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seg 6–1405. Diagnosis and inpatient treatment
*(a) A patient in a detoxification center shall be encouraged, on his first stay, to consent to an intensive diagnosis for possible alcoholism and to treatment at the inpatient and outpatient facilities provided for under section 6-1403 (b) and (c) of this chapter. Any person may voluntary request admission to this inpatient center, and no person committed under section (–1407 shall take precedence over a person who voluntarily requests admission unless he is found by a court to endanger the public safety. The medical officer in charge of the inpatient center is authorized to determine who shall be admitted as a patient. A complete medical, social, occupational and family history shall be obtained as part of the diagnosis and classification at the inpatient center, and an effort shall also be made to obtain copies of all pertinent records from other agencies, institutions, and medical facilities in order to develop a complete and permanent history on each patient. A person who has previously been diagnosed and treated at the inpatient center may again be admitted for further diagnosis and treatment at the discretion of the medical officer in charge of the center.
“(b) If a patient is not diagnosed as a chronic alcoholic he shall be so informed. An attempt shall be made to utilize appropriate preventive techniques, such as educating him about the seriousness of the illness and the dangers of excessive consumption of alcoholic beverages.
*(C) If a patient is diagnosed as a chronic alcoholic he shall be so informed. If he consents, intensive treatment for the illness shall begin immediately at the inpatient center while a comprehensive plan is being made for his future outpatient treatment.
"(d) No patient may be detained at the inpatient center without his consent except under the provisions of section 6–1407 of this chapter, Provided, That reasonable regulations for checking out of the center and for providing transportation may be adopted by the Bureau. Once a patient has checked out of the center against medical advice he may be readmitted at the discretion of the medical officer in charge of the center, and he may not be denied readmission because he left against medical advice. "96-1406. Outpatient and aftercare treatment
"(a) A chronic alcoholic shall be encouraged to consent to outpatient and aftercare treatment for his illness at the types of facilities provided for under section 6-1403(c) of this chapter. Any person may voluntarily request admission to outpatient treatment. The medical officer in charge of the outpatient treatment is authorized to determine who shall be admitted to such treatment. There shall be one central outpatient treatment office, to be open 24 hours every day, which shall coordinate the operation of all outpatient facilities, and particularly shall be responsble for locating residential facilities for indigent inebriates and alcoholics.
"(b) Because of the nature and seriousness of the disease, a chronic alcoholic must be expected to relapse into intoxication one or more times after the onset of therapy. No alcoholic shall be dropped from outpatient treatment because of such relapses, but all reasonable methods of treatment should be used to prevent their recurrence.
"(c) There are some chronic alcoholics for whom recovery is unlikely. For these, voluntary supportive services and residential facilities shall be provided so that they may survive in a decent manner.
“(d) The Bureau of Alcoholism Control shall be responsible, through its outpatient treatment programs, for coordinating all public and private community efforts, including but not limited to welfare services, vocational rehabilitation, and job placement, to integrate chronic alcoholics back into society as productive citizens.
"(e) No patient shall be required to participate in outpatient treatment without his consent except under the provisions of section 6–1407 of this chapter, Provided, That reasonable requirements may be placed upon such a person as conditions for his participation in such treatment. Once a patient has withdrawn from outpatient treatment against medical advice he may be readmitted at the discretion of the medical officer in charge of outpatient treatment, and he may not be denied readmission because he withdrew against medical advice. "§ 6–1407. Civil commitment
“(a) A judge of the District of Columbia Court of General Sessions may, on a petition of the Corporation Counsel on behalf of the Bureau of Alcoholism Control, filed and heard before the 72-hour period of detention for detoxifica
tion expires, order a person to be temporarily committed to the Bureau for inpatient treatment and care for a period not to exceed 30 days from the date of admission to a detoxification center if, sitting without a jury, he deterinines that the person (1) is a chronic alcoholic, and (2) as a result of chronic or acute intoxication is in immediate danger of substantial physical harm.
