Act No. 137 Page 1 of 4
2024
This act summary is provided for the convenience of the public and members of the General Assembly. It
is intended to provide a general summary of the act and may not be exhaustive. It has been prepared by the
staff of the Office of Legislative Counsel without input from members of the General Assembly. It is not
intended to aid in the interpretation of legislation or to serve as a source of legislative intent.
Act No. 137 (S.192). An act relating to civil commitment procedures at a secure residential
recovery facility and a psychiatric residential treatment facility for youth and civil
commitment procedures for individuals with an intellectual disability
Subjects: Health; human services; mental health; developmental disabilities;
commitment
Sec. 1 of this act outlines its purposes, including to enable treatment at a secure
residential recovery facility, regardless of a prior hospitalization; enable treatment at a
psychiatric residential treatment facility for youth; update civil commitment procedures
for individuals with intellectual disabilities; and authorize the proposal of alternative
options for a secure community-based residence or residences to treat certain individuals
with intellectual disability who have been charged with a crime and found incompetent to
stand trial or adjudicated not guilty by reason of insanity and require a more secure level
of care than is currently available.
Secs. 2 through 16 make changes to civil commitment processes for individuals with a
mental health condition. Sec. 2 amends 13 V.S.A. § 4822 by modifying existing
language authorizing initial commitment “for an indeterminate period” to “a period of
90 days.” It further provides a victim with the right to submit a victim impact statement
to the Family Division of the Superior Court or through the prosecutor.
Sec. 3 amends 18 V.S.A. § 7101 to add a definition of “Department” and “psychiatric
residential treatment facility for youth.” It also moves and modifies the definition of
“secure residential recovery facility” from elsewhere in Title 18.
Sec. 4 amends 18 V.S.A. § 7253 to add a psychiatric residential treatment facility for
youth to the list of facilities at which patients are entitled to access a mental health patient
representative.
Sec. 5 amends 18 V.S.A. § 7255 to add the psychiatric residential treatment facility for
youth as a component of the mental health system of care.
Sec. 6 amends the existing reporting requirement in 18 V.S.A. § 7256 to update the
receiving committee from the House Committee on Human Services to the House
Committee on Health Care; to move an existing reporting requirement regarding
involuntary medication from 1998 Acts and Resolves No. 114 to be part of the
Department of Mental Health’s systemwide annual report; and to add a new reporting
requirement regarding individuals in the Commissioner’s custody who are unable to
move to a less restrictive setting due to lack of alternative placements.
Sec. 7 amends 18 V.S.A. § 7257 to add a psychiatric residential treatment facility for
youth to the list of facilities that must report adverse events occurring at the facility to the
Department of Mental Health.
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Sec. 7a amends 18 V.S.A. § 7279 to require the Department of Mental Health to
provide notice of any reportable adverse events to the Mental Health Care Ombudsman.
Sec. 8 adds 18 V.S.A. § 7260, which establishes a licensing requirement for the
operation of a psychiatric residential treatment facility for youth. Specifically, this
section requires that an applicant is a nonprofit entity and has demonstrated the capacity
to operate a psychiatric residential treatment for youth in accordance with Department of
Health rules; the applicant has maintained certification from the Centers for Medicare and
Medicaid Services; the applicant has maintained accreditation by the Joint Commission
or other accrediting organization; the applicant has demonstrated that the psychiatric
residential treatment facility for youth complies with health, safety, and sanitation
standards; residents of the psychiatric residential treatment facility for youth are under the
care of a physician; the applicant has a clear process for responding to resident
complaints; and the applicant is subject to inspection by the Department of Disabilities,
Aging, and Independent Living and other authorized entities.
Sec. 9 amends 18 V.S.A. § 7503 to add the psychiatric residential treatment facility for
youth to the list of facilities that a person 14 years of age or older could apply to for
voluntary psychiatric care.
Sec. 9a amends 18 V.S.A. § 7509 to add the secure residential recovery facility and
psychiatric residential treatment facility for youth to the list of facilities in which
residents are statutorily required to be treated with dignity and respect.
Sec. 9b amends 18 V.S.A. § 7511 to apply existing protections for the transportation
of individuals in need of mental health care to residents of the secure residential recovery
facility and psychiatric residential treatment facility for youth.
Sec. 10 amends 18 V.S.A. § 7612 to specify that an application for initial involuntary
treatment at a secure residential recovery facility or psychiatric residential treatment
facility for youth must expressly state where treatment is being sought and why the
Commissioner of Mental Health has determined that clinically appropriate treatment for
the individual’s condition can only be provided safely in a secure residential recovery
facility or psychiatric residential treatment facility for youth, respectively.
