Relating to the certificate of medical examination for chemical dependency and the duration of court-ordered treatment for a person with a chemical dependency.

Contracts

• Facility Acceptance Agreements: Amend standard acceptance letters provided to the court. Remove any language guaranteeing a fixed length of stay. Insert clauses stating admission is "subject to ongoing clinical evaluation and statutory discharge authority under Section 462.080(b)," protecting the facility if early discharge is medically necessary.
• Physician Agreements: Update agreements for psychiatrists and addiction specialists to require adherence to the new "causal nexus" documentation standard in medical certifications.

Hiring/Training

• Physician Training: Medical staff must be trained on the new "Nexus Requirement." It is no longer sufficient to list dependency and harm separately. The physician must document that the patient meets harm criteria *specifically as a result of* the chemical dependency.
• Administrator Training: Facility administrators must be trained on the "Clinical Override" workflow—invoking statutory authority to discharge a patient prior to the court-ordered 30-day minimum if clinical stabilization occurs.

Reporting & Record-Keeping

• Certificate of Medical Examination: Immediate Redline Required. Create a new template with mandatory fields/checkboxes forcing the physician to identify which statutory prong (harm to self, harm to others, or deterioration) is caused by the dependency.
• Discharge Documentation: Create a specific discharge form for patients released before the 30-day minimum. It must explicitly state: "Patient no longer meets criteria for court-ordered treatment," to serve as a defense against potential contempt of court citations.

Fees & Costs

• Insurance Risk: There is a high risk of revenue loss if facilities hold patients for the full 30-day mandatory minimum solely to satisfy the court order. Commercial payers and Medicaid will deny claims lacking medical necessity. Facilities must discharge based on clinical criteria, not the judicial clock.