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To: Public Health and Human
Services; Judiciary A
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026
By: Representatives Creekmore IV, Scott
HOUSE BILL NO. 424
(As Passed the House)
AN ACT TO AMEND SECTION 41-21-74, MISSISSIPPI CODE OF 1972, 1
TO AUTHORIZE ASSISTED OUTPATIENT TREATMENT (AOT) AS AN ALTERNATIVE 2
TO INPATIENT COMMITMENT FOR PERSONS WHO MEET CERTAIN CRITERIA; TO 3
SPECIFY WHO MAY INITIATE AN AOT ORDER; TO REQUIRE THE COURT TO 4
MAKE CERTAIN FINDINGS BEFORE ENTERING AN AOT ORDER; TO REQUIRE THE 5
SUBMISSION AND UPDATING OF A TREATMENT PLAN AFTER ENTRY OF AN AOT 6
ORDER; TO PROVIDE THAT THE RESPONDENT SHALL HAVE THE RIGHT TO AN 7
ATTORNEY AT ALL STAGES OF ANY PROCEEDING INVOLVING AOT; TO SPECIFY 8
THE INITIAL LENGTH OF AN AOT ORDER AND AUTHORIZE RENEWALS OF THE 9
ORDER; TO AUTHORIZE CERTAIN PERSONS TO FILE AN AFFIDAVIT OF 10
NONCOMPLIANCE WITH A TREATMENT PLAN; TO REQUIRE SCREENING BEFORE 11
SUCH AN AFFIDAVIT IS FILED; TO PROVIDE THAT THE COUNTY OF 12
RESIDENCE SHALL BE RESPONSIBLE FOR COMMUNITY COORDINATION, 13
TRANSPORTATION, AND FOLLOW-UP SERVICES; TO REQUIRE LOCAL SCREENING 14
BEFORE RETURNING THE RESPONDENT TO A STATE HOSPITAL FOR 15
NONCOMPLIANCE; TO PROVIDE THAT THE CHANCERY COURT OF THE COUNTY 16
WHERE THE PUBLIC FACILITY IS LOCATED OR THE COMMITTING COURT SHALL 17
HAVE JURISDICTION OVER MATTERS RELATING TO AOT ORDERS; AND FOR 18
RELATED PURPOSES. 19
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 20
SECTION 1. Section 41-21-74, Mississippi Code of 1972, is 21
amended as follows: 22
41-21-74. * * * (1) Use of commitment procedures. The 23
procedures set forth in Sections 41-21-61 through 41-21-107 may be 24
used to order assisted outpatient treatment (AOT), formerly 25
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referred to as outpatient commitment (OPC), for individuals who 26
meet the criteria in this section. 27
(2) Definition of AOT. As used in this section, "assisted 28
outpatient treatment" means a court-ordered plan of 29
community-based behavioral health treatment for an individual with 30
a serious mental illness or co-occurring disorder who is unlikely 31
to maintain stability without structured support. AOT shall 32
provide a structured, court-supervised alternative to inpatient 33
hospitalization and shall be administered in the least restrictive 34
environment consistent with clinical needs and public safety. 35
(3) Eligibility for AOT. An individual is eligible for AOT 36
when: 37
(a) The individual has a serious mental illness or 38
co-occurring disorder; 39
(b) Nonadherence to treatment has previously resulted 40
in at least one (1) of the following: 41
(i) Rehospitalization; 42
(ii) Criminal justice involvement; or 43
(iii) Demonstrated risk of harm to self or others; 44
(c) The individual is unlikely to remain stable without 45
supervised outpatient treatment; and 46
(d) The individual is likely to benefit from AOT. 47
(4) Initiation of an AOT order. An AOT order may be 48
initiated by any of the following: 49
(a) A state hospital; 50
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(b) A crisis stabilization unit for individuals at high 51
risk of recidivism; or 52
(c) A chancery judge or special master as an 53
alternative to civil commitment. 54
(5) Required judicial findings. Before entering an AOT 55
order, the chancery or circuit court shall make written findings, 56
based upon clear and convincing evidence, that the respondent: 57
(a) Has a serious mental illness or co-occurring 58
disorder; 59
(b) Is unlikely to remain stable in the community 60
without supervision based upon a pattern of treatment nonadherence 61
resulting in hospitalization, arrest or dangerousness within the 62
preceding thirty-six (36) months; 63
(c) Is capable of living safely in the community with a 64
court-ordered treatment plan; and 65
(d) Is likely to benefit from structured outpatient 66
treatment and requires such treatment to prevent relapse likely to 67
result in serious harm to self or others. 68
(6) Submission and updating of treatment plan. (a) Within 69
ten (10) days of the entry of an AOT order, the community mental 70
health center or treating mental health professional shall submit 71
to the court an update on the respondent's compliance with the 72
AOT, which shall be incorporated into the order. This update 73
shall state in detail whether or not the respondent is in 74
compliance. 75
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(b) The same update on compliance shall be resubmitted 76
at least every ninety (90) days to the court. 77
(7) Authority to provide treatment under AOT. (a) If the 78
commitment order directs outpatient treatment, the outpatient 79
treatment physician or treating provider may prescribe or 80
administer to the respondent treatment consistent with accepted 81
medical standards and within the scope of the AOT order. 82
(b) The order shall incorporate or reference the 83
individualized treatment plan developed by the community mental 84
health center or other aftercare provider and the discharge plan 85
