A bill that would expand which medical professionals can authorize an involuntarily civil commitment of a potentially dangerous person passed the House Health and Human Services Committee on Thursday on an 8-3 vote.
HB261, sponsored by state Rep. Phil Lyman, R-Blanding, would give physician assistants and nurse practitioners the authority to temporarily institutionalize an individual if they are likely to harm themselves or others to a local mental health authority.
Currently, police officers, licensed physicians and designated examiners have the power to authorize a civil commitment of an individual for no more than 24 hours, excluding weekends and holidays, under law.
“We’re not talking about expanding the ability to commit somebody civilly. What we’re talking about is allowing nurse practitioners and physician assistants to fill that gap,” Lyman said.
Lyman said it can oftentimes take hours for an available physician to sign off on an institutionalization in a document called a “blue sheet.” During the waiting period for a physician to sign the blue sheet to temporarily commit someone, the individual can leave the premises and potentially cause harm to themselves or others, according to Jen Newman, an advanced practice provider director for emergency medicine at Intermountain Healthcare, who advocated for the passage of the bill.
“Physicians are stretched,” she explained. “I think we’re qualified to be able to take care of these patients and to know when patients are a threat to themselves or others.”
Under the bill, if an individual is involuntarily committed and no longer poses a danger to themselves or the public, a local mental health authority or designee is expected to release the patient.
Several community members, including a representative from the Disability Law Center, spoke out against the bill. Andrew Riggle, a public policy advocate for the Disability Law Center, said physicians assistants and nurse practitioners have not received sufficient training to make such decisions.
“At its core, involuntary commitment deprives a person of their fundamental rights and freedoms. Thankfully, doctors receive some training on making these hard calls in medical school,” he said. “However, we’re talking about expanding authority to conduct these extremely consequential evaluations. Unfortunately, our understanding is neither physician assistants nor nurse practitioners get significant training or experience in this area during their education. Anyone given this kind of power should be required to have specialized training and experience needed to make a difficult decision with such serious implications.”
One West Valley City resident, Martin King, said the bill threatens to take away his “sovereign rights.”
“This gives them a false sense of a power over me that they can incarcerate me or take me and take away my sovereign rights to decide for myself what I want to do,” he said.
State Rep. Jennifer Daily-Provost, D-Salt Lake City, said she received communications from several concerned constituents about the impact of the bill.
“I want to reassure everybody that we, as a legislative body, take this very seriously. Nobody is looking to create any kind of mechanism where if somebody comes into an emergency room or to their doctor’s office and they’re just having a bad day that suddenly their rights are going to be taken away,” Daily-Provost said, who voted to pass the bill. “We are very cognizant that we do not want that to happen.”