“(b) The courts in the District of Columbia are authorized and directed to take judicial notice of the facts set out in this chapter and to exercise their judicial responsibilities in a manner onsistent with them. The courts may, in their discretion, commit to the Bureau for treatment and care for up to a specified period of time a chronic alcoholic who:
“(1) is charged with a crime and who, prior to trial, voluntarily requests such treatment in lieu of criminal prosecution; or
“(2) is charged with a crime and is acquitted on the ground of chronic alcoholism; or
“(3) is convicted of a violation of section 25-128 of the D.C. Code and is found to be a continuing danger to the safety of other persons;
“(4) Provided, that no term of commitment shall be ordered for a period longer than the maximum sentence that could have been imposed for the
crime for which he was charged. "(c) Prior to the commitment of any person under subsection (b) the court shall, after diagnosis by the Bureau of Alcoholism Controi, hold a civil hearing without a jury and must make the following findings:
“(1) The person is a chronic alcoholic; and
“(2) Commitment for treatment has a substantial possibility for success for the person; and
“(3) Adequate and appropriate treatment is available to the Bureau for the person; and
"(4) In the case of a person described in subsection (b)(3), he constitutes a continuing danger to the safety of other persons. "(d) The Bureau shall immediately inform the court whenever any one of the findings required by subsection (c) is no longer applicable, and the court shall order the person released. A committed person may also challenge by a petition for a writ of habeas corpus the applicability of such findings, except that no more than one such petition may be filed in any six-month period.
“(e) Provided, that no chronic alcoholic shall fail to be committed under subsection (c), and no person shall be released from commitment under subsection (d), if he is found to constitute a danger to the safety of other persons if the Bureau has made a good faith attempt to comply with subsection (c)(3), but the likelihood that a person may become intoxicated and exhibit the usual characteristics of an inebriate does not constitute a threat to the safety of other persons.
“(f) The Bureau may transfer a committed person who has been adjudged a continuing danger to the safety of other persons from inpatient to outpatient status only with court permission. The Bureau may transfer any other committed person from inpatient to outpatient status, and any committed persons from outpatient to inpatient status, without court dermission, but may not release a committed person without court permission. The Bureau shall make every reasonable effort to place a committed person on outpatient treatment. and to return him to the court with a recommendation for release, as quickly as is consistent with sound medical practice and with the safety of other persons.
"(g) If the respondent in any proceeding under this chapter does not have an attorney and cannot afford one, the court shall appoint one to represent him. "§ 6–1408. This chapter inapplicable to the mentally ill
"Chronic alcoholism is not to be regarded as a form of mental illness. The provisions of this chapter shall apply to chronic alcoholics who have not been determined to be mentally ill. The handling of a chronic alcoholic who is also mentally ill shall be governed by the provisions of chapter 5 of title 21 of the D.C. Code. "S 6–1409. Retention of civil rights and liberties
"Any person treated under the provisions of this chapter shall retain his civil rights and liberties, including but not limited to the right not to be experimented upon with treatment not accepted as good medical practice with his fully informed consent, the right as an ill person to refuse treatment for an ailment that presents no danger to the safety of other persons, the right as a patient to maintain the confidentiality of health and medical records, the right as a per.
son detained for medical purposes to receive adequate and appropriate treatment, and the right to vote. "g 6-1410. Contract with other agencies
"The Commissioners of the District of Columbia may contract with any appropriate public or private agency, organization, or institution that has proper and adequate treatment facilities, programs, and personnel, in order to carry out the purposes of this chapter. "6–1411. Alcoholism policy for District of Columbia employees
“(a) The Bureau of Alcoholism Control shall be responsible for developing and maintaining, in cooperation with other District of Columbia agencies and departments, an enlightened policy and appropriate programs for the prevention and treatment of alcoholism and the rehabilitation of alcoholics among District of Columbia employees consistent with the intent of this chapter. Employees of the District of Columbia afflicted with alcoholism shall not be punished or penalized, but shall instead retain the same employment benefits as other persons afflicted with serious illnesses while undergoing rehabilitative treatment, and shall not lose pension, retirement, or medical rights, in order to prevent the development of a more serious alcoholism problem in the District of Columbia.
