                                 CODE OF VIRGINIA

MANDATORY OUTPATIENT TREATMENT (§ 37.2-817.01)

A. Prior to ordering involuntary admission pursuant to &#xA7; 37.2-817, a judge
or special justice shall investigate and determine whether (i) mandatory
outpatient treatment is appropriate as a less restrictive alternative to
admission pursuant to subsection B or (ii) mandatory outpatient treatment
following a period of inpatient treatment is appropriate pursuant to subsection
C.

B. After observing the person and considering (i) the recommendations of any
treating or examining physician or psychologist licensed in Virginia, if
available, (ii) any past actions of the person, (iii) any past mental health
treatment of the person, (iv) any examiner&#8217;s certification, (v) any health
records available, (vi) the preadmission screening report, and (vii) any other
relevant evidence that may have been admitted, if the judge or special justice
finds by clear and convincing evidence that (a) the person has a mental illness
and that there exists a substantial likelihood that, as a result of mental
illness, the person will, in the near future, (1) cause serious physical 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 from harm or to provide for
his basic human needs, (b) 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, as
reflected in the initial outpatient treatment plan prepared in accordance with
subsection F, (c) the person has the ability to adhere to the mandatory
outpatient treatment plan, and (d) the ordered treatment will be delivered on an
outpatient basis by the community services board or designated provider to the
person, the judge or special justice shall by written order and specific
findings so certify and order that the person be admitted involuntarily to
mandatory outpatient treatment. Less restrictive alternatives shall not be
determined to be appropriate unless the services are actually available in the
community. The duration of mandatory outpatient treatment shall be determined by
the court based on recommendations of the community services board but shall not
exceed 180 days; in prescribing the terms of the order, including its length,
the judge or special justice shall consider the impact on the person&#8217;s
opportunities and obligations, including education and employment. Upon
expiration of an order for mandatory outpatient treatment, the person shall be
released from the requirements of the order unless the order is continued in
accordance with &#xA7; 37.2-817.4.

C. Upon finding by clear and convincing evidence that, in addition to the
findings described in subsection C of &#xA7; 37.2-817, (i) the person has a
history of lack of adherence to treatment for mental illness that has, at least
twice within the past 36 months, resulted in the person being subject to an
order for involuntary admission pursuant to subsection C of &#xA7; 37.2-817 or
being subject to a temporary detention order and then voluntarily admitting
himself in accordance with subsection B of &#xA7; 37.2-814, except that such
36-month period shall not include any time during which the person was receiving
inpatient psychiatric treatment or was incarcerated, as established by evidence
admitted at the hearing, (ii) in view of the person&#8217;s treatment history
and current behavior, the person is in need of mandatory outpatient treatment
following inpatient treatment in order to prevent a relapse or deterioration
that would be likely to result in the person meeting the criteria for
involuntary inpatient treatment, (iii) the person has the ability to adhere to
the comprehensive mandatory outpatient treatment plan, and (iv) the person is
likely to benefit from mandatory outpatient treatment, the judge or special
justice may order that, upon discharge from inpatient treatment, the person
adhere to a comprehensive mandatory outpatient treatment plan.
			The period of mandatory outpatient treatment shall begin upon discharge of
the person from involuntary inpatient treatment, either upon expiration of the
order for inpatient treatment pursuant to subsection C of &#xA7; 37.2-817 or
pursuant to &#xA7; 37.2-837 or 37.2-838. The duration of mandatory outpatient
treatment shall be determined by the court on the basis of recommendations of
the community services board, and the maximum period of mandatory outpatient
treatment shall not exceed 180 days; in prescribing the terms of the order,
including its length, the judge or special justice shall consider the impact on
the person&#8217;s opportunities and obligations, including education and
employment.
			The treating physician and facility staff shall develop the comprehensive
mandatory outpatient treatment plan in conjunction with the community services
board and the person. The comprehensive mandatory outpatient treatment plan
shall include all of the components described in, and shall be filed with the
court and incorporated into, the order for mandatory outpatient treatment
following a period of involuntary inpatient treatment in accordance with
subsection G. The community services board where the person resides upon
discharge shall monitor the person&#8217;s progress and adherence to the
comprehensive mandatory outpatient treatment plan. Upon expiration of the order
for mandatory outpatient treatment following a period of involuntary inpatient
treatment, the person shall be released unless the order is continued in
accordance with &#xA7; 37.2-817.4.

