Representative Nelson T. Abbott proposes the following substitute bill:


1     
CIVIL COMMITMENT AMENDMENTS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Nelson T. Abbott

5     
Senate Sponsor: Luz Escamilla

6     

7     LONG TITLE
8     General Description:
9          This bill makes changes concerning involuntary commitment and assisted outpatient
10     treatment.
11     Highlighted Provisions:
12          This bill:
13          ▸     allows a patient to provide an informed waiver to a court regarding the patient's
14     appearance at a hearing;
15          ▸     sets requirements for when a court may involuntarily commit a person originally
16     ordered to assisted outpatient treatment; and
17          ▸     makes technical and conforming amendments.
18     Money Appropriated in this Bill:
19          None
20     Other Special Clauses:
21          None
22     Utah Code Sections Affected:
23     AMENDS:
24          62A-15-602, as last amended by Laws of Utah 2019, Chapters 189 and 256
25          62A-15-630.5, as enacted by Laws of Utah 2019, Chapter 256

26          62A-15-631, as last amended by Laws of Utah 2019, Chapters 256 and 419
27     REPEALS AND REENACTS:
28          62A-15-632, as last amended by Laws of Utah 2019, Chapter 419
29     

30     Be it enacted by the Legislature of the state of Utah:
31          Section 1. Section 62A-15-602 is amended to read:
32          62A-15-602. Definitions.
33          As used in this part, Part 7, Commitment of Persons Under Age 18 to Division of
34     Substance Abuse and Mental Health, Part 8, Interstate Compact on Mental Health, Part 9, Utah
35     Forensic Mental Health Facility, Part 10, Declaration for Mental Health Treatment, and Part
36     12, Essential Treatment and Intervention Act:
37          (1) "Adult" means an individual 18 years of age or older.
38          (2) "Approved treatment facility or program" means a treatment provider that meets the
39     standards described in Subsection 62A-15-103(2)(a)(v).
40          (3) "Assisted outpatient treatment" means involuntary outpatient mental health
41     treatment ordered under Section 62A-15-630.5.
42          (4) "Commitment to the custody of a local mental health authority" means that an adult
43     is committed to the custody of the local mental health authority that governs the mental health
44     catchment area where the adult resides or is found.
45          (5) "Community mental health center" means an entity that provides treatment and
46     services to a resident of a designated geographical area, that operates by or under contract with
47     a local mental health authority, and that complies with state standards for community mental
48     health centers.
49          (6) "Designated examiner" means:
50          (a) a licensed physician, preferably a psychiatrist, who is designated by the division as
51     specially qualified by training or experience in the diagnosis of mental or related illness; or
52          (b) a licensed mental health professional designated by the division as specially
53     qualified by training and who has at least five years' continual experience in the treatment of
54     mental illness.
55          (7) "Designee" means a physician who has responsibility for medical functions
56     including admission and discharge, an employee of a local mental health authority, or an

57     employee of a person that has contracted with a local mental health authority to provide mental
58     health services under Section 17-43-304.
59          (8) "Essential treatment" and "essential treatment and intervention" mean court-ordered
60     treatment at a local substance abuse authority or an approved treatment facility or program for
61     the treatment of an adult's substance use disorder.
62          (9) "Harmful sexual conduct" means the following conduct upon an individual without
63     the individual's consent, including the nonconsensual circumstances described in Subsections
64     76-5-406(2)(a) through (l):
65          (a) sexual intercourse;
66          (b) penetration, however slight, of the genital or anal opening of the individual;
67          (c) any sexual act involving the genitals or anus of the actor or the individual and the
68     mouth or anus of either individual, regardless of the gender of either participant; or
69          (d) any sexual act causing substantial emotional injury or bodily pain.
70          (10) "Informed waiver" means the patient was informed of a right and, after being
71     informed of that right and the patient's right to waive the right, expressly communicated his or
72     her intention to waive that right.
73          [(10)] (11) "Institution" means a hospital or a health facility licensed under Section
74     26-21-8.
75          [(11)] (12) "Local substance abuse authority" means the same as that term is defined in
76     Section 62A-15-102 and described in Section 17-43-201.
77          [(12)] (13) "Mental health facility" means the Utah State Hospital or other facility that
78     provides mental health services under contract with the division, a local mental health
79     authority, a person that contracts with a local mental health authority, or a person that provides
80     acute inpatient psychiatric services to a patient.
81          [(13)] (14) "Mental health officer" means an individual who is designated by a local
82     mental health authority as qualified by training and experience in the recognition and
83     identification of mental illness, to:
84          (a) apply for and provide certification for a temporary commitment; or
85          (b) assist in the arrangement of transportation to a designated mental health facility.
86          [(14)] (15) "Mental illness" means:
87          (a) a psychiatric disorder that substantially impairs an individual's mental, emotional,

