House committee substitute makes the following changes to 1st edition. Amends GS 122C-3, adding gender-neutral language. Adds new definition (16a) for health screening. Changes the definition of incapable to have the same definition as that set forth in GS 122C-72(4). Amends definition of legally responsible person to refer to GS 122C-72(4) in defining incapable. Makes clarifying and technical changes to definition of outpatient treatment physician or center. Amends GS 122C-53(g), removing gender-neutral changes in two places to revert to the masculine pronoun. Amends GS 122C-54, amending subsection (c) for clarity. Restricts the records the treating facility may disclose to only those records gathered during the course of the current commitment or admission. Allows the facility to disclose, upon request, confidential information collected and used in treating the respondent during the current proceeding only. Further records may be disclosed only by court order. Amends subsection (d), including the respondent in the parties that may make a motion to access confidential records contained in the court file. Removes provision allowing the respondent to seek these records by written request to the court clerk. 

Amends GS 122C-55, removing the Community Care of North Carolina Program from the definition of Secretary. Makes clarifying changes to subsections (a2) and (a3).

Adds subsection (c1), allowing a facility to furnish confidential information to any sheriff upon request regarding any client of that facility who is confined in the county jail when the county jail medical unit has determined the inmate to be in need of treatment for mental illness, developmental disabilities, or substance abuse. Allows the sheriff to give a facility confidential information about inmates that the jail medical unit has treated if the inmate is presently seeking treatment from the requesting facility or the inmate has been involuntarily committed to the requesting facility. Allows this exchange of private and confidential patient information regardless of whether the person consents, and allows it to be shared even if the person objects. 

Amends GS 112C-117(a)(18), directing the area authority to develop and adopt community crisis services plans in accordance with GS 122C-202.2.

Amends GS 122C-202.2, which sets out requirements for each LME/MCO local area crisis services plan, with clarifying changes. Deletes content of subsubsection (a)(1) and replaces it with a requirement to incorporate in the local area crisis service plan the involuntary commitment transportation agreement adopted under GS 122C-251(g) for the local planning area. Deletes subsubsection (a)(2) and replaces it with a requirement to identify and contract with one or more facilities for the provision of health screenings and first examinations. Amends subsubsection (a)(3), allowing law enforcement officers to request to participate in the training program, rather than mandating participation to the extent possible. Makes other clarifying changes. Removes requirement that the LME/MCO identify training that includes a component for dialogue with consumers of mental health, developmental disabilities, and substance abuse services to the extent possible. Amends subsection (b), requiring that no plan be adopted unless it has first been agreed upon in writing by all entities identified in the plan. Directs the Secretary to attempt to resolve any conflicts if the plan is not agreed upon. Amends subsection (c), requiring mutual agreement of all identified entities for the plan to address other matters. 

Amends GS 122C-206 with conforming change. Removes provision for individuals with a health care power of attorney in the requirements for a facility to notify a client's legally responsible person in the event of a transfer between facilities. Makes clarifying change to subsection (e). Amends subsection (f1), adding requirement when a patient has been transferred to a crisis center from a 24-hour facility that the original facility must hold the client's room or bed for 12 hours, unless both facilities agree that return of the client at that time is not feasible. Creates exception to this requirement for facility-based crisis centers. Requires the original facility to accept return of the client in priority over other clients seeking admission, unless it is a patient designated incapable to proceed to trial by court order. 

Amends GS 122C-210.1, adding persons, and specifically law enforcement officers, to umbrella of immunity from liability provided. Removes requirement that the person or facility takes reasonable measures in good faith under the authority in this Article in order to be covered by immunity. Adds activities of management, supervision, treatment, and release to activities covered by immunity. 

Amends GS 122C-210.3, allowing electronic or facsimile delivery of custody order to persons required to provide transportation and custody. Amends GS 122C-211 with conforming change. Amends GS 122C-213, subsection (c), making an advance instruction for mental health treatment during voluntary admission of individuals determined to be incapable to be governed by GS Chapter 122C, Article 3, Part 2. Amends subsection (e) to clarify that this provision applies to voluntary admissions. Adds new provision that a 24-hour facility may file a petition for involuntary commitment pursuant to Article 5 of this Chapter if an individual meets applicable criteria at the conclusion of this 15-day period. 

Amends GS 122C-214(c), allowing a legally responsible professional to submit a written request to discharge an incapable person. Adds requirement that a request to discharge an incapable person must only be complied with if it is not inconsistent with a controlling document. 

