By Naishtat H.B. No. 2745 A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the provision of in-patient and out-patient mental 1-3 health services. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Section 574.034, Texas Health and Safety Code, is 1-6 amended to read as follows: 1-7 Sec.574.034. Order for Temporary Mental Health Services 1-8 (a) The judge (or jury) may determine that a proposed patient 1-9 requires court-ordered temporary mental health services as an 1-10 in-patient only if the judge or jury finds, from clear and 1-11 convincing evidence, that: 1-12 (1) the proposed patient is mentally ill; and 1-13 (2) as a result of that mental illness the proposed 1-14 patient: 1-15 (A) is likely to cause serious harm to himself; or 1-16 (B) is likely to cause serious harm to others; 1-17 (b) The judge (or jury) may determine that a proposed 1-18 patient requires court-ordered temporary mental health services as 1-19 an out-patient only if the judge or jury finds, from clear and 1-20 convincing evidence, that: 1-21 (1) the proposed patient is mentally ill; and 1-22 (2) as a result of that mental illness the proposed 1-23 patient will: 2-1 (A) if not treated, continue to suffer severe and 2-2 abnormal mental, emotional, or physical distress, and 2-3 (B) if not treated, will continue to experience 2-4 deterioration of his ability to function independently, and 2-5 (C) is unable to make a rational and informed decision 2-6 as to whether or not to submit to treatment. 2-7 (D) The mental illness is chronic in nature, and 2-8 (E) The proposed patient shows a likelihood to not 2-9 participate voluntarily in out-patient treatment services based on 2-10 the proposed patient's actions during the two (2) years prior to 2-11 the hearing. 2-12 (c) The judge or jury must specify which criterion 2-13 listed in Subsection (a)(2) forms the basis for the decision of the 2-14 necessity of in-patient treatment. 2-15 (d) To be clear and convincing under this section, the 2-16 evidence must include expert testimony and, unless waived, evidence 2-17 of a recent overt act or a continuing pattern of behavior that 2-18 tends to confirm the likelihood of serious harm to the proposed 2-19 patient or others or the proposed patient's distress and the 2-20 deterioration of ability to function. 2-21 (e) The proposed patient or the proposed patient's 2-22 attorney, by a written document filed with the court, may waive the 2-23 right to cross-examine witnesses, and, if that right is waived, the 2-24 court may admit, as evidence, the certificates of medical 2-25 examination for mental illness. The certificates admitted under 3-1 this subsection constitute competent medical or psychiatric 3-2 testimony, and the court may make its findings solely from the 3-3 certificates. If the person and his attorney do not waive in 3-4 writing the right to cross-examine witnesses, the court shall 3-5 proceed to hear testimony. The testimony must include competent 3-6 medical or psychiatric testimony. In addition, the court may 3-7 consider the testimony of a nonphysician mental health professional 3-8 as provided by section 547.031. 3-9 (f) An order for temporary mental health services 3-10 shall state that treatment is authorized for not longer than 90 3-11 days. The order may not specify a shorter period. 3-12 (g) A judge may not issue an order for temporary 3-13 mental health services for a proposed patient who is charged with a 3-14 criminal offense. 3-15 (h) If extremely hazardous weather conditions exist or 3-16 a disaster occurs, the judge of a court having jurisdiction of a 3-17 proceeding under the chapter or a magistrate appointed by the judge 3-18 may by written order made each day extend the period during which 3-19 the person may be detained under this chapter until 4 p.m. on the 3-20 first succeeding business day. The written order must declare that 3-21 an emergency exists because of the weather or the occurrence of a 3-22 disaster. This subsection does not apply to a situation for which 3-23 a specific procedure is prescribed by this code for extending the 3-24 detention period because of extremely hazardous weather conditions 3-25 or the occurrence of a disaster. 4-1 SECTION 2. Section 574.035, Texas Health and Safety Code, is 4-2 amended to read as follows: 4-3 Sec. 574.035. Order for Extended Mental Health Services (a) The 4-4 (jury, or the) judge (if the right to a jury is waived,) may 4-5 determine that a proposed patient requires court-ordered extended 4-6 mental health services as an in-patient only if the jury or the 4-7 judge, if the right to a jury is waived, finds, from clear and 4-8 convincing evidence, that: 4-9 (1) the proposed patient is mentally ill; and 4-10 (2) as a result of that mental illness the proposed 4-11 patient: 4-12 (A) is likely to cause serious harm to himself; 4-13 (B) is likely to cause serious harm to others; or 4-14 (b) The judge (or jury) may determine that a proposed 4-15 patient requires court-ordered extended mental health services as 4-16 an out-patient