US  PATRICK’S ACT
A Bill to Establish National Standards for Early Intervention, Psychiatric Stabilization, Family Protections, and Continuity of Mental Health Care

SECTION 1. SHORT TITLE.
This Act may be cited as the “Patrick’s Act.”

SECTION 2. CONGRESSIONAL FINDINGS.
Congress finds that:

1.      Severe mental illness (SMI) is a brain-based medical condition requiring evidence-based treatment.

2.      Individuals declared incompetent to stand trial are frequently detained in correctional facilities awaiting psychiatric placement.

3.      Arbitrary insurance limitations interfere with medically necessary stabilization.

4.      Anosognosia is a neurologically recognized impairment affecting awareness of illness.

5.      Inadequate staffing, discharge planning, and continuity of care increase relapse and recidivism.

6.      Failure to recognize Medical Power of Attorney and psychiatric advance directives across jurisdictions creates preventable harm.

7.      Stable maintenance treatment is a medically recognized outcome in severe mental illness.

SECTION 3. EARLY INTERVENTION & CIVIL COMMITMENT GUIDANCE.
(a) Federal behavioral health funding incentives shall encourage states to include:

·        Grave disability,

·        Neurological deterioration,

·        Substantial psychiatric decline,

as qualifying criteria for intervention.

(b) Nothing in this section removes constitutional due process protections.

SECTION 4. RECOGNITION OF ANOSOGNOSIA.
(a) Anosognosia is recognized as a neurological impairment affecting awareness of illness.

(b) Documented anosognosia may be considered in:

·        Civil commitment determinations,

·        Assisted Outpatient Treatment eligibility,

·        Court-ordered stabilization.

SECTION 5. COMPETENCY TRANSFER STANDARD.
(a) Transfer to an appropriate psychiatric facility shall occur immediate of an incompetency adjudication.

(b) Annual reporting to the Secretary of Health and Human Services shall include average transfer times.

SECTION 6. ASSISTED OUTPATIENT TREATMENT (AOT).
(a) Federal grants shall incentivize statewide AOT implementation.

(b) Programs shall include:

·        Court supervision,

·        ACT teams,

·        Medication management,

·        Housing coordination,

·        Family inclusion when authorized.

SECTION 7. MEDICAL POWER OF ATTORNEY & ADVANCE DIRECTIVES.
(a) A Medical Power of Attorney executed in any U.S. state shall be recognized nationwide.

(b) Psychiatric advance directives shall remain enforceable during documented incapacity.

(c) Psychiatric inpatients shall be offered the opportunity to complete a psychiatric advance directive.

 

SECTION 8. CORRECTIONAL FAMILY NOTIFICATION REQUIREMENT.
Correctional facilities shall notify the legally designated Medical POA or emergency contact when an incarcerated individual:

·        Is hospitalized,

·        Is declared incompetent,

·        Is placed on suicide watch,

·        Experiences significant deterioration.

SECTION 9. JAIL-TO-COMMUNITY CONTINUITY PROGRAM.
Prior to release, individuals with SMI shall receive:

·        Psychiatric evaluation,

·        Confirmed outpatient appointment within 7 days,

·        Medication supply,

·        Housing assessment,

·        Medical record transfer,

·        Post-release case management for 30–90 days.

SECTION 10. NATIONAL PSYCHIATRIC STAFFING STANDARDS.
The Secretary of HHS shall establish minimum psychiatric staffing guidelines addressing:

·        Nurse-to-patient ratios,

·        Psychiatric-trained RN presence,

·        Behavioral health technician support,

·        Continuing education requirements.

SECTION 11. PATIENT SAFETY PROTECTIONS.
Facilities shall implement:

·        Crisis prevention training,

·        Trauma-informed care education,

·        Restraint and seclusion reduction standards,

·        Transparent reporting of serious incidents.

SECTION 12. DISCHARGE PLANNING STANDARDS.
Discharge shall require:

·        Clinical stabilization,

·        Verified outpatient follow-up within 7 days,

·        Medication continuity,

·        Housing and safety assessment,

·        Warm handoff to community providers.

 

SECTION 13. PROTECTION OF MEDICALLY NECESSARY ANTIPSYCHOTIC TREATMENT.
(a) A long-term care facility, nursing home, correctional facility, or healthcare provider may not discontinue a clinically effective antipsychotic medication solely due to:

·        Administrative reduction initiatives,

·        Facility-wide compliance quotas,

·        Cost-containment policies,

·        Blanket deprescribing protocols.

(b) Stability achieved through prescribed antipsychotic treatment shall be recognized as a legitimate clinical outcome.

(c) Prior to discontinuation or tapering:

·        A documented psychiatric reassessment must occur,

·        Relapse risk must be evaluated,

·        The Medical POA shall be notified when applicable,

·        Clinical justification must be recorded.

(d) Federal nursing facility regulations intended to prevent inappropriate use shall not be misapplied to individuals with diagnosed severe mental illness.

(e) Nothing in this section restricts individualized clinical judgment when medically appropriate.

SECTION 14. PRECISION PSYCHIATRY COVERAGE.
Federally regulated plans shall provide coverage for pharmacogenomic testing relevant to psychiatric medication metabolism when clinically indicated.

SECTION 15. MENTAL HEALTH PARITY ENFORCEMENT.
(a) Arbitrary psychiatric hospitalization caps are prohibited.

(b) Court-ordered treatment duration shall be honored by federally regulated insurers.

(c) Psychiatric authorization denial rates shall be publicly reported.

SECTION 16. IMPLEMENTATION & OVERSIGHT.
(a) The Secretary of HHS shall issue implementing regulations within 18 months.

(b) Annual compliance reports shall be submitted to Congress.

(c) Grant funding shall support state implementation.