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Legislature Approves Codey Bill To Close The Gap In Mental Health Services

New Program Would Help Get Treatment for Those Most Overlooked and in Need

TRENTON – The full Senate today unanimously approved a bill sponsored by Senate President Richard J. Codey (D-Essex) that would create an Involuntary Outpatient Commitment (IOC) program in the State of New Jersey, bringing much-needed mental health assistance to a portion of the population that often gets overlooked. With the Assembly also approving the bill today, it now heads to the Governor for his signature.

“Our goal is to minimize time in the hospital and keep patients in the least restrictive environment that will help foster their recovery. Without the option of outpatient commitment, those that go untreated are likely to pose a serious danger to themselves or others,” added Sen. Codey. “At the very least, they will be utilizing other state resources such as the hospital or jail, which end up costing taxpayers far more money. With our mental health infrastructure ranking fourth in the nation, it makes far more sense to try and get patients the treatment they need in an outpatient setting.”

Bill S735 would amend the state’s civil commitment law to allow involuntary commitment to treatment in an outpatient setting as an alternative to current law which allows for involuntary inpatient commitment for people who are established to be dangerous in the reasonably foreseeable future to themselves, others, or property.

Sen. Codey noted that two recent homicides have renewed the urgency for this bill. One incident occurred in August of 2008, when a schizophrenic man from Galloway Township who had refused treatment, attacked and killed his mother and one of his 12 year-old twin nieces and seriously injured his other twin niece. A separate incident occurred in September of 2008 when a schizophrenic man from Jersey City, whose parents had been fighting for years to get him treatment, fatally stabbed a commuter at the light rail train station in Jersey City.

Studies have shown that IOC has been highly successful in helping patients comply with their medication needs, reducing their hospital stays and helping patients along on the path to recovery and productivity. Sen. Codey’s bill is modeled after Kendra’s Law which was passed in New York in 1999. A study published by the State of New York five years after Kendra’s Law was implemented showed that among individuals in the program:

– 74 percent fewer experienced homelessness;

– 77 percent fewer experienced psychiatric hospitalization;

– 83 percent fewer experienced arrest; and

– 87 percent fewer experienced incarceration

The legislation would provide for involuntary outpatient treatment, sometimes known as Assisted Outpatient Treatment, for people who refuse mental health treatment despite their need for it, as long as they would not pose a threat to themselves or others in an outpatient setting. Currently, 42 other states have laws for assisted outpatient treatment. The bill would use the following uniform standard for determining the need for involuntary commitment:

a)an adult with mental illness;

b)whose mental illness causes the person to be dangerous to self or to others or property;

c)who is unwilling to accept appropriate treatment voluntarily after it has been offered; and

d)needs outpatient treatment or inpatient care at a short-term care or psychiatric facility or special psychiatric hospital because other services are not appropriate or available.

Consistent with current law, screening service staff, typically a hospital, would determine the least restrictive environment for the appropriate treatment of that individual, after a psychiatrist or physician completes an assessment and a clinical certificate, taking into account the person’s prior history, current mental health condition, and input from family whenever possible.

Under the bill, a person could not be assigned to an outpatient treatment provider by referral from a screening service, without a temporary court order, for more than 72 hours from the time the screening certificate was executed. During this period, the provider would be required to initiate court proceedings for IOC treatment consistent with the requirements of current law. If the court finds convincing evidence that the patient meets the dangerousness standard and needs continued involuntary commitment to treatment, it would issue an order authorizing the placement of the patient in an outpatient or inpatient setting for treatment.

The bill was amended in the Assembly recently to allow for a three-year phase-in by county, with seven counties adopting the program each year, as directed by the commissioner of DHS. The requirements would go into effect one year after being signed into law.

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