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chapter-334•Hawaii Revised Statutes, Chapter 334 — Mental Health, Mental Illness, Drug Addiction, and Alcoholism
chapter-334Haw. Rev. Stat. ch. 334CodeJan 1, 1967
Division 1. Government — Title 19. Health
Hawaii Revised Statutes as published by the Hawaii State Legislature (files updated 1/5/2026 7:14 PM).
As used in this chapter unless otherwise indicated by the context:
"Administrator" means the person in charge of a public or private hospital.
"Admission procedures" mean the various methods for admission of mentally ill persons or of persons habituated to the excessive use of drugs or alcohol to public and private psychiatric facilities.
"Authorized absence" means absence of a patient from a psychiatric facility for any period of time with permission.
"Behavioral health crisis center" means a facility that is specifically designed and staffed to provide care, diagnosis, or treatment for persons who are experiencing a mental illness or substance use disorder crisis.
"Community mental health center" means one or more facilities which alone or in conjunction with other facilities, public or private, are part of a coordinated program providing a variety of mental health services principally for persons residing in a community or communities in or near which the center is located.
"Conservator" shall have the meaning provided in section 560:5-102.
"Court" means any duly constituted court and includes proceedings, hearings of per diem judges as authorized by law.
"Dangerous to others" means likely to do substantial physical or emotional injury on another, as evidenced by a recent act, attempt or threat.
"Dangerous to property" means inflicting, attempting or threatening imminently to inflict damage to any property in a manner which constitutes a crime, as evidenced by a recent act, attempt or threat.
"Dangerous to self" means the person recently has:
(1) Threatened or attempted suicide or serious bodily harm; or
(2) Behaved in such a manner as to indicate that the person is unable, without supervision and the assistance of others, to satisfy the need for nourishment, essential medical care, including treatment for a mental illness, shelter or self-protection, so that it is probable that death, substantial bodily injury, or serious physical debilitation or disease will result unless adequate treatment is afforded.
"Department" means the department of health.
"Director" means the director of health.
"Discharge" means the formal termination on the records of a psychiatric facility of a patient's period of treatment at the facility.
"Guardian" shall have the meaning provided in section 560:5-102.
"Health care operations" means the services and activities conducted by an institution, facility, or agency licensed, certified, or otherwise authorized or permitted by law to provide medical or health services in the ordinary course of business, including case management and care coordination, quality assessment and improvement activities, medical reviews, and administrative activities.
"Health care provider" means an individual or entity licensed, certified, or otherwise authorized or permitted by law to provide medical or health services in the ordinary course of business or practice of a profession.
"Homeless individual" means an individual who is homeless as defined under section 346-361 and who has a serious and persistent mental illness or is otherwise eligible for treatment.
"Imminently dangerous to self or others" means that, without intervention, the person will likely become dangerous to self or dangerous to others within the next forty-five days.
"Incapacitated person" shall have the meaning provided in section 560:5-102.
"Interested person" means an interested, responsible adult, including but not limited to a public official, the legal guardian, spouse, parent, legal counsel, adult child, or next of kin of a person allegedly mentally ill, mentally deficient or suffering from substance abuse or as otherwise provided in article I of chapter 560.
"Intoxicated person" means a person who is deprived of reasonable self-control because of intake of alcohol or because of any substance which includes in its composition volatile organic solvents.
"Judge" means any judge of the family court or per diem judge appointed by the chief justice as provided in section 604-2.
"Law enforcement officer" has the same meaning as in section 710-1000.
"Licensed physician" means a physician or surgeon licensed by the State to practice medicine, including a physician and surgeon granted a limited and temporary license under section 453-3(1), (2), and (5) or a resident physician and surgeon granted a limited and temporary license under paragraph (4) thereof, or a medical officer of the United States while in this State in the performance of the medical officer's official duties.
"Mental health" means a state of social, psychological, and physical well-being, with capacity to function effectively in a variety of social roles.
"Mental health emergency worker" means a person designated by the department to provide crisis intervention and emergency stabilization services and to assist in determining whether a mentally ill person is likely to meet the criteria for emergency admission and examination.
"Mentally ill person" means a person having psychiatric disorder or other disease which substantially impairs the person's mental health and necessitates treatment or supervision.
"Patient" means an individual under observation, care, or treatment at a psychiatric facility or other facility designated by the director.
"Person suffering from substance abuse" means a person who uses narcotic, stimulant, depressant, or hallucinogenic drugs or alcohol to an extent which interferes with the person's personal, social, family, or economic life.
"Protected person" shall have the meaning provided in section 560:5-102.
"Psychiatric facility" means a public or private hospital or part thereof which provides inpatient or outpatient care, custody, diagnosis, treatment or rehabilitation services for mentally ill persons or for persons habituated to the excessive use of drugs or alcohol or for intoxicated persons.
"Qualified psychiatric examiner" means a licensed psychiatrist or advanced practice registered nurse with prescriptive authority who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization.
"Special treatment facility" means a public or private facility which provides a therapeutic residential program for care, diagnosis, treatment or rehabilitation services for emotionally distressed persons, mentally ill persons or persons suffering from substance abuse.
"Surrogate" means a person appointed under:
(1) A power of attorney for health care to make a health care decision for the individual who made the appointment; or
(2) Law or court order to make health care decisions for an individual.
"Therapeutic living program" means a supervised living arrangement that provides mental health or substance abuse services for individuals or families who do not need the structure of a special treatment facility and are transitioning from a more restrictive treatment setting to independent living. The program aids residents in meeting basic needs and provides supportive services through a required service plan.
"Treatment" means the broad range of emergency, out-patient, intermediate, domiciliary, and inpatient services and care, including diagnostic evaluation, medical, psychiatric, psychological, and social service care, vocational rehabilitation, psychosocial rehabilitation, career counseling, and other special services that may be extended to an individual with a disability.
"Treatment summary" means a record of information including present history and physical examination, mental status examination, emergency department record, intake evaluation, eligibility determination, current medication list and prescription history, treatment plan, consultant reports, diagnosis and problem lists, recent laboratory and diagnostic testing, clinical or discharge summaries, and discharge instructions, or any combination of such information.
"Unauthorized absence" means absence of a patient from a psychiatric facility for any period of time without permission.
[L 1967, c 259, pt of §1; HRS §334-1; am L 1968, c 6, §2; am L 1969, c 153, §1; am L 1973, c 93, pt of §2; am L 1976, c 130, §1(1), (2); am L 1977, c 76, §1; am L 1979, c 228, §2; am L 1984, c 94, §1; am L 1985, c 75, §1; gen ch 1985; am L 1986, c 335, §1 and c 339, §43; am L 1997, c 220, §1; am L 2004, c 161, §7; am L 2008, c 98, §1; am L 2013, c 221, §§3, 24 and c 232, §1; am L 2016, c 114, §§1, 6 and c 186, §2; am L 2019, c 129, §3; am L 2020, c 28, §2; am L 2024, c 86, §3; am L 2025, c 219, §5]
The department of health shall foster and coordinate a comprehensive mental health system utilizing public and private resources to reduce the incidence of mental or emotional disorders and substance abuse, to treat and rehabilitate the victims in the least restrictive and most therapeutic environment possible, and to provide treatment and care for homeless individuals with serious and persistent mental health challenges to enable them to reside in a permanent dwelling unit or homeless facility, as defined in section 346-361. The department shall administer such programs, services, and facilities as may be provided by the State to promote, protect, preserve, care for, and improve the mental health of the people.
[L 1967, c 259, pt of §1; HRS §334-2; am L 1984, c 218, §2; am L 2016, c 186, §3]
(a) The director may contract with any person for:
(1) The development or operation of private in-state psychiatric facilities;
(2) The placement of patients in existing private or public psychiatric facilities; and
(3) The provision of:
(A) Secure psychiatric rehabilitation services;
(B) Crisis intervention and stabilization services;
(C) Intensive treatment and wraparound services;
(D) Diversion services;
(E) Special treatment facilities or therapeutic living programs as defined in section 334-1;
(F) Case management services;
(G) Housing services;
(H) Outreach services, with priority for outreach services intended to help homeless individuals with serious and persistent mental health challenges reside in homeless facilities, permanent dwelling units, or other facilities and avoid returning to homelessness; and
(I) Other mental health treatment and rehabilitation services.
(b) The department may operate or contract for a secure psychiatric rehabilitation program for individuals who require intensive therapeutic treatment and rehabilitation in a secure setting. The services authorized by this section shall be for persons:
(1) Involuntarily hospitalized under this chapter for whom the services cannot be reimbursed, covered, or provided by an insurer, plan, or other person;
(2) Committed to the custody of the director under chapter 704; and
(3) Appropriately hospitalized under chapter 704 or 706.
The director shall be responsible for the appropriate placement of all persons placed in facilities or services contracted for or operated by the director under paragraphs (1) through (3).
Any such person placed in a facility or services contracted for or operated by the director who leaves or remains away from the facility or services, without permission, may be apprehended and returned to the facility or services by any employee of the department or by any law enforcement officer without any warrant or further proceeding.
(c) The department shall:
(1) See that patients who receive services under contract or provided directly by the department pursuant to subsection (a) receive the care and treatment for which the department has contracted or for which appropriate services are provided directly by the department;
(2) Make periodic reviews of the records of each person committed to the director's custody or hospitalized pursuant to this chapter, chapter 704, or chapter 706;
(3) In suitable cases, discharge or place on authorized absence persons committed to the director's custody or hospitalized pursuant to this chapter, chapter 704, or chapter 706; and
(4) Keep a medical record of each person committed to the director's custody or hospitalized pursuant to this chapter, chapter 704, or chapter 706.
[L 1999, c 119, §2; am L 2013, c 232, §2; am L 2016, c 186, §4]
[ §334-2.7] Development or expansion of a forensic facility of the department of health. (a) Notwithstanding any other law to the contrary, the governor, with the assistance of the director, may negotiate with any person for the development or expansion of a forensic facility of the department; provided that if an environmental assessment or environmental impact statement is required for a proposed site or for the expansion of the forensic facility under section 343-5, then notwithstanding the time periods specified for public review and comments under section 343-5, the governor shall accept public comments for a period of sixty days following public notification of either an environmental assessment or an environmental impact statement.
(b) Any development or expansion proposal shall address the construction of the forensic facility separate from the operation of the facility and shall consider and include:
(1) The percentages of low, medium, and high risk patients;
(2) The impact of the facility on existing infrastructure and an assessment of improvements and additions that will be necessary;
(3) The impact of the facility on available modes of transportation, including airports, roads, and highways; and
(4) A useful life costs analysis.
(c) For the purposes of this section:
"Forensic facility" means a facility that assesses and treats forensically committed persons.
"Useful life costs" means an economic evaluation that compares alternate building and operating methods and provides information on the design, construction methods, and materials to be used with respect to efficiency in building maintenance and facility operation.