Sec. 11 amends 18 V.S.A. § 7618 to authorize the Family Division of the Superior
Court to place an individual in need of involuntary treatment on an order of
nonhospitialization at a secure residential recovery facility or psychiatric residential
treatment facility for youth. The section further authorizes the Family Division of the
Superior Court at any time, on its own motion or on the motion of an interested party, to
review the need for treatment at a secure residential recovery facility or psychiatric
residential treatment facility for youth, respectively.
Sec. 12 amends 18 V.S.A. § 7620 to specify that an application for continued
treatment at a secure residential recovery facility or psychiatric residential treatment
facility for youth must expressly state where treatment is being sought and why the
Commissioner of Mental Health has determined that clinically appropriate treatment for
the individual’s condition can only be provided safely in a secure residential recovery
facility or psychiatric residential treatment facility for youth, respectively. This section
also repeals definitions that this act recodifies in 18 V.S.A. § 7101.
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Sec. 13 amends 18 V.S.A. § 7621 to authorize the Family Division of the Superior
Court to place an individual in need of further treatment due to a mental condition on an
order of nonhospitialization at a psychiatric residential treatment facility for youth. This
section also authorizes the Family Division of the Superior Court at any time, on its own
motion or on the motion of an interested party, to review the need for treatment at the
secure residential recovery facility or psychiatric residential treatment facility for youth.
Sec. 14 amends 18 V.S.A. § 7624 to allow the Commissioner of Mental Health to seek
involuntary medication for an individual refusing to accept psychiatric medication who
has been placed under an order of nonhospitalization at a secure residential recovery
facility.
Sec. 15 amends 18 V.S.A. § 7628 to add a secure residential recovery facility to the
Department of Mental Health’s protocol ensuring health, safety, and respect for patients
subject to involuntary medication.
Sec. 15a amends 18 V.S.A. § 7701 to require that notice of rights is provided to
residents of a secure residential recovery facility and a psychiatric residential treatment
facility for youth.
Sec. 16 amends 18 V.S.A. § 7703 to add a secure residential recovery facility and a
psychiatric residential treatment facility for youth to the list of facilities where emergency
involuntary procedure data is collected by the Department of Mental Health.
Sec. 17 directs the Commissioner of Disabilities, Aging, and Independent Living, in
consultation with the Commissioner of Mental Health, to file initial proposed permanent
rule amendments (and interim emergency rules) to the Licensing and Operating
Regulations for Therapeutic Community Residences to allow the use of emergency
involuntary procedures at a secure residential recovery facility; to require that a
certificate of need for all emergency involuntary procedures performed at a secure
residential recovery facility be submitted to Department of Mental Health and the Mental
Health Care Ombudsman; and to authorize the use of involuntary medication at the
secure residential recovery facility.
Sec. 17a authorizes an individual who has been committed to a secure residential
recovery facility continuously since June 30, 2024, or earlier to apply to the Family
Division of the Superior Court for review as to whether the secure residential recovery
facility continues to be the least restrictive and most appropriate setting.
Sec. 18 amends 2021 Acts and Resolves No. 50, Sec. 3(c) to remove language in a
former Capital Bill restricting use of emergency involuntary procedures at a secure
residential recovery facility.
Sec. 19 authorizes the current secure residential recovery facility, River Valley, to
operate under its existing certificate of need despite the policy changes made in this act.
Sec. 20 repeals 1998 Acts and Resolves No. 114, Sec. 5, an existing reporting
requirement on involuntary medication, as the topic has been consolidated into the
Department of Mental Health’s annual report pursuant to Sec. 6 of this act.
Secs. 21 through 27 pertain to the changes to the civil commitment process for
individuals with intellectual disabilities. Sec. 21 amends 13 V.S.A. § 4814 to remove a
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sunset, which has the effect of allowing psychologists to complete competency
examinations on a permanent basis.
Sec. 22 amends 13 V.S.A. § 4816(b) to specify that a competency evaluation for an
individual thought to have a developmental disability shall be conducted by a doctoral-
level psychologist trained in forensic psychology.
Sec. 23 amends 13 V.S.A. § 4817 to specify that a psychiatrist or psychologist may
conduct a competency exam in accordance with 13 V.S.A. §§ 4814–1816.
Sec. 24 amends 13 V.S.A. § 4820 by reorganizing subsection (a) and by specifying
that a commitment hearing may be for commitment to the Commissioner of Mental
Health or of Disabilities, Aging, and Independent Living, as appropriate.
