This publication is a fact sheet that gives general information about what Assisted Outpatient Treatment (AOT) is. The publication also talks about how you are ordered to AOT, what your rights are at AOT hearings, and what treatment rights you have while in AOT. Finally, the publication talks about what happens if you do not follow AOT and how you end AOT.

You have a right to an attorney if the county has asked the court to order you to AOT. If you want a lawyer but don’t have enough money, ask the judge to give you a public defender.

Definition of Assisted Outpatient Treatment (AOT)

AOT is court-ordered outpatient treatment for people with mental health disabilities.1

Some Counties Have AOT and Others Do Not

Under a new law that started on July 1, 2021, counties in California must have AOT unless they opt out.2 As of December 2021, 31 counties have AOT: Alameda; Contra Costa; El Dorado; Fresno; Humboldt; Kern; Kings; Los Angeles; Marin; Mariposa; Mendocino; Napa; Nevada; Orange; Placer; Riverside; Sacramento; San Diego; San Francisco; San Luis Obispo; San Mateo; Santa Barbara; Santa Clara; Shasta; Siskiyou; Stanislaus; Tehama; Tulare; Ventura; and Yolo.   

27 counties do not have AOT: Alpine; Amador; Butte; Calaveras; Colusa; Del Norte; Glenn; Imperial; Inyo; Lake; Lassen; Madera; Merced; Modoc; Mono; Monterey; Plumas; San Benito; San Bernardino; San Joaquin; Santa Cruz; Sierra; Sonoma; Sutter/Yuba; Trinity; and Tuolumne.

How Someone is Ordered to AOT

• The county mental health department asks the court to order AOT. This is called a petition.3
• The petition must include an official statement (called an affidavit) by a licensed mental health provider. The affidavit must say you qualify for AOT, the reasons why you qualify for AOT and why AOT is recommended for you.4
• The court will then set a date and time for a hearing to see if you qualify for AOT. This hearing takes place within 5 business days of the petition.5
• You have a right to a lawyer for the hearing.6 You can ask the court to appoint you a lawyer. You will only pay for the lawyer if you are able to do so.7
• If the judge decides after the hearing that you qualify for AOT under the law, you may be ordered to AOT.8 For more information about who qualifies for AOT under the law, you can read the publication called “Who Can Be Ordered to AOT.”
• The judge can order you to AOT for up to 6 months.9
• For more information about how you are ordered to AOT, you can read the publication called “How You are Ordered to AOT.”

Who Qualifies to be Ordered to AOT

To qualify for AOT under the law, the judge at the hearing must find that all the requirements are proven by clear and convincing evidence.10 “Clear and convincing” means that the judge must find that it is much more likely to be true than untrue that you meet all of the requirements to qualify for AOT. The requirements are:11

1. You are at least 18 years old.
2. You have a serious mental disorder.
3. There has been a decision, based on a clinical opinion, that either one of the following two things is true:
   • You are unlikely to survive safely in the community without supervision (like AOT) and your mental health condition is getting worse; OR
   • You need AOT to prevent a relapse or worsening of your mental health that would make you gravely disabled (unable to care for your basic needs like food, clothing, and shelter), or make you a danger to yourself or others.
4. You have not followed your treatment plan for your mental health disability before. This is true if either of the following things has happened:
   • Twice within the last 3 years (36 months) your mental health disability was the main reason why you were hospitalized, or got help in a mental health unit of a state prison or local jail.12 It does not count if this was right before the county asked for (petitioned) you to be ordered to AOT.
   • Because of your mental health disability, you have acted seriously violent towards yourself or others. The serious and violent act must have happened within the last 48 months (4 years). Threats or attempts also count. It does not count if you it was right before the county asked for (petitioned) you to be ordered to AOT.13
5. You were given a chance to have voluntary treatment, but you did not, or do not, participate in the treatment.
6. AOT is the least restrictive treatment (allows you the most freedom) while still ensuring your mental health is improving and stable.
7. You will likely benefit from AOT.

For more information about who can be ordered to AOT, you can read the publication called “Who Can Be Ordered to AOT”.

