                                 CODE OF VIRGINIA

MANDATORY OUTPATIENT TREATMENT; CRITERIA; ORDERS (§ 16.1-345.2)

A. After observing the minor and considering (i) the recommendations of any
treating or examining physician or psychologist licensed in Virginia, if
available, (ii) any past actions of the minor, (iii) any past mental health
treatment of the minor, (iv) any evaluation of the minor, (v) any medical
records available, (vi) the preadmission screening report, and (vii) any other
relevant evidence that may have been admitted, the court shall order that the
minor be admitted involuntarily to mandatory outpatient treatment for a period
not to exceed 90 days if it finds, by clear and convincing evidence, that:

   1. Because of mental illness, the minor (i) presents a serious danger to
   himself or others to the extent that severe or irremediable injury is likely
   to result, as evidenced by recent acts or threats or (ii) is experiencing a
   serious deterioration of his ability to care for himself in a developmentally
   age-appropriate manner, as evidenced by delusionary thinking or by a
   significant impairment of functioning in hydration, nutrition,
   self-protection, or self-control;

   2. The minor is in need of compulsory treatment for a mental illness and is
   reasonably likely to benefit from the proposed treatment;

   3. Less restrictive alternatives to involuntary inpatient treatment that would
   offer an opportunity for improvement of his condition have been investigated
   and are determined to be appropriate;

   4. The minor, if 14 years of age or older, and his parents (i) have sufficient
   capacity to understand the stipulations of the minor&#8217;s treatment, (ii)
   have expressed an interest in the minor&#8217;s living in the community and
   have agreed to abide by the minor&#8217;s treatment plan, and (iii) are deemed
   to have the capacity to comply with the treatment plan and understand and
   adhere to conditions and requirements of the treatment and services; and

   5. The ordered treatment can be delivered on an outpatient basis by the
   community services board or a designated provider.
   				Less restrictive alternatives shall not be determined to be appropriate
   unless the services are actually available in the community and providers of
   the services have actually agreed to deliver the services.

B. Mandatory outpatient treatment may include day treatment in a hospital, night
treatment in a hospital, or other appropriate course of treatment as may be
necessary to meet the needs of the minor. The community services board serving
the area in which the minor resides shall recommend a specific course of
treatment and programs for the provision of mandatory outpatient treatment. Upon
expiration of an order for mandatory outpatient treatment, the minor shall be
released from the requirements of the order unless the order is continued in
accordance with &#xA7; 16.1-345.5.

C. Any order for mandatory outpatient treatment shall include an initial
mandatory outpatient treatment plan developed by the community services board
serving the area in which the minor resides. The plan shall, at a minimum, (i)
identify the specific services to be provided, (ii) identify the provider who
has agreed to provide each service, (iii) describe the arrangements made for the
initial in-person appointment or contact with each service provider, and (iv)
include any other relevant information that may be available regarding the
mandatory outpatient treatment ordered. The order shall require the community
services board to monitor the implementation of the mandatory outpatient
treatment plan and report any material noncompliance to the court.

D. No later than five business days after an order for mandatory outpatient
treatment has been entered pursuant to this section, the community services
board that is responsible for monitoring compliance with the order shall file a
comprehensive mandatory outpatient treatment plan. The comprehensive mandatory
outpatient treatment plan shall (i) identify the specific type, amount,
duration, and frequency of each service to be provided to the minor, (ii)
identify the provider that has agreed to provide each service included in the
plan, (iii) certify that the services are the most appropriate and least
restrictive treatment available for the minor, (iv) certify that each provider
has complied and continues to comply with applicable provisions of the
Department of Behavioral Health and Developmental Services&#8217; licensing
regulations, (v) be developed with the fullest involvement and participation of
the minor and his parents and reflect their preferences to the greatest extent
possible to support the minor&#8217;s recovery and self-determination, (vi)
specify the particular conditions with which the minor shall be required to
comply, and (vii) describe how the community services board shall monitor the
minor&#8217;s compliance with the plan and report any material noncompliance
with the plan. The minor shall be involved in the preparation of the plan to the
maximum feasible extent consistent with his ability to understand and
participate, and the minor&#8217;s family shall be involved to the maximum
extent consistent with the minor&#8217;s treatment needs. The community services
board shall submit the comprehensive mandatory outpatient treatment plan to the
court for approval. Upon approval by the court, the comprehensive mandatory
outpatient treatment plan shall be filed with the court and incorporated into
the order of mandatory outpatient treatment. Any subsequent substantive
modifications to the plan shall be filed with the court for review and attached
to any order for mandatory outpatient treatment.

E. If the community services board responsible for developing the comprehensive
mandatory outpatient treatment plan determines that the services necessary for
the treatment of the minor&#8217;s mental illness are not available or cannot be
provided to the minor in accordance with the order for mandatory outpatient
treatment, it shall notify the court within five business days of the entry of
the order for mandatory outpatient treatment. Within five business days of
receiving such notice, the judge, after notice to the minor, the minor&#8217;s
attorney, and the community services board responsible for developing the
comprehensive mandatory outpatient treatment plan, shall hold a hearing pursuant
to &#xA7; 16.1-345.4.

F. Upon entry of any order for mandatory outpatient treatment, the clerk of the
court shall provide a copy of the order to the minor who is the subject of the
order, his parents, his attorney, his guardian ad litem, and the community
services board required to monitor his compliance with the plan. The community
services board shall acknowledge receipt of the order to the clerk of the court
on a form established by the Office of the Executive Secretary of the Supreme
Court and provided by the court for this purpose.

G. After entry of any order for mandatory outpatient treatment if the court that
entered the order is not the juvenile and domestic relations district court for
the jurisdiction in which the minor resides, it shall transfer jurisdiction of
the case to the court where the minor resides.

HISTORY: 2009, cc. 455, 555; 2010, cc. 778, 825.