Assisted Community Treatment

HRS div. 1, tit. 19, ch. 334, pt. VIII

in effect

HRS §334-121 Criteria for assisted community treatment

334-121. Criteria for assisted community treatment A person may be ordered to obtain assisted community treatment if the family court finds, based on the professional opinion of a psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, that: (1) The person is mentally ill or suffering from substance abuse; (2) The person is unlikely to live safely in the community without available supervision, is now in need of treatment in order to prevent a relapse or deterioration that would predictably result in the person becoming imminently dangerous to self or others, and the person's current mental status or the nature of the person's disorder limits or negates the person's ability to make an informed decision to voluntarily seek or comply with recommended treatment; (3) The person has a: (A) Mental illness that has caused that person to refuse needed and appropriate mental health services in the community; or (B) History of lack of adherence to treatment for mental illness or substance abuse that resulted in the person becoming dangerous to self or others and that now would predictably result in the person becoming imminently dangerous to self or others; and (4) Considering less intrusive alternatives, assisted community treatment is essential to prevent the danger posed by the person, is medically appropriate, and is in the person's medical interests. [L 1984, c 251, pt of §1; am L 1992, c 138, §2; am L 2013, c 221, §§7, 24; am L 2016, c 114, §6; am L 2017, c 88, §2; am L 2019, c 129, §4]

HRS §334-121.5 Examination for assisted community treatment indication

334-121.5. Examination for assisted community treatment indication A licensed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization associated with the licensed psychiatric facility where a person is located who was committed to involuntary hospitalization, delivered for emergency examination or emergency hospitalization, or voluntarily admitted to inpatient treatment at a psychiatric facility pursuant to part IV shall, before the person's discharge, examine the person to determine whether an assisted community treatment plan is indicated pursuant to this part. If a plan is indicated, the psychiatrist or advanced practice registered nurse shall prepare the certificate specified by section 334-123. The department of the attorney general shall assist with the preparation and filing of any petition brought pursuant to section 334-123 and with the presentation of the case at any related court proceedings; provided that, if the petitioner is a private provider or other private individual, the petitioner may decline the assistance. The psychiatric facility may notify another mental health program for assistance with the coordination of care in the community for the person. Nothing in this section shall delay the appropriate discharge of a person from the psychiatric facility after the examination for assisted community treatment indication has been completed. [L 2019, c 129, §2; am L 2023, c 153, §1; am L 2024, c 87, §2]

HRS §334-122 Definitions

334-122. Definitions For the purposes of this part: "Advanced practice registered nurse" means a registered nurse licensed to practice in this State who: (1) Has met the qualifications set forth in chapter 457 and this part; (2) Because of advanced education and specialized clinical training, is authorized to assess, screen, diagnose, order, utilize, or perform medical, therapeutic, preventive, or corrective measures; (3) Holds an accredited national certification in an advanced practice registered nurse psychiatric specialization; and (4) Holds prescriptive authority pursuant to section 457-8.6. "Assisted community treatment" includes medication specifically authorized by court order; individual or group therapy; day or partial day programming activities; services and training, including educational and vocational activities; supervision of living arrangements; and any other services prescribed to either alleviate the person's disorder or disability, maintain or maximize semi-independent functioning, or prevent further deterioration that may reasonably be predicted to result in the need for hospitalization or more intensive or restrictive levels of care in the community or incarceration for criminal behavior. "Designated mental health program" includes a state-operated or private provider who is authorized to provide mental health services, including but not limited to inpatient treatment, outpatient treatment, case management, day treatment, or crisis services. "Interested party" means a parent, grandparent, spouse, sibling, adult child, reciprocal beneficiary, service provider, case manager, outreach worker, or mental health professional. "Subject of the order" means a person who has been ordered by the court to obtain assisted community treatment. "Subject of the petition" means the person who, under a petition filed under section 334-123, is alleged to meet the criteria for assisted community treatment. "Treating psychiatrist" means the psychiatrist who is responsible for the management and supervision of a person's treatment under order of the court. [L 1984, c 251, pt of §1; am L 2013, c 221, §§8, 24; am L 2016, c 114, §6; am L 2017, c 88, §3]

