A BILL TO BE ENTITLED
AN ACT to authorize first‑level examinations by a licensed clinical social worker for outpatient and inpatient INVOLUNTARY COMMITMENTS under the mental health statutes.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 122C‑262 reads as rewritten:
"§ 122C‑261.  Affidavit and petition before clerk or magistrate when immediate hospitalization is not necessary; custody order.
(a)	Anyone who has knowledge of an individual who is mentally ill and either (i) dangerous to self, as defined in G.S. 122C‑3(11)a., or dangerous to others, as defined in G.S. 122C‑3(11)b., or (ii) in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness, may appear before a clerk or assistant or deputy clerk of superior court or a magistrate and execute an affidavit to this effect, and petition the clerk or magistrate for issuance of an order to take the respondent into custody for examination by a physician, eligible psychologist, or licensed clinical social worker. The affidavit shall include the facts on which the affiant's opinion is based. If the affiant has knowledge or reasonably believes that the respondent, in addition to being mentally ill, is also mentally retarded, this fact shall be stated in the affidavit. Jurisdiction under this subsection is in the clerk or magistrate in the county where the respondent resides or is found.
(b)	If the clerk or magistrate finds reasonable grounds to believe that the facts alleged in the affidavit are true and that the respondent is probably mentally ill and either (i) dangerous to self, as defined in G.S. 122C‑3(11)a., or dangerous to others, as defined in G.S. 122C‑3(11)b., or (ii) in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness, the clerk or magistrate shall issue an order to a law enforcement officer or any other person authorized under G.S. 122C‑251 to take the respondent into custody for examination by a physician, eligible psychologist, or licensed clinical social worker. If the clerk or magistrate finds that, in addition to probably being mentally ill, the respondent is also probably mentally retarded, the clerk or magistrate shall contact the area authority before issuing a custody order and the area authority shall designate the facility to which the respondent is to be taken for examination by a physician, eligible psychologist, or licensed clinical social worker. The clerk or magistrate shall provide the petitioner and the respondent, if present, with specific information regarding the next steps that will occur for the respondent.
(c)	If the clerk or magistrate issues a custody order, the clerk or magistrate shall also make inquiry in any reliable way as to whether the respondent is indigent within the meaning of G.S. 7A‑450. A magistrate shall report the result of this inquiry to the clerk.
(d)	If the affiant is a physician, eligible psychologist, or licensed clinical social worker, the affiant may execute the affidavit before any official authorized to administer oaths. This affiant is not required to appear before the clerk or magistrate for this purpose. This affiant's examination shall comply with the requirements of the initial examination as provided in G.S. 122C‑263(c). If the physician, eligible psychologist, or licensed clinical social worker recommends outpatient commitment and the clerk or magistrate finds probable cause to believe that the respondent meets the criteria for outpatient commitment, the clerk or magistrate shall issue an order that a hearing before a district court judge be held to determine whether the respondent will be involuntarily committed. The physician, eligible psychologist, or licensed clinical social worker shall provide the respondent with written notice of any scheduled appointment and the name, address, and telephone number of the proposed outpatient treatment physician or center. If the physician, eligible psychologist, or licensed clinical social worker recommends inpatient commitment and the clerk or magistrate finds probable cause to believe that the respondent meets the criteria for inpatient commitment, the clerk or magistrate shall issue an order for transportation to or custody at a 24‑hour facility described in G.S. 122C‑252. However, if the clerk or magistrate finds probable cause to believe that the respondent, in addition to being mentally ill, is also mentally retarded, the clerk or magistrate shall contact the area authority before issuing the order and the area authority shall designate the facility to which the respondent is to be transported. If a  physician, eligible psychologist, or licensed clinical social worker executes an affidavit for inpatient commitment of a respondent, a second physician shall be required to perform the examination required by G.S. 122C‑266.
(e)	Upon receipt of the custody order of the clerk or magistrate or a custody order issued by the court pursuant to G.S. 15A‑1003, a law enforcement officer or other person designated in the order shall take the respondent into custody within 24 hours after the order is signed, and proceed according to G.S. 122C‑263.
