Residential and Outpatient Handbook - Plymouth - 59

An incompetent patient who has prepared a directive under subdivision 6d
regarding intrusive mental health treatment must be treated in accordance
with this section, except in cases of emergencies.
Subd. 6c. [Repealed, 1997 c 217 art 1 s 118]
Subd. 6d. Adult mental health treatment. (a) A competent adult patient
may make a declaration of preferences or instructions regarding intrusive
mental health treatment. These preferences or instructions may include, but
are not limited to, consent to or refusal of these treatments. A declaration of
preferences or instructions may include a health care directive under chapter
145C or a psychiatric directive.
(b) A declaration may designate a proxy to make decisions about intrusive
mental health treatment. A proxy designated to make decisions about
intrusive mental health treatments and who agrees to serve as proxy may
make decisions on behalf of a declarant consistent with any desires the
declarant expresses in the declaration.
(c) A declaration is effective only if it is signed by the declarant and two
witnesses. The witnesses must include a statement that they believe the
declarant understands the nature and significance of the declaration.
A declaration becomes operative when it is delivered to the declarant's
physician, advanced practice registered nurse, or other mental health
treatment provider. The physician, advanced practice registered nurse, or
provider must comply with the declaration to the fullest extent possible,
consistent with reasonable medical practice, the availability of treatments
requested, and applicable law. The physician, advanced practice
registered nurse, or provider shall continue to obtain the declarant's
informed consent to all intrusive mental health treatment decisions if
the declarant is capable of informed consent. A treatment provider must
not require a patient to make a declaration under this subdivision as a
condition of receiving services.
(d) The physician, advanced practice registered nurse, or other provider
shall make the declaration a part of the declarant's medical record. If
the physician, advanced practice registered nurse, or other provider is
unwilling at any time to comply with the declaration, the physician,
advanced practice registered nurse, or provider must promptly notify
the declarant and document the notification in the declarant's medical
record. The physician, advanced practice registered nurse, or provider
may subject the declarant to intrusive treatment in a manner contrary to
the declarant's expressed wishes, only if the declarant is committed as
a person who poses a risk of harm due to mental illness or as a person
who has a mental illness and is dangerous to the public and a court order
authorizing the treatment has been issued or an emergency has been
declared under section 253B.092, subdivision 3.
(e) A declaration under this subdivision may be revoked in whole or in
part at any time and in any manner by the declarant if the declarant
is competent at the time of revocation. A revocation is effective when
a competent declarant communicates the revocation to the attending
physician, advanced practice registered nurse, or other provider. The
attending physician, advanced practice registered nurse, or other
provider shall note the revocation as part of the declarant's medical
record.
(f) A provider who administers intrusive mental health treatment according
to and in good faith reliance upon the validity of a declaration under
this subdivision is held harmless from any liability resulting from a
subsequent finding of invalidity.
(g) In addition to making a declaration under this subdivision, a competent
adult may delegate parental powers under section 524.5-211 or may
nominate a guardian under sections 524.5-101 to 524.5-502.
Subd. 7. Treatment plan. A patient receiving services under this chapter
has the right to receive proper care and treatment, best adapted, according
to contemporary professional standards, to rendering further supervision
unnecessary. The treatment facility, state-operated treatment program, or
community-based treatment program shall devise a written treatment plan
for each patient which describes in behavioral terms the case problems, the
precise goals, including the expected period of time for treatment, and the
specific measures to be employed. The development and review of treatment
plans must be conducted as required under the license or certification of the
treatment facility, state-operated treatment program, or community-based
treatment program. If there are no review requirements under the license or
certification, the treatment plan must be reviewed quarterly. The treatment
plan shall be devised and reviewed with the designated agency and with
the patient. The clinical record shall reflect the treatment plan review. If the
designated agency or the patient does not participate in the planning and
review, the clinical record shall include reasons for nonparticipation and the
plans for future involvement. The commissioner shall monitor the treatment
plan and review process for state-operated treatment programs to ensure
compliance with the provisions of this subdivision.
Subd. 8. Medical records. A patient has the right to access to personal
medical records. Notwithstanding the provisions of section 144.292, every
person subject to a proceeding or receiving services pursuant to this chapter
and the patient's attorney shall have complete access to all medical records
relevant to the person's commitment. A provider may require an attorney to
provide evidence of representation of the patient or an authorization signed
by the patient.
Subd. 9. [Repealed, 1997 c 217 art 1 s 118]
Subd. 10. Notification. (a) All patients admitted or committed to a treatment
facility or state-operated treatment program, or temporarily confined
under section 253B.045, shall be notified in writing of their rights regarding
hospitalization and other treatment.
(b) This notification must include:
(1) patient rights specified in this section and section 144.651, including
nursing home discharge rights;
(2) the right to obtain treatment and services voluntarily under this
chapter;
(3) the right to voluntary admission and release under section 253B.04;
(4) rights in case of an emergency admission under section 253B.051,
including the right to documentation in support of an emergency
hold and the right to a summary hearing before a judge if the patient
believes an emergency hold is improper;
(5) the right to request expedited review under section 62M.05 if
additional days of inpatient stay are denied;
(6) the right to continuing benefits pending appeal and to an expedited
administrative hearing under section 256.045 if the patient is a
recipient of medical assistance or MinnesotaCare; and
(7) the right to an external appeal process under section 62Q.73, including
the right to a second opinion.
Subd. 11. Proxy. A legally authorized health care proxy, agent, or guardian
may exercise the patient's rights on the patient's behalf.
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