House Bill 573

AN ACT TO AMEND SECTION 41-21-140, MISSISSIPPI CODE OF 1972, TO ESTABLISH THE MISSISSIPPI HELPING ENSURE ALTERNATIVE LAW ENFORCEMENT TRANSPORTATION FOR HEALING (MISSHEALTH) PILOT PROGRAM TO PROVIDE FINANCIAL ASSISTANCE TO LAW ENFORCEMENT AGENCIES FOR THE PURPOSE OF TRANSPORTING INDIVIDUALS EXPERIENCING A MENTAL HEALTH OR BEHAVIORAL CRISIS TO A HOSPITAL OR TREATMENT FACILITY; TO PROVIDE THAT THE PROGRAM'S IMPLEMENTATION IS SUBJECT TO APPROPRIATION; TO PROVIDE THAT THE PROGRAM SHALL BE JOINTLY ADMINISTERED BY THE DEPARTMENT OF FINANCE AND ADMINISTRATION, DEPARTMENT OF MENTAL HEALTH AND DIVISION OF MEDICAID; TO REQUIRE THE DEPARTMENT OF MENTAL HEALTH TO ESTABLISH GUIDELINES AND APPLICATION DEADLINES FOR THE PARTICIPATION IN THE MISSHEALTH PILOT PROGRAM; TO REQUIRE GRANT RECIPIENTS TO PROVIDE A 25% FUNDING MATCH OF THE TOTAL GRANT FUNDS RECEIVED; TO ALLOW LAW ENFORCEMENT AGENCIES TO CONTRACT WITH ONE OR MORE THIRD PARTIES OR OTHER LAW ENFORCEMENT AGENCIES TO TRANSPORT INDIVIDUALS IN ACCORDANCE WITH THE PROVISIONS OF THIS ACT; TO PROVIDE THAT CONTRACTS ENTERED INTO UNDER THE AUTHORITY OF THIS ACT ARE SUBJECT TO AUDIT BY THE OFFICE OF THE STATE AUDITOR; TO PRESCRIBE THE PURPOSES FOR WHICH GRANT FUNDS RECEIVED UNDER THE MISSHEALTH PILOT PROGRAM MAY BE USED; TO PROVIDE FOR TELEHEALTH EVALUATION OF INDIVIDUALS IF AVAILABLE TO DETERMINE NEED FOR ADMISSION; TO PRESCRIBE THE MANNER BY WHICH THE ORIGINAL CERTIFICATE OF NEED FOR TRANSPORT MAY BE DETERMINED AND PROVIDED TO THE TRANSPORTING LAW ENFORCEMENT AGENCY BY THE COMPLETING PHYSICIAN, PSYCHOLOGIST OR DESIGNATED PROFESSIONAL; TO REQUIRE THE COMPLETING PHYSICIAN, PSYCHOLOGIST OR DESIGNATED PROFESSIONAL TO INFORM THE TRANSPORTING LAW ENFORCEMENT AGENCY THAT THE HOSPITAL OR TREATMENT FACILITY OF ADMISSION HAS BEEN CONTACTED AND HAS AVAILABLE SUITABLE ACCOMMODATIONS FOR THE INDIVIDUALS IN CRISIS; TO REQUIRE THE TRANSPORTING LAW ENFORCEMENT AGENCY OR TRANSPORTATION AGENT TO NOTIFY THE ADMITTING HOSPITAL OR TREATMENT FACILITY OF AN ESTIMATED TIME OF ARRIVAL; TO REQUIRE THE LAW ENFORCEMENT AGENCY OR TRANSPORTATION AGENT TO REMAIN AT THE HOSPITAL OR TREATMENT FACILITY LONG ENOUGH FOR THE INDIVIDUAL TO BE EVALUATED FOR ADMISSION, BUT NOT TO EXCEED TWO HOURS; TO PROVIDE THAT IF A LAW ENFORCEMENT OFFICER IS AUTHORIZED TO MAKE AN ARREST AND A PROFESSIONAL DESIGNATED BY A CRISIS INTERVENTION TEAM HAS REASON TO BELIEVE THAT THE INDIVIDUAL SUBJECT TO ARREST IS EXPERIENCING A MENTAL OR BEHAVIORAL CRISIS, THE SUCH PERSON MAY BE TAKEN INTO CUSTODY WITHOUT A CIVIL ORDER OR WARRANT FOR IMMEDIATE MENTAL EXAMINATION TO DETERMINE NEED FOR BEHAVIORAL HEALTH TREATMENT AT A HOSPITAL OR TREATMENT FACILITY; TO REQUIRE IMMEDIATE EXAMINATION OF INDIVIDUALS SO DETAINED BY A PHYSICIAN, PSYCHOLOGIST OR DESIGNATED PROFESSIONAL TO DETERMINE IF SUCH PERSON IS SUBJECT TO ADMISSION TO A HOSPITAL OR TREATMENT FACILITY; TO PRESCRIBE THE PROCEDURES TO BE FOLLOWED UPON A DETERMINATION BY THE EVALUATING PHYSICIAN, PSYCHOLOGIST OR DESIGNATED PROFESSIONAL IF THE PERSON IS OR IS NOT TO BE ADMITTED INTO A HOSPITAL OR TREATMENT FACILITY; TO DEFINE THE TERM "QUALIFIED ADVANCED PRACTICE PROVIDER AND PRESCRIBE THE PROCEDURES TO BE FOLLOWED BY SUCH INDIVIDUALS WHEN EVALUATING AND RECOMMENDING ADMISSION FOR PERSON EXPERIENCING A MENTAL HEALTH CRISIS; TO PRESCRIBE THE DUTY OF LAW ENFORCEMENT AGENCIES OR TRANSPORTATION AGENTS TO RETURN INDIVIDUALS SUSPECTED OF EXPERIENCING A MENTAL HEALTH CRISIS WHO ARE DETERMINED NOT ELIGIBLE FOR ADMISSION BACK TO THE COUNTY OR MUNICIPALITY OF ORIGIN WHERE THE INITIAL INTERACTION OCCURRED; TO PROVIDE CIVIL AND CRIMINAL IMMUNITY TO HOSPITALS, TREATMENT FACILITIES AND HEALTHCARE PROVIDERS FROM CLAIMS ARISING FROM DETERMINATIONS OF ADMISSION AND FROM TRANSPORTATION OF PERSON TO AND FROM SUCH FACILITIES; TO REQUIRE THE DEPARTMENT OF MENTAL HEALTH TO PROVIDE TRAINING ON MENTAL HEALTH CRISIS MANAGEMENT FOR LOCAL LAW ENFORCEMENT AGENCIES' PERSONNEL AND FOR TRANSPORTATION AGENTS; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 41-21-140, Mississippi Code of 1972, is amended as follows:

