PURPOSE: This rule sets guidelines for implementation of House Bill 971, section 632.385, RSMo and applies to all department facilities and private mental health facilities certified by the Division of Comprehensive Psychiatric Services to provide outpatient treatment.

1. (1) The head of a mental health facility or designee may conditionally release a patient who is involuntarily detained pursuant to Chapter 632, RSMo for twenty-one (21) days, ninety (90) days or one (1) year for a period, not to exceed one (1) year, under written conditions provided by the facility. The facility shall have a continuing responsibility to assist the client in following the written conditions and, as provided in section (6) of this rule, may revoke the patient’s conditional release and return the patient to the facility for further inpatient treatment.

2. (2) The head of the facility or designee shall develop written conditions for the patient’s release. These conditions may include, but are not limited to, the following:

   1. (A) Where the patient will reside;
   2. (B) What medications the patient must take to treat the mental illness;
   3. (C) When and where the patient will receive required psychotherapy, day treatment, community placement or other required care and treatment necessary to continue the patient on conditional release;
   4. (D) Which behaviors the patient is expected to exhibit or avoid; and
   5. (E) Any other conditions necessary for the patient to comply with to reasonably assure success.
3. (3) The patient, the head of the facility or designee and the persons providing services to the patient while on conditional release shall agree to the conditions of the release agreement.
4. (4) The head of the releasing facility or designee may modify the patient’s conditions for release when s/he believes that these changes are in the best interest of the patient. Suggested modifications to the conditional release agreement may be made to the head of the releasing facility or designee by the patient or the persons providing services. Any modifications shall be given to the patient in writing and as required in sections
5. (3) and (5) of this rule.

6. (5) The signed conditional release shall be filed by the head of the facility or designee with the probate division of the circuit court that committed the patient. Copies of the conditional release shall be given to—

   1. (A) The patient;
   2. (B) The facility that conditionally released the patient;
   3. (C) The person(s) providing for the conditions of release;
   4. (D) The mental health coordinator;
   5. (E) The patient’s last attorney of record; and
   6. (F) The prosecuting attorney, county counselor or circuit attorney, as appropriate.

7. (6) If the patient violates one (1) or more conditions of the release, the head of the facility or designee that conditionally released the patient shall be notified. After review the head of the facility or designee may revoke the patient’s conditional release and return the patient to the hospital if there is reason to believe that—

   1. (A) The patient has violated one (1) or more of the conditions of release;
   2. (B) The patient requires resumption of fulltime hospitalization; or
   3. (C) The safety of the patient or public may be in jeopardy if the patient is not hospitalized.

8. (7) If a decision to revoke the patient’s conditional release is made by the head of the facility or designee, s/he shall notify and give written notice as to the conditions that were violated, how they were violated and reasons for returning the patient to inpatient hospitalization within ninety-six (96) hours of the patient’s return to the mental health facility to the following:

   1. (A) The patient;
   2. (B) The person(s) providing services which are called for by the conditions of release;
   3. (C) The court of jurisdiction;
   4. (D) The mental health coordinator;
   5. (E) The patient’s last attorney of record; and
   6. (F) The prosecuting attorney, county counselor or circuit attorney, as appropriate.
9. (8) If, after given notice, the patient refuses to return to the facility, the head of the facility or designee may take the written notice to the probate division of the circuit court where the conditional release was filed and request that the probate division of the circuit court issue a warrant for the patient’s apprehension and return to the facility. The court may consider the request on an ex parte basis. Any court costs related to revocation shall be paid as provided in section 632.415, RSMo.
10. (9) When the patient is returned to the facility, the head of the facility or designee shall give written notification to the patient that if the patient disagrees with the revocation that the patient may ask the court to hold a hearing on the matter. Upon readmission to the facility, the patient shall be given notice of his/her commitment rights as if s/he were detained for the initial ninety-six (96)-hour period and be given the name and phone number of his/her attorney who represented him/her in the last commitment hearing. The attorney who represented the patient on the last commitment hearing shall continue to be the attorney of record unless the patient has obtained other legal counsel. If the attorney of record is unable to represent the patient, a new attorney shall be designated by the facility from the list of attorneys. The mental health coordinator shall be given notice as to the patient’s revocation and return to inpatient hospitalization.
11. (10) The period of inpatient hospitalization shall not exceed the period of time left on the previous commitment without further hearings for the next appropriate period of commitment. The head of the facility placing the patient on conditional release shall keep adequate records to assure that the patient is not involuntarily treated as an inpatient for a longer period than necessary while on conditional release.

AUTHORITY: section 630.050, RSMo 1986.* Original rule filed Aug. 4, 1988, effective Jan. 13, 1989. *Original authority: 630.050, RSMo 1980.