PROPOSED
HOUSE OF REPRESENTATIVES AMENDMENTS TO S.B. 1510
(Reference to Senate engrossed bill)
Strike everything after the enacting clause and insert:
"Section 1. Section 13-4501, Arizona Revised Statutes, is amended to read:
13-4501. Definitions
In this chapter, unless the context otherwise requires:
1. "Clinical liaison" means a mental health expert or any other individual who has experience and training in mental health or developmental disabilities and who is qualified and appointed by the court to aid in coordinating the treatment or training of individuals who are found incompetent to stand trial. If intellectual disability is an issue, the clinical liaison shall be an expert in intellectual disabilities.
2. "Dangerous" means, except as used in paragraph 7 of this section, a threat to public safety and is likely, as a result of a mental illness, defect or disability, to commit an act of violence or cause serious physical injury to another person.
2. 3. "Incompetent
to stand trial" means that as a result of a mental illness, defect or
disability a defendant is unable to understand the nature and object of the proceeding
or to assist in the defendant's defense. In the case of a person
under eighteen years of age when the issue of competency is raised, incompetent
to stand trial also means a person who does not have sufficient present ability
to consult with the person's lawyer with a reasonable degree of rational
understanding or who does not have a rational and factual understanding of the
proceedings against the person. The presence of a mental illness,
defect or disability alone is not grounds for finding a defendant incompetent
to stand trial.
3. 4. "Mental
health expert" means a physician who is licensed pursuant to title 32,
chapter 13 or 17 or a psychologist who is licensed pursuant to title 32,
chapter 19.1 and who is:
(a) Familiar with this state's competency standards and statutes and criminal and involuntary commitment statutes.
(b) Familiar with the treatment, training and restoration programs that are available in this state.
(c) Certified by the court as meeting court developed guidelines using recognized programs or standards.
4. 5. "Mental
illness, defect or disability" means a psychiatric or neurological
disorder that is evidenced by behavioral or emotional symptoms, including
congenital mental conditions, conditions resulting from injury or disease and
developmental disabilities as defined in section 36‑551.
6. "secure mental health facility" means a licensed facility under the supervision of the superintendent of the Arizona state hospital.
5. 7. "Threat to public
safety" means charged with the commission of any of the following:
(a) A crime involving the discharge, use or threatening exhibition of a deadly weapon or dangerous instrument or the infliction of physical injury on another person.
(b) A dangerous crime against children pursuant to section 13‑705.
(c) Two or more nondangerous felonies within a period of twenty‑four months.
Sec. 2. Section 13-4503, Arizona Revised Statutes, is amended to read:
13-4503. Request for competency examination; request for sexually violent person screening
A. At any time after the prosecutor charges a criminal offense by complaint, information or indictment, any party or the court on its own motion may request in writing that the defendant be examined to determine the defendant's competency to stand trial, to enter a plea or to assist the defendant's attorney. The motion shall state the facts on which the mental examination is sought.
B. Within three working days after a motion is filed pursuant to this section, the parties shall provide all available medical and criminal history records to the court.
C. The court may request that a mental health expert assist the court in determining if reasonable grounds exist for examining a defendant.
D. Once any court determines that reasonable grounds exist for further competency proceedings, the superior court shall have exclusive jurisdiction over all competency hearings.
E. If the defendant is charged with a sexually violent offense as defined in section 36‑3701 and the county attorney requests a screening, the court may order a screening of the defendant to determine if the defendant is a sexually violent person.
Sec. 3. Section 13-4505, Arizona Revised Statutes, is amended to read:
13-4505. Appointment of experts; costs
A. If the court determines pursuant to section 13‑4503
that reasonable grounds exist for a competency examination, the court shall
appoint two or more mental health experts to examine the defendant, issue a
report and, if necessary, testify regarding the defendant's competency. The
court, on its own motion or upon on motion of any party, may
order that one of the mental health experts appointed shall be a physician
specializing in psychiatry and licensed pursuant to title 32, chapter 13 or
17. The state and the defendant, upon on approval of the court,
may stipulate to the appointment of only one expert.
B. The court may order the defendant to submit to physical, neurological or psychological examinations, if necessary, to adequately determine the defendant's mental condition.
C. If the court has ordered a screening of the defendant to determine if the defendant is a sexually violent person, one of the mental health experts appointed by the court shall be a competent professional as defined in section 36-3701. If that expert determines that the defendant is incompetent to stand trial and not restorable to competency within twenty-one months, the expert shall determine whether the defendant may be a sexually violent person.
C. D. The court
shall order the defendant to pay the costs of the court ordered examination,
except that if the court finds the defendant is indigent or otherwise unable to
pay all or any part of the costs or if the prosecution requested the
examination, the court shall order the county to pay the costs of the
examination or, if the case is referred by a municipal court judge, the court
shall order the city to pay the costs of the examination.
D. E. This section
does not prohibit any party from retaining its own expert to conduct any
additional examinations at its own expense.
E. F. A person who
is appointed as a mental health expert or clinical liaison is entitled to
immunity, except that the mental health expert or clinical liaison may be
liable for intentional, wanton or grossly negligent acts that are done in the
performance of the expert's or liaison's duties.
Sec. 4. Section 13-4508, Arizona Revised Statutes, is amended to read:
13-4508. Privilege against self-incrimination; sealed reports
A. The privilege against self‑incrimination applies to any examination that is ordered by the court pursuant to this chapter.
B. Any evidence or statement that is obtained during an examination is not admissible at any proceeding to determine a defendant's guilt or innocence unless the defendant presents evidence that is intended to rebut the presumption of sanity.
C. Any statement made by the defendant during an examination or any evidence resulting from that statement concerning any other event or transaction is not admissible at any proceeding to determine the defendant's guilt or innocence of any other criminal charges that are based on those events or transactions, except that a statement or evidence may be used by any party in a hearing to determine if the defendant is eligible for commitment pursuant to section 13‑4518.
D. Any statement made by the defendant or any part of the evaluations that is obtained during an examination may not be used for any purpose without the written consent of the defendant or the defendant's guardian or a court order that is entered by the court that ordered the examination or that is conducting a dependency or severance proceeding.
E. After a plea of guilty or guilty except insane or the trial or after the defendant is found to be unable to be restored to competence, the court shall order all the reports submitted pursuant to this section sealed. The court may order that the reports be opened only as follows:
1. For use by the court or defendant, or by the prosecutor if otherwise permitted by law, for further competency or sanity evaluations or in a hearing to determine whether the defendant is dangerous and eligible for commitment pursuant to section 13‑4518 or eligible for court ordered treatment pursuant to title 36, chapter 5.
2. For statistical analysis.
3. When the records are deemed necessary to assist in mental health treatment pursuant to section 13‑502 or 13‑4517.
4. For use by the probation department or the state department of corrections if the defendant is in the custody of or is scheduled to be transferred into the custody of the state department of corrections for the purposes of assessment and supervision or monitoring of the defendant by that department.
5. For use by a mental health treatment provider that provides treatment to the defendant or that assesses the defendant for treatment.
6. For data gathering.
7. For scientific study.
F. Any statement made by the defendant during an examination that is conducted pursuant to this chapter or any evidence resulting from that statement is not subject to disclosure pursuant to section 36‑509.
Sec. 5. Section 13-4509, Arizona Revised Statutes, is amended to read:
13-4509. Expert's report
A. An expert who is appointed pursuant to section 13‑4505 shall submit a written report of the examination to the court within ten working days after the examination is completed. The report shall include at least the following information:
1. The name of each mental health expert who examines the defendant.
2. A description of the nature, content, extent and results of the examination and any test conducted and of any instrument or tool used to assess whether the defendant is likely to be dangerous.
3. The facts on which the findings are based.
4. An opinion as to the competency of the defendant.
B. If the mental health expert determines that the defendant is incompetent to stand trial, the report shall also include the following information:
1. The nature of the mental disease, defect or disability that is the cause of the incompetency.
2. The defendant's prognosis.
3. The nature of the mental health disorder, disease or defect or of any personality or other disorder that makes the defendant likely to be dangerous or a sexually violent person.
3. 4. The most
appropriate form and place of treatment in this state, based on the defendant's
therapeutic needs and potential threat to public safety.
4. 5. Whether the
defendant is incompetent to refuse treatment and should be subject to
involuntary treatment.
6. If the prognosis includes a determination as to whether there is no substantial probability that the defendant will regain competency within twenty-one months after the date of the original finding of incompetency, whether the defendant should be considered dangerous or may be a sexually violent person.
C. If the mental health examiner determines that the defendant is currently competent by virtue of ongoing treatment with psychotropic medication, the report shall address the necessity of continuing that treatment and shall include a description of any limitations that the medication may have on competency.
Sec. 6. Section 13-4515, Arizona Revised Statutes, is amended to read:
13-4515. Duration of order; excluded time calculation; notice of dismissed charge or voided order; petitions
A. An order or combination of orders that is issued pursuant to section 13‑4512 or 13‑4514 shall not be in effect for more than twenty‑one months or the maximum possible sentence the defendant could have received pursuant to section 13‑702, section 13‑703, section 13‑704, subsection A, B, C, D or E, section 13‑705, section 13‑706, subsection A, section 13‑708, subsection D or section 13‑751 or any section for which a specific sentence is authorized, whichever is less. In making this determination the court shall not consider the sentence enhancements under section 13‑703 or 13-704 for prior convictions.
B. The court shall only consider the time a defendant actually spends in a restoration to competency program when calculating the time requirements pursuant to subsection A of this section.
C. The court shall notify the prosecutor, the
defense attorney, the medical supervisor and the treating facility if the
charges against the defendant are dismissed or if an order is voided by the
court. No charges shall be dismissed without a hearing prior to before the dismissal.
D. If a defendant is discharged or released on the
expiration of an order or orders issued pursuant to section 13‑4512 or 13‑4514,
the medical supervisor may file a petition stating that the defendant requires
further treatment pursuant to title 36, chapter 5, or
appointment of a guardian pursuant to title 14 or involuntary commitment pursuant to section 13‑4518
because the defendant is dangerous.
Sec. 7. Section 13-4517, Arizona Revised Statutes, is amended to read:
13-4517. Incompetent defendants; disposition
A. If the court finds that a defendant is incompetent to stand trial and that there is no substantial probability that the defendant will regain competency within twenty‑one months after the date of the original finding of incompetency, any party may request that the court:
1. Remand the defendant to the custody of the department of health services for the institution of civil commitment proceedings pursuant to title 36, chapter 5 and order the prosecutor to file a petition for evaluation and provide any known criminal history for the defendant.
2. Appoint a guardian pursuant to title 14, chapter 5.
3. Release the defendant from custody and dismiss the charges against the defendant without prejudice.
4. Hold a hearing to determine if the defendant is dangerous and should be involuntarily committed pursuant to section 13-4518.
B. If the court enters an order pursuant to subsection a, paragraph 1, 2 or 4 of this section, the court may also order an assessment of the defendant's eligibility for private insurance or public benefits that may be applied to the expenses of the defendant's medically necessary maintenance and treatment, including services pursuant to title 36, chapter 29, state‑only behavioral health services, title xviii services and medicare part d prescription drug benefits, supplemental security income and supplemental security disability income.
C. the court may retain jurisdiction over the defendant until the defendant is committed for treatment pursuant to title 36, chapter 5 or a guardian is appointed pursuant to title 14, chapter 5.
D. If the court remands the defendant to the custody of the department of health services for the institution of civil commitment proceedings pursuant to title 36, chapter 5 and the court is notified that the defendant has not had a civil commitment evaluation, the court shall order the sheriff to take the defendant into custody so that the court may explore options pursuant to subsection A, paragraph 2 or 3 of this section. If the defendant is out of custody, the court may order that the defendant be taken into custody for a disposition pursuant to this section.
