OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 249 Bill Analysis
135th General Assembly
Click here for H.B. 249’s Fiscal Note
Version: As Introduced
Primary Sponsors: Reps. Galonski and Hillyer
Effective date:
Jason Hoskins, Attorney
SUMMARY
Establishes a new category under which an individual may be considered a “mentally ill
person subject to a court order” and subject to emergency hospitalization: psychiatric
deterioration.
Modifies the requirement for emergency hospitalization (“pink slipping”) that an
individual represent a substantial risk of physical harm to self or others if allowed to
remain at liberty pending an examination by removing the requirement that the
substantial risk of harm be a risk of physical harm.
Specifies that a written statement required to be made by an individual transporting a
“mentally ill person subject to a court order” is not invalid if the statement identifies a
general hospital as the receiving hospital.
Requires an individual making a written statement regarding a person considered a
“mentally ill person subject to a court order” under the psychiatric deterioration
standard established by the bill to include additional available relevant information
about a person’s mental illness.
Establishes conditions under which a general hospital that receives a “mentally ill
person subject to a court order” is not required to transfer the person to a hospital
licensed by the Ohio Department of Mental Health and Addiction Services.
Adds state highway patrol troopers to the list of individuals who are authorized to
detain a person and initiate emergency involuntary hospitalization.
DETAILED ANALYSIS
Emergency hospitalization
Existing Ohio law establishes a process under which certain health professionals or law
enforcement officers may initiate an individual’s involuntary treatment for mental illness when
an emergency exists. This process is referred to as emergency hospitalization or “pink slipping.”
September 22, 2023
Office of Research and Drafting LSC Legislative Budget Office
Currently, before the emergency hospitalization process may be initiated, an individual must
(1) meet one or more statutory categories to be considered a “mentally ill person subject to a
court order” and (2) represent a substantial risk of physical harm to self or others if allowed to
remain at liberty pending examination. The bill creates an additional statutory category under
which an individual may be considered a “mentally ill person subject to a court order” and
modifies the requirement that an individual also represent a substantial risk of physical harm to
self or others if allowed to remain at liberty pending examination to remove the requirement
that the substantial risk of harm be a risk of physical harm.
Mentally ill person subject to a court order
Under Ohio law, an individual is a “mentally ill person subject to a court order” if,
because of the individual’s mental illness, the individual falls into one of five specified
categories. Those categories are:1
The individual represents a substantial risk of physical harm to self as manifested by
evidence of threats of, or attempts at, suicide or serious self-inflicted bodily harm;
The individual represents a substantial risk of physical harm to others as manifested by
evidence of recent homicidal or other violent behavior, evidence of recent threats that
place another in reasonable fear of violent behavior and serious physical harm, or other
evidence of present dangerousness;
The individual represents a substantial and immediate risk of serious physical
impairment or injury to self as manifested by evidence that the individual is unable to
provide for and is not providing for the individual’s basic physical needs because of the
individual’s mental illness and that appropriate provision for those needs cannot be
made immediately available in the community;
The individual would benefit from treatment for the individual’s mental illness and is in
need of treatment as manifested by evidence of behavior that creates a grave and
imminent risk to substantial rights of others or the individual;
The individual would benefit from treatment as manifested by evidence of behavior that
indicates all of the following:
The individual is unlikely to survive safely in the community without supervision,
based on a clinical determination;
The individual has a history of lack of compliance with treatment for mental illness
and either (1) at least twice within the preceding 36 months, the lack of compliance
has been a factor in necessitating hospitalization or receipt of services in a forensic
or other mental health unit of a correctional facility or (2) within the preceding
48 months, the lack of compliance resulted in one or more acts of serious violent
1 R.C. 5122.01(B).
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behavior toward self or others, or threats of, or attempts at, serious physical harm
to self or others;
The individual, as a result of the individual’s mental illness, is unlikely to voluntarily
participate in necessary treatment;
In view of the individual’s treatment history and current behavior, the individual is in
need of treatment to prevent a relapse or deterioration that would likely result in
substantial risk of serious harm to the individual or others.
An individual who only meets this final category without also meeting at least one other
category is not subject to emergency hospitalization.2
The bill establishes a new category under which an individual may be considered a
“mentally ill person subject to a court order.” Under this category, an individual is considered a
“mentally ill person subject to a court order” if the individual represents a substantial risk of
harm to self or others as manifested by evidence that indicates all of the following:
The person’s judgment is impaired by a lack of understanding of having an illness or a
need for treatment, or both;
The person refuses treatment or is not adhering to prescribed treatment;
The person has been diagnosed with one or more of the following conditions as defined
in the most recent addition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association:
Schizophrenia;
Schizoaffective disorder;
Bipolar disorder;
Delusional disorder;
Major depressive disorder.
