A Basic Guide to laws covering involuntary admission to psychiatric hospitals

This manual is designed as a simple guide through the involuntary hospitalization process. This manual includes an appendix with the legal references to the laws that are referenced in the manual. 

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This manual is designed as a simple guide through the involuntary hospitalization process. Below each section you'll find a reference to the law being explained in that section. Each of these laws is included in the appendix.

Involuntary hospitalization laws cover the following hospitals:

• AMHI and BMHI
• Free-standing psychiatric hospitals (Spring Harbor and Acadia)
• Community hospitals with psychiatric units, although not all of them actually take involuntary patients.

An involuntary admission may start with protective custody. This happens when a law enforcement officer takes a person into custody to bring the person in for an evaluation for possible involuntary psychiatric hospitalization. A law enforcement officer most often is a policeman but might also be an officer of the county sheriff's department.

34-B MRSA §3862

The law enforcement officer must bring the person to a licensed doctor or a licensed clinical psychologist for an evaluation. A physician assistant, nurse practitioner or a certified psychiatric clinical nurse may also do the evaluation if it takes place in an emergency room.

34-B MRSA §3862

The law enforcement officer must use the least restrictive form of transportation that meets the security needs of the situation when taking the person to the evaluation.

34-B MRSA §3862

In order to take a person into protective custody, the police officer must have reasonable grounds, based upon "probable cause," to believe that the person -

• may be mentally ill, AND
• presents a threat of imminent and substantial physical harm to himself or to other persons due to mental illness.

34-B MRSA §3862

If the probable cause is based on information from a 3rd party -- such as a family member or a mental health worker - the police officer must make sure that the 3rd party recently talked with or recently saw the person who is being considered for protective custody.

34-B MRSA §3862

The person may have to wait for an evaluation. The person cannot be made to wait in a jail or in a correctional facility.

The police officer may leave if (s)he has formally transferred custody of the person to a health care agency. A formal transfer can only happen if the law enforcement agency has a written agreement with the health care agency.

34-B MRSA §3863

A person can remain in protective custody up to and during the evaluation and then:

• For a period up to 18 hours while a law enforcement officer tries to get a judge to sign the evaluator's official statement, OR,
• If the evaluator's official statement was filled out after 11:00 p.m., the person may be transported to a hospital and held there until the judge's signature is obtained as soon as possible after 7:00 a.m.

34-B MRSA §3863

If the examiner decides that the person doesn't need hospitalization, the law enforcement officer must release the person, and, with the person's permission, return the person home or to the place where he or she was taken into custody.

If the individual is also under arrest for a criminal charge, he or she may be held on the criminal charges under criminal proceedings.

34-B MRSA §3863

If the evaluator believes that the person needs to be hospitalized, a person can be admitted on a voluntary basis.

An emergency application must be completed before a person can be admitted to a psychiatric hospital involuntarily. This application is called the "blue paper" in Maine.

34-B MRSA §3831 | 34-B MRSA §3863

"Likelihood of serious harm", used on the blue paper means:

• A substantial risk of physical harm to the person himself, as evidence by recent threats of, or attempts at, suicide or serious bodily harm to himself, OR
• A substantial risk of physical harm to others as evidenced by recent homicidal or other violent behavior or recent evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them, OR
• A reasonable certainty that severe physical or mental impairment or injury will result to the person as evidenced by recent actions or behavior which demonstrate his inability to avoid or protect himself from such impairment or injury, AND
• After consideration of less restrictive treatment settings and methods, a determination that community resources or care and treatment are unavailable.

34-B MRSA §3801

Any person, including health professionals and law enforcement officers, may complete Part 1 of the blue paper. The person must state:

• His/her belief that the person being examined has a mental illness
• His/her belief that the person poses a likelihood of serious harm because of the mental illness
• Why s/he believes this.

34-B MRSA §3863

The examiner completes Part 2 of the blue paper. The examiner must make an official statement that the person examined:

• has a mental illness and
• because of the mental illness, poses a likelihood of serious harm.

34-B MRSA §3863

A judge or justice of the peace signs Part 3 of the blue paper.

This judge or justice is simply making sure that the application was completed the way the law requires. This official is not making any decision about whether the statements on the application are true or not.

The judge or justice of the peace must also name:

• The hospital that the person is to be taken to
• The person or agency that will do the transporting.

34-B MRSA §3863

Transportation to the hospital must be by the least restrictive form of transportation that meets the clinical needs of the patient.

34-B MRSA §3863

When the person is brought to the hospital on the blue paper, s/he is not automatically admitted. The head of the psychiatric hospital may do one of three things.

• Admit the person as an involuntary patient, so long as the professional who signed the blue paper completed the examination no more than two days before the date of admission,
• Admit the person as a voluntary patient,
• Not admit the person at all, if the hospital believes that the person does not need involuntary hospitalization and either does not need or does not agree to voluntary hospitalization.

34-B MRSA §3863

A doctor or psychologist must examine the patient within 24 hours of admission. If this professional does not officially state that the person has a mental illness and due to the mental illness poses a likelihood of serious harm, the person must be released.

This doctor or psychologist must be someone other than the professional who signed the blue paper.

34-B MRSA §3863

After consulting the patient, the hospital must give notify the patient's guardian, spouse, parent, adult child or, if none exists, next of kin or friend that the person has been admitted to the hospital.

If the hospital believes that this notice would pose a risk of harm to the patient, then it will not be given.

34-B MRSA §3863

A hospital may keep a person on "blue paper" admission, for up to 5 days, not counting the day of admission, week ends and legal holidays.

The patient may be discharged sooner, if during this time the hospital decides that the person may be safely discharged.

The hospital may admit a person as a voluntary patient at any time during the period of the "blue paper."

34-B MRSA §3863

If the hospital believes that the person needs continued hospitalization beyond the blue paper period, then it may -

• Admit the person as a voluntary patient if suitable and if the person agrees; OR
• File for a court order of hospitalization.

If the hospital does not do either of these, then it must discharge the person.

