1-1 By: Moncrief, Harris of Tarrant, Zaffirini S.B. No. 205
1-2 (In the Senate - Filed January 29, 1993; February 1, 1993,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; March 19, 1993, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 8, Nays 0;
1-6 March 19, 1993, sent to printer.)
1-7 COMMITTEE VOTE
1-8 Yea Nay PNV Absent
1-9 Zaffirini x
1-10 Ellis x
1-11 Madla x
1-12 Moncrief x
1-13 Nelson x
1-14 Patterson x
1-15 Shelley x
1-16 Truan x
1-17 Wentworth x
1-18 COMMITTEE SUBSTITUTE FOR S.B. No. 205 By: Moncrief
1-19 A BILL TO BE ENTITLED
1-20 AN ACT
1-21 relating to the regulation of the provision of services to persons
1-22 with certain disabilities or in need of counseling in a crisis or
1-23 an emergency; creating offenses and providing civil,
1-24 administrative, and criminal penalties.
1-25 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-26 ARTICLE 1
1-27 SECTION 1.01. Title 4, Health and Safety Code, is amended by
1-28 adding Subtitle G to read as follows:
1-29 SUBTITLE G. PROVISION OF SERVICES IN CERTAIN FACILITIES
1-30 CHAPTER 321. PROVISION OF MENTAL HEALTH, CHEMICAL DEPENDENCY,
1-31 AND REHABILITATION SERVICES
1-32 Sec. 321.001. DEFINITIONS. In this chapter:
1-33 (1) "Comprehensive medical rehabilitation" means the
1-34 provision of rehabilitation services that are designed to improve
1-35 or minimize a person's physical or cognitive disabilities, maximize
1-36 a person's functional ability, or restore a person's lost
1-37 functional capacity through close coordination of services,
1-38 communication, interaction, and integration among several
1-39 professions that share the responsibility to achieve team treatment
1-40 goals for the person.
1-41 (2) "Hospital" has the meaning assigned by Section
1-42 241.003.
1-43 (3) "License" means a state agency permit,
1-44 certificate, approval, registration, or other form of permission
1-45 required by state law.
1-46 (4) "Mental health facility" has the meaning assigned
1-47 by Section 571.003.
1-48 (5) "State health care regulatory agency" means a
1-49 state agency that licenses a health care professional.
1-50 (6) "Treatment facility" has the meaning assigned by
1-51 Section 464.001.
1-52 Sec. 321.002. BILL OF RIGHTS. (a) The Texas Board of
1-53 Mental Health and Mental Retardation, Texas Board of Health, and
1-54 Texas Commission on Alcohol and Drug Abuse by rule shall each adopt
1-55 a "patient's bill of rights" that includes the applicable rights
1-56 included in this chapter, Subtitle C of Title 7, Chapters 241, 462,
1-57 464, and 466, and any other provisions the agencies consider
1-58 necessary to protect the health, safety, and rights of a patient
1-59 receiving voluntary or involuntary mental health, chemical
1-60 dependency, or comprehensive medical rehabilitation services in an
1-61 inpatient facility. In addition, each agency shall adopt rules
1-62 that:
1-63 (1) provide standards to prevent the admission of a
1-64 minor to a facility for treatment of a condition that is not
1-65 generally recognized as responsive to treatment in an inpatient
1-66 treatment setting; and
1-67 (2) prescribe the procedure for presenting the
1-68 applicable bill of rights and obtaining each necessary signature
2-1 if:
2-2 (A) the patient cannot comprehend the
2-3 information because of illness, age, or other factors; or
2-4 (B) an emergency exists that precludes immediate
2-5 presentation of the information.
2-6 (b) The Board of Protective and Regulatory Services by rule
2-7 shall adopt a "children's bill of rights" for a minor receiving
2-8 treatment in a child-care facility for an emotional, mental health,
2-9 or chemical dependency problem.
2-10 (c) A "bill of rights" adopted under this section must
2-11 specifically address the rights of minors and provide that a minor
2-12 is entitled to:
2-13 (1) appropriate treatment in the least restrictive
2-14 setting available;
2-15 (2) not receive unnecessary or excessive medication;
2-16 (3) an individualized treatment plan and to
2-17 participate in the development of the plan; and
2-18 (4) a humane treatment environment that provides
2-19 reasonable protection from harm and appropriate privacy for
2-20 personal needs.
