Hon. Michael J. Kramer AOT Program Initiative
What is AOT?
AOT stands for Assisted Outpatient Treatment, a type of court ordered civil commitment for individuals with severe mental illness. Many Indiana counties already utilize outpatient commitment orders, which are authorized under Indiana law. (See Ind. Code ยงยง 12-26-14-1,12-26-14-7, 12-26-6-8 (a), 12-26-7-5(a); J.W. v Community Fairbanks Behavioral Health, 260 N.E.3d 946 (Ind. June 24, 2025)).
Learn more about AOT:
What is an AOT program?
An AOT program is more than just a court order. It is a structured program, built around the court order, which includes an active and involved treatment team and a court/judge, who monitor an individual’s treatment progress and operate with compassion.
An AOT program focuses on person-centered treatment based on engagement and outreach. A successful AOT program relies on enhanced communication between treatment providers and the court, along with the treatment team’s diligent efforts to keep the participant actively engaged in treatment.
AOT programs have resulted in:
- A decrease in the length of hospital stays
- A reduction in the number of encounters with law enforcement for individuals under outpatient commitment
- A reduction in an individual’s involvement with the criminal justice system
- A reduction in violent behavior
- A decrease in the number of petitions to apprehend and return individuals under commitment
- An alternative in criminal cases to the often lengthy and complex competency process
Articles about AOT Programs
Pilot for Treatment Programs Named in Honor of Judge Kramer
By Brittany Kelly, Indiana Court Times, November 14, 2025
Read Nov. 14 Court Times Article
Assisted Outpatient Treatment in Lake County: A collaborative effort by courts and treatment systems to improve outcomes for those in need of mental health treatment
By Brittany Kelly, Indiana Court Times, February 18, 2025
Read Feb. 18 Court Times Article
Indiana's Judiciary Advancing Mental Health Treatment through Assisted Outpatient Treatment Programs
By Judge Matthew E. Sarber, Res Gestae, June 2025
AOT Program Sites in Indiana
- Bartholomew County - A partnership between Judge Rohde and Centerstone and Columbus Regional Health
- Lake County - A partnership between Judge McDermott and Regional Care Group
- Porter County - A partnership between Judge Fish and Porter-Starke Services
The Office of Behavioral Health is beginning a pilot for Assisted Outpatient Treatment programs. It has selected seven counties to join the three mentor counties above, with the ten making up the Hon. Michael J. Kramer AOT Program Initiative. The seven additional sites are:
- DeKalb County - A partnership between Judge Patrick Jessup and Northeastern Center
- Knox County - A partnership between Judge Monica Gilmore and Family Health Center
- Marion County - A partnership between Judge Amy Jones and Sandra Eskenazi
- Marshall County - A partnership between Judge Matthew Sarber and Bowen Health and Michiana Behavioral Health
- St. Joseph County - A partnership between Magistrate Elizabeth Hardtke and Oaklawn
- Tippecanoe County - A partnership between Judge Sean Persin, Magistrate Sarah Wyatt, and Valley Oaks
- Vanderburgh County - A partnership between Magistrate Jill Marcrum and Southwestern Behavioral Healthcare
About Hon. Michael J. Kramer
This initiative is named after the Honorable Michael J. Kramer, the longest serving Judge in Noble County history. Michael Kramer first took office on January 1, 1991, where he served as Judge for Noble County Superior Court 2 until 2016 when he took the bench for the Noble County Circuit Court.
Judge Kramer dedicated his life to service, leading with compassion and empathy while promoting best practices for those experiencing mental illness. On December 14, 1999, he was named Distinguished Hoosier by then Governor Frank O'Bannon. Kramer had also been named Volunteer of the Year by Drug-Free Indiana. In 2009, he was named Indiana Addiction Recovery Advocate of the Year as a result of his work to prevent and treat substance abuse. In 2010, Community Anti-Drug Coalitions of America named Kramer its Advocate of the Year.
At the time of his passing in March 2025, Judge Kramer was serving as the chair of Drug-Free Noble County and on the board of Community Anti-Drug Coalitions of America (CADCA). He was a member of the Advisory Council for the Indiana Division of Mental Health and Addictions, a member and former president of the Noble County Bar Association, and a Fellow of the Indiana Bar Foundation. He served as an inaugural member of the Behavioral Health Committee of the Indiana Supreme Court and was a long-time Judges and Lawyers Assistance Program (JLAP) volunteer.
Judge Kramer was very proud of his involvement with the creation of the Drug Court, Family Preservation Court, Veterans Court, and Mental Health Court in Noble County. His legacy will not be forgotten, and his memory lives on in this initiative.