a Dementia
Crisis Unit
When an individual with dementia is placed or remains in a dementia crisis unit
under any of the new procedures created in the bill, the director and staff of the dementia
crisis unit may evaluate, diagnose and treat the individual if the individual consents. The
individual has a right to refuse medication and treatment, except as provided in an order
for involuntary administration of psychotropic medication as a protective service or an
emergency protective service, or in a situation in which medication or treatment is
necessary to prevent serious physical harm to the individual or others. The individual
must be advised of these rights by the director of the dementia crisis unit or his or her
designee.
Provisions Applicable to Dementia Crisis Units Used for Emergency or
Temporary Protective Placements; Liability
Discharge
The bill provides that when, upon the advice of the treatment staff, the director of
a dementia crisis unit to which an individual has been transferred or placed for
emergency protective placement determines that the grounds for transfer or emergency
placement no longer exist, he or she must notify the county department in order to
arrange for transfer of the individual to a protective placement facility.
Liability
Any individual who acts in accordance with the provisions of the bill, including
making a determination that an individual has or does not have dementia or evidences
or does not evidence a substantial probability of harm, is not liable for any actions taken
in good faith. The good faith of the actor shall be presumed in any civil action. The bill
states that whomever asserts that the individual who acts in accordance with this section
has not acted in good faith has the burden of proving that assertion by evidence that is
clear, satisfactory, and convincing.
AB575,1
1Section
1. 51.01 (4r) of the statutes is amended to read:
AB575,13,62
51.01
(4r) "Degenerative brain disorder" means the loss or dysfunction of brain
3cells to the extent that the individual is substantially impaired in his or her ability
4to provide adequately for his or her own care or custody or to manage adequately his
5or her property or financial affairs.
"Degenerative brain disorder" includes
6dementia.
AB575,2
7Section
2. 51.01 (4v) of the statutes is created to read:
AB575,14,5
151.01
(4v) "Dementia" means deterioration or loss of intellectual faculties,
2reasoning power, memory, and will due to organic brain disease characterized by
3confusion, disorientation, apathy, or stupor of varying degrees that is not capable of
4being reversed and from which recovery is impossible. "Dementia" includes
5Alzheimer's disease.
AB575,3
6Section
3. 51.01 (13) (b) of the statutes is amended to read:
AB575,14,107
51.01
(13) (b) "Mental illness", for purposes of involuntary commitment, means
8a substantial disorder of thought, mood, perception, orientation, or memory which
9grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet
10the ordinary demands of life, but does not include
dementia or alcoholism.
AB575,4
11Section
4. 51.12 of the statutes is created to read:
AB575,14,14
1251.12 Involuntary admissions under protective placement
13procedures. Admission to a dementia crisis unit as defined under s. 55.01 (1y) may
14be made under protective placement procedures under ss. 55.59 and 55.65.
AB575,5
15Section
5. 51.15 (1) (a) (intro.) of the statutes is amended to read:
AB575,14,2216
51.15
(1) (a) (intro.)
A Except as provided in sub. (1m), a law enforcement
17officer or other person authorized to take a child into custody under ch. 48 or to take
18a juvenile into custody under ch. 938 may take an individual into custody if the officer
19or person has cause to believe that the individual is mentally ill, is drug dependent,
20or is developmentally disabled
and, based on observation and currently available
21information, that the individual does not have or does not appear to have dementia,
22and that the individual evidences any of the following:
AB575,6
23Section
6. 51.15 (1m) of the statutes is created to read:
AB575,15,524
51.15
(1m) Detention of individuals with dementia. An individual who has
25or, based on observation and currently available information, appears to have
1dementia may not be detained under this section. An individual who has or, based
2on observation and currently available information, appears to have dementia may
3be detained only as provided under s. 55.59 for purposes of emergency protective
4placement or as provided under s. 55.65 for purposes of transfer of protective
5placement.
AB575,7
6Section
7. 51.20 (1) (a) 1m. of the statutes is created to read:
AB575,15,97
51.20
(1) (a) 1m. Based on observation and currently available information, the
8individual does not have or appear to have dementia or the individual has or appears
9to have dementia but is competent.
AB575,8
10Section
8. 51.20 (1) (aw) of the statutes is created to read:
AB575,15,1611
51.20
(1) (aw) Notwithstanding the prohibitions against emergency detention
12of a individual who has dementia under ss. 51.12 and 51.15 (1m), an individual who
13has or, based on observation and currently available information, appears to have
14dementia and who is competent may be involuntarily committed based on a petition
15filed under this section if the individual otherwise meets the criteria for involuntary
16commitment under sub. (1) (a).
