The Court Advisory Task Force on Civil Commitment in 1994 recommended in their task force report that a statewide civil commitment training and resource center be created to provide interdisciplinary training and information regarding the civil commitment process and related topics. The Office of Ombudsman for Mental Health and Developmental Disabilities (OMHDD) received funding in the 1997 Omnibus Health and Human Services Act to develop and implement the CCTRC.
The OMHDD contracted with Hamline University School of Law and the Minnesota Attorney Generals Office to provide the training component of the CCTRC. Starting in March, 1998 through June, 1999, Hamline and the Attorney General's Office provided a minimum of eight statewide, interdisciplinary training seminars on the Civil Commitment Act and related law.
The first five training seminars provided a step-by-step overview of civil commitment in Minnesota, with a special emphasis on the 1997 amendments. These seminars also provided detailed, specialized training on individualized topics in civil commitment, including pre-petition issues, post-petition issues, neuroleptic medications and substitute decision making, and more effective advocacy. The training locations included Mankato, Bemidji, St. Cloud, St. Paul, and Minneapolis.
The second set of training seminars focused on two narrower topics in greater depth. For each of the two topics selected, a detailed, stand-alone training package was developed that can be easily replicated throughout the state. One training package will be designed for substitute decision-making, the other topic will be decided following evaluation of the first year of training. These two training packages were each tested at a minimum of two sites.
The OMHDD developed the resource component of the CCTRC. The OMHDD developed a general brochure that provides information on the CCTRC. The CCTRC also provides informational fact sheets, brochures and pamphlets on the civil commitment process and related topics.
The OMHDD also developed training on the civil commitment law and other civil commitment resources. The OMHDD will continue to provide advocacy and support for persons going through the civil commitment process. The focus of the CCTRC is to assist persons who want training and information on the Civil Commitment and Treatment Act. Please call the OMHDD at 651-757-1800 for more information.
Many people felt the Minnesota Commitment Act was outdated and was put together piece-meal over the years. In 1994, the Mental Health Association of Minnesota pushed for legislation to have a Task Force set up to review the Commitment Act. The legislature agreed that the law should be reviewed and updated. The legislature passed legislation mandated a Task Force be set up by the Minnesota Supreme Court.
The Task Force came up with five major recommendations.
The first recommendation was Early Intervention. The Task Force kept hearing about how difficult it was to get individuals into treatment when they were opposed to it. It meant waiting until the individual deteriorated to the point where they were a danger to themselves or others. The Task Force debated this issue for some time. Some felt the Task Force should make it easier to commit; but clients, advocates and defense attorneys were opposed to making it easier to commit. The Task Force reached a compromise with this recommendation. It loosened the standard on individuals who have been committed two times in three years and are at a point where historically they will eventually be committed, or they have made it known they would choose treatment when they were competent (e.g., Advanced Mental Health Declaration). This also put an emphasis on treating early and in the individuals community.
The second recommendation was for a new Neuroleptic Medication Administration Process. The Task Force heard testimony about how protracted the process is for administration of neuroleptics to persons who refuse to take them or those who agree to take but lack capacity for informed consent. The Task Force reviewed the law and the Supreme Court decision on Jarvis v. Levine. The Task Force concluded that it could not do away with Jarvis but could speed up the process by having the Courts rule regarding capacity to give consent at the Probable Cause or Commitment hearings. There were also ways to avoid Jarvis hearings on clients who occasionally refuse medications. The Task Force also came up with clear criteria for what constitutes a lack of capacity and what substitute decision makers should use for giving consent. This has never been done before.
The third recommendation was to change/strengthen the Provisional Discharge process. The Commitment Act had set up two different ways to revoke a Provisional Discharge, depending on how long the client had been out of the treating facility. The new process made it the same for everyone. It also gave the court the authority to revoke. The new process requires the county to do the reports to the court when the client is in the community, as well as the authority to initiate the revocation process. It made it clear that courts can recommit for purpose of extending a Provisional Discharge and requires a copy of the Provisional Discharge be sent to the clients attorney.
The fourth recommendation is for consent to treatment for incompetent consenters. The Task Force heard that RTC's were refusing to voluntarily admit individuals who lacked capacity to give informed consent to admission based on a lawsuit in Florida. The Task Force decided that if a person was willing to go into treatment but lacked capacity to consent, the County could consent for him/her. It also set up the right to seek judicial review if there was a question of voluntary consent.
The fifth recommendation was for the CCTRC, which would be set up and overseen by the OMHDD. The legislation passed and implementation is underway. Much credit goes to Justice Gardebring and the dedicated members of the Task Force.