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SB1244 - 572R - S Ver
Senate Engrossed
court-ordered
treatment; continuation
State of Arizona
Senate
Fifty-seventh Legislature
Second Regular Session
2026
SENATE BILL 1244
AN
ACT
Amending sections 36-504.01, 36-542 and
36-543, Arizona Revised Statutes; amending title 36, chapter 5, article
5, Arizona Revised Statutes, by adding section 36-543.01; relating to
mental health services.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it
enacted by the Legislature of the State of Arizona:
Section 1. Section 36-504.01, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-504.01.
Guardians and agents; rights in proceedings
Guardians and agents who have decisional authority to make
personal, medical and treatment decisions for a patient pursuant to an order of
the court or pursuant to a validly executed mental health power of attorney in
which the principal has been found incapable of giving informed consent have
the following rights in any proceedings under this article regarding
involuntary treatment of the patient:
1. To be notified of any petition for treatment,
motion for amended court order, application for
continued court-ordered
renewal of the court order for
treatment
,
application for conversion to an order for continuing court-ordered
treatment
and request for judicial review.
2. If allowed by the court, to provide the court
with the guardian's or agent's position regarding the relief being sought in
any of the proceedings set forth in paragraph 1 of this section and to provide
the court with any relevant information to help the court make a determination.
3. To provide relevant information to any agency
providing inpatient or outpatient screening, evaluation or treatment to the
patient.
4. When appropriate, to participate in treatment and
discharge planning with the inpatient or outpatient treatment providers.
END_STATUTE
Sec. 2. Section 36-542, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-542.
Discharge of patient at expiration of period ordered by court;
change to voluntary status; immunity
A. A patient
who is
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
renewal of the court order for
treatment
is granted pursuant to section 36-543.
4. An application for conversion to
an order for continuing court-ordered treatment is granted pursuant to
section 36-543.01.
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
of the mental health treatment agency
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
renewed
, the
patient may not be discharged or released from treatment before compliance with
section 36-541.01.
D. The medical director
of the mental
health treatment agency
is not civilly liable for any acts committed by
a released or discharged patient if the medical director
of the
mental health treatment agency
has in good faith followed the
requirements of this article.
END_STATUTE
Sec. 3. Section 36-543, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-543.
Annual review; patients with a grave disability or a persistent
or acute disability; notice; renewal of court order for treatment; rules;
immunity
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 who is undergoing
court-ordered treatment to determine whether the
continuation
of court-ordered
renewal of the court order for
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
of the mental
health treatment agency
believes that a
continuation of
court-ordered
renewal of the court order for
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.
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
renewal of the court order for
treatment. In evaluating the patient's need for
continued
court-ordered
renewal of the court order for
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.
C. After conducting the annual review as prescribed
in this section, if the medical director
of the mental health
treatment agency
believes that
continued court-ordered
renewal of the court order for
treatment is necessary or
appropriate, not later than thirty days before the expiration of the court
order for treatment, the medical director
of the mental health
treatment agency
shall file with the court an application for
continued court-ordered
renewal of the court
order for
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
of the mental health treatment agency
shall
mail a copy of the application to the patient's guardian.
D. If an application for
continued
court-ordered
renewal of the court order for
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
of the medical director of the mental
health treatment agency
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 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
renewal of the
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
for renewal
of the court order for
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.
E. If a hearing is held pursuant to subsection D of
this section, the party seeking the renewal of the court order
for
treatment
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
renewal of the court order for
treatment.
3. The patient is either unwilling or unable to
accept treatment voluntarily.
F. After a hearing held pursuant to subsection D of
this section, the court may order the patient to be released from court-ordered
treatment or to
undergo continued court-ordered
renew the court order for
treatment for a period not to exceed
the time periods prescribed in section 36-540, subsection D.
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
of the mental health treatment
agency
has in good faith complied with the requirements of this article.
END_STATUTE
Sec. 4. Title 36, chapter 5, article 5, Arizona
Revised Statutes, is amended by adding section 36-543.01, to read:
START_STATUTE
36-543.01.
Continuing court-ordered treatment; annual review; order for
conversion; annual report; burden of proof
A. After conducting a patient's
second consecutive annual review as prescribed in section 36-543,
subsection A, if the medical director of the mental health treatment agency
believes that an order for continuing 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 and submit a report as set forth in section 36-543 and shall
request the examiner to provide an opinion about the issues set forth in
subsection C of this section in addition to the reporting requirements
prescribed in section 36-543, subsection B.