AB575,9
17Section
9. 51.61 (1) (intro.) of the statutes is amended to read:
AB575,16,1118
51.61
(1) (intro.) In this section, "patient" means any individual who is
19receiving services for mental illness, developmental disabilities, alcoholism or drug
20dependency, including any individual who is admitted to a treatment facility in
21accordance with this chapter or ch. 48 or 55 or who is detained, committed or placed
22under this chapter or ch. 48, 55, 971, 975 or 980, or who is transferred to a treatment
23facility under s. 51.35 (3) or 51.37 or who is receiving care or treatment for those
24conditions through the department or a county department under s. 51.42 or 51.437
25or in a private treatment facility.
In this section, "patient" also means any individual
1who is receiving psychiatric or behavioral care or services in a dementia crisis unit,
2as defined in s. 55.01 (1y), under subch. II of ch. 55, to the extent that provisions of
3this section do not conflict with provisions of ch. 55 applicable to that individual. 4"Patient" does not include persons committed under ch. 975 who are transferred to
5or residing in any state prison listed under s. 302.01. In private hospitals and in
6public general hospitals, "patient" includes any individual who is admitted for the
7primary purpose of treatment of mental illness, developmental disability, alcoholism
8or drug abuse but does not include an individual who receives treatment in a hospital
9emergency room nor an individual who receives treatment on an outpatient basis at
10those hospitals, unless the individual is otherwise covered under this subsection.
11Except as provided in sub. (2), each patient shall:
AB575,10
12Section
10. 51.67 of the statutes is amended to read:
AB575,17,17
1351.67 Alternate procedure; protective services. If, after a hearing under
14s. 51.13 (4) or 51.20, the court finds that commitment under this chapter is not
15warranted and that the subject individual is a fit subject for guardianship and
16protective placement or services, the court may, without further notice, appoint a
17temporary guardian for the subject individual and order temporary protective
18placement or services under ch. 55 for a period not to exceed 30 days. Temporary
19protective placement for an individual in a center for the developmentally disabled
20is subject to s. 51.06 (3). Any interested party may then file a petition for permanent
21guardianship or protective placement or services, including medication, under ch.
2255. If the individual is in a treatment facility,
and the individual does not have or,
23based on observation and currently available information, appear to have dementia, 24the individual may remain in the facility during the period of temporary protective
25placement if no other appropriate facility is available.
If the individual is in a
1treatment facility and the individual has or, based on currently available
2information, appears to have dementia, the individual may remain in the facility
3during the period of temporary protective placement only if the facility is designated
4by a county as a dementia crisis unit under s. 55.55 and the facility provides an
5environment that is appropriate for the individual. For an individual who has or,
6based on currently available information, appears to have dementia, the court may
7order psychotropic medication as an emergency protective service under this section
8only as provided in s. 55.70. The court may order psychotropic medication as a
9temporary protective service under this section
for an individual who does not have
10or appear to have dementia if it finds that there is probable cause to believe the
11individual is not competent to refuse psychotropic medication and that the
12medication ordered will have therapeutic value and will not unreasonably impair the
13ability of the individual to prepare for and participate in subsequent legal
14proceedings. An individual is not competent to refuse psychotropic medication if,
15because of serious and persistent mental illness, and after the advantages and
16disadvantages of and alternatives to accepting the particular psychotropic
17medication have been explained to the individual, one of the following is true:
AB575,11
18Section
11. Subchapter I (title) of chapter 55 [precedes 55.001] of the statutes
19is created to read:
AB575,17,2221
subchapter I
22
protective serviceS; generally
AB575,12
23Section
12. 55.01 (1v) of the statutes is amended to read:
AB575,18,324
55.01
(1v) "Degenerative brain disorder" means the loss or dysfunction of brain
25cells to the extent that the individual is substantially impaired in his or her ability
1to provide adequately for his or her own care or custody or to manage adequately his
2or her property or financial affairs.
"Degenerative brain disorder" includes
3dementia.
AB575,13
4Section
13. 55.01 (1x) of the statutes is created to read:
AB575,18,95
55.01
(1x) "Dementia" means deterioration or loss of intellectual faculties,
6reasoning power, memory, and will due to organic brain disease characterized by
7confusion, disorientation, apathy, or stupor of varying degrees that is not capable of
8being reversed and from which recovery is impossible. "Dementia" includes
9Alzheimer's disease.
AB575,14
10Section
14. 55.01 (1y) of the statutes is created to read:
AB575,18,1611
55.01
(1y) "Dementia crisis unit" means a unit or part of a unit of a public or
12private facility that has been designated by a county department under s. 55.55 as
13qualified and equipped to provide and competent in providing diagnosis, evaluation,
14and treatment of dementia and medical, psychiatric, and behavioral care to
15individuals who have dementia and that provides a therapeutic environment that is
16appropriate for and designed to prevent harm to individuals who have dementia.