[L 2016, c 90, §2]
(a) The department of health within the limits of available funds within the designated programs, shall promote and provide for the establishment and operation of a community-based mental health system responsive to the needs of persons of all ages, ethnic groups, and geographical areas of the State, reflective of an appropriate distribution of resources and services, and monitored and evaluated in terms of standards, goal attainment, and outcomes. The elements of the system shall be defined by departmental rules recognizing the need for at least the following services:
(1) Informational and educational services to the general public and to lay and professional groups;
(2) Collaborative and cooperative services with public and private agencies and groups for the prevention and treatment of mental or emotional disorders and substance abuse and rehabilitation of patients;
(3) Consultation services to the judiciary, to educational institutions, and to health and welfare agencies;
(4) Case management, outreach, and follow-up services;
(5) Emergency crisis and noncrisis intervention services accessible to all residents;
(6) Community-based, relevant, and responsive outpatient services;
(7) Community residential care comprising a comprehensive range of small, homelike, and appropriately staffed treatment and rehabilitation facilities;
(8) Short-term psychiatric treatment, preferably in facilities where access to other health and medical services are readily available;
(9) Intensive psychiatric treatment for patients in need of long-term, highly structured, or highly specialized care and treatment under section 334-2.5, and provision of appropriate community resources;
(10) Training programs, activities, and staffing standards for the major mental health disciplines and ancillary services; and
(11) Rehabilitative services for hospital and community-based individuals who have experienced short- or long-term mental or emotional disorders and substance abuse.
(b) The department shall revise, refine, and develop the system to ensure optimal responsiveness to the many and varied needs of the people of the State. The development of the system shall be based on an annual statewide comprehensive integrated service plan that is the cumulative result of comprehensive integrated service area planning within each county. The statewide plan shall determine the specific content of the department of health budget for the mental health system.
(c) The department shall specifically:
(1) Perform statewide assessments of the need for prevention, treatment, and rehabilitation services in the areas of mental or emotional disorders and substance abuse;
(2) Adopt rules pursuant to chapter 91 for establishing the number and boundaries of the geographical service areas for the delivery of services in the areas of mental or emotional disorders and substance abuse. The department shall periodically review the effectiveness of the geographical service areas in promoting accessibility and continuity of appropriate care to all residents of that geographical area;
(3) Appoint a service area administrator in each county who shall be responsible for the development, delivery, and coordination of services in that area;
(4) Ensure statewide and community-based planning for the ongoing development and coordination of the service delivery system as guided by needs assessment data and performance related information;
(5) Establish standards and rules for psychiatric facilities and their licensing, where applicable;
(6) Establish standards and rules for services in the areas of mental health and substance abuse treatment, including assurances of the provision of minimum levels of accessible service to persons of all ages, ethnic groups, and geographical areas in the State;
(7) Ensure community involvement in determining the service delivery arrangements appropriate to each community of the State;
(8) Cooperate with public and private health, education, and human service groups, agencies, and institutions in establishing a coordinated system to meet the needs of persons with mental or emotional disorders and substance abuse difficulties;
(9) Evaluate and monitor all services in the fields of mental health and substance abuse where services are supported fully or in part by state resources;
(10) Promote and conduct research, demonstration projects, and studies concerned with the nature, prevention, intervention, and consequences of mental or emotional disorders and substance abuse;
(11) Keep records, statistical data, and other information as may be necessary in carrying out the functions of the mental health system and this chapter;
(12) Advocate patients' rights in all psychiatric facilities in the State and investigate any grievances submitted to the department by any patient in a psychiatric facility, except as provided in section 334E-2(d). The department shall establish rules and procedures for the purpose of this paragraph within one year after January 1, 1985, and post the rules in a conspicuous manner and accessible place;
(13) Promote and conduct a systematic program of accountability for all services provided, funds expended, and activities carried out under its direction or support in accordance with sound business, management, and scientific principles;
(14) Coordinate mental health resources in each county of the State by the development and presentation of a comprehensive integrated service area plan developed by the service area administrator in conjunction with the service area board. The service area administrator and the service area board, in collaboration with private and public agencies serving their population, shall submit recommendations for the statewide comprehensive integrated service plan, including needs assessment, program planning, resource development, priorities for funding, monitoring, and accountability activities;
(15) Oversee and coordinate service area programs and provide necessary administrative and technical assistance to assist service area programs in meeting their program objectives;
(16) Provide staffing to the state council and service area boards to assist in the performance of their functions; and
(17) Establish standards and rules for the designation of mental health emergency workers.
[L 1967, c 259, pt of §1; HRS §334-3; am L 1982, c 200, §2; am L 1984, c 218, §3; am L 1985, c 6, §2; am L 1999, c 119, §3; am L 2004, c 79, §2; am L 2024, c 86, §4]
There is established within the mental health division of the department of health a community-based employment program for the chronically mentally ill to (1) create business enterprises for employment of the chronically mentally ill; (2) teach the skills and attitudes which will enable the chronically mentally ill to become employed; and (3) provide support services including housing so that the chronically mentally ill can secure and maintain employment and live within the community.
[L 1987, c 340, §2]
The director shall appoint professional and nonprofessional staff as the director deems necessary to carry out the state mental health program and for which appropriations are available. Positions for psychiatrists are exempted from chapter 76. The director may employ psychiatrists as needed by the department on a contractual basis, subject to the approval of the governor. The director may appoint an administrator, three associate administrators, a director of psychosocial rehabilitation, a chief of the department of nursing, a risk manager, a patients' rights advisor, and a facilities plant engineer for the state hospital or a secure psychiatric rehabilitation facility established pursuant to this chapter and these positions shall be exempt from chapter 76.
[L 1967, c 259, pt of §1; HRS §334-4; gen ch 1985; am L 1996, c 125, §2; am L 1998, c 97, §1; am L 1999, c 119, §4; am L 2000, c 253, §150]
All certificates, applications, records, and reports made for the purposes of this chapter that are maintained, used, or disclosed by health care providers as defined in this chapter, health plans as defined in title 45 Code of Federal Regulations section 160.103, and health care clearinghouses as defined in title 45 Code of Federal Regulations section 160.103, and directly or indirectly identifying a person subject hereto shall be kept confidential and shall not be disclosed by any person except as allowed by title 45 Code of Federal Regulations part 164, subpart E. Nothing in this section shall preclude the:
(1) Application of more restrictive rules of confidentiality set forth for records covered by title 42 Code of Federal Regulations part 2, relating to the confidentiality of alcohol and drug abuse patient records;
(2) Disclosure deemed necessary under the federal Protection and Advocacy for Mentally Ill Individuals Act of 1986, P.L. 99-319, to protect and advocate for the rights of persons with mental illness who reside in facilities providing treatment or care; or
(3) Disclosures made by a court or the Hawaii criminal justice data center of orders of involuntary civil commitment issued pursuant to section 334-60.5 for the purpose of firearms permitting or registration pursuant to chapter 134.
[L 1967, c 259, pt of §1; HRS §334-5; am L 1973, c 122, §1; gen ch 1985; am L 1987, c 148, §1; am L 1999, c 87, §3; am L Sp 2000 2d, c 1, §1; am L 2001, c 244, §§3, 6; am L 2003, c 204, §8; am L 2004, c 22, §1; am L 2008, c 98, §2; am L 2014, c 87, §3 and c 214, §4]
(a) Pursuant to chapter 91, the director shall establish reasonable charges for treatment services and may make collections on such charges. In making the collections on such charges the director shall take into consideration the financial circumstances of the patient and the patient's family including a reciprocal beneficiary, and no collections shall be made where in the judgment of the director, such collections would tend to make the patient or the patient's family including a reciprocal beneficiary, a public charge or deprive the patient and the patient's family including a reciprocal beneficiary, of necessary support.
(b) Every person hospitalized at a psychiatric facility or receiving treatment services through a community mental health center under the jurisdiction of the State or a county, or at a psychiatric facility or through a community mental health center which derives more than fifty per cent of its revenues from the general fund of the State, or pursuant to contract with the director under section 334-2.5, shall be liable for the expenses attending their reception, maintenance, and treatment and any property not exempt from execution belonging to the person shall be subject to sequestration for the payment of the expenses. Every parent or legal guardian of a patient who is a minor and every spouse or reciprocal beneficiary of a patient shall be liable for the expenses attending the reception, maintenance, and treatment of that minor child or spouse or reciprocal beneficiary who is hospitalized at a psychiatric facility or receiving treatment through a community mental health center under the jurisdiction of the State or a county, or at a psychiatric facility or through a community mental health center which derives more than fifty per cent of its revenues from the general fund of the State, or pursuant to contract with the director under section 334-2.5.
[L 1967, c 259, pt of §1; HRS §334-6; am L 1971, c 153, §1; am L 1972, c 80, §1; am L 1991, c 243, §2; gen ch 1992; am L 1997, c 383, §44; am L 1999, c 119, §5]
The department of health is authorized to accept donations or grants from individuals and other agencies, public and private, to further the purposes of the mental health program. The donations or grants shall in fact be used for the mental health program and for the intended purpose, if specified.
[L 1967, c 259, pt of §1; HRS §334-7]
In carrying out the director's duties under this chapter:
(1) The director of health may enter into agreements with the United States and with other state departments, agencies, and political subdivisions and enter into assistance agreements for services with a profit organization incorporated under the laws of the State or a nonprofit organization determined to be exempt from the federal income tax by the Internal Revenue Service and allocate and expend any funds appropriated for the purposes of such agreements and do all things necessary to accomplish the purposes and provisions thereof.
(2) The director shall establish standards and review procedures to assure that recipients of state funding provide the services and facilities necessary to accomplish the purposes for which the funds are provided.
[L 1967, c 259, pt of §1; HRS §334-8; am L 1984, c 78, §1 and c 218, §4; gen ch 1985]
The director of health shall adopt rules in accordance with chapter 91 to carry out this chapter.
[L 1967, c 259, pt of §1; HRS §334-9; am L 1984, c 218, §5]
(a) There is established, within the department of health for administrative purposes, a state council on mental health. The council shall consist of twenty-one members appointed by the governor as provided in section 26-34. In making appointments to the council, the governor shall ensure that all service area boards of the State are represented, and that a majority of the members are nonproviders of mental health or other health services, and that a majority of the members are not state employees. The number of parents of children with serious emotional disturbances shall be sufficient to provide adequate representation of such children in the deliberations of the council. The council shall be composed of residents of the State, including individuals representing:
(1) The principal state agencies with respect to mental health, education, vocational rehabilitation, criminal justice, housing, medicaid, and social services;
(2) Public and private entities concerned with the need, planning, operation, funding, and use of mental health services and related support services;
(3) Adults with serious mental illnesses who are receiving, or have received, mental health services;
(4) The families of such adults or families of children with serious emotional disturbances; and
(5) The Hawaii advisory commission on drug abuse and controlled substances who shall be a person knowledgeable about the community and the relationships between mental health, mental illness, and substance abuse.
(b) The council shall elect a chairperson from among its members. All members shall serve without compensation but shall be paid their necessary expenses in attending meetings of the council.