34-B MRSA §3863

To begin court commitment procedures, the hospital files an application with the District Court. The hospital must give the person a copy of the application. It must also give the person and his or her guardian or next of kin notice of the following:

• The right to hire an attorney or to have an attorney appointed;
• The right to choose an independent examiner or to have his/her attorney select an independent examiner;
• How to contact the District Court.

34-B MRSA §3864

The hospital must attach the following documents to the application that it files with the court and that it gives to the person.

• The blue paper;
• The evaluation completed within 24 hours of admission;
• A statement certifying that they gave the person a copy of the application and the attached documents and that they gave the person and his or her guardian or next of kin the required notice of rights.

34-B MRSA §3864

When the court receives the application, it must:

• Send a notice to the person that the application has been received and include the date of the hearing. This notice has to be mailed with two days of the filing of the application.
• Send the same notice to the person's guardian, spouse, parent, adult child, or, if none exist, to the person's next of kin or friend, unless this notice would pose a risk of harm to the patient.

34-B MRSA §3864

The court waits three days after the person was notified of the right to hire an attorney to give time for the person to contact the court with his/her choices. After that time, if the person has not made his/her own arrangements for hiring an attorney, the court will appoint one.

The court will also appoint two professionals (physicians or clinical psychologists) to examine the person. The examiners can't be any of the professionals who signed the blue paper, 24-hour certificate or court commitment application.

One of the examiners appointed by the court is the one chosen by the person or his or her attorney.

34-B MRSA §3864

If the examiners find that the person does not have a mental illness, or that the s/he does not pose a likelihood of serious harm, the person must be discharged.

In other instances, a hearing will be held.

34-B MRSA §3864

The hearing must be held within 15 days of the date of application. The hearing may be postponed for up to 10 days if the hospital or the patient requests a postponement for a good reason.

The hearing will be conducted in an informal, but orderly manner, in a setting that is not likely to have a harmful effect on the mental health of the patient.

34-B MRSA §3864

The hearing may occur at the hospital. If not, the person must be transported to the hearing by the least restrictive means appropriate to his or her clinical condition.

34-B MRSA §3864

The person has the right to appear at the hearing, to testify, to have witnesses testify on her/his behalf and to cross-examine the hospital's witnesses.

34-B MRSA §3864

The hospital is required to show by recent evidence of the person's actions and behaviors, that:

• The person poses a likelihood of serious harm;
• After consideration of lesser restrictive treatment settings, that inpatient hospitalization is the best available means for treatment.

34-B MRSA §3864

The hospital must include expert psychiatric testimony in its evidence.

34-B MRSA §3864

The court must answer the following questions:

• Does the person have a mental illness?
• Does the person's recent actions and behavior demonstrate that the person poses a likelihood of serious harm?
• Is hospitalization is the best available means for treatment? AND
• Is the individual treatment plan offered by the hospital is satisfactory?

Before the court can answer these question "YES" it must have a very strong conviction that its decision is based on the truth. The court must base its decision on "clear and convincing" evidence.

34-B MRSA §3864

If the court answers all the questions on the previous section YES, it may commit the person to the hospital as an involuntary patient for a period up to 4 months.

If it answers the first three questions YES but it is not satisfied with the hospital's treatment plan, it may postpone the hearing for 10 days to let the hospital revise its treatment plan.

If the court answers any of the first three questions NO, the application must be dismissed and the person must be discharged from the hospital.

34-B MRSA §3864

The person may appeal an order of commitment to the Superior Court. The appeal must be filed within 30 days of the District Court's order.

34-B MRSA §3864
(and Rule 76D, Maine Rules of Civil Procedure, not in appendix)

The hospital may apply for an additional period of commitment if it believes that the person needs continued involuntary hospitalization. The application must be filed no later than 30 days before the end of the original period of commitment.

All other procedures for recommitment are the same as for an original commitment, except that a person may be recommitted for a period of up to 12 months.

34-B MRSA §3864

The hospital must discharge the person at the end of the commitment period unless it has started recommitment procedures, or unless the person is suitable for and has accepted voluntary admission.

34-B MRSA §3864

A hospital is not required to hospitalize a person for the entire period of commitment. In fact, it must discharge a person during the commitment period if it determines that conditions have changed and that the person no longer needs hospitalization.

34-B MRSA §3871

A hospital may release a person on convalescent status.

People on convalescent status technically remain patients of the hospital.

34-B MRSA §3870

A person who was a voluntary patient at the time convalescent status started may only be returned voluntarily unless "blue papers" are started.

A person who was an involuntary patient may be returned voluntarily OR involuntarily if:

• The hospital considered it in the person's best interest, or
• The hospital believes that the person poses a likelihood of serious harm, and
• The hospital issues an order for return, and
• The order is endorsed by a judge or justice of the peace, and
• The judge decides it is in the person's best interest to return or that the person poses a likelihood of serious harm.

34-B MRSA §3870

As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings.

1. Hospital. "Hospital" means:

1. A state mental health institute; or
2. A nonstate mental health institution.

1-A. Designated nonstate mental health institution. "Designated nonstate mental health institution" means a nonstate mental health institution that is under contract with the department for receipt by the hospital of involuntary patients.

1-B. Least restrictive form of transportation. "Least restrictive form of transportation" means the vehicle used for transportation and any restraining devices that may be used during transportation that impose the least amount of restriction, taking into consideration the stigmatizing impact upon the individual being transported.

2. Licensed physician. "Licensed physician" means a person licensed under the laws of the State to practice medicine or osteopathy or a medical officer of the Federal Government while in this State in the performance of his official duties.

3. Licensed clinical psychologist. "Licensed clinical psychologist" means a person licensed under the laws of the State as a psychologist and who practices clinical psychology.

