Policy NDCC 50-25.1-15 - Abandoned Infant – Approved Location Procedure – Reporting Immunity How will the Policy be Implemented? Who will be the Agencies or Organizations Charged with Overseeing, Ev

Policy Description 9

Running head: POLICY DESCRIPTION SB2098

Policy Description Senate Bill 2098:

Mental Illness or Chemical Dependency Treatment Evaluation

Names Deleted

University of North Dakota

April 5, 2009

How is the Policy Expected to Work?

North Dakota has specific guidelines directing the involuntary commitment of individuals as outlined in the North Dakota Century Code 25-03.1. The process of petitioning for commitment is directly related to Senate Bill 2098. Currently, any adult can submit a petition for the involuntary commitment of an individual if he or she feels there is serious risk of harm if the individual is left untreated. Petitioners bring the information to the state attorney of their county, who then helps them complete the petition. The petition may be accompanied by a signed statement from a physician, psychiatrist, or psychologist who has examined the individual within 45 days. After this is complete, the state’s attorney files the petition if there is reasonable evidence that the identified individual requires treatment (NDLC, 2001; NDCC 25.03-1, 2009).

Though this is the formal operation of the policy, its practical application varies. For example, persons requiring treatment are often hospitalized. At this point, families and friends who are willing to file petitions are assisted by hospital social workers (G. Drengson, personal communication, March 18, 2009) nice reference, I’m sure she was happy to hear from you!. This is an intermediate step designed to help uncertain families and friends before the state’s attorney becomes involved. Nothing about LADs???

What Resources or Opportunities is the Policy Expected to Provide?

SB 2098 will not provide any additional resources or opportunities. Its passage would give addiction counselors the ability to sign the petitions necessary for commitment which was previously reserved for only physicians, psychiatrists, and psychologists (SB 2098, 2009). This does not represent a major change to the system and the state is not allocating any funding for its implementation. SB 2098 will give addiction counselors more authority but will not significantly increase their workload. Still, it will permit addiction counselors to use their expertise and help clients in a more comprehensive fashion. Nice summary

Who will be Covered by the Policy and How?

The current commitment policy, NDCC 25-03.1, covers individuals in need of commitment, their families, and their friends. It is meant to provide safety to those who are endangered as a result of extreme chemical dependency or mental illness. It also provides physicians, psychiatrists, and psychologists authority in commitment proceedings. SB 2098 will add addiction counselors to the approved list of experts as they are given the new role mentioned above.

How will the Policy be Implemented?

The process of allowing addiction counselors to sign commitment petitions is a minor change that does not require any great alterations in the current system. Implementation of the policy would simply give addictions counselors this authority (Dr. A. McLean, personal communication, February 4, 2009). If the policy is passed, it would be the responsibility of the state’s attorney to inform judges presiding over commitment procedures about the change in policy.

What are the Short- and Long-Term Goals and Outcomes of the Policy?

SB 2098 does not have separate short- and long-term goals; rather, the goals of the policy are consistent throughout its implementation. Overall, the system is not being changed drastically as neither commitment admissions nor workloads of addiction counselors will increase considerably. The goal in the short- and long-term is to improve the policy by making it more inclusive of the professionals best equipped to participate in the commitment process. Any reasons to believe that this is either a ‘good’ thing or that it might be problematic?

What are the Administrative Auspices under which the Policy will be Lodged?

As SB 2098 would be incorporated into the existing North Dakota Century Code, a primary administrative auspice governing the policy would be the courts at both the county and state level. For example, the state’s attorney of a respondent’s county would assist with any petitions being completed outside of a hospital environment, while North Dakota courts would govern the commitment process and accept petitions signed by addiction counselors.

The Department of Human Services, who requested the introduction of SB 2098, will also be an administrative auspice. This will occur at the regional and state levels. For example, human service centers at both levels employ many addiction counselors. The centers would guide the commitment proceedings and ensure addiction counselors are given the authority to sign commitment petitions. The state hospital, who admits most of the individuals placed under involuntary commitment, will continue to play an active role in treating individuals and carrying out commitments (Dr. A. McLean, personal communication, February 4, 2009).

