1. Why is the Brown County Health & Human Services Department entering into a Settlement Agreement?
First, it allows for some protection for the subject in the immediate crisis situation. That is, it allows for some extended inpatient treatment, not afforded by the Statement of Emergency detention. Second, it allows for a thorough evaluation of the patient, to make sure that the treatment that is being received or will be received is appropriate for the patient. Finally, as a primary purpose it gives some structure to the outpatient plans of the patient, and provides some guarantees that the patient will comply with the outpatient treatment plan.
2. What happens after the court accepts the Hold Open?
The patient may need to remain in an inpatient setting for a brief period of time. Upon discharge from inpatient treatment or shortly after, the Health & Human Services Department should be in contact with the patient (and if a juvenile the patient’s family) to identify them as a contact person. A brief interview may be held to establish the terms and conditions of the Hold Open. Once that is done, the case manager will maintain the contact that they feel is clinically necessary. Once discharged, the subject will participate in the outpatient program designed pursuant to the discharge plan.
3. Will I (my child) be supervised by a social worker?
Yes and No: One of the major differences between the Settlement Agreement and a commitment is the level of supervision that is provided by the Health & Human Services Department. In a mental health commitment the case manager of the subject will take a proactive stance on the treatment being received, they will establish such contacts as necessary. On the contrary, a Hold Open allows the subject (and the subject’s family) to have a great deal of control over their own care and treatment. Only when the subject becomes non-compliant with the treatment, or other terms of the Hold Open, does the Health & Human Services Department reactively intervene.
4. Is the child/youth solely responsible for complying with the requirements of the 90 day hold open/commitment?
Yes and No. When a minor enters into a 90 day hold open or commitment the youth will need to comply with service recommendations made at discharge. However, the Health & Human Services Department looks to work with the youth and family as a whole in a collaborative, supportive relationship. Thus meaning, if a child is willing to go to therapy or any other required services, but is not allotted the support to do so; this cannot be viewed as non-compliance.
5. What happens at the end of the 90 days when there has been no non-compliance?
At the end of the 90 days the matter is dismissed without further court action. A final notice is provided to the Office of Corporation Counsel, and a petition is filed with the Probate Court to dismiss the action. Settlement Agreements are not extendable. If there are no reports of significant non-compliance during the term of the Hold Open, the matter is dismissed, expunged and the document no longer has any legal bearing.
6. What type of ‘non-complaint behavior” is significant enough to warrant a revocation of the Hold Open?
All non-compliant behavior should be reported to the Brown County Health & Human Services Department. The reporter should keep in mind that revocation will only be considered when the non-compliant behavior is either significant dangerous behavior (that is, a suicide attempt or assault of another) or a pattern of behavior that is interfering with the subject’s treatment.
A significant piece of the evaluation will be the pattern of the behaviors and the impact that other efforts to conform the activities have had.
Examples of behavior that MAY result in revocation:
- Repeated pattern of medication non-compliance.
- Acts, attempts or threats to harm self or others.
- Failing to comply with, or removing one’s self from day treatment or outpatient AODA.
- A pattern of failing to keep appointments with treatment providers.
- Pattern of alcohol or narcotics abuse (if prohibited by settlement agreement).
Examples of behaviors that MAY NOT result in revocation
- Failing to shower/brush teeth/properly groom.
- Failing to comply with parents wishes regarding religion.
- “Hanging out” with “bad kids.”
- Having sexual intercourse against parents’ wishes.
- Dressing inappropriately.
- Failure to comply with “house rules.”
7. What happens if the agreement needs to be revoked?
If the Health & Human Services Department determines that the non-compliant behavior is of a nature that the Hold Open agreement has been violated they can ask the Office of the Corporation Counsel to “revoke” the Hold Open. If such a determination is made, the Health & Human Services Department will determine whether it wishes to proceed with a probable cause hearing or dispose of the matter in an alternative fashion. If a revocation is done, the following procedure is followed:
- Office of the Corporation Counsel receives a report of non-compliant behavior.
- Based on the merits of the report, the attorney will complete an Affidavit of Non-Compliance.
- The Affidavit will be taken to the Judge’s Office with an Order for Detention for review and signature.
- Once detained the subject will be taken to Bellin Psychiatric Center.
- Within 72 hours* of arrival (or the first available court date) the subject will have a probable cause hearing at the Brown County Mental Health Center on both the allegations in the Affidavit and the Original Statement of Emergency Detention.
- A final hearing will be held, if there has been a prior finding of probable cause, within 14 days of detention. The subject will have two independent examinations to determine the necessity of further hospitalization and a hearing will be held on the final commitment.
*72 hrs does not include weekends or holidays
8. Who should be contacted for what type of situation?
If you are in need of emergency assistance, call 911 immediately;
If you are in need of crisis assessment, contact the Crisis Center (920) 436-8888.
To report non-compliant behavior, contact your representative social worker, Amy Ricker, at 391-4734.