(c) The council shall advise the department on allocation of resources, statewide needs, and programs affecting two or more service areas. The council shall review and comment on the statewide comprehensive integrated service plan and shall serve as an advocate for adults with serious mental illness, children with serious emotional disturbances, other individuals with mental illnesses or emotional problems, and individuals with combined mental illness substance abuse disorders.
(d) If the department's action is not in conformance with the council's advice, the department shall provide a written explanation of its position to the council.
(e) The council shall prepare and submit an annual report to the governor and the legislature on implementation of the statewide comprehensive integrated service plan. The report presented to the legislature shall be submitted at least twenty days prior to the convening of each regular session.
(f) A quorum for purposes of doing business shall consist of a majority of the members serving on the council immediately before a meeting begins.
(g) If a quorum is present when a vote is taken, the affirmative vote of a majority of members present shall constitute a valid act of the council unless this chapter, part I of chapter 92, the articles of incorporation, or the bylaws require a greater number of affirmative votes.
[L 1984, c 218, pt of §1; am L 1993, c 210, §2; am L 2004, c 79, §3; am L 2018, c 137, §1]
§334-11 Service area boards. (a) A service area board shall be established within the department of health for administrative purposes to advise each service area administrator. Each board shall consist of nine members appointed by the governor, who shall serve for terms to be determined by the governor. After the initial appointees, the governor shall fill each vacancy on a board by appointing a member from a list of four persons submitted by that board, except that, if the board is unable to achieve a quorum at two consecutive meetings called for the purpose of making such a list, the list may be provided by a group of at least seven service area consumers and nonproviders of mental health services. This group shall consist of all board members willing to participate in making the list and other area consumers and nonproviders of mental health services to be selected by the service area board chairperson and service area administrator. Any meeting called for the purpose of making the list shall be subject to part I of chapter 92. The members of the board shall be service area residents, who are consumers or nonproviders of mental health services and service area providers with a majority being non-state employees and nonproviders of mental health or other health services.
Each board shall elect a chairperson from among its members. All members shall serve without compensation but shall be paid their necessary expenses in attending meetings of the board.
(b) Each service area administrator and board, in consultation with public and private providers, shall participate in the development of comprehensive integrated service area plans and budgets. Each board shall advise the service area administrator about service area needs to prevent and treat mental or emotional disorders, combined mental illness substance abuse disorders, and persons afflicted by these disorders, and provide advice, guidance, and recommendations to both the advisory commission on drug abuse and controlled substances, section 329-2, and the state council on mental health, section 334-10, as they deem appropriate.
(c) If a service area administrator's actions are not in conformance with the board's planning decisions, the service area administrator shall provide a written explanation to the board.
(d) A quorum for purposes of doing business shall consist of a majority of the members serving on a board immediately before a meeting begins.
(e) If a quorum is present when a vote is taken, the affirmative vote of a majority of the members present shall constitute a valid act of a board unless this chapter, part I of chapter 92, or the articles or bylaws of the board require the vote of a greater number of members.
[L 1984, c 218, pt of §1; am L 1985, c 6, §1; am L 1987, c 14, §1; am L 1993, c 210, §3; am L 2004, c 79, §4; am L 2018, c 138, §1]
(a) There is established in the mental health division of the department of health, a mental health unit which shall provide bilingual mental health services statewide.
(b) The mental health unit established in this section shall have the following functions and shall provide the following services:
(1) Outreach;
(2) Education;
(3) Case finding;
(4) Screening;
(5) Referral and linkage;
(6) Consultation;
(7) Crisis stabilization;
(8) Community support services;
(9) System advocacy;
(10) Client support and advocacy; and
(11) Monitoring and follow-up.
[L 1989, c 78, §3]
(a) There is established a representative payee program within the department of health, to be administered by the director of health, to provide representative payee services to "mentally ill persons", "persons suffering from substance abuse", and persons referred from the department of human services who receive financial assistance and have a primary medical diagnosis of substance abuse.
(b) In developing this program, the department of health shall consider the following:
(1) Services to the neighbor islands;
(2) Training for representative payees;
(3) Representative payees for care home residents;
(4) Representative payees for homeless persons;
(5) The use of case managers as representative payees;
(6) The development of due process procedures to protect the rights of mentally ill persons and persons suffering from substance abuse; and
(7) The development and implementation of an inter-agency working agreement with the department of human services to carry out the purposes of this program.
[L 1990, c 169, §2; am L 1995, c 207, §3]
(a) All moneys to make loans for the establishment of housing in which individuals recovering from alcohol or drug abuse may reside in groups of not less than four individuals, shall be allocated by the legislature through appropriations out of the state general fund.
(b) The department shall include in its budgetary request for each upcoming fiscal period, the amounts necessary to effectuate the purposes of this section.
(c) All moneys received from other funding sources, including but not limited to federal sources, or in repayment of loan principal, payment of interest, or fees, under this section shall be deposited to the credit of the state general fund.
[L 1990, c 177, §2; am L 1993, c 280, §36]
(a) There is established a special fund to be known as the mental health and substance abuse special fund into which shall be deposited all revenues and other moneys collected from certification programs and treatment services rendered by the mental health and substance abuse programs operated by the State. Notwithstanding any other law to the contrary, the department is authorized to establish separate accounts within the special fund for depositing moneys received from certification programs and from each mental health and substance abuse program. Moneys deposited into the respective accounts of each program shall be used for the payment of the operating expenses of the respective program.
(b) The director shall submit a report to the legislature, not later than twenty days prior to the convening of each regular session, which identifies for each account in the special fund, the account balance and ceiling increase, any transfers and expenditures made, and the purposes of the expenditures.
[L 1991, c 243, §1; am L 1995, c 214, §2]
The department of health shall submit an annual report to the legislature no later than twenty days prior to the convening of each regular session which, at a minimum, shall summarize yearly data on forensic patients, including:
(1) Gross numbers for admissions to and discharges from the Hawaii state hospital;
(2) The number of admissions to, discharges from, and lengths of stays in the Hawaii state hospital, broken down by the following commitment categories:
(A) Original order under section 704-411(1)(a);
(B) Pending examination under section 704-411(3);
(C) Maximum seventy-two-hour recommitment pending examination under section 704-413(1);
(D) Original order under section 704-404; and
(E) Original order under section 704-406;
(3) Number of persons committed to the Hawaii state hospital by each court and county;
(4) Gross lengths of stay in the Hawaii state hospital for:
(A) Patients discharged during the fiscal year; and
(B) Individuals remaining as inpatients at the end of the fiscal year; and
(5) Number of patients in the Hawaii state hospital on forensic status, broken down by categories of underlying crimes, such as by crimes against the person, sex offenses, and property crimes, and by grade of offense.
[L 2008, c 100, §2]
Each provider of services involved in an emergency transportation initiated by a law enforcement officer, court order, or health care provider; assisted community treatment petition; or assisted community treatment order pursuant to part IV or VIII, and the department of the attorney general, shall provide the necessary data to the department to complete the report under this section. Based on this data, the department shall submit an annual report to the legislature no later than thirty days prior to the convening of each regular session.
The report shall include, at a minimum, an evaluation of the effectiveness of the strategies employed by each provider operating pursuant to parts IV and VIII in reducing hospitalization of persons subject to emergency transportation or assisted community treatment and in reducing involvement with local law enforcement by persons subject to assisted community treatment orders. The evaluation and report shall also include any other measures identified by the department regarding individuals subject to assisted community treatment petitions and orders and all of the following, based on information that is available:
(1) The number of individuals brought to each of the facilities operated by service providers through emergency transportation, and the number of those individuals transported due to enforcement of an order for assisted community treatment;
(2) The number of individuals involuntarily hospitalized through emergency transportation and emergency examination;
(3) The number of individuals subject to assisted community treatment orders;
(4) The petitioner's relationship to the individual subject to the assisted community treatment petition;
(5) The number of individuals under assisted community treatment orders who become involved with the criminal justice system by way of arrests, convictions, probation, incarceration, or other relevant data;
(6) The need for hospitalization and related length of stay for individuals after they become subject to an assisted community treatment order;
(7) Adherence to prescribed treatment by individuals subject to an assisted community treatment order; and
(8) Other indicators of successful engagement, if any, by individuals subject to an assisted community treatment order.
[L 2025, c 219, §2]
No person, association, corporation, or government agency shall establish, maintain, or operate a psychiatric facility to which persons are involuntarily admitted without first obtaining a license therefor from the department of health. The license may be for a definite period and shall be subject to revocation as hereinafter provided. The issuance of a license shall be based upon an application which shall be in such form and shall contain such information as the department may require. The facility must be able to provide adequate care and treatment in conformance with standards established by the department. The department may, at any and all times, examine and ascertain whether a licensed facility is being conducted in compliance with the license and applicable rules and regulations. Subject to chapter 91, the department may, if the interests of the public or of the patients of a facility so demand, for just and reasonable cause then appearing and to be stated in its order, amend or revoke a license by an order to take effect within such time as the department shall determine. This section shall not apply to any facility operated by the United States or any agency thereof.
[L 1967, c 259, pt of §1; HRS §334-21; am L 1968, c 6, §3; am L 1977, c 76, §2]
Any person who and any association or corporation which establishes, maintains, or operates a psychiatric facility for compensation or hire without holding a valid license issued under this part, and any officer of any association or corporation who participates in the violation, shall be fined not more than $1,000 or, in the case of an individual, imprisoned not more than six months, or both.
[L 1967, c 259, pt of §1; HRS §334-22]
Whenever small amounts of cash come into the hands of the administrator of a psychiatric facility, the administrator may, without seeking the appointment of a guardian, deposit the money in a bank or other financial institution and from time to time as the administrator may determine apply the same or any part thereof for the benefit of the patient, provided that so long as a guardian is not appointed, the administrator shall not apply any part of the cash for the maintenance of the patient in the facility.
[L 1967, c 259, pt of §1; HRS §334-23; gen ch 1985]
No person shall be admitted to, detained at, or discharged from any psychiatric facility except as provided in this chapter and in chapters 571, 704 and 706.
[L 1967, c 259, pt of §1; HRS §334-24; am L 1976, c 130, §2]
L 1999, c 119, §8.
The emergency procedures in this subpart shall consist of emergency transportation, emergency examination, and emergency hospitalization for individuals who may be mentally ill or suffering from substance abuse and imminently dangerous to self or others.
[L 2025, c 219, pt of §3]
(a) When a law enforcement officer has a reasonable suspicion that an individual is imminently dangerous to self or others and needs to be detained for emergency examination, the law enforcement officer shall contact a mental health emergency worker; provided that the law enforcement officer may temporarily detain the individual if the law enforcement officer:
(1) Is unable to reach a mental health emergency worker telephonically after three attempts;
(2) Has reason to believe that the situation requires immediate intervention to prevent harm to the individual or others;
(3) Contacts a mental health emergency worker at the earliest time possible; and
(4) Documents the reasons why the situation necessitated that the individual be detained.
If the mental health emergency worker determines that the individual is mentally ill or suffering from substance abuse and is imminently dangerous to self or others, the law enforcement officer shall detain the individual for transportation to a facility for an emergency examination.