D. At any time prior to the discharge of a person who has been involuntarily
admitted pursuant to subsection C of &#xA7; 37.2-817, the person, the
person&#8217;s treating physician, a family member or personal representative of
the person, or the community services board serving the county or city where the
facility is located, the county or city where the person resides, or the county
or city where the person will receive treatment following discharge may file a
motion with the court for a hearing to determine whether such person should be
ordered to mandatory outpatient treatment following a period of inpatient
treatment upon discharge if such person, on at least two previous occasions
within 36 months preceding the date of the hearing, has been (i) involuntarily
admitted pursuant to subsection C of &#xA7; 37.2-817 or (ii) the subject of a
temporary detention order and voluntarily admitted himself in accordance with
subsection B of &#xA7; 37.2-814, except that such 36-month period shall not
include any time during which the person was receiving inpatient psychiatric
treatment or was incarcerated, as established by evidence admitted at the
hearing. A district court judge or special justice shall hold the hearing within
72 hours after receiving the motion for a hearing to determine whether the
person should be ordered to mandatory outpatient treatment following a period of
involuntary inpatient treatment; however, if the 72-hour period expires on a
Saturday, Sunday, or legal holiday, the hearing shall be held by the close of
business on the next day that is not a Saturday, Sunday, or legal holiday. The
district court judge or special justice may enter an order for a period of
mandatory outpatient treatment following a period of involuntary inpatient
treatment upon finding that the person meets the criteria set forth in
subsection C.

E. Mandatory outpatient treatment may include day treatment in a hospital, night
treatment in a hospital, outpatient involuntary treatment with antipsychotic
medication pursuant to Chapter 11 (&#xA7; 37.2-1100 et seq.), or other
appropriate course of treatment as may be necessary to meet the needs of the
person. Mandatory outpatient treatment shall not include the use of restraints
or physical force of any kind in the provision of the medication. The community
services board that serves the county or city in which the person resides shall
recommend a specific course of treatment and programs for the provision of
mandatory outpatient treatment.

F. Any order for mandatory outpatient treatment entered pursuant to subsection B
shall include an initial mandatory outpatient treatment plan developed by the
community services board that completed the preadmission screening report. 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 the person&#8217;s progress and
adherence to the initial mandatory outpatient treatment plan.

G. The community services board where the person resides that is responsible for
monitoring the person&#8217;s progress and adherence to the comprehensive
mandatory outpatient treatment plan shall file a comprehensive mandatory
outpatient treatment plan no later than five days, excluding Saturdays, Sundays,
or legal holidays, after an order for mandatory outpatient treatment has been
entered pursuant to subsection B. The community services board where the person
resides that is responsible for monitoring the person&#8217;s progress and
adherence to the comprehensive mandatory outpatient treatment plan shall file a
comprehensive mandatory outpatient treatment plan prior to discharging a person
to mandatory outpatient treatment pursuant to subsection C or D. The
comprehensive mandatory 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
included in the plan; (iii) certify that the services are the most appropriate
and least restrictive treatment available for the person; (iv) certify that each
provider has complied and continues to comply with applicable provisions of the
Department&#8217;s licensing regulations; (v) be developed with the fullest
possible involvement and participation of the person and his family, with the
person&#8217;s consent, and reflect his preferences to the greatest extent
possible to support his recovery and self-determination, including incorporating
any preexisting crisis plan or advance directive of the person; (vi) specify the
particular conditions to which the person shall be required to adhere; and (vii)
describe (a) how the community services board shall monitor the person&#8217;s
progress and adherence to the plan and (b) any conditions, including scheduled
meetings or continued adherence to medication, necessary for mandatory
outpatient treatment to be appropriate for the person. 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 entered pursuant to subsection B, C,
or D, as appropriate. A copy of the comprehensive mandatory outpatient treatment
plan shall be provided to the person by the community services board upon
approval of the comprehensive mandatory outpatient treatment plan by the court.

H. If the community services board responsible for developing a comprehensive
mandatory outpatient treatment plan pursuant to subsection B, C, or D determines
that the services necessary for the treatment of the person&#8217;s mental
illness are not available or cannot be provided to the person in accordance with
the order for mandatory outpatient treatment, it shall petition the court for
rescission of the mandatory outpatient treatment order or order for mandatory
outpatient treatment following a period of involuntary inpatient treatment in
accordance with the provisions of subsection D of &#xA7; 37.2-817.1.

I. Upon entry of any order for mandatory outpatient treatment pursuant to
subsection B or mandatory outpatient treatment following a period of involuntary
inpatient treatment pursuant to subsection C or D, the clerk of the court shall
provide a copy of the order to the person who is the subject of the order, to
his attorney, and to the community services board required to monitor the
person&#8217;s progress and adherence to the comprehensive mandatory outpatient
treatment 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 within five business days.

J. The court may transfer jurisdiction of the case to the district court where
the person resides at any time after the entry of the mandatory outpatient
treatment order. The community services board responsible for monitoring the
person&#8217;s progress and adherence to the comprehensive mandatory outpatient
treatment plan shall remain responsible for monitoring the person&#8217;s
progress and adherence to the plan until the community services board serving
the locality to which jurisdiction of the case has been transferred acknowledges
the transfer and 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. The community services board serving the
locality to which jurisdiction of the case has been transferred shall
acknowledge the transfer and receipt of the order within five business days.

K. Any order entered pursuant to this section shall provide for the disclosure
of medical records pursuant to &#xA7; 37.2-804.2. This subsection shall not
preclude any other disclosures as required or permitted by law.

HISTORY: 2022, c. 763.