4. Likelihood of serious harm. "Likelihood of serious harm" means:

1. A substantial risk of physical harm to the person himself as manifested by evidence of recent threats of, or attempts at, suicide or serious bodily harm to himself and, after consideration of less restrictive treatment settings and modalities, a determination that community resources for his care and treatment are unavailable;
2. A substantial risk of physical harm to other persons as manifested by recent evidence of homicidal or other violent behavior or recent evidence that others are placed in reasonable fear of violent behavior and serious physical harm to them and, after consideration of less restrictive treatment settings and modalities, a determination that community resources for his care and treatment are unavailable; or
3. A reasonable certainty that severe physical or mental impairment or injury will result to the person alleged to be mentally ill as manifested by recent evidence of his actions or behavior which demonstrate his inability to avoid or protect himself from such impairment or injury, and, after consideration of less restrictive treatment settings and modalities, a determination that suitable community resources for his care are unavailable.

5. Mentally ill person. "Mentally ill person" means a person having a psychiatric or other disease which substantially impairs his mental health, including persons suffering from the effects of the use of drugs, narcotics, hallucinogens or intoxicants, including alcohol, but not including mentally retarded or sociopathic persons.

6. Nonstate mental health institution. "Nonstate mental health institution" means a public institution, a private institution or a mental health center, which is administered by an entity other than the State and which is equipped to provide inpatient care and treatment for the mentally ill.

7. Patient. "Patient" means a person under observation, care or treatment in a hospital or residential care facility pursuant to this subchapter.

8. Residential care facility. "Residential care facility" means a licensed or approved boarding care, nursing care or foster care facility which supplies supportive residential care to individuals due to their mental illness.

9. State mental health institute. "State mental health institute" means the Augusta Mental Health Institute or the Bangor Mental Health Institute.

Any person detained pursuant to this subchapter is entitled to the writ of habeas corpus, upon proper petition by himself or by a friend to any justice generally empowered to issue the writ of habeas corpus in the county in which the person is detained.

1. Unwarranted hospitalization. A person is guilty of causing unwarranted hospitalization, if he willfully causes the unwarranted hospitalization of any person under this subchapter.

2. Denial of rights. A person is guilty of causing a denial of rights if he willfully causes the denial to any person of any of the rights accorded to him by this subchapter.

3. Penalty. Causing unwarranted hopitalization or causing a denial of rights is a Class C crime.

A hospital for the mentally ill may admit on an informal voluntary basis for care and treatment of a mental illness any person desiring admission or the adult ward of a legally appointed guardian, subject to the following conditions.

1. Availability of accommodations. Except in cases of medical emergency, voluntary admission is subject to the availability of suitable accommodations.

2. Standard hospital information. Standard hospital information may be elicited from the person if, after examination, the chief administrative officer of the hospital deems the person suitable for admission, care and treatment.

3. Persons under 18 years of age. Any person under 18 years of age must have the consent of his parent or guardian.

4. State mental health institute. Any person under 18 years of age must have the consent of the commissioner for admission to a state mental health institute.

5. Adults under guardianship. An adult ward may be admitted on an informal voluntary basis only if his legally appointed guardian consents to the admission and the ward makes no objection to the admission.

6. Adults with advance health care directives. An adult with an advance health care directive authorizing mental health hospital treatment may be admitted on an informal voluntary basis if the conditions specified in the advance health care directive for the directive to be effective are met in accordance with the method stated in the advance health care directive or, if no such method is stated, as determined by a physician or a psychologist. If no conditions are specified in the advance health care directive as to how the directive becomes effective, the person may be admitted on an informal voluntary basis if the person has been determined to be incapacitated pursuant to Title 18-A, Article 5, Part 8. A person may be admitted only if the person does not at the time object to the admission or, if the person does object, if the person has directed in the advance health care directive that admission to the hospital may occur despite that person's objections. The duration of the stay in the hospital of a person under this subsection may not exceed 5 working days. If at the end of that time the chief administrative officer of the hospital recommends further hospitalization of the person, the chief administrative officer shall proceed in accordance with section 3863, subsection 5.

This subsection does not create an affirmative obligation of a hospital to admit a person consistent with the person's advance health care directive. This subsection does not create an affirmative obligation on the part of the hospital or treatment provider to provide the treatment consented to in the person's advance health care directive if the physician or psychologist evaluating or treating the person or the chief administrative officer of the hospital determines that the treatment is not in the best interest of the person.

1. Patient's right. A patient admitted under section 3831 is free to leave the hospital at any time after admission without undue delay following examination by a licensed physician or a licensed clinical psychologist, except that admission of the person under section 3863 is not precluded, if at any time such an admission is considered necessary in the interest of the person and of the community.

2. Notice. The chief administrative officer of the hospital shall cause every patient admitted under section 3831 to be informed, at the time of admission, of:

1. His status as an informally admitted patient; and
2. His freedom to leave the hospital under this section.

1. Nonstate mental health institution. The chief administrative officer of a nonstate mental health institution may receive for observation, diagnosis, care and treatment in the institution any person whose admission is applied for under any of the procedures in this subchapter. An admission may be made under the provisions of section 3863 only if the certifying examination conducted pursuant to section 3863, subsection 2 was completed no more than 2 days before the date of admission.

1. The institution, any person contracting with the institution and any of its employees when admitting, treating or discharging a patient under the provisions of sections 3863 and 3864 under a contract with the department, for purposes of civil liability, must be deemed to be a governmental entity or an employee of a governmental entity under the Maine Tort Claims Act, Title 14, chapter 741.
2. Patients with a diagnosis of mental illness or psychiatric disorder in nonstate mental health institutions that contract with the department under this subsection are entitled to the same rights and remedies as patients in state mental health institutes as conferred by the constitution, laws, regulations and rules of this State and of the United States.
3. Before contracting with and approving the admission of involuntary patients to a nonstate mental health institution, the department shall require the institution to:
   1. Comply with all applicable regulations;
   2. Demonstrate the ability of the institution to comply with judicial decrees as those decrees relate to services already being provided by the institution; and
   3. Coordinate and integrate care with other community-based services.
4. Beginning July 31, 1990, the capital, licensing, remodeling, training and recruitment costs associated with the start-up of beds designated for involuntary patients under this section must be reimbursed, within existing resources, of the Department of Mental Health, Mental Retardation and Substance Abuse Services.