88     behavioral, or related functioning; or
89          (b) the same as that term is defined in:
90          (i) the current edition of the Diagnostic and Statistical Manual of Mental Disorders
91     published by the American Psychiatric Association; or
92          (ii) the current edition of the International Statistical Classification of Diseases and
93     Related Health Problems.
94          [(15)] (16) "Patient" means an individual who is:
95          (a) under commitment to the custody or to the treatment services of a local mental
96     health authority; or
97          (b) undergoing essential treatment and intervention.
98          [(16)] (17) "Physician" means an individual who is:
99          (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
100          (b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
101     Practice Act.
102          [(17)] (18) "Serious bodily injury" means bodily injury that involves a substantial risk
103     of death, unconsciousness, extreme physical pain, protracted and obvious disfigurement, or
104     protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
105          [(18)] (19) "Substantial danger" means that due to mental illness, an individual is at
106     serious risk of:
107          (a) suicide;
108          (b) serious bodily self-injury;
109          (c) serious bodily injury because the individual is incapable of providing the basic
110     necessities of life, including food, clothing, or shelter;
111          (d) causing or attempting to cause serious bodily injury to another individual; or
112          (e) engaging in harmful sexual conduct.
113          [(19)] (20) "Treatment" means psychotherapy, medication, including the administration
114     of psychotropic medication, or other medical treatments that are generally accepted medical or
115     psychosocial interventions for the purpose of restoring the patient to an optimal level of
116     functioning in the least restrictive environment.
117          Section 2. Section 62A-15-630.5 is amended to read:
118          62A-15-630.5. Assisted outpatient treatment proceedings.

119          (1) A responsible individual who has credible knowledge of an adult's mental illness
120     and the condition or circumstances that have led to the adult's need for assisted outpatient
121     treatment may file, in the district court in the county where the proposed patient resides or is
122     found, a written application that includes:
123          (a) unless the court finds that the information is not reasonably available, the proposed
124     patient's:
125          (i) name;
126          (ii) date of birth; and
127          (iii) social security number; and
128          (b) (i) a certificate of a licensed physician or a designated examiner stating that within
129     the seven-day period immediately preceding the certification, the physician or designated
130     examiner examined the proposed patient and is of the opinion that the proposed patient has a
131     mental illness and should be involuntarily committed; or
132          (ii) a written statement by the applicant that:
133          (A) the proposed patient has been requested to, but has refused to, submit to an
134     examination of mental condition by a licensed physician or designated examiner;
135          (B) is sworn to under oath; and
136          (C) states the facts upon which the application is based.
137          (2) (a) Subject to Subsection (2)(b), before issuing a judicial order, the court may
138     require the applicant to consult with the appropriate local mental health authority, and the court
139     may direct a mental health professional from that local mental health authority to interview the
140     applicant and the proposed patient to determine the existing facts and report them to the court.
141          (b) The consultation described in Subsection (2)(a):
142          (i) may take place at or before the hearing; and
143          (ii) is required if the local mental health authority appears at the hearing.
144          (3) If the proposed patient refuses to submit to an interview described in Subsection
145     (2)(a) or an examination described in Subsection (8), the court may issue an order, directed to a
146     mental health officer or peace officer, to immediately place the proposed patient into the
147     custody of a local mental health authority or in a temporary emergency facility, as provided in
148     Section 62A-15-634, to be detained for the purpose of examination.
149          (4) Notice of commencement of proceedings for assisted outpatient treatment, setting