(b) The Bureau shall also be responsible for fostering such alcoholism rehabilitation programs in private industry in the District of Columbia. "56-1412. Alcoholism program in Department of Corrections
"The Bureau of Alcoholism Control shall be responsible for establishing and maintaining, in cooperation with the Department of Corrections, a program for the prevention and treatment of alcoholism and the rehabilitation of alcoholics in correctional institutions. "g 6-1413. Alcoholism program for juveniles
“Because of the increasing public concern about intemperance, intoxication, and incipient alcoholism among juveniles, the Bureau of Alcoholism Control shall be responsible for establishing and maintaining, in cooperation with the schools, the police, the courts, and other public agencies, an effective program for the prevention of intemperance and alcoholism, and the treatment and rehabilitation of incipient alcoholics, among juveniles and young adults. "g 6-1414. Reports of the Bureau
“(a) The Bureau of Alcoholism Control shall submit an annual report to the director of public health, which shall be forwarded to the Commissioners and sball be made public.
"1b) The Bureau shall maintain a continuing evaluation of its programs and shall conduct pilot and demonstration projects to improve its programs, and shall from time to time submit to the director of public health and to the Commissioners such recommendations as will further the rehabilitation of chronic alcoholics, prevent the excessive and abusive use of alcoholic beverages, and promote moderation.
"(c) The Bureau shall prepare and publish materials, data, information, and statistics that relate to the problems of intoxication and alcoholism in the District of Columbia and that may be used in a program of public education directed toward the prevention of the excessive and abusive use of alcoholic beverages. "86–1415. Alcoholism advisory and consulting committees
“(a) The Commissioners shall appoint an alcoholism advisory committee, to consist of five prominent residents of the Washington metropolitan area who have knowledge of and an interest in the subject of alcoholism, to advise and consult with them and to assist them in carrying out the provisions of this ebapter. This committee shall be maintained as a separate advisory committee, with responsibilities solely in the field of alcoholism, and shall not be consolidated into or become attached to any committee with other responsibilities. The members of the committee shall serve without compensation for terms of five years, staggered so that one vacancy occurs each year. The committee shall meet at regular intervals with the Commissioners and representatives of the Bureau of Alcoholism Control, the judiciary, the Departments of Corrections, Probation, Vocational Rehabilitation, and Public Welfare, the Board of Parole, and such other agencies as may become involved in a total community effort to control intoxication and alcoholism.
"(b) Upon the recommendation of the alcoholism advisory committee, the chairman of that committee shall appoint one or more technical consulting committees from experts throughout the country to assist in making certain that the District of Columbia has the best possible programs for alcoholism care and control.”
TITLE IV-EFFECTIVE DATE
SEC. 402. Title III of this Act shall become effective no later than three months from the date of enactment of this Act.
(H.R. 7327, by Mr. Adams, 90th Cong., ist sess.]
TITLE VIII-INTOXICATED PERSONS
SEC. 801. It is hereby declared to be the policy of Congress that persons who are intoxicated in the District of Columbia shall not be subject to arrest unless they are conducting themselves in a manner which endangers the safety of other persons or property. Absent any danger to other persons or property, persons who are intoxicated may be taken into protective custody by law enforcement officers or by personnel of the District of Columbia Department of Public Health and detained until they are no longer intoxicated. It is further the policy of the Congress that the detention of intoxicated persons who are taken into protective custody shall not be considered arrests and shall not be denoted as arrests in any records.
SEC. 802. (a) Subsection (a) of section 28 of the District of Columbia Alcoholic Beverage Control Act approved January 24, 1934 (48 Stat. 319, 333) as amended (D.C. Code, section 25–128(a)), is amended by striking the second sentence and inserting in lieu thereof the following: "No person, whether in or on public or private property, shall be intoxicated and endanger the safety of any other person or of property."
(b) Subsection (b) of section 28 (D.C. Code, section 25–128(b)) is amended by striking “this section” and inserting in lieu thereof “subsection (a)”.
(c) Section 28 is further amended by adding the following subsections :
"(c) Any person who is intoxicated (1) in or on public property, or (2) in any vehicle, whether in or on public or private property, or (3) in any place to which the public is invited, but is not conducting himself in such manner as to endanger the safety of another person or of property, may be taken into protective custody by a law enforcement officer or by an agent of the District of Columbia Department of Public Health. A person so taken into protective custody shall be transported to a facility staffed and equipped to provide appropriate medical services, where he shall be detained until he is no longer intoxicated.