E. If a mental health expert has determined that the defendant may be a sexually violent person, the mental health expert shall provide the report to the prosecuting agency so that the prosecuting agency may file a petition pursuant to section 36‑3702.
Sec. 8. Title 13, chapter 41, Arizona Revised Statutes, is amended by adding section 13-4518, to read:
13-4518. Dangerous and incompetent defendants; commitment hearing; disposition
A. If an incompetent defendant is found to be not restorable to competency, the state may request a hearing to determine if the defendant is dangerous and should be involuntarily committed.
B. If there has not been a previous evaluation to determine whether the defendant is dangerous, the defendant shall be examined by mental health experts in the same manner prescribed in section 13‑4505 to determine if the defendant should be considered dangerous.
C. At a hearing to determine if the defendant is dangerous the state shall establish by clear and convincing evidence that the defendant is dangerous and that the defendant committed the acts that constitute the charged offense. If the court does not find the defendant is dangerous, the court shall proceed pursuant to section 13-4517, subsection A, paragraph 1, 2 or 3.
D. If the court finds that the defendant is dangerous, the court shall order the defendant to be committed to a secure state mental health facility licensed by the department of health services or the joint commission on accreditation of health care organizations. The defendant shall receive education, care, supervision and treatment to render the defendant either competent or nondangerous.
E. if the court issues a commitment order pursuant to this section:
1. all further proceedings for the defendant's continued treatment and the circumstances under which the defendant may be released shall be conducted pursuant to title 36, chapter 40.
2. the order shall require that the defendant remain committed to the custody of the secure state mental health facility until any of the following occurs:
(a) the court finds that the defendant is competent to stand trial.
(b) the court finds that the defendant is no longer dangerous.
(c) the expiration of a period of time equal to either the sentence the defendant would have received if the defendant had been sentenced pursuant to section 13-751 or the presumptive sentence for all other offenses.
F. The court shall retain jurisdiction over a defendant who is committed pursuant to this section until the court discharges the defendant from treatment.
G. If a defendant is involuntarily committed pursuant to this section, the director of the department of health services shall determine the extent to which the defendant is receiving or is eligible to receive private or public benefits that may be applied to the expenses of the defendant's maintenance and treatment that are medically necessary, including federal and state medicaid, arizona health care cost containment system monies and regional behavioral health care authority monies. The department may accept these monies without a court order. The department is responsible for all remaining costs associated with the commitment.
Sec. 9. Section 36-501, Arizona Revised Statutes, is amended to read:
36-501. Definitions
In this chapter, unless the context otherwise requires:
1. "Administration" means the Arizona health care cost containment system administration.
2. "Admitting officer" means a psychiatrist or other physician or psychiatric and mental health nurse practitioner with experience in performing psychiatric examinations who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency.
3. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital.
4. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person.
5. "Court" means the superior court in the county in this state in which the patient resides or was found before screening or emergency admission under this title.
6. "Criminal history" means police reports, lists of prior arrests and convictions, criminal case pleadings and court orders, including a determination that the person has been found incompetent to stand trial pursuant to section 13‑4510.
6. 7. "Danger to others" means that the judgment of a person who has a mental disorder is so impaired that the person is unable to understand the person's need for treatment and as a result of the person's mental disorder the person's continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm.
7. 8. "Danger to self":
(a) Means behavior that, as a result of a mental disorder:
(i) Constitutes a danger of inflicting serious physical harm on oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual's previous acts, it is substantially supportive of an expectation that the threat will be carried out.
(ii) Without hospitalization will result in serious physical harm or serious illness to the person.
(b) Does not include behavior that establishes only the condition of having a grave disability.
8. 9. "Department" means the department of health services.
9. 10. "Detention" means the taking into custody of a patient or proposed patient.
10. 11. "Director" means the director of the administration.
11. 12. "Evaluation" means:
(a) A professional multidisciplinary analysis that may include firsthand observations or remote observations by interactive audiovisual media and that is based on data describing the person's identity, biography and medical, psychological and social conditions carried out by a group of persons consisting of not less than the following:
(i) Two licensed physicians, who shall be qualified psychiatrists, if possible, or at least experienced in psychiatric matters, and who shall examine and report their findings independently. The person against whom a petition has been filed shall be notified that the person may select one of the physicians. A psychiatric resident in a training program approved by the American medical association or by the American osteopathic association may examine the person in place of one of the psychiatrists if the resident is supervised in the examination and preparation of the affidavit and testimony in court by a qualified psychiatrist appointed to assist in the resident's training, and if the supervising psychiatrist is available for discussion with the attorneys for all parties and for court appearance and testimony if requested by the court or any of the attorneys.
(ii) Two other individuals, one of whom, if available, shall be a psychologist and in any event a social worker familiar with mental health and human services that may be available placement alternatives appropriate for treatment. An evaluation may be conducted on an inpatient basis, an outpatient basis or a combination of both, and every reasonable attempt shall be made to conduct the evaluation in any language preferred by the person.
(b) A physical examination that is consistent with the existing standards of care and that is performed by one of the evaluating physicians or by or under the supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15 if the results of that examination are reviewed or augmented by one of the evaluating physicians.
12. 13. "Evaluation agency" means a health care agency that is licensed by the department and that has been approved pursuant to this title, providing those services required of such agency by this chapter.
13. 14. "Family member" means a spouse, parent, adult child, adult sibling or other blood relative of a person undergoing treatment or evaluation pursuant to this chapter.
14. 15. "Grave disability" means a condition evidenced by behavior in which a person, as a result of a mental disorder, is likely to come to serious physical harm or serious illness because the person is unable to provide for the person's own basic physical needs.
15. 16. "Health care decision maker" has the same meaning prescribed in section 12‑2801.
16. 17. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority under contract with the administration.
17. 18. "Health care provider" means a health care institution as defined in section 36‑401 that is licensed as a behavioral health provider pursuant to department rules or a mental health provider.
18. 19. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist selected by the person to be evaluated or by such person's attorney.
19. 20. "Informed consent" means a voluntary decision following presentation of all facts necessary to form the basis of an intelligent consent by the patient or guardian with no minimizing of known dangers of any procedures.
20. 21. "Least restrictive treatment alternative" means the treatment plan and setting that infringe in the least possible degree with the patient's right to liberty and that are consistent with providing needed treatment in a safe and humane manner.
21. 22. "Licensed physician" means any medical doctor or doctor of osteopathy who is either:
(a) Licensed in this state.
(b) A full‑time hospital physician licensed in another state and serving on the staff of a hospital operated or licensed by the United States government.
22. 23. "Medical director of an evaluation agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and may include the chief medical officer of the state hospital.
23. 24. "Medical director of a mental health treatment agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and includes the chief medical officer of the state hospital.
24. 25. "Mental disorder" means a substantial disorder of the person's emotional processes, thought, cognition or memory. Mental disorder is distinguished from:
(a) Conditions that are primarily those of drug abuse, alcoholism or intellectual disability, unless, in addition to one or more of these conditions, the person has a mental disorder.
(b) The declining mental abilities that directly accompany impending death.
(c) Character and personality disorders characterized by lifelong and deeply ingrained antisocial behavior patterns, including sexual behaviors that are abnormal and prohibited by statute unless the behavior results from a mental disorder.
25. 26. "Mental health provider" means any physician or provider of mental health or behavioral health services involved in evaluating, caring for, treating or rehabilitating a patient.
26. 27. "Mental health treatment agency" means the state hospital or a health care agency that is licensed by the department and that provides those services that are required of the agency by this chapter.
27. 28. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program not requiring continuous inpatient hospitalization.
28. 29. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization.
29. 30. "Patient" means any person undergoing examination, evaluation or behavioral or mental health treatment under this chapter.
30. 31. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns.
31. 32. "Persistent or acute disability" means a severe mental disorder that meets all the following criteria:
(a) If not treated has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm that significantly impairs judgment, reason, behavior or capacity to recognize reality.
(b) Substantially impairs the person's capacity to make an informed decision regarding treatment, and this impairment causes the person to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages and alternatives are explained to that person.
(c) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment.
32. 33. "Prepetition screening" means the review of each application requesting court‑ordered evaluation, including an investigation of facts alleged in such application, an interview with each applicant and an interview, if possible, with the proposed patient. The purpose of the interview with the proposed patient is to assess the problem, explain the application and, when indicated, attempt to persuade the proposed patient to receive, on a voluntary basis, evaluation or other services.
33. 34. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state.
34. 35. "Professional" means a physician who is licensed pursuant to title 32, chapter 13 or 17, a psychologist who is licensed pursuant to title 32, chapter 19.1 or a psychiatric and mental health nurse practitioner who is certified pursuant to title 32, chapter 15.
35. 36. "Proposed patient" means a person for whom an application for evaluation has been made or a petition for court‑ordered evaluation has been filed.
37. "Prosecuting agency" means the county attorney, attorney general or city attorney who applied or petitioned for an evaluation or treatment pursuant to chapter 5 of this title.
36. 38. "Psychiatric and mental health nurse practitioner" means a registered nurse practitioner as defined in section 32‑1601 who has completed an adult or family psychiatric and mental health nurse practitioner program and who is certified as an adult or family psychiatric and mental health nurse practitioner by the state board of nursing.
37. 39. "Psychiatrist" means a licensed physician who has completed three years of graduate training in psychiatry in a program approved by the American medical association or the American osteopathic association.
38. 40. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology.
39. 41. "Records" means all communications that are recorded in any form or medium and that relate to patient examination, evaluation or behavioral or mental health treatment. Records include medical records that are prepared by a health care provider or other providers. Records do not include:
(a) Materials that are prepared in connection with utilization review, peer review or quality assurance activities, including records that a health care provider prepares pursuant to section 36‑441, 36‑445, 36‑2402 or 36‑2917.
(b) Recorded telephone and radio calls to and from a publicly operated emergency dispatch office relating to requests for emergency services or reports of suspected criminal activity.
40. 42. "Regional behavioral health authority" has the same meaning prescribed in section 36‑3401.
41. 43. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of such agency by this chapter.
42. 44. "Social worker" means a person who has completed two years of graduate training in social work in a program approved by the council of social work education and who has experience in mental health.
43. 45. "State hospital" means the Arizona state hospital.
44. 46. "Superintendent" means the superintendent of the state hospital.
Sec. 10. Section 36-521, Arizona Revised Statutes, is amended to read:
36-521. Preparation of petition for court‑ordered evaluation; procedures for prepetition screening
A. On receiving the application for evaluation, the screening agency, before filing a petition for court‑ordered evaluation, shall provide prepetition screening within forty‑eight hours excluding weekends and holidays when possible to determine whether there is reasonable cause to believe the allegations of the applicant for the court‑ordered evaluation, whether the person will voluntarily receive evaluation at a scheduled time and place and whether the person has a persistent or acute disability or a grave disability or is likely to present a danger to self or others until the voluntary evaluation.
B. After prepetition screening has been completed, the screening agency shall prepare a report of opinions and conclusions. If prepetition screening is not possible, the screening agency shall prepare a report giving reasons why the screening was not possible and including opinions and conclusions of staff members who attempted to conduct prepetition screening or otherwise investigated the matter.
C. If the prepetition screening report indicates that there exists no reasonable cause to believe the allegations of the applicant for the court‑ordered evaluation, it shall be reviewed by the medical director of the screening agency or the medical director's designee.
D. If, based on the allegations of the applicant for the court‑ordered evaluation and the prepetition screening report or other information obtained while attempting to conduct a prepetition screening, the agency determines that there is reasonable cause to believe that the proposed patient is, as a result of mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability and that the proposed patient is unable or unwilling to voluntarily receive evaluation or is likely to present a danger to self or to others, has a grave disability or will further deteriorate before receiving a voluntary evaluation, the agency shall prepare a petition for court‑ordered evaluation and shall file the petition, which shall be signed by the person who prepared the petition unless the county attorney performs these functions. If the agency determines that there is reasonable cause to believe that the person is in such a condition that without immediate hospitalization he is likely to harm himself or others, the agency shall take all reasonable steps to procure such hospitalization on an emergency basis.
