37.2-817 - Involuntary admission and mandatory outpatient treatment orders.
§ 37.2-817. Involuntary admission and mandatory outpatient treatment orders.
A. The district court judge or special justice shall render a decision on thepetition for involuntary admission after the appointed examiner has presentedthe report required by § 37.2-815, and after the community services boardthat serves the county or city where the person resides or, if impractical,where the person is located has presented a preadmission screening reportwith recommendations for that person's placement, care, and treatmentpursuant to § 37.2-816. These reports, if not contested, may constitutesufficient evidence upon which the district court judge or special justicemay base his decision. The examiner, if not physically present at thehearing, and the treating physician at the facility of temporary detentionshall be available whenever possible for questioning during the hearingthrough a two-way electronic video and audio or telephonic communicationsystem as authorized in § 37.2-804.1.
B. Any employee or designee of the local community services board, as definedin § 37.2-809, representing the community services board that prepared thepreadmission screening report shall attend the hearing in person or, ifphysical attendance is not practicable, shall participate in the hearingthrough a two-way electronic video and audio or telephonic communicationsystem as authorized in § 37.2-804.1. Where a hearing is held outside of theservice area of the community services board that prepared the preadmissionscreening report, and it is not practicable for a representative of the boardto attend or participate in the hearing, arrangements shall be made by theboard for an employee or designee of the board serving the area in which thehearing is held to attend or participate on behalf of the board that preparedthe preadmission screening report. The employee or designee of the localcommunity services board, as defined in § 37.2-809, representing thecommunity services board that prepared the preadmission screening report orattending or participating on behalf of the board that prepared thepreadmission screening report shall not be excluded from the hearing pursuantto an order of sequestration of witnesses. The community services board thatprepared the preadmission screening report shall remain responsible for theperson subject to the hearing and, prior to the hearing, shall send thepreadmission screening report through certified mail, personal delivery,facsimile with return receipt acknowledged, or other electronic means to thecommunity services board attending the hearing. Where a community servicesboard attends the hearing on behalf of the community services board thatprepared the preadmission screening report, the attending community servicesboard shall inform the community services board that prepared thepreadmission screening report of the disposition of the matter upon theconclusion of the hearing. In addition, the attending community servicesboard shall transmit the disposition through certified mail, personaldelivery, facsimile with return receipt acknowledged, or other electronicmeans.
At least 12 hours prior to the hearing, the court shall provide to thecommunity services board that prepared the preadmission screening report thetime and location of the hearing. If the representative of the communityservices board will be present by telephonic means, the court shall providethe telephone number to the board.
C. After observing the person and considering (i) the recommendations of anytreating or examining physician or psychologist licensed in Virginia, ifavailable, (ii) any past actions of the person, (iii) any past mental healthtreatment of the person, (iv) any examiner's certification, (v) any healthrecords available, (vi) the preadmission screening report, and (vii) anyother relevant evidence that may have been admitted, if the judge or specialjustice finds by clear and convincing evidence that (a) the person has amental illness and there is a substantial likelihood that, as a result ofmental illness, the person will, in the near future, (1) cause seriousphysical harm to himself or others as evidenced by recent behavior causing,attempting, or threatening harm and other relevant information, if any, or(2) suffer serious harm due to his lack of capacity to protect himself fromharm or to provide for his basic human needs, and (b) all available lessrestrictive treatment alternatives to involuntary inpatient treatment,pursuant to subsection D, that would offer an opportunity for the improvementof the person's condition have been investigated and determined to beinappropriate, the judge or special justice shall by written order andspecific findings so certify and order that the person be admittedinvoluntarily to a facility for a period of treatment not to exceed 30 daysfrom the date of the court order. Such involuntary admission shall be to afacility designated by the community services board that serves the city orcounty in which the person was examined as provided in § 37.2-816. If thecommunity services board does not designate a facility at the commitmenthearing, the person shall be involuntarily admitted to a facility designatedby the Commissioner. Upon the expiration of an order for involuntaryadmission, the person shall be released unless he is involuntarily admittedby further petition and order of a court, which shall be for a period not toexceed 180 days from the date of the subsequent court order, or such personmakes application for treatment on a voluntary basis as provided for in §37.2-805 or is ordered to mandatory outpatient treatment pursuant tosubsection D.