HRS §334-123 Initiation of proceeding for assisted community treatment

334-123. Initiation of proceeding for assisted community treatment (a) Any interested party may file a petition with the family court alleging that another person meets the criteria for assisted community treatment. The petition shall state: (1) Each of the criteria under section 334-121 for assisted community treatment; (2) Petitioner's good faith belief that the subject of the petition meets each of the criteria under section 334‑121; (3) Facts that support the petitioner's good faith belief that the subject of the petition meets each of the criteria under section 334-121; and (4) That the subject of the petition is present within the county where the petition is filed. The hearing on the petition need not be limited to the facts stated in the petition. The petition shall be executed subject to the penalties of perjury but need not be sworn to before a notary public. (b) The department of the attorney general shall assist with the preparation and filing of any petition brought pursuant to this section and with the presentation of the case at any related court proceedings; provided that, if the petitioner is a private provider or other private individual, the petitioner may decline the assistance. (c) The petition may be accompanied by a certificate of a licensed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who has examined the subject of the petition within twenty calendar days before the filing of the petition. For purposes of the petition, an examination shall be considered valid so long as the licensed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization has obtained enough information from the subject of the petition to reach a diagnosis of the subject of the petition, and to express a professional opinion concerning the same, even if the subject of the petition is not fully cooperative. If the petitioner believes that further evaluation is necessary before treatment, the petitioner may request further evaluation. (d) The petition shall include the name, address, and telephone number of at least one of the following persons in the following order of priority: the subject of the petition's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult children, or legal guardian, or if none can be found, the petition shall include the name, address, and telephone number of at least one of the subject's closest adult relatives, if any can be found. [L 1984, c 251, pt of §1; am L 1986, c 339, §44; am L 2013, c 221, §§9, 24; am L 2015, c 231, §1; am L 2016, c 114, §6; am L 2017, c 88, §4; am L 2018, c 144, §9; am L 2019, c 129, §5; am L 2024, c 87, §3]

HRS §334-123.5 Appointment of a guardian ad litem

334-123.5. Appointment of a guardian ad litem The family court, upon receipt of a petition filed under this part, shall determine the existence of a guardian and if none, shall appoint a guardian ad litem to represent the best interests of the subject of the petition throughout the pendency of the proceedings. [L 2021, c 58, §2]

HRS §334-124 Hearing date

334-124. Hearing date The family court shall set a hearing date on a petition, and any subsequent hearing dates for the petition, as soon as possible. L 1984, c 251, pt of §1; am L 2013, c 221, §10; am L 2015, c 231, §2; am L 2023, c 153, §2

HRS §334-125 Notice

334-125. Notice (a) Notice of the hearing shall be: (1) Served personally on the subject of the petition pursuant to family court rules; (2) Served personally or by certified or registered mail, return receipt requested, deliverable to the addressee only, to as many as are known to the petitioner of the subject's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult children, or legal guardian, or if none can be found, notice of the hearing shall be served on at least one of the subject's closest adult relatives, if any can be found; (3) Served on the guardian ad litem appointed for the subject of the petition or the subject's existing guardian, if the court determines the existence of one; (4) Served on the attorney for the subject of the petition, if applicable; and (5) Given to other persons as the court may designate. (b) The notice shall include the following: (1) The date, time, place of hearing, a clear statement of the purpose of the proceedings and possible consequences to the subject, and a statement of the legal standard upon which assisted community treatment is being considered; (2) A copy of the petition; (3) Notice that the subject of the petition has been assigned a guardian ad litem to represent the best interests of the subject throughout the proceeding, unless the court determined the existence of a guardian for the subject; and (4) Notice that the subject of the petition is entitled to the assistance of an attorney, and that the subject may contact their own attorney. (c) Notice of all subsequent hearings shall be served in accordance with subsections (a) and (b), and in accordance with all applicable family court rules relating to service of notice, including that service need not be made on parties in default for failure to appear. [L 1984, c 251, pt of §1; am L 1997, c 383, §48; am L 2013, c 221, §§11, 24; am L 2015, c 231, §3; am L 2016, c 114, §6; am L 2018, c 144, §10; am L 2021, c 58, §3]

HRS §334-126 Hearing.

