Policy and Practice Comparisons Between States52
| Time Limit on Original Commitment | Conditional Release Process | Internal Review Process for Release or Discharge | Statutory Language Re Priority or Goals in Decision-Making | Release from Hospital Decisions | |
|---|---|---|---|---|---|
| OR | As ordered, not to exceed max prison sentence | Internal review process grants “CR readiness” privilege prior to requesting that the Board order evaluation for CR by community MH agency; results in hearing before PSRB | Internal review process grants “CR readiness” privilege prior to requesting that the Board order evaluation for CR by community MH agency | From PSRB Work Group: “protect the public and balance the public’s concern for safety with the rights of the client” (Ref. 27, p 13); from ORS 161.351(3): “the board shall have as its primary concern the protection of society” | PSRB |
| CT | As ordered, not to exceed max prison sentence | Hospital or patient petition PSRB; results in hearing before PSRB | Consulting forensic psychiatrists and forensic review committee | Safety of public and well-being of patient | PSRB |
| AZ | Committed for length of possible sentence | Court and community treatment provider must agree on CR plan; court orders CR and conditions | State hospital, community provider, and court agree on plan for CR | Public safety and protection are primary | Court |
| WA | Not to exceed max prison sentence | Hospital or patient petition court; hospital's materials, recommendations sent to PSRP for review and recommendation, which is sent to the court and designee of Secretary of DSHS | Forensic evaluator from OFMHS, hospital-based care coordinator, and hospital-based Risk Review Board | Safety of the public primary; petitioner must show by a preponderance of the evidence | Court |
| CA | Max possible sentence (for inpatient commitment); conditional release program (CONREP) portion indeterminate | Hospital medical director recommends CONREP; court decides | Hospital medical director or community program director, as applicable | Danger to the health and safety of others | Court |
| GA | Court may order commitment for six mos; chief medical officer may apply for order of continued hospitalization | Team drafts CR plan; reviewed by hospital forensic director, external FRC (if serious violent felony), then FRC, then clinical director, then hospital administrator, then to court for hearing and review | Team drafts CR plan; reviewed by hospital forensic director, external FRC (if serious violent felony), then FRC, then clinical director, then hospital administrator | Civil commitment criteria | Court |
| HI | No | After 90 days, hospital director or patient may apply | Three concurrent, independent forensic evaluations completed as part of CR involving felony charges (including at least one psychiatrist)53 | Danger to persons or property | Court |
| MA | Six mos; then one yr recommitments | None | Medical director or superintendent, after independent forensic risk assessment | Likelihood of serious harm | Court |
| MD | Indeterminate | Hospital requests release hearing with ALJ, who makes recommendation to criminal court. Initial CR is five yrs, can be extended | Forensic Review Board for inpatients; “Central Admissions Office” for those on CR | Danger to self, others, or property | Court |
| ME | No | Psychiatrist files report to Comm’r as soon as person may be released; Comm'r applies to court. In practice, patient encouraged to apply through attorney to facilitate a court date | Treatment team or psychiatrist to Comm'r; review by State Forensic Service | Likelihood of injury to self or others | Court |
| MN | Indeterminate | SRB and Comm’r make decision; called “provisional discharge” | SRB and Comm’r | Reasonable degree of safety for the public; will enable person to adjust successfully to community | SRB and Comm’r |
| MO54 | Indeterminate | Treatment team to facility FRC, to COO, to state forensic director, to court. Courts generally grant release when DMH supports it. Patient may also request | Treatment team to FRC of facility, to COO, to state forensic director | Not now or likely in reasonable future to commit another violent crime because of mental illness; has capacity to conform behavior to requirements of law in future | Court |
| NC | Indeterminate | None; 1st release hearing at 50 days, then 90, then 180, then one yr | Periodic discharge panel meetings | No longer dangerous or no longer mentally ill | Court |
| NY | One yr for hospital commitment | Comm’r applies to court; hearing held. CR order for five yrs, may be renewed for five yrs indefinitely | Treating clinicians and OMH staff; court rarely disagrees with OMH recommendation | Presence of dangerous mental disorder | Court |
| OH | Max prison sentence; almost always committed for full time | Review by FRT, Forensic Center, and trial court | FRT and Forensic Centers review | LRA consistent with public safety and welfare of person; preference to public safety | Trial court |
| SC | Max possible sentence | Hospital director requests of court | Not specified in state interagency protocol | Likelihood of serious harm; lacks insight or capacity to make responsible decisions re treatment | Court |
| TN | No | Reviewed by COO and RMRC; court may hold hearing, where COO decision presumed correct but may be challenged | RMRC, COO | Likelihood of harm unless under court-ordered treatment, other factors | RMRC ± court |
| VA | Indeterminate; first hearing re continued commitment at one yr; for misdemeanors, max one yr | Petition by Comm'r, with CR plan jointly prepared by hospital and community service board | If one examiner (psychologist or psychiatrist) recommends release, 2nd examiner appointed; if 2nd agrees, recommend release to court and detailed CR plan created with community | Does not need inpatient, needs outpatient monitoring to prevent deterioration, appropriate outpatient available and significant reason to believe acquittee would comply with conditions and CR will not present “undue risk to public safety” (VA Code § 19.2-182.7) | Court |
ALJ, administrative law judge; Comm’r, Commissioner; COO, Chief Operating Officer; CR, conditional release; DMH, Department of Mental Health; DSHS, Department of Social and Health Services; FRC, forensic review committee; FRT, forensic review team; LRA, least restrictive alternative; MH, mental health; mos, months; OFMHS, Office of Forensic Mental Health Services; OMH, Office of Mental Health; ORS, Oregon Revised Statutes; PSRB, Psychiatric Security Review Board; RMRC, Risk Management Review Committee; SRB, Special Review Board; yr, year.
We have noted where we used statutes or additional references outside the survey.