(b) When a crisis intervention officer has probable cause to believe that an individual is mentally ill or suffering from substance abuse and is imminently dangerous to self or others, the crisis intervention officer shall detain the individual for transportation to a facility for an emergency examination. The crisis intervention officer shall contact a mental health emergency worker to determine the type of facility where the individual shall be transported.
(c) Any individual detained under this section shall be transported directly to a psychiatric facility or other facility designated by the director, as determined by a mental health emergency worker; provided that if a medical emergency occurs during transport, the individual shall be transported to the nearest emergency department. A law enforcement officer shall make an application for the emergency examination of the individual. The application shall state in detail the circumstances under which and reasons why the individual was taken into custody. The application shall be transmitted with the individual to the psychiatric facility or other facility designated by the director and be made a part of the individual's clinical record.
(d) For the purposes of this section, "crisis intervention officer" has the same meaning as defined in section 353C-1.
[L 2025, c 219, pt of §3]
(a) Upon written or oral application of any licensed physician, advanced practice registered nurse, psychologist, attorney, member of the clergy, health or social service professional, or any state or county employee in the course of employment, a judge may issue a written or oral ex parte order:
(1) Stating that there is probable cause that the individual is:
(A) Mentally ill or suffering from substance abuse; and
(B) Imminently dangerous to self or others;
(2) Stating the findings upon which the conclusion is based; and
(3) Directing that a law enforcement officer take the individual into custody and transport the individual directly to a psychiatric facility or other facility designated by the director for an emergency examination.
The person who made the application shall notify a mental health emergency worker of the written or oral ex parte order and, when possible, shall coordinate the transport of the individual with the emergency worker.
(b) If an application under subsection (a) was made orally, the person who made the application shall reduce the application to writing and submit it to the judge who issued the ex parte order by noon of the next court day after the order was issued. The written application shall be made under penalty of law but need not be sworn to before a notary public. If the judge issued an ex parte order orally, the judge shall reduce the oral order to writing by the close of the next court day after the order was issued. The written ex parte order shall be transmitted with the individual to the psychiatric facility or other facility designated by the director and be made a part of the individual's clinical record.
[L 2025, c 219, pt of §3]
(a) Any licensed physician, advanced practice registered nurse, physician assistant, licensed clinical social worker, or psychologist who has examined an individual and determines that the individual is mentally ill or suffering from substance abuse and is imminently dangerous to self or others may direct a law enforcement officer to detain and transport the individual by ambulance or other suitable means to a psychiatric facility or other facility designated by the director for an emergency examination, and may administer treatment, within the examining health care provider's scope of practice, as necessary for the individual's safe transportation. The examining health care provider shall provide a written statement of circumstances and reasons necessitating the emergency examination. The written statement shall be transmitted with the individual to the psychiatric facility or other facility designated by the director and be made a part of the individual's clinical record.
(b) Any individual who is subject to an order for assisted community treatment and fails to comply with the order for assisted community treatment, despite reasonable efforts made by a designated assisted community treatment provider, as defined in section 334-122, to solicit compliance, may be transported to a psychiatric facility or other facility designated by the director for an emergency examination if it is in the clinical judgment of a licensed physician, advanced practice registered nurse, physician assistant, licensed clinical social worker, or psychologist that the individual may be in need of emergency hospitalization pursuant to section 334-46. At the direction of the examining health care provider, a law enforcement officer may detain and transport the individual by ambulance or other suitable means to a psychiatric facility or other facility designated by the director. The examining health care provider shall provide a written statement of circumstances and reasons explaining why the individual may be in need of emergency hospitalization. The written statement shall be transmitted with the individual to the psychiatric facility or other facility designated by the director and be made a part of the individual's clinical record.
(c) Those performing the emergency transport shall coordinate the transport of the individual with the mental health emergency worker.
(d) The examining health care provider shall also provide a copy of the written statement required under this section to the department within five business days.
[L 2025, c 219, pt of §3]
(a) A licensed physician, medical resident under the supervision of a licensed physician, physician assistant, psychologist, or advanced practice registered nurse may conduct an initial examination and screening of a patient transported under section 334-42, 334-43, or 334-44 to determine whether the criteria for involuntary hospitalization listed in section [334-60.2] persists and administer treatment as indicated by good medical practice; provided that if after the examination, screening, and treatment, the licensed physician, medical resident under the supervision of a licensed physician, physician assistant, psychologist, or advanced practice registered nurse determines that the involuntary hospitalization criteria persists, then the patient shall be further examined by a qualified psychiatric examiner to diagnose the presence or absence of a mental illness or substance use disorder, further assess the risk that the patient may be dangerous to self or others, and assess whether or not the patient continues to meet the criteria for involuntary hospitalization as provided in section 334-60.2. If no initial examination and screening of the patient is conducted, a qualified psychiatric examiner shall conduct an emergency examination of a patient transported under section 334-42, 334-43, or 334-44 without unnecessary delay and provide the patient with treatment as indicated by good medical practice; provided that the emergency examination shall include a determination of whether the patient meets the criteria for involuntary hospitalization as provided in section 334-60.2.
(b) If, following an emergency examination of a patient under subsection (a), a qualified psychiatric examiner determines that the criteria for involuntary hospitalization do not exist, the patient shall be discharged expeditiously; provided that if the patient is not under an order for assisted community treatment, a qualified psychiatric examiner shall conduct an examination pursuant to section 334-121.5 before the discharge. A patient under criminal charges shall be returned to the custody of a law enforcement officer.
[L 2025, c 219, pt of §3]
(a) If, following an emergency examination pursuant to section 334-45(a), a qualified psychiatric examiner determines that the criteria for involuntary hospitalization exist, the patient shall be hospitalized on an emergency basis or transferred to another psychiatric facility or other facility designated by the director for emergency hospitalization.
(b) The patient admitted under subsection (a) shall be released within seventy-two hours of the patient's admission to a psychiatric facility or other facility designated by the director, unless:
(1) The patient voluntarily agrees to further hospitalization; or
(2) A proceeding for court-ordered evaluation or hospitalization is initiated as provided in section 334-60.3.
If the seventy-two-hour time period expires on a Saturday, Sunday, or holiday, the time for initiation shall be extended to the close of the next court day. Upon initiation of the proceeding, the facility may detain the patient until further order of the court.
(c) If at any time during the period of emergency hospitalization a qualified psychiatric examiner determines that a patient no longer meets the criteria for emergency hospitalization, the patient shall be discharged expeditiously; provided that if the patient is not under an order for assisted community treatment, a qualified psychiatric examiner shall conduct an examination pursuant to section 334-121.5 before the discharge. A patient under criminal charges shall be returned to the custody of a law enforcement officer.
(d) The patient shall have the right, immediately upon emergency hospitalization, to telephone an attorney and the patient's surrogate, guardian, family member including a reciprocal beneficiary, or adult friend. The patient shall be allowed to confer with an attorney in private.
[L 2025, c 219, pt of §3]
Notice of an individual's emergency transportation, examination, and hospitalization under this subpart may be given to at least one of the following persons in the following order of priority: the individual's spouse or reciprocal beneficiary, legal parents, adult children, surrogate, legal guardian, or if none can be found, the closest adult relative, as long as the individual:
(1) Has capacity to make health care decisions and consents that notice may be given to at least one of the persons listed in this section;
(2) Is given the opportunity to object and does not object, or the health care provider can reasonably infer from the circumstances based on the exercise of professional judgment that the individual does not object; or
(3) Is incapacitated or an emergency circumstance exists, and the health care provider determines, based on the exercise of professional judgment, that giving notification is in the best interest of the individual.
The staff of the facility shall make reasonable efforts to ensure that the patient's family, including a reciprocal beneficiary, is notified of the emergency hospitalization, unless the patient is an adult and waives notification.
[L 2025, c 219, pt of §3]
L 1976, c 130, pt of §4.
L 2025, c 219, §§27, 28.
[Repealed]
[L 1984, c 188, §2]
(a) Acceptance for voluntary inpatient treatment at a psychiatric facility shall be in accordance with usual standards for hospital admissions.
(b) A facility may admit for evaluation, diagnosis, or treatment any individual under fifteen years of age for whom application is made by the individual's parent or guardian. If application for admission is countersigned by a minor aged fifteen through seventeen years before a family court officer, no hearing shall be necessary. If the minor elects not to sign, involuntary hospitalization proceedings shall be initiated.
(c) A facility shall discharge a voluntary patient who has sufficiently improved so that hospitalization is no longer desirable. A voluntary patient or the patient's guardian, representative, or attorney may request discharge in writing at any time following admission to the facility. If discharge would be dangerous to the patient or others, proceedings for involuntary hospitalization must be initiated as soon as possible but within twenty-four hours of the receipt by the administrator of the written request for discharge. If that time expires on a Saturday, Sunday, or holiday, the time for initiation is extended to the close of the next court day. Upon the initiation of the proceedings, the facility is authorized to detain the patient until further order of the court. If the patient was admitted on the patient's own application and the request for discharge is made by a person other than the patient, the discharge may be conditioned upon the agreement of the patient.
(d) Notice of right to release. At the time of the patient's admission and each six months thereafter, a voluntary patient and the patient's guardian or representatives shall be notified in writing of the patient's right and how to apply for a discharge.
[L 1984, c 188, pt of §3; gen ch 1985]
An individual may be committed to a psychiatric facility for involuntary hospitalization if the court finds:
(1) That the individual is mentally ill or suffering from substance abuse;
(2) That the individual is imminently dangerous to self or others; and
(3) That the individual is in need of care or treatment, or both, and there is no suitable alternative available through existing facilities and programs that would be less restrictive than hospitalization.
[L 1984, c 188, pt of §3; am L 1985, c 75, §2; am L 1986, c 335, §4; am L 2013, c 221, §§5, 24; am L 2016, c 114, §6; am L 2025, c 219, §6]
(a) Any person may file a petition alleging that an individual meets the criteria for commitment to a psychiatric facility as provided in section 334-60.2. The petition shall be filed in the county where the individual resides and executed subject to penalties provided by law but need not be sworn to before a notary public. The department of the attorney general shall assist the petitioner in stating the substance of the petition in plain and simple language. The petition may be accompanied by a certificate of the qualified psychiatric examiner or psychologist who has examined the individual within two days before the petition is filed, unless the individual whose commitment is sought has refused to submit to medical or psychological examination, in which case the fact of refusal shall be alleged in the petition. The certificate shall set forth the signs and symptoms relied upon by the qualified psychiatric examiner or psychologist to determine the individual is in need of treatment and whether the individual is capable of realizing and making a rational decision with respect to the individual's need for treatment. If the petitioner believes that further examination is necessary before commitment, the petitioner may request further examination.
(b) In the event the subject of the petition has been given an examination, evaluation, or treatment in a psychiatric facility within five days before submission of the petition, and hospitalization is recommended by the staff of the facility, the petition may be accompanied by the administrator's certificate in lieu of a qualified psychiatric examiner's or psychologist's certificate.