E. The agency may contact the county attorney in order to obtain assistance in preparing the petition for court‑ordered evaluation, and the agency may request the advice and judgment of the county attorney in reaching a decision as to whether the court‑ordered evaluation is justified.
F. The county attorney may prepare or sign or file the petition if a court has ordered the county attorney to prepare the petition.
G. If a petition for court‑ordered evaluation alleges danger to others as described in section 36‑501, the screening agency, before filing such a petition, shall contact the county attorney for a review of the petition. The county attorney shall examine the petition and make one of the following written recommendations:
1. That a criminal investigation is warranted.
2. That the screening agency shall file the petition.
3. That no further proceedings are warranted. The screening agency shall consider the recommendation in determining whether a court‑ordered evaluation is justified and shall include the recommendation with the petition if the agency decides to file the petition with the court.
H. The petition shall be made in the form and manner prescribed by the director.
I. If a petition for court‑ordered evaluation is filed by a prosecutor pursuant to section 13‑4517, a prior application for court‑ordered evaluation or prescreening is not necessary.
Sec. 11. Section 36-523, Arizona Revised Statutes, is amended to read:
36-523. Petition for evaluation
A. The petition for evaluation shall contain the following:
1. The name, address and interest in the case of the individual who applied for the petition.
2. The name, and address if known, of the proposed patient for whom evaluation is petitioned.
3. The present whereabouts of the proposed patient, if known.
4. A statement alleging that there is reasonable cause to believe that the proposed patient has a mental disorder and is as a result a danger to self or others, has a persistent or acute disability or a grave disability and is unwilling or unable to undergo voluntary evaluation.
5. A summary of the facts that support the allegations that the proposed patient is dangerous, has a persistent or acute disability or a grave disability and is unwilling or unable to be voluntarily evaluated, including the facts that brought the proposed patient to the screening agency's attention.
6. If the petition is filed by a prosecutor pursuant to section 13‑4517, the petition shall include any known criminal history of the proposed patient, including whether the proposed patient has ever been found incompetent to stand trial pursuant to section 13‑4510.
6. 7. Other
information that the director by rule or the court by rule or order may
require.
B. The petition shall request that the court issue an order requiring that the proposed patient be given an evaluation and shall advise the court of both of the following:
1. That the opinion of the petitioner is either that the proposed patient is or is not in such a condition that without immediate or continuing hospitalization the patient is likely to suffer serious physical harm or further deterioration or inflict serious physical harm on another person.
2. If the opinion of the petitioner is that the proposed patient is not in the condition described in paragraph 1 of this subsection, that the opinion of the petitioner is either that the evaluation should or should not take place on an outpatient basis.
C. The petition for evaluation shall be accompanied by the application for evaluation, by the recommendation of the county attorney pursuant to section 36‑521 and by a prepetition screening report, unless the documents have not been prepared under a provision of law or in accordance with an order of the court. The petition for evaluation shall also be accompanied by a copy of the application for emergency admission if one exists.
D. A petition and other forms required in a court may be filed only by the screening agency that has prepared the petition.
E. If the petition is not filed because it has been determined that the person does not need an evaluation, the agency after a period of six months shall destroy the petition and the various reports annexed to the petition as required by this section.
F. If the petition is not filed because it has been determined that the person does not need an evaluation and a prosecutor filed a petition pursuant to section 13‑4517, the person shall be remanded for a disposition pursuant to section 13-4517. If the person is out of custody, the court may order that the person be taken into custody for a disposition pursuant to this section.
G. If the person is the subject of a petition filed by a prosecutor pursuant to section 13‑4517, an evaluation shall be completed within seventy‑two hours after the person is delivered to the evaluation agency.
Sec. 12. Section 36-529, Arizona Revised Statutes, is amended to read:
36-529. Order for evaluation; order for detention; hearing
A. If, from the review of the petition for
evaluation, the court does not determine that the proposed patient is likely to
present a danger to self or others or further deteriorate prior to his hearing
on court‑ordered treatment, but determines that there is reasonable cause
to believe that the proposed patient is, as a result of a mental disorder, a
danger to self or others, or has a persistent or
acute disability or a grave disability, the court shall issue an order
directing the proposed patient to submit to an evaluation at a designated time
and place, specifying that the evaluation will take place on an inpatient or an
outpatient basis. The court may also order that if the person does not
or cannot so submit, that he be taken into custody by a police peace officer and delivered to an evaluation
agency. If the court makes such a conditional order, it shall also
make a conditional appointment of counsel for the person to become effective
when and if the person is taken into custody pursuant to this section.
B. If, from review of the petition for evaluation,
there is reasonable cause to believe that the proposed patient is, as a result
of a mental disorder, a danger to self or others,
or has a persistent or
acute disability or a grave disability and that the person requires immediate
or continued hospitalization prior to his hearing on court‑ordered
treatment, the court shall order the proposed patient taken into custody and
evaluated at an evaluation agency. The court shall promptly appoint
counsel for the proposed patient. If an intercounty agreement
authorizes the same, the court may order that the evaluation be conducted in
another county, and the superior court in the county where the evaluation is
conducted shall have concurrent jurisdiction to make appropriate orders
concerning the proposed patient.
C. If the person is not taken into custody or if the evaluation pursuant to the order of the court under subsection A or B is not initiated within fourteen days from the date of the order, the order and petition for evaluation shall expire. If a prosecutor filed a petition pursuant to section 13‑4517, the court and the prosecuting agency shall receive notice of the expiration of the order for evaluation. The court may enter any orders necessary for further disposition pursuant to section 13‑4517, including a pickup order directing that the person be taken into custody. this subsection does not prevent any person from initiating another court ordered evaluation of the person pursuant to title 36, chapter 5.
D. If the person is involuntarily hospitalized, the person shall be informed by his appointed attorney of his rights to a hearing to determine whether he should be involuntarily hospitalized for evaluation and to be represented at the hearing by an attorney. If the patient requests a hearing to determine whether he should be involuntarily hospitalized during evaluation, the court shall schedule a hearing at its first opportunity.
Sec. 13. Section 36-531, Arizona Revised Statutes, is amended to read:
36-531. Evaluation; possible dispositions; release
A. A person who is being evaluated on an inpatient basis in an evaluation agency shall be released if, in the opinion of the medical director of the agency, further evaluation is not appropriate unless the person applies for further care and treatment on a voluntary basis.
B. If it is determined on an evaluation of the patient's condition that the patient is, as a result of a mental disorder, a danger to self or to others or has a persistent or acute disability or a grave disability, the medical director in charge of the agency that provided the evaluation, unless the person applies for further care and treatment on a voluntary basis, shall prepare, sign and file a petition for court‑ordered treatment unless the county attorney performs the functions of preparing, signing or filing the petition as provided in subsection C of this section.
C. The agency may contact the county attorney to obtain assistance in preparing the petition for court‑ordered treatment, and the agency may request the advice and judgment of the county attorney in reaching a decision as to whether court‑ordered treatment is justified.
D. A person being evaluated on an inpatient basis in an evaluation agency shall be released within seventy‑two hours, excluding weekends and holidays, from the time that the person is hospitalized pursuant to a court order for evaluation, unless the person applies for further care and treatment on a voluntary basis or unless a petition for court‑ordered treatment has been filed pursuant to subsection B of this section.
E. If a prosecutor filed a petition pursuant to section 13‑4517, the medical director of an evaluation agency shall provide notice within twenty‑four hours to the court and the prosecuting agency of the director's intention to release the person under this section. The court may order the person returned to custody for a disposition pursuant to section 13‑4517. At any hearing held pursuant to this subsection, the court shall order the medical director to provide the patient's records, including medical and treatment records, to the court and the prosecuting agency.
E. F. The
administration may conduct jointly with a school district, directly or
indirectly, an educational evaluation pursuant to sections 15‑765 and 15‑766
for nonadjudicated youth. The evaluation information may be shared
by and among authorized personnel employed by the administration and the
department of education, or authorized personnel from the local education
agency, for purposes of ensuring the provision of special education and related
services as required by the individuals with disabilities education act (20
United States Code sections 1400 through 1415).
Sec. 14. Section 36-533, Arizona Revised Statutes, is amended to read:
36-533. Petition for treatment
A. The petition for court‑ordered treatment shall allege:
1. That the patient is in need of a period of
treatment because the patient, as a result of mental disorder, is a danger to
self or to others, or has a persistent or acute
disability or a grave disability.
2. The treatment alternatives that are appropriate or available.
3. That the patient is unwilling to accept or incapable of accepting treatment voluntarily.
B. The petition shall be accompanied by the
affidavits of the two physicians who participated in the evaluation and by the
affidavit of the applicant for the evaluation, if any. The
affidavits of the physicians shall describe in detail the behavior that
indicates that the person, as a result of mental disorder, is a danger to self
or to others, or has a persistent or acute
disability or a grave disability and shall be based on the physician's
observations of the patient and the physician's study of information about the
patient. A summary of the facts that support the allegations of the petition
shall be included. The affidavit shall also include any of the results of the
physical examination of the patient if relevant to the patient's psychiatric
condition.
C. The petition shall request the court to issue an order requiring the person to undergo a period of treatment. If provided by the prosecutor pursuant to section 13‑4517 the petition shall set forth any known criminal history of the person.
D. In cases of grave disability the petition shall also include:
1. A statement that in the opinion of the petitioner the person with a grave disability does or does not require guardianship or conservatorship, or both, under title 14 and the reasons on which the statement is based.
2. A request that the court order an independent investigation and report for the court if in the opinion of the petitioner the person does require guardianship or conservatorship, or both.
3. A statement that in the opinion of the petitioner the person with a grave disability does or does not require temporary guardianship or conservatorship, or both, and the reasons on which the statement is based.
4. A request that the court appoint a temporary guardian or conservator, or both, if in the opinion of the petitioner the person does require temporary guardianship or conservatorship, or both.
E. A copy of the petition in cases of grave disability shall be mailed to the public fiduciary in the county of the patient's residence or in which the patient was found before evaluation and to any person nominated as guardian or conservator.
F. A copy of all petitions shall be mailed to the superintendent of the Arizona state hospital.
Sec. 15. Section 36-534, Arizona Revised Statutes, is amended to read:
36-534. Change to voluntary status; discharge; notice; hearing
A. If, after a petition for court‑ordered treatment has been filed and prior to the hearing, the medical director of the agency finds that it is more appropriate to discharge the patient or to admit the proposed patient on a voluntary basis, the medical director shall, after receiving approval from the court, shall either discharge the patient or admit the patient for further treatment on a voluntary basis.
b. If the court approves admitting a patient for whom a petition has been filed by a prosecutor pursuant to section 13‑4517 to voluntary treatment or before a patient is discharged pursuant to this section, the medical director shall provide notice to the prosecuting agency. The prosecuting agency may request a hearing to determine whether the court should order the defendant returned to custody for a disposition pursuant to section 13-4517. For any hearing held pursuant to this subsection, the court shall order the medical director to provide the patient's records, including medical and treatment records, to the court and to the prosecuting agency.
Sec. 16. Section 36-540, Arizona Revised Statutes, is amended to read:
36-540. Court options
A. If the court finds by clear and convincing evidence that the proposed patient, as a result of mental disorder, is a danger to self, is a danger to others, has a persistent or acute disability or a grave disability and is in need of treatment, and is either unwilling or unable to accept voluntary treatment, the court shall order the patient to undergo one of the following:
1. Treatment in a program of outpatient treatment.
2. Treatment in a program consisting of combined inpatient and outpatient treatment.
3. Inpatient treatment in a mental health treatment agency, in a hospital operated by or under contract with the United States department of veterans affairs to provide treatment to eligible veterans pursuant to article 9 of this chapter, in the state hospital or in a private hospital, if the private hospital agrees, subject to the limitations of section 36‑541.
