                                 CODE OF VIRGINIA

MONITORING AND COURT REVIEW OF MANDATORY OUTPATIENT TREATMENT (§ 37.2-817.1)

A. As used in this section, &#8220;material nonadherence&#8221; means deviation
from a comprehensive mandatory outpatient treatment plan by a person who is
subject to an order for mandatory outpatient treatment following a period of
involuntary inpatient treatment pursuant to subsection C or D of &#xA7;
37.2-817.01 or an order for mandatory outpatient treatment pursuant to
subsection B of &#xA7; 37.2-817.01 that it is likely to lead to the
person&#8217;s relapse or deterioration and for which the person cannot provide
a reasonable explanation.

B. The community services board where the person resides shall monitor the
person&#8217;s progress and adherence to the comprehensive mandatory outpatient
treatment plan prepared in accordance with &#xA7; 37.2-817.01. Such monitoring
shall include (i) contacting or making documented efforts to contact the person
regarding the comprehensive mandatory outpatient treatment plan and any support
necessary for the person to adhere to the comprehensive mandatory outpatient
treatment plan, (ii) contacting the service providers to determine if the person
is adhering to the comprehensive mandatory outpatient treatment plan and, in the
event of material nonadherence, if the person fails or refuses to cooperate with
efforts of the community services board or providers of services identified in
the comprehensive mandatory outpatient treatment plan to address the factors
leading to the person&#8217;s material nonadherence, petitioning for a review
hearing pursuant to this section. Service providers identified in the
comprehensive mandatory outpatient treatment plan shall report any material
nonadherence and any material changes in the person&#8217;s condition to the
community services board. Any finding of material nonadherence shall be based
upon a totality of the circumstances.

C. The community services board responsible for monitoring the person&#8217;s
progress and adherence to the comprehensive mandatory outpatient treatment plan
shall report monthly, in writing, to the court regarding the person&#8217;s and
the community services board&#8217;s compliance with the provisions of the
comprehensive mandatory outpatient treatment plan. If the community services
board determines that the deterioration of the condition or behavior of a person
who is subject to an order for mandatory outpatient treatment following a period
of involuntary inpatient treatment pursuant to subsection C or D of &#xA7;
37.2-817.01 or a mandatory outpatient treatment order pursuant to subsection B
of &#xA7; 37.2-817.01 is such that there is a substantial likelihood that, as a
result of the person&#8217;s mental illness, the person will, in the near
future, (i) 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 (ii) suffer serious harm due to his lack of capacity to
protect himself from harm or to provide for his basic human needs, it shall
immediately request that the magistrate issue an emergency custody order
pursuant to &#xA7; 37.2-808 or a temporary detention order pursuant to &#xA7;
37.2-809. Entry of an emergency custody order, temporary detention order, or
involuntary inpatient treatment order shall suspend but not rescind an existing
order for mandatory outpatient treatment following a period of involuntary
inpatient treatment pursuant to subsection C or D of &#xA7; 37.2-817.01 or a
mandatory outpatient treatment order pursuant to subsection B of &#xA7;
37.2-817.01.

D. The district court judge or special justice shall hold a hearing within five
days after receiving the petition for review of the comprehensive mandatory
outpatient treatment plan; however, if the fifth day is a Saturday, Sunday,
legal holiday, or day on which the court is lawfully closed, the hearing shall
be held by the close of business on the next day that is not a Saturday, Sunday,
legal holiday, or day on which the court is lawfully closed. The clerk shall
provide notice of the hearing to the person, the community services board, all
treatment providers listed in the comprehensive mandatory outpatient treatment
order or discharge plan, and the original petitioner for the person&#8217;s
involuntary treatment. If the person is not represented by counsel, the court
shall appoint an attorney to represent the person in this hearing and any
subsequent hearing under this section or § 37.2-817.4, giving consideration to
appointing the attorney who represented the person at the proceeding that
resulted in the issuance of the mandatory outpatient treatment order or order
for mandatory outpatient treatment following a period of involuntary inpatient
treatment. The same judge or special justice that presided over the hearing
resulting in the mandatory outpatient treatment order or order for mandatory
outpatient treatment following a period of involuntary inpatient treatment need
not preside at the nonadherence hearing or any subsequent hearings. The
community services board shall offer to arrange the person&#8217;s
transportation to the hearing if the person is not detained and has no other
source of transportation.
			Any of the following may petition the court for a hearing pursuant to this
subsection: (i) the person who is subject to the mandatory outpatient treatment
order or order for mandatory outpatient treatment following a period of
involuntary inpatient treatment; (ii) the community services board responsible
for monitoring the person&#8217;s progress and adherence to the mandatory
outpatient treatment order or order for mandatory outpatient treatment following
a period of involuntary inpatient treatment; (iii) a treatment provider
designated in the comprehensive mandatory outpatient treatment plan; (iv) the
person who originally filed the petition that resulted in the entry of the
mandatory outpatient treatment order or order for mandatory outpatient treatment
following a period of involuntary inpatient treatment; (v) any health care agent
designated in the advance directive of the person who is the subject of the
mandatory outpatient treatment order or order for mandatory outpatient treatment
following a period of involuntary inpatient treatment; or (vi) if the person who
is the subject of the mandatory outpatient treatment order or order for
mandatory outpatient treatment following a period of involuntary inpatient
treatment has been determined to be incapable of making an informed decision,
the person&#8217;s guardian or other person authorized to make health care
decisions for the person pursuant to § 54.1-2986.
			A petition filed pursuant to this subsection may request that the court do
any of the following:

   1. Enforce a mandatory outpatient treatment order or order for mandatory
   outpatient treatment following a period of involuntary inpatient treatment and
   require the person who is the subject of the order to adhere to the
   comprehensive mandatory outpatient treatment plan, in the case of material
   nonadherence;