(c) 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, surrogate, and legal guardian. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult child, surrogate, or legal guardian, or if none can be found, notice shall be served on at least one of the subject's closest adult relatives, if any can be found.
[L 1984, c 188, pt of §3; gen ch 1985; am L 1994, c 58, §2; am L 2015, c 27, §3; am L 2018, c 144, §3; am L 2025, c 219, §7]
(a) The court shall set a hearing on the petition and notice of the time and place of the hearing shall be served in accordance with, and to those persons specified in, a current order of commitment. If there is no current order of commitment, notice of the hearing shall be served personally on the subject of the petition and served personally or by certified or registered mail, return receipt requested, deliverable to the addressee only, on the subject's spouse or reciprocal beneficiary, legal parents, adult children, surrogate, and legal guardian. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult child, surrogate, 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. Notice of the hearing to the subject's spouse or reciprocal beneficiary, legal parents, adult children, or closest adult relative may be waived if the subject of the petition is an adult and requests that these persons not be notified. Notice of the hearing shall also be served on the public defender, attorney for the subject of the petition, or other court-appointed attorney. If the subject of the petition is a minor, notice of the hearing shall also be served upon the person who has had the principal care and custody of the minor during the sixty days preceding the date of the petition, if that person can be found within the State. Notice shall also be given to other persons as the court may designate.
(b) The notice shall include the following:
(1) The date, time, and place of the hearing; a clear statement of the purpose of the proceedings and of possible consequences to the subject of the petition; and a statement of the legal standard upon which commitment is authorized;
(2) A copy of the petition;
(3) A statement, in plain and simple language, that the subject may waive the hearing by voluntarily agreeing to hospitalization or, with the approval of the court, to some other form of treatment;
(4) A filled-out form indicating the waiver;
(5) A statement, in plain and simple language, that the subject or the subject's surrogate, guardian, or representative may apply at any time for a hearing on the issue of the subject's need for hospitalization, if the subject has previously waived such a hearing;
(6) A statement that the subject is entitled to the assistance of an attorney and that the public defender has been notified of these proceedings; and
(7) A statement that if the subject does not want to be represented by the public defender, the subject may contact the subject's own attorney.
(c) If the subject of the petition executes and files a waiver of the hearing, upon acceptance by the court following a court determination that the subject understands the subject's rights and is competent to waive them, the court shall order the subject to be committed to a facility that has agreed to admit the subject as an involuntary patient or, if the subject is at such a facility, that the subject be retained there.
(d) Notice of adjournments, continuances, other delays, dates of rescheduled hearings, and waivers of the hearing under subsection (c) shall also be served on the persons specified in subsection (a).
[L 1984, c 188, pt of §3; gen ch 1985; am L 1997, c 383, §46; am L 2004, c 161, §36; am L 2018, c 144, §4; am L 2025, c 219, §8]
(a) The court shall adjourn or continue a hearing for failure to timely notify the subject of the petition's spouse or reciprocal beneficiary, legal parent, adult child, surrogate, guardian, or relative, or other person determined by the court to be entitled to notice, or for failure by the subject to contact an attorney as provided in section 334-60.4(b)(7) unless the subject waived notice pursuant to section 334-60.4(a) or the court determines that the interests of justice require that the hearing continue without adjournment or continuance.
(b) The time and form of the procedure incident to hearing the issues in the petition shall be provided by court rule. Unless the hearing is waived, the judge shall hear the petition as soon as possible and no later than ten days after the date the petition is filed unless a reasonable delay is sought for good cause shown by the subject of the petition, the subject's attorney, or those persons entitled to receive notice of the hearing under section 334-60.4.
(c) The subject of the petition shall be present at all hearings unless the subject waives the right to be present, is unable to attend, or creates conditions that make it impossible to conduct a hearing in a reasonable manner as determined by the judge. A waiver is valid only upon acceptance by the court following a judicial determination that the subject understands the subject's rights and is competent to waive them, or is unable to participate. If the subject is unable to participate, the judge shall appoint a guardian ad litem or a temporary guardian as provided in article V of chapter 560, to represent the subject throughout the proceedings.
(d) Hearings may be held at any convenient place within the circuit. Hearings may be conducted by video conferencing unless the court determines personal appearance is necessary. The subject of the petition, any interested party, or the court on its own motion may request a hearing in another circuit because of convenience to the parties, witnesses, or the court or because of the subject's mental or physical condition.
(e) The department of the attorney general shall present the case for a petitioner for hearings convened under this chapter, unless a petitioner has retained private counsel who will be present in court and will present to the court the case for involuntary hospitalization.
(f) Counsel for the subject of the petition shall be allowed adequate time for investigation of the matters at issue and for preparation and shall be permitted to present the evidence that the counsel believes necessary to a proper disposition of the proceedings, including evidence as to alternatives to inpatient hospitalization.
(g) No individual may be found to require treatment in a psychiatric facility unless at least one qualified psychiatric examiner or psychologist who has personally examined the individual testifies in person at the hearing. This testimony may be waived by the subject of the petition. If the subject of the petition refuses to be examined by a qualified psychiatric examiner or psychologist, the subject may be examined by a court-appointed qualified psychiatric examiner or psychologist. If the subject refuses to be examined and there is sufficient evidence to believe that the allegations of the petition are true, the court may make a temporary order committing the subject to a psychiatric facility for a period of no more than five days for the purpose of a diagnostic examination. The subject's refusal to be examined shall be treated as a denial that the subject is mentally ill or suffering from substance abuse. Nothing in this section shall limit the subject's privilege against self-incrimination.
(h) The subject of the petition in a hearing under this section has the right to secure an independent examination and present evidence thereon.
(i) If after hearing all relevant evidence, including the result of any diagnostic examination ordered by the court, the court finds that a subject of a petition is not a person requiring medical, psychiatric, psychological, or other rehabilitative treatment or supervision, the court shall order that the subject be discharged if the subject has been hospitalized before the hearing.
(j) If the court finds that the criteria for involuntary hospitalization under section 334-60.2(1) has been met beyond a reasonable doubt and that the criteria under section 334-60.2(2) and (3) have been met by clear and convincing evidence, the court may issue an order to any law enforcement officer to transport the subject of the order to a facility that has agreed to admit the subject as an involuntary patient, or if the subject is already a patient in a psychiatric facility, authorize the facility to retain the patient for treatment for a period of ninety days unless sooner discharged. The court may also authorize the involuntary administration of medication, where the subject has an existing order for assisted community treatment issued pursuant to part VIII of this chapter and in accordance with the treatment prescribed by that existing order. Notice of the subject's commitment and the facility name and location where the subject will be committed shall be provided to those persons entitled to notice pursuant to section 334-60.4. An order of commitment shall specify which of those persons served with notice pursuant to section 334-60.4, together with such other persons as the court may designate, shall be entitled to receive any subsequent notice of intent to discharge, transfer, or recommit. The court shall forward to the Hawaii criminal justice data center all orders of involuntary civil commitment or information from all orders of involuntary civil commitment, as requested by the Hawaii criminal justice data center, which in turn shall forward the information to the Federal Bureau of Investigation, or its successor agency, for inclusion in the National Instant Criminal Background Check System database. The orders or information shall also be maintained by the Hawaii criminal justice data center for disclosure to and use by law enforcement officials for the purpose of firearms permitting, licensing, or registration pursuant to chapter 134. This subsection shall apply to all involuntary civil commitments without regard to the date of the involuntary civil commitment.
(k) Persons entitled to notice pursuant to this section shall also be entitled to be present in the courtroom for the hearing and to receive a copy of the hearing transcript or recording, unless the court determines that the interests of justice require otherwise.
[L 1984, c 188, pt of §3; am L 1985, c 220, §1; gen ch 1985; am L 1994, c 58, §3; am L 1997, c 383, §47; am L 2004, c 161, §8; am L 2013, c 221, §§6, 24 and c 232, §4; am L 2014, c 87, §4; am L 2015, c 27, §4; am L 2016, c 114, §6; am L 2018, c 144, §5; am L 2025, c 219, §9]
The psychiatric facility may detain a subject for a period of time ordered by the court not to exceed ninety days from date of admission unless sooner discharged by the facility pursuant to section 334-76 or section 334-74. At the end of the ninety-day period the subject shall be discharged automatically except as provided in sections 704-406, 704-411, and 706-607, unless before expiration of the period and by a proceeding initiated pursuant to section 334-60.3 the facility obtains a court order for the subject's recommitment. Recommitment for a period not to exceed ninety days may not be ordered unless the court determines that the criteria for involuntary hospitalization set forth in section 334-60.2 continue to exist. If at the end of a recommitment period the court finds that the criteria for involuntary hospitalization set forth in section 334-60.2 continue to exist and are likely to continue beyond ninety days, the court may order recommitment for a period not to exceed one hundred eighty days.
Nothing in this section shall preclude a facility from accepting for voluntary inpatient treatment, in accordance with the procedures in section 334-60.1, a patient, for whom the facility contemplates discharge pursuant to section 334-60.7 and who voluntarily agrees to further hospitalization after the period of commitment has expired, or where the patient is no longer a proper subject for commitment.
[L 1984, c 188, pt of §3; gen ch 1985; am L 1988, c 44, §1]
(a) When the administrator, the administrator's deputy, or the attending physician of a psychiatric facility contemplates discharge of an involuntary patient because of expiration of the court order for commitment or because the patient is no longer a proper subject for commitment, as determined by the criteria for involuntary hospitalization in section 334-60.2, the administrator, the administrator's deputy, or the attending physician shall provide notice of intent to discharge, or if the patient voluntarily agrees to further hospitalization, the administrator, the administrator's deputy, or the attending physician shall provide notice of the patient's admission to voluntary inpatient treatment. The following requirements and procedures shall apply:
(1) The notice and a certificate of service shall be filed with the family court and served on those persons whom the order of commitment specifies as entitled to receive notice, by mail at the person's last known address. If the commitment resulted directly from legal proceedings under chapter 704 or 706, notice shall also be sent to the prosecuting attorney of the county from which the person was originally committed, by facsimile or electronically, for the sole purpose of victim notification; and
(2) Any person specified as entitled to receive notice may waive this right in writing with the psychiatric facility.
(b) For civil commitments that do not result directly from legal proceedings under chapter 704 or 706, when the administrator, the administrator's deputy, or the attending physician of a psychiatric facility contemplates discharge of an involuntary patient, the administrator, the administrator's deputy, or the attending physician shall assess whether an assisted community treatment plan is indicated pursuant to section 334-123 and, if so indicated, may communicate with an aftercare provider as part of discharge planning, as appropriate.