from a state hospital, and approved by the court. 86
(8) Appointment of attorney. (a) The respondent shall have 87
the right to be represented by an attorney at all stages of any 88
proceeding involving AOT, including, but not limited to: 89
(i) Entry of an AOT order; 90
(ii) Modification, extension, or termination of an 91
AOT order; and 92
(iii) Proceedings to return the respondent to 93
inpatient care. 94
(b) If the respondent is indigent, unwilling, or unable 95
to retain counsel, the court shall immediately appoint an attorney 96
to represent the respondent as under Sections 41-21-67 and 97
41-21-83. 98
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(c) Any waiver of rights under Section 41-21-76 shall 99
be made only after consultation with counsel and shall be placed 100
on the record. 101
(9) Length of order. An initial AOT order shall not exceed 102
one hundred eighty (180) days. 103
(10) Renewal of order. The court may thereafter renew the 104
order for additional periods not to exceed one hundred eighty 105
(180) days each, not to exceed twelve (12) months in total, based 106
upon: 107
(a) A current clinical evaluation; and 108
(b) Documentation demonstrating continued benefit or 109
clinical necessity. 110
(11) Definition of noncompliance. (a) As used in this 111
section, "noncompliance" means failure to follow material 112
components of the treatment plan after reasonable efforts to 113
re-engage have been attempted and documented. 114
(b) Minor lapses, including missed medications where 115
prompt re-administration is possible, shall not alone constitute 116
noncompliance. 117
(12) Authorized filers of noncompliance affidavits. An 118
affidavit of noncompliance may only be filed by: 119
(a) The director of the treatment facility, his or her 120
designee or an interested person; 121
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(b) A community mental health center mental health 122
professional or other treating mental health professional 123
responsible for the respondent's aftercare; or 124
(c) A district attorney or assistant district attorney 125
only in cases arising out of a circuit court order involving 126
competency or nonrestorability. 127
Any affidavit of noncompliance must result in a clinical 128
screening by a mental health professional before any inpatient 129
placement is ordered. 130
(13) Required screening. (a) Before such affidavit of 131
noncompliance is filed, a community mental health center mental 132
health professional shall conduct and document a pre-affidavit 133
screening to determine: 134
(i) Whether the individual meets criteria for 135
civil commitment; and 136
(ii) Whether the concerns can be addressed at a 137
lower level of care. 138
(b) Documentation shall include: 139
(i) The specific ways the individual has failed to 140
comply; and 141
(ii) The reasonable efforts made to assist the 142
individual in complying, including offering the opportunity to 143
receive missed medication. 144
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(c) An isolated failure, such as a single missed 145
medication dose, shall not support return to a state hospital 146
without opportunity to remediate. 147
(14) Resumption after hospitalization. If an individual 148
under an AOT order is hospitalized, the order shall pause and 149
automatically resume upon discharge unless modified by the court. 150
(15) County of responsibility. The county of residence 151
shall be responsible for community coordination, transportation, 152
and follow-up services unless the court orders otherwise. 153
(16) Substance use disorder treatment. AOT may be ordered 154
for individuals with substance use disorders when a qualified 155
nonhospital provider is designated to deliver treatment. 156
(17) Requirement of local screening before return to 157
hospital. (a) Upon filing of a properly documented affidavit of 158
noncompliance, the sheriff may take custody of the respondent. 159
(b) Before return to a state hospital, the respondent 160
shall first be transported, when practicable, to: 161
(i) A community mental health center; or 162
(ii) A Department of Mental Health-certified 163
crisis stabilization unit for screening, triage and stabilization. 164
(c) Return to a state hospital may occur only if 165
screening determines civil commitment criteria are met and no 166
lesser restrictive level is sufficient. 167
(d) Screening results shall be made part of the record. 168
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ST: Mental health; authorize assisted
outpatient treatment (AOT) as alternative to
impatient commitment for certain persons.
(18) Jurisdiction. The chancery court of the county where 169
the public facility is located or the committing court shall have 170
jurisdiction over matters relating to AOT orders. 171
(19) Terminology. Wherever the term "outpatient commitment" 172
appears in a statute, rule, order or document, it shall be 173
construed to mean "assisted outpatient treatment (AOT)." 174
SECTION 2. This act shall take effect and be in force from 175
and after July 1, 2026. 176