334-126. Hearing. (a) The time and form of the procedure incident to hearing the issues in the petition shall be provided by family court rule and consistent with this part. (b) The hearing may be held at any convenient place within the circuit. The subject of the petition, any interested person, or the family court upon its own motion may request a hearing in another court because of inconvenience to the parties, witnesses, or the family court or because of the subject’s physical or mental condition. (c) The hearing shall be closed to the public, unless the subject of the petition requests otherwise. (d) The subject of the petition shall be present at the hearing. However, if the subject has been served with the petition and does not appear at the hearing, the court, in its discretion, may go forward with the hearing. (e) The subject of the petition need not, but may, be represented by an attorney. If the subject desires an attorney and is indigent, or if the family court determines that the legal or factual issues raised are of such complexity that the assistance of an attorney is necessary for an adequate presentation of the merits or that the subject of the petition is unable to speak for the subject’s self, the family court shall order the appointment of a public defender or other attorney to represent the subject and continue the hearing for not more than five days. (f) If the subject of the petition is represented by an attorney, the attorney shall be allowed adequate time for investigation of the matters at issue and preparation. The attorney shall be permitted to present evidence believed necessary for proper disposition of the proceeding. (g) No subject of the petition shall be ordered to receive involuntary outpatient treatment unless at least one psychiatrist testifies in person at the hearing who has personally examined the subject within the time period commencing five calendar days before the filing of the petition and ending at the time of the psychiatrist’s testimony. The psychiatrist’s testimony shall state the facts which support the allegation that the subject meets all the criteria for involuntary outpatient treatment, the recommended outpatient treatment, and the rationale for the recommended outpatient treatment. If the recommended outpatient treatment includes medication, the psychiatrist’s testimony shall describe the types or classes of medication(s) which should be authorized, and describe the physical and mental beneficial and detrimental effects of such medication(s). If the subject of the petition has refused to be examined by a licensed psychiatrist, the family court may request the subject to consent to examination by a psychiatrist appointed by the court or employed at a community mental health center. If the subject of the petition does not consent and the family court finds sufficient evidence to believe that the allegations in the petition are true, the family court may order the commitment of the subject to a psychiatric facility for examination. The commitment shall not be for more than twenty-four hours. The examining psychiatrist shall submit the findings and recommendations to the family court. The subject of the petition’s refusal to submit voluntarily to examination shall be treated as a denial that the subject is suffering from a severe mental disorder or substance abuse, and a denial that the subject otherwise fits within the criteria for a court order of involuntary outpatient treatment. Nothing herein shall be construed in a way that limits the subject of the petition’s privilege against self-incrimination. (h) The subject of the petition may secure one or more psychiatric examinations and present the findings as evidence at the hearing. The subject shall be entitled to a psychiatric examination at a community mental health center if the subject so desires, and if an examination has not already been conducted at a community mental health center which will lead to psychiatric testimony at the hearing. [L 1984, c 251, pt of §1]

HRS §334-127 Disposition

334-127. Disposition (a) If after hearing all relevant evidence, including the results of any diagnostic examination ordered by the family court, the family court finds that the subject of the petition does not meet the criteria for assisted community treatment, the family court shall dismiss the petition. Notice of the dismissal shall be provided to those persons entitled to notice pursuant to section 334-125. (b) If after hearing all relevant evidence, including the results of any diagnostic examination ordered by the family court, the family court finds that the criteria for assisted community treatment under section 334-121(1) have been met beyond a reasonable doubt and that the criteria under section 334-121(2) to (4) have been met by clear and convincing evidence, the family court shall order the subject to obtain assisted community treatment for a period of no more than two years. The written treatment plan submitted pursuant to section 334-126(g) shall be attached to the order and made a part of the order. If the family court finds by clear and convincing evidence that the beneficial mental and physical effects of recommended medication outweigh the detrimental mental and physical effects, if any, the order may authorize types or classes of medication to be included in treatment at the discretion of the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization. The court order shall also state who should receive notice of intent to discharge early in the event that the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization determines, before the end of the court ordered period of treatment, that the subject should be discharged early from assisted community treatment. Notice of the order shall be provided to the director, the interested party who filed the petition, and those persons entitled to notice pursuant to section 334-125. (c) The family court shall also designate on the order the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization who is to be responsible for the management and supervision of the subject's treatment, or shall assign an administrator of a designated mental health program to, in turn, designate the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization during the treatment period without court approval, and may designate either a publicly employed psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization, or a private psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization; provided that the private psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization shall agree to the designation. The order for assisted community treatment shall be subject to the Health Care Privacy Harmonization Act, chapter 323B. (d) Nothing in this section shall preclude the subject's stipulation to the continuance [of] an existing court order. [L 1984, c 251, pt of §1; am L 2013, c 221, §§13, 24; am L 2016, c 114, §§3, 6; am L 2017, c 88, §6; am L 2018, c 144, §12; am L 2019, c 129, §6; am L 2021, c 58, §5; am L 2023, c 153, §4]

HRS §334-128 Treatment costs and fees

334-128. Treatment costs and fees Private treatment pursuant to the court order shall be at the expense of the subject of the petition, except to the extent such charges are covered by other laws or programs. Treatment through a designated mental health program shall be pursuant to its fee schedules; however, the subject of the order shall not be denied treatment by a designated mental health program for failure to pay the fees. [L 1984, c 251, pt of §1; am L 2013, c 221, §§14, 24; am L 2016, c 114, §6]

HRS §334-129 Failure to comply with outpatient treatment.