Amends GS 122C-251 with conforming change. Clarifies that the duties in (a) apply to taking of physical custody. Includes transportation for a first examination in the duties of transportation provided by the county. Deletes provision requiring transportation for a first examination at a location described in GS 122C-263(a) or GS 122C-238(a) to be provided by the county where the respondent is taken into custody. Amends subsection (e), allowing the use of reasonable force and restraints if it appears necessary to protect the law enforcement officer, the respondent, or others. Removes requirement for law enforcement officer to use least restrictive and most reasonable restraint under the circumstances. Removes requirement for officer to afford the respondent as much dignity as circumstances permit. Removes requirement for officer's application of force or restraint to avoid aggravating or worsening the respondent's preexisting injuries or medical conditions to the extent feasible. Removes requirement for officer to consult a parent before restraining a child. Adds requirement to make every effort to avoid restraint of a child under 10 years old. Removes provision that these limitations do not apply to acute care hospitals or general hospitals. Requires cities and counties to adopt involuntary commitment transportation agreements. Makes clarifying changes and separates the subsection into subsubsections for clarity. Holds the county of residence of a person involuntarily committed financially responsible for their transportation, adding caveat for reimbursement from third-party insurer. 

Amends GS 122C-261, subsection (b), with clarifying change. Amends subsubsection (d)(3), deleting requirement that the LME/MCO determine whether the respondent is a client or eligible for its services and contact the outpatient treatment center when a commitment examiner recommends outpatient commitment. Removes allowance for an authorized person other than a police officer to take the respondent into custody when inpatient treatment is recommended. Amends subsubsection (d)(8), expanding legal immunity for those involved in handling an involuntary commitment by removing requirement for immunity that the person follows accepted professional judgment, standards, and practice. Amends subsection (e) with conforming change. Makes other technical changes. 

Amends GS 122C-262(g), clarifying that this statute applies only to an individual who is transported to an area facility or other place for an examination by a commitment examiner according to (a) of the statute.

Amends GS 122C-263 and GS 122C-283 with clarifying and conforming changes. Removes requirement that if no identified facility or acute care hospital is available, the transporter must transport the respondent to a commitment examiner at a private hospital or clinic or State facility for the mentally ill. Defines non-hospital provider. Removes provision for the patient to be transported to another location if there is no suitable professional to perform a health screening and commitment exam. Deletes section (a2), which provided for the ability to transport a patient to an acute care hospital for emergency medical treatment not available at the first site. Amends (d)(2), requiring the law enforcement officer to take a respondent found to be mentally ill and dangerous to self to a 24-hour facility upon notification, rather than without unnecessary delay. Adds provision that to the extent feasible in this situation the officer should act within six hours of notification. Makes other conforming changes. Modifies notice requirement for the examiner, in that examiner must give written notice rather than a phone call with a copy of the notice. 

Amends GS 122C-263.1, clarifying that a nurse practitioner seeking certification may hold a master's or higher level degree. 

Amends GS 122C-265 with conforming changes. Corrects spelling error. Deletes all amendments to GS 122C-266(a)(2). 

Amends GS 122C-271, removing condition that the designated outpatient treatment physician or center will be monitoring the respondent's outpatient commitment pursuant to a contract for services with the LME/MCO for the clerk of court to send a copy of the outpatient commitment order to the LME/MCO. Makes other clarifying changes.  

Amends GS 122C-276(c) with conforming changes. Amends GS 122C-281 to allow any person designated under GS 122C-251(g) to be permitted to complete the duties of a law enforcement officer. Expands immunity for individuals taking measures to temporarily detain an individual to complete a commitment examination by removing condition for immunity that the person follows accepted professional judgment, standards, and practice, so long as the commitment examiner has a reasonable and good-faith basis belief that detention pending the examination and issuance of a custody order is necessary to protect individuals from harm. 

Amends GS 122C-284, allowing the respondent to file a written waiver of notice themselves or through counsel. Amends GS 122C-285, requiring the qualified professional to provide a written summary in the event of a second commitment. Amends GS 122C-287, removing provision forbidding a court to order commitment to an area facility if the respondent is not eligible for services at the area facility through an LME/MCO or otherwise qualifies for the services. Modifies GS 122C-294 to require the local plan to be submitted to the Division of Mental Health by October 1, 2019. Amends GS 35A-1105, allowing a healthcare provider to petition for an adjudication of incompetence. Clarifies that legal counsel is not required for the petition. Amends GS 35A-1112, allowing for State and local human service agencies and health care providers to present evidence on such a petition without the need for legal counsel. 

Section 44, setting the deadlines by which LME/MCOs must submit their community crisis services plan to DHHS effective when it becomes law. Remainder of this act is effective October 1, 2019 (was, December 1, 2017), and applies to proceedings initiated on or after that date.