Task force to examine rules of involuntary hospitalizations

Gov. David Ige on June 7 signed legislation that aims to improve mental health care.

House Bill 1013, now Act 90, will create a task force within the state Department of Health to examine sections of state statutes pertaining to involuntary hospitalization.

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State statutes require individuals at risk of harming themselves or others, as determined by mental health emergency workers and law enforcement officers, be transported by law enforcement to facilities designated by the state director of health for evaluation and possible involuntary hospitalization, a process referred to as MH-1.

That task force also will make recommendations to the Legislature to help decrease unnecessary admissions to hospital emergency departments and improve access to appropriate levels of care for individuals found to be a risk of harm to themselves or others.

While the “broader framework of mental health treatment needs restructuring, the magnitude and complexity of that task requires a significant long-term commitment of resources,” the legislation reads. “However, incremental improvements may yield relief more presently by addressing ambiguities and inconsistencies in chapter 334 (of the) Hawaii Revised Statutes, as expressed by the community, that contribute to concerns about access, resources, and capacity, and which may impact continuity of care and public safety.”

According to the legislation, the task force will:

• Develop criteria for the director of health to designate facilities to transport, examine and treat patients;

• Review existing laws, law enforcement protocols and procedures for inconsistencies and ensure MH-1 patients are appropriately transported;

• Develop recommendations for efficient and appropriate distribution of patients transported for emergency examination across health care facilities in a given county;

•Assess current law enforcement and health care facility needs and capacities for the evaluation and treatment of MH-1 patients, including the availability of beds and necessary services to treat patients experiencing a mental health crisis, preventing crisis situations and avoiding unnecessary transport of patients;

• Develop recommendations for building a coordinated system of care with capacity for crisis services, community services, and outpatient and inpatient services to address the needs of those with mental illness and substance use disorders who are in crisis; and

• Make recommendations for reimbursement to support these efforts.

In testimony submitted before a hearing of the Senate Judiciary Committee in late March, Director of Health Bruce Anderson said the DOH supported the measure and the establishment of the task force is “a welcome opportunity for the DOH to continue our work.”

The task force, which will be made of representatives from law enforcement, health care providers, hospitals and hospital systems, patient advocates, social service agencies, state offices and more, will end June 30, 2020. Hilo Medical Center spokeswoman Elena Cabatu said the hospital already receives mental health patients and doesn’t anticipate any changes to its patient census.

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“We’ll monitor the development of the task force recommendations and findings and participate where we can and provide information to the task force,” she said.

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

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