B. The court shall consider all available and appropriate alternatives for the treatment and care of the patient. The court shall order the least restrictive treatment alternative available.
C. The court may order the proposed patient to undergo outpatient or combined inpatient and outpatient treatment pursuant to subsection A, paragraph 1 or 2 of this section if the court:
1. Determines that all of the following apply:
(a) The patient does not require continuous inpatient hospitalization.
(b) The patient will be more appropriately treated in an outpatient treatment program or in a combined inpatient and outpatient treatment program.
(c) The patient will follow a prescribed outpatient treatment plan.
(d) The patient will not likely become dangerous or suffer more serious physical harm or serious illness or further deterioration if the patient follows a prescribed outpatient treatment plan.
2. Is presented with and approves a written treatment plan that conforms with the requirements of section 36‑540.01, subsection B. If the treatment plan presented to the court pursuant to this subsection provides for supervision of the patient under court order by a mental health agency that is other than the mental health agency that petitioned or requested the county attorney to petition the court for treatment pursuant to section 36‑531, the treatment plan must be approved by the medical director of the mental health agency that will supervise the treatment pursuant to subsection E of this section.
D. An order to receive treatment pursuant to subsection A, paragraph 1 or 2 of this section shall not exceed three hundred sixty‑five days. The period of inpatient treatment under a combined treatment order pursuant to subsection A, paragraph 2 of this section shall not exceed the maximum period allowed for an order for inpatient treatment pursuant to subsection F of this section.
E. If the court enters an order for treatment pursuant to subsection A, paragraph 1 or 2 of this section, all of the following apply:
1. The court shall designate the medical director of the mental health treatment agency that will supervise and administer the patient's treatment program.
2. The medical director shall not use the services of any person, agency or organization to supervise a patient's outpatient treatment program unless the person, agency or organization has agreed to provide these services in the individual patient's case and unless the department has determined that the person, agency or organization is capable and competent to do so.
3. The person, agency or organization assigned to supervise an outpatient treatment program or the outpatient portion of a combined treatment program shall be notified at least three days before a referral. The medical director making the referral and the person, agency or organization assigned to supervise the treatment program shall share relevant information about the patient to provide continuity of treatment.
4. The court may order that the medical director provide notice to the court of any noncompliance with the terms of a treatment order.
4. 5. During any
period of outpatient treatment under subsection A, paragraph 2 of this section,
if the court, on its own
motion or on motion by the medical director of the patient's outpatient
mental health treatment facility, determines that the patient is not complying
with the terms of the order or that the outpatient treatment plan is no longer
appropriate and the patient needs inpatient treatment, the court, without a
hearing and based on the court record, the patient's medical record, the
affidavits and recommendations of the medical director, and the advice of staff
and physicians or the psychiatric and mental health nurse practitioner familiar
with the treatment of the patient, may enter an order amending its original
order. The amended order may alter the outpatient treatment plan or order the
patient to inpatient treatment pursuant to subsection A, paragraph 3 of this
section. The amended order shall not increase the total period of commitment
originally ordered by the court or, when added to the period of inpatient
treatment provided by the original order and any other amended orders, exceed
the maximum period allowed for an order for inpatient treatment pursuant to
subsection F of this section. If the patient refuses to comply with
an amended order for inpatient treatment, the court, on its own motion or on the request of the medical
director, may authorize and direct a peace officer, on the request of the medical director, to take
the patient into protective custody and transport the patient to the agency for
inpatient treatment. Any
authorization, directive or order issued to a peace officer to take the patient
into protective custody shall include the patient's criminal history and the
name and telephone numbers of the patient's case manager, guardian, spouse,
next of kin or significant other, as applicable. When reporting to or
being returned to a treatment agency for inpatient treatment pursuant to an
amended order, the patient shall be informed of the patient's right to judicial
review and the patient's right to consult with counsel pursuant to section 36‑546.
5. 6. During any
period of outpatient treatment under subsection A, paragraph 2 of this section,
if the medical director of the outpatient treatment facility in charge of the
patient's care determines, in concert with the medical director of an inpatient
mental health treatment facility who has agreed to accept the patient, that the
patient is in need of immediate acute inpatient psychiatric care because of
behavior that is dangerous to self or to others, the medical director of the
outpatient treatment facility may order a peace officer to apprehend and
transport the patient to the inpatient treatment facility pending a court
determination on an amended order under paragraph 4 5 of this subsection. The
patient may be detained and treated at the inpatient treatment facility for a
period of no more than forty‑eight hours, exclusive of weekends and
holidays, from the time that the patient is taken to the inpatient treatment
facility. The medical director of the outpatient treatment facility
shall file the motion for an amended court order requesting inpatient treatment
no later than the next working day following the patient being taken to the
inpatient treatment facility. Any period of detention within the inpatient
treatment facility pending issuance of an amended order shall not increase the
total period of commitment originally ordered by the court or, when added to
the period of inpatient treatment provided by the original order and any other
amended orders, exceed the maximum period allowed for an order for inpatient
treatment pursuant to subsection F of this section. If a patient is
ordered to undergo inpatient treatment pursuant to an amended order, the
medical director of the outpatient treatment facility shall inform the patient
of the patient's right to judicial review and to consult with an attorney
pursuant to section 36‑546.
F. The maximum periods of inpatient treatment that the court may order, subject to the limitations of section 36‑541, are as follows:
1. Ninety days for a person found to be a danger to self.
2. One hundred eighty days for a person found to be a danger to others.
3. One hundred eighty days for a person found to have a persistent or acute disability.
4. Three hundred sixty‑five days for a person found to have a grave disability.
G. If, on finding that the patient meets the criteria for court‑ordered treatment pursuant to subsection A of this section, the court also finds that there is reasonable cause to believe that the patient is an incapacitated person as defined in section 14‑5101 or is a person in need of protection pursuant to section 14‑5401 and that the patient is or may be in need of guardianship or conservatorship, or both, the court may order an investigation concerning the need for a guardian or conservator, or both, and may appoint a suitable person or agency to conduct the investigation. The appointee may include a court appointed guardian ad litem, an investigator appointed pursuant to section 14‑5308 or the public fiduciary if there is no person willing and qualified to act in that capacity. The court shall give notice of the appointment to the appointee within three days of the appointment. The appointee shall submit the report of the investigation to the court within twenty‑one days. The report shall include recommendations as to who should be guardian or who should be conservator, or both, and a report of the findings and reasons for the recommendation. If the investigation and report so indicate, the court shall order the appropriate person to submit a petition to become the guardian or conservator, or both, of the patient.
H. In any proceeding for court‑ordered treatment in which the petition alleges that the patient is in need of a guardian or conservator and states the grounds for that allegation, the court may appoint an emergency temporary guardian or conservator, or both, for a specific purpose or purposes identified in its order and for a specific period of time not to exceed thirty days if the court finds that all of the following are true:
1. The patient meets the criteria for court-ordered treatment pursuant to subsection A of this section.
2. There is reasonable cause to believe that the patient is an incapacitated person as defined in section 14‑5101 or is in need of protection pursuant to section 14‑5401, paragraph 2.
3. The patient does not have a guardian or conservator and the welfare of the patient requires immediate action to protect the patient or the ward's property.
4. The conditions prescribed pursuant to section 14‑5310, subsection B or section 14‑5401.01, subsection B have been met.
I. The court may appoint as a temporary guardian or conservator pursuant to subsection H of this section a suitable person or the public fiduciary if there is no person qualified and willing to act in that capacity. The court shall issue an order for an investigation as prescribed pursuant to subsection G of this section and, unless the patient is represented by independent counsel, the court shall appoint an attorney to represent the patient in further proceedings regarding the appointment of a guardian or conservator. The court shall schedule a further hearing within fourteen days on the appropriate court calendar of a court that has authority over guardianship or conservatorship matters pursuant to this title to consider the continued need for an emergency temporary guardian or conservator and the appropriateness of the temporary guardian or conservator appointed, and shall order the appointed guardian or conservator to give notice to persons entitled to notice pursuant to section 14‑5309, subsection A or section 14‑5405, subsection A. The court shall authorize certified letters of temporary emergency guardianship or conservatorship to be issued on presentation of a copy of the court's order. If a temporary emergency conservator other than the public fiduciary is appointed pursuant to this subsection, the court shall order that the use of the money and property of the patient by the conservator is restricted and not to be sold, used, transferred or encumbered, except that the court may authorize the conservator to use money or property of the patient specifically identified as needed to pay an expense to provide for the care, treatment or welfare of the patient pending further hearing. This subsection and subsection H of this section do not:
1. Prevent the evaluation or treatment agency from seeking guardianship and conservatorship in any other manner allowed by law at any time during the period of court‑ordered evaluation and treatment.
2. Relieve the evaluation or treatment agency from its obligations concerning the suspected abuse of a vulnerable adult pursuant to title 46, chapter 4.
J. If, on finding that a patient meets the criteria for court-ordered treatment pursuant to subsection A of this section, the court also learns that the patient has a guardian appointed under title 14, the court with notice may impose on the existing guardian additional duties pursuant to section 14‑5312.01. If the court imposes additional duties on an existing guardian as prescribed in this subsection, the court may determine that the patient needs to continue treatment under a court order for treatment and may issue the order or determine that the patient's needs can be adequately met by the guardian with the additional duties pursuant to section 14‑5312.01 and decline to issue the court order for treatment. If at any time after the issuance of a court order for treatment the court finds that the patient's needs can be adequately met by the guardian with the additional duties pursuant to section 14‑5312.01 and that a court order for treatment is no longer necessary to assure compliance with necessary treatment, the court may terminate the court order for treatment. If there is a court order for treatment and a guardianship with additional mental health authority pursuant to section 14‑5312.01 existing at the same time, the treatment and placement decisions made by the treatment agency assigned by the court to supervise and administer the patient's treatment program pursuant to the court order for treatment are controlling unless the court orders otherwise.
K. The court shall file a report as part of the court record on its findings of alternatives for treatment.
L. Treatment shall not include psychosurgery, lobotomy or any other brain surgery without specific informed consent of the patient or the patient's legal guardian and an order of the superior court in the county in which the treatment is proposed, approving with specificity the use of the treatment.
M. The medical director or any person, agency or organization used by the medical director to supervise the terms of an outpatient treatment plan is not civilly liable for any acts committed by a patient while on outpatient treatment if the medical director, person, agency or organization has in good faith followed the requirements of this section.
N. A peace officer who in good faith apprehends and
transports a patient to an inpatient treatment facility on the order of the
medical director of the outpatient treatment facility pursuant to subsection E,
paragraph 5 6 of this section is not subject to civil
liability.
O. If a person has been found, as a result of a mental disorder, to constitute a danger to self or others or to have a persistent or acute disability or a grave disability and the court enters an order for treatment pursuant to subsection A of this section, the court shall transmit the person's name, sex, date of birth, social security number, if available, and date of the order for treatment to the supreme court. The supreme court shall transmit the information to the department of public safety to comply with the requirements of title 13, chapter 31 and title 32, chapter 26. The department of public safety shall transmit the information to the national instant criminal background check system. The superior court may access the information of a person who is ordered into treatment to enforce or facilitate a treatment order.
P. On request, the clerk of the court shall provide certified copies of the commitment order to a law enforcement or prosecuting agency that is investigating or prosecuting a prohibited possessor as defined in section 13‑3101.
Q. If the court does not find a person to be in need of treatment and a prosecutor filed a petition pursuant to section 13‑4517, the court shall notify the prosecuting agency of its finding. The person shall be remanded to the custody of the sheriff for further disposition pursuant to section 13‑4517.