41-21-140. (1) A law enforcement officer shall transport the person who is in crisis to the appropriate health care facility in the county or outside of the county at the request of the crisis intervention team or mobile crisis response team, if:

(a) The person has a mental illness or serious emotional disturbance;

(b) The person poses an imminent substantial likelihood of serious harm because of the mental illness or serious emotional disturbance, as determined by behavior that he or she:

(i) Has threatened or attempted suicide or to inflict serious bodily harm on the person;

(ii) Has threatened or attempted homicide or other violent behavior;

(iii) Has placed others in reasonable fear of violent behavior and serious physical harm to them; or

(iv) Is unable to avoid severe impairment or injury from specific risks; and

(2) (a) Subject to annual appropriations, there is established the Mississippi Helping Ensure Alternative Law Enforcement Transportation for Healing (MissHEALTH) Pilot Program to provide financial grant assistance to law enforcement agencies required to transport persons to a hospital or treatment facility for emergency mental health transport under this section. The Department of Finance and Administration, in consultation with the Department of Mental Health and substance abuse services and the Division of Medicaid, shall develop and administer the pilot program. Grant assistance from the pilot program must not be provided for emergency mental health transports where a physician, psychologist, or designated professional determines that the person can be transported by one or more friends, neighbors or other mental health professionals familiar with the person, relatives of the person, or a member of the clergy under Section 5 of this act.

