Vermont H 724: An act relating to administration of involuntary psychiatric medication in emergency circumstances

Bill Text

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VT LEG #385946 v.1
H.724 1
Introduced by Representatives Canfield of Fair Haven, Bosch of Clarendon, 2
Casey of Hubbardton, Harvey of Castleton, Howland of Rutland 3
Town, Keyser of Rutland City, McCoy of Poultney, Pinsonault 4
of Dorset, Pritchard of Pawlet, and Taylor of Mendon 5
Referred to Committee on 6
Date: 7
Subject: Health; mental health; involuntary medication; emergency 8
circumstances 9
Statement of purpose of bill as introduced: This bill proposes to allow the 10
administration of involuntary psychiatric medication in emergency 11
circumstances. 12
An act relating to administration of involuntary psychiatric medication in 13
emergency circumstances 14
It is hereby enacted by the General Assembly of the State of Vermont: 15
Sec. 1. 18 V.S.A. § 7624a is added to read: 16
§ 7624a. ADMINISTRATION OF INVOLUNTARY MEDICATION 17
EMERGENCY CIRCUMSTANCES 18
(a) In emergency circumstances where an application for involuntary 19
medication has been filed pursuant to section 7624 of this chapter, but an order 20

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has not yet been issued, a patient’s treating physician may authorize the 1
administration of involuntary psychiatric medication when the following 2
conditions are met: 3
(1) the patient’s treating physician has informed the patient of the 4
following: 5
(A) the name and dosage of the proposed medication; 6
(B) the reason for ordering the proposed medication; 7
(C) the expected benefits of the proposed medication; 8
(D) the potential risks and side effects of the proposed medication; 9
(E) the right to refuse the proposed medication; and 10
(F) the status of the application for involuntary medication pursuant 11
to section 7624 of this title; 12
(2) the patient either orally refuses the proposed medication, cannot 13
communicate refusal, or otherwise indicates refusal of the proposed medication 14
after a reasonable attempt to obtain voluntary acceptance of the proposed 15
medication; and 16
(3) the medical director of the hospital unit or secure residential 17
recovery facility where the patient is committed and the medical director of the 18
Department have jointly determined that: 19

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(A) less intrusive alternatives to the proposed medication have been 1
considered, documented in the patient’s medical record, and found unlikely to 2
meet the needs of the patient; and 3
(B) the proposed medication is necessary and the least restrictive 4
intervention reasonably required to address the emergency circumstance. 5
(b)(1) Authority to administer the medication under this section shall expire 6
when the emergency circumstance ceases to exist or after 72 hours, whichever 7
is first occurring. 8
(2)(A) Notwithstanding subdivision (1) of this subsection (b), if the 9
emergency circumstance persists or the emergency circumstance has abated 10
because of the effect of the medication and the treating physician is of the 11
opinion that the medication is necessary to keep the emergency in abeyance 12
beyond 72 hours, then within that 72 hours, the hospital or secure residential 13
recovery facility where the patient is committed shall file a written request to 14
the court where the patient’s application for involuntary medication is pending 15
for an emergency hearing within five business days. The filing shall contain a 16
joint certification from the medical director of the hospital unit or secure 17
residential recovery facility where the patient is committed and the medical 18
director of the Department that continued medication is necessary to prevent an 19
emergency circumstance or to keep the emergency circumstance in abeyance. 20
Upon receipt of the emergency filing, the court shall review the patient’s 21

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underlying application for involuntary medication in accordance with sections 1
7624 and 7625 of this chapter. 2
(B) If a complete court filing is not made within 72 hours, then the 3
medication shall be discontinued until the filing can be made, except in cases 4
where life threatening consequences could result from an abrupt medication 5
discontinuation. Under these circumstances, the patient shall be taken safely 6
off the medication according to standards of medical practice with 7
corresponding clinical documentation. 8
(3) In no case shall a patient receive emergency medication under this 9
section for a period exceeding 10 days without an order from the court where 10
the patient’s application for involuntary medication is pending. 11
(c) Within 12 hours after administering medication pursuant to this section, 12
the treating physician shall document the basis for the emergency 13
circumstance, less intrusive alternatives considered, the type and dosage of the 14
medication administered, information provided to the patient prior to and at the 15
time of administrat