Talking Points for Support of SB 2102 and HB 693

Support SB 2102 & HB 693 –Commitment Evaluator Expansion
The Shortage of Physicians & Psychologists in MS is Problematic
The Health Resources and Services Administration (HRSA) within the U.S. Department of Health and
Human Services (HHS) designate certain areas as Health Professional Shortage Areas (HPSAs).
Approximately 55 counties in MS have been designated as high Mental Health Professional Shortage
Areas. The shortage of physicians and psychologists available to conduct commitment evaluations in rural
MS specifically- has resulted in mentally ill citizens to being unreasonably held in jails awaiting
evaluations. Allowing nurse practitioners to conduct the commitment evaluation when a physician is
unavailable, and adding LCSWs and LPCs to the list of potential evaluators is the most effective way to
address this access barrier that plague many of our rural counties.
Statutory Time Limits on Restricting the Liberty of Persons Should not be Casually Disregarded.
By law, evaluations in MS should be conducted within 48 hours (not including weekends) after the order
of examination, with a possible 8 hour extension. It is inhumane to detain an individual over the statutory
required time, simply because a physician or other professional is not available to evaluate them. It is a
serious deprivation of individual liberty, as it is possible that the individual should not have been held
(especially in a jail) in the first place.
LCSW and LPCs are Qualified to Conduct Commitment Evaluations
Due to their extensive clinical training and 2 years of required clinical supervision, LCSWs and LPCs
possess the advanced knowledge and skills to conduct commitment evaluations.
LPCs are licensed as independent practitioners who can diagnose and treat mental illness. Their
extension, education, training, supervision in the field prepare them for assessment and diagnosis and
Licensed Certified Social Workers (Clinical), LCSWs, are also licensed to practice independently.
LCSWs are qualified to diagnose psychosocial dysfunction, disability, and impairment including
emotional, mental, and behavioral disorders. LCSWs are also qualified to use the Diagnostic and
Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), and
other diagnostic classification systems in assessment, diagnosis, and other activities.
Professionals Added as Evaluators Will be Required to Obtain Certification and Training
As required by MS psychologists, the Social Work and Counseling Associations will be required to
oversee a commitment certification process for their members. The training will provide assurance to the
public that these professionals possess the appropriate skills in making a proper diagnosis of the presence
or absence of mental illness. In addition, it will confirm their competence in understanding the civil
commitment law, including the legal and ethical implications of involuntary civil commitment.
The Legislation Does Not Change Current Nurse Practitioner Laws
The NP conducting the evaluation will continue to collaborate with a physician, as presently required by
state law. Even if a physician is not an evaluator, he/she will continue to play an active role in the
commitment evaluation process through the collaborative agreement with the NP.
Procedural Safeguards Protect From Arbitrary and Erroneous Commitments
There have been arguments suggesting that expanding professionals who can conduct commitment
evaluations would inevitably lead to erroneous commitments. First, these professionals are qualified to
examine the patient and assess the need for commitment. However, there are sound procedural safeguards
in place to make sure that the one commitment evaluator’s opinion is not the sole determination of a
judicial commitment. First, MS requires two distinct evaluations. Second, mental health professionals are
required to pre-screen the individual and determine if a commitment evaluation is warranted and
appropriate. Last, the chancellor must also look all of the evidence presented and find by clear and
convincing (a high standard of proof) that the person in in need of judicial commitment.
Our Sister States Have Recognized Other Mental Health Professionals as Commitment Evaluators
Alabama allows Licensed Medical Doctors and “Qualified Mental Health Professionals” to perform
examinations. These professionals are required to have master’s degrees in psychology, social work, or
counseling and are required to have a minimum of 3 years post-master’s relevant clinical experience:
In Tennessee, the Mental Health Commissioner may designate a person to take any action authorized and
perform any duty imposed on a physician if they complete a training program. These professionals
include but are not limited to: psychological examiners, licensed master's social worker with two (2) years
of mental health experience, licensed clinical social worker, marital and family therapist, nurse with a
master's degree in nursing who functions as a psychiatric nurse, and professional counselor.
Georgia requires that a physician perform the evaluation, but also allows any psychologist, clinical social
worker, LPC, or clinical nurse specialist in psychiatric/mental health to conduct the commitment
evaluation in place of the physician.
Cost Efficiency
Very often counties bear the costs associated with commitment evaluations. As counties struggle with
fiscal challenges, they are searching for ways to humanely and cost-effectively treat and assess
individuals with mental illnesses. Adding LPCs and LCSWs as evaluators will give counties more
practical options while also increasing access to a greater number of professionals--without jeopardizing
the quality of the commitment evaluation process.
Inpatient Care Should Always Be the Last Resort
We believe that the best treatment is the most clinically appropriate, least restrictive care that can be
found in an individual’s community. The intent of this legislation is not to increase the number of
individuals committed in the state. This legislative intent is to ensure access to timely commitment
evaluations as well as getting mentally ill individuals access to the necessary supports as quickly as