(b) The MissHEALTH Pilot Program shall support a minimum of three (3) law enforcements agencies over the course of a one-year period, which shall be selected upon the submission of an application for grant funds by local law enforcement agencies to the Department of Mental Health, which shall determine the criteria for approval of application and establish guidelines for the administration of the program and application deadlines. The department shall determine the minimum amount of grant assistance allocated to each approved law enforcement agency selected to participate in the pilot program, and condition additional funding support to approved applicants based upon historical and anticipated transport volume, which such award amount shall require an twenty-five percent (25%) funding match from each local law enforcement agency selected for participation.

(3) A law enforcement agency may contract with one or more third parties or other law enforcement agencies to transport persons to a hospital or treatment facility in accordance with this section. The law enforcement agency shall deem a third party or other law enforcement agency contracted to perform this function to be the designated secondary transportation agent pursuant to Section 5 of this act. Any contract entered into under this subsection is subject to audit by the Office of the State Auditor or his or her designee.

(4) A law enforcement agency may receive grant funds provided under this section for use as payment to third parties or other law enforcement agencies with which it contracts to transport persons to a hospital or treatment facility in accordance with this section. The receipt or expenditure of grant funds received by a law enforcement agency under this section is subject to audit by the Office of the State Auditor or his or her designee.

(5) If telehealth services are available and offered by a hospital or treatment facility at which a person is proposed to be admitted pursuant to this act, then the hospital or treatment facility may elect to conduct an evaluation for admission under Section 41-127-1 through telehealth as defined in Section 83-9-351.

(6) If the person certified for admission under Section 3 of this act is not already at the facility, hospital or treatment facility at which the person is proposed to be admitted, the physician, psychologist or designated professional who completed the certificate of need under Section 3 of this act shall give the law enforcement agency or the transportation agent designated under this act the original of the certificate and turn the person over to the custody of the law enforcement agency or transportation agent who shall transport the person to a hospital or treatment facility that has available suitable accommodations for the person for proceedings under Section 4 of this act. If admission is sought to a state-owned or operated hospital or treatment facility, the physician, psychologist or designated professional who completed the certificate of need under Section 3 of this act shall also provide to the law enforcement agency or transportation agent a written statement verifying that the state-owned or operated hospital or treatment facility has been contacted and has available suitable accommodations, and the law enforcement agency or transportation agent shall not be required to take custody of the person for transportation unless both the original of the certificate and the written statement are provided. If the original of the certificate is unavailable, then an identical hard copy or electronic copy submitted by reliable electronic means must be accepted for purposes of this section. Failure of the law enforcement agency or other transportation agent to provide both a certificate of need and the written statement to the receiving state-owned or operated hospital or treatment facility for proceedings under Section 4 of this act shall result in all costs attendant to the person's admission and treatment being assessed to the transporting county.

(7) (a) Before transportation begins, the law enforcement agency or transportation agent shall notify the hospital or treatment facility at which the person is proposed to be admitted as to where the person is and the best estimate of anticipated time of arrival at the hospital or treatment facility.

(b) The law enforcement agency or transportation agent shall notify the hospital or treatment facility of the anticipated time of arrival. If the law enforcement agency or transportation agent has given notice and arrives at the hospital or treatment facility within the anticipated time of arrival, then the law enforcement agency or transportation agent is required to remain at the hospital or treatment facility long enough for the person to be evaluated for admission under Section 4 of this act, but not longer than two (2) hours. After the two (2) hours have expired, the person becomes the responsibility of the evaluating hospital or treatment facility, and the law enforcement agency or transportation agent may leave.

