GENERAL ASSEMBLY OF NORTH CAROLINA

1987 SESSION

 

 

CHAPTER 370

HOUSE BILL 551

 

AN ACT CONCERNING VOLUNTARY ADMISSIONS AND DISCHARGES OF MINORS AT FACILITIES FOR THE MENTALLY ILL AND SUBSTANCE ABUSERS.

 

The General Assembly of North Carolina enacts:

 

Section 1.  Part 3 of Article 5 of Chapter 122C of the General Statutes is rewritten to read:

"Part 3.  Voluntary Admissions and Discharges, Minors,

Facilities for the Mentally Ill and Substance Abusers.

"§ 122C-221.  Admissions.-(a)     Except as otherwise provided in this Part, a minor may be admitted to a facility if the minor is mentally ill or a substance abuser and in need of treatment.  Except as otherwise provided in this Part, the provisions of G.S. 122C-211 shall apply to admissions of minors under this Part.  Except as provided in G.S. 90-21.5, in applying for admission to a facility, in consenting to medical treatment when consent is required, and in any other legal procedure under this Article, the legally responsible person shall act for the minor.  If a minor reaches the age of 18 while in treatment under this Part, further treatment is authorized only on the written authorization of the client or under the provisions of Part 7 or Part 8 of Article 5 of this Chapter.

(b)       The Commission shall adopt rules governing procedures for admission to 24-hour facilities not falling within the category of facilities where freedom of movement is restricted.  These rules shall be designed to ensure that no minor is improperly admitted to or improperly remains in a 24-hour facility.

"§ 122C-222.  Admissions to State facilities.-Admission of a minor who is a resident of a county that is not in a single portal area shall be made to a State facility following screening and upon referral by an area authority, a physician, or an eligible psychologist.  Further planning of treatment and discharge for the minor is the joint responsibility of the State facility and the person making the referral.

"§ 122C-223.  Emergency admission to a 24-hour facility.-(a)        In an emergency situation, when the legally responsible person does not appear with the minor to apply for admission, a minor who is mentally ill or a substance abuser and in need of treatment may be admitted to a 24-hour facility upon his own written application.  The application shall serve as the initiating document for the hearing required by G.S. 122C-224.

(b)       Within 24 hours of admission, the facility shall notify the legally responsible person of the admission unless notification is impossible due to an inability to identify, to locate, or to contact him after all reasonable means to establish contact have been attempted.

(c)       If the legally responsible person cannot be located within 72 hours of admission, the responsible professional shall initiate proceedings for juvenile protective services as described in Article 44 of Chapter 7A of the General Statutes in either the minor's county of residence or in the county in which the facility is located.

(d) Within 24 hours of an emergency admission to a State facility, the State facility shall notify the area authority and, as appropriate, the minor's physician or eligible psychologist.  Further planning of treatment and discharge for the minor is the joint responsibility of the State facility and the appropriate person in the community.

"§ 122C-224.  Judicial review of voluntary admission.-(a)   When a minor is admitted to a 24-hour facility where the minor will be subjected to the same restrictions on his freedom of movement present in the State facilities for the mentally ill, or to similar restrictions, a hearing shall be held by the district court in the county in which the 24-hour facility is located within 15 days of the day that the minor is admitted to the facility.  A continuance of not more than five days may be granted.

(b)       Before the admission, the facility shall provide the minor and his legally responsible person with written information describing the procedures for court review of the admission and informing them about the discharge procedures.  They shall also be informed that, after a written request for discharge, the facility may hold the minor for 72 hours during which time the facility may apply for a petition for involuntary commitment.

(c)       Within 24 hours after admission, the facility shall notify the clerk of court in the county where the facility is located that the minor has been admitted and that a hearing for concurrence in the admission must be scheduled.  At the time notice is given to schedule a hearing, the facility shall notify the clerk of the names and addresses of the legally responsible person and the responsible professional.