334-129. Failure to comply with outpatient treatment. (a) An outpatient treatment psychiatrist may prescribe or administer to the subject of the order reasonable and appropriate medication, if specifically authorized by the court order, and treatment which is consistent with accepted medical standards and the family court order. (b) No subject of the order shall be physically forced to take medication or forcibly detained for treatment under a family court order for involuntary outpatient treatment. (c) The outpatient treatment psychiatrist or psychiatrist’s designee shall make all reasonable efforts to solicit the subject’s compliance with the prescribed treatment. If the subject fails or refuses to comply after the efforts to solicit compliance, the outpatient treatment psychiatrist shall so notify the court and may submit a petition under part IV for the involuntary hospitalization of the subject, provided that the refusal of treatment shall not constitute evidence toward any of the criteria for involuntary hospitalization. [L 1984, c 251, pt of §1]

HRS §334-130 Period of assisted community treatment

334-130. Period of assisted community treatment (a) The assisted community treatment order shall continue to apply to the subject, for the duration specified in the order, regardless of whether the treatment setting changes. (b) A subject of assisted community treatment is automatically and fully discharged at the end of the family court ordered period of treatment, a period of no more than two years, unless a new family court order has been obtained as provided hereinbelow. (c) Nothing in this section shall preclude the subject's stipulation to the continuance [of] an existing court order. [L 1984, c 251, pt of §1; am L 2013, c 221, §§16, 24; am L 2016, c 114, §§5, 6; am L 2023, c 153, §5]

HRS §334-131 Notice of intent to discharge

334-131. Notice of intent to discharge (a) When the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization contemplates discharge for a subject of the order because of expiration of the court order or because the subject of the order is no longer a proper subject for assisted community treatment, as determined by the criteria in section 334-121, the treating psychiatrist or advanced practice registered nurse with prescriptive authority and who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization shall provide notice of intent to discharge. (b) The notice shall be filed with the family court that issued the order for assisted community treatment, and served by personal service or by certified mail on the interested party who filed the petition and those persons whom the order for assisted community treatment specifies as entitled to receive notice. (c) The notice of intent to discharge shall be mailed at least ten days prior to the intended date of discharge. (d) If no objection is filed under section 334-132 prior to the intended date of discharge, the subject of the order is thereupon fully discharged from assisted community treatment. [L 1984, c 251, pt of §1; am L 2013, c 221, §§17, 24; am L 2016, c 114, §6; am L 2017, c 88, §8; am L 2023, c 153, §6]

HRS §334-132 Objection to discharge

334-132. Objection to discharge (a) If any person specified as entitled to receive notice files a written objection with the family court on the grounds that the subject of the order is a proper subject for assisted community treatment, the family court shall conduct a hearing to determine if the subject of the order still meets the criteria for assisted community treatment in section 334-121. The hearing shall be conducted as provided under section 334-134. (b) If the family court finds that the subject of the order continues to meet the criteria for assisted community treatment in section 334-121, the family court shall order the subject to continue the treatment for the unexpired period of its earlier order. (c) If the family court finds that the subject of the order does not meet the criteria for assisted community treatment in section 334-121, the court shall dismiss the objection and order the early discharge of the subject. [L 1984, c 251, pt of §1; am L 2013, c 221, §§18, 24; am L 2016, c 114, §6]

HRS §334-134 Hearing for discharge

334-134. Hearing for discharge Any person may petition the family court for the discharge of an order of assisted community treatment during the period of assisted community treatment after sixty days from the most recent hearing involving the subject of the order. The petition shall be filed, and unless the court determines the existence of a guardian, guardian ad litem appointed, notice given, hearing held, and order made in the same manner as provided for the original petition alleging that the subject of the order met the criteria for assisted community treatment. [L 1984, c 251, pt of §1; am L 2013, c 221, §§20, 24; am L 2016, c 114, §6; am L 2021, c 58, §8]

Source: Hawaii State Legislature (capitol.hawaii.gov), via Internet Archive capturesURL: http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0334/HRS_0334-.htmFetched: 11/10/2026