2-21 (d) Rules adopted under this section shall provide for:
2-22 (1) treatment of minors by persons who have
2-23 specialized education and training in the emotional, mental health,
2-24 and chemical dependency problems and treatment of minors;
2-25 (2) separation of minor patients from adult patients;
2-26 and
2-27 (3) regular communication between a minor patient and
2-28 the patient's family, subject only to a restriction in accordance
2-29 with Section 576.006.
2-30 (e) The Texas Board of Health, Texas Board of Mental Health
2-31 and Mental Retardation, Texas Commission on Alcohol and Drug Abuse,
2-32 and Board of Protective and Regulatory Services shall consult each
2-33 other for assistance in adopting rules under this section.
2-34 (f) Before a facility may admit a patient for inpatient
2-35 mental health, chemical dependency, or comprehensive medical
2-36 rehabilitation services, or before a child-care facility may accept
2-37 a minor for treatment, the facility shall provide to the person
2-38 and, if appropriate, to the person's parent, managing conservator,
2-39 or guardian, a written copy of the applicable "bill of rights"
2-40 adopted under this section. The facility shall provide the written
2-41 copies in the person's primary language, if possible. In addition,
2-42 the facility shall ensure that, within 24 hours after the person is
2-43 admitted to the facility, the rights specified in the written copy
2-44 are explained to the person and, if appropriate, to the person's
2-45 parent, managing conservator, or guardian:
2-46 (1) orally, in simple, nontechnical terms in the
2-47 person's primary language, if possible; or
2-48 (2) through a means reasonably calculated to
2-49 communicate with a person who has an impairment of vision or
2-50 hearing, if applicable.
2-51 (g) The facility shall ensure that:
2-52 (1) each patient admitted for inpatient mental health,
2-53 chemical dependency, or comprehensive rehabilitation services and
2-54 each minor admitted for treatment in a child-care facility and, if
2-55 appropriate, the person's parent, managing conservator, or guardian
2-56 signs a copy of the document stating that the person has read the
2-57 document and understands the rights specified in the document; and
2-58 (2) the signed copy is made a part of the person's
2-59 clinical record.
2-60 (h) A facility shall prominently and conspicuously post a
2-61 copy of the "bill of rights" for display in a public area of the
2-62 facility that is readily available to patients, residents,
2-63 employees, and visitors. The "bill of rights" must be in English
2-64 and in a second language.
2-65 Sec. 321.003. SUIT FOR HARM RESULTING FROM VIOLATION.
2-66 (a) A treatment facility or mental health facility that violates a
2-67 provision of, or a rule adopted under, this chapter, Subtitle C of
2-68 Title 7, or Chapter 241, 462, 464, or 466 is liable to a person
2-69 receiving care or treatment in or from the facility who is harmed
2-70 as a result of the violation.
3-1 (b) A person who has been harmed by a violation may sue for
3-2 injunctive relief, damages, or both.
3-3 (c) A court shall award to a plaintiff who prevails in a
3-4 suit under this section not less than the greater of $1,000 or
3-5 actual damages, including damages for mental anguish even if an
3-6 injury other than mental anguish is not shown.
3-7 (d) In addition to an award under Subsection (c), a court
3-8 may award to a plaintiff who prevails in a suit under this section:
3-9 (1) exemplary damages;
3-10 (2) court costs; and
3-11 (3) reasonable attorney fees.
3-12 (e) A suit under this section may be brought in the district
3-13 court of the county in which:
3-14 (1) the plaintiff resides;
3-15 (2) the plaintiff received care or treatment; or
3-16 (3) the defendant conducts business.
3-17 (f) A person harmed by a violation must bring suit not later
3-18 than the second anniversary of the date on which the person's
3-19 injury is discovered, except that a minor whose injury is
3-20 discovered before the minor's 18th birthday may bring suit at any
3-21 time before the minor's 20th birthday.
3-22 (g) This section does not supersede or abrogate any other
3-23 remedy existing in law.
3-24 Sec. 321.004. PENALTIES. In addition to the penalties
3-25 prescribed by this chapter, a violation of a provision of this
3-26 chapter by an individual or facility that is licensed by a state
3-27 health care regulatory agency is subject to the same consequence as
3-28 a violation of the licensing law applicable to the individual or
3-29 facility or of a rule adopted under that licensing law.
3-30 SECTION 1.02. The changes in law made by this article apply
3-31 only to a cause of action that accrues on or after the effective
3-32 date of this article. A cause of action that accrues before the
3-33 effective date of this article is governed by the law in effect on
3-34 the date the cause of action accrues, and that law is continued in
3-35 effect for this purpose.