"§ 122C-224.1.  Duties of clerk of court.-(a)     Within 48 hours of receipt of notice that a minor has been admitted to a 24-hour facility wherein his freedom of movement will be restricted, the clerk of superior court, under direction of the district court judge, shall appoint an attorney for the minor.  When a minor has been admitted to a State facility for the mentally ill, the attorney appointed shall be the attorney employed in accordance with G.S. 122C-270(a) through (c).  All minors shall be conclusively presumed to be indigent, and it shall not be necessary for the court to receive from any minor an affidavit of indigency.  The attorney shall be paid a reasonable fee fixed by the court in the same manner as fees for attorneys appointed in cases of indigency.  The judge may require payment of the attorney's fee from a person other than the minor as provided in G.S. 7A-450.1 through G.S. 7A-450.4.

(b)       Upon receipt of notice that a minor has been admitted to a 24-hour facility wherein his freedom of movement will be restricted, the clerk shall calendar a hearing to be held within 15 days of admission for the purpose of review of the minor's admission.  Notice of the time and place of the hearing shall be given as provided in G.S. 1A-1, Rule 4(j) to the attorney in lieu of the minor, as soon as possible but not later than 72 hours before the scheduled hearing.  Notice of the hearing shall be sent to the legally responsible person and the responsible professional as soon as possible but not later than 72 hours before the hearing by first-class mail postage prepaid to the individual's last known address.

(c)       The clerk shall schedule all hearings and rehearings and send all notices as required by this Part.

"§ 122C-224.2.  Duties of the attorney for the minor.-(a)      The attorney shall meet with the minor within 10 days of his appointment but not later than 48 hours before the hearing.  In addition, the attorney shall inform the minor of the scheduled hearing and shall give the minor a copy of the notice of the time and place of the hearing no later than 48 hours before the hearing.

(b)       The attorney shall counsel the minor concerning the hearing procedure and the potential effects of the hearing proceeding on the minor. If the minor does not wish to appear, the attorney shall file a motion with the court before the scheduled hearing to waive the minor's right to be present at the hearing procedure except during the minor's own testimony.  If the attorney determines that the minor does not wish to appear before the judge to provide his own testimony, the attorney shall file a separate motion with the court before the hearing to waive the minor's right to testify.

(c)       In all actions on behalf of the minor, the attorney shall represent the minor until formally relieved of the responsibility by the judge.

"§ 122C-224.3.  Hearing for review of admission.-(a)            Hearings shall be held at the 24-hour facility in which the minor is being treated, if it is located within the judge's judicial district, unless the judge determines that the court calendar will be disrupted by such scheduling.  In cases where the hearing cannot be held in the 24-hour facility, the judge may schedule the hearing in another location, including the judge's chambers.  The hearing may not be held in a regular courtroom, over objection of the minor's attorney, if in the discretion of the judge a more suitable place is available.

(b)       The minor shall have the right to be present at the hearing unless the judge rules favorably on the motion of the attorney to waive the minor's appearance.  However, the minor shall retain the right to appear before the judge to provide his own testimony and to respond to the judge's questions unless the judge makes a separate finding that the minor does not wish to appear upon motion of the attorney.

(c)       Certified copies of reports and findings of physicians, psychologists and other responsible professionals as well as previous and current medical records are admissible in evidence, but the minor's right, through his attorney, to confront and cross-examine witnesses may not be denied.

(d)       Hearings shall be closed to the public unless the attorney requests otherwise.

(e)       A copy of all documents admitted into evidence and a transcript of the proceedings shall be furnished to the attorney, on request, by the clerk upon the direction of a district court judge.  The copies shall be provided at State expense.

(f)        For an admission to be authorized beyond the hearing, the minor must be (1) mentally ill or a substance abuser and (2) in need of further treatment at the 24-hour facility to which he has been admitted.  Further treatment at the admitting facility should be undertaken only when lesser measures will be insufficient.  It is not necessary that the judge make a finding of dangerousness in order to support a concurrence in the admission.