only if the jury or the judge, if the right to a 4-17 jury is waived,(or jury) finds, from clear and convincing evidence, 4-18 that: 4-19 (1) the proposed patient is mentally ill; and 4-20 (2) as a result of that mental illness the proposed 4-21 patient will: 4-22 (a) if not treated, continue to suffer severe and 4-23 abnormal mental, emotional, or physical distress, and 4-24 (b) if not treated, will continue to experience 4-25 deterioration of his ability to function independently, and 5-1 (c) is unable to make a rational and informed decision 5-2 as to whether or not to submit to treatment; 5-3 (d) if not treated, the proposed patient's condition 5-4 is expected to continue for more than 90 days; and 5-5 (e) the mental illness is chronic in nature, and 5-6 (f) the proposed patient has shown a likelihood to not 5-7 participate voluntarily in out-patient treatment services based on 5-8 the proposed patient's actions during the two (2) years prior to 5-9 the hearing. 5-10 (g) the proposed patient has received court-ordered 5-11 inpatient mental health services under this subtitle or under 5-12 Section 5, Article 46.02, Code of Criminal Procedure, for at least 5-13 60 consecutive days during the preceding 12 months. 5-14 (h) The jury or judge must specify which criterion 5-15 listed in Subsection (a)(2) forms the basis for the decision. 5-16 (i) The jury or judge is not required to make the 5-17 finding under Subsection (a)(4) if the proposed patient has already 5-18 been subject to an order for extended mental health services. 5-19 (j) To be clear and convincing under this section, the 5-20 evidence must include expert testimony and evidence of a recent 5-21 overt act or a continuing pattern of behavior that tends to confirm 5-22 the likelihood of serious harm to the proposed patient or others or 5-23 the proposed patient's distress and the deterioration of ability to 5-24 function. 5-25 (k) The court may not make its finds solely from the 6-1 certificates of medical examination for mental illness but shall 6-2 hear testimony. The court may not enter an order for extended 6-3 mental health services unless appropriate findings are made and are 6-4 supported by testimony taken at the hearing. The testimony must 6-5 include competent medical or psychiatric testimony. 6-6 (l) An order for extended mental health services shall 6-7 state that treatment is authorized for not longer than 12 months. 6-8 The order may not specify a shorter period. 6-9 (m) If extremely hazardous weather conditions exist or 6-10 a disaster occurs, the judge of a court having jurisdiction of a 6-11 proceeding under this chapter or a magistrate appointed by the 6-12 judge may by written order made each day extend the period during 6-13 which the person may be detained under this chapter until 4 p.m. on 6-14 the first succeeding business day. The written order must declare 6-15 that an emergency exists because of the weather or the occurrence 6-16 of a disaster. This subsection does not apply to a situation for 6-17 which a specific procedure is prescribed by this code for extending 6-18 the detention period because of extremely hazardous weather 6-19 conditions or the occurrence of a disaster. 6-20 (n) A judge may not issue an order for extended mental 6-21 health services for a proposed patient who is charged with a 6-22 criminal offense. 6-23 SECTION 3. Section 574.036, Texas Health and Safety Code, is 6-24 amended to read as follows: 6-25 Sec. 574.036. Order of Care or Commitment (a) The 7-1 judge shall dismiss the jury, if any, after a hearing in which a 7-2 person is found to be mentally ill and to meet the criteria for 7-3 court-ordered temporary or extended mental health services. 7-4 (b) The judge may hear additional evidence relating to 7-5 alternative settings for care before entering an order relating to 7-6 the setting for the care the person will receive. 7-7 (c) The judge shall consider in determining the 7-8 setting for care the recommendation for the most appropriate 7-9 treatment alternative filed under Section 574.012. 7-10 (d) The judge shall order the mental health services 7-11 provided in the least restrictive appropriate setting available. 7-12 (e) The judge may enter an order: 7-13 (1) committing the person to a mental health facility 7-14 for inpatient care if the criteria under Section 574.034(a) or 7-15 Section 574.035(a) have been found by the trier of fact; or 7-16 (2) requiring the person to participate in other 7-17 mental health services, including community center programs and 7-18 services provided by a private psychiatrist or psychologist if the 7-19 criteria under Section 574.034(b) or 574.035(b) have been found by 7-20 the trier of fact. 7-21 SECTION 4. The importance of this legislation and the 7-22 crowded condition of the calendars in both houses create an 7-23 emergency and an imperative public necessity that the 7-24 constitutional rule requiring bills to be read on three several 7-25 days in each house be suspended, and this rule is hereby suspended.