53-21-162. Establishment of patient treatment plan — patient’s rights. (1) Each patient admitted as an inpatient to a mental health facility must have a comprehensive physical and mental examination and review of behavioral status within 48 hours after admission to the mental health facility, except as provided in 53-21-1206.

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Terms Used In Montana Code 53-21-162

  • Court: means any district court of the state of Montana. See Montana Code 53-21-102
  • Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-21-102
  • Emergency situation: means :

    (a)a situation in which any person is in imminent danger of death or bodily harm from the activity of a person who appears to be suffering from a mental disorder and appears to require commitment; or

    (b)a situation in which any person who appears to be suffering from a mental disorder and appears to require commitment is substantially unable to provide for the person's own basic needs of food, clothing, shelter, health, or safety. See Montana Code 53-21-102

  • facility: means the state hospital, the Montana mental health nursing care center, or a hospital, a behavioral health inpatient facility, a mental health center, a residential treatment facility, or a residential treatment center licensed or certified by the department that provides treatment to children or adults with a mental disorder. See Montana Code 53-21-102
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Mental health professional: means :

    (a)a certified professional person;

    (b)a physician licensed under Title 37, chapter 3;

    (c)a clinical professional counselor licensed under Title 37, chapter 39;

    (d)a psychologist licensed under Title 37, chapter 17;

    (e)a clinical social worker licensed under Title 37, chapter 39;

    (f)an advanced practice registered nurse, as provided for in 37-8-202, with a clinical specialty in psychiatric mental health nursing;

    (g)a physician assistant licensed under Title 37, chapter 20, with a clinical specialty in psychiatric mental health; or

    (h)a marriage and family therapist licensed under Title 37, chapter 39. See Montana Code 53-21-102

  • Patient: means a person committed by the court for treatment for any period of time or who is voluntarily admitted for treatment for any period of time. See Montana Code 53-21-102
  • Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
  • Professional person: means :

    (a)a medical doctor;

    (b)an advanced practice registered nurse, as provided for in 37-8-202, with a clinical specialty in psychiatric mental health nursing;

    (c)a licensed psychologist;

    (d)a physician assistant licensed under Title 37, chapter 20, with a clinical specialty in psychiatric mental health; or

    (e)a person who has been certified, as provided for in 53-21-106, by the department. See Montana Code 53-21-102

(2)Each patient must have an individualized treatment plan. This plan must be developed by appropriate professional persons, including a psychiatrist, and must be implemented no later than 10 days after the patient’s admission, except as provided in 53-21-1206. Each individualized treatment plan must contain:

(a)a statement of the nature of the specific problems and specific needs of the patient;

(b)a statement of the least restrictive treatment conditions necessary to achieve the purposes of hospitalization;

(c)a description of treatment goals, with a projected timetable for their attainment;

(d)a statement and rationale for the plan of treatment for achieving these goals;

(e)a specification of staff responsibility for attaining each treatment goal;

(f)criteria for release to less restrictive treatment conditions; and

(g)a notation of any therapeutic tasks and labor to be performed by the patient.

(3)Overall development, implementation, and supervision of the treatment plan must be assigned to an appropriate professional person.

(4)The inpatient mental health facility shall periodically reevaluate the patient and revise the individualized treatment plan based on changes in the patient’s condition. At a minimum, the treatment plan must be reviewed:

(a)at the time of any transfer within the facility;

(b)at the time of discharge;

(c)upon any major change in the patient’s condition;

(d)at the conclusion of the initial estimated length of stay and subsequent estimated lengths of stay;

(e)no less than every 90 days; and

(f)at each of the times specified in subsections (4)(a) through (4)(e), by a treatment team that includes at least one professional person who is not primarily responsible for the patient’s treatment plan.

(5)A patient has the right:

(a)to ongoing participation, in a manner appropriate to the patient’s capabilities, in the planning of mental health services to be provided and in the revision of the plan;

(b)to a reasonable explanation of the following, in terms and language appropriate to the patient’s condition and ability to understand:

(i)the patient’s general mental condition and, if given a physical examination, the patient’s physical condition;

(ii)the objectives of treatment;

(iii)the nature and significant possible adverse effects of recommended treatments;

(iv)the reasons why a particular treatment is considered appropriate;

(v)the reasons why access to certain visitors may not be appropriate; and

(vi)any appropriate and available alternative treatments, services, or providers of mental health services; and

(c)not to receive treatment established pursuant to the treatment plan in the absence of the patient’s informed, voluntary, and written consent to the treatment, except treatment:

(i)during an emergency situation if the treatment is pursuant to or documented contemporaneously by the written order of a responsible mental health professional; or

(ii)permitted under the applicable law in the case of a person committed to a facility by a court.

(6)In the case of a patient who lacks the capacity to exercise the right to consent to treatment described in subsection (5)(c), the right must be exercised on behalf of the patient by a guardian appointed pursuant to the provisions of Title 72, chapter 5.

(7)The department shall develop procedures for initiating limited guardianship proceedings in the case of a patient who appears to lack the capacity to exercise the right to consent described in subsection (5)(c).