"(d) An appropriate record shall be made of the detention of any person under the authority of subsection (c) but such detention shall not be considered to be an arrest or be recorded as such."
SEC. 803. This title shall become effective on August 1, 1967, or, if enacted after that date, on the date of enactment.
STAFF MEMORANDUM ON H.R. 6143 In 1965 the District of Columbia Court of Appeals held that an alcoholic may not be found guilty of public intoxication. (Easter v. District of Columbia, 209 A 2d 625, reviewed en banc by the U.S. Court of Appeals, 361 F20 50, March 31, 1966.)
There were 44,218 intoxication arrests in the District in 1966. As of March 14th, 1967, 4,080 persons have been adjudicated alcoholics by the District of Columbia Court of General Sesisons since the Easter decision a year ago.
Public health facilities of the District, which are presently in operation, are (1) the inpatient Alcoholic Rehabilitation Clinic, with 425 beds, at Occoquan, Virginia; (2) an outpatient center in the District, serving approximately 500 persons monthly; and (3) the Area C Mental Health Clinic at D.C. General Hospital with 35 beds and outpatient services. Several mission-type operations in the District can take care of approximately 450 alcoholics.
PURPOSE OF PROPOSED BIT.L
TITLE I declares findings and sets out the purpose of the bill.
TITLE III repeals the alcoholic rehabilitation program under penal institutions and creates a program for prevention of alcoholism and rehabilitation of alcoholics under public health.
Three types of facilities are to be established, none to be located with a correctional institution :
1. Detoxification centers, in D.C., minimum 200 beds; 2. In patient treatment center, minimum 500 beds;
3. Outpatient and aftercare centers, in D.C., minimum 2,000 beds. The Detoxification centers will take care of intoxicated persons who enter voluntarily or who are brought in by police or health officials. If not under criminal charge, the patient shall be released after a maximum 72-hour period; if charged, he shall be kept no longer than 96 hours, and shall be either treated as in a criminal case or certified to the Court as requiring further treatment.
Inpatient facilities will treat patients who enter voluntarily or who are under authorized civil commitment, not in exces of 30 days or for a period not in excess or the maximum sentence which might be imposed in the event of criminal prosecution. Court permission is required for transfer or release, except for transfer of voluntary patients from inpatient to outpatient care.
Outpatient and aftercare treatment shall include clinics, social centers, vocational and rehabilitation services, and supportive residential facilities (hotels and halfway houses). Services will be rendered to persons entering voluntarily or under court order.
The bill also provides that the court may appoint counsel for patients; that this program shall not apply to mentally ill persons or deprive one of civil rights and liberties; and that coordinated programs of preventive and rehabilitational nature shall be instituted. An Alcoholism Advisory Committee, with supporting consultants, is authorized.
H.R. 7327 (the so-called Administration crime bill) codifies the Easter decision. (Title VIII).
Public drunkeness is a misdemeanor punishable by maximum fine of $100, 90 days or both ($ 25–128).
(Adjudicated alcoholics are either released or committed to the Workhouse, the Alcoholic Rehabilitation Clinic, D.C. General Hospital, or Glenn Dale Hospital.)
Rehabilitation of alcoholics is authorized and directed by Title 24, Chapter 5, providing for medical evaluation, treatment of chronic alcoholics, commitment and discharge.
Funds derived from percentage of licensing fees for manufacture or sale of alcoholic beverages ($ 25–111a) are earmarked for rehabilitation program under Title 24.
Commissioners' Estimate: $15 million initial capital outlay, $4 million anually thereafter.
Mr. Dowdy. Mr. Hagan, we will be glad to hear from you as our first witness.
STATEMENT OF HON. G. ELLIOTT HAGAN, REPRESENTATIVE IN
CONGRESS FROM THE STATE OF GEORGIA
Mr. HAGAN. Thank you very much, Mr. Chairman. First, let me thank you for taking up at this time the community alcohol care and control in the Nation's Capital.
To my knowledge this is the first Congressional hearing to be devoted exclusively to this problem in the District of Columbia in two decades. We may hope that out of the testimony and information given the Subcommittee, will come positive legislation action toward the care and treatment of chronic inebriates, as well as the control of the disease of alcoholism, in our National Capital community.