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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
court-ordered treatment; continuation
Purpose
Effective January 1, 2027, establishes a process to convert an order for court-ordered treatment to an order for continuing court-ordered treatment after a patient's second consecutive annual review by the medical director of the mental health treatment agency (medical director) that is conducting the patient's court-ordered treatment.
Background
If, after a petition and hearing for court-ordered treatment, 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 in a hospital as specified (A.R.S. § 36-540).
Within 90 days before the expiration of a court order for treatment, the
medical director must conduct an annual review of a patient who has a grave
disability or a persistent or acute disability and who 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. The annual review must consist of the mental
health treatment and clinical records contained in the patient's treatment file
and the mental health treatment agency must keep a record of the annual review.
If the medical director believes that a continuation of court-ordered treatment
is appropriate, the medical director must appoint one or more psychiatrists to
carry out a psychiatric examination of the patient. A patient has the right to
have an analysis of the patient's mental condition by an independent evaluation
in any proceeding conducted to determine whether the patient requires an order
to continue court-ordered treatment. If a hearing is held to determine whether
an order for continuing court-ordered treatment should be issued, the party
seeking the renewal of the court order must prove by clear and convincing
evidence that the patient:
1) 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) is in need of
continued court-ordered treatment; and 3) is either unwilling or unable to
accept treatment voluntarily (A.R.S.
§ 36-543).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Replaces references to the current process for continued court-ordered treatment with references to renewal of the court order for treatment.
2. Modifies the list of conditions which exempt a patient from the requirement that the patient be discharged at the expiration period of treatment that is court ordered to include the granting of an application for:
a) renewal, rather than continuation, of the court order for treatment; and
b) conversion to an order for continuing court-ordered treatment.
3. Requires the medical director, after conducting a patient's second consecutive annual review following a renewal of court-ordered treatment and if the medical director believes that an order for continuing court-ordered treatment is appropriate, to:
a) appoint at least one psychiatrist to carry out a psychiatric examination of the patient and to submit a report in the same manner as prescribed for the renewal process; and
b) request the examiner to provide an opinion on the conditions which allow the court order for treatment to be converted to an order for continuing court-ordered treatment.
4. Instructs the medical director, after receiving the psychiatric examination report and at least 30 days before the expiration of the court order for treatment, to file an application with the court for a conversion to an order for continuing court-ordered treatment if the medical director believes that an order for continuing court-ordered treatment is still appropriate.
5. Requires the application for conversion to an order for continuing court-ordered treatment to allege the basis for the application and to be filed simultaneously with the report from the psychiatric examination.
6. Requires the court to appoint an attorney for the patient if the patient does not have an attorney on application for a conversion to an order for continuing court-ordered treatment.
7. Requires a copy of an application for conversion to an order for continuing court-ordered treatment to be provided to the patient, patient's attorney and guardian, if applicable.
8. Allows a court order for treatment to be converted to an order for continuing court-ordered treatment if the court finds by clear and convincing evidence that:
a) the patient continues to have a mental disorder that results in a persistent or acute disability or a grave disability;
b) the patient is either unwilling or unable to accept treatment voluntarily; and
c) without an order for continuing court-ordered treatment, the patient's condition is not likely to significantly improve and there is a substantial probability that the patient will suffer severe and abnormal mental, emotional or physical harm or will be unable to provide for the patient's own basic physical needs.
9. Stipulates that, if the application for conversion to an order for continuing treatment is denied and conditions for the renewal of court-ordered treatment are met, the court may order the patient to be released from court-ordered treatment or for the court order for treatment to be renewed for a period of time within the maximum prescribed durations for court-ordered outpatient and combined inpatient and outpatient treatment.
10. Requires the court, when granting an order for continuing court-ordered treatment, to order a patient to continue treatment until the order for continuing court-ordered treatment is terminated by the court.
11. Exempts an order for continuing court-ordered treatment from the maximum periods that a court may order for inpatient treatment.
12. Requires the medical director to conduct an annual review of the patient and file a written annual report with the court within 90 days before the anniversary date of the order for continuing treatment.
