36-543

36-543. Release from treatment of gravely
disabled patient or persistently or acutely disabled patient;
annual review and examination

A. A patient found to be gravely disabled or persistently or acutely disabled and
ordered to undergo treatment may be released from inpatient treatment when, in the
opinion of the medical director of the mental health treatment agency, the level of care
offered by the agency is no longer required. The patient may agree to continue treatment
voluntarily. If the patient is to be released, the medical director shall arrange for an
appropriate alternative placement.

B. If a patient to be released is under guardianship as a gravely disabled person
or as a persistently or acutely disabled person, the medical director of the mental
health treatment agency shall notify the guardian and any relevant regional behavioral
health authority ten days before the intended release date that the ward no longer
requires the level of care offered by the agency. The guardian and, if relevant, the
regional behavioral health authority shall arrange alternative placement with the advice
and recommendations of the medical director of the mental health treatment agency.

C. The medical director of the mental health treatment agency is not civilly liable
for any acts committed by the released patient if the medical director has in good faith
complied with the requirements of this article.

D. A patient who has been found to be gravely disabled and is undergoing
court-ordered treatment shall have an annual examination and review to determine whether
the continuation of court-ordered treatment is appropriate and to assess the needs of the
patient for guardianship or conservatorship, or both. The medical director of the mental
health treatment agency shall appoint one or more examiners qualified to carry out the
examination, at least one of whom shall be a psychiatrist licensed to practice in this
state, and may at the discretion of the medical director appoint one or more additional
examiners.

E. A patient who has been found to be persistently or acutely disabled and who is
undergoing court-ordered treatment shall have an annual examination and review to
determine whether the continuation of court-ordered treatment is appropriate if the
medical director of the mental health treatment agency determines that the patient has
been substantially noncompliant with treatment during the period of the court order. The
medical director of the mental health treatment agency shall appoint one or more
examiners qualified to carry out the examination, at least one of whom shall be a
psychiatrist licensed to practice in this state.

F. Each examiner participating in the annual examination and review of a gravely
disabled person or a persistently or acutely disabled person shall submit a report to the
medical director of the mental health treatment agency which includes the following:

1. The examiner's opinions as to whether the patient continues to be gravely
disabled or persistently or acutely disabled and in need of treatment.

2. A statement as to whether suitable alternatives to court-ordered treatment are
available.

3. A statement as to whether voluntary treatment would be appropriate.

4. A review of the patient's status as to guardianship or conservatorship, or both,
the adequacy of existing protections of the patient and the continued need for
guardianship or conservatorship, or both. If the examiner concludes that the patient's
needs in these areas are not being adequately met, the examiner's report shall recommend
that the court order an investigation into the patient's needs.

G. The medical director of the mental health treatment agency shall forward the
results of the annual examination and review of a gravely disabled person or a
persistently or acutely disabled person to the court including the medical director's
recommendation based on the review which may be release of the patient without delay,
release with delay or no release. If the patient does not have a guardian, the court, on
receipt of the medical director's report, shall appoint an attorney to represent the
patient. An attorney appointed under this subsection, within three days after
appointment, to the extent possible, shall fulfill the duties imposed by section 36-537
and review the medical director's report and the patient's medical records, interview the
physician who prepared the report and, if appropriate, request a hearing. At all
proceedings conducted pursuant to this section, a patient has the right to have an
analysis of the patient's mental condition by an independent evaluator pursuant to
section 36-538. If the patient is under guardianship pursuant to section 14-5312.01, a
copy of the report shall be mailed to the patient's guardian. If the medical director's
recommendation is no release or release with delay, the court may accept the report and
recommendation of the medical director or order a hearing. The hearing shall be held
within three weeks of the request. At the hearing the court may order the patient
released or may order that treatment be continued. The court may also order an
investigation into the need for guardianship or conservatorship, or both.

H. If a hearing is held pursuant to subsection G of this section the party seeking
the renewal of the court order must prove all of the following by clear and convincing
evidence:

1. The patient is one of the following:

(a) A danger to self.

(b) A danger to others.

(d) Gravely disabled.

2. The patient is in need of treatment.

3. The patient is either unwilling or unable to accept treatment voluntarily.

I. The deputy director shall create and operate a program to assure that the
examination and review of gravely disabled persons or persistently or acutely disabled
persons who have been substantially noncompliant while under court order are carried out
in an effective and timely manner. The deputy director, with the approval of the
director, shall adopt rules needed to operate this program.