Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness)

There are all sorts of forms executors, beneficiaries, and probate court clerks have to fill out and correspond with during probate and estate settlement, including affidavits, letters, petitions, summons, orders, and notices.

Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) is a commonly used form within Kansas. Here’s an overview of what the form is and means, including a breakdown of the situations when (or why) you may need to use it:

This form is not one which will be prepared by counsel. It can be obtained only from a participating community mental health center. It will be provided only after the mental health reform screening process is completed by a Qualified Mental Health Professional employed at the center. It is documentation of the determination by the mental health center’s staff that locally available treatment resources are insufficient to meet the needs of that patient for the particularly identified services. No patient may be admitted to a state psychiatric hospital without first being screened at a participating local community mental health center and being provided this “ticket letter” form. This requirement is applicable to both voluntary and involuntary admissions. A copy of the form will be sent directly to the state hospital and staff from the mental health center will arrange and coordinate the admission.

Atticus Fast Facts About Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness)

Sometimes it’s tough to find a quick summary— here’s the important details you should know about Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness):

• This form pertains to the State of Kansas

• The relevant probate statute or Kansas laws related to this form include: K.S.A. 59-2946, K.S.A. 59-2949, K.S.A. 59-2953, K.S.A. 59-2954, K.S.A. 59-2957, K.S.A. 59-2958, K.S.A. 59-2959, K.S.A. 59-2961, K.S.A. 59- 2964, K.S.A. 59-2966, K.S.A. 59-2967, S. Ct. Rule 123

Government forms are not typically updated often, though when they are, it often happens rather quietly. While Atticus works hard to keep this information about Kansas’s Form 2105 - Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) up to date, certain details can change from time-to-time with little or no communication.

Step 1 - Download the correct Kansas form based on the name and ID if applicable

Double check that you have both the correct form name and the correct form ID. Some Kansas probate forms can look remarkably similar, so it’s best to double, even triple-check that you’re using the right one! Keep in mind that not all States have a standardized Form ID system for their probate forms.

Step 2 - Complete the Document

Fill out all relevant fields in Form 2105, take a break, and then review. Probate and estate settlement processes in KS are long enough to begin with, and making a silly error can push your timeline even farther back. No thank you!

Note: If you don’t currently know all of the answers and are accessing Form 2105 online, be sure to avoid closing the browser tab and potentially losing all your progress (or use a platform like Atticus to help avoid making mistakes).

Step 3 - Have Form 2105 witnessed or notarized (if required)

Some States and situations require particular forms to be notarized. If you have been instructed to get the document notarized or see it in writing on the document, then make sure to hire a local notary. There are max notary fees in the United States that are defined and set by local law. Take a look at our full guide to notary fees to make sure you aren’t overpaying or getting ripped off.

Step 4 - Submit Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) to the relevant office

This is most often the local probate court where the decedent (person who passed away) is domiciled (permanently resides) or the institution involved with this particular form (e.g. a bank). Some offices allow you to submit forms online, other’s don’t, and we while we generally recommend going in-person to expedite the process, sometimes that simply isn’t an option.

It’s also a generally good idea to establish a positive working relationship with any probate clerk (unfortunately there’s enough people & process out there making things more difficult and unnecessarily confusing for them), so a best practice is to simply ask the probate clerk proactively exactly how and where they’d prefer you to submit all forms.

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Different probate forms or processes can require different deadlines or response times for completing the appropriate form.

While some steps in the process are bound to specific deadlines (like petitioning for probate, having to submit an inventory of assets, or filing applicable notices to creditors and beneficiaries), many probate forms or processes are not tied to a specific deadline since the scope of work can vary based on situational factors or requirements involved.

Either way, there are a bunch of practical reasons why personal representatives should work to complete each step as thoroughly and quickly as possible when completing probate in Kansas.

5 reasons you should submit 2105 as quickly as possible:

1. The sooner you begin, the faster Kansas can allow heirs and beneficiaries to get their share of assets subject to probate. Acting promptly can also decrease the costs & overall mental fatigue through an otherwise burdensome process.
   
