14101200D Be it enacted by the General Assembly of Virginia: 1. That §§37.2-805, 37.2-813, 37.2-815, 37.2-817, 37.2-817.2, 37.2-817.3, and 37.2-817.4 of the Code of Virginia are amended and reenacted as follows: §37.2-805. Voluntary admission. Any state facility shall admit any person requesting admission
who has been (i) screened by the community services board or behavioral health
authority that serves the county or city where the person resides or, if
impractical, where the person is located, (ii) examined by a physician on the
staff of the state facility, and (iii) deemed by the board or authority and the
state facility physician to be in need of treatment, training, or habilitation
in a state facility. Upon motion of the 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 receives treatment, a
hearing shall be held prior to the release date of any person who has been the
subject of a temporary detention order and voluntarily admitted himself in
accordance with subsection B of §37.2-814 to determine whether such person
should be ordered to mandatory outpatient treatment pursuant to subsection D of §37.2-817 upon his release §37.2-813. Release of person prior to commitment hearing for involuntary admission. Prior to a hearing as authorized in §§37.2-814 through
37.2-819, the district court judge or special justice may release the person on
his personal recognizance or bond set by the district court judge or special
justice if it appears from all evidence readily available that the person does
not meet the commitment criteria specified in subsection §37.2-815. Commitment hearing for involuntary admission; examination required. A. Notwithstanding §37.2-814, the district court judge or special justice shall require an examination of the person who is the subject of the hearing by a psychiatrist or a psychologist who is licensed in Virginia by the Board of Medicine or the Board of Psychology and is qualified in the diagnosis of mental illness or, if such a psychiatrist or psychologist is not available, a mental health professional who (i) is licensed in Virginia through the Department of Health Professions as a clinical social worker, professional counselor, marriage and family therapist, psychiatric nurse practitioner, or clinical nurse specialist, (ii) is qualified in the assessment of mental illness, and (iii) has completed a certification program approved by the Department. The examiner chosen shall be able to provide an independent clinical evaluation of the person and recommendations for his placement, care, and treatment. The examiner shall (a) not be related by blood or marriage to the person, (b) not be responsible for treating the person, (c) have no financial interest in the admission or treatment of the person, (d) have no investment interest in the facility detaining or admitting the person under this chapter, and (e) except for employees of state hospitals, the U.S. Department of Veterans Affairs, and community service boards, not be employed by the facility. For purposes of this section, the term "investment interest" shall be as defined in §37.2-809. B. The examination conducted pursuant to this section shall be
a comprehensive evaluation of the person conducted in-person or, if that is not
practicable, by two-way electronic video and audio communication system as
authorized in §37.2-804.1. Translation or interpreter services shall be
provided during the evaluation where necessary. The examination shall consist
of (i) a clinical assessment that includes a mental status examination;
determination of current use of psychotropic and other medications; a medical
and psychiatric history; a substance use, abuse, or dependency determination;
and a determination of the likelihood that, as a result of mental illness, the
person will, in the near future, suffer serious harm due to his lack of
capacity to protect himself from harm or to provide for his basic human needs;
(ii) a substance abuse screening, when indicated; (iii) a risk assessment that
includes an evaluation of the likelihood that, as a result of mental illness,
the person will, in the near future, cause serious physical harm to himself or
others as evidenced by recent behavior causing, attempting, or threatening harm
and other relevant information, if any; (iv) an assessment of the person's
capacity to consent to treatment, including his ability to maintain and
communicate choice, understand relevant information, and comprehend the
situation and its consequences; (v) a review of the temporary detention
facility's records for the person, including the treating physician's
evaluation, any collateral information, reports of any laboratory or toxicology
tests conducted, and all admission forms and nurses' notes; (vi) a discussion
of treatment preferences expressed by the person or contained in a document
provided by the person in support of recovery; (vii) an assessment of whether
the person meets the criteria for an order authorizing discharge to mandatory
outpatient treatment following a period of inpatient treatment pursuant to
subsection C. All such examinations shall be conducted in private. The judge or special justice shall summons the examiner who shall certify that he has personally examined the person and state whether he has probable cause to believe that the person (i) has a mental illness and there is a substantial likelihood that, as a result of mental illness, the person will, in the near future, (a) 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 (b) suffer serious harm due to his lack of capacity to protect himself from harm or to provide for his basic human needs, and (ii) requires involuntary inpatient treatment. The judge or special justice shall not render any decision on the petition until the examiner has presented his report. The examiner may report orally at the hearing, but he shall provide a written report of his examination prior to the hearing. The examiner's written certification may be accepted into evidence unless objected to by the person or his attorney, in which case the examiner shall attend in person or by electronic communication. When the examiner attends the hearing in person or by electronic communication, the examiner shall not be excluded from the hearing pursuant to an order of sequestration of witnesses. §37.2-817. Involuntary admission and mandatory outpatient treatment orders. A. The district court judge or special justice shall render a decision on the petition for involuntary admission after the appointed examiner has presented the report required by §37.2-815, and after the community services board that serves the county or city where the person resides or, if impractical, where