Idaho bill to allow holds for neurological crises widely passes Senate

BOISE (Idaho Capital Sun) — A bill that would let Idaho law enforcement officials temporarily detain people who are a danger to themselves or others because of neurological conditions, like Alzheimer’s, widely passed the Idaho Senate on Tuesday.

The bill, Senate Bill 1247, addresses a gap in Idaho law that doesn’t let police detain people for neurological crises, but allows for 72-hour mental health holds, bill sponsor Sen. Melissa Wintrow, D-Boise, said when the bill cleared a committee last month. 

The bill would allow for 24-hour holds for neurological patients in crisis that health care providers can halt at any time. The bill does not allow patients in neurological crises to be detained “in a nonmedical unit” to detain people charged or convicted with penal offenses. 

“Many times people with dementia and Alzheimer’s become a danger to themselves because of an underlying, undetected medical condition that creates a crisis,” Wintrow said on the Senate floor, like a urinary tract infection or medications being off. She even recalled a story of an elderly woman’s infection from untrimmed toenails escalating. 

RELATED | Idaho would have mental health holds for neurological patients under a new bill

Wintrow recently overhauled her bill, essentially replacing it with a new bill through amendments on Feb. 28. She said the amended bill’s due process now mirrors that of the mental health hold outlined in Idaho law. 

That’s after some law enforcement representatives raised concerns over the liability that law enforcement officials could face under a previous version of the bill. Wintrow had said she worked with law enforcement groups on the bill. 

“What we want to do is look for a medical condition that might be undetected to see if it’s escalating somebody. And if it is, let’s treat it and get them stabilized and back in their home,” Wintrow told the Sun in an interview Tuesday. 

The Idaho Senate passed the revamped bill on a 32-2 vote Tuesday. Republican Sens. Dan Foreman, from Viola, and Brian Lenney, from Nampa, voted against it. 

The bill — sponsored by seven senators and five House representatives — drew little debate on the Senate floor. 

“This is really threading the needle and closing up any potential loop that needs to be addressed, to make sure our most vulnerable are taken care of,” said Sen. Carl Bjerke, R-Coeur d’Alene.

Sen. Geoff Schroeder, R-Mountain Home, said he supported the bill, drawing on his experience as a prosecutor.

“This is an excellent mechanism because officers frequently have to respond to the hospitals or to people unattended on the street as a hazard to themselves or becoming violent,” Schroeder said. 

The bill now heads to the Idaho House for consideration.

Idahoans in neurological crisis were detained under longer mental health holds, doctor said

The bill would allow health care providers to lift holds for neurological crises at any time. Neurological holds could last longer than 24 hours upon request to a judge under the bill, but Wintrow said on the Senate floor she doubted that would happen.

“Let’s say they do have pneumonia and the physician is afraid they might do something more harmful. They could ask a judge if they could keep them longer,” Wintrow said. “I don’t think that’s ever going to happen. The physicians don’t want that to happen. We didn’t even want that in the bill. We want to get people out the door as quickly as possible.”

Idaho police, without other options, are essentially forced to detain people without mental health conditions under the state’s mental health hold process, Dr. Nicole Fox, president of the Idaho Psychiatric Association and regional medical director for behavioral health for St. Luke’s Health System, told a Senate committee last month. That leaves patients with neurological conditions to wait 48 to 72 hours for an examiner to decide if the hold should be dropped, she said.

The bill draws on an existing legal definition of “neurocognitive disorder” in Idaho law that means “decreased mental function due to a medical disease other than a psychiatric illness.” 

The bill would allow people with neurocognitive disorders to be detained “if (law enforcement) or a health care provider in such hospital has reason to believe that person … is likely to injure themselves or others.” 

Courts must be presented with evidence that neurocognitive patients detained without a court order are a danger to themselves or others within 24 hours, according to the bill.

The bill also allows for friends, family, health care providers or public officials to petition courts for emergency protective placement of people who likely have neurocognitive disorders and “are in acute crisis due to an underlying medical condition.” That can result in proceedings for involuntary care and treatment of such patients, a process that involves review by health care providers and a court.

“If, upon completion of the hearing and consideration of the record, and after consideration of reasonable alternatives, the court finds by clear and convincing evidence that the person likely has a neurocognitive disorder and is likely to injure themselves or others, the court shall order the person to be placed under protective custody of a suitable medical hospital for observation, care, and treatment for an indeterminate period of time not to exceed seven … days,” the bill says.