North Carolina § 122C-262 - Special emergency procedure for individuals needing immediate hospitalization.

§ 122C-262. Special emergency procedure for individuals needing immediate hospitalization.

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-263(d)(2) 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 individuals with mental illnesses, for examination by a commitment examiner in accordance with G.S. 122C-263(c). Upon examination by the commitment examiner, if the individual meets the inpatient commitment criteria specified in G.S. 122C-263(d)(2) and requires immediate hospitalization to prevent harm to self or others, the commitment examiner 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 commitment examiner knows or has reason to believe that the individual has an intellectual disability, the certificate shall so state. If the commitment examiner executes the oath, appearance before a magistrate shall be waived. The commitment examiner 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 or eligible psychologist shall also communicate the findings to the clerk by telephone. 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 individuals with mental illnesses 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 commitment examiner's certificate shall serve as the custody order and the law enforcement officer or other designated person shall provide transportation in accordance with G.S. 122C-251. If a 24-hour facility is not immediately available or appropriate to the respondent's medical condition, the respondent may be temporarily detained under appropriate supervision in accordance with G.S. 122C-263(d)(2) and released in accordance with G.S. 122C-263(d)(2). Persons described in G.S. 122C-266(b). Persons admitted pursuant to G.S. 15A-1321. 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 the Director's designee. 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 the Director's designee. Respondents received at a 24-hour facility under 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. If, upon examination of a respondent presented in accordance with subsection (a) of this section, the commitment examiner finds that the individual meets the criteria for inpatient commitment specified in G.S. 122C-263(d)(2) but does not require immediate hospitalization to prevent harm to self or others, the commitment examiner may petition the clerk or magistrate in accordance with G.S. 122C-261(d) for an order to take the individual into custody for transport to a 24-hour facility described in G.S. 122C-252. If the commitment examiner 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 transport to or custody at a 24-hour facility described in G.S. 122C-252. If, however, a 24-hour facility is not immediately available or appropriate to the respondent's medical condition, the respondent may be temporarily detained under appropriate supervision in accordance with G.S. 122C-263(d)(2) and released in accordance with G.S. 122C-263(d)(2). This section applies exclusively to an individual who is transported to an area facility or other place for an examination by a commitment examiner in accordance with subsection (a) of this section. In the event an individual known or reasonably believed to have an intellectual disability is transported to a State facility for individuals with mental illnesses, in no event shall that individual be admitted to that facility unless the individual is in one or more of the following categories: Individuals transported to a State facility for individuals with mental illnesses 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. History (1973, c. 726, s. 1; c. 1408, s. 1; 1985, c. 589, s. 2; c. 695, s. 2; 1987, c. 596, s. 1; 1995 (Reg. Sess., 1996), c. 739, s. 7; 2018-33, s. 23; 2019-76, s. 8.) Temporary Waiver of Certain Mental Health Commitment Requirements. - Session Laws 2003-178, s. 1, as amended by Session Laws 2006-66, s. 10.27, Session Laws 2007-504, s. 1.1(a), Session Laws 2009-340, s. 3, Session Laws 2010-119, s. 1, and Session Laws 2010-123, s. 4.8, effective July 1, 2003, and expiring October 1, 2012, provides: "The Secretary of Health and Human Services may, upon request of an LME, waive temporarily the requirements of G.S. 122C-261 through G.S. 122C-263 and G.S. 122C-281 through G.S. 122C-283 pertaining to initial (first-level) examinations by a physician or eligible psychologist of individuals meeting the criteria of G.S. 122C-261(a) or G.S. 122C-281(a) , as applicable, as follows: "(1) The Secretary has received a request from an LME to substitute for a physician or eligible psychologist, a licensed clinical social worker, a masters level psychiatric nurse, or a masters level licensed clinical addictions specialist to conduct the initial (first-level) examinations of individuals meeting the criteria of G.S. 122C-261(a) or G.S. 122C-281(a) . The waiver shall be implemented on a pilot-program basis. The request from the LME shall specifically describe: "a. How the purpose of the statutory requirement would be better served by waiving the requirement and substituting the proposed change under the waiver. "b. How the waiver will enable the LME to improve the delivery or management of mental health, developmental disabilities, and substance abuse services. "c. How the services to be provided by the licensed clinical social worker, the masters level psychiatric nurse, or the masters level licensed clinical addictions specialist under the waiver are within each of these professional's scope of practice. "d. How the health, safety, and welfare of individuals will continue to be at least as well protected under the waiver as under the statutory requirement. "(2) The Secretary shall review the request and may approve it upon finding that: "a. The request meets the requirements of this section. "b. The request furthers the purposes of State policy under G.S. 122C-2 and mental health, developmental disabilities, and substance abuse services reform. "c. The request improves the delivery of mental health, developmental disabilities, and substance abuse services in the counties affected by the waiver