Note: Creates a definition of "dementia crisis unit" for the purpose of ch. 55.
AB575,15
17Section
15. 55.02 (3) of the statutes is renumbered 55.02 (3) (intro.) and
18amended to read:
AB575,18,2219
55.02
(3) Corporation counsel. (intro.) The corporation counsel of the county
20in which the petition is brought may or, if requested by the court, shall assist in
21conducting proceedings under this chapter.
The corporation counsel shall assist in
22conducting any proceedings under this chapter in which all of the following are true:
AB575,16
23Section
16. 55.02 (3) (a) and (b) of the statutes are created to read:
AB575,18,2424
55.02
(3) (a) The proceedings are initiated under s. 51.20 (7) (d) 1. or 51.67.
AB575,19,1
1(b) The subject individual has or appears to have dementia.
AB575,17
2Section
17. 55.10 (1) of the statutes is amended to read:
AB575,19,163
55.10
(1) Time limits. A petition for protective placement or protective services
4shall be heard within 60 days after it is filed unless an extension of this time is
5requested by the petitioner, the individual sought to be protected or the individual's
6guardian ad litem, or the county department, in which case the court may extend the
7date for hearing by up to 45 days.
The court shall hear a petition for protective
8placement that is filed under s. 55.59 (6) in conjunction with an emergency protective
9placement in a dementia crisis unit within 45 days after it is filed. The court may
10not extend the time for hearing a petition for protective placement that is filed under
11s. 55.59 (6) in conjunction with an emergency protective placement in a dementia
12crisis unit. If an individual under s. 50.06 (3) alleges that another individual is
13making a health care decision under s. 50.06 (5) (a) that is not in the best interests
14of the incapacitated individual or if the incapacitated individual verbally objects to
15or otherwise actively protests the admission, the petition shall be heard as soon as
16possible within the 60-day period.
AB575,18
17Section
18. 55.12 (2) of the statutes is amended to read:
AB575,20,1418
55.12
(2) Subject to s. 46.279, protective placement may be made to nursing
19homes, public medical institutions, centers for the developmentally disabled under
20the requirements of s. 51.06 (3), foster care services or other home placements, or to
21other appropriate facilities
, but. Protective placement may not be made to
units a
22unit for the acutely mentally ill
unless the unit is designated as a dementia crisis unit
23under s. 55.55 and appropriate procedures under subch. II are followed. A protective
24placement that is otherwise permissible under subch. I is not prohibited solely
25because the placement facility has one or more units or locations designated under
1s. 55.55 or is associated with a facility that is designated under s. 55.55. An
2individual
, other than an individual who has or, based on observation and currently
3available information, appears to have dementia, who is subject to an order for
4protective placement or protective services may be detained on an emergency basis
5under s. 51.15 or involuntarily committed under s. 51.20
or
. An individual who is
6subject to an order for protective placement or protective services may be voluntarily
7admitted to a treatment facility
or a dementia crisis unit for inpatient care under s.
851.10 (8). No individual who is subject to an order for protective placement or
9services may be involuntarily transferred to, detained in, or committed to a
10treatment facility for care except under s. 51.15 or 51.20.
This subsection does not
11prohibit the placement or transfer of an individual who has or, based on currently
12available information, appears to have dementia in or to a dementia crisis unit as
13provided in s. 55.59 or 55.65. Protective placement in a locked unit shall require a
14specific finding of the court as to the need for the action.
AB575,19
15Section
19. 55.13 (6) of the statutes is created to read:
AB575,20,1916
55.13
(6) For an individual who has or, based on observation and currently
17available information, appears to have dementia, involuntary administration of
18psychotropic medications may be provided as an emergency protective service only
19as provided under s. 55.70.
AB575,20
20Section
20. 55.135 (1) of the statutes is amended to read:
AB575,21,1921
55.135
(1) If, from personal observation of, or a reliable report made by a person
22who identifies himself or herself to, a sheriff, police officer, fire fighter, guardian, if
23any, or authorized representative of a county department or an agency with which
24it contracts under s. 55.02 (2), it appears probable that an individual is so totally
25incapable of providing for his or her own care or custody as to create a substantial
1risk of serious physical harm to himself or herself or others as a result of
2developmental disability, degenerative brain disorder, serious and persistent mental
3illness, or other like incapacities if not immediately placed, the individual who
4personally made the observation or to whom the report is made may take into custody
5and transport the individual to an appropriate medical or protective placement
6facility.