(f)	When a petition is filed for an individual who is a resident of a single portal area, the procedures for examination by a physician, eligible psychologist, or licensed clinical social worker as set forth in G.S. 122C‑263 shall be carried out in accordance with the area plan. Prior to issuance of a custody order for a respondent who resides in an area authority with a single portal plan, the clerk or magistrate shall communicate with the area authority to determine the appropriate 24‑hour facility to which the respondent should be admitted according to the area plan or to determine if there are more appropriate resources available through the area authority to assist the petitioner or the respondent. When an individual from a single portal area is presented for commitment at a 24‑hour area or State facility directly, the individual may not be accepted for admission until the facility notifies the area authority and the area authority agrees to the admission. If the area authority does not agree to the admission, it shall determine the appropriate 24‑hour facility to which the individual should be admitted according to the area plan or determine if there are more appropriate resources available through the area authority to assist the individual. If the area authority agrees to the admission, further planning of treatment for the client is the joint responsibility of the area authority and the facility as prescribed in the area plan.
Notwithstanding the provisions of this section, in no event shall an individual known or reasonably believed to be mentally retarded be admitted to a State psychiatric hospital, except as follows:
(1)	Persons described in G.S. 122C‑266(b);
(2)	Persons admitted pursuant to G.S. 15A‑1321;
(3)	Respondents who are so extremely dangerous as to pose a serious threat to the community and to other patients committed to non‑State hospital psychiatric inpatient units, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee; and
(4)	Respondents who are so gravely disabled by both multiple disorders and medical fragility or multiple disorders and deafness that alternative care is inappropriate, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee.
Individuals transported to a State facility for the mentally ill who are not admitted by the facility may be transported by law enforcement officers or designated staff of the State facility in State‑owned vehicles to an appropriate 24‑hour facility that provides psychiatric inpatient care.
No later than 24 hours after the transfer, the responsible professional at the original facility shall notify the petitioner, the clerk of court, and, if consent is granted by the respondent, the next of kin, that the transfer has been completed."
SECTION 2.  G.S. 122C‑262 reads as rewritten:
"§ 122C‑262.  Special emergency procedure for individuals needing immediate hospitalization.
(a)	Anyone, including a law enforcement officer, who has knowledge of an individual who is subject to inpatient commitment according to the criteria of G.S. 122C‑261(a) and who requires immediate hospitalization to prevent harm to self or others, may transport the individual directly to an area facility or other place, including a State facility for the mentally ill, for examination by a physician, eligible psychologist, or licensed clinical social worker in accordance with G.S. 122C‑263(c).
(b)	Upon examination by the physician, eligible psychologist, or licensed clinical social worker, if the individual meets the criteria required in G.S. 122C‑261(a), the physician, eligible psychologist, or licensed clinical social worker shall so certify in writing before any official authorized to administer oaths. The certificate shall also state the reason that the individual requires immediate hospitalization. If the physician, eligible psychologist, or licensed clinical social worker knows or has reason to believe that the individual is mentally retarded, the certificate shall so state.
(c)	If the physician, eligible psychologist, or licensed clinical social worker executes the oath, appearance before a magistrate shall be waived. The physician, eligible psychologist, or licensed clinical social worker shall send a copy of the certificate to the clerk of superior court by the most reliable and expeditious means. If it cannot be reasonably anticipated that the clerk will receive the copy within 24 hours, excluding Saturday, Sunday, and holidays, of the time that it was signed, the physician, eligible psychologist, or licensed clinical social worker shall also communicate the findings to the clerk by telephone.
(d)	Anyone, including a law enforcement officer if necessary, may transport the individual to a 24‑hour facility described in G.S. 122C‑252 for examination and treatment pending a district court hearing. If there is no area 24‑hour facility and if the respondent is indigent and unable to pay for care at a private 24‑hour facility, the law enforcement officer or other designated person providing transportation shall take the respondent to a State facility for the mentally ill designated by the Commission in accordance with G.S. 143B‑147(a)(1)a and immediately notify the clerk of superior court of this action. The physician's, eligible psychologist's, or licensed clinical social worker's certificate shall serve as the custody order and the law enforcement officer or other designated person shall provide transportation in accordance with the provisions of G.S. 122C‑251.
In the event an individual known or reasonably believed to be mentally retarded is transported to a State facility for the mentally ill, in no event shall that individual be admitted to that facility except as follows:
(1)	Persons described in G.S. 122C‑266(b);
(2)	Persons admitted pursuant to G.S. 15A‑1321;
(3)	Respondents who are so extremely dangerous as to pose a serious threat to the community and to other patients committed to non‑State hospital psychiatric inpatient units, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee; and
(4)	Respondents who are so gravely disabled by both multiple disorders and medical fragility or multiple disorders and deafness that alternative care is inappropriate, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee.