and also protects the health, safety, and welfare of individuals receiving these services. "d. The duties and responsibilities performed by the licensed clinical social worker, the masters level psychiatric nurse, or the masters level licensed clinical addictions specialist are within the individual's scope of practice. "(3) The Secretary shall evaluate the effectiveness, quality, and efficiency of mental health, developmental disabilities, and substance abuse services and protection of health, safety, and welfare under the waiver. The Secretary shall send a report on the evaluation to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substances Abuse Services by October 1, 2009. The report shall include data gathered from all participating LMEs since the beginning of the pilot. "(4) The waiver granted by the Secretary under this section shall be in effect until October 1, 2012. "(5) The Secretary may grant a waiver under this section to up to 20 LMEs. "(6) In no event shall the substitution of a licensed clinical social worker, masters level psychiatric nurse, or masters level licensed clinical addictions specialist under a waiver granted under this section be construed as authorization to expand the scope of practice of the licensed clinical social worker, the masters level psychiatric nurse, or the masters level licensed clinical addictions specialist. "(7) The Department shall assure that staff performing the duties are trained and privileged to perform the functions identified in the waiver. The Department shall involve stakeholders including, but not limited to, the North Carolina Psychiatric Association, The North Carolina Nurses Association, National Association of Social Workers, The North Carolina Substance Abuse Professional Practice Board, North Carolina Psychological Association, The North Carolina Society for Clinical Social Work, and the North Carolina Medical Society in developing required staff competencies. "(8) The LME shall assure that a physician is available at all times to provide backup support to include telephone consultation and face-to-face evaluation, if necessary." Session Laws 2006-66, s. 1.2, provides: "This act shall be known as 'The Current Operations and Capital Improvements Appropriations Act of 2006'." Session Laws 2006-66, s. 28.3, provides: "Except for statutory changes or other provisions that clearly indicate an intention to have effects beyond the 2006-2007 fiscal year, the textual provisions of this act apply only to funds appropriated for, and activities occurring during, the 2006-2007 fiscal year." Session Laws 2006-66, s. 28.6, is a severability clause. Session Laws 2007-504, s. 1.1(b), provides: "The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services (LOC) shall review the report submitted by the Secretary under Section 1.1.(a) of this act. The LOC shall make recommendations to the 2010 Regular Session of the 2009 General Assembly regarding whether to extend the pilot, discontinue the pilot, or make the provisions of the pilot permanent and statewide." Editor's note. - Session Laws 1995 (Reg. Sess., 1996), c. 739, s. 15, effective January 1, 1997, and applicable to commitments on or after that date, provides: "Nothing in this act shall require hospitals licensed under G.S. 131E or G.S. 122C to contract with area mental health, developmental disabilities, and substance abuse authorities to provide inpatient or outpatient treatment for persons who are mentally retarded with mental illness." Session Laws 2010-119, s. 2, provides: "The Division of Mental Health, Developmental Disabilities, and Substance Abuse Services shall expand its standardized certification training program to include refresher training for all certified providers and shall report to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services on the participation rate of licensed clinical social worker, the master's level psychiatric nurse, or the master's level certified clinical addictions specialist in the pilot program and whether the program should include other licensed or certified health care professionals." Session Laws 2018-33, s. 46, made the amendment of this section by Session Laws 2018-33, s. 23, effective October 1, 2019, and applicable to proceedings initiated on or after that date. Session Laws 2019-76, s. 33, provides: "Parts I and II of this act do not affect the coverage, eligibility, rights, responsibilities, or provision of State or federal services or benefits for individuals who have been diagnosed with mental retardation and whose diagnosis has not been changed to a diagnosis of intellectual disability." Session Laws 2019-76, s. 34, made the amendments by Session Laws 2019-76, s. 8 effective October 1, 2019, and applicable to proceedings commenced or services rendered on or after that date. Effect of Amendments. - Session Laws 2018-33, s. 23, substituted "commitment examiner" for "physician or eligible psychologist" throughout the section; in subsection (a), substituted "G.S. 122C-263(d)(2)" for "G.S. 122C-261(a)"; in subsection (b), in the first sentence, substituted "inpatient commitment criteria specified in G.S. 122C-263(d)(2) and requires immediate hospitalization to prevent harm to self or others, the commitment examiner" for "criteria required in G.S. 122C-261(a) , the physician or eligible psychologist"; in subsection (d), in the first paragraph, added the last sentence; and added subsections (f) and (g). For effective date and applicability, see editor's note. Session Laws 2019-76, s. 8, substituted "individuals with mental illnesses" for "the mentally ill" near the end of subsection (a); substituted "has an intellectual disability" for "is mentally retarded" in the last sentence of subsection (b); rewrote subsection (d); deleted "the provisions of" preceding "this section" in the first sentence of subsection (e); and substituted "G.S. 122C-252. If, however," for "G.S. 122C-252; provided, however, that if" in the last sentence of subsection (f). For effective date and applicability, see editor's notes. Legal Periodicals. - For survey of 1980 constitutional law, see 59 N.C.L. Rev. 1097 (1981).