Your Rights at AOT Hearings

If your county asks the court to order you into AOT, you have the following rights:14

• Adequate notice of the hearing.
  • The hearing must be no more than five business days (excluding Saturdays, Sundays, and holidays) after the county files the petition for AOT. The county must provide you with a copy of the petition as soon as possible after they file it.15
• A copy of the evaluation, or decision, that says you qualify and recommends you for AOT.
• An attorney for free if you cannot pay for one.
• To be informed of your right to later file a writ of habeas corpus if you are ordered into AOT and disagree.
• To attend the hearing unless you choose not to or do not show up after the court tries more than once to get you to attend.
• To present evidence to show why you do not qualify for AOT.
• To have people (witnesses) speak at the hearing who support why you do not need or qualify for AOT.
• To question people who speak at the hearing (witnesses) after they say you need AOT.
• To know and understand your right to prove that the judge made the wrong decision and appeal the decision.
• For more information about how to get ready for an AOT hearing, you can read “Rights if the County is Asking for AOT and AOT Hearings.”

Your Treatment Rights While in AOT

Your treatment rights while in AOT include the following, but are not limited to:16

• Client-directed and recovery-oriented treatment, which means you have a voice regarding your treatment.
• Coordination and access to medication, therapy substance use disorder services, supportive housing/housing assistance, vocational rehabilitation, and veterans’ services.
• Personalized service plans based on your culture, native language, gender, age, or other special needs related to your identity.
• Not being forced to take medication you do not want to take (involuntary medication).
• Psychiatric and psychological services.
• For more information about what AOT treatment should look like, you can read the publication called “Treatment Rights While in AOT”.

What Happens if You Do Not Follow Your AOT Order

• You may be placed involuntarily into a hospital for 72 hours if you do not follow your AOT order, but only if the following to things are true:
  1. Treatment providers first tried to reach out to you to follow AOT,
     AND
  2. A licensed provider thinks you qualify for involuntary hospitalization.17
• You can only be forced to stay in the hospital past 72 hours if you qualify for involuntary hospitalization because your mental health disability makes you unable to care for yourself or a danger to yourself or others. You cannot be forced to stay past 72 hours simply because you did not follow AOT.
• If you are placed into a hospital against your will for 72 hours, you have the same rights as a patient who is not in AOT.
  • You can find information about your rights as a patient in the State of California’s publication, Rights for Individuals in Mental Health Facilities Admitted Under the Lanterman-Petris-Short Act.

How AOT Ends

You can contact your lawyer for help with ending AOT. As stated above, you have a right to a lawyer for free if you do not have enough money for a lawyer.

• Right to Hearing if the County Director Still Thinks You Need AOT
  • Every 60 days, the director of the program must give an official statement (called an affidavit) saying you still qualify for AOT under the law.18
  • If you do not think the director is right, you have a right to a hearing on whether or not you still qualify for AOT under the law. The director will have to show (prove) that you still qualify for AOT under the law. For more information about whether you qualify for AOT under the law, you can read the publication called “Who Can Be Ordered to AOT.”
• Filing a Writ of Habeas Corpus
  • If you believe that you are wrongfully being subjected to AOT, you have the right to file a petition for a writ of habeas corpus.19 The director of AOT will then have to prove to a judge that you still qualify and need AOT based on the law. For more information about the requirements of the law, you can read the publication called “Who Can Be Ordered to AOT.”
• Expiration of an AOT Order
  • Another way that AOT ends is when the number of days the judge ordered you to AOT has passed.

Additional Information

If you need more information or have questions you can:

• Ask your lawyer. You have a right to an attorney if the county has asked (petitioned) the court to order you to AOT. If you want a lawyer but don’t have enough money, ask the judge to give you a public defender. You will only have to pay the public defender if you have the money to.
• Contact your county’s Patient’s Rights Advocate. To find the Patient’s Rights Advocate where you live, (916) 504-5810 and ask for your local Patient’s Rights Advocate or click on this link: https://www.disabilityrightsca.org/post/patients-rights-advocacy-directory.
• Call Disability Rights California at 1-800-776-5746.

• 1. Welf. & Inst. Code § 5345(b). All code sections cited below are from the Welfare and Institutions Code.
• 2. § 5349.
• 3. § 5346(b)(1)-(2).
• 4. § 5346(b)(5).
• 5. § 5346(d)(1).
• 6. § 5346(c).
• 7. § 5346(c).
• 8. § 5346(a), (d).
• 9. § 5346(d)(5)(B).
• 10. § 5346(a).
• 11. § 5346(a)(1)-(7).
• 12. § 5346(a)(4)(A).
• 13. § 5346(a)(4)(B).
• 14. § 5346(d)(4)(A)-(I).
• 15. § 5346(d)(1).
• 16. § 5348(a)(2)(A)-(F).
• 17. § 5346(f).
• 18. § 5346(h).
• 19. § 5346(i).