Sec. 17. Section 36-540.01, Arizona Revised Statutes, is amended to read:
36-540.01. Conditional outpatient treatment
A. The medical director may issue an order for conditional outpatient treatment for a patient ordered to undergo treatment pursuant to section 36‑540 if, after consultation with staff familiar with the patient's case history, the medical director determines with a reasonable degree of medical probability that all of the following apply:
1. The patient no longer requires continuous inpatient hospitalization.
2. The patient will be more appropriately treated in an outpatient treatment program.
3. The patient will follow a prescribed outpatient treatment plan.
4. The patient will not likely become dangerous, suffer more serious physical harm or serious illness or further deteriorate if the patient follows a prescribed outpatient treatment plan.
B. The order for conditional outpatient treatment issued by the medical director shall include a written outpatient treatment plan prepared by staff familiar with the patient's case history and approved by the medical director. The plan shall include all of the following:
1. A statement of the patient's requirements, if any, for supervision, medication and assistance in obtaining basic needs such as employment, food, clothing or shelter.
2. The address of the residence where the patient is to live and the name of the person in charge of the residence, if any.
3. The name and address of any person, agency or organization assigned to supervise an outpatient treatment plan or care for the patient, and the extent of authority of the person, agency or organization in carrying out the terms of the plan.
4. The conditions for continued outpatient treatment, which may require periodic reporting, continuation of medication and submission to testing, and may restrict travel, consumption of spirituous liquor and drugs, associations with others and incurrence of debts and obligations or such other reasonable conditions as the medical director may specify.
5. any other provisions that the medical director or the court believes are necessary to protect the well‑being of the patient and the public.
C. The court may order that the medical director provide notice to the court of specific instances of noncompliance as specified by the court.
C. d. Before release for conditional outpatient treatment, the patient shall be provided with copies and full explanations of the medical director's order and the treatment plan. If, after full explanation, the patient objects to the plan or any part of it, the objection and reasons for the objection shall be noted in the patient's record. The medical director's order and treatment plan shall be filed in the patient's medical file and shall also be filed with the court.
D. e. The period for which conditional outpatient treatment may be ordered may not exceed the remainder of the period of court ordered treatment.
E. f. Before the
release of a patient for outpatient treatment, the medical director shall give
notice pursuant to section 36‑541.01, subsection B C
and a motion for a determination by the court as to whether the
standard for conditional release of the patient has been met may be made by the
persons and in the manner provided for in section 36‑541.01, subsection H I. Before the release of a person found to be
a danger to self, or others or found to be a person with have a persistent or acute disability or a
grave disability for outpatient treatment, the medical director shall give
notice to the court that ordered the patient to undergo treatment. If criminal
charges against a patient involving death or serious physical injury or a violation of title 13,
chapter 14 are dismissed pursuant to section 13‑4517, the medical
director shall notify the prosecuting agency if a civil commitment order issued
pursuant to this chapter expires or is terminated, or if the patient is
discharged to outpatient treatment. The medical director shall provide this
notice by mail at least five days before the anticipated date of the
expiration, termination or discharge.
F. g. The medical director shall require periodic reports concerning the condition of patients on conditional outpatient treatment from any person, agency or organization assigned to supervise an outpatient treatment plan. The medical director shall require these reports at intervals not to exceed thirty days.
G. h. The medical director shall review the condition of a patient on conditional outpatient treatment at least once every thirty days and enter the findings in writing in the patient's file. In conducting the review, the medical director shall consider all reports and information received and may require the patient to report for further evaluation.
H. i. The medical director may amend any part of the outpatient treatment plan during the course of conditional outpatient treatment. If the plan is amended, the medical director shall issue a new order including the amended outpatient treatment plan. The new order and amended outpatient treatment plan shall be filed in the patient's medical file. Copies of the new order and outpatient treatment plan shall be immediately provided to the patient and to any person, agency or organization assigned to supervise an outpatient treatment plan. Copies of the new order and outpatient treatment plan shall be immediately filed with the court and, if a prosecutor filed a petition pursuant to section 13‑4517, with the prosecuting agency.
I. j. The medical director may rescind an order for conditional outpatient treatment and order the patient to return to a mental health treatment agency at any time during the period of court ordered treatment if, in the medical director's judgment, the patient has failed to comply with a term of the outpatient treatment plan or if, for any reason, the medical director determines that the patient needs inpatient treatment or that conditional outpatient treatment is no longer appropriate. The medical director shall give notice to the court that issued the treatment order and the prosecuting agency if a prosecutor filed a petition pursuant to section 13‑4517.
J. k. If the medical director rescinds an order for conditional outpatient treatment and the patient is returned to a mental health treatment agency for inpatient treatment, the patient shall be informed of the patient's right to judicial review and right to consult with counsel pursuant to section 36‑546.
K. l. If the medical director rescinds an order for conditional outpatient treatment and orders the patient to return to a mental health treatment agency, the medical director may request, or a court may order, a peace officer or a designated officer or employee of the treatment agency to take the patient into custody for immediate delivery to the agency pursuant to section 36‑544.
L. m. The medical director is not civilly liable for any act committed by a patient while on conditional outpatient treatment if the medical director has in good faith followed the requirements of this section.
M. n. This section does
not prevent the medical director from authorizing a patient ordered to undergo
treatment pursuant to section 36‑540 as a danger to self, or a danger to others, or a patient with a
persistent or acute disability or a grave disability to leave the treatment
agency for periods of no more than five days under the care, custody and
control of a spouse, relative or other responsible person if the medical
director determines that the patient will not become dangerous or suffer
serious physical harm or illness during that time.
N. o. The medical director may authorize a patient who is civilly committed pursuant to section 36‑540 to leave the state hospital grounds unaccompanied if the leave is part of an inpatient individualized treatment and discharge plan and the medical director determines that the patient will not become dangerous or suffer serious physical harm or illness during that time.
Sec. 18. Section 36-541.01, Arizona Revised Statutes, is amended to read:
36-541.01. Release or discharge from treatment before expiration of period ordered by court; notification of intent to release or discharge; hearing
A. A patient who is found to have a grave disability or a persistent or acute disability and ordered to undergo treatment pursuant to this article may be released from inpatient treatment when, in the opinion of the medical director of the mental health treatment agency, the level of care offered by the agency is no longer required. The patient may agree to continue treatment voluntarily. If the patient is to be released, the medical director shall arrange for an appropriate alternative placement. If the patient who is to be released from inpatient treatment is under a guardianship, the medical director of the mental health treatment agency shall notify the guardian and any relevant regional behavioral health authority ten days before the intended release date that the patient no longer requires the level of care that is offered by the agency. The guardian and, if relevant, the regional behavioral health authority shall arrange alternative placement with the advice and recommendations of the medical director of the mental health treatment agency.
A. B. A patient who is ordered to undergo treatment pursuant to this article may be released from treatment before the expiration of the period ordered by the court if, in the opinion of the medical director of the mental health treatment agency, the patient no longer is, as a result of a mental disorder, a danger to others or a danger to self or no longer has a persistent or acute disability or a grave disability. A person who is ordered to undergo treatment as a danger to others or who has had a petition filed by a prosecutor pursuant to section 13‑4517 may not be released or discharged from treatment before the expiration of the period for treatment ordered by the court unless the medical director first gives notice of intention to do so as provided by this section.
B. C. Before the release or discharge of a patient who is ordered to undergo treatment, the medical director of the mental health treatment agency shall notify the following of the medical director's intention to release or discharge the patient:
1. The presiding judge of the court that entered the order for treatment.
2. Any relative or victim of the patient who has filed a demand for notice with the treatment agency.
3. Any person found by the court to have a legitimate reason for receiving notice.
C. D. If criminal charges against a patient involving death or serious physical injury or a violation of title 13, chapter 14 are dismissed the patient is undergoing court ordered treatment as the result of a petition filed by a prosecuting agency pursuant to section 13‑4517, the medical director shall notify the court and the prosecuting agency if a civil commitment order issued pursuant to this chapter expires or is terminated, or if the patient is discharged to outpatient treatment. The medical director shall provide this notice by mail at least five days before the anticipated date of the expiration, termination or discharge.
D. E. If the director of the mental health treatment agency is unable to determine, based on the information submitted pursuant to subsection E F of this section, that a person who has filed a demand for notice is a victim, the director shall inform that person that that person's demand for notice is denied and that notice will not be given unless ordered by the court pursuant to subsection F G of this section.
E. F. A demand for notice by a relative or victim, and a petition for notice by other persons, shall be on a form prescribed by the administration and shall include the following information:
1. The full name of the person to receive notice.
2. The address to which notice is to be mailed.
3. The telephone number of the person to receive notice.
4. The relationship to the patient, if any, or the reasons why the person believes the person has a legitimate reason to receive notice.
5. A statement that the person will advise the treatment agency in writing by certified mail, return receipt requested, of any change in the address to which notice is to be mailed.
6. The full name of the patient ordered to undergo treatment as a danger to others or who has had a petition filed by a prosecutor pursuant to section 13‑4517.
7. The mental health number assigned to the case by the superior court.
F. G. If the court receives a demand for notice by a relative or victim, the court shall order the medical director of the mental health treatment agency not to release or discharge the patient before the expiration of the period of court‑ordered treatment without first giving notice to the relative or victim as provided in subsection G H of this section. After considering a petition for notice, if the court finds that the petitioner has a legitimate reason for receiving prior notice, the court may order the medical director of the mental health treatment agency not to release or discharge the patient from inpatient treatment before the expiration of the period of court‑ordered treatment without first giving notice to the petitioner as provided in subsection G H of this section. Any order for notice shall be delivered to the mental health treatment agency and shall be filed with the patient's clinical record. If the patient is transferred to another agency or institution, any orders for notice shall be transferred with the patient.
G. H. A notice of intention to release or discharge shall include the following information:
1. The name of the patient to be released or discharged.
2. The type of release or discharge.
3. The date of anticipated release or discharge. Notices shall be placed in the mail, postage prepaid and addressed to the court and to each person for whom notice has been ordered, at least ten days before the date of intended release or discharge, except that notice shall be sent to the prosecuting agency at least five days before the date of intended release or discharge. For purposes of computing the notice requirement, the day of mailing shall not be counted.
H. I. Any person for whom prior notice is required pursuant to this section, or the court, may make a motion within the notification period that requires the court to determine whether the standard for release of the patient before the expiration of the period for court‑ordered treatment has been met. A determination that the standard for release has been met may be made by the court based on a review of the record and any affidavits submitted without further hearing. For good cause, the court may order an evidentiary hearing. Whether or not a hearing is held, the court shall make a determination at the earliest possible time but no longer than three weeks after the anticipated date of release pursuant to subsection G H of this section, and the patient shall be retained for the additional time required for the court's determination. In making its determination the court may order an independent examination of the patient. If a motion is not made, the patient may be released in accordance with the terms set forth in the notice without further court order. If a hearing is held pursuant to this subsection, the court shall order the medical director to provide the patient's records, including medical and treatment records, to the court and the prosecuting agency.
I. J. If a motion has not been made pursuant to subsection H I of this section, the patient may be released or discharged and the medical director of the mental health treatment agency shall send to the court a certificate that the patient is no longer a danger to others or a danger to self or no longer has a persistent or acute disability or a grave disability as the result of a mental disorder and therefore is released before the expiration of the period ordered for treatment. The court shall enter an order terminating the patient's court‑ordered treatment.
J. K. The medical director of the mental health treatment agency shall not be held civilly liable for any acts committed by a patient who is released before the expiration of the period of court‑ordered treatment if the medical director has in good faith followed the requirements of this section.