2. State mental health institute. The chief administrative officer of a state mental health institute:

1. May receive for observation, diagnosis, care and treatment in the hospital any person whose admission is applied for under section 3831 or 3863 if the certifying examination conducted pursuant to section 3863, subsection 2 was completed no more than 2 days before the date of admission; and
2. May receive for observation, diagnosis, care and treatment in the hospital any person whose admission is applied for under section 3864 or is ordered by a court.

Any business entity contracting with the department for psychiatric physician services or any person contracting with a state mental health institute or the department to provide services pertaining to the admission, treatment or discharge of patients under sections 3863 and 3864 within a state institute or any person contracting with a business entity to provide those services within a state institute is deemed to be a governmental entity or an employee of a governmental entity for purposes of civil liability under the Maine Tort Claims Act, Title 14, chapter 741, with respect to the admission, treatment or discharge of patients within a state institute under sections 3863 and 3864.

1. Law enforcement officer's power. If a law enforcement officer has reasonable grounds to believe, based upon probable cause, that a person may be mentally ill and that due to that condition the person presents a threat of imminent and substantial physical harm to that person or to other persons, or if a law enforcement officer knows that a person has an advance health care directive authorizing mental health treatment and the officer has reasonable grounds to believe, based upon probable cause, that the person lacks capacity, the law enforcement officer:

1. A. May take the person into protective custody; and
2. B. If the law enforcement officer does take the person into protective custody, shall deliver the person immediately for examination as provided in section 3863 or, for a person taken into protective custody who has an advance health care directive authorizing mental health treatment, for examination as provided in Title 18-A, section 5-802, subsection (d) to determine the individual's capacity and the existence of conditions specified in the advance health care directive for the directive to be effective. If the examination occurs in a hospital emergency room, the examination may be performed by a licensed physician, a licensed clinical psychologist, a physician's assistant, a nurse practitioner or a certified psychiatric clinical nurse specialist. If the examination does not occur in a hospital emergency room, the examination may be performed only by a licensed physician or licensed clinical psychologist.

When, in formulating probable cause, the law enforcement officer relies upon information provided by a 3rd-party informant, the officer shall confirm that the informant has reason to believe, based upon the informant's recent personal observations of or conversations with a person, that the person may be mentally ill and that due to that condition the person presents a threat of imminent and substantial physical harm to that person or to other persons.

2. Certificate not executed. If a certificate relating to the person's likelihood of serious harm is not executed by the examiner under section 3863, and, for a person who has an advance health care directive authorizing mental health treatment, if the examiner determines that the conditions specified in the advance health care directive for the directive to be effective have not been met or, in the absence of stated conditions, that the person does not lack capacity, the officer shall:

1. A. Release the person from protective custody and, with the person's permission, return the person forthwith to the person's place of residence, if within the territorial jurisdiction of the officer;
2. B. Release the person from protective custody and, with the person's permission, return the person forthwith to the place where the person was taken into protective custody;
3. C. If the person is also under arrest for a violation of law, retain the person in custody until the person is released in accordance with the law.

3. Certificate executed. If the certificate is executed by the examiner under section 3863, the officer shall undertake forthwith to secure the endorsement of a judicial officer under section 3863 and may detain the person for a reasonable period of time, not to exceed 18 hours, pending that endorsement.

3-A. Advance health care directive effect. If the examiner determines that the conditions specified in the advance health care directive for the directive to be effective have been met or, in the absence of stated conditions, that the person lacks capacity, the person may be treated in accordance with the terms of the advance health care directive.

4. Transportation costs. The costs of transportation under this section must be paid in the manner provided under section 3863. Any person transporting an individual to a hospital under the circumstances described in this section shall use the least restrictive form of transportation available that meets the security needs of the situation.

A person may be admitted to a mental hospital on an emergency basis according to the following procedures.

1. Application. Any health officer, law enforcement officer or other person may make a written application to admit a person to a mental hospital, subject to the prohibitions and penalities of section 3805, stating:

1. His belief that the person is mentally ill and, because of his illness, poses a likelihood of serious harm; and
2. The grounds for this belief.

2. Certifying examination. The written application must be accompanied by a dated certificate, signed by a licensed physician, physician's assistant, certified psychiatric clinical nurse specialist, nurse practitioner or a licensed clinical psychologist, stating:

1. The physician, physician's assistant, certified psychiatric clinical nurse specialist, nurse practitioner or psychologist has examined the person on the date of the certificate; and
2. The physician, physician's assistant, certified psychiatric clinical nurse specialist, nurse practitioner or psychologist is of the opinion that the person is mentally ill and, because of that illness, poses a likelihood of serious harm.

2-A. Custody agreement. A state, county or municipal law enforcement agency may meet with representatives of those public and private health practitioners and health care facilities that are willing and qualified to perform the certifying examination required by this section in order to attempt to work out a procedure for the custody of the person who is to be examined while that person is waiting for that examination. Any agreement must be written and signed by and filed with all participating parties. In the event of failure to work out an agreement that is satisfactory to all participating parties, the procedures of section 3862 and this section continue to apply.

As part of an agreement the law enforcement officer requesting certification may transfer protective custody of the person for whom the certification is requested to another law enforcement officer, a health officer if that officer agrees or the chief administrative officer of a public or private health practitioner or health facility or the chief administrative officer's designee. Any arrangement of this sort must be part of the written agreement between the law enforcement agency and the health practitioner or health care facility. In the event of a transfer, the law enforcement officer seeking the transfer shall provide the written application required by this section.

A person with mental illness may not be detained or confined in any jail or local correctional or detention facility, whether pursuant to the procedures described in section 3862, pursuant to a custody agreement, or under any other circumstances, unless that person is being lawfully detained in relation to or is serving a sentence for commission of a crime.

3. Judicial review. The application and accompanying certificate must be reviewed by a Justice of the Superior Court, Judge of the District Court, Judge of Probate or a justice of the peace.