   Helpful Context: What’s the Difference Between Probate and Non-Probate Assets?

2. In general, creditors of an estate usually have around 3-6 months from the time you file notice to creditors to file any claims for debt against the deceased’s assets. If they don’t, then that debt is forfeited (and more importantly, the executor won’t be held personally responsible). So doing this sooner means you have a better idea of who is owed what and ensures you won’t get a surprise collector months later.

3. Not filing a will within 30 days (on average) could mean that the probate process proceeds according to intestate laws (laws that govern what happens to someone's stuff without a will) or is subject to unnecessary supervision by the probate court. And if you aren't directly related to the deceased (a.k.a. next of kin), this could also mean you lose your inheritance.

4. It’s important to file any necessary state tax returns on behalf of the deceased or estate by the following tax season in Kansas. If you don’t, you could owe penalties and interest. This also includes any necessary federal tax returns such as Forms 1040, 1041, or even a Form 706 estate tax return.

5. If a house in the State of Kansas is left empty (or abandoned) for a while, insurance can get dicey. For example, if the house burns down and no one has been there for a year, an insurance company may get out of paying your claim.

If you’re not using Atticus to get specific forms, deadlines, and timelines for Kansas probate, then try and stay as organized as possible, pay close attention to the dates mentioned in any correspondence you have with the State’s government officials, call the local Kansas probate clerk or court for exact answers regarding Form 2105, and when in doubt— consult a qualified trust & estates lawyer for that area.

Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) is one of the many probate court forms available for download through Atticus.

It may also be available through some Kansas probate court sites, such as . In order to access the latest version, be updated with any revisions, and get full instructions on how to complete each form, check out the Atticus Probate & Estate Settlement software or consider hiring a qualified legal expert locally within Kansas.

While Atticus automatically provides the latest forms, be sure to choose the correct version of Form 2105 - Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) f using any other site or resource in order to avoid having to re-complete the form process and/or make another trip to the Kansas probate court office.

Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness) is a .pdf, so opening it should be as simple as clicking “View Form” from within the Atticus app or by clicking the appropriate link found on any Kansas-provided government platform. Once you’ve opened the form, you should be able to directly edit the form before saving or printing.

Here’s the text, verbatim, that is found on Kansas Form 2105 - Statement From A Qualified Mental Health Professional Authorizing Admission To A State Psychiatric Hospital (Mental Illness). You can use this to get an idea of the context of the form and what type of information is needed.