the person is located has presented a preadmission screening report with recommendations for that person's placement, care, and treatment pursuant to §37.2-816. These reports, if not contested, may constitute sufficient evidence upon which the district court judge or special justice may base his decision. The examiner, if not physically present at the hearing, and the treating physician at the facility of temporary detention shall be available whenever possible for questioning during the hearing through a two-way electronic video and audio or telephonic communication system as authorized in §37.2-804.1. B. Any employee or designee of the local community services board, as defined in §37.2-809, representing the community services board that prepared the preadmission screening report shall attend the hearing in person or, if physical attendance is not practicable, shall participate in the hearing through a two-way electronic video and audio or telephonic communication system as authorized in §37.2-804.1. Where a hearing is held outside of the service area of the community services board that prepared the preadmission screening report, and it is not practicable for a representative of the board to attend or participate in the hearing, arrangements shall be made by the board for an employee or designee of the board serving the area in which the hearing is held to attend or participate on behalf of the board that prepared the preadmission screening report. The employee or designee of the local community services board, as defined in §37.2-809, representing the community services board that prepared the preadmission screening report or attending or participating on behalf of the board that prepared the preadmission screening report shall not be excluded from the hearing pursuant to an order of sequestration of witnesses. The community services board that prepared the preadmission screening report shall remain responsible for the person subject to the hearing and, prior to the hearing, shall send the preadmission screening report through certified mail, personal delivery, facsimile with return receipt acknowledged, or other electronic means to the community services board attending the hearing. Where a community services board attends the hearing on behalf of the community services board that prepared the preadmission screening report, the attending community services board shall inform the community services board that prepared the preadmission screening report of the disposition of the matter upon the conclusion of the hearing. In addition, the attending community services board shall transmit the disposition through certified mail, personal delivery, facsimile with return receipt acknowledged, or other electronic means. At least 12 hours prior to the hearing, the court shall provide to the community services board that prepared the preadmission screening report the time and location of the hearing. If the representative of the community services board will be present by telephonic means, the court shall provide the telephone number to the board. C. 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's certification, (v)
any health records available, (vi) the preadmission screening report, and (vii)
any other relevant evidence that may have been admitted, including whether the
person recently has been found unrestorably incompetent to stand trial after a
hearing held pursuant to subsection E of §19.2-169.1, if the judge or special
justice finds by clear and convincing evidence that (a) the person has a mental
illness and there is 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, and (b) all available less restrictive treatment
alternatives to involuntary inpatient treatment, pursuant to subsection Upon the expiration of an order for involuntary admission, the person shall be released unless he is involuntarily admitted by further petition and order of a court, which shall be for a period not to exceed 180 days from the date of the subsequent court order, or such person makes application for treatment on a voluntary basis as provided for in §37.2-805 or is ordered to mandatory outpatient treatment pursuant to subsection D. D. Upon
motion of the 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 receives treatment, a hearing shall be held
prior to the release date of any involuntarily admitted person to determine
whether such person should be ordered to mandatory outpatient treatment If the judge or special justice further finds by clear and convincing evidence that (i) the person has a history of lack of compliance with treatment for mental illness and as a result of such noncompliance, on at least two previous occasions within 36 months preceding the date of the hearing, has been (a) involuntarily admitted pursuant to this section or (b) the subject of a temporary detention order and voluntarily admitted himself in accordance with subsection B of §37.2-814; (ii) in view of the person'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) as a result of mental illness, the person is unlikely to voluntarily participate in outpatient treatment unless the court enters an order authorizing discharge to mandatory outpatient treatment following inpatient treatment; (iv) the person has agreed to abide by his discharge plan and has the ability to do so; (v) the ordered treatment will be delivered on an outpatient basis by the community services board or designated provider to the person; and (vi) the person is likely to benefit from mandatory outpatient treatment; 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. When considering whether the person has a history of lack of compliance with treatment for mental illness as required by clause (i) of this subsection, the judge or special justice may consider any relevant hearsay evidence, any medical records available, or any other available information that the judge or special justice deems relevant to the determination. The duration of mandatory outpatient treatment shall be determined by the court based on recommendations of the community services board, but shall not exceed 90 days. A comprehensive mandatory outpatient treatment plan shall be filed in accordance with subsection J. Upon expiration of the order for mandatory outpatient treatment, the person shall be released unless the order is continued in accordance with §37.2-817.4.
The duration of mandatory outpatient treatment shall be determined by the court based on recommendations of the community services board, but shall not exceed 90 days. Upon expiration of the order for mandatory outpatient treatment, the person shall be released unless the order is continued in accordance with §37.2-817.4.
