LCAR approves Department of Mental Health rule adding locations for court‑ordered nonemergency involuntary psychiatric medication

Karen Barber, general counsel for the Department of Mental Health, told the Legislative Committee on Administrative Rules on Dec. 5 that the department’s proposed revisions to rule 24P23 largely update where court‑ordered nonemergency involuntary psychiatric medications may be administered and modernize language.

Barber said the rule governs court‑ordered long‑acting psychotropic and voluntary medications and that emergency medications — short‑acting drugs used during seclusion or restraint — remain governed by a different rule. She said the package is not a wholesale rewrite: “there’s nothing overly substantive that we change, other than adding locations to where we can do this,” and that the edits include a new definition of a “qualified practitioner” and more inclusive, person‑first language.

The revision responds to legislative direction in Act 27 (2023) and Act 137 (2024), Barber said, and adds a category of “designated facilities,” including a forensic facility and the River Valley facility, where nonemergency involuntary medications may be administered. She also said the department removed seclusion‑and‑restraint text from this rule and instead cross‑references the newer emergency and voluntary procedures rule.

Committee members asked whether any outstanding concerns remained from the public comment process. Barber said the rule had been in effect in practice since 1999 and that the recent changes were limited and developed through legislative discussion and stakeholder input. Senator Ginny Lyons, participating by video, said she had submitted a cover sheet concluding the revisions met legislative intent.

Representative Pickwick moved to approve rule 24P23 with the department’s memorandum dated Nov. 25, 2024, included; the committee approved the motion by voice vote.

The committee did not record a roll‑call tally in the transcript; the motion was approved by voice vote and the chair declared the measure approved. The department submitted a redline and a memo documenting minor technical edits and said it had consulted Vermont Legal Aid, Disability Rights Vermont, Vermont Care Partners, NAMI, Vermont Psychiatric Survivors and others during rule development.

The rule as approved updates locations and clarifications for nonemergency involuntary medication while deferring emergency‑use and restraint procedures to the separate, more detailed emergency rule.