1. If the judge or justice finds the application and accompanying certificate to be regular and in accordance with the law, the judge or justice shall endorse them.
2. A person may not be held against the person's will in the hospital under this section, whether informally admitted under section 3831 or sought to be involuntarily admitted under this section, unless the application and certificate have been endorsed by a judge or justice, except that a person for whom an examiner has executed the certificate under subsection 2 may be detained in a hospital for a reasonable period of time, not to exceed 18 hours, pending endorsement by a judge or justice, if:
   1. For a person informally admitted under section 3831, the chief administrative officer of the hospital undertakes to secure the endorsement immediately upon execution of the certificate by the examiner; and
   2. For a person sought to be involuntarily admitted under this section, the person or persons transporting the person sought to be involuntarily admitted to the hospital undertake to secure the endorsement immediately upon execution of the certificate by the examiner.
3. Notwithstanding paragraph B, subparagraphs (1) and (2), a person sought to be admitted informally under section 3831 or involuntarily under this section may be transported to a hospital and held for evaluation and treatment at a hospital pending judicial endorsement of the application and certificate if the endorsement is obtained between the soonest available hours of 7:00 a.m. and 11:00 p.m.

4. Custody and transportation. Custody and transportation under this section are governed as follows.

1. Upon endorsement of the application and certificate by the judge or justice, law enforcement officer or other person designated by the judge or justice may take the person into custody and transport that person to the hospital designated in the application. Transportation of an individual to a hospital under these circumstances must involve the least restrictive form of transportation available that meets the clinical needs of that individual.
2. The Department of Mental Health, Mental Retardation and Substance Abuse Services is responsible for any transportation expenses under this section, including return from the hospital if admission is declined. The department shall utilize any 3rd-party payment sources that are available. [1995, c. 560, Pt. K, §37 (amd); §83 (aff).]
3. When a person who is under a sentence or lawful detention related to commission of a crime and who is incarcerated in a jail or local correctional or detention facility is admitted to a hospital under any of the procedures in this subchapter, the county where the incarceration originated shall pay all expenses incident to transportation of the person between the hospital and the jail or local correctional or detention facility.

5. Continuation of hospitalization. If the chief administrative officer of the hospital recommends further hospitalization of the person, the chief administrative officer shall determine the suitability of admission, care and treatment of the patient as an informally admitted patient, as described in section 3831.

1. If the chief administrative officer of the hospital determines that admission of the person as an informally admitted patient is suitable, the chief administrative officer shall admit the person on this basis, if the person so desires.
2. If the chief administrative officer of the hospital determines that admission of the person as an informally admitted patient is not suitable, or if the person declines admission as an informally admitted patient, the chief administrative officer of the hospital may seek involuntary commitment of the patient by filing an application for the issuance of an order for hospitalization under section 3864, except that if the hospital is a designated nonstate mental health institution and if the patient was admitted under the contract between the hospital and the department for receipt by the hospital of involuntary patients, then the chief administrative officer may seek involuntary commitment only by requesting the commissioner to file an application for the issuance of an order for hospitalization under section 3864.
   1. The application must be made to the District Court having territorial jurisdiction over the hospital to which the person was admitted on an emergency basis.
   2. The application must be filed within 5 days from the admission of the patient under this section, excluding the day of admission and any Saturday, Sunday or legal holiday.
3. If neither readmission nor application to the District Court is effected under this subsection, the chief administrative officer of the hospital to which the person was admitted on an emergency basis shall discharge the person immediately.

6. Notice. Upon admission of a person under this section, and after consultation with the person, the chief administrative officer of the hospital shall notify, as soon as possible regarding the fact of admission, the person's:

1. Guardian, if known;
2. Spouse;
3. Parent;
4. Adult child; or
5. One of next of kin or a friend, if none of the listed persons exists.

If the chief administrative officer has reason to believe that notice to any individual in paragraphs A to E would pose risk of harm to the person admitted, then notice may not be given to that individual.

7. Post-admission examination. Every patient admitted to a hospital shall be examined as soon as practicable after his admission.

1. The chief administrative officer of the hospital shall arrange for examination by a staff physician or licensed clinical psychologist of every patient hospitalized under this section.
2. The examiner may not be the certifying examiner under this section or under section 3864.
3. If the post-admission examination is not held within 24 hours after the time of admission, or if a staff physician or licensed clinical psychologist fails or refuses after the examination to certify that, in his opinion, the person is mentally ill and due to his mental illness poses a likelihood of serious harm, the person shall be immediately discharged.

1. Application. An application to the District Court to admit a person to a mental hospital, filed under section 3863, subsection 5, paragraph B, shall be accompanied by:

1. The emergency application under section 3863, subsection 1
2. The accompanying certificate of the physician or psychologist under section 3863, subsection 2;
3. The certificate of the physician or psychologist under section 3863, subsection 7 that:
   1. The physician or psychologist has examined the patient; and
   2. It is the opinion of the physician or psychologist that the patient is a mentally ill person and, because of that patient's illness, poses a likelihood of serious harm;
4. A written statement, signed by the chief administrative officer of the hospital, certifying that a copy of the application and the accompanying documents have been given personally to the patient and that the patient and the patient's guardian or next of kin have been notified of the patient's right to retain an attorney or to have an attorney appointed, of the patient's right to select or to have the patient's attorney select an independent examiner and regarding instructions on how to contact the District Court; and
5. A copy of the notice and instructions given to the patient.

2. Detention pending judicial determination. Notwithstanding any other provisions of this subchapter, a person, with respect to whom an application for the issuance of an order for hospitalization has been filed, may not be released or discharged during the pendency of the proceedings, unless:

1. The District Court orders release or discharge upon the request of the patient, or the patient's guardian, parent, spouse or next of kin;
2. The District Court orders release or discharge upon the report of the applicant that the person may be discharged with safety;
3. A court orders release or discharge upon a writ of habeas corpus under section 3804; or
4. Upon request of the commissioner, the District Court orders the transfer of a patient in need of more specialized treatment to another hospital. In the event of a transfer, the court shall transfer its file to the District Court having territorial jurisdiction over the receiving hospital.