150     forth the allegations of the application and any reported facts, together with a copy of any
151     official order of detention, shall:
152          (a) be provided by the court to a proposed patient before, or upon, placement into the
153     custody of a local mental health authority or, with respect to any proposed patient presently in
154     the custody of a local mental health authority;
155          (b) be maintained at the proposed patient's place of detention, if any;
156          (c) be provided by the court as soon as practicable to the applicant, any legal guardian,
157     any immediate adult family members, legal counsel for the parties involved, the local mental
158     health authority or its designee, and any other person whom the proposed patient or the court
159     shall designate; and
160          (d) advise that a hearing may be held within the time provided by law.
161          (5) The district court may, in its discretion, transfer the case to any other district court
162     within this state, provided that the transfer will not be adverse to the interest of the proposed
163     patient.
164          (6) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the issuance
165     of a judicial order, or after commitment of a proposed patient to a local mental health authority
166     or its designee under court order for detention in order to complete an examination, the court
167     shall appoint two designated examiners:
168          (a) who did not sign the assisted outpatient treatment application nor the certification
169     described in Subsection (1);
170          (b) one of whom is a licensed physician; and
171          (c) one of whom may be designated by the proposed patient or the proposed patient's
172     counsel, if that designated examiner is reasonably available.
173          (7) The court shall schedule a hearing to be held within 10 calendar days of the day on
174     which the designated examiners are appointed.
175          (8) The designated examiners shall:
176          (a) conduct their examinations separately;
177          (b) conduct the examinations at the home of the proposed patient, at a hospital or other
178     medical facility, or at any other suitable place that is not likely to have a harmful effect on the
179     proposed patient's health;
180          (c) inform the proposed patient, if not represented by an attorney:

181          (i) that the proposed patient does not have to say anything;
182          (ii) of the nature and reasons for the examination;
183          (iii) that the examination was ordered by the court;
184          (iv) that any information volunteered could form part of the basis for the proposed
185     patient to be ordered to receive assisted outpatient treatment; and
186          (v) that findings resulting from the examination will be made available to the court;
187     and
188          (d) within 24 hours of examining the proposed patient, report to the court, orally or in
189     writing, whether the proposed patient is mentally ill. If the designated examiner reports orally,
190     the designated examiner shall immediately send a written report to the clerk of the court.
191          (9) If a designated examiner is unable to complete an examination on the first attempt
192     because the proposed patient refuses to submit to the examination, the court shall fix a
193     reasonable compensation to be paid to the examiner.
194          (10) If the local mental health authority, its designee, or a medical examiner determines
195     before the court hearing that the conditions justifying the findings leading to an assisted
196     outpatient treatment hearing no longer exist, the local mental health authority, its designee, or
197     the medical examiner shall immediately report that determination to the court.
198          (11) The court may terminate the proceedings and dismiss the application at any time,
199     including prior to the hearing, if the designated examiners or the local mental health authority
200     or its designee informs the court that the proposed patient [is not mentally ill] does not meet the
201     criteria in Subsection (14).
202          (12) Before the hearing, an opportunity to be represented by counsel shall be afforded
203     to the proposed patient, and if neither the proposed patient nor others provide counsel, the court
204     shall appoint counsel and allow counsel sufficient time to consult with the proposed patient
205     before the hearing. In the case of an indigent proposed patient, the payment of reasonable
206     attorney fees for counsel, as determined by the court, shall be made by the county in which the
207     proposed patient resides or is found.
208          (13) (a) All persons to whom notice is required to be given shall be afforded an
209     opportunity to appear at the hearing, to testify, and to present and cross-examine witnesses. The
210     court may, in its discretion, receive the testimony of any other individual. The court may allow
211     a waiver of the proposed patient's right to appear [only] for good cause [shown, and that cause