Sec. 19. Section 36-542, Arizona Revised Statutes, is amended to read:
36-542. Discharge of patient at expiration of period ordered by court; change to voluntary status; relief from civil liability
A. A patient ordered by a court to undergo treatment pursuant to this article shall be discharged from treatment at the expiration of the period of treatment ordered unless one of the following occurs:
1. The person accepts voluntary treatment at the mental health treatment agency.
2. Before the discharge date, a new petition is filed in the county in which the patient is being treated. The proceedings shall then be governed by this article. The costs of the proceedings shall be a charge against the county in which the patient resided or was found prior to hospitalization.
3. An application for continued court ordered treatment is granted pursuant to section 36‑543.
B. If a patient to be discharged is under guardianship, the medical director of the mental health treatment agency shall notify the guardian ten days before discharge.
C. If a patient to be discharged is undergoing court ordered treatment as a result of a petition filed by a prosecutor pursuant to section 13‑4517 and the patient is being discharged because the medical director has decided not to file a new petition for court ordered evaluation or treatment or has decided not to request the court to order that the previous order for treatment be continued, the patient may not be discharged or released from treatment before the patient complies with the provisions of section 36‑541.01.
C. D. The medical director is not civilly liable for any acts committed by a released or discharged patient if the medical director has in good faith followed the requirements of this article.
Sec. 20. Section 36-543, Arizona Revised Statutes, is amended to read:
36-543. Annual review of a patient with a grave disability or a persistent or acute disability; notice; court order for continued treatment; rules
A. A patient who is found to have a grave disability or a persistent or acute disability and ordered to undergo treatment may be released from inpatient treatment when, in the opinion of the medical director of the mental health treatment agency, the level of care offered by the agency is no longer required. The patient may agree to continue treatment voluntarily. If the patient is to be released, the medical director shall arrange for an appropriate alternative placement.
B. If a patient who is to be released from inpatient treatment is under guardianship, the medical director of the mental health treatment agency shall notify the guardian and any relevant regional behavioral health authority ten days before the intended release date that the ward no longer requires the level of care offered by the agency. The guardian and, if relevant, the regional behavioral health authority shall arrange alternative placement with the advice and recommendations of the medical director of the mental health treatment agency.
C. The medical director of the mental health treatment agency is not civilly liable for any acts committed by the released patient if the medical director has in good faith complied with the requirements of this article.
D. A. Within ninety days before the expiration of a court order for treatment, the medical director of the mental health treatment agency shall conduct an annual review of a patient who has been found to have a grave disability or a persistent or acute disability and is undergoing court‑ordered treatment to determine whether the continuation of court‑ordered treatment is appropriate and to assess the needs of the patient for guardianship or conservatorship, or both. The annual review shall consist of the mental health treatment and clinical records contained in the patient's treatment file. The mental health treatment agency shall keep a record of the annual review. If the medical director believes that a continuation of court‑ordered treatment is appropriate, the medical director of the mental health treatment agency shall appoint one or more psychiatrists to carry out a psychiatric examination of the patient. In any proceeding conducted pursuant to this section, a patient has the right to have an analysis of the patient's mental condition by an independent evaluation pursuant to section 36‑538.
E. B. Each examiner participating in the psychiatric examination of the patient shall submit a report to the medical director of the mental health treatment agency that includes the following:
1. The examiner's opinions as to whether the patient continues to have a grave disability or a persistent or acute disability as the result of a mental disorder and be in need of continued court-ordered treatment. In evaluating the patient's need for continued court-ordered treatment, the examiner must consider, along with all other evidence, the patient's history before and during the current period of court‑ordered treatment, the patient's compliance with recommended treatment and any other evidence relevant to the patient's ability and willingness to follow recommended treatment with or without a court order.
2. A statement as to whether suitable alternatives to court‑ordered treatment are available.
3. A statement as to whether voluntary treatment would be appropriate.
4. A review of the patient's status as to guardianship or conservatorship, or both, the adequacy of existing protections of the patient and the continued need for guardianship or conservatorship, or both. If the examiner concludes that the patient's needs in these areas are not being adequately met, the examiner's report shall recommend that the court order an investigation into the patient's needs.
5. If the patient has an existing guardian who does not have the mental health powers authorized pursuant to section 14‑5312.01, a recommendation as to whether the additional mental health powers authorized by section 14‑5312.01 should be imposed on the existing guardian and whether the patient's needs can be adequately addressed by a guardian with mental health powers without the need for a court order for treatment or whether the court order for treatment should continue regardless of the additional mental health powers imposed on the guardian.
6. The results of any physical examination conducted during the period of court‑ordered treatment if relevant to the psychiatric condition of the patient.
F. C. After conducting the annual review as prescribed in this section, if the medical director believes that continued court‑ordered treatment is necessary or appropriate, not later than thirty days before the expiration of the court order for treatment, the medical director shall file with the court an application for continued court-ordered treatment alleging the basis for the application and shall file simultaneously with the application any psychiatric examination conducted as part of the annual review. If the patient is under guardianship, the medical director shall mail a copy of the application to the patient's guardian.
G. D. If an application for continued court-ordered treatment is filed, all of the following apply:
1. If the patient does not have an attorney, the court shall appoint an attorney to represent the patient.
2. Within ten days after appointment, an attorney appointed pursuant to this subsection, to the extent possible, shall fulfill the duties imposed pursuant to section 36‑537, review the medical director's report and the patient's medical records, interview any physician who prepared a report on the annual review and file a response requesting a hearing or submitting the matter to the court for a ruling based on the record without a hearing.
3. If a hearing is not requested, the court shall rule on the application or set the matter for hearing. If a hearing is requested, the hearing shall be held within three weeks after the request for hearing is filed. The hearing may be continued for good cause on motion of a party or on the court's own motion, and the expiration of the current court order for treatment may be extended until a ruling by the court on an application filed pursuant to this subsection.
4. The patient's attorney must be present at all hearings and may subpoena and cross-examine witnesses and present evidence. The patient has the right to attend all hearings, but may choose not to attend a hearing. The patient's attorney may waive the patient's presence after speaking with the patient and confirming that the patient understands the right to be present and does not desire to attend. If the patient is unable to be present at the hearing for medical or psychiatric reasons and the hearing cannot be conducted where the patient is being treated or confined, or the patient cannot appear by another reasonably feasible means, the court shall require clear and convincing evidence that the patient is unable to be present at the hearing and on such a finding may proceed with the hearing in the patient's absence.
5. The evidence presented by the applicant includes the testimony of one or more witnesses acquainted with the patient during the period of court‑ordered treatment, which may be satisfied by a statement agreed on by the parties, and the testimony of any physician who performed an annual review of the patient, which may be satisfied by stipulating to the admission of the examining physicians' written report prepared pursuant to subsection E B of this section. The court may waive the need for the applicant to present the testimony of witnesses acquainted with the patient as required by this subsection, if it finds that the need for a continued court order for treatment has been established by clear and convincing evidence from the other testimony and evidence presented at the hearing.
6. At a hearing held pursuant to this subsection, the court, with notice, may impose on an existing guardian additional powers pursuant to section 14‑5312.01. If the court finds that the patient's needs can be adequately met by an existing guardian with the additional powers pursuant to section 14‑5312.01 and that a court order for treatment is not necessary to ensure compliance with necessary treatment, the court may terminate the court order for treatment or decline to issue an order continuing court-ordered treatment. The court may also order an investigation into the need for guardianship or conservatorship, or both, and may appoint a suitable person or agency to conduct the investigation. The appointee may include a court‑appointed guardian ad litem, a court‑appointed investigator pursuant to section 14‑5308 or the public fiduciary if there is no person willing and qualified to act in that capacity. The court shall give notice of the appointment to the appointee within three days after the appointment. The appointee shall submit the report of the investigation to the court within twenty-one days. The report shall include recommendations as to who should be guardian or conservator, or both, and the findings and reasons for the recommendation. If the investigation and report so indicate, the court may authorize an appropriate person to file a petition for appointment of a guardian or conservator for the patient.
H. E. If a hearing is held pursuant to subsection G D of this section, the party seeking the renewal of the court order must prove all of the following by clear and convincing evidence:
1. The patient continues to have a mental disorder and, as a result of that disorder, has either a persistent or acute disability or a grave disability.
2. The patient is in need of continued court-ordered treatment.
3. The patient is either unwilling or unable to accept treatment voluntarily.
I. F. After a hearing held pursuant to subsection G D of this section, the court may order the patient to be released from court‑ordered treatment or to undergo continued court-ordered treatment for a period not to exceed the time periods prescribed in section 36‑540, subsection D.
J. G. The director shall create and operate a program to ensure that the examination and review of persons with grave disabilities or persistent or acute disabilities under court order are carried out in an effective and timely manner. The director shall adopt rules needed to operate this program.
H. The medical director of the mental health treatment agency is not civilly liable for any acts committed by the released patient if the medical director has in good faith complied with the requirements of this article.
Sec. 21. Section 36-544, Arizona Revised Statutes, is amended to read:
36-544. Unauthorized absences; violation; classification; tolling period; hearing; civil liability; definition
A. When any patient who is being evaluated or treated is absent without proper authorization from an evaluation agency or a mental health treatment agency, or when an order for outpatient treatment is rescinded, any peace officer shall, upon oral or written request of the medical director of the agency and without the necessity of a warrant or court order, or any officer or employee of the agency who has been previously designated in writing by the medical director of the agency to perform such duties may, take into custody and deliver such patient to the agency. Such officers and employees of the agency have the powers and duties of peace officers so far as is necessary to carry out the provisions of this section. If necessary, the evaluation or treatment agency may apply to the court for a warrant or court order directing any peace officer to take a patient who is absent without proper authorization into custody and deliver the patient to the agency.
B. Any person who intentionally assists any patient being evaluated or treated in an agency to be absent from the agency without proper authorization, or who intentionally assists a patient whom he knows to be absent without proper authorization or whom he knows to be a patient whose order for outpatient treatment has been rescinded and who has been ordered to return to the agency, or to resist being returned to the agency after such absence is guilty of a class 2 misdemeanor.
C. If confirmed in a court order that is issued pursuant to this section, the period of court‑ordered treatment ceases to run during the unauthorized absence of the patient from the jurisdiction or from any required supervision and resumes running only on the patient's voluntary or involuntary return to the treatment agency. The court shall confirm the tolling and the resumption of the running of the period of court‑ordered treatment in an order issued by the court after a petition is filed by the treatment agency. Notice of the petition and the opportunity to appear shall be provided to the patient by regular mail at the patient's last known address. If the patient is undergoing treatment as a result of a remand pursuant to section 13-4517, notice of the petition shall be provided to the prosecuting agency.
D. A patient who remains on unauthorized absence status continuously for at least ninety days may petition the court on his return to the treatment agency for a hearing to determine his current mental status and his present need for treatment. The court shall order a hearing if requested by the patient, his legal guardian or an interested party. The hearing shall be held within seventy‑two hours after the request.
E. Subsections C and D of this section shall apply only to inpatient treatment pursuant to section 36‑540, subsection A, paragraphs 2 and 3.
D. A patient whose period of court ordered treatment is tolled for a period of at least sixty continuous days may request a judicial review pursuant to section 36-546 on the patient's voluntary or involuntary return to treatment. During the period tolled by a court order issued pursuant to this section, the treatment agency shall make active and diligent efforts to find and return the patient to appropriate treatment and at least once every sixty days, or as often as otherwise ordered by the court, shall file a report of the agency's efforts with the court. After the period of treatment is tolled for a period of one hundred eighty days, if the court is satisfied that the agency has made active and diligent efforts to find and return the patient to appropriate treatment, on petition of the treatment agency, the court may terminate the order for treatment or may order the treatment agency to make further specific efforts to find and return the patient to appropriate treatment. The treatment agency shall provide notice to the prosecuting agency of the petition to terminate treatment.