   2. Modify a mandatory outpatient treatment order or order for mandatory
   outpatient treatment following a period of involuntary inpatient treatment or
   a comprehensive mandatory outpatient treatment plan due to a change in
   circumstances, including changes in the condition, behavior, living
   arrangement, or access to services of the person who is the subject to the
   order; or

   3. Rescind a mandatory outpatient treatment order or order for mandatory
   outpatient treatment following a period of involuntary inpatient treatment.
   				At any time after 30 days from entry of the mandatory outpatient treatment
   order pursuant to subsection B of &#xA7; 37.2-817.01 or from the discharge of
   the person from involuntary inpatient treatment pursuant to an order under
   subsection C or D of &#xA7; 37.2-817.01, the person may petition the court to
   rescind the order. The person shall not file a petition to rescind the order
   more than once during a 90-day period.

E. If requested in a petition filed pursuant to subsection D or on the
court&#8217;s own motion, the court may appoint an examiner in accordance with
&#xA7; 37.2-815 who shall personally examine the person on or before the date of
the review, as directed by the court, and certify to the court whether or not he
has probable cause to believe that the person meets the criteria for mandatory
outpatient treatment as specified in subsection B, C, or D of &#xA7;
37.2-817.01, as may be applicable. The examination shall include all applicable
requirements of &#xA7; 37.2-815. The certification of the examiner may be
admitted into evidence without the appearance of the examiner at the hearing if
not objected to by the person or his attorney. If the person is not incarcerated
or receiving treatment in an inpatient facility, the community services board
shall arrange for the person to be examined at a convenient location and time.
The community services board shall offer to arrange for the person&#8217;s
transportation to the examination if the person has no other source of
transportation and resides within the service area or an adjacent service area
of the community services board. If the person refuses or fails to appear, the
community services board shall notify the court, or a magistrate if the court is
not available, and the court or magistrate shall issue a mandatory examination
order and capias directing the primary law-enforcement agency in the
jurisdiction where the person resides to transport the person to the
examination. The person shall remain in custody until a temporary detention
order is issued or until the person is released, but in no event shall the
period exceed eight hours.

F. If the person fails to appear for the hearing, the court may, after
consideration of any evidence regarding why the person failed to appear at the
hearing, (i) dismiss the petition, (ii) issue an emergency custody order
pursuant to &#xA7; 37.2-808, or (iii) reschedule the hearing pursuant to
subsection D and issue a subpoena for the person&#8217;s appearance at the
hearing and enter an order for mandatory examination, to be conducted prior to
the hearing and in accordance with subsection E.

G. After observing the person and considering (i) the recommendations of any
treating or examining physician or psychologist licensed to practice in the
Commonwealth, if available, (ii) the person&#8217;s adherence to the
comprehensive mandatory outpatient treatment plan, (iii) any past mental health
treatment of the person, (iv) any examiner&#8217;s certification, (v) any health
records available, (vi) any report from the community services board, and (vii)
any other relevant evidence that may have been admitted at the hearing, the
judge or special justice shall make one of the following dispositions:

   1. In a hearing on any petition seeking enforcement of a mandatory outpatient
   treatment order, upon finding that continuing mandatory outpatient treatment
   is warranted, the court shall direct the person to fully comply with the
   mandatory outpatient treatment order or order for mandatory outpatient
   treatment following a period of involuntary inpatient treatment and may make
   any modifications to such order or the comprehensive mandatory outpatient
   treatment plan that are acceptable to the community services board or
   treatment provider responsible for the person&#8217;s treatment. In
   determining the appropriateness of the outpatient treatment specified in such
   order and the comprehensive mandatory outpatient treatment plan, the court may
   consider the person&#8217;s material nonadherence to the existing mandatory
   treatment order.

   2. In a hearing on any petition seeking modification of a mandatory outpatient
   treatment order or order for mandatory outpatient treatment following a period
   of involuntary inpatient treatment, upon a finding that (i) one or more
   modifications of the order would benefit the person and help prevent relapse
   or deterioration of the person&#8217;s condition, (ii) the community services
   board and the treatment provider responsible for the person&#8217;s treatment
   are able to provide services consistent with such modification, and (iii) the
   person is able to adhere to the modified comprehensive mandatory outpatient
   treatment plan, the court may order such modification of the mandatory
   outpatient treatment order or order for mandatory outpatient treatment
   following a period of involuntary inpatient treatment or the comprehensive
   mandatory outpatient treatment plan as the court finds appropriate.

   3. In a hearing on any petition filed to enforce, modify, or rescind a
   mandatory outpatient treatment order, upon finding that mandatory outpatient
   treatment is no longer appropriate, the court may rescind the order.

H. The judge or special justice may schedule periodic status hearings for the
purpose of obtaining information regarding the person&#8217;s progress while the
mandatory outpatient treatment order or order for mandatory outpatient treatment
following a period of involuntary inpatient treatment remains in effect. The
clerk shall provide notice of the hearing to the person who is the subject of
the order and the community services board responsible for monitoring the
person&#8217;s condition and adherence to the plan. The person shall have the
right to be represented by counsel at the hearing, and if the person does not
have counsel the court shall appoint an attorney to represent the person.
However, status hearings may be held without counsel present by mutual consent
of the parties. The community services board shall offer to arrange the
person&#8217;s transportation to the hearing if the person is not detained and
has no other source of transportation. During a status hearing, the treatment
plan may be amended upon mutual agreement of the parties. Contested matters
shall not be decided during a status hearing, nor shall any decision regarding
enforcement, rescission, or renewal of the order be entered.

HISTORY: 2008, cc. 850, 870; 2010, cc. 330, 461; 2021, Sp. Sess. I, c. 221;
2022, c. 763.