[L 1984, c 188, pt of §3; am L 1988, c 44, §2; am L 2014, c 156, §1; am L 2018, c 144, §6; am L 2025, c 219, §10]
No presumption of insanity or legal incompetency shall exist with respect to any patient by reason of the patient's admission to a psychiatric facility under this chapter. The fact of the admission shall not in itself modify or vary any civil right of any such person, including but not limited to civil service statutes or rights relating to the granting, forfeiture, or denial of a license, permit, privilege, or benefit pursuant to any law, or the right to dispose of property, execute instruments, make purchases, enter into contractual relationships, and to vote. If the administrator of a psychiatric facility or the deputy is of the opinion that a patient should not exercise any civil right, application for a show cause order shall be made to the court under the above proceedings after notice pursuant to section 334-60.4.
[L 1976, c 130, pt of §4; am L 1977, c 76, pt of §3; am L 1985, c 68, §7]
(a) Service of process and papers upon a patient in a psychiatric facility or a patient on authorized or unauthorized absence from a psychiatric facility shall be made in the following manner:
(1) Service of process and papers relating to the involuntary hospitalization of the patient shall be made directly and personally upon the patient and shall also be made personally or by certified mail upon the patient's guardians and the public defender, the patient's attorney or court-appointed attorney; otherwise, service upon the patient shall be incomplete. A copy of the legal process or paper served on a patient under this paragraph shall be given to the administrator of the psychiatric facility or the administrator's deputy and shall be filed with the records of the patient.
(2) Service of process and papers not relating to the involuntary hospitalization of the patient shall be made directly and personally upon the patient, the patient's guardians, and the administrator of the psychiatric facility or the administrator's deputy; otherwise, service upon the patient shall be incomplete and shall not give the issuing court or agency jurisdiction over the person of the patient. A legal process or paper served under this paragraph shall be filed with the records of the patient, and the administrator of the psychiatric facility or the administrator's deputy shall immediately inform the court or other agency out of which the process or paper issued, in writing, of the date of service and of the mental and physical condition of the patient.
(b) Neither the administrator nor anyone connected with a psychiatric facility shall accept service of process or papers on behalf of a patient.
[L 1976, c 130, pt of §4; am L 1977, c 76, pt of §3; gen ch 1985]
(a) Rates of payments for medical care for patients of the Hawaii state hospital and for patients under the custody of the director at a psychiatric facility other than the Hawaii state hospital shall be limited to the Hawaii medicaid fee schedule or the provider's billed amount, whichever is less.
(b) The department may establish rates of payment for long-term care services provided for patients who are discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.
(c) The department shall be exempt from chapter 103F for the procurement of medical care for patients of the Hawaii state hospital and for patients of a psychiatric facility other than the Hawaii state hospital who are under the custody of the director, and for the procurement of long-term care for patients discharged to a long-term care facility from the Hawaii state hospital or from a psychiatric facility other than the Hawaii state hospital where they were under the custody of the director.
(d) For the purposes of this section:
"Long-term care" means care provided by a long-term care facility.
"Long-term care facility" has the same meaning as defined in section 349-21.
"Medical care" means examination, diagnosis, or treatment for medical and dental conditions, including outpatient and hospital-based services as well as appliances and supplies deemed clinically necessary by the department. "Medical care" does not include long-term care.
[L 2025, c 50, §1]
A patient at a psychiatric facility, including those held on court order, may be transferred to another psychiatric facility when the administrator of the sending facility determines that it would be in the best interest of the patient that the patient be transferred and the administrator of the receiving facility agrees to accept the patient; provided that prior notice of such transfer be given to the subject of such transfer and to those persons specified in a current order of commitment. If there is no current order of commitment, notice shall be given to those persons enumerated in section 334-60.4.
[L 1967, c 259, pt of §1; HRS §334-71; am L 1976, c 130, §5; am L 1977, c 76, §4; am L 1985, c 68, §8]
(a) Upon receipt of a certificate of the Department of Veterans Affairs or other agency of the United States that facilities are available for the care and treatment of a person previously admitted to a psychiatric facility and that the person is eligible for such care and treatment, the administrator of the psychiatric facility or the administrator's deputy may transfer the person to the Department of Veterans Affairs or other agency of the United States for care and treatment, except a person admitted or committed on court order as provided in chapters 571, 704 and 706 or transferred under section 334-74. The administrator of the sending facility or the administrator's deputy shall send prior notice of such transfer as provided in section 334-71. A person transferred under this section shall be deemed to be admitted for hospitalization to any facility of the Department of Veterans Affairs or other agency of the United States pursuant to the provisions of part IV. The person, when admitted to a facility operated by or contracting with the Department of Veterans Affairs or other agency of the United States, within or without this State, shall be subject to the rules and regulations of the Department of Veterans Affairs or other agency of the United States. The chief officer of the Department of Veterans Affairs or of the institution operated by any other agency of the United States to which the person is so admitted shall with respect to such person be vested with the same powers as administrators of licensed psychiatric facilities within this State with regard to detention, transfer, authorized absence or discharge. Jurisdiction is retained in this State and specifically in the family court of the circuit in which the sending facility was located to inquire at any time into the mental and physical condition of the person so admitted and to determine the necessity for the person's continued hospitalization, and all transfers under this section are so conditioned.
(b) The judgment or order of hospitalization by a court of competent jurisdiction of another state, the District of Columbia, Guam, or Puerto Rico, hospitalizing a person with the Department of Veterans Affairs or other agency of the United States for care and treatment shall have the same force and effect with respect to the hospitalized person while in this State with the Department of Veterans Affairs or other agency of the United States as in the state or district in which the judgment or order was made, and the court making the judgment or order shall be deemed to have retained jurisdiction of the person so hospitalized for the purpose of inquiring into the mental and physical condition of the person and of determining the necessity for the person's continued hospitalization. Consent is hereby given to the application of the law of the state or district with respect to the authority of the chief officer of the Department of Veterans Affairs or of the institution operated by any other agency of the United States in which the person is hospitalized to detain, transfer, place on authorized absence, or discharge the hospitalized person.
(c) Nothing in this section shall be construed as conferring upon the department of health or any other agency or officer of this State any power of licensing, supervision, inspection, or control over hospitals or other institutions operated by the Department of Veterans Affairs or other agency of the United States, or over any officers or employees thereof.
[L 1967, c 259, pt of §1; HRS §334-72; am L 1976, c 130, §6; gen ch 1985; am L 2017, c 12, §1]
[Repealed]
[L 1976, c 130, §7]
[Section effective until December 31, 2023. For section effective January 1, 2024, see below.] If any resident of a state correctional facility is in need of acute psychiatric treatment for mental illness, the director of public safety or the officer in charge of the correctional facility may file with the director an application for the transfer of the resident to a facility operated by the department of health or at which the director of health contracts for services, together with the certificate of a psychiatrist or psychologist employed by the department showing the need for such treatment, and, upon approval of the application by the director, the official having custody of the resident shall transfer the resident to the facility operated by the department or at which the director contracts for care and treatment. The official effecting the transfer of the resident shall keep the director informed of the maximum period of commitment of the resident to the director of public safety, and, if the continued care of the resident beyond the expiration of the period is deemed necessary, the director shall institute the procedures required to detain the resident as a patient notwithstanding the resident's release from the state correctional facility; provided that a judicial hearing pursuant to sections 334-60.2 to 334-60.7 be held by the same circuit court that sentenced the resident. In the event that discharge from the facility operated by the department or at which the director contracts for services occurs before the expiration of the maximum period of commitment or confinement, the resident shall be returned to the appropriate state correctional facility.
As used in this section, "resident" means any person serving a sentence in a state correctional facility or any child or minor detained in a state correctional facility.
[L 1967, c 259, pt of §1; HRS §334-74; am L 1976, c 130, §8; am L 1977, c 76, §5; am L 1985, c 68, §9; am L 1987, c 338, §10; am L 1988, c 14, §1; am L 1989, c 211, §8; am L 1994, c 153, §3; am L 1999, c 119, §6]
The administrator of a psychiatric facility or the administrator's deputy may grant authorized absence from the facility to any patient upon such terms and conditions as the administrator or the administrator's deputy may deem advisable, and, as to a patient admitted or committed on court order, with the prior approval of the court for periods in excess of thirty days, and without the approval of the court for periods up to thirty days, or, as to a patient transferred under section 334-74, with the prior approval of the official effecting the transfer; provided that if a patient has been admitted or committed on court order after having been charged with a felony or misdemeanor pursuant to chapter 707, an absence can be authorized only with the prior approval of the court, except where the absence is supervised by the presence of someone from the facility.
[L 1967, c 259, pt of §1; HRS §334-75; am L 1972, c 141, §1; am L 1982, c 42, §1; gen ch 1985]
L 1976, c 130, §9.
At any time after the admission of a patient to a psychiatric facility under part IV of this chapter or after the transfer of a patient to another psychiatric facility under section 334-71, the patient or, on the patient's behalf, any member of the patient's family, relative, friend, or responsible person, may obtain a judicial determination of the regularity of the patient's admission or of the need for the patient's continued hospitalization by filing a written request therefor in the family court of the circuit in which the psychiatric facility is located. The form of the request shall be prescribed and supplied free of charge by the court, and the proceedings in connection therewith shall be styled "In the Interest of (the named patient)". The administrator of the psychiatric facility shall assist the patient in obtaining legal counsel if the patient objects to the patient's admission or continued hospitalization.
[L 1967, c 259, pt of §1; HRS §334-81; am L 1977, c 76, §7; gen ch 1985]
Immediately upon receipt of a request, the court shall issue an order to show cause directed to the administrator of the facility and commanding the administrator to show cause at a date and time certain no later than five days thereafter why the patient should not be discharged immediately. A copy of the request shall be attached to the order to show cause. The form of the order to show cause shall be prescribed and supplied free of charge by the court. The order to show cause shall issue without cost and may be served as any other civil process or by any responsible person appointed by the court for that purpose. At any stage of the proceedings, the court may appoint a guardian ad litem for the patient. The guardian ad litem may be a member of the bar of the court or any other responsible person. Service on the administrator may be effected by leaving certified copies of the order to show cause and request at the facility with any person exercising authority. Notice of the order to show cause and the hearing date, and any adjournments, continuances, other delays, and dates of rescheduled hearings shall be provided to those persons entitled to notice pursuant to section 334-60.4.
[L 1967, c 259, pt of §1; HRS §334-82; gen ch 1985; am L 2018, c 144, §7]
The court may take testimony and may examine the patient and after a full and complete hearing shall render a decision in writing, setting forth its findings of fact and conclusions of law. The court may award a fee to the guardian ad litem to be paid out of any property of the patient or funds of the court available therefor.
[L 1967, c 259, pt of §3; HRS §334-83; am L 1973, c 93, pt of §2]
If it is determined that the admission of the patient is regular and that the patient needs continued hospitalization, the court shall issue an order authorizing the detention of the patient at the facility. If it is determined that the admission of the patient is not regular or that the patient does not need continued hospitalization, the court shall issue an order requiring the immediate discharge of the patient from the facility. Notice of the detention or discharge shall be provided to those persons entitled to notice pursuant to section 334-60.4.
[L 1967, c 259, pt of §1; HRS §334-84; am L 2018, c 144, §8]
A judicial determination under this part regarding the detention of a patient at the same psychiatric facility may not be demanded as of right more often than once in a period of six months.