SECTION 2. (1) If a law enforcement officer authorized to make arrests in the state, a licensed physician, a psychologist or a professional designated by crisis intervention team has reason to believe that a person is subject to detention under Section 41-21-140(1), then the law enforcement officer, physician, psychologist or designated professional may take the person into custody without a civil order or warrant for immediate examination under Section 3 for certification of need for care and treatment.

(2) If a person is experiencing a mental health crisis as determined by the criteria established in Section 41-21-140(1), then the person may be admitted and detained by a hospital or treatment facility for emergency diagnosis, evaluation and treatment under this act.

SECTION 3. (1) If a licensed physician, psychologist or professional designated by crisis intervention team takes a person into custody under Section 2(1) of this act, a person is brought to the physician, psychologist or designated professional for examination under this section, then the physician, psychologist or designated professional shall immediately examine the person and decide whether the person is subject to admission to a hospital or treatment facility under Section 2(2) of this act.

(2) (a) If the person is not subject to admission under the authority of subsection (1), then the physician, psychologist or designated professional shall release the person.

(b) If the person is subject to admission under the authority of subsection (1), then the physician, psychologist or designated professional shall complete a certificate of need for the emergency diagnosis, evaluation and treatment showing the factual foundation for the conclusions on each item of Section 41-21-140(1). The physician, psychologist or designated professional shall assess the person's clinical needs and need for physical restraint or vehicle security and determine the mode of transportation to the hospital in consultation with a prescreening agent, other mental health professional familiar with the person, or a knowledgeable family member.

(c) If admission is sought at a state-owned or operated hospital or treatment facility, the physician, psychologist or designated professional shall verify that the state-owned or operated hospital or treatment facility has been contacted and has available suitable accommodations, acknowledging such verification in writing before transport is effectuated.

SECTION 4. (1) As used in this section, "qualified advanced practice provider" means an individual working in collaboration with a licensed physician, and who is a:

(a) Licensed advanced practice nurse with a current certification from a national certifying organization, as a psychiatric-mental health advanced practice nurse; or

(b) Physician assistant with a current certification from a national certifying organization, as having additional qualifications in psychiatry.

(2) A hospital or treatment facility that receives a person transported under Section 41-21-140 must have a licensed physician or a qualified advanced practice provider examine the person to determine whether the person is subject to admission.

(3) If the person is subject to admission under Section 41-21-140, then the physician or qualified advanced practice provider must complete a certificate of need for the emergency diagnosis, evaluation and treatment showing the factual foundation for the conclusions on each item of Section 41-21-140(1).

(4) If the person is not subject to admission and the law enforcement agency or transportation agent is under a duty to remain at the hospital or treatment facility under Section 41-21-140, then the law enforcement agency or transportation agent shall return the person to the county or municipality of original interaction with said law enforcement agency or transportation agent.

(5) If the person is not subject to admission and the local law enforcement agency or transportation agent is not under a duty to remain at the hospital or treatment facility under 41-21-140(7)(b), then the hospital or treatment facility shall return the person to the county or municipality of original interaction with said law enforcement agency or transportation agent.

(6) A hospital, treatment facility or healthcare provider is immune from civil liability and has an affirmative defense to criminal liability arising either from a determination relative to admission of a person to a facility or treatment facility or from the transportation of a person to and from the hospital or treatment facility.

SECTION 5. (1) (a) The local law enforcement agency having primary jurisdiction of the area in which a person with mental illness or serious emotional disturbance is to be transported under this act, shall transport the person except for persons who are transported by:

(i) A secondary transportation agent under this section;

(ii) Another county or municipal law enforcement agency that meets the requirements for a secondary transportation agent under this section with whom the primary local law enforcement agency has entered into contract under the authority of Section 41-21-140(3); or

(iii) One or more friends, neighbors, other mental health professionals familiar with the person, relatives of the person or a member of the clergy.

