IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR THE COUNTY OF [EXAMPLE]

IN THE MATTER OF THE COMMITMENT
OF
JANE E. DOE
AN ALLEGED MENTALLY ILL PERSON / )
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STIPULATION AND AGREEMENT

(1) These stipulations of face set forth the bases for the civil commitment of Jane Doe under the 2013 Session Senate Bill 421, Chapter 715 Oregon Laws 2013 (“SB 421”) regarding extended commitment periods under the Psychiatric Security Review Board (PSRB).

(2) On [Date of Instant Offense] Jane Doe caused [details of instant offense].

(3) Jane Doe is an [age] year old mentally ill woman. She has a long standing mental disorder which includes [details of psychiatric diagnosis]. Her most recent diagnosis was made on [date] pursuant to ORS 161.370 while an indictment charging her with the [instant offense] was pending.

(4) There is no substantial probability that Jane Doe, in the foreseeable future, will gain or regain the capacity to stand trial. The indictment in [County] County Circuit Court number [#] is therefore to be dismissed, without prejudice, under ORS 161.370(10).

(5) [Guardian] has been appointed Jane Doe’s guardian.

(6) [If applicable, add no contact of victims] That Jane Doe shall not have direct, indirect or third party contact with [Names/Initials of Victims].

(7) This stipulation constitutes notice and acknowledgement of the allegation that Jane Doe is an extremely dangerous person to be committed to the jurisdiction of the Psychiatric Security Review Board for at least 24 months under SB 421, Chapter 715 Oregon Laws 2013.

(8) Jane Doe is extremely dangerous under the criteria set forth by SB 421, Chapter 715 Oregon Laws 2013:

(a) Jane Doe is exhibiting symptoms or behaviors of a mental disorder substantially similar to those that preceded her [instant offense].

(b) Because of her mental disorder, Jane Doe presents a serious danger to the safety of other persons by reason of an extreme risk that she will inflict grave or potentially lethal physical injury on other persons.

(c) Unless committed, Jane Doe will continue to represent an extreme risk to the safety of other persons in the foreseeable future.

(9) There is clear evidence that:

(a) Jane Doe is extremely dangerous

(b) Jane Doe suffers from a mental disorder that is resistant to treatment; after receiving care from a licensed psychiatrist and exhausting all reasonable psychiatric treatment, Jane Doe continues to be significantly impaired in her ability to make competent decisions and to be aware of and control extremely dangerous behavior.

(c) Because of the mental disorder that is resistant to treatment, Jane Doe [details of instant offense].

(d) Jane Doe cannot be controlled in the community with proper care, medication, supervision and treatment on conditional release.

Stipulated and greed this ___ day of ______, 2016

______

Guardian’s name Attorney’s Name

______

Other Attorney’s Name

______

DDA Name

[Name] County Deputy District Attorney

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