E. The period of treatment under a court order may not be tolled for more than three hundred sixty‑five days.
F. If the treatment agency has in good faith followed the requirements of this section, the treatment agency is not liable in a civil action for damages that result from the actions of a patient during any period of treatment tolled by an order issued pursuant to this section.
G. For the purpose of this section, "Absent without proper authorization" or "unauthorized absence" includes being absent from an inpatient treatment facility without authorization, no longer living in a placement or residence specified by the treatment plan without authorization and leaving or failing to return to the county or state without authorization.
Sec. 22. Section 36-546, Arizona Revised Statutes, is amended to read:
36-546. Judicial review; right to be informed; request; jurisdiction
A. In addition to the procedure for applying for a writ of habeas corpus, as provided in title 13, chapter 38, article 26, a patient receiving court‑ordered treatment or any person acting on the patient's behalf may request the patient's release pursuant to the following:
1. A request in writing may be presented to any member of the treatment staff of the agency providing the patient's treatment. The request may be made on a prescribed form that shall be prepared by the facility and made available for use by any person. The completed form shall identify:
(a) The patient being treated and the agency at which the patient is being treated.
(b) The person to whom the request for release was made.
(c) The person making the request for release, indicating whether the person is the patient being treated or someone acting on the person's behalf.
2. The request, when signed and dated by the person making the request for release, shall be delivered to the medical director of the agency. Within three days of receipt of the request, the medical director shall deliver the form, along with a current psychiatric report of the patient's condition, to the clerk of the court. If the person presenting the request refuses to sign the form, the medical director of the agency shall proceed as if the form had been signed and shall note on the form the circumstances as to why the form was not signed.
B. The patient shall be informed of the patient's right to judicial review by the medical director of the agency and the patient's right to consult with counsel at least once each sixty days while the patient is undergoing court‑ordered treatment. The notification required by this subsection shall be recorded in the clinical record of the patient by the individual who gave the notice.
C. With the exception of requests made pursuant to
section 36‑540, subsection E, paragraphs 4 6 and 5 7 and section 36‑540.01, subsection J k for judicial review, a request for judicial
review may not be made sooner than sixty days after the issuance of the order
for treatment or a hearing on a previous petition for habeas corpus or the
issuance of the court order or other final resolution determining a previous
request for judicial review by the patient.
D. Judicial review shall be in the superior court in the county in which the patient is being treated. That court may review the additional material presented and enter its order without necessity of further hearing.
E. The reviewing court may order a further hearing on the affidavit of the attorney for the patient setting forth the need for further evidentiary hearing and the reasons why the hearing is necessary before the time set for the release of the patient.
F. The patient shall be informed of the patient's right to consult an attorney by the person or court to whom the patient makes the request for release at the time the patient makes the request and, in the case of confinement in an agency, by the reviewing court within one day of its receipt of notice from the medical director of the agency where the patient is being treated. The patient shall be permitted to consult an attorney to assist in preparation of a petition for the writ of habeas corpus and to represent the patient in the hearing. If the patient is not represented by an attorney, the reviewing court, within two days of its notice to the patient of the patient's right to counsel, shall appoint an attorney to assist the patient in the preparation of a petition and to represent the patient in the hearing.
G. The medical director of the mental health treatment agency, at least twenty‑four hours before the hearing, shall provide the patient's attorney with a copy of the patient's medical records.
H. The patient's attorney shall fulfill all of the following minimal duties:
1. Within twenty‑four hours of appointment, conduct an interview with the patient.
2. At least twenty‑four hours before the hearing, interview the patient's treatment physician or psychiatric and mental health nurse practitioner if available.
3. Before the hearing, examine the clinical record of the patient.
4. Before the hearing, examine the patient's court records as to the patient's involuntary treatment.
I. An attorney who does not fulfill the duties prescribed by subsection H of this section is subject to contempt of court.
Sec. 23. Section 36-3701, Arizona Revised Statutes, is amended to read:
36-3701. Definitions
In this article, unless the context otherwise requires:
1. "Agency" means any agency that is authorized to direct the release of a person who is serving a sentence or term of confinement or who is receiving treatment, including a state or federal prison, a county jail and the Arizona state hospital or other mental health treatment agency.
2. "Competent professional" means a person who is:
(a) Familiar with the state's sexually violent persons statutes and sexual offender treatment programs available in this state.
(b) Approved by the superior court as meeting court approved guidelines.
3. "Conviction" includes a finding of guilt at any time for a sexually violent offense or an order of the juvenile court adjudicating the person delinquent for any sexually violent offense.
4. "Less restrictive alternative" means court ordered treatment in a setting that is less restrictive than total confinement and that is conducted in a setting approved by the superintendent of the state hospital.
5. "Mental disorder" means a paraphilia, personality disorder or conduct disorder or any combination of paraphilia, personality disorder and conduct disorder that predisposes a person to commit sexual acts to such a degree as to render the person a danger to the health and safety of others.
6. "Sexually violent offense" means any of the following:
(a) Indecent exposure to a person who is under fifteen years of age pursuant to section 13‑1402, public sexual indecency to a minor pursuant to section 13‑1403, sexual conduct with a minor pursuant to section 13‑1405, sexual assault pursuant to section 13‑1406, molestation of a child pursuant to section 13‑1410, continuous sexual abuse of a child pursuant to section 13‑1417 or sexual assault of a spouse if the offense was committed before August 12, 2005.
(b) Second degree murder pursuant to section 13‑1104, first degree murder pursuant to section 13‑1105, assault pursuant to section 13‑1203, aggravated assault pursuant to section 13‑1204, unlawful imprisonment pursuant to section 13‑1303, kidnapping pursuant to section 13‑1304 or burglary in the first degree pursuant to section 13‑1508 if the court at the time of sentencing or civil commitment proceedings determines beyond a reasonable doubt that the act was sexually motivated pursuant to section 13‑118.
(c) An attempt, a solicitation, a facilitation or a conspiracy to commit an offense listed in subdivision (a) or (b) of this paragraph.
(d) An act committed in another jurisdiction that if committed in this state would be a sexually violent offense listed in subdivision (a), (b) or (c) of this paragraph.
(e) A conviction for a felony offense that was in effect before September 1, 1978 and that if committed on or after September 1, 1978 would be comparable to a sexually violent offense listed in subdivision (a) or (b) of this paragraph.
7. "Sexually violent person" means a person to whom both of the following apply:
(a) Has ever been convicted of or found guilty but insane of a sexually violent offense or was charged with a sexually violent offense and was determined incompetent to stand trial.
(b) Has a mental disorder that makes the person likely to engage in acts of sexual violence.
Sec. 24. Title 36, Arizona Revised Statutes, is amended by adding chapter 40, to read:
CHAPTER 40
DANGEROUS AND INCOMPETENT PERSONS
ARTICLE 1. GENERAL PROVISIONS
36-4001. Definitions
In this article, unless the context otherwise requires:
1. "Competent professional" means a person who is:
(a) familiar with this state's criminal and involuntary commitment standards and statutes for persons with a mental illness, defect or disability that are available in this state.
(b) approved by the superior court as meeting court approved guidelines.
2. "Dangerous incompetent" means a person who has been determined to be incompetent and nonrestorable and dangerous pursuant to title 13, chapter 41.
3. "Less restrictive alternative" means court ordered treatment in a setting that is less restrictive than total confinement and that is conducted in a setting approved by the superintendent of the state hospital.
4. "Mental illness, defect or disability" means a psychiatric or neurological disorder that is evidenced by behavioral or emotional symptoms, including congenital mental conditions, conditions resulting from injury or disease and developmental disabilities as defined in section 36-551.
36-4002. Annual examination of committed persons; report
A. The psychiatrist, psychologist or other competent professional of the state hospital or a licensed facility under the supervision of the Arizona state hospital shall annually examine each person who is committed pursuant to section 13-4518. The person who conducts the annual examination shall submit the examination report to the court. The annual report shall state the treatment and education that the person has received, a prognosis for the person's restoration to competency and whether the person remains dangerous.
B. If the psychiatrist, psychologist or other competent professional submits a report indicating that the person is competent to stand trial or is no longer dangerous the court shall hold a hearing to determine whether the person is competent or is no longer dangerous.
C. If the psychiatrist, psychologist or other competent professional submits a report that the person is no longer dangerous in whole or in part because of medication that the person is taking, the report shall state whether the defendant will continue to take that medication if released to a less restrictive alternative and would comply with all other conditions of a less restrictive alternative.
D. The court shall hold the hearing within forty‑five days after receiving the report. The court may continue the hearing on the request of either party and a showing of good cause or on its own motion if the person will not be substantially prejudiced. The prosecuting agency shall represent the state at the hearing and may request that the person be examined by a competent professional selected by the prosecuting agency. The attorney for the state has the burden of proving by clear and convincing evidence that the person's mental illness, defect or disability has not changed and that the person remains dangerous or that the person is competent to stand trial.
E. A retained or appointed competent professional shall have access to all records concerning the person. All competent professionals shall have equal access to the person as well as all records concerning the person.
F. this section does not preclude the person from petitioning the court for conditional release to a less restrictive alternative or unconditional discharge from treatment pursuant to section 36-4004.
36-4003. Disposition
After a hearing pursuant to section 36-4002 or 36‑4004, if the court finds that:
1. The person has been restored to competency, the court shall order that the criminal proceedings resume.
2. The person has not been restored to competency and:
(a) The person is not dangerous, the court shall release the person from treatment and proceed pursuant to section 13-4517, paragraph 1, 2 or 3.
(b) The person is not dangerous in whole or in part because of the habilitation or treatment that the patient is receiving, including the taking of medication, the court may release the person to a less restrictive alternative pursuant to sections 36‑4005 and 36‑4006.
(c) The person is dangerous, the person shall remain committed for education, care, supervision and treatment to render the person competent or nondangerous.
36-4004. Petition for change of status; procedures
A. If the superintendent of the state hospital or the director of the department of health services determines that the person's mental illness, defect or disability has so changed that the person is no longer dangerous if conditionally released to a less restrictive alternative, the superintendent or director shall allow the person to petition the court for conditional release to a less restrictive alternative. The person shall serve the petition on the court and the attorney for the state. The court shall hold a hearing on the petition for conditional release to a less restrictive alternative within forty‑five days after receiving the petition. The court may continue the hearing on the request of either party and a showing of good cause or on its own motion if the person will not be substantially prejudiced. The prosecuting agency shall represent the state at the hearing and may request that the person be examined by a competent professional selected by the prosecuting agency.
B. The attorney for the state has the burden of proving by clear and convincing evidence that the person's mental illness, defect or disability has not changed and that the person remains dangerous if conditionally released to a less restrictive alternative or unconditionally discharged.
C. This section does not prohibit the committed person from annually petitioning the court for conditional release to a less restrictive alternative without the approval of the superintendent of the state hospital or the director of the department of health services. The director of the department of health services shall provide an annual written notice to the committed person of the person's right to petition the court for conditional release to a less restrictive alternative without the approval of the superintendent or director. The notice must contain a waiver of rights. The director shall submit the notice and waiver to the court with the annual examination report.
D. The committed person may be present at the hearing. The prosecuting agency may request that the person be examined by a competent professional selected by the prosecuting agency. The committed person may retain and the court, on request of an indigent person, may appoint a competent professional. The attorney for the state has the burden of proving by clear and convincing evidence that the person's mental illness, defect or disability has not changed and that the person remains dangerous if conditionally released to a less restrictive alternative. If the state does not meet its burden of proof, the person shall be discharged from treatment.
E. At the conclusion of a hearing, if the court finds that there is no legally sufficient evidentiary basis to conclude that the conditions prescribed in section 36-4006 have been met, the court shall grant the state's motion for a judgment on the issue of conditional release to a less restrictive alternative.