(b) The local law enforcement agency may designate a secondary transportation agent or agents for the county or municipality for persons with mental illness or serious emotional disturbance whom a physician or prescreening authority has evaluated and determined do not require physical restraint or vehicle security. Like the local law enforcement agency, a secondary transportation agent shall be available twenty-four (24) hours per day, provide adequately for the safety and security of the person to be transported, and provide appropriate medical conditions for transporting persons for involuntary hospitalization. The local law enforcement agency having primary jurisdiction shall take into account in designating a secondary transportation agent or other county or municipal law enforcement agency both its funding and the characteristics of the persons who will be transported. The local law enforcement agency shall consult with the appropriate local governing authority before designating a secondary transportation agent. A secondary transportation agent has the same duties and authority under this chapter in the detention or transportation of those persons as the local law enforcement agency. The designation of a transportation agent other than the local law enforcement agency is a discretionary function. If a prescreening agent, physician or licensed psychologist with health service provider designation, who is acting under Section 3(2)(b), determines that the person does not require physical restraint or vehicle security, then any person identified in subsection (1)(a)(iii) of this section may, instead of the local law enforcement agency, transport the person at the transporter's expense.

(c) (i) If a physician, psychologist, or professional designated by the crisis intervention team, operating under Section 3(2)(b), determines to a reasonable degree of professional certainty that the person subject to transportation under this part does not require physical restraint or vehicle security and does not pose a reasonable risk of danger to the person's self or others, then the local law enforcement agency may permit one or more persons designated under this section, other than the local law enforcement agency or secondary transportation agent, to transport the person; provided, that the person or persons provide proof of current automobile insurance. Before a person is transported, the local law enforcement agency or other transportation agent designated under paragraphs (a) or (b) of this subsection (1) shall give the notice required by Section 41-21-14(7), along with the name or names of the person or persons who will actually transport the person subject to admission to a hospital or treatment resource. The person or persons designated to transport under this section must comply with the requirements of Section 41-21-14(7)(b)(2) and Section 4(3) of this act, and must provide the original of the certificate completed under Section 3(2)(b) to the hospital or treatment resource.

(ii) When making this determination, the physician, psychologist or designated professional operating under Section 3(2)(b) shall be immune from any civil liability and shall have an affirmative defense to any criminal liability arising from that protected activity.

(iii) When making this determination, if the physician, psychologist or designated professional operating under Section 3(2)(b) is an agent of a hospital, health care facility, or community mental health center, that hospital, health care facility or community mental health center shall be immune from any civil liability and shall have an affirmative defense to any criminal liability arising from this agent's protected activity and from the transportation of the person to and from the facility.

(2) When a local law enforcement agency or secondary transportation agent is required to transport a person to a hospital or treatment resource for screening, evaluation, diagnosis or hospitalization, the county or municipality in which the person is initially transported by the local law enforcement agency or secondary transportation agent is responsible for the remainder of such person's transportation requirements. The initial transporting county or municipality is responsible for the continuing transportation of the person even if the person is assessed, diagnosed, screened or evaluated in a second county before being admitted to a facility, hospital or treatment resource in a third county within the state. If the person is transported to a hospital or treatment resource by the local law enforcement agency or secondary transportation agent of a county other than the initial transporting county, the local law enforcement agency or secondary transportation agent actually providing transportation may bill the initial transporting county for transportation costs.

(3) The Department of Mental Health shall provide training on mental health crisis management for transportation agents and the local law enforcement agencies' personnel.

SECTION 6. It is the policy of this state that people with mental illness who are determined to be a danger to themselves and in need of physical restraint or vehicular security shall be transported by the local law enforcement agency or secondary transportation agents designated by the local law enforcement agency. People with a mental illness who do not present themselves as a danger to themselves or are not in need of physical restraint or vehicular security may be transported by one or more friends, neighbors, other mental health professionals familiar with the person, relatives of the person or a member of the clergy; provided, that these persons are willing and able to provide such transport.

SECTION 7. This act shall take effect and be in force from and after July 1, 2025.