Individuals transported to a State facility for the mentally ill who are not admitted by the facility may be transported by law enforcement officers or designated staff of the State facility in State‑owned vehicles to an appropriate 24‑hour facility that provides psychiatric inpatient care.
No later than 24 hours after the transfer, the responsible professional at the original facility shall notify the petitioner, the clerk of court, and, if consent is granted by the respondent, the next of kin, that the transfer has been completed.
(e)	Respondents received at a 24‑hour facility under the provisions of this section shall be examined by a second physician in accordance with G.S. 122C‑266. After receipt of notification that the district court has determined reasonable grounds for the commitment, further proceedings shall be carried out in the same way as for all other respondents under this Part."
SECTION 3.  G.S. 122C‑263 reads as rewritten:
"§ 122C‑263.  Duties of law‑enforcement officer; first examination by physician or eligible psychologist.
(a)	Without unnecessary delay after assuming custody, the law enforcement officer or the individual designated by the clerk or magistrate under G.S. 122C‑251(g) to provide transportation shall take the respondent to an area facility for examination by a physician, eligible psychologist, or licensed clinical social worker; if a physician, eligible psychologist, or licensed clinical social worker is not available in the area facility, the person designated to provide transportation shall take the respondent to any physician, eligible psychologist, or licensed clinical social worker locally available. If a physician, eligible psychologist, or licensed clinical social worker is not immediately available, the respondent may be temporarily detained in an area facility, if one is available; if an area facility is not available, the respondent may be detained under appropriate supervision in the respondent's home, in a private hospital or a clinic, in a general hospital, or in a State facility for the mentally ill, but not in a jail or other penal facility.
(b)	The examination set forth in subsection (a) of this section is not required if:
(1)	The affiant who obtained the custody order is a physician, eligible psychologist, or licensed clinical social worker who recommends inpatient commitment;
(2)	The custody order states that the respondent was charged with a violent crime, including a crime involving assault with a deadly weapon, and he was found incapable of proceeding; or
(3)	Repealed by Session Laws 1987, c. 596, s. 3.
In any of these cases, the law‑enforcement officer shall take the respondent directly to a 24‑hour facility described in G.S. 122C‑252.
(c)	The physician, eligible psychologist, or licensed clinical social worker described in subsection (a) of this section shall examine the respondent as soon as possible, and in any event within 24 hours, after the respondent is presented for examination. The examination shall include but is not limited to an assessment of the respondent's:
(1)	Current and previous mental illness and mental retardation including, if available, previous treatment history;
(2)	Dangerousness to self, as defined in G.S. 122C‑3(11)a. or others, as defined in G.S. 122C‑3(11)b.;
(3)	Ability to survive safely without inpatient commitment, including the availability of supervision from family, friends or others; and
(4)	Capacity to make an informed decision concerning treatment.
(d)	After the conclusion of the examination the physician, eligible psychologist, or licensed clinical social worker shall make the following determinations:
(1)	If the physician, eligible psychologist, or licensed clinical social worker finds that:
a.	The respondent is mentally ill;
b.	The respondent is capable of surviving safely in the community with available supervision from family, friends, or others;
c.	Based on the respondent's psychiatric history, the respondent is in need of treatment in order to prevent further disability or deterioration that would predictably result in dangerousness as defined by G.S. 122C‑3(11); and
d.	The respondent's current mental status or the nature of the respondent's illness limits or negates the respondent's ability to make an informed decision to seek voluntarily or comply with recommended treatment.
The physician, eligible psychologist, or licensed clinical social worker shall so show on the examination report and shall recommend outpatient commitment. In addition the examining physician, eligible psychologist, or licensed clinical social worker shall show the name, address, and telephone number of the proposed outpatient treatment physician or center. The person designated in the order to provide transportation shall return the respondent to the respondent's regular residence or, with the respondent's consent, to the home of a consenting individual located in the originating county, and the respondent shall be released from custody.