36-4005. Conditional release to a less restrictive alternative; conditions; reports; review
A. If the court determines that conditional release to a less restrictive alternative is in the best interest of the person and will adequately protect the community and the court determines that the minimum conditions under section 36‑4006 are met, the court shall enter judgment and order the person's conditional release to a less restrictive alternative.
B. If the court concludes that the only reason the person does not meet the standard for continued commitment is the effect of treatment or habilitation being received, the court may deny the request for conditional release to a less restrictive alternative unless the court finds by a preponderance of the evidence that the person will continue to receive such treatment and habilitation following release for as long as the treatment and habilitation is required. If the court finds that the person will continue to receive the needed treatment or habilitation, it may order the person to be conditionally released to a less restrictive alternative on the condition that the person continue to receive such treatment or habilitation. If the person fails to receive the treatment or habilitation ordered, the court may revoke the conditional release.
C. The court may impose any additional conditions on the person that the court determines are necessary to ensure the person's compliance with treatment and to protect the community. If the court finds that conditions do not exist that will both ensure the person's compliance with treatment and protect the community, the court shall remand the person to the custody of the superintendent of the state hospital for care, supervision or treatment in a licensed facility that is under the supervision of the superintendent.
D. If the provider that is designated to provide inpatient or outpatient treatment or to monitor or supervise any other terms and conditions of a person's placement in a less restrictive alternative is not the state hospital, the provider shall agree in writing to provide the treatment.
E. Before the court authorizes a person's conditional release to a less restrictive alternative, the court shall impose any conditions on the person that the court determines are necessary to ensure the safety of the community. The conditions shall include that before a release to a less restrictive alternative, a person shall be required to submit to ninety days of inpatient evaluation at the Arizona state hospital. At the discretion of the superintendent of the state hospital, the duration of the evaluation period may be less than ninety days. The court shall order the superintendent of the state hospital to investigate the less restrictive alternative and to submit additional conditions to the court. The court shall give a copy of the conditions of release to the person and to any designated service provider. Other conditions may include any of the following:
1. Specification of a residence.
2. Compliance with any medications prescribed and any testing or monitoring required.
3. Prohibition on any contact with potential or past victims or other persons and prohibition on associating with other persons or types of persons.
4. Prohibition on the use of alcohol and other drugs.
5. Supervision by the department of health services.
6. A requirement that the person remain in this state unless the person receives prior authorization from the court.
7. Compliance with any supervision or monitoring or reporting required.
8. Other conditions that the court or the superintendent of the state hospital determines are in the best interest of the person or others.
F. Following a determination that a person's release to a less restrictive alternative is warranted and after considering the recommendation regarding the duration and amount of treatment by the superintendent of the state hospital, the court shall require as a condition of release to a less restrictive alternative that the person participate in outpatient treatment. The outpatient supervision and treatment may include monitoring a person by use of an electronic bracelet. The treatment shall continue until the court orders a change in the person's treatment requirements or the person is discharged pursuant to section 36‑4009.
G. Each month or as otherwise directed by the court, each designated service provider shall submit a report that states whether the person is complying with the terms and conditions of the conditional release to a less restrictive alternative to:
1. The court.
2. The facility from which the person was released.
3. The county attorney in the county where the person was found to be a dangerous incompetent or to the attorney general.
H. The court shall review the case of each person who is conditionally released to a less restrictive alternative within one year after the person's release and thereafter on motion of either party or the superintendent of the state hospital or on the court's own motion until the person is discharged. At a case review, the court shall determine only if the person shall continue to be conditionally released to a less restrictive alternative. In making its determination, the court shall consider the periodic reports that are submitted to the court pursuant to subsection G of this section and the opinions of the superintendent of the state hospital and any other competent professional.
I. If a person is conditionally released to a less restrictive alternative, the department of health services shall notify the department of public safety of the person's release so that the department of public safety can commence any applicable notification process as provided in section 13‑3825.
36-4006. Conditional release to a less restrictive alternative; findings
Before the court orders that a person be conditionally released to a less restrictive alternative, the court shall find that all of the following apply:
1. The person will be treated by a provider who is qualified to provide the necessary treatment in this state.
2. The provider presents a specific course of treatment for the person, agrees to assume responsibility for the person's treatment, will report on the person's progress to the court on a regular basis and will report any violations as prescribed in paragraphs 4 and 5 of this subsection immediately to the court, the attorney for the state and the superintendent of the state hospital.
3. The person who is conditionally released to a less restrictive alternative has housing arrangements that are sufficiently secure to protect the community and the person or agency that is providing the housing to the conditionally released person agrees in writing to the following conditions:
(a) To accept the conditionally released person.
(b) To provide the level of security that the court requires.
(c) To immediately report the unauthorized absence of the conditionally released person from the housing arrangement to which the person has been assigned.
4. The person will comply with the provider and all of the requirements that are imposed by the provider and the court.
5. The person will comply with the supervision requirements that are imposed by the department of health services.
36-4007. Detention and commitment requirements; definition
A. A person who is committed or conditionally released to a less restrictive alternative pursuant to this article does not forfeit any legal right and shall not suffer any legal disability as a consequence of any actions taken or orders made except as specifically provided in this article.
B. A person who is committed or conditionally released to a less restrictive alternative pursuant to this article shall receive care, supervision or treatment. The superintendent of the state hospital shall keep records detailing all medical, expert and professional care and treatment that a committed person receives and shall keep copies of all reports of periodic examinations that are made pursuant to this article. These records and reports shall be made available on request only to any of the following:
1. The committed person.
2. The committed person's attorney.
3. The county attorney or the attorney general.
4. The court.
5. On proper showing, an expert or professional person who demonstrates a need for access to the records or reports.
6. Any mental health professional directly responsible or associated with the mental health professional who is directly responsible for the care, control, assessment or treatment of the committed person.
C. At the time a person is detained or transferred into a licensed facility pursuant to this article, the person in charge of the facility or the person's designee shall take reasonable precautions to inventory and safeguard the personal property of the detained or transferred person. The staff member who makes an inventory of the person's personal property shall give a signed copy of that inventory to the person. The facility shall allow a responsible relative to inspect the property, subject to any limitations that the person specifically imposes. The facility shall not disclose the contents of the inventory to any other person without the consent of the person or a court order.
D. This article does not prohibit a person who is committed or conditionally released to a less restrictive alternative from exercising any right that is available for the purpose of obtaining release from confinement, including the right to petition for a writ of habeas corpus. The committed person must exhaust all direct appeal and postcommitment procedures before exercising the committed person's right to petition for a writ of habeas corpus.
E. A person who is indigent may not be conditionally released to a less restrictive alternative or discharged without suitable clothing. When a person is conditionally released to a less restrictive alternative or discharged, the superintendent of the state hospital shall furnish the person with an amount of money pursuant to section 31-228.
F. For the purposes of this section, "responsible relative" means the spouse, parent, adult child or adult sibling of the person and includes the guardian, conservator or attorney of the person.
36-4008. Revocation of conditional release to a less restrictive alternative; hearing
A. If the petitioner or the court believes that the person who is conditionally released to a less restrictive alternative is not complying with the terms and conditions of release or is in need of additional care and treatment, the designated service provider or the attorney for the state may petition the court for, or the court on its own motion may schedule, a hearing for the purpose of revoking or modifying the terms and conditions of the person's conditional release. The hearing shall be held within ten days after the petition is filed.
B. If the attorney for the state or the court reasonably believes that a person who is conditionally released to a less restrictive alternative is not complying with the terms and conditions of the person's conditional release, is in need of additional care or treatment or if the circumstances of the release have changed so that the community is no longer safe, the court or the department of health services may order that the conditionally released person be detained and taken into custody until a hearing can be scheduled to determine if the person's conditional release should be revoked or modified. The court shall be notified before the close of the next judicial day of the person's detention. The attorney for the state and the conditionally released person may request an immediate mental examination of the person. If the conditionally released person is indigent, the court, on request, shall assist the person in obtaining a competent professional to conduct the examination.
C. Within five days after receiving notice of the person's detention, the court shall schedule a hearing. At the hearing, the court shall determine if the state has proved by a preponderance of the evidence that the person who is conditionally released to a less restrictive alternative did not comply with the terms and conditions of release, is in need of additional care or treatment or if the circumstances of the release have changed so that the community is no longer safe and if the person should continue on conditional release under the same or modified conditions or if the conditional release should be revoked and the person should be committed to total confinement, subject to release only under the provisions of this article. The court may admit hearsay evidence if the court finds that the hearsay evidence is otherwise reliable.
36-4009. Petition for discharge; procedures
A. If the superintendent of the state hospital or the director of the department of health services determines that the person's mental illness, defect or disability has so changed that the person is no longer dangerous if discharged, the superintendent or director shall allow the person to petition the court for discharge. The person shall serve the petition on the court and the attorney for the state. The court shall hold a hearing on the petition for discharge within forty-five days after receiving the petition. The court may continue the hearing on the request of either party and a showing of good cause or on its own motion if the respondent will not be substantially prejudiced. The prosecuting agency shall represent the state at the hearing and may request that the petitioner be examined by a competent professional who is selected by the prosecuting agency. The attorney for the state has the burden of proving by clear and convincing evidence that the petitioner's mental illness, defect or disability has not changed and that the petitioner remains dangerous or that the defendant is currently competent to stand trial.
B. This section does not prohibit the committed person from annually petitioning the court for discharge without the approval of the superintendent of the state hospital or the director of the department of health services. The director of the department of health services shall give annual written notice to the committed person of the person's right to petition the court for discharge without the approval of the superintendent or director. The notice shall contain a waiver of rights. The director shall submit the notice and waiver to the court with the annual examination report.
C. The committed person may be present at the discharge hearing. The prosecuting agency may request that the person be examined by a competent professional who is selected by the attorney for the state. The committed person may retain and the court on the request of an indigent person may appoint a competent professional. The attorney for the state has the burden of proving beyond a reasonable doubt that the person's mental illness, defect or disability has not changed and that the person remains a danger to others and is likely to engage in acts that are a danger to public safety if discharged. If the state does not meet its burden of proof, the person shall be discharged from treatment.
D. If a person is discharged, the department of health services shall notify the department of public safety of the person's discharge so that the department of public safety can commence any notification process as provided in section 13-3825.
36-4010. Place for proceedings; transportation; immunity
A. Except as provided in subsection B of this section, a person who is detained or civilly committed pursuant to this article shall not be transported from a licensed facility under the supervision of the superintendent of the Arizona state hospital, except that a person may be transported to court for any of the following reasons:
1. A hearing on an annual examination.
2. A hearing on a petition for conditional release to a less restrictive alternative pursuant to section 36-4005.
3. A hearing on a petition for discharge pursuant to section 36-4009.
4. Any evidentiary hearing in which the presence of a person who is detained or civilly committed pursuant to this article is necessary.
5. Any court proceeding not otherwise specified in this article where the presence of the committed person is required.
B. Subsection A of this section does not apply to any person whom the court has determined is subject to conditional release pursuant to section 36-4009 or to any necessary medical transports.
C. Subsection A of this section does not preclude any proceeding from being held on the grounds of the Arizona state hospital or from using a telephonic conference or an interactive audiovisual device. The court shall adopt rules concerning the conduct of proceedings pursuant to this article. The rules shall ensure the safety of all persons. The rules may include provisions that allow for proceedings to be held on the grounds of the Arizona state hospital or for the use of a telephonic conference or an interactive audiovisual device.
D. The department of health services is responsible for the transportation to and from a medical facility of a person who is detained or committed pursuant to this article. The department of health services shall determine the appropriate mode of transportation and level of security and restraint for the transportation needs of the person. In determining the appropriate mode of transportation and level of security and restraint, the department shall consider the safety of the public, the transporting personnel and the detained or committed person.
E. The department of health services and any county sheriff are immune from liability for any good faith acts under this section.
Sec. 25. Effective date
This act is effective from and after December 31, 2016."
Amend title to conform