(g)       The court shall make one of the following dispositions:

(1)       If the court finds by clear, cogent, and convincing evidence that the requirements of subsection (f) have been met, the court shall concur with the voluntary admission and set the length of the authorized admission of the minor for a period not to exceed 90 days; or

(2)       If the court determines that there exist reasonable grounds to believe that the requirements of subsection (f) have been met but that additional diagnosis and evaluation is needed before the court can concur in the admission, the court may make a one time authorization of up to an additional 15 days of stay, during which time further diagnosis and evaluation shall be conducted; or

(3)       If the court determines that the conditions for concurrence or continued diagnosis and evaluation have not been met, the judge shall order that the minor be released.

(h)       The decision of the District Court in all hearings and rehearings is final.  Appeal may be had to the Court of Appeals by the State or by any party on the record as in civil cases.  The minor may be retained and treated in accordance with this Part, pending the outcome of the appeal, unless otherwise ordered by the District Court or the Court of Appeals.

"§ 122C-224.4.  Rehearings.-(a)  A minor admitted to a 24-hour facility upon order of the court for further diagnosis and evaluation shall have the right to a rehearing if the responsible professional determines that the minor is in need of further treatment beyond the time authorized by the court for diagnosis and evaluation.

(b)       A minor admitted to a 24-hour facility upon the concurrence of the court shall have the right to a rehearing for further concurrence in continued treatment before the end of the period authorized by the court.  The court shall review the continued admission in accordance with the hearing procedures in this Part.  The court may order discharge of the minor if the minor no longer meets the criteria for admission.  If the minor continues to meet the criteria for admission the court shall concur with the continued admission of the minor and set the length of the authorized admission for a period not to exceed 180 days.  Subsequent rehearings shall be scheduled at the end of each subsequent authorized treatment period, but no longer than every 180 days.

(c)       The responsible professional shall notify the clerk, no later than 15 days before the end of the authorized admission, that continued stay beyond the authorized admission is recommended for the minor.  The clerk shall calendar the rehearing to be held before the end of the current authorized admission.

"§ 122C-224.5.  Transportation.-When it is necessary for a minor to be transported to a location other than the treating facility for the purpose of a hearing, transportation shall be provided under the provisions of G.S. 122C-251.  However, the 24-hour facility may obtain permission from the court to routinely provide transportation of minors to and from hearings.

"§ 122C-224.6.  Treatment pending hearing and after authorization for or concurrence in admission.-(a)         Pending the initial hearing and after authorization for further diagnosis and evaluation, or concurrence in admission, the responsible professional may administer to the minor reasonable and appropriate medication and treatment that is consistent with accepted medical standards and consistent with Article 3 of this Chapter.

(b)       The responsible professional may release the minor conditionally for periods not in excess of 30 days on specified appropriate conditions.  Violation of the conditions is grounds for return of the minor to the 24-hour facility.  A law enforcement officer, on request of the responsible professional, shall take the minor into custody and return him to the facility in accordance with G.S. 122C-205.

"§ 122C-224.7.  Discharge.-(a)     The responsible professional shall unconditionally discharge a minor from treatment at any time that it is determined that the minor is no longer mentally ill or a substance abuser, or no longer in need of treatment at the facility.

(b)       The legally responsible person may file a written request for discharge from the facility at any time.  The facility may hold the minor in the facility for 72 hours after receipt of the request for discharge.  If the responsible professional believes that the minor is mentally ill and dangerous to himself or others, he may file a petition for involuntary commitment under the provisions of Part 7 of this Article.  If the responsible professional believes that the minor is a substance abuser and dangerous to himself or others, he may file a petition for involuntary commitment under the provisions of Part 8 of this Article.  If an order authorizing the holding of the minor under involuntary commitment procedures is issued, further treatment and holding shall follow the provisions of Part 7 or Part 8 whichever is applicable.  If an order authorizing the holding of the minor under involuntary commitment procedures is not issued, the minor shall be discharged.

(c)       If a client reaches age 18 while in treatment, and the client refuses to sign an authorization for continued treatment within 72 hours of reaching 18, he shall be discharged unless the responsible professional obtains an order to hold the client under the provisions of Part 7 or Part 8 of this Article pursuant to an involuntary commitment."

Sec. 2.  This act shall become effective October 1, 1987.

In the General Assembly read three times and ratified this the 15th day of June, 1987.