3. Notice of receipt of application. The giving of notice of receipt of application and date of hearing under this section is governed as follows

1. Upon receipt by the District Court of the application and accompanying documents specified in subsection 1, the court shall cause written notice of the application and date of hearing:
   1. To be mailed within 2 days of filing to the person; and
   2. To be mailed to the person's guardian, if known, and to the person's spouse, parent or one of the person's adult children or, if none of these persons exist or if none of those persons can be located, to one of the person's next of kin or a friend, except that if the chief administrative officer has reason to believe that harm to the person who is the subject of the application, notice to that individual may not be given.
2. A docket entry is sufficient evidence that notice under this subsection has been given.

4. Examination. Examinations under this section are governed as follows.

1. Upon receipt by the District Court of the application and the accompanying documents specified in subsection 1 and at least 3 days after the person who is the subject of the examination was notified by the hospital of the proceedings and of that person's right to retain counsel or to select an examiner, the court shall cause the person to be examined by 2 examiners.
   1. Each examiner must be either a licensed physician or a licensed clinical psychologist.
   2. One of the examiners must be a physician or psychologist chosen by the person or by that person's counsel, if the chosen physician or psychologist is reasonably available.
   3. Neither examiner appointed by the court may be the certifying examiner under section 3863, subsection 2 or 7.
2. The examination shall be held at the hospital or at any other suitable place not likely to have a harmful effect on the mental health of the person.
3. If the report of the examiners is to the effect that the person is not mentally ill or does not pose a likelihood of serious harm, the application shall be ordered discharged forthwith.
4. If the report of the examiners is to the effect that the person is mentally ill or poses a likelihood of serious harm, the hearing shall be held on the date, or on the continued date, which the court has set for the hearing.

5. Hearing. Hearings under this section are governed as follows.

1. The District Court shall hold a hearing on the application not later than 15 days from the date of the application.
   1. On a motion by any party, the hearing may be continued for cause for a period not to exceed 10 additional days.
   2. If the hearing is not held within the time specified, or within the specified continuance period, the court shall dismiss the application and order the person discharged forthwith.
   3. In computing the time periods set forth in this paragraph, the District Court Civil Rules shall apply.
2. The hearing must be conducted in as informal a manner as may be consistent with orderly procedure and in a physical setting not likely to have harmful effect on the mental health of the person. If the setting is outside the hospital to which the patient is currently admitted, the Department of Mental Health, Mental Retardation and Substance Abuse Services shall bear the responsibility and expense of transporting the patient to and from the hearing. If the patient is to be admitted to a hospital following the hearing, then the responsible hospital shall transport the patient to the admitting hospital. If the patient is to be released following the hearing, then the responsible hospital shall return the patient to the hospital or, at the patient's request, return the patient to the patient's place of residence.
3. The court shall receive all relevant and material evidence which may be offered in accordance with accepted rules of evidence and accepted judicial dispositions.
   1. The person, the applicant and all other persons to whom notice is required to be sent shall be afforded an opportunity to appear at the hearing to testify and to present and cross-examine witnesses.
   2. The court may, in its discretion, receive the testimony of any other person and may subpoena any witness.
4. The person shall be afforded an opportunity to be represented by counsel, and, if neither the person nor others provide counsel, the court shall appoint counsel for the person.
5. In addition to proving that the patient is a mentally ill individual, the applicant shall show:
   1. By evidence of the patient's actions and behavior, that the patient poses a likelihood of serious harm; and
   2. That, after full consideration of less restrictive treatment settings and modalities, inpatient hospitalization is the best available means for the treatment of the person.
6. In each case, the applicant shall submit to the court, at the time of the hearing, testimony, including expert psychiatric testimony, indicating the individual treatment plan to be followed by the hospital staff, if the person is committed under this section, and shall bear any expense for witnesses for this purpose.
7. A stenographic or electronic record shall be made of the proceedings in all judicial hospitalization hearings.
   1. The record and all notes, exhibits and other evidence shall be confidential.
   2. The record and all notes, exhibits and other evidence shall be retained as part of the District Court records for a period of 2 years from the date of the hearing.
8. The hearing shall be confidential and no report of the proceedings may be released to the public or press, except by permission of the person or his counsel and with approval of the presiding District Court Judge, except that the court may order a public hearing on the request of the person or his counsel.

6. Court findings. Procedures dealing with the District Court's findings under this section are as follows.

1. The District Court shall so state in the record, if it finds upon completion of the hearing and consideration of the record:
   1. Clear and convincing evidence that the person is mentally ill and that the person's recent actions and behavior demonstrate that the person's illness poses a likelihood of serious harm;
   2. That inpatient hospitalization is the best available means for treatment of the patient; and
   3. That it is satisfied with the individual treatment plan offered by the hospital to which the applicant seeks the patient's involuntary commitment.
2. If the District Court makes the findings described in paragraph A, subparagraphs 1 and 2, but is not satisfied with the individual treatment plan as offered, it may continue the case for not longer than 10 days, pending reconsideration and resubmission of an individual treatment plan by the hospital

7. Commitment. Upon making the findings described in subsection 6, the court may order commitment to a hospital for a period not to exceed 4 months in the first instance and not to exceed one year after the first and all subsequent hearings.

1. The court may issue an order of commitment immediately after the completion of the hearing, or it may take the matter under advisement and issue an order within 24 hours of the hearing.
2. If the court does not issue an order of commitment within 24 hours of the completion of the hearing, it shall dismiss the application and order the patient discharged immediately.

8. Continued involuntary hospitalization. If the chief administrative officer of the hospital to which a person has been committed involuntarily by the District Court recommends that continued involuntary hospitalization is necessary for that person, the chief administrative officer shall notify the commissioner. The commissioner may then, not later than 30 days prior to the expiration of a period of commitment ordered by the court, make application in accordance with this section to the District Court that has territorial jurisdiction over the hospital designated for treatment in the application by the commissioner for a hearing to be held under this section.