[L 1967, c 259, pt of §1; HRS §334-85]
Unless otherwise ordered by the court, the authority of the psychiatric facility to detain a patient shall not be diminished by the institution of proceedings under this part until a final order requiring the discharge of the patient.
[L 1967, c 259, pt of §1; HRS §334-86]
It is the intent of the legislature to establish a statewide system of residential treatment programs which provide a range of available services which will be alternatives to institutional care and are based on principles of residential, community-based treatment.
It is further the intent of the legislature that community residential mental health programs in the State of Hawaii be developed in accordance with the guidelines and principles set forth in this part. To this end, the department may implement the community residential treatment system described in this part either with available allocations or applying for funds from the legislature. Any private, nonprofit, or public organization, or both, within the State is eligible to submit an application for operation under this part.
It is further the intent of the legislature to provide guidelines for such a system to the applicants, while allowing each applicant the flexibility to design a system specific to the nature of the community and the needs of the clients.
It is further the intent of the legislature that the director, in authorizing programs which serve as alternatives to institutionalization, follow the guidelines and principles developed herein.
[L 1980, c 221, pt of §2; am L 1986, c 237, §1]
The director shall use the following as criteria in determining the eligibility of each applicant:
(1) Facilities:
(A) Settings, whether residential or day, shall be as close to a normal home environment as possible without sacrificing client safety or care;
(B) Residential treatment centers shall be relatively small, preferably fifteen beds or less, but in any case with the appearance of noninstitutional setting; and
(C) The individual elements of the system, where possible, shall be in separate facilities and not part of one large facility attempting to serve an entire range of clients;
(2) Staffing patterns:
(A) Staffing patterns shall reflect, to the maximum extent feasible, at all levels, the cultural, linguistic, ethnic, sexual, and other social characteristics of the community the facility serves;
(B) The programs shall be designed to use appropriate multidisciplinary professional consultation and staff to meet the specific diagnostic and treatment needs of the client; and
(C) Programs shall be encouraged to use paraprofessionals where appropriate;
(3) Programs:
(A) The programs shall have a rehabilitation focus which encourages the client to develop the skills to become self-sufficient and capable of increasing levels of independent functioning where appropriate. They shall include prevocational and vocational programs;
(B) The programs shall encourage the participation of the clients in the daily operation of the setting in development of treatment and rehabilitation planning and evaluation;
(C) Participation in any element of the system shall not preclude the involvement of clients in individual therapy. Individual therapists of clients, where possible, shall be directly involved in the development and implementation of a treatment plan;
(4) Coordination: The programs shall demonstrate specific linkages with one another, and with the general treatment and social service system, as a whole. These connections should not be limited to the mental health system, but shall include, whenever possible, community resources utilized by the general population. To ensure coordination occurs, each program shall include a case management system in which the case manager serves as a coordinator to assure the cooperative operation of the various elements of the system and to act as an active advocate for the clients in the system. The case manager shall assure that each client receives the appropriate type of service. The case manager shall meet regularly with clients, work closely with program staff, and serve as an advocate. The case manager shall work directly with the client and the system to assure continuity of care between the service elements of the system.
[L 1980, c 221, pt of §2]
The following shall be the program elements of the system. These shall be designed to provide, at every level, alternatives to institutional settings. Applicants applying to operate program elements shall show how each of these elements works with the current programs in the community the facility will serve. Applicants may apply for operation under the following program elements:
(1) A short-term crisis residential alternative to hospitalization for individuals experiencing an acute episode or situational crisis. The program shall be available for admissions twenty-four hours a day, seven days a week. The primary focus of this element shall be on reduction of the crisis, stabilization, diagnostic evaluation, and assessment of the person's existing support system, including recommendations for referrals upon discharge. This service in the program shall be designed for persons who would otherwise be referred to an acute inpatient psychiatric unit;
(2) A long-term residential treatment program for clients who would otherwise be living marginally in the community with little or no service support, and who would return many times to the hospital for treatment. It also will serve those who are referred to, and maintained in, state facilities or nursing homes, or private or public facilities or programs under contract with the director pursuant to section 334-2.5, because they require long-term, intensive support. This service shall be designed to provide a rehabilitation program for the so-called "chronic" patient who needs long-term support in order to develop independent living skills. This program goes beyond maintenance to provide an active rehabilitation focus for these individuals;
(3) A transitional residential program designed for persons who are able to take part in programs in the general community, but who, without the support of counseling as well as the therapeutic community, would be at risk of returning to the hospital or becoming homeless by reason of serious and persistent mental health challenges. These programs may employ a variety of staffing patterns and are for persons who are expected to move toward a more independent living setting. The clients shall be expected to play a major role in the functioning of the household and shall be encouraged to accept increasing levels of responsibility, both in the residential community and in the community as a whole. Residents are required to be involved in daytime activities outside of the facility that are relevant to their personal goals and conducive to their achieving more self-sufficiency; or
(4) A semisupervised, independent, but structured living arrangement for persons who do not need the intensive support of the system elements of paragraph (1), (2), or (3), but who, without some support and structure, are at risk of requiring hospitalization or becoming homeless by reason of serious and persistent mental health challenges. The small cooperative housing units shall function as independent households with direct linkages to staff support in case of emergencies, as well as for regular assessment and evaluation meetings. Individuals may use satellite housing as a transition to independent living or may remain in this setting indefinitely in order to avoid the need for more intensive settings. This element is for persons who only need minimum professional or paraprofessional support in order to live in the community. These units should be as normative as the general living arrangements in the communities in which they are developed.
[L 1980, c 221, pt of §2; am L 1985, c 219, §1; am L 1986, c 237, §2; am L 1997, c 220, §3; am L 1999, c 119, §7; am L 2016, c 186, §5]
The system shall be developed in such a way that clients may move within the system to the most appropriate, least restrictive level of service. The system shall also allow for direct referral of clients, without requiring that a person pass through the entire system to reach the most appropriate level.
[L 1980, c 221, pt of §2]
An adequate proportion of funds shall be applied to the development and implementation of an appropriate evaluation mechanism. The department, in conjunction with the programs, shall specify the criteria to be used in the evaluation of each program and in the evaluation of the entire system.
By June 30, 1982, the department shall conduct or contract for the evaluation. Evaluation reports shall be transmitted to the legislature.
[L 1980, c 221, pt of §2]
Facilities operated pursuant to this part shall be licensed under existing licensing categories, including provisional licenses, or accredited pursuant to section 321-193(10). Facilities operated pursuant to section 334-103(1) or (2) to provide services to mentally ill adults shall be licensed, including provisional licenses. Facilities operated to provide services to mentally ill adults pursuant to section 334-103(3) or (4) shall be accredited rather than licensed. The director shall review the appropriateness of these licensing and accreditation categories. If the director determines that new licensing or accreditation categories are necessary, the director shall issue a report and recommendation to the legislature.
[L 1980, c 221, pt of §2; gen ch 1985; am L 1986, c 237, §3; am L 2002, c 54, §1]
An individual may be ordered to obtain assisted community treatment if the family court finds, based on the professional opinion of a qualified psychiatric examiner, that:
(1) The individual is mentally ill or suffering from substance abuse;
(2) The individual 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 individual becoming imminently dangerous to self or others, and the individual's current mental status or the nature of the individual's disorder limits or negates the individual's ability to make an informed decision to voluntarily seek or comply with recommended treatment;
(3) The individual has a:
(A) Mental illness that has caused that individual 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 individual becoming dangerous to self or others and that now would predictably result in the individual 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 individual, is medically appropriate, and is in the individual'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; am L 2025, c 219, §12]
A qualified psychiatric examiner associated with the psychiatric facility where a patient 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 patient's discharge, examine the patient to determine whether an assisted community treatment plan is indicated pursuant to this part. If a plan is indicated, the qualified psychiatric examiner 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 patient 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; am L 2025, c 219, §13]
For the purposes of this part:
"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 subject of the order'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.
"Assisted community treatment provider" means a mental health provider, which may include a qualified psychiatric examiner or a mental health program, that is or will be responsible, in accordance with an assisted community treatment order, for the coordination, management, or administration of a subject of the order's treatment.
"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.
"Mental health program" means a hospital, psychiatric facility, clinic, or other facility providing mental health treatment to individuals suffering from mental illness or substance abuse.
"Subject of the order" means an individual who has been ordered by the court to obtain assisted community treatment.
"Subject of the petition" means the individual who, under a petition filed under section 334-123, is alleged to meet the criteria for assisted community treatment.
[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; am L 2025, c 219, §14]
(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 qualified psychiatric examiner who has examined the subject of the petition in person 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 qualified psychiatric examiner has obtained enough information from the subject of the petition and has had face-to-face contact 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 examination is necessary before treatment, the petitioner may request further examination.
(d) The petition shall include the name of a proposed assisted community treatment provider and 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, surrogate, or legal guardian. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult child, surrogate, 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; am L 2025, c 219, §15]
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]
The family court shall set a hearing date on a petition, and any subsequent hearing dates for the petition, as soon as possible but no later than ten days after the filing of the petition. A hearing on the petition may be continued pending further examination of the subject of the petition, for the appointment of a guardian ad litem, or for good cause.
[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; am L 2025, c 219, §16]
(a) Notice of the hearing under this part 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 parent, adult child, surrogate, and legal guardian. If the subject of the petition has no living spouse or reciprocal beneficiary, legal parent, adult child, surrogate, 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 as provided in section 334-123.5;
(4) Served on the attorney for the subject of the petition, if applicable;
(5) Served on the assisted community treatment provider proposed in the petition, unless the petitioner is also the proposed assisted community treatment provider; and
(6) 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 to the subject of the petition's spouse or reciprocal beneficiary, legal parent, adult child, or closest adult relative may be waived if the subject is an adult and requests that these persons not be notified.
[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; am L 2025, c 219, §17]
(a) The court shall adjourn or continue a hearing for failure to timely notify a person entitled to be notified unless the court determines that the interests of justice require that the hearing continue without adjournment or continuance.
(b) 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.
(c) Hearings may be held at any convenient place within the circuit. The subject of the petition, any interested party, 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. The court may use online hearings to accommodate the needs of the parties and witnesses, in accordance with family court rules.
(d) The hearing shall be closed to the public, unless the subject of the petition requests otherwise. Individuals entitled to notice are entitled to be present in the courtroom or other approved location for the hearing and to receive a copy of the hearing transcript or recording, unless the court determines that the interests of justice require otherwise.
(e) The subject of the petition shall not be required to be present at the hearing; provided that the subject has been served with the petition and the appointed guardian ad litem, or existing guardian, is present to represent the best interests of the subject through the proceedings.
(f) The court may appoint an attorney for the subject if the court determines that the interests of justice require one be appointed. If the subject of the petition is represented by an attorney, whether retained by the subject or appointed by the court, the attorney shall be allowed adequate time for investigation of the matters at issue and for preparation, and shall be permitted to present the evidence that the attorney believes necessary for a proper disposition of the proceeding.