2011 2100-14 Kansas Probate Forms 3d 2105 STATEMENT FROM A QUALIFIED MENTAL HEALTH PROFESSIONAL AUTHORIZING ADMISSION TO A STATE PSYCHIATRIC HOSPITAL RE: (name of patient) (year of birth) (age) (sex) (patient’s address) (city, state, zip) (county) Based upon my screening of the above named person, done by me in person and/ or by review of this person’s records and of reports concerning this person, and being familiar with the resources and services which are available within this community, I find that the needs of this person for the services indicated below cannot be adequately met in this community, and I therefore authorize that the following service(s) be provided at a state psychiatric hospital. CHECK EACH TYPE OF SERVICE AUTHORIZED: A.  VOLUNTARY care and treatment (which this person has indicated to me that he/she wishes to be admitted for and which I believe he/she has the capacity to consent to) (See K.S.A. 59-2949(a)) B. INVOLUNTARY care and treatment as specified below:  EMERGENCY or TEMPORARY DETENTION AND TREATMENT pursuant to K.S.A. 59-2954, or under the Court’s EX PARTE EMERGENCY CUSTODY ORDER (see K.S.A. 59-2958), or under the Court’s TEMPORARY CUSTODY ORDER (see K.S.A. 59-2959) if either are issued  MENTAL EVALUATION, including the examination(s) necessary to prepare the report to be submitted to the Court to assist in the trial of the issue of whether or not this person is a mentally ill person subject to involuntary commitment (see K.S.A. 59-2961)  INPATIENT CARE and TREATMENT as may be ordered by the Court in any ORDER OF CONTINUANCE AND REFERRAL (see K.S.A. 59- 2964) or ORDER FOR TREATMENT (see K.S.A. 59-2966), or ORDER FOR CONTINUED TREATMENT (see K.S.A. 59-2969(f)) 2011 2100-15 Kansas Probate Forms 3d (date) (signature of QMHP) (telephone no.) (CMHC address)  original to be filed with the Court (if involuntary proceedings)  copy to ________________________________ State Hospital  copy to ________________________________ CMHC (if courtesy screen) EMERGENCY ROOM /HOSPITAL TRANSFERS: If the patient has been taken to any emergency room of any community hospital, or is currently admitted to any inpatient department at any community hospital, medical consultations must have been completed prior to any transfer of the patient to any state psychiatric hospital and the treating physician at the community hospital and the physician on duty at the state hospital must concur that the patient is medically stable and that the state hospital is capable of managing the patient’s physical condition. (See 42 U.S.C. Sec. 1395dd) List below (1) the name of the local treating/emergency room physician and (2) the name of the physician on duty at the state hospital who has agreed to accept the transfer: (1) (2) Reference K.S.A. 59-2946, 59-2949, 59-2953, 59-2954, 59-2957, 59-2958, 59-2959, 59-2961, 59- 2964, 59-2966, 59-2967; S. Ct. Rule 123. Comment This form is not one which will be prepared by counsel. It can be obtained only from a participating community mental health center. It will be provided only after the mental health reform screening process is completed by a Qualified Mental Health Professional employed at the center. It is documentation of the determination by the mental health center’s staff that locally available treatment resources are insufficient to meet the needs of that patient for the particularly identified services. No patient may be admitted to a state psychiatric hospital without first being screened at a participating local community mental health center and being provided this “ticket letter” form. This requirement is applicable to both voluntary and involuntary admissions. A copy of the form will be sent directly to the state hospital and staff from the mental health center will arrange and coordinate the admission. If the admission is to be involuntary, and court proceedings are contemplated or have begun, an original “Statement from a Qualified Mental Health Professional Authorizing Admission to a State Psychiatric Hospital” must be filed with the court if the court is being asked to order treatment at any state psychiatric hospital. Care must be taken to insure that the statement authorizes the services contemplated. Since local services may be able to meet some, even though not all of the patient’s needs, the form sub-groups involuntary services into three areas: 1) emergency/ temporary services--for when the patient’s acute needs exceed community services resources; 2) 2011 2100-16 Kansas Probate Forms 3d the formal mental evaluation--which will become central to the proof of the case at trial; and 3) long term treatment provided after any initial emergency circumstances have passed. The mental health centers have the option, and have been given specific direction, to authorize the provision of services at a state psychiatric hospital only when staff can clearly determine that such services cannot reasonably be provided locally. Therefore, in particular cases, the center may not be in a position to authorize long term care, for example, at the onset of a case, but will need to defer that determination until the patient’s progress can be assessed after emergency care and treatment has been provided. Accordingly, during the course of a legal case, more than one “Statement from a Qualified Mental Health Professional Authorizing Admission to a State Psychiatric Hospital” may be required to be completed and filed with the court. For very long term care, new statements may be periodically required to be filed by the court even though a prior statement is on file authorizing long term care if the court determines that the prior statement may no longer be based on current conditions or is said to have become “stale with age.” At the end of the form is a place for recording the names of the physicians involved in satisfying federal law requirements with regard to emergency room to hospital or hospital to hospital transfers. While not germane to the Kansas Care and Treatment Act for Mentally Ill Persons, satisfaction of these federal requirements is separately necessary and included. See Form 504 for required cover sheets and information about the use of personal identifiers in pleadings.