212     shall be made a matter of court record], which cause shall be set forth in the record, or an
213     informed waiver by the patient, which shall be included in the record.
214          (b) The court is authorized to exclude all individuals not necessary for the conduct of
215     the proceedings and may, upon motion of counsel, require the testimony of each examiner to be
216     given out of the presence of any other examiners.
217          (c) The hearing shall be conducted in as informal a manner as may be consistent with
218     orderly procedure, and in a physical setting that is not likely to have a harmful effect on the
219     mental health of the proposed patient.
220          (d) The court shall consider all relevant historical and material information that is
221     offered, subject to the rules of evidence, including reliable hearsay under Rule 1102, Utah
222     Rules of Evidence.
223          (e) (i) A local mental health authority or its designee, or the physician in charge of the
224     proposed patient's care shall, at the time of the hearing, provide the court with the following
225     information:
226          (A) the detention order, if any;
227          (B) admission notes, if any;
228          (C) the diagnosis, if any;
229          (D) doctor's orders, if any;
230          (E) progress notes, if any;
231          (F) nursing notes, if any; and
232          (G) medication records, if any.
233          (ii) The information described in Subsection (13)(e)(i) shall also be provided to the
234     proposed patient's counsel:
235          (A) at the time of the hearing; and
236          (B) at any time prior to the hearing, upon request.
237          (14) The court shall order a proposed patient to assisted outpatient treatment if, upon
238     completion of the hearing and consideration of the information presented, the court finds by
239     clear and convincing evidence that:
240          (a) the proposed patient has a mental illness;
241          (b) there is no appropriate less-restrictive alternative to a court order for assisted
242     outpatient treatment; and

243          (c) (i) the proposed patient lacks the ability to engage in a rational decision-making
244     process regarding the acceptance of mental health treatment, as demonstrated by evidence of
245     inability to weigh the possible risks of accepting or rejecting treatment; or
246          (ii) the proposed patient needs assisted outpatient treatment in order to prevent relapse
247     or deterioration that is likely to result in the proposed patient posing a substantial danger to self
248     or others.
249          (15) The court may order the applicant or a close relative of the patient to be the
250     patient's personal representative, as described in 45 C.F.R. Sec. 164.502(g), for purposes of the
251     patient's mental health treatment.
252          (16) In the absence of the findings described in Subsection (14), the court, after the
253     hearing, shall dismiss the proceedings.
254          (17) (a) The assisted outpatient treatment order shall designate the period for which the
255     patient shall be treated, which may not exceed [six] 12 months without a review hearing.
256          [(b) An individual identified under Subsection (4) may request a review hearing at any
257     time while the assisted outpatient treatment order is in effect.]
258          [(c)] (b) At a review hearing, the court may extend the duration of an assisted
259     outpatient treatment order by up to [six] 12 months, if:
260          (i) the court finds by clear and convincing evidence that the patient meets the
261     conditions described in Subsection (14); or
262          (ii) (A) the patient does not appear at the review hearing; [and]
263          (B) notice of the review hearing was provided to the patient's last known address by the
264     applicant described in Subsection (1) or by a local mental health authority[.]; and
265          (C) the patient has appeared in court or signed an informed waiver within the previous
266     18 months.
267          [(d)] (c) The court shall maintain a current list of all patients under its order of assisted
268     outpatient treatment.
269          [(e)] (d) At least two weeks prior to the expiration of the designated period of any
270     assisted outpatient treatment order still in effect, the court that entered the original order shall
271     inform the appropriate local mental health authority or its designee.
272          (18) Costs of all proceedings under this section shall be paid by the county in which the
273     proposed patient resides or is found.

274          (19) A court may not hold an individual in contempt for failure to comply with an
275     assisted outpatient treatment order.
276          (20) As provided in Section 31A-22-651, a health insurance provider may not deny an
277     insured the benefits of the insured's policy solely because the health care that the insured
278     receives is provided under a court order for assisted outpatient treatment.
279          Section 3. Section 62A-15-631 is amended to read:
280          62A-15-631. Involuntary commitment under court order -- Examination --
281     Hearing -- Power of court -- Findings required -- Costs.
282          (1) A responsible individual who has credible knowledge of an adult's mental illness
283     and the condition or circumstances that have led to the adult's need to be involuntarily
284     committed may initiate an involuntary commitment court proceeding by filing, in the district
285     court in the county where the proposed patient resides or is found, a written application that
286     includes:
287          (a) unless the court finds that the information is not reasonably available, the proposed
288     patient's:
289          (i) name;
290          (ii) date of birth; and
291          (iii) social security number;
292          (b) (i) a certificate of a licensed physician or a designated examiner stating that within
293     the seven-day period immediately preceding the certification, the physician or designated
294     examiner examined the proposed patient and is of the opinion that the proposed patient has a
295     mental illness and should be involuntarily committed; or
296          (ii) a written statement by the applicant that:
297          (A) the proposed patient has been requested to, but has refused to, submit to an
298     examination of mental condition by a licensed physician or designated examiner;
299          (B) is sworn to under oath; and
300          (C) states the facts upon which the application is based; and
301          (c) a statement whether the proposed patient has previously been under an assisted
302     outpatient treatment order, if known by the applicant.
303          (2) (a) Subject to Subsection (2)(b), before issuing a judicial order, the court may
304     require the applicant to consult with the appropriate local mental health authority, and the court

