TUCSON, Ariz. » The man accused of wounding Rep. Gabrielle Giffords in a deadly shooting rampage is scheduled Wednesday to make his first court appearance since an angry outburst got him kicked out of a May competency hearing.

Jared Lee Loughner’s mental status is again the order of business, as a judge decides whether it’s likely the 23-year-old can be made competent to stand trial.

But this time around, Loughner will be under the effects of psychotropic drugs, which he has been forced to take the past 60 days.

U.S. District Judge Larry Burns will decide whether to grant prosecutors’ request to extend Loughner’s stay at a Missouri prison facility by another eight months. A psychologist told the court that Loughner remains mentally unfit to stand trial, but that the extended stay would give him time to improve and become competent.

Burns may also discuss whether to hold another hearing on Loughner’s forcible medication.

Loughner has been at the Springfield, Mo., facility the past four months after Burns found him mentally unfit for trial.

The judge’s decision followed a May 25 hearing in Tucson in which Loughner interrupted the proceedings with a loud rant. "Thank you for the free kill. She died in front of me. Your cheesiness," he said, according to court transcripts.

Federal marshals whisked Loughner from the courtroom, and he watched the rest of the hearing on closed-circuit TV from a separate room.

Experts have concluded Loughner suffers from schizophrenia.

The judge required Loughner’s presence at Wednesday’s hearing, even though Loughner’s lawyers objected and argued traveling would be disruptive for their mentally ill client.

Loughner wanted to attend the hearing so he could see his parents, who live in Tucson.

Dr. Christina Pietz, a psychologist treating Loughner, is expected to testify that she believes Loughner can be made mentally fit for trial during an extended stay at the Missouri facility.

Loughner’s attorneys argue prosecutors have failed to prove such an outcome is probable.

Loughner has pleaded not guilty to 49 charges stemming from the Jan. 8 shooting that killed six and injured 13, including Giffords.

If Burns decides to extend Loughner’s stay in Missouri, the judge likely will discuss whether to hold another hearing to determine if Loughner should continue to be forcibly medicated in a bid to make him mentally fit for trial.

Prison officials have forcibly medicated Loughner with psychotropic drugs after concluding at an administrative hearing that he posed a danger at the prison.

Loughner’s lawyers have been seeking to have the judge, rather than the prison, decide whether Loughner should be medicated.

Loughner was first forcibly medicated between June 21 and July 1, but an appeals court temporarily halted the medications after defense lawyers objected.

The forced medication resumed July 19 after prison officials concluded Loughner’s psychological condition was deteriorating, noting he had been pacing in circles near his cell door, screaming and crying for hours at a time.

Defense lawyers have repeatedly asked Burns and a federal appeals court to halt the forced medications.

Loughner’s medications include the sedative lorazepam, the antidepressant Wellbutrin and Risperidone, a drug used for people with schizophrenia, bipolar disorder and severe behavior problems.

Pietz has said Loughner has recently made progress in making more eye contact with people, improving his personal hygiene and pacing less.

But defense attorneys said none of the changes confront Loughner’s delusions and noted he remains on suicide watch.

If Loughner is later determined to be competent enough to understand the case against him, the court proceedings will resume. If he isn’t deemed mentally fit at the end of his treatment, Loughner’s stay at the facility can be extended. There are no limits on the number of times such extensions can be granted.

If doctors conclude they can’t restore Loughner’s mental competency, the judge must make another decision. If he finds there’s no likelihood of Loughner being restored to competency, he can dismiss the charges.

In that case, state and federal authorities can petition to have Loughner civilly committed and could seek to extend that commitment repeatedly.