Finally, law enforcement and private agencies employing addiction counselors will take part in the process. For example, law enforcement may take on an active practical role by transporting recently committed clients to rehabilitation facilities (G. Drengson, personal communication, March 18, 2009). Agencies employing addiction counselors will also be responsible to modify current commitment procedures to incorporate the changes of SB 2098.

What is the Funding Mechanism for the Policy?

There is no specific funding mechanism for the proposed changes of SB 2098. There are, however, a few financial ripple effects that follow the bill’s implementation. For example, though the proposed changes of SB 2098 will not greatly increase workload, addiction counselors may request additional compensation for undertaking this extra duty. Furthermore, though physicians are prohibited from billing time spent filling out commitment petitions, they may bill their time to complete physical examinations (G. Drengson, personal communication, March 18, 2009). If either of these occurs, payment depends on the nature of the agency. In public agencies, tax payers would likely be forced to fund additional fees. Conversely, private agencies may place responsibility on the individual or their insurance company to pay any additional cost. (good, informed analysis)

Who will be the Agencies or Organizations Charged with Overseeing, Evaluating, and Coordinating the Policy?

The primary organization who will oversee the commitment process is the court system of North Dakota. Involuntary commitments are a component of North Dakota law; therefore, the court system will be in charge of making sure commitments are enacted effectively and efficiently. As stated previously, it would be the court’s responsibility to ensure a petition signed by an addition counselor is accepted. In regards to the evaluation of SB 2098, there are no current mechanisms for this to take place. No one will be hired to evaluate this policy; rather, it will simply be implemented. Finally, hospital social workers often coordinate the petition process for patients who are hospitalized. If this is not the case, the state’s attorney office assists in the coordination of the petition process (G. Drengson, personal communication, March 18, 2009). Should there be any evaluation mechanism put in place or is that not necessary?

What is the Formal or Informal Criteria that will be Used to Determine the Effectiveness of the Policy?

There are no formal or informal measures that exist to determine the effectiveness of SB 2098. It will be implemented and accepted as it currently stands. According to the current NDCC 25-03.1, addiction counselors can testify in commitment hearings but are not able to sign commitment petitions. SB 2098 is appropriately fixing an oversight in the existing policy.good—you might have even mentioned this up front in your introduction Therefore, it is not necessary to conduct extensive effectiveness studies on SB 2098.

For What Length of Time is the Policy Expected to be in Existence?

SB 2098 has no fixed life; rather, it is expected to exist as long as involuntary commitments are practiced in North Dakota.

What is the Knowledge Base or Scientific Grounding on which the Policy Rests?

SB 2098 is not based on scientific grounding; rather, it is designed to correct an omission in the current policy. This stems from the accepted practice of involuntary commitments. Currently, all 50 states have laws permitting the involuntary commitment of severely mentally ill or chemically dependent individuals who are deemed to be in serious risk of harm to themselves or others (Stavis, 1995). North Dakota’s commitment laws have been enacted since 1957 (NDLC, 2001). Since addiction counselors can testify in commitment hearings, they are already considered experts in this field. It is natural to allow addiction counselors to utilize their expertise throughout the entire commitment process, not just certain components. Instead of being the result of extensive scientific study, SB 2098 is a “housekeeping bill” intended to correct this oversight.

References

North Dakota Century Code (NDCC). (2009). Chapter 25-03.1 Commitment procedures. Retrieved February 26, 2009, from http://www.legis.nd.gov/cencode/t25c031.pdf.

North Dakota Legislative Council. (2001). Mental illness commitment procedures – Background memorandum. Retrieved February 3, 2009, from http://www.legis.nd.gov/assembly/57-2001/docs/pdf/39028.pdf.

Senate Bill 2098: Mental Illness or Chemical Dependency Treatment Evaluation. 61st Legislative Assembly of North Dakota. (2009).

Stavis, J. (1995). Civil commitment: Past, present, and future. Quality of Care Newsletter, 64. Retrieved February 6, 2009, from http://www.cqc.state.ny.us/ counsels_corner/cc64.htm.