§37.2-817.2. Court review of mandatory outpatient treatment plan or discharge plan. A. The district court judge or special justice shall hold a hearing within five days after receiving the petition for review of the mandatory outpatient treatment plan or discharge plan; however, if the fifth day is 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. If the person is being detained under a temporary detention order, the hearing shall be scheduled within the same time frame provided for a commitment hearing under §37.2-814. 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'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 hearings under §§37.2-817.3 and 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 authorizing discharge to mandatory outpatient treatment following inpatient treatment. The same judge or special justice that presided over the hearing resulting in the mandatory outpatient treatment order or order authorizing discharge to mandatory outpatient treatment following inpatient treatment need not preside at the noncompliance hearing or any subsequent hearings. The community services board shall offer to arrange the person's transportation to the hearing if the person is not detained and has no other source of transportation. B. If requested by the person, the community services board, a
treatment provider listed in the comprehensive mandatory outpatient treatment
plan or discharge plan, or the original petitioner for the person's involuntary
treatment, the court shall appoint an examiner in accordance with §37.2-815
who shall personally examine the person and certify to the court whether or not
he has probable cause to believe that the person meets the criteria for
involuntary inpatient admission or mandatory outpatient treatment as specified
in subsections C, C. If the person fails to appear for the hearing, the court shall, after consideration of any evidence from the person, from the community services board, or from any treatment provider identified in the mandatory outpatient treatment plan or discharge plan regarding why the person failed to appear at the hearing, either (i) reschedule the hearing pursuant to subsection A, (ii) issue an emergency custody order pursuant to §37.2-808, or (iii) issue a temporary detention order pursuant to §37.2-809. D. After hearing the evidence regarding the person's material noncompliance with the mandatory outpatient treatment order or order authorizing discharge to mandatory outpatient treatment following inpatient treatment and the person's current condition, and any other relevant information referenced in subsection C of §37.2-817, the judge or special justice shall make one of the following dispositions: 1. Upon finding by clear and convincing evidence that the person meets the criteria for involuntary admission and treatment specified in subsection C of §37.2-817, the judge or special justice shall order the person's involuntary admission to a facility designated by the community services board for a period of treatment not to exceed 30 days; 2. Upon finding that the person continues to meet the criteria
for mandatory outpatient treatment specified in 3. Upon finding that neither of the above dispositions is appropriate, the judge or special justice shall rescind the order for mandatory outpatient treatment or order authorizing discharge to mandatory outpatient treatment following inpatient treatment. Upon entry of an order for involuntary inpatient admission, transportation shall be provided in accordance with §37.2-829. §37.2-817.3. Rescission of mandatory outpatient treatment order. A. If the community services board determines at any time prior to the expiration of the mandatory outpatient treatment order or order authorizing discharge to mandatory outpatient treatment following inpatient treatment that the person has complied with the order and no longer meets the criteria for involuntary treatment, or that continued mandatory outpatient treatment is no longer necessary for any other reason, it shall file a petition to rescind the order with the court that entered the order or to which venue has been transferred. If the court agrees with the community services board's determination, the court shall rescind the order. Otherwise, the court shall schedule a hearing and provide notice of the hearing in accordance with subsection A of §37.2-817.2. B. At any time after 30 days from entry of the mandatory
outpatient treatment order or from the discharge of the person from involuntary
inpatient treatment pursuant to an order authorizing discharge to mandatory
outpatient treatment following inpatient treatment, the person may petition the
court to rescind the order on the grounds that he no longer meets the criteria
for mandatory outpatient treatment as specified in subsection §37.2-817.4. Continuation of mandatory outpatient treatment order. A. At any time within 30 days prior to the expiration of a mandatory outpatient treatment order or order authorizing discharge to mandatory outpatient treatment following inpatient treatment, the community services board that is required to monitor the person's compliance with the order, the treating physician, or other responsible person may petition the court to continue the order for a period not to exceed 180 days. B. If the person who is the subject of the order and the monitoring community services board, if it did not initiate the petition, join the petition, the court shall grant the petition and enter an appropriate order without further hearing. If either the person or the monitoring community services board does not join the petition, the court shall schedule a hearing and provide notice of the hearing in accordance with subsection A of § 37.2-817.2. C. Upon receipt of the petition, the court shall appoint an examiner who shall personally examine the person pursuant to subsection B of § 37.2-815. The community services board required to monitor the person's compliance with the mandatory outpatient treatment order or order authorizing discharge to mandatory outpatient treatment following inpatient treatment shall provide a preadmission screening report as required in §37.2-816. D. If, after observing the person, reviewing the preadmission screening report and considering the appointed examiner's certification and any other relevant evidence, including any relevant evidence referenced in subsection D, E, or G of §37.2-817, the court shall make one of the dispositions specified in subsection D of §37.2-817.2. If the court finds that a continued period of mandatory outpatient treatment is warranted, it may continue the order for a period not to exceed 180 days. Any order of mandatory outpatient treatment that is in effect at the time a petition for continuation of the order is filed shall remain in effect until the disposition of the hearing. |