9. Transportation. Except for transportation expenses paid by the District Court pursuant to subsection 10, a continued involuntary hospitalization hearing that requires transportation of the patient to and from any hospital to a court that has committed the person must be provided at the expense of the Department of Mental Health, Mental Retardation and Substance Abuse Services. Transportation of an individual to a hospital under these circumstances must involve the least restrictive form of transportation available that meets the clinical needs of that individual and be in compliance with departmental regulations.

10. Expenses. With the exception of expenses incurred by the applicant pursuant to subsection 5, paragraph F, the District Court shall be responsible for any expenses incurred under this section, including fees of appointed counsel, witness and notice fees and expenses of transportation for the person.

11. Appeals. A person ordered by the District Court to be committed to a hospital may appeal from that order to the Superior Court.

1. The appeal is on questions of law only.
2. Any findings of fact of the District Court may not be set aside unless clearly erroneous.
3. The order of the District Court shall remain in effect pending the appeal.
4. The District Court Civil Rules and the Maine Rules of Civil Procedure apply to the conduct of the appeals, except as otherwise specified in this subsection.

If a person ordered to be hospitalized under section 3864 is eligible for hospital care or treatment by any agency of the United States, the court, upon receipt of a certificate from the agency showing that facilities are available and that the person is eligible for care or treatment in the facilities, may order him to be placed in the custody of the agency for hospitalization.

1. Rules and rights. A person admitted under this section to any hospital or institution operated by any agency of the United States, inside or outside the State, is subject to the rules of the agency, but retains all rights to release and periodic court review granted by this subchapter.

2. Powers of chief administrative officer. The chief administrative officer of any hospital or institution operated by a federal agency in which the person is hospitalized has, with respect to the person, the same powers as the chief administrative officer of hospitals or the commissioner within this State with respect to detention, custody, transfer, conditional release or discharge of patients.

3. Court jurisdiction. Every order of hospitalization issued under this section is conditioned on the retention of jurisdiction in the courts of this State to, at any time:

1. Inquire into the mental condition of a person hospitalized; and
2. Determine the necessity for continuance of his hospitalization

1. Admission to hospital. Any member of the Armed Forces of the United States who was a resident of the State at the time of his induction into the service and who is determined by a federal board of medical officers to have a mental disease not incurred in line of duty shall be received, at the discretion of the commissioner and without formal commitment, at either of the state hospitals for the mentally ill, upon delivery at the hospital designated by the commissioner of:

1. The member of the Armed Forces; and
2. The findings of the board of medical officers that he is mentally ill.

2. Status. After delivery of the member of the Armed Forces at the hospital designated by the commissioner, his status shall be the same as if he had been committed to the hospital under section 3864.

1. Commissioner's authority. The commissioner may, upon request of a competent authority of the District of Columbia or of a state that is not a member of the Interstate Compact on Mental Health, authorize the transfer of a mentally ill patient directly to a hospital in Maine, if:

1. The patient has resided in this State for a consecutive period of one year during the 3-year period immediately preceding commitment in the other state or the District of Columbia;
2. The patient is currently confined in a recognized institution for the care of the mentally ill as the result of proceedings considered legal by that state or by the District of Columbia;
3. A duly certified copy of the original commitment proceedings and a copy of the patient's case history is supplied;
4. The commissioner, after investigation, considers the transfer justifiable;
5. All expenses of the transfer are borne by the agency requesting it.

2. Receipt of patient. When the commissioner has authorized a transfer under this section, the superintendent of the hospital designated by the commissioner shall receive the patient as having been regularly committed to the mental health institute under section 3864.

1. To other hospitals. The commissioner may transfer, or authorize the transfer of, a patient from one hospital to another, either inside or outside the State, if the commissioner determines that it would be consistent with the medical needs of the patient to do so.

1. Before a patient is transferred, the commissioner shall give written notice of the transfer to the patient's guardian, the patient's parents or spouse or, if none of these persons exists or can be located, to the patient's next of kin or friend, except that if the chief administrative officer of the hospital to which the patient is currently admitted has reason to believe that notice to any of these individuals would pose risk of harm to the person, then notice may not be given to that individual.
2. In making all such transfers, the commissioner shall give due consideration to the relationship of the patient to his family, guardian or friends, in order to maintain relationships and encourage visits beneficial to the patient. [1983, c. 459, §7(new).]

2. To federal agency. Upon receipt of a certificate of an agency of the United States that facilities are available for the care or treatment of any involuntarily hospitalized person and that the person is eligible for care and treatment in a hospital or institution of the agency, the chief administrative officer of the hospital may cause his transfer to the agency of the United States for hospitalization.

1. Upon making such a transfer, the chief administrator of the hospital shall notify the court which ordered hospitalization and the persons specified in subsection 1, paragraph A.
2. No person may be transferred to an agency of the United States if he is confined pursuant to conviction of any felony or misdemeanor or if he has been acquitted of the charge solely on the ground of mental illness, unless before the transfer the court originally ordering confinement of the person enters an order for transfer after appropriate motion and hearing.
3. Any person transferred under this section to an agency of the United States is deemed to be hospitalized by the agency pursuant to the original order of hospitalization.

If any patient committed under section 3864 leaves the grounds of the hospital without authorization of the chief administrative officer of the hospital or his designee, or refuses to return to the hospital from a community pass when requested to do so by the chief administrative officer or his designee, law enforcement personnel of the State or of any of its subdivisions may, upon request of the chief administrative officer or his designee, assist in the return of the patient to the hospital.

Authority. The chief administrative officer of a state mental health institute may release an improved patient on convalescent status when the chief administrative officer believes that the release is in the best interest of the patient and that the patient does not pose a likelihood of serious harm. The chief administrative officer of a nonstate mental health institute may release an improved patient on convalescent status when the chief administrative officer believes that the release is in the best interest of the patient, the patient does not pose a likelihood of serious harm and, when releasing an involuntarily committed patient, the chief administrative officer has obtained the approval of the commissioner after submitting a plan for continued responsibility.

