ND HB1181

Creates new section 12.1-04-04.1 establishing that defendants are presumed fit to stand trial, plead, or be sentenced, and defines key terms including "fitness to proceed," "least restrictive appropriate setting," and "therapeutically appropriate treatment."

Requires courts to order examination by a tier 1a mental health professional when fitness to proceed is questioned, with examination occurring within 15 days and written report due within 30 days.

Establishes examination report requirements including identity of interviewees, procedures used, findings on defendant's fitness, and opinion on whether defendant will attain fitness in the foreseeable future.

For felony charges, suspends proceedings for up to 180 days (extendable by 365 days) if defendant may attain fitness; for misdemeanor charges, suspension period limited to maximum sentence for most serious offense charged.

Mandates dismissal of charges if defendant will not attain fitness in the foreseeable future, and allows courts to order least restrictive treatment and refer defendants for guardianship, civil commitment, or other appropriate services.