(2)	If the physician, eligible psychologist, or licensed clinical social worker finds that the respondent is mentally ill and is dangerous to self, as defined in G.S. 122C‑3(11)a., or others, as defined in G.S. 122C‑3(11)b., the  physician, eligible psychologist, or licensed clinical social worker shall recommend inpatient commitment, and shall so show on the examination report. If, in addition to mental illness and dangerousness, the physician, eligible psychologist, or licensed clinical social worker also finds that the respondent is known or reasonably believed to be mentally retarded, this finding shall be shown on the report. The law enforcement officer or other designated person shall take the respondent to a 24‑hour facility described in G.S. 122C‑252 pending a district court hearing. If there is no area 24‑hour facility and if the respondent is indigent and unable to pay for care at a private 24‑hour facility, the law enforcement officer or other designated person shall take the respondent to a State facility for the mentally ill designated by the Commission in accordance with G.S. 143B‑147(a)(1)a. for custody, observation, and treatment and immediately notify the clerk of superior court of this action.
In the event an individual known or reasonably believed to be mentally retarded is transported to a State facility for the mentally ill, in no event shall that individual be admitted to that facility except as follows:
a.	Persons described in G.S. 122C‑266(b);
b.	Persons admitted pursuant to G.S. 15A‑1321;
c.	Respondents who are so extremely dangerous as to pose a serious threat to the community and to other patients committed to non‑State hospital psychiatric inpatient units, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee; and
d.	Respondents who are so gravely disabled by both multiple disorders and medical fragility or multiple disorders and deafness that alternative care is inappropriate, as determined by the Director of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services or his designee.
Individuals transported to a State facility for the mentally ill who are not admitted by the facility may be transported by law enforcement officers or designated staff of the State facility in State‑owned vehicles to an appropriate 24‑hour facility that provides psychiatric inpatient care.
No later than 24 hours after the transfer, the responsible professional at the original facility shall notify the petitioner, the clerk of court, and, if consent is granted by the respondent, the next of kin, that the transfer has been completed.
(3)	If the physician, eligible psychologist, or licensed clinical social worker finds that neither condition described in subdivisions (1) or (2) of this subsection exists, the proceedings shall be terminated. The person designated in the order to provide transportation shall return the respondent to the respondent's regular residence or, with the respondent's consent, to the home of a consenting individual located in the originating county and the respondent shall be released from custody.
(e)	The findings of the physician, eligible psychologist, or licensed clinical social worker and the facts on which they are based shall be in writing in all cases. The physician, eligible psychologist, or licensed clinical social worker shall send a copy of the findings to the clerk of superior court by the most reliable and expeditious means. If it cannot be reasonably anticipated that the clerk will receive the copy within 48 hours of the time that it was signed, the physician, eligible psychologist, or licensed clinical social worker shall also communicate his findings to the clerk by telephone.
(f)	When outpatient commitment is recommended, the examining  physician, eligible psychologist, or licensed clinical social worker, if different from the proposed outpatient treatment physician or center, shall give the respondent a written notice listing the name, address, and telephone number of the proposed outpatient treatment physician or center and directing the respondent to appear at the address at a specified date and time. The examining physician, eligible psychologist, or licensed clinical social worker before the appointment shall notify by telephone the designated outpatient treatment physician or center and shall send a copy of the notice and his examination report to the physician or center.
(g)	The physician, eligible psychologist, or licensed clinical social worker at the completion of the examination, shall provide the respondent with specific information regarding the next steps that will occur."
SECTION 4.  G.S. 122C‑264 reads as rewritten:
"§ 122C‑264.  Duties of clerk of superior court and the district attorney.
(a)	Upon receipt of a physician's, eligible psychologist's, or licensed clinical social worker's finding that the respondent meets the criteria of G.S. 122C‑263(d)(1) and that outpatient commitment is recommended, the clerk of superior court of the county where the petition was initiated, upon direction of a district court judge, shall calendar the matter for hearing and shall notify the respondent, the proposed outpatient treatment physician or center, and the petitioner of the time and place of the hearing. The petitioner may file a written waiver of his right to notice under this subsection with the clerk of court.
(b)	Upon receipt of a physician's, eligible psychologist's, or licensed clinical social worker's finding that a respondent meets the criteria of G.S. 122C‑263(d)(2) and that inpatient commitment is recommended, the clerk of superior court of the county where the 24‑hour facility is located shall, after determination required by G.S. 122C‑261(c) and upon direction of a district court judge, assign counsel if necessary, calendar the matter for hearing, and notify the respondent, his counsel, and the petitioner of the time and place of the hearing. The petitioner may file a written waiver of his right to notice under this subsection with the clerk of court.