(g) No subject of the petition shall be ordered to receive assisted community treatment unless at least one qualified psychiatric examiner who has personally examined the subject within a reasonable time before the filing of the petition provides oral testimony at the hearing. The qualified psychiatric examiner shall provide the facts that support the allegation that the subject meets all the criteria for assisted community treatment, provide a written treatment plan, which shall include non-mental health treatment if appropriate, provide the rationale for the recommended treatment, and identify the assisted community treatment provider.
If the recommended assisted community treatment includes medication, the testimony provided by the qualified psychiatric examiner shall describe the types or classes of medication that should be authorized, and describe the physical and mental beneficial and detrimental effects of the medication.
(h) The subject of the petition may secure a psychiatric examination 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; am L 2013, c 221, §§12, 24; am L 2015, c 231, §4; am L 2016, c 114, §6; am L 2017, c 88, §5; am L 2018, c 144, §11; am L 2021, c 58, §4; am L 2023, c 153, §3; am L 2024, c 87, §12; am L 2025, c 219, §18]
§334-127 Disposition. (a) If, after considering 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 assisted community treatment provider.
The court order shall state who should receive notice of intent to discharge early in the event that the assisted community treatment provider 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 petitioner, and those persons entitled to notice pursuant to section 334-125.
(c) The family court shall also designate on the order the assisted community treatment provider.
(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; am L 2025, c 219, §19]
(a) A treatment provider who provided or is providing medical, psychiatric, therapeutic, or social services treatment to an individual shall provide relevant treatment information, if available, to the department of the attorney general upon the department's request for the purpose of preparing a petition for assisted community treatment. The treatment information may include a certificate issued pursuant to section 334-123(c), a treatment plan prepared pursuant to section 334-126(g), records related to actions or proceedings pursuant to part IV, records relating to the individual's treatment history, and other records deemed relevant by the individual's treatment provider.
(b) The petitioner of an assisted community treatment order, department of the attorney general, and family court shall disclose an assisted community treatment order to state and county law enforcement agencies, an assisted community treatment provider, or any other entity necessary to carry out the terms of the assisted community treatment order.
[L 2025, c 219, §4]
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]
(a) A qualified psychiatric examiner may prescribe or administer to the subject of the order reasonable and appropriate medication or medications, if specifically authorized by a court order, and treatment that is consistent with accepted medical standards and the court order, including the written treatment plan submitted pursuant to section 334-126(g), in accordance with the procedures described in subsection (b).
(b) A qualified psychiatric examiner may administer medication or medications specifically authorized by a court order to a subject of the order over objection of the subject during emergency examination or hospitalization under part IV, subpart A or while committed for involuntary hospitalization under part IV, subpart C.
(c) A subject of the order may be transported to a psychiatric facility or other facility designated by the director for failure to comply with an order for assisted community treatment via the following methods:
(1) By an interested party with the consent of the subject of the order; or
(2) In accordance with section 334-44(b).
(d) The assisted community treatment provider shall make 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 assisted community treatment provider shall proceed pursuant to section 334-43 or 334-44; provided that the refusal of treatment shall not, by itself, constitute a basis for involuntary hospitalization.
(e) Notice of any transport or hospitalization under this section shall be provided pursuant to section 334-47.
[L 1984, c 251, pt of §1; am L 2013, c 221, §§15, 24; am L 2016, c 114, §§4, 6; am L 2017, c 88, §7; am L 2018, c 144, §13; am L 2021, c 58, §6; am L 2025, c 219, §20]
(a) Unless a family court orders otherwise, 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 the order shall be automatically and fully discharged at the end of the family court-ordered period of treatment pursuant to an assisted community treatment order, a period of no more than two years, unless a new family court order has been obtained.
(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; am L 2025, c 219, §21]
(a) When the assisted community treatment provider contemplates discharge for a subject of the order because of the imminent 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 assisted community treatment provider shall provide notice of intent to discharge.
(b) The notice shall be filed with thefamily 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; am L 2025, c 219, §22]
(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]
(a) Before the expiration of the period of assisted community treatment ordered by the family court, any interested party may file a petition with the family court for an order of continued assisted community treatment. 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. The petition shall be filed, and unless the court determines the existence of a guardian, a guardian ad litem appointed, and notice provided in the same manner as under sections 334-123 and 334-125.
(b) The family court shall appoint a guardian ad litem, unless there is an existing guardian, hold a hearing on the petition, and make its decision in the same manner as provided under sections 334-123 to 334-127. The family court may order the continued assisted community treatment for no more than two years after the date of the hearing pursuant to this section if the court finds that the criteria for assisted community treatment continue to exist and are likely to continue beyond one hundred days.
(c) Nothing in this section shall preclude the subject's stipulation to the continuance of an existing order. This section shall be in addition to the provisions on the objection to discharge.
[L 1984, c 251, pt of §1; am L 2013, c 221, §§19, 24; am L 2016, c 114, §6; am L 2021, c 58, §7; am L 2023, c 153, §7; am L 2024, c 87, §4]
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]
As used in this part:
"Family member" means any individual who is a member of the immediate family of the person who is the subject of the petition, including spouse, child, parent, grandparent, or any related individual who resides in the same household as the individual who is the subject of the petition.
"Outpatient treatment" includes any substance abuse treatment provided through individual or group therapy, day or partial day programs, and intensive day treatment and which does not require the individual to reside on a twenty-four-hour basis in the facility for more than three days to benefit from the treatment program.
"Petitioner" means the family member who applies to the court for an order to require an individual to enter into an outpatient treatment program.
"Respondent" means the individual who is eighteen years of age or older who is the subject of the petition for a court order to require the individual to enter into an outpatient treatment program.
[L 2004, c 44, pt of §20]
Any family member may petition the family court for an order requiring a respondent to enter into an outpatient treatment program for substance abuse. The petition shall be in writing under penalty of perjury and include facts relating to:
(1) The conduct of the respondent that indicates substance abuse or addiction;
(2) The respondent's history of substance abuse, treatment, and relapse;
(3) The effects of the respondent's conduct on the family;
(4) The petitioner's good faith belief that the respondent poses an imminent danger to self or to others if the respondent does not receive treatment;
(5) The availability of treatment and financial resources to pay for treatment; and
(6) Any other reason for seeking court intervention.
[L 2004, c 44, pt of §20]
The court shall set a time and date for hearing on the petition, within ten days of the filing of the petition. The notice of hearing and petition shall be served on the respondent.
[L 2004, c 44, pt of §20]
(a) The court shall conduct a hearing to consider all facts relating to the petition. The court may postpone the hearing and order the respondent to be assessed for substance abuse or addiction by a certified substance abuse counselor, at the petitioner's expense.
(b) The court may grant the petition if it finds clear and convincing evidence that:
(1) The respondent has a history of substance abuse and refuses to enter treatment voluntarily;
(2) The respondent has a family support system that will encourage and participate in the respondent's treatment program;
(3) The respondent can benefit from outpatient treatment and is capable of surviving safely in the community with the family support system and if outpatient treatment is received;
(4) The respondent or the petitioner has financial resources to pay for the outpatient treatment program;
(5) The respondent poses an imminent danger to self or to others if treatment is not received; and
(6) The respondent understands the nature of the proceeding and the effect of the court order to enter into outpatient treatment.
(c) The court order shall be limited to ninety days of outpatient treatment. Upon renewal of the petition, the court may extend the petition for an additional ninety days.
[L 2004, c 44, pt of §20]
The petitioner shall bear all fees and costs related to bringing the petition. The petitioner or respondent shall bear all costs of private treatment. Nothing in this part authorizes publicly funded substance abuse treatment. However, if the respondent is eligible to receive publicly funded treatment and such a program is available for the respondent, the court may order the treatment in such a program.
[L 2004, c 44, pt of §20]
If the respondent successfully completes the outpatient treatment program and is discharged from the program prior to the end of the court-ordered treatment period, the court order shall automatically lapse.
[L 2004, c 44, pt of §20]
The court may impose sanctions for violation of the court order.
[L 2004, c 44, pt of §20]
Notwithstanding any other law to the contrary, this part shall apply to all petitions filed by family members seeking involuntary outpatient commitment of the respondent with substance abuse as the primary diagnosis.
[L 2004, c 44, pt of §20]
(a) A patient who has been committed to a psychiatric facility for involuntary hospitalization or who is in the custody of the director and residing in a psychiatric facility may be ordered to receive treatment over the patient's objection, including the taking or application of medication, if the court, or administrative decision-maker through the administrative authorization process established pursuant to section 334-162, finds that:
(1) The patient suffers from a physical or mental disease, disorder, or defect;
(2) The patient is imminently dangerous to self or others;
(3) The proposed treatment is medically appropriate; and
(4) After considering less intrusive alternatives, treatment is necessary to forestall the danger posed by the patient.
(b) For the purposes of this section, "imminently dangerous to self or others" means that, without intervention, the person will likely become dangerous to self or dangerous to others within the next forty-five days.
[L 2017, c 111, pt of §2, §8; am L 2024, c 87, §13; am L 2025, c 219, §23]
(a) A patient who is in the custody of the director and in a psychiatric facility may be ordered to receive medical treatment over the patient's objection through an administrative authorization process that includes the following due process safeguards:
(1) The facility shall give notice to the patient of the authorization process and the reasons for initiating the process;
(2) The administrative decision-maker, who shall be a psychiatrist with relevant clinical training and experience, and who is not involved with the current treatment of the patient, shall, after considering all relevant evidence, determine whether the criteria under section 334-161 are met;
(3) The patient shall have the right to attend the hearing, receive assistance from an advisor, cross examine witnesses, and present testimony, exhibits, and witnesses; and
(4) The patient shall have the right to appeal the decision of the administrative decision-maker.
(b) The administrative process described by this section is exempt from the contested case requirements of sections 91-8.5 to 91-15.
(c) The department may adopt rules, pursuant to chapter 91, to effectuate this part.
[L 2017, c 111, pt of §2, §8; am L 2024, c 87, §13; am L 2025, c 219, §24]
(a) There shall be established within the department a crisis intervention and diversion services program to redirect persons, including homeless persons, experiencing mental health disorders or co-occurring mental health and substance use disorders, or both, who are at risk for involvement, or currently involved, with the criminal justice system to the appropriate health care system and services. The program shall establish at least two crisis intervention and diversion services sites on the island of Oahu; provided that of the two sites on Oahu, one site shall be located in an area for which data shows disproportionate numbers of individuals with mental health disorders or co-occurring mental health and substance use disorders, or both. The program may include the use of intensive mobile treatment services and intensive mobile outreach services. The department shall collaborate with law enforcement agencies, courts, mental health providers, and the community for the execution and implementation of these services. Any appropriation for the crisis intervention and diversion services program shall be used only for services contracted directly between the department and the service provider.
(b) The department may lease or acquire a facility to operate a behavioral health crisis center to treat and refer persons experiencing behavioral health crises, including persons in the criminal justice system, to the appropriate services and providers.
[L 2024, c 86, §2; am L 2025, c 299, §2 and c 300, §2]
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