C1. In the order for involuntary admission, the judge or special justice mayauthorize the treating physician to discharge the person to mandatoryoutpatient treatment not to exceed the length of such order under a dischargeplan developed pursuant to subsection C2, if the judge or special justicefurther finds by clear and convincing evidence that (i) the person has ahistory of lack of compliance with treatment for mental illness that at leasttwice within the past 36 months has resulted in the person being subject toan order for involuntary admission pursuant to subsection C; (ii) in view ofthe person's treatment history and current behavior, the person is in need ofmandatory outpatient treatment following inpatient treatment in order toprevent a relapse or deterioration that would be likely to result in theperson meeting the criteria for involuntary inpatient treatment; (iii) as aresult of mental illness, the person is unlikely to voluntarily participatein outpatient treatment unless the court enters an order authorizingdischarge to mandatory outpatient treatment following inpatient treatment;and (iv) the person is likely to benefit from mandatory outpatient treatment.
C2. Prior to discharging the person to mandatory outpatient treatment under adischarge plan as authorized pursuant to subsection C1 of this section, thetreating physician shall determine, based upon his professional judgment,that (1) the person (a) in view of the person's treatment history and currentbehavior, no longer needs inpatient hospitalization, (b) requires mandatoryoutpatient treatment at the time of discharge to prevent relapse ordeterioration of his condition that would likely result in his meeting thecriteria for involuntary inpatient treatment, (c) has sufficient capacity tounderstand the stipulations of his treatment, (d) has expressed an interestin living in the community and has agreed to abide by his discharge plan, (e)is deemed to have the capacity to comply with the discharge plan andunderstand and adhere to conditions and requirements of the treatment andservices, and (f) the ordered treatment can be delivered on an outpatientbasis by the community services board or designated provider; and (2) at thetime of discharge, services are actually available in the community andproviders of services have actually agreed to deliver the services. In noevent shall the treating physician discharge a person to mandatory outpatienttreatment under a discharge plan as authorized pursuant to subsection C1 ifthe person meets the criteria for involuntary commitment set forth insubsection C. The discharge plan developed by the treating physician andfacility staff in conjunction with the community services board and theperson shall serve as and shall contain all the components of thecomprehensive mandatory outpatient treatment plan set forth in subsection G,and no initial mandatory outpatient treatment plan set forth in subsection Fshall be required. The discharge plan shall be submitted to the court forapproval and, upon approval by the court, shall be filed and incorporatedinto the order entered pursuant to subsection C1. The discharge plan shall beprovided to the person by the community services board at the time of theperson's discharge from the inpatient facility. The community services boardwhere the person resides upon discharge shall monitor the person's compliancewith the discharge plan and report any material noncompliance to the court inaccordance with § 37.2-817.1.
D. After observing the person and considering (i) the recommendations of anytreating or examining physician or psychologist licensed in Virginia, ifavailable, (ii) any past actions of the person, (iii) any past mental healthtreatment of the person, (iv) any examiner's certification, (v) any healthrecords available, (vi) the preadmission screening report, and (vii) anyother relevant evidence that may have been admitted, if the judge or specialjustice finds by clear and convincing evidence that (a) the person has amental illness and that there exists a substantial likelihood that, as aresult of mental illness, the person will, in the near future, (1) causeserious physical harm to himself or others as evidenced by recent behaviorcausing, attempting, or threatening harm and other relevant information, ifany, or (2) suffer serious harm due to his lack of capacity to protecthimself from harm or to provide for his basic human needs; (b) lessrestrictive alternatives to involuntary inpatient treatment that would offeran opportunity for improvement of his condition have been investigated andare determined to be appropriate; and (c) the person (A) has sufficientcapacity to understand the stipulations of his treatment, (B) has expressedan interest in living in the community and has agreed to abide by histreatment plan, and (C) is deemed to have the capacity to comply with thetreatment plan and understand and adhere to conditions and requirements ofthe treatment and services; and (d) the ordered treatment can be delivered onan outpatient basis by the community services board or designated provider,the judge or special justice shall by written order and specific findings socertify and order that the person be admitted involuntarily to mandatoryoutpatient treatment. Less restrictive alternatives shall not be determinedto be appropriate unless the services are actually available in the communityand providers of the services have actually agreed to deliver the services.
E. Mandatory outpatient treatment may include day treatment in a hospital,night treatment in a hospital, outpatient involuntary treatment withanti-psychotic medication pursuant to Chapter 11 (§ 37.2-1100 et seq.), orother appropriate course of treatment as may be necessary to meet the needsof the person. The community services board that serves the city or county inwhich the person resides shall recommend a specific course of treatment andprograms for the provision of mandatory outpatient treatment. The duration ofmandatory outpatient treatment shall be determined by the court based onrecommendations of the community services board, but shall not exceed 90days. Upon expiration of an order for mandatory outpatient treatment, theperson shall be released from the requirements of the order unless the orderis continued in accordance with § 37.2-817.4.