An individual may be transported to a dementia crisis unit for emergency
7protective placement only if the individual has or, based on observation and
8currently available information, appears to have dementia and only as provided
9under s. 55.59. The person making emergency protective placement shall prepare
10a statement at the time of detention providing specific factual information
11concerning the person's observations or reports made to the person and the basis for
12emergency placement. The statement shall be filed with the director of the facility
13and with any petition under s. 55.075. At the time of emergency protective placement
14the individual shall be informed by the director of the facility or the director's
15designee, orally and in writing, of his or her right to contact an attorney and a
16member of his or her immediate family and the right to have an attorney provided
17at public expense, as provided under s. 55.105. The director or designee shall also
18provide the individual with a copy of the statement by the person making emergency
19protective placement.
AB575,21
20Section
21. 55.14 (1) (b) 2. of the statutes is amended to read:
AB575,21,2421
55.14
(1) (b) 2. The individual is substantially incapable of applying an
22understanding of the advantages
, and disadvantages
of accepting treatment and
the 23alternatives
to accepting treatment to his or her condition in order to make an
24informed choice as to whether to accept or refuse psychotropic medication.
AB575,22
25Section
22. 55.14 (3) (e) (intro.) and (4) of the statutes are amended to read:
AB575,22,6
155.14
(3) (e) (intro.) Unless psychotropic medication is administered
2involuntarily, the individual will incur a substantial probability of physical harm,
3impairment, injury, or debilitation or will present a substantial probability of
4physical harm to others.
The Except as provided in par. (em), the substantial
5probability of physical harm, impairment, injury, or debilitation shall be evidenced
6by one of the following:
AB575,22,16
7(4) A petition under this section
must
shall include a written statement signed
8by a physician who has personal knowledge of the individual that provides general
9clinical information regarding the appropriate use of psychotropic medication for the
10individual's condition and specific data that indicates that the individual's current
11condition necessitates the use of psychotropic medication.
If the individual has or
12appears to have dementia, the statement shall state that the physician has
13determined and documented in writing that there is a reasonable probability that
14the behavior for which treatment with psychotropic medication is sought is not
15caused by a physical condition or illness that could be treated successfully by means
16other than psychotropic medication.
AB575,23
17Section
23. 55.14 (3) (em) and (4m) of the statutes are created to read:
AB575,22,2418
55.14
(3) (em) In the case of an individual who has or appears to have dementia,
19the substantial probability of physical harm, impairment, injury, or debilitation
20under par. (e) shall be shown by evidence of recent behavior of the individual or of
21recent acts or attempts or a pattern of recent acts or omissions by the individual or
22by evidence that the individual or others are placed at substantial risk of serious
23physical harm to them as evidenced by a recent overt act, attempt, or threat by the
24individual to do serious physical harm to them
.
AB575,23,8
1(4m) In the case of an individual who has or appears to have dementia, and who
2resides in a nursing home, as defined in s. 50.01 (3), a community-based residential
3facility, as defined in s. 50.01 (1g), an adult family home, as defined in s. 50.01 (1),
4or a residential care apartment complex, as defined in s. 50.01 (6d), the petition shall
5also allege that reasonable efforts have been made to address or accommodate the
6behavior or condition for which treatment with psychotropic medication is sought.
7Evidence of the facility's response to the individual's behavior or condition, as
8documented in records maintained by the facility, shall be attached to the petition.
AB575,24
9Section
24. 55.15 (1) of the statutes is amended to read:
AB575,23,1710
55.15
(1) Transfers authorized. An individual under a protective placement
11order may be transferred between protective placement units, between protective
12placement facilities, or from a protective placement unit to a medical facility. The
13individual may not be transferred, under the protective placement order, to any
14facility for which commitment procedures are required under ch. 51.
This provision
15does not prohibit temporary transfer of an individual who has or, based on currently
16available information, appears to have dementia, to a dementia crisis unit as
17provided in s. 55.65.
AB575,25
18Section
25. 55.18 (1) (b) of the statutes is amended to read:
AB575,24,619
55.18
(1) (b) If, following an annual review of an individual's status under par.
20(a), the individual or the individual's guardian or guardian ad litem requests
21modification or termination of the individual's protective placement and a hearing
22under the requirements of s. 55.10 (2) to (4) is provided, or if a hearing under the
23requirements of s. 55.10 (2) to (4) is provided pursuant to a petition for modification
24or termination of the protective placement, the county is not required to initiate a
25subsequent review of the individual's status under par. (a) until the first day of the
111th month after the date that the court issues a final order after the hearing.
A
2petition under s. 55.61, 55.65, or 55.67 is not a request for modification or
3termination of an individual's protective placement for purposes of this paragraph,
4and the fact that a hearing has been held at any time under any of those sections with
5respect to an individual does not affect the duty of the county to perform an annual
6review of the individual's protective placement as required under par. (a).
AB575,26
7Section
26. Subchapter II (title) of chapter 55 [precedes 55.50] of the statutes
8is created to read:
AB575,24,1010
SUBCHAPTER II