HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The purpose of this Act is to authorize the
 2 Department of Health to adopt administrative rules to establish
 3 an administrative process allowing involuntary medication of
 4 psychiatric patients institutionalized at the Hawaii State
 5 Hospital in order to alleviate mental illness and restore
 6 competency while protecting the rights of patients.
 7      SECTION 2.  Chapter 334, Hawaii Revised Statutes, is amended
 8 by adding a new section to be appropriately designated and to
 9 read as follows:
10      "334-    Involuntary treatment with psychiatric medication.
11 (a)  The department shall adopt rules in accordance with chapter
12 91 to enable interdisciplinary clinical review panels to
13 authorize the involuntary administration of psychotropic
14 medication for appropriate patients at the state hospital
15 established pursuant to section 334-31.  The rules shall permit
16 involuntary administration of psychotropic medication only when
17 medically appropriate and, considering less intrusive
18 alternatives, essential for the sake of the individual or the
19 safety of others and, in the case of individuals hospitalized

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 1 pursuant to chapter 704-406, when treatment is necessary to
 2 obtain an adjudication of the individuals guilt or innocence.
 3      (b)  The administrative rules shall include an appeals
 4 process to a second body, appointed by the director, whose
 5 decision shall be deemed the final administrative decision.
 6      (c)  The final decision in the administrative process may be
 7 appealed to the Circuit Courts within 14 days."
 8      SECTION 3.  Section 334E-2, Hawaii Revised Statues, is
 9 amended by amending subsection (a) to read as follows:
10      "(a)   Any patient in a psychiatric facility shall be
11 afforded rights; and any psychiatric facility shall provide the
12 rights to all patients; provided that when a patient is not able
13 to exercise the patient's rights, the patient's legal guardian or
14 legal representative shall have the authority to exercise the
15 same on behalf of the patient.  The rights shall include, but not
16 be limited to, the following:
17      (1)  Access to written rules and regulations with which the
18           patient is expected to comply;
19      (2)  Access to the facility's grievance procedure or to the
20           department of health as provided in section 334-3;
21      (3)  Freedom from reprisal;
22      (4)  Privacy, respect, and personal dignity;
23      (5)  A humane environment;

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 1      (6)  Freedom from discriminatory treatment based on race,
 2           color, creed, national origin, age, and sex;
 3      (7)  A written treatment plan based on the individual
 4           patient;
 5      (8)  Participation in the planning of the patient's
 6           treatment plan;
 7      (9)  Refusal of treatment except in emergency situations or
 8           where a court order or administrative authorization
 9           pursuant to section 334-   exists;
10     (10)  Refusal to participate in experimentation;
11     (11)  The choice of physician if the physician chosen agrees;
12     (12)  A qualified, competent staff;
13     (13)  A medical examination before initiation of non-
14           emergency treatment;
15     (14)  Confidentiality of the patient's records;
16     (15)  Access to the patient's records;
17     (16)  Knowledge of rights withheld or removed by a court or
18           by law;
19     (17)  Physical exercise and recreation;
20     (18)  Adequate diet;
21     (19)  Knowledge of the names and titles of staff members with
22           whom the patient has frequent contact;
23     (20)  The right to work at the facility and fair compensation

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 1           for work done; provided that work is available and is
 2           part of the patient's treatment plan;
 3     (21)  Visitation rights, unless the patient poses a danger to
 4           self or others; provided that where visitation is
 5           prohibited, the legal guardian or legal representative
 6           shall be allowed to visit the patient upon request;
 7     (22)  Uncensored communication;
 8     (23)  Notice of and reasons for an impending transfer;
 9     (24)  Freedom from seclusion or restraint, except:
10           (A)  When necessary to prevent injury to self of
11                others; or
12           (B)  When part of the treatment plan; or
13           (C)  When necessary to preserve the rights of other
14                patients or staff;
15     (25)  Disclosure to a court, at an involuntary civil
16           commitment hearing, of all treatment procedures which
17           have been administered prior to the hearing;
18     (26)  Receipt by the patient and the patient's guardian or
19           legal guardian, if the patient has one, of this
20           enunciation of rights at the time of admission."
21      SECTION 4.  Statutory material to be repealed is bracketed.
22 New statutory material is underscored.

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 1      SECTION 5.  This Act shall take effect upon its approval.
 3                           INTRODUCED BY:  _______________________

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