(b1)	Upon receipt of a physician's, eligible psychologist's, or licensed clinical social worker's certificate that a respondent meets the criteria of G.S. 122C‑261(a) and that immediate hospitalization is needed pursuant to G.S. 122C‑262, the clerk of superior court of the county where the treatment facility is located shall submit the certificate to the Chief District Court Judge. The court shall review the certificate within 24 hours, excluding Saturday, Sunday, and holidays, for a finding of reasonable grounds in accordance with 122C‑261(b). The clerk shall notify the treatment facility of the court's findings by telephone and shall proceed as set forth in subsections (b), (c), and (f) of this section.
(c)	Notice to the respondent, required by subsections (a) and (b) of this section, shall be given as provided in G.S. 1A‑1, Rule 4(j) at least 72 hours before the hearing. Notice to other individuals shall be sent at least 72 hours before the hearing by first‑class mail postage prepaid to the individual's last known address. G.S. 1A‑1, Rule 6 shall not apply.
(d)	In cases described in G.S. 122C‑266(b) in addition to notice required in subsections (a) and (b) of this section, the clerk of superior court shall notify the chief district judge and the district attorney in the county in which the defendant was found incapable of proceeding. The notice shall be given in the same way as the notice required by subsection (c) of this section. The judge or the district attorney may file a written waiver of his right to notice under this subsection with the clerk of court.
(d1)	For hearings and rehearings pursuant to G.S. 122C‑268.1 and G.S. 122C‑276.1, the clerk of superior court shall calendar the hearing or rehearing and shall notify the respondent, his counsel, counsel for the State, and the district attorney involved in the original trial. The notice shall be given in the same manner as the notice required by subsection (c) of this section. Upon receipt of the notice, the district attorney shall notify any persons he deems appropriate, including anyone who has filed with his office a written request for notification of any hearing or rehearing concerning discharge or conditional release of a respondent. Notice sent by the district attorney shall be by first‑class mail to the person's last known address.
(e)	The clerk of superior court of the county where outpatient commitment is to be supervised shall keep a separate list regarding outpatient commitment and shall prepare quarterly reports listing all active cases, the assigned supervisor, and the disposition of all hearings, supplemental hearings, and rehearings.
(f)	The clerk of superior court of the county where inpatient commitment hearings and rehearings are held shall provide all notices, send all records and maintain a record of all proceedings as required by this Part; provided that if the respondent has been committed to a 24‑hour facility in a county other than his county of residence and the district court hearing is held in the county of the facility, the clerk of superior court in the county of the facility shall forward the record of the proceedings to the clerk of superior court in the county of respondent's residence, where they shall be maintained by receiving clerk."
SECTION 5.  G.S. 122C‑265 reads as rewritten:
"§ 122C‑265.  Outpatient commitment; examination and treatment pending hearing.
(a)	If a respondent, who has been recommended for outpatient commitment by an examining physician, eligible psychologist, or licensed clinical social worker different from the proposed outpatient treatment physician or center, fails to appear for examination by the proposed outpatient treatment physician or center at the designated time, the physician or center shall notify the clerk of superior court who shall issue an order to a law‑enforcement officer or other person authorized under G.S. 122C‑251 to take the respondent into custody and take him immediately to the outpatient treatment physician or center for evaluation. The law‑enforcement officer may wait during the examination and return the respondent to his home after the examination.
(b)	The examining physician or the proposed outpatient treatment physician or center may prescribe to the respondent reasonable and appropriate medication and treatment that are consistent with accepted medical standards pending the district court hearing.
(c)	In no event may a respondent released on a recommendation that he meets the outpatient commitment criteria be physically forced to take medication or forceably detained for treatment pending a district court hearing.
(d)	If at any time pending the district court hearing the outpatient treatment physician or center determines that the respondent does not meet the criteria of G.S. 122C‑263(d)(1), he shall release the respondent and notify the clerk of court and the proceedings shall be terminated.
(e)	If a respondent becomes dangerous to himself, as defined in G.S. 122C‑3(11)a., or others, as defined in G.S. 122C‑3(11)b., pending a district court hearing on outpatient commitment, new proceedings for involuntary inpatient commitment may be initiated.
(f)	If an inpatient commitment proceeding is initiated pending the hearing for outpatient commitment and the respondent is admitted to a 24‑hour facility to be held for an inpatient commitment hearing, notice shall be sent by the clerk of court in the county where the respondent is being held to the clerk of court of the county where the outpatient commitment was initiated and the outpatient commitment proceeding shall be terminated."
SECTION 6.  This act is effective when it becomes law.