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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
mental health; intensive treatment orders
Purpose
Allows the court to enter an order for intensive treatment services if the court finds by clear and convincing evidence that the patient is seriously mentally ill and chronically resistant to treatment, as prescribed. Outlines requirements and procedures related to orders for intensive treatment and intensive treatment plans.
Background
If the court finds by clear and convincing evidence that a patient, as a result of a mental disorder, is a danger to self or others or has a persistent, acute or grave disability and is in need of treatment but is either unwilling or unable to accept voluntary treatment, the court must order the patient to undergo: 1) treatment in a program of outpatient treatment; 2) treatment in a program consisting of combined inpatient and outpatient treatment; or 3) inpatient treatment in a mental health treatment agency or in a hospital, as prescribed. If the court enters an order for outpatient treatment or combined inpatient and outpatient treatment, the court must designate the medical director of the mental health treatment agency that will supervise and administer the patient's treatment program and may order the medical director to provide notice to the court of any noncompliance with the treatment order. During any period of outpatient treatment under an order for combined inpatient and outpatient treatment, if the court determines that the patient is not complying with the terms of the order or that the outpatient treatment plan is no longer appropriate, the court may enter an order to amend the original order for treatment without a hearing, as prescribed (A.R.S. ยง 36-540).
The Joint Legislative Budget Committee (JLBC) estimates that H.B. 2706 may generate additional costs at the state and local levels to pay the cost of intensive treatment services and for any increase in administrative costs associated with the bill. However, the magnitude cannot be estimated in advance as the total impact will depend on the frequency with which the courts utilize orders for intensive mental health treatment services (JLBC Fiscal Note).
Provisions
1. Allows the court to enter an order for intensive treatment services if the court finds by clear and convincing evidence that a patient is seriously mentally ill and chronically resistant to treatment.
2. Allows an order for intensive treatment services to be entered by the court as an initial order for treatment or when amending or renewing the order for treatment.
3. Requires an order for intensive treatment services to incorporate a written intensive treatment services plan (treatment plan) that is:
a) approved by the court;
b) prepared by staff who are familiar with the patient's case history; and
c) approved by the medical director of the agency or organization designated to administer and supervise the patient's treatment program.
4. Requires the treatment plan to conform to prescribed requirements relating to conditional outpatient treatment plans for persons found incompetent to stand trial.
5. Allows the court to determine that a person is chronically resistant to treatment if, within the 24 months before an order for intensive treatment services is issued, excluding time that the person was hospitalized or incarcerated, the person demonstrated a persistent or recurrent unwillingness or inability to participate in or adhere to treatment for a mental disorder.
6. Requires the court's finding that a person is chronically resistant to treatment to be based on clear and convincing evidence that establishes:
a) the person received unsuccessful, or likely to be unsuccessful, treatment in the preceding 24 months in community mental health residential treatment services and facilities, including unsecured residential treatment settings with on-site 24-hour supportive treatment and supervision by behavioral health staff;
b) the person's nonadherence to or nonparticipation in treatment during the preceding 24 months resulted in:
i. serious harm to self;
ii. serious harm or threats of serious harm to others;
iii. recurrent periods of homelessness due to the mental disorder;
iv. recurrent serious medical problems due to poor self-care or failure to follow medical treatment recommendations;
v. recurrent arrests due to behavior resulting from the mental disorder; and
c) any other evidence relevant to the person's willingness or ability to participate in and adhere to treatment without an intensive treatment order.
7. Directs the court, if entering an order for intensive treatment services, to advise the patient:
a) verbally and in writing, that the plan is part of the enforceable court order, and that noncompliance may result in an order for a peace officer to detain the patient for placement or return to inpatient treatment;
b) that the court may set periodic compliance hearings to address the patient's compliance with the treatment plan and the services provided to the patient; and
c) that the treatment plan may be modified at any compliance hearing, whether or not the patient is present.
8. Requires the court to order the medical director of the mental health treatment agency that is designated to administer and supervise the patient's treatment plan to provide notice to the court of specific instances of the patient's significant or persistent noncompliance with the treatment plan and to file written progress reports with the court at least every 60 days.
9. Allows the court to set a compliance hearing at a time designated by the court and to require the patient and a representative of the patient's treatment team to appear to address the patient's compliance with the treatment plan and services provided.
10. Allows the court to modify the treatment plan at any compliance hearing on the motion of any party or the court's own motion.
11. Requires the treatment agency to provide notice of the date, time and place of a compliance hearing to the patient, patient's attorney and, if applicable, the patient's guardian at the last known address provided to the agency for those persons.
12. Stipulates that the patient is not required to consent to intensive treatment services if the court specifically finds that the patient's mental disorder significantly impairs the patient's capacity to make an informed decision regarding treatment.
13. Defines intensive treatment services as services for which the patient is eligible pursuant to statutory requirements and that are identified in a written plan approved by the court and includes:
a) assignment of the patient, for any outpatient services, to a treatment team with an intensive case manager who must;
i. have in-person contact with the patient to facilitate and assess the patient's progress and compliance with the plan; and
ii. designate a team of professionals to address the specific needs of the patient to improve the patient's condition and prevent a relapse or harmful deterioration of the patient's condition;
b) residential placement that provides the patient with stable, safe and, if necessary, secure residence to enhance compliance with the treatment plan and protect the safety of the patient and the public;
c) medically necessary nonemergency transportation to transport the patient to and from a covered physical or behavioral health service for the patient to comply with the plan; and
d) treatment services specified in the plan for which the patient is found to be eligible that are designated by the treatment team, ordered by the court and are believed to be necessary to improve and prevent the deterioration of the patient's condition and to protect the patient and the public.
14. Becomes effective on the general effective date.
House Action
HHS 2/18/25 W/D
GOV 2/20/25 DP 7-0-0
3rd Read 3/4/25 46-12-2
Prepared by Senate Research
March 24, 2025
MM/KS/slp