Judicial Branch Mental Health Working Group

Type:                           Short-Term Working Group
Established:               August 15, 2014
Chair:                        Chief Justice Thomas E. Humphrey and Chief Judge Charles LaVerdiere
Report Date:              December 15, 2014
Reports to:                 Supreme Judicial Court and the Joint Standing Committee on Judiciary
Completion Date:     June 30, 2015

Judicial Branch Mental Health Working Group (PDF)

  1. Purpose:
    At the request of the 126th Maine Legislature, the Chief Justice calls together this stakeholder Working Group to review the judicial process for involuntary commitment and treatment; examine immediate and long-term needs; and develop short‑term and long-term solutions that address both legislative changes needed and resource improvements.

  2. Authority:
    Authorized by Resolves 2013, ch. 106, § 1, which provides that "the Chief Justice or the Chief Justice's designee shall convene a working group to review the current situation for both individuals and hospitals when individuals present emergency psychiatric needs in hospital emergency departments and to develop recommendations for addressing immediate and long-term needs of individuals, hospitals, psychiatric hospitals and health care providers."

  3. Issues to be Considered:

             A.   Hospitals—Liability and Resources
             A complete review of the judicial process for proposed involuntary commitment and treatment will be undertaken to determine whether improvements and clarification in the procedures and communication of those procedures can be identified, with the goal of providing appropriate due process, greater clarity for treatment providers, and improved public safety.

             B.   Judicial Branch—Independent Examiners—Due Process
             An update on professional resources for evaluations, preliminary examinations, and full mental health exams will be undertaken.  There is a growing lack of independent examiners available to timely evaluate individuals for court hearings related to involuntary commitments and/or medications; as a result, either the involuntary medication request is unable to be heard, or there are inordinate delays in scheduling such hearings.

             C.   Other—Independent Examiners—Responsibility and Resources
             Independent examiners perform services and appear as witnesses for parties in court cases and hearings related to involuntary commitments and/or medications. As a result of historic budgeting processes, the payment of those individuals is channeled through the Judicial Branch, which has no expertise in setting appropriate professional rates, in seeking third-party contributions, or in seeking Medicaid reimbursement.  Consideration must be given to reallocating responsibility for engaging and maintaining a sufficient roster of independent examiners for court proceedings.  In addition, increases in costs must be addressed in order to assure prompt assignment of cases and timely resolution.

  4. Tasks of Working Group:

    (1) Review the current process for both individuals and hospitals when individuals present emergency psychiatric needs in hospital emergency departments;

    (2) Develop recommendations for addressing immediate and long-term process improvement for individuals, hospitals, psychiatric hospitals, and healthcare providers regarding involuntary commitments and involuntary medication; and

    (3) Address the following:

    (a) Timing and length of preliminary and follow-up holding and commitment periods and requirements for involuntary treatment during such periods;

    (b) Process improvements for holding and commitment period determinations;

    (c) Current lack of healthcare providers available to address (i) compliance with due process requirements, and (ii) any procedural changes recommended by the Working Group;

    (d) Establish responsibilities for (i) engaging and maintaining a sufficient roster of independent examiners to timely perform services and appear as witnesses for parties in court cases and hearings related to involuntary commitments and/or medications, and (ii) paying all costs and fees associated with their services, including court appearances; and

    (e) Any other recommendations for improvement in the judicial process for involuntary commitment and treatment.

  5. Membership:

    The Working Group shall be comprised of various stakeholders in the judicial process for involuntary commitment and treatment.

    Its members shall include representatives of persons and entities interested in the judicial process concerning the detention of individuals for emergency responses, involuntary treatment, and involuntary commitment in connection with the medical and psychiatric needs of such individuals.

    A.      Members of Stakeholders Group:
    Trial Court Chiefs
    Attorney General's Representative
    DHHS Representative
    NAMI Representative
    Patient Attorneys Representative
    Maine Hospital Association Representative
    Maine Medical Association
    Maine Nurse Practitioner's Association Representative
    Mental Health Institution Representative
    Consumer Council System Of Maine (CCSM) Representative
    Disability Rights Center Representative
    Family Advocate Representative
    Treatment Advocacy Center Representative

    B.      Subgroups of the Stakeholders Group:
             (i) Due Process Subgroup
             (ii) Providers & Costs Subgroup

  6. Statutes That Implicate Mental Health Issues In Court Proceedings::
    The Task Force will issue a report to be presented to the Supreme Judicial Court on or before September 21, 2012.

    1.   Involuntary Medication – 34-A M.R.S. § 3049
    2.   Hospitalization for Mental Illness – 34-A M.R.S. § 3069
    3.   Transfer of Inmates for Mental Health Services – 34-A M.R.S. § 3069-A
    4.   Placement of Defendants for Observation – 34-A M.R.S. § 3069-B
    5.   Reception of Involuntary Patients – 34-B M.R.S. § 3861
    6.   Notification of Hospitalization – 34-B M.R.S. § 3861-A
    7.   Involuntary Medication – 34-A M.R.S. § 3049
    8.   Protective Custody – 34-B M.R.S. § 3862
    9.    Emergency Procedure – 34-B M.R.S. § 3863
    10. Judicial Procedure and Commitment – 34-B M.R.S. § 3864

  7. Meetings:
    The Workgroup shall meet as often as necessary to complete its responsibilities.

  8. Reporting
    The Workgroup shall report to the Maine Supreme Judicial Court and the Joint Standing Committee on Judiciary on or before December 15, 2014.
  9. Duration
    Unless the Chief Justice extends the charter, the Workgroup will cease to exist on June 30, 2015. 

Dated: August 26, 2014

Approved by:

         /s/                                         
Chief Justice Leigh I. Saufley
Maine Supreme Judicial Court


Membership Roster

Trial Court Chiefs
            Chief Justice Thomas E. Humphrey
            Chief Judge Charles Laverdiere

Attorney General's Representative
            Katherine Greason, AAG

DHHS Representative
            [To be appointed by Commissioner Mayhew]

Maine Hospital Association Representative
            Jeff Austin

Maine Medical Association
            Gordon Smith, Esq.

Maine Nurse Practitioner's Association Representative
            Connie Jordan

NAMI Representative
            Jenna Mehnert 

Mental Health Institution Representative
            (Representative from Riverside or Dorothea Dix)

Patient Attorneys Representative
            William Lee, Esq.

Consumer Council System Of Maine (CCSM) Representative
            Charlie Ames 

Disability Rights Center Representative
            Helen Bailey 

Family Advocate Representative
            Jeanie Coltart 

Treatment Advocacy Center Representative
            Joe Bruce