305     may direct a mental health professional from that local mental health authority to interview the
306     applicant and the proposed patient to determine the existing facts and report them to the court.
307          (b) The consultation described in Subsection (2)(a):
308          (i) may take place at or before the hearing; and
309          (ii) is required if the local mental health authority appears at the hearing.
310          (3) If the court finds from the application, from any other statements under oath, or
311     from any reports from a mental health professional that there is a reasonable basis to believe
312     that the proposed patient has a mental illness that poses a substantial danger to self or others
313     requiring involuntary commitment pending examination and hearing; or, if the proposed patient
314     has refused to submit to an interview with a mental health professional as directed by the court
315     or to go to a treatment facility voluntarily, the court may issue an order, directed to a mental
316     health officer or peace officer, to immediately place the proposed patient in the custody of a
317     local mental health authority or in a temporary emergency facility as provided in Section
318     62A-15-634 to be detained for the purpose of examination.
319          (4) Notice of commencement of proceedings for involuntary commitment, setting forth
320     the allegations of the application and any reported facts, together with a copy of any official
321     order of detention, shall be provided by the court to a proposed patient before, or upon,
322     placement in the custody of a local mental health authority or, with respect to any proposed
323     patient presently in the custody of a local mental health authority whose status is being changed
324     from voluntary to involuntary, upon the filing of an application for that purpose with the court.
325     A copy of that order of detention shall be maintained at the place of detention.
326          (5) Notice of commencement of those proceedings shall be provided by the court as
327     soon as practicable to the applicant, any legal guardian, any immediate adult family members,
328     legal counsel for the parties involved, the local mental health authority or its designee, and any
329     other persons whom the proposed patient or the court shall designate. That notice shall advise
330     those persons that a hearing may be held within the time provided by law. If the proposed
331     patient has refused to permit release of information necessary for provisions of notice under
332     this subsection, the extent of notice shall be determined by the court.
333          (6) Proceedings for commitment of an individual under the age of 18 years to a local
334     mental health authority may be commenced in accordance with Part 7, Commitment of Persons
335     Under Age 18 to Division of Substance Abuse and Mental Health.

336          (7) The district court may, in its discretion, transfer the case to any other district court
337     within this state, provided that the transfer will not be adverse to the interest of the proposed
338     patient.
339          (8) Within 24 hours, excluding Saturdays, Sundays, and legal holidays, of the issuance
340     of a judicial order, or after commitment of a proposed patient to a local mental health authority
341     or its designee under court order for detention or examination, the court shall appoint two
342     designated examiners:
343          (a) who did not sign the civil commitment application nor the civil commitment
344     certification under Subsection (1);
345          (b) one of whom is a licensed physician; and
346          (c) one of whom may be designated by the proposed patient or the proposed patient's
347     counsel, if that designated examiner is reasonably available.
348          (9) The court shall schedule a hearing to be held within 10 calendar days of the day on
349     which the designated examiners are appointed.
350          (10) The designated examiners shall:
351          (a) conduct their examinations separately;
352          (b) conduct the examinations at the home of the proposed patient, at a hospital or other
353     medical facility, or at any other suitable place that is not likely to have a harmful effect on the
354     proposed patient's health;
355          (c) inform the proposed patient, if not represented by an attorney:
356          (i) that the proposed patient does not have to say anything;
357          (ii) of the nature and reasons for the examination;
358          (iii) that the examination was ordered by the court;
359          (iv) that any information volunteered could form part of the basis for the proposed
360     patient's involuntary commitment;
361          (v) that findings resulting from the examination will be made available to the court;
362     and
363          (vi) that the designated examiner may, under court order, obtain the proposed patient's
364     mental health records; and
365          (d) within 24 hours of examining the proposed patient, report to the court, orally or in
366     writing, whether the proposed patient is mentally ill, has agreed to voluntary commitment, as

