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Providers, prosecutors and zones urge clearer timing for emergency mental-health holds; committee hears 72-hour option
Summary
Hospital and provider representatives urged the Senate Human Services Committee to clarify when the statutory 24-hour involuntary hold begins and to consider a 72-hour hold, citing rural transport times and lab/testing delays; the committee heard fiscal and operational questions but did not vote on SB 2171.
Providers, prosecutors and human services zone directors told the Senate Human Services Committee that North Dakota’s 24-hour emergency mental-health hold can be impractical in rural areas and asked for statutory clarity or expansion to a 72-hour hold.
Ty Hegland, CEO of Prairie St. John’s, a 132-bed acute psychiatric hospital in Fargo, described long transport distances and volunteer ambulance reliance that can leave little or no time remaining on a 24-hour hold by the time a patient reaches an assessment facility. “Quite often when they present to an ER, an ER provider is called in, provider assesses them, makes a determination to put them on hold, and then the journey for traveling to that referring facility starts,” Hegland said, later adding that transport times sometimes reach seven hours and that “quite often what happens based upon the transportation realities is that patients present, and there's no time left on the hold.”
Hegland and other witnesses asked the committee for three clarifications: start the statutory hold when the patient presents to the receiving assessment facility, exclude holidays from the hold clock, and exclude weekends. Hegland said the overall aim is to allow sufficient time for psychosocial assessments and medication stabilization, processes that can take multiple days. Several witnesses noted that Minnesota’s 72-hour hold law complicates cross-border care for residents near the state line and that 33 states permit 72-hour holds or processes in some form.
Committee members pressed witnesses on practical and legal details: whether law enforcement will transport without a legal document, how the patient's legal status is defined while in transport, and whether extending the hold would increase costs for facilities or create unintended consequences. Hegland and others said they consult frequently with law enforcement and that clarity would reduce reliance on back-to-back holds, which providers avoid.
No formal amendments or votes were taken on SB 2171 during the hearing. Committee members asked the Department of Human Services and the Division of Medical Services to return with suggested drafting options, fiscal implications, and operational language — including whether a 72-hour statutory hold is feasible and how payment or hospitalization eligibility would be determined.