3-36 ARTICLE 2
3-37 SECTION 2.01. Subtitle H, Title 2, Health and Safety Code,
3-38 is amended by adding Chapter 164 to read as follows:
3-39 CHAPTER 164. TREATMENT FACILITIES MARKETING AND ADMISSION
3-40 PRACTICES
3-41 Sec. 164.001. SHORT TITLE. This chapter may be cited as the
3-42 Treatment Facilities Marketing Practices Act.
3-43 Sec. 164.002. LEGISLATIVE PURPOSE. The purpose of this
3-44 chapter is to safeguard the public against fraud, deceit, and
3-45 misleading marketing practices and to foster and encourage
3-46 competition and fair dealing by mental health facilities and
3-47 chemical dependency treatment facilities by prohibiting or
3-48 restricting practices by which the public has been injured in
3-49 connection with the marketing and advertising of mental health
3-50 services and the admission of patients. Nothing in this chapter
3-51 should be construed to prohibit a mental health facility from
3-52 advertising its services in a general way or promoting its
3-53 specialized services. However, the public should be able to
3-54 distinguish between the marketing activities of the facility and
3-55 its clinical functions.
3-56 Sec. 164.003. DEFINITIONS. In this chapter:
3-57 (1) "Advertising" or "advertise" means a solicitation
3-58 or inducement, through print or electronic media, including radio,
3-59 television, or direct mail, to purchase the services provided by a
3-60 treatment facility.
3-61 (2) "Chemical dependency" has the meaning assigned by
3-62 Section 462.001.
3-63 (3) "Chemical dependency facility" means a treatment
3-64 facility as that term is defined by Section 462.001.
3-65 (4) "Intervention and assessment service" means a
3-66 service that offers assessment, counseling, evaluation,
3-67 intervention, or referral services or makes treatment
3-68 recommendations to an individual with respect to mental illness or
3-69 chemical dependency.
3-70 (5) "Mental health facility" means:
4-1 (A) a "mental health facility" as defined by
4-2 Section 571.003;
4-3 (B) a residential treatment facility, other than
4-4 a mental health facility, in which persons are treated for
4-5 emotional problems or disorders in a 24-hour supervised living
4-6 environment; and
4-7 (C) an adult day-care facility or adult day
4-8 health care facility as defined by Section 103.003, Human Resources
4-9 Code.
4-10 (6) "Mental health professional" means a:
4-11 (A) "physician" as defined by Section 571.003;
4-12 (B) "licensed professional counselor" as defined
4-13 by Section 2, Licensed Professional Counselor Act (Article 4512g,
4-14 Vernon's Texas Civil Statutes);
4-15 (C) "chemical dependency counselor" as defined
4-16 by Section 1, Chapter 635, Acts of the 72nd Legislature, Regular
4-17 Session, 1991 (Article 4512o, Vernon's Texas Civil Statutes);
4-18 (D) "psychologist" offering "psychological
4-19 services" as defined by Section 2, Psychologists' Certification and
4-20 Licensing Act (Article 4512c, Vernon's Texas Civil Statutes);
4-21 (E) "registered nurse" licensed under Chapter 7,
4-22 Title 71, Revised Statutes;
4-23 (F) "licensed vocational nurse" as defined by
4-24 Section 1, Article 4528c, Revised Statutes;
4-25 (G) "licensed marriage and family therapist" as
4-26 defined by Section 2, Licensed Marriage and Family Therapist Act
4-27 (Article 4512c-1, Vernon's Texas Civil Statutes); and
4-28 (H) "social worker" as defined by Section
4-29 50.001(a), Human Resources Code.
4-30 (7) "Mental health services" has the meaning assigned
4-31 by Section 531.002.
4-32 (8) "Mental illness" has the meaning assigned by
4-33 Section 571.003.
4-34 (9) "Referral source" means a person who is in a
4-35 position to refer or who refers a person to a treatment facility.
4-36 Referral source does not include a physician, an insurer, a health
4-37 maintenance organization (HMO), a preferred provider arrangement
4-38 (PPA), or other third party payor or discount provider organization
4-39 (DPO) where the insurer, HMO, PPA, third party payor, or DPO pays
4-40 in whole or in part for the treatment of mental illness or chemical
4-41 dependency.
4-42 (10) "Treatment facility" means a chemical dependency
4-43 facility and a mental health facility.
