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.