Sec. 25 amends 13 V.S.A. § 4823 to specify that if the Criminal Division of the
Superior Court finds by clear and convincing evidence that a person is a person in need of
custody, care, and habilitation, it shall issue a commitment order for up to one year in a
designated program in the least restrictive environment consistent with the person’s need
for custody. It further specifies that commitment procedures and orders from discharge
shall occur in accordance with 18 V.S.A. chapter 206, subchapter 3.
Sec. 26 makes multiple amendments to 18 V.S.A. chapter 206, subchapter 3. In
addition to amending definitions in 18 V.S.A. § 8839, this section repeals 18 V.S.A.
§§ 8840–8843 to eliminate provisions rendered irrelevant by the previous repeal of cross-
referenced sections. This section rewrites 18 V.S.A. § 8845, creating a petition and order
for continued custody, care, and habilitation. More specifically, 18 V.S.A. § 8845 states
that prior to the expiration of a commitment order pursuant to Title 13, the Commissioner
may seek continued commitment in the Family Division of the Superior Court by filing a
petition and that once filed the court shall hold a hearing within 14 days after the date of
the petition’s filing, which may be continued for good cause shown. Orders of continued
commitment may be made up to one year in a designated program in the least restrictive
environment. 18 V.S.A. § 8846 authorizes a person to initiate judicial review in the
Family Division of the Superior Court or an administrative review any time after 90 days
following a current commitment or continued commitment order, but not earlier than six
months after the filing of a previous review under this section. 18 V.S.A. § 8847
addresses discharge from the Commissioner’s custody and also authorizes a crime victim
receiving notice of the alleged perpetrator’s discharge from the Commissioner’s custody
to submit a victim impact statement to the Family Division of the Superior Court.
Sec. 27 authorizes the Department of Disabilities, Aging, and Independent Living to
propose alternative options for a secure community-based residence to treat individuals
who have been charged with a crime and found incompetent to stand trial or adjudicated
not guilty by reason of insanity, who are in the Commissioner’s custody, and who require
a more secure level of care than is currently available.
Lastly, Sec. 28 directs the Agency of Human Services to submit a report to the
General Assembly that provides a fiscal estimate for the implementation of a competency
restoration program operated or under contract with the Department of Mental Health.
Effective Date: July 1, 2024
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Statutes affected:
As Introduced: 13-4821, 18-7101, 18-7612, 18-7615, 18-7618, 18-7620, 18-7621, 18-7624, 18-7627, 13-4823, 18-8839, 18-8840, 18-8841, 18-8842, 18-8843, 18-8844, 18-8845
As Passed By the Senate -- Official: 13-4821, 18-7101, 18-7612, 18-7615, 18-7618, 18-7620, 18-7621, 18-7624, 18-7627, 13-4823, 18-8839, 18-8840, 18-8841, 18-8842, 18-8843, 18-8844, 18-8845, 13-4822, 18-206, 13-4814
As Passed By the Senate -- Unofficial: 13-4821, 13-4822, 18-7101, 18-7620, 18-7621, 18-7624, 18-7627, 13-4823, 18-206, 13-4814
As Passed by Both House and Senate -- Official: 13-4821, 18-7101, 18-7612, 18-7615, 18-7618, 18-7620, 18-7621, 18-7624, 18-7627, 13-4823, 18-8839, 18-8840, 18-8841, 18-8842, 18-8843, 18-8844, 18-8845, 13-4822, 18-206, 13-4814, 18-7253, 18-7255, 18-7256, 18-7257, 18-7259, 18-7503, 18-7509, 18-7511, 18-7628, 18-7701, 18-7703, 13-4816, 13-4817, 13-4820
As Passed by Both House and Senate -- Unofficial: 13-4822, 18-7101, 18-7253, 18-7255, 18-7256, 18-7257, 18-7259, 18-7503, 18-7509, 18-7511, 18-7612, 18-7618, 18-7620, 18-7621, 18-7624, 18-7628, 18-7701, 18-7703, 13-4814, 13-4816, 13-4817, 13-4820, 13-4823, 18-206
As Enacted: 13-4822, 18-7101, 18-7253, 18-7255, 18-7256, 18-7257, 18-7259, 18-7503, 18-7509, 18-7511, 18-7612, 18-7618, 18-7620, 18-7621, 18-7624, 18-7628, 18-7701, 18-7703, 13-4814, 13-4816, 13-4817, 13-4820, 13-4823, 18-206