13. Requires the annual report to include:
a) a summary of the treatment provided to the patient since the last annual review;
b) the patient's compliance with the treatment provided or recommended; and
c) the opinion of the medical director as to whether the order for continuing court-ordered treatment should remain in effect or whether the order should be terminated.
14. Requires a copy of the annual report to be provided to the patient, the patient's attorney and guardian.
15. Stipulates that if the annual report states that the patient's court-ordered treatment should be terminated the report must:
a) state the basis for the opinion;
b) affirm that in reaching the opinion, the medical director considered the patient's entire history of engagement in and compliance with treatment ordered or recommended; and
c) confirm that it is the medical director's opinion that the patient is willing and able to voluntarily engage in and follow any recommended treatment.
16. Allows a patient's guardian to request a hearing to determine whether the standard for release has been met and that an independent evaluation of the patient be performed, if the annual report states that court-ordered treatment should be terminated.
17. Stipulates that if the annual report states that the patient's court-ordered treatment should remain in effect the report must include the report of a psychiatrist who conducted an examination of the patient within 90 days before the anniversary date of the order for continuing treatment that contains:
a) confirmation that the psychiatrist reviewed the treatment records of the patient, including the services provided during the period since the last annual report;
b) a summary of the psychiatrist's observations of the patient's physical and mental condition; and
c) the opinion of the psychiatrist as to whether an order for continuing court-ordered treatment should remain in place and the basis for the opinion.
18. Allows the court to order, without a hearing, that the order for continuing court-ordered treatment remain in place if the annual report supports the continuation.
19. Allows a patient to object to an order for continuing court-ordered treatment by filing a request for a hearing within 10 business days of the filing of the annual report.
20. Grants the patient the right to request an independent evaluation on objection to an order for continuing treatment.
21. Requires the court to hold a
hearing on a patient's objection to an order for continuing
court-ordered treatment within 30 calendar days of receiving the request for
hearing.
22. Specifies that, at the hearing on an objection to continuing court-ordered treatment, the mental health treatment agency has the burden of proving by clear and convincing evidence that an order for continuing court-ordered treatment is necessary.
23. Specifies that a patient's treatment that is consistent with an existing court order must continue pending the court's ruling on an objection to continuing court-ordered treatment.
24. Makes technical and conforming changes.
25. Becomes effective on January 1, 2027.
Amendments Adopted by Committee
· Removes physicians, physician assistants and nurse practitioners in counties with populations of fewer than 500,000 persons from the list of medical professionals who may complete the annual examination of a patient required for continued court-ordered treatment.
Amendments Adopted by Committee of the Whole
1. Requires the medical director to appoint at least one psychiatrist, rather than an appropriate medical professional, to carry out the psychiatric examination of a patient for orders for continuing court-ordered treatment.
2. Requires the court to appoint an attorney for the patient on application to convert an order to an order for continuing treatment, if the patient does not already have an attorney.
3. Removes
the specification that the processes relating to the appointment of attorneys,
duties of appointed attorneys and hearings that follow the filing of an
application to renew court-ordered treatment also apply to conversions of court-ordered
treatment to orders for continuing
court-ordered treatment.
4. Requires the annual review of a patient to occur within 90 days before, rather than 30 days before the anniversary date of a patient's order for continuing court-ordered treatment.
5. Outlines specific information that the annual report must include based on whether the medical director's opinion in the report states that continuing court-ordered treatment should be terminated or remain in effect.
6. Grants a patient the right to request an independent evaluation on objection to an order for continuing court-ordered treatment.
7. Replaces the burden on the patient of proving by clear and convincing evidence at a hearing on objection that the patient no longer meets the criteria for continuing court-ordered treatment, with the burden on the mental health treatment agency to prove that an order for continuing treatment is necessary.
8. Adds a delayed effective date of January 1, 2027.
9. Makes technical and conforming changes.
Senate Action
JUDE 1/28/26 DPA 6-1-0
Prepared by Senate Research
February 24, 2026
ZD/KS/ci