1. Release on convalescent status may include provisions for continuing responsibility to and by the hospital, including a plan of treatment on an outpatient or nonhospital basis.
2. Before release on convalescent status under this section, the chief administrative officer of a hospital shall make a good faith attempt to notify, by telephone, personal communication or letter, of the intent to release the patient on convalescent status and of the plan of treatment, if any:
   1. The parent or guardian of a minor patient;
   2. The legal guardian of an adult incompetent patient, if any is known; or
   3. The spouse or adult next of kin of an adult competent patient, if any is known, unless the patient requests in writing that the notice not be given.
   If the chief administrative officer of the hospital to which the patient is currently admitted has reason to believe that notice to any of the individuals listed in this paragraph would pose risk of harm to the person, then notice may not be given to that individual.
3. The hospital is not liable when good faith attempts to notify the parents, spouse or guardian have failed.
4. Before releasing a patient on convalescent status, the chief administrative officer of the hospital shall advise the patient, orally and in writing, of the terms of the patient's convalescent status, the treatment available while the patient is on convalescent status and, if the patient is a voluntary patient, of the patient's right to request termination of the status and, if involuntarily committed, the means by which and conditions under which rehospitalization may occur.

2. Reexamination. Before a patient has spent a year on convalescent status, and at least once a year thereafter, the chief administrative officer of the hospital shall reexamine the facts relating to the hospitalization of the patient on convalescent status.

3. Discharge. Discharge from convalescent status is governed as follows.

1. If the chief administrative officer of the hospital determines that, in view of the condition of the patient, convalescent status is no longer necessary, the chief administrative officer shall discharge the patient and make a report of the discharge to the commissioner.
2. The chief administrative officer shall terminate the convalescent status of a voluntary patient within 10 days after the day the chief administrative officer receives from the patient a request for discharge from convalescent status.

4. Rehospitalization. Rehospitalization of patients under this section is governed as follows.

1. If, prior to discharge, there is reason to believe hat it is in the best interest of an involuntarily committed patient on convalescent status to be rehospitalized, or if an involuntary committed patient on convalescent status poses a likelihood of serious harm the commissioner or the chief administrative officer of the hospital, with the approval of the commissioner, may issue an order for the immediate rehospitalization of the patient.
2. If the order is not voluntarily complied with, an involuntarily committed patient on convalescent leave may be returned to the hospital if the following conditions are met:
   1. An order is issued pursuant to paragraph A;
   2. The order is brought before a District Court Judge or justice of the peace; and
   3. Based upon clear evidence that return to the hospital is in the patient's best interest or that the patient poses a likelihood of serious harm, the District Court Judge or justice of the peace approves return to the hospital.

After approval by the District Court Judge or justice of the peace, a law enforcement officer may take the patient into custody and arrange for transportation of the patient in accordance with the provisions of section 3863, subsection 4

This paragraph does not preclude the use of protective custody by law enforcement officers pursuant to section 3862.

5. Notice of change of status. Notice of the change of convalescent status of patients is governed as follows.

1. If the convalescent status of a patient in a hospital is to be changed, either because of a decision of the chief administrative officer of the hospital or because of a request made by a voluntary patient, the chief administrative officer of the hospital shall immediately make a good faith attempt to notify, by telephone, personal communication or letter, of the contemplated change:
   1. The parent or guardian of a minor patient;
   2. The guardian of an adult incompetent patient, if any is known; or
   3. The spouse or adult next of kin of an adult competent patient, unless the patient requests in writing that the notice not be given.
   If the chief administrative officer of the hospital to which the patient is currently admitted has reason to believe that notice to any of the individuals listed in this paragraph would pose risk of harm to the person, then notice may not be given to that individual.
2. If the change in convalescent status is due to the request of a voluntary patient, the chief administrative officer of the hospital shall give the required notice within 10 days after the day the chief administrative officer receives the request.
3. The hospital is not liable when good faith attempts to notify the parents, spouse or guardian have failed.

1. Examination. The chief administrative officer of a hospital shall, as often as practicable, but no less often than every 30 days, examine or cause to be examined every patient to determine that patient's mental status and need for continuing hospitalization.

2. Conditions for discharge. The chief administrative officer of a hospital shall discharge, or cause to be discharged, any patient when:

1. Conditions justifying hospitalization no longer obtain;
2. The patient is transferred to another hospital for treatment for that patient's mental or physical condition;
3. The patient is absent from the hospital unlawfully for a period of 90 days;
4. Notice is received that the patient has been admitted to another hospital, inside or outside the State, for treatment for that patient's mental or physical condition;
5. Although lawfully absent from the hospital, the patient is admitted to another hospital, inside or outside the State, for treatment of that patient's mental or physical condition, except that, if the patient is directly admitted to another hospital and it is the opinion of the chief administrative officer of the hospital that the patient will directly reenter the hospital within the foreseeable future, the patient need not be discharged.

3. Discharge against medical advice. The chief administrative officer of a hospital may discharge, or cause to be discharged, any patient even though the patient is mentally ill and appropriately hospitalized in the hospital, if:

1. The patient and either the guardian, spouse or adult next of kin of the patient request that patient's discharge; and
2. In the opinion of the chief administrative officer of the hospital, the patient does not pose a likelihood of serious harm due to that patient's mental illness.

4. Reports. Repealed

5. Notice. Notice of discharge is governed as follows.

1. When a patient is discharged under this section, the chief administrative officer of the hospital shall immediately make a good faith attempt to notify the following people, by telephone, personal communication or letter, that the discharge has taken or will take place:
   1. The parent or guardian of a minor patient;
   2. The guardian of an adult incompetent patient, if any is known; or
   3. The spouse or adult next of kin of an adult competent patient, if any is known, unless the patient requests in writing that the notice not be given or unless the patient was transferred from or will be returned to a state correctional facility.
   If the chief administrative officer of the hospital to which the patient is currently admitted has reason to believe that notice to any of the individuals listed in this paragraph would pose a risk of harm to the person, then notice may not be given to that individual.
2. The hospital is not liable when good faith attempts to notify the parents, spouse or guardian have failed.