367     described in Section 62A-15-625, or has acceptable programs available to the proposed patient
368     without court proceedings. If the designated examiner reports orally, the designated examiner
369     shall immediately send a written report to the clerk of the court.
370          (11) If a designated examiner is unable to complete an examination on the first attempt
371     because the proposed patient refuses to submit to the examination, the court shall fix a
372     reasonable compensation to be paid to the examiner.
373          (12) If the local mental health authority, its designee, or a medical examiner determines
374     before the court hearing that the conditions justifying the findings leading to a commitment
375     hearing no longer exist, the local mental health authority, its designee, or the medical examiner
376     shall immediately report that determination to the court.
377          (13) The court may terminate the proceedings and dismiss the application at any time,
378     including prior to the hearing, if the designated examiners or the local mental health authority
379     or its designee informs the court that the proposed patient:
380          (a) [is not mentally ill] does not meet the criteria in Subsection (16);
381          (b) has agreed to voluntary commitment, as described in Section 62A-15-625; or
382          (c) has acceptable options for treatment programs that are available without court
383     proceedings.
384          (14) Before the hearing, an opportunity to be represented by counsel shall be afforded
385     to the proposed patient, and if neither the proposed patient nor others provide counsel, the court
386     shall appoint counsel and allow counsel sufficient time to consult with the proposed patient
387     before the hearing. In the case of an indigent proposed patient, the payment of reasonable
388     attorney fees for counsel, as determined by the court, shall be made by the county in which the
389     proposed patient resides or is found.
390          (15) (a) The proposed patient, the applicant, and all other persons to whom notice is
391     required to be given shall be afforded an opportunity to appear at the hearing, to testify, and to
392     present and cross-examine witnesses. The court may, in its discretion, receive the testimony of
393     any other person. The court may allow a waiver of the proposed patient's right to appear [only]
394     for good cause [shown, and that cause shall be made a matter of court record], which cause
395     shall be set forth in the record, or an informed waiver by the patient, which shall be included in
396     the record.
397          (b) The court is authorized to exclude all persons not necessary for the conduct of the

398     proceedings and may, upon motion of counsel, require the testimony of each examiner to be
399     given out of the presence of any other examiners.
400          (c) The hearing shall be conducted in as informal a manner as may be consistent with
401     orderly procedure, and in a physical setting that is not likely to have a harmful effect on the
402     mental health of the proposed patient, while preserving the due process rights of the proposed
403     patient.
404          (d) The court shall consider all relevant historical and material information that is
405     offered, subject to the rules of evidence, including reliable hearsay under Rule 1102, Utah
406     Rules of Evidence.
407          (e) (i) A local mental health authority or its designee or the physician in charge of the
408     proposed patient's care shall, at the time of the hearing, provide the court with the following
409     information:
410          (A) the detention order;
411          (B) admission notes;
412          (C) the diagnosis;
413          (D) any doctors' orders;
414          (E) progress notes;
415          (F) nursing notes;
416          (G) medication records pertaining to the current commitment; and
417          (H) whether the proposed patient has previously been civilly committed or under an
418     order for assisted outpatient treatment.
419          (ii) That information shall also be supplied to the proposed patient's counsel at the time
420     of the hearing, and at any time prior to the hearing upon request.
421          (16) The court shall order commitment of a proposed patient who is 18 years of age or
422     older to a local mental health authority if, upon completion of the hearing and consideration of
423     the information presented, the court finds by clear and convincing evidence that:
424          (a) the proposed patient has a mental illness;
425          (b) because of the proposed patient's mental illness the proposed patient poses a
426     substantial danger to self or others;
427          (c) the proposed patient lacks the ability to engage in a rational decision-making
428     process regarding the acceptance of mental treatment as demonstrated by evidence of inability

