NOTICE TO PERSONS RECEIVING THIS ORDER IF YOU ARE AFFECTED BY OR INTERESTED IN THIS COURT ORDER, YOU SHOULD KNOW THAT: 1. A FINAL ORDER OF COURT MAY BE APPEALED. The court must notify the respondent of the right to appeal and of an indigent's right to free transcripts and counsel. If the individual wishes to appeal and cannot obtain counsel, counsel should be appointed pursuant to Sections 3-818 or 4-605 of the Mental Health and Developmental Disabilities Code. AN ORDER FOR ADMISSION IS INITIALLY VALID FOR NOT MORE THAN 90 DAYS. A SUBSEQUENT ORDER MAY BE ENTERED FOR AN ADDITIONAL PERIOD OF 90 DAYS. Thereafter an order may be valid for up to 180 days. If the facility director does not discharge the individual during that period or petition for continued hospitalization, the individual must be released. RELATIVES OR FRIENDS MAY TRANSPORT A PERSON ADMITTED BY COURT ORDER. The court may authorize a relative or friend of the person to transport him/her to the appropriate facility if such person can do so safely and humanely. UNWILLINGNESS OR INABILITY OF THE INDIVIDUAL'S PARENT, GUARDIAN, OR PERSON IN LOCO PARENTIS TO PROVIDE FOR HIS/HER CARE OR RESIDENCE IS NOT GROUNDS FOR THE COURT'S REFUSING TO ORDER DISCHARGE. A petition may be filed under the Juvenile Court Act or Probate Act to ensure appropriate care and residence. THE COURT MAY MODIFY THIS ORDER IN THE FUTURE. If the individual's treatment needs change, or if the facility or program cannot meet the individual's needs, upon petition or other method of review the court may modify this order. 2. 3. 4. 5. AT A MINIMUM, THESE PERSONS SHOULD RECEIVE THIS ORDER: (a) the respondent; (b) his or her attorney; and (c) the director of the facility or program. (02/06/13) CCCO 0078 (Page 1 of 3) Print Form Clear Form Commitment Order IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, COUNTY DIVISION In the Matter of CoMH ______________________________________________________ Respondent (Rev. 02/06/13) CCCO 0078 A COMMITMENT ORDER This matter coming on to be heard on the Petition of ___________________________________________ seeking involuntary admission of the Respondent under provisions of 405 ILCS 5/1-100 et seq., the Mental Health and Developmental Disabilities Code of Illinois (hereinafter "the Code") and the Court being fully advised in the premises, IT IS ORDERED: On the Motion of the Petitioner, the matter is Voluntarily Dismissed. ___________________________________ (8006). On the Motion of the Respondent, the matter is dismissed on the basis that _____________________________________ ____________________________________________________________________________________________________ (8002). AFTER HEARING, THE COURT'S FINDINGS AND CONCLUSIONS BEING OF RECORD, THE COURT FINDS: That the Respondent is subject to involuntary admission on an inpatient basis because, in accordance with Section 1-119 of the Mental Health and Disabilities Code, she/he is a person with mental illness and who because of that mental illness is: (4017) Reasonably expected, unless treated on an inpatient basis, to engage in conduct placing such person or another in physical harm or in reasonable expectation of being physically harmed. Unable to provide for his or her basic physical needs so as to guard himself or herself from serious harm without the assistance of family or others unless treated on an inpatient basis. A person with mental illness who (i) refuses treatment or is not adhering to prescribed treatment; (ii) because of the nature of his or her illness, is unable to understand his or her need for treatment; and (iii) if not treated on an inpatient basis, is reasonably expected, based on his or her behavioral history, to suffer mental or emotional deterioration and is reasonably expected, after such deterioration, to meet the criteria of paragraph (1) or (2) above. That the Respondent is subject to involuntary admission on an outpatient basis because the Respondent is a person with mental illness who: (Check all that apply.) Would meet the criteria for admission on an inpatient basis as specified in Section 1-119 of the Code in the absence of treatment on an outpatient basis and for whom treatment on an outpatient basis can only be reasonably ensured by a court order mandating such treatment; or such mental illness is left untreated, is reasonably expected to result in an increase in the symptoms caused by If the illness to the point that the person would meet the criteria for commitment under Section 1-119 of the Code, and whose mental illness has, on more than one occasion in the past, caused that person to refuse needed and appropriate mental health services in the community. Respondent is not a person subject involuntary admission and is discharged. IT IS FURTHER ORDERED: That the Respondent hospitalized at the Department of Human Services mental health or developmental center, which is the least be restrictive environment currently appropriate and available. hospitalized at ________________________________________________, a licensed private hospital. be be hospitalized with the Veterans Administration. (Page 2 of 3) (Rev. 02/06/13) CCCO 0078 B undergo a program of alternative treatment as prescribed in the attached Addendum. be treated at ______________________________________________________ , a private or community health facility. be placed in the care and custody of ___________________________________________ ; and the custodian shall have the authority granted in the Addendum to this Order and no other. Other, please specify: _______________________________________________________________________________. (Attach Addendum if additional space is required) The Clerk of Court shall forward a certified copy of this Order to the Department of State Police, Firearm Services Bureau; 801 S. 7th Street; Springfield, IL 62703. (4016) The Facility Director shall file a treatment plan with this Court as a required by 405 ILCS 5/3-814 within 30 days of the date of this Order. The period of hospitalization shall not exceed 90 days. The petitioner who initiated this matter pursuant to 405 ILCS 5/3-701 is present and received oral and written notice of his/her right under 405 ILCS 5/3-902 to receive notice of the Facility Director's decision to discharge the Respondent. The petitioner who initiated this matter pursuant to 405 ILCS 5/3-701 is not present and the Clerk of Court is directed to mail notice to the Petitioner of his/her right u