F. Any order for mandatory outpatient treatment entered pursuant tosubsection D shall include an initial mandatory outpatient treatment plandeveloped by the community services board that completed the preadmissionscreening report. The plan shall, at a minimum, (i) identify the specificservices to be provided, (ii) identify the provider who has agreed to provideeach service, (iii) describe the arrangements made for the initial in-personappointment or contact with each service provider, and (iv) include any otherrelevant information that may be available regarding the mandatory outpatienttreatment ordered. The order shall require the community services board tomonitor the implementation of the mandatory outpatient treatment plan andreport any material noncompliance to the court.
G. No later than five days, excluding Saturdays, Sundays, or legal holidays,after an order for mandatory outpatient treatment has been entered pursuantto subsection D, the community services board where the person resides thatis responsible for monitoring compliance with the order shall file acomprehensive mandatory outpatient treatment plan. The comprehensivemandatory outpatient treatment plan shall (i) identify the specific type,amount, duration, and frequency of each service to be provided to the person,(ii) identify the provider that has agreed to provide each service includedin the plan, (iii) certify that the services are the most appropriate andleast restrictive treatment available for the person, (iv) certify that eachprovider has complied and continues to comply with applicable provisions ofthe Department's licensing regulations, (v) be developed with the fullestpossible involvement and participation of the person and his family, with theperson's consent, and reflect his preferences to the greatest extent possibleto support his recovery and self-determination, (vi) specify the particularconditions with which the person shall be required to comply, and (vii)describe how the community services board shall monitor the person'scompliance with the plan and report any material noncompliance with the plan.The community services board shall submit the comprehensive mandatoryoutpatient treatment plan to the court for approval. Upon approval by thecourt, the comprehensive mandatory outpatient treatment plan shall be filedwith the court and incorporated into the order of mandatory outpatienttreatment. Any subsequent substantive modifications to the plan shall befiled with the court for review and attached to any order for mandatoryoutpatient treatment.
H. If the community services board responsible for developing thecomprehensive mandatory outpatient treatment plan determines that theservices necessary for the treatment of the person's mental illness are notavailable or cannot be provided to the person in accordance with the orderfor mandatory outpatient treatment, it shall notify the court within fivebusiness days of the entry of the order for mandatory outpatient treatment.Within two business days of receiving such notice, the judge or specialjustice, after notice to the person, the person's attorney, and the communityservices board responsible for developing the comprehensive mandatoryoutpatient treatment plan shall hold a hearing pursuant to § 37.2-817.2.
I. Upon entry of any order for mandatory outpatient treatment enteredpursuant to subsection D, the clerk of the court shall provide a copy of theorder to the person who is the subject of the order, to his attorney, and tothe community services board required to monitor compliance with the plan.The community services board shall acknowledge receipt of the order to theclerk of the court on a form established by the Office of the ExecutiveSecretary of the Supreme Court and provided by the court for this purpose.
J. The court may transfer jurisdiction of the case to the district courtwhere the person resides at any time after the entry of the mandatoryoutpatient treatment order. The community services board responsible formonitoring compliance with the mandatory outpatient treatment plan ordischarge plan shall remain responsible for monitoring the person'scompliance with the plan until the community services board serving thelocality to which jurisdiction of the case has been transferred acknowledgesthe transfer and receipt of the order to the clerk of the court on a formestablished by the Office of the Executive Secretary of the Supreme Court andprovided by the court for this purpose.
K. Any order entered pursuant to this section shall provide for thedisclosure of medical records pursuant to § 37.2-804.2. This subsection shallnot preclude any other disclosures as required or permitted by law.
(1976, c. 671, § 37.1-67.3; 1979, c. 426; 1980, cc. 166, 582; 1982, c. 471;1984, c. 277; 1985, c. 261; 1986, cc. 349, 609; 1988, c. 225; 1989, c. 716;1990, cc. 59, 60, 728, 798; 1991, c. 636; 1992, c. 752; 1994, cc. 736, 907;1995, cc. 489, 668, 844; 1996, cc. 343, 893; 1997, cc. 558, 921; 1998, c.446; 2001, cc. 478, 479, 507, 658, 837; 2004, cc. 66, 1014; 2005, cc. 458,716; 2008, cc. 779, 780, 782, 793, 850, 870; 2009, cc. 21, 838; 2010, cc.330, 461.)