Montana State Legislature

HJR 39: Commitment of persons with Dementia
STUDY MATERIALS (BY MEETING)

House Joint Resolution 39 requested a study of the use of involuntary commitments for people with Alzheimer's disease or other dementia. At its September 2021 meeting, the committee learned about the number of people with dementia who are committed to the Montana State Hospital and Montana Mental Health Nursing Care Center and about the laws governing the involuntary commitment process.

In November, the committee members heard presentations involving dementia and the most appropriate and least restrictive for individuals with dementia, including those who are exhibiting behavioral problems. 

At a March 2022 meeting focusing on an Immediate Jeopardy notice issued for the Montana State Hospital, members agreed to proceed with the drafting of two committee bills for future consideration. One would establish a transition process to eliminate involuntary commitment of  individuals with dementia and traumatic brain injury, while the other would give the state protection and advocacy entity access to reports of abuse, neglect, and serious incidents at the State Hospital.

The committee reviewed the bill drafts in May. Based on public comment, members agreed to make several changes to the bill to transition people out of the State Hospital. The committee in June approved changes to bill draft HJR 39-1 to limit involuntary commitment of individuals with a primary diagnosis of dementia or TBI to only those instances where a person poses a danger to self or others. Commitment would not be allowed after July 1, 2025, for people with those primary diagnoses if they only meet commitment criteria related to being unable to provide for their basic needs.  

The committee also approved as a committee bill HJR 39-2, which requires DPHHS to share reports of abuse and neglect at the State Hospital with the state protection and advocacy organization.

A final report for the 2021-2022 interim summarizes the committee's work on this study, as well as studies of the children's mental health system and the adult mental health system.

Meeting Materials: June 27, 2022, Meeting

• Bill Draft Materials:
  • HJR 39-1v2: Revise Involuntary Commitment Laws
  • HJR 39-2v2: Share Montana State Hospital Abuse and Neglect Laws
  • Briefing Paper:
    • Bill Draft Revisions/Decision Points
• Draft Final Report

Meeting Materials: May 13, 2022, Meeting

• Bill Drafts:
  • HJR 39-1: Revise Involuntary Commitment Laws for Dementia/TBI Patients
  • HJR 39-2: Share Montana State Hospital Abuse and Neglect Reports
• Staff Briefing Papers:
  • Bill Draft Considerations
  • Retrospective of the MDC Closure

Meeting Materials: March 4, 2022: Montana State Hospital Meeting

• Immediate Jeopardy Notice
  • CMS State Operations Manual
    • Appendix Q: Core Guidelines for Determining Immediate Jeopardy
• WICHE Report (2020): Geropsychiatric Care at the Montana State Hospital
• Speaker Materials:
  • Dr. Coon PowerPoint: Appropriate Placement for Persons Living with Dementia and Behavioral Issues

Meeting Materials: November 22, 2021

• Staff Briefing Papers
  • Diagnoses for MSH Patients with Dementia Diagnoses
• Speaker Materials
  • Dr. Coon PowerPoint: Understanding Alzheimer's Disease and Other Dementias
  • Justice in Aging: Dementia Care in Long-Term Care Facilities
  • LaHood Handouts:
    • HB 987 Key Provisions
    • Georgia Training Requirements
  • Montana Health Care Association:
    • Skilled Nursing Definition
    • Assisted Living Categories

Meeting Materials: September 22, 2021

• Staff Briefing Papers
  • Overview of Involuntary Commitment Laws
• Speaker Materials
  • HJR 39 Study: Addictive and Mental Disorders Division PowerPoint Presentation

Meeting Materials: June 16, 2021

• House Joint Resolution 39