B. After receiving the report
pursuant to subsection A of this section, if the medical director of the mental
health treatment agency believes that an order for continuing court-ordered
treatment is appropriate, at least thirty days before the expiration of the
court order for treatment, the medical director of the mental health treatment
agency shall file with the court an application for a conversion to an order
for continuing court-ordered treatment alleging the basis for the
application and shall file simultaneously with the application the report from
the psychiatric examination performed pursuant to subsection A of this
section.� if the patient does not have an attorney, the court shall appoint an
attorney to represent the patient.� A copy of the application shall be provided
to the patient and the patient's attorney and, If the patient is under
guardianship, to the patient's guardian.
C. A court order for treatment may be
converted to an order for continuing court-ordered treatment as set forth
in this section if the court finds all 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 either unwilling or
unable to accept treatment voluntarily.
3. 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 be unable
to provide for the patient's own basic physical needs.
D. If the application for conversion
to an order for continuing court-ordered treatment is denied, the court
may order the patient to be released from court-ordered treatment or, if
the provisions of section 36-543, subsection E have been met, order that
the court order for treatment be renewed for a period of not more than the time
periods prescribed in section 36-540, subsection D.
E. If the application for conversion
to an order for continuing court-ordered treatment is granted, the court
shall order the patient to continue in treatment until the order for continuing
court-ordered treatment is terminated by the court.� The maximum periods
for inpatient treatment that a court may order pursuant to section 36-540,
subsection F do not apply to an order for continuing court-ordered
treatment issued pursuant to this section.
F. Within
ninety days before the anniversary date of the order for continuing court-ordered
treatment, the medical director of the mental health treatment agency shall
conduct an annual review of the patient and shall file a written annual report
with the court. �The annual report shall contain a summary of the treatment
provided to the patient since the last annual review and the patient's
compliance with the treatment provided or recommended and shall state the
opinion of the medical director whether the order for continuing court-ordered
treatment should remain in effect or whether court-ordered treatment
should be terminated.� A copy of the annual report shall be provided to the
patient and the patient's attorney and, if the patient is under guardianship,
to the patient's guardian.� On filing the annual report, the following apply:
1. If the annual report states that
it is the opinion of the medical director of the mental health treatment agency
that the patient's court-ordered treatment should be terminated, the
annual report shall state the basis for that opinion, shall affirm that in
reaching that opinion the medical director of the mental health treatment
agency considered the patient's entire history of engagement in and compliance
with treatment ordered or recommended and shall confirm that it is the opinion
of the medical director of the mental health treatment agency that the patient
is both willing and able to engage in and follow any recommended treatment
voluntarily.� A copy of the annual report shall be provided to the patient and
the patient's attorney and, if the patient is under guardianship, to the
patient's guardian.� The guardian for the patient has the right to request a
hearing to determine whether the standard for release has been met and to
request that an independent evaluation of the patient be performed.
2. If the annual report states that
it is the opinion of the medical director of the mental health treatment agency
that the patient's court-ordered treatment should remain in effect, the
annual report shall include a report of a psychiatrist who conducted an
examination of the patient within ninety days before the anniversary date of
the order for continuing court-ordered treatment that contains the
following:
(
a
) Confirmation
that the psychiatrist reviewed the treatment records of the patient, including
the services provided to the patient over the period since the last annual
report.
(
b
) A summary
of the psychiatrist's observations of the patient's physical and mental
condition.
(
c
) The opinion
of the psychiatrist as to whether an order for continuing court-ordered
treatment should remain in place and the basis for that opinion.
3. If the annual report supports the continuation
of the court order for treatment, the court, without a hearing, may order that
the order for continuing court-ordered treatment remain in
place. The patient may object to the order for continuing court-ordered
treatment by filing a request for hearing within ten business days after the
annual report is filed. The court shall hold this hearing within
thirty calendar days after receipt of the request. Treatment
pursuant to the existing court order shall continue pending the court's ruling
on the issue. The patient has the right to request an independent
evaluation.� At the hearing, the mental health treatment agency has the burden
of proving by clear and convincing evidence that an order for continuing court-ordered
treatment pursuant to this section is necessary.
END_STATUTE
Sec. 5.
Effective date
This act is effective from and after
December 31, 2026.