If not treated and based on the individual’s prior history, the individual is reasonably
expected to suffer mental deterioration and, as a result of that deterioration, will meet
one of the first four categories described above.3
Substantial risk of physical harm to self or others
In addition to being considered a “mentally ill person subject to a court order,” to be
eligible for emergency involuntary hospitalization, an individual also must represent a
substantial risk of physical harm to self or others if allowed to remain at liberty pending
examination. The bill modifies this requirement to remove the restriction that the substantial
risk of harm be a risk of physical harm. Therefore, under the bill, an individual must be
2 R.C. 5122.01(B)(6)(b).
3 R.C. 5122.01(B)(5).
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considered a “mentally ill person subject to a court order” and represent a substantial risk of
harm to self or others if allowed to remain at liberty pending examination to be eligible for
emergency involuntary hospitalization.
Required written statement
Under current law, specified individuals who believe that a person is a “mentally ill
person subject to a court order” and represents a substantial risk of harm to self or others if
allowed to remain at liberty pending examination are authorized to detain a person and initiate
emergency involuntary hospitalization by transporting the person to a general hospital or
hospital licensed by the Ohio Department of Mental Health and Addiction Services
(OhioMHAS).4 Existing law further specifies that when an authorized individual does so, the
transporting individual must give the receiving hospital a written statement detailing the
circumstances under which the person was taken into custody and the reasons for believing
emergency involuntary hospitalization is necessary.5 The bill adds state highway patrol troopers
to the list of individuals who are authorized to detain a person and initiate emergency
involuntary hospitalization.6
Additionally, the bill makes two changes regarding this required written statement.
First, the bill specifies that a written statement is not invalid if it is given to a general hospital
rather than a hospital licensed by OhioMHAS. The bill requires a general hospital that receives a
written statement to transmit that statement to a hospital licensed by OhioMHAS when the
general hospital transfers a person to an OhioMHAS hospital.7
Second, the bill requires that an individual transporting a person they believe to be a
“mentally ill person subject to a court order” under the psychiatric deterioration category
established by the bill specify, in addition to the required written statement described above,
any available relevant information about the history of the person’s mental illness, if the
transporting individual determines that the additional information has a reasonable bearing on
the decision to transport the person. This additional information may include (1) information
from anyone who has provided mental health or related support services to the person being
transported, (2) information from one or more family members of the person being
transported, or (3) information from the person being transported or anyone designated to
speak on the person’s behalf.8
Authority of a general hospital
Under current law, a general hospital may admit and provide care to a “mentally ill
person subject to a court order” who is taken into custody and transported to the general
4 R.C. 5122.10(A).
5 R.C. 5122.10(B)(1).
6 R.C. 5122.10(A)(1)(j).
7 R.C. 5122.10(B)(1).
8 R.C. 5122.10(B)(2).
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hospital. However, the general hospital must transport the person to a hospital that is licensed
by OhioMHAS not later than 24 hours after the person arrives at the general hospital.9 The bill
permits a general hospital to continue to provide care to a person for longer than 24 hours if
either of the following is the case:
At the end of the 24-hour period, the general hospital determines that the person is not
medically stable to be transferred10;
Within the 24-hour period, the general hospital is unable to identify an OhioMHAS-
licensed hospital that is willing to accept the person.11
Additionally, the bill provides that if a licensed physician responsible for diagnosing or
treating mental illness, a licensed clinical psychologist, a psychiatrist, or other health officer
examines a “mentally ill person subject to a court order” who is transported to a general
hospital, and determines that the person is not a “mentally ill person subject to a court order,”
the general hospital may release the person, unless a court has issued a temporary order of
detention for the person. The bill specifies that this provision is not to be construed as requiring
a general hospital to have the resources for or provide licensed professionals to make a
determination as to whether someone is a “mentally ill person subject to a court order.”12
Background
For a more detailed explanation of current Ohio law regarding the emergency
hospitalization process, please see LSC’s Members Brief, Involuntary Treatment for Mental
Illness, which may be accessed under the “Publications” tab on LSC’s website: lsc.ohio.gov.
HISTORY
Action Date
Introduced 08-01-23
ANHB0249IN-135/ts
9 R.C. 5122.10(D).
10 R.C. 5122.10(E).
11 R.C. 5122.10(F).
12 R.C. 5122.10(G).
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As Introduced