4-44 Sec. 164.004. EXEMPTIONS. This chapter does not apply to:
4-45 (1) a treatment facility operated by the Texas
4-46 Department of Mental Health and Mental Retardation, a federal
4-47 agency, or a political subdivision;
4-48 (2) a community center established under Subchapter A,
4-49 Chapter 534, or a facility operated by a community center; or
4-50 (3) a facility owned and operated by a nonprofit or
4-51 not-for-profit organization offering counseling concerning family
4-52 violence, help for runaway children, or rape.
4-53 Sec. 164.005. CONDITIONING EMPLOYEE OR AGENT RELATIONSHIPS
4-54 ON PATIENT REVENUE. A treatment facility may not permit or provide
4-55 compensation or anything of value to its employees or agents,
4-56 condition employment or continued employment of its employees or
4-57 agents, set its employee or agent performance standards, or
4-58 condition its employee or agent evaluations, based on:
4-59 (1) the number of patient admissions resulting from an
4-60 employee's or agent's efforts;
4-61 (2) the number or frequency of telephone calls or
4-62 other contacts with referral sources or patients if the purpose of
4-63 the telephone calls or contacts is to solicit patients for the
4-64 treatment facility; or
4-65 (3) the existence of or volume of determinations made
4-66 respecting the length of patient stay.
4-67 Sec. 164.006. SOLICITING AND CONTRACTING WITH CERTAIN
4-68 REFERRAL SOURCES. A treatment facility or a person employed or
4-69 under contract with a treatment facility, if acting on behalf of
4-70 the treatment facility, may not:
5-1 (1) contact a referral source or potential client for
5-2 the purpose of soliciting, directly or indirectly, a referral of a
5-3 patient to the treatment facility without disclosing its soliciting
5-4 agent's, employee's, or contractor's affiliation with the treatment
5-5 facility;
5-6 (2) offer to provide or provide mental health or
5-7 chemical dependency services to a public or private school in this
5-8 state, on a part-time or full-time basis, the services of any of
5-9 its employees or agents who make, or are in a position to make, a
5-10 referral, if the services are provided on an individual basis to
5-11 individual students or their families. Nothing herein prohibits a
5-12 treatment facility from:
5-13 (A) offering or providing educational programs
5-14 in group settings to public schools in this state if the
5-15 affiliation between the educational program and the treatment
5-16 facility is disclosed; or
5-17 (B) providing counseling services to a public
5-18 school in this state in an emergency or crisis situation if the
5-19 services are provided in response to a specific request by a
5-20 school; provided that, under no circumstances may a student be
5-21 referred to the treatment facility offering the services;
5-22 (3) provide to an entity of state or local government,
5-23 on a part-time or full-time basis, the mental health or chemical
5-24 dependency services of any of its employees, agents, or contractors
5-25 who make or are in a position to make referrals unless:
5-26 (A) the treatment facility discloses to the
5-27 governing authority of the entity:
5-28 (i) the employee's, agent's, or
5-29 contractor's relationship to the facility; and
5-30 (ii) the fact that the employee, agent, or
5-31 contractor might make a referral, if permitted, to the facility;
5-32 and
5-33 (B) the employee, agent, or contractor makes a
5-34 referral only if:
5-35 (i) the treatment facility obtains the
5-36 governing authority's authorization in writing for the employee,
5-37 agent, or contractor to make the referrals; and
5-38 (ii) the employee, agent, or contractor
5-39 discloses to the prospective patient the employee's, agent's, or
5-40 contractor's relationship to the facility at initial contact; or
5-41 (4) in relation to intervention and assessment
5-42 services, contract with, offer to remunerate, or remunerate a
5-43 person who operates an intervention and assessment service that
5-44 makes referrals to a treatment facility for inpatient treatment of
5-45 mental illness or chemical dependency unless the intervention and
5-46 assessment service is:
5-47 (A) operated by a community mental health and
5-48 mental retardation center funded by the Texas Department of Mental
5-49 Health and Mental Retardation;
5-50 (B) operated by a county or regional medical
5-51 society;
5-52 (C) a qualified mental health referral service
5-53 as defined by Section 164.007; or
5-54 (D) owned and operated by a nonprofit or
5-55 not-for-profit organization offering counseling concerning family
5-56 violence, help for runaway children, or rape.
5-57 Sec. 164.007. QUALIFIED MENTAL HEALTH REFERRAL SERVICE:
5-58 DEFINITION AND STANDARDS. (a) A qualified mental health referral
5-59 service means a service that conforms