429     to weigh the possible risks of accepting or rejecting treatment;
430          (d) there is no appropriate less-restrictive alternative to a court order of commitment;
431     and
432          (e) the local mental health authority can provide the proposed patient with treatment
433     that is adequate and appropriate to the proposed patient's conditions and needs. In the absence
434     of the required findings of the court after the hearing, the court shall dismiss the proceedings.
435          (17) (a) The order of commitment shall designate the period for which the patient shall
436     be treated. When the patient is not under an order of commitment at the time of the hearing,
437     that period may not exceed six months without benefit of a review hearing. Upon such a review
438     hearing, to be commenced prior to the expiration of the previous order, an order for
439     commitment may be for an indeterminate period, if the court finds by clear and convincing
440     evidence that the required conditions in Subsection (16) will last for an indeterminate period.
441          (b) The court shall maintain a current list of all patients under its order of commitment.
442     That list shall be reviewed to determine those patients who have been under an order of
443     commitment for the designated period. At least two weeks prior to the expiration of the
444     designated period of any order of commitment still in effect, the court that entered the original
445     order shall inform the appropriate local mental health authority or its designee. The local
446     mental health authority or its designee shall immediately reexamine the reasons upon which the
447     order of commitment was based. If the local mental health authority or its designee determines
448     that the conditions justifying that commitment no longer exist, it shall discharge the patient
449     from involuntary commitment and immediately report the discharge to the court. Otherwise,
450     the court shall immediately appoint two designated examiners and proceed under Subsections
451     (8) through (14).
452          (c) The local mental health authority or its designee responsible for the care of a patient
453     under an order of commitment for an indeterminate period shall, at six-month intervals,
454     reexamine the reasons upon which the order of indeterminate commitment was based. If the
455     local mental health authority or its designee determines that the conditions justifying that
456     commitment no longer exist, that local mental health authority or its designee shall discharge
457     the patient from its custody and immediately report the discharge to the court. If the local
458     mental health authority or its designee determines that the conditions justifying that
459     commitment continue to exist, the local mental health authority or its designee shall send a

460     written report of those findings to the court. The patient and the patient's counsel of record
461     shall be notified in writing that the involuntary commitment will be continued, the reasons for
462     that decision, and that the patient has the right to a review hearing by making a request to the
463     court. Upon receiving the request, the court shall immediately appoint two designated
464     examiners and proceed under Subsections (8) through (14).
465          (18) Any patient committed as a result of an original hearing or a patient's legally
466     designated representative who is aggrieved by the findings, conclusions, and order of the court
467     entered in the original hearing has the right to a new hearing upon a petition filed with the court
468     within 30 days of the entry of the court order. The petition must allege error or mistake in the
469     findings, in which case the court shall appoint three impartial designated examiners previously
470     unrelated to the case to conduct an additional examination of the patient. The new hearing
471     shall, in all other respects, be conducted in the manner otherwise permitted.
472          (19) Costs of all proceedings under this section shall be paid by the county in which the
473     proposed patient resides or is found.
474          Section 4. Section 62A-15-632 is repealed and reenacted to read:
475          62A-15-632. Circumstances under which conditions justifying initial involuntary
476     commitment shall be considered to continue to exist.
477          (1) When an individual is involuntarily committed to the custody of a local mental
478     health authority under Subsection 62A-15-631(16), the conditions justifying commitment
479     under that Subsection shall be considered to continue to exist for purposes of continued
480     treatment under Subsection 62A-15-631(17) or conditional release under Section 62A-15-637
481     if the court finds that:
482          (a) the patient is still mentally ill;
483          (b) there is no appropriate less restrictive alternative to a court order of involuntary
484     commitment; and
485          (c) absent an order of involuntary commitment, the patient will likely pose a substantial
486     danger to self or others.
487          (2) When an individual has been ordered to assisted outpatient treatment under
488     Subsection 62A-15-630.5(14), the individual may be involuntarily committed to the custody of
489     a local mental health authority under Subsection 62A-15-631(16) for purposes of continued
490     treatment under Subsection 62A-15-631(17) or conditional release under Section 62A-15-637,

491     if the court finds that:
492          (a) the patient is still mentally ill;
493          (b) there is no appropriate less-restrictive alternative to a court order of involuntary
494     commitment; and
495          (c) based upon the patient's conduct and statements during the preceding six months, or
496     the patient's failure to comply with treatment recommendations during the preceding six
497     months, the court finds that absent an order of involuntary commitment, the patient is likely to
498     pose a substantial danger to self or others.
499          (3) A patient whose treatment is continued or who is conditionally released under the
500     terms of this section shall be maintained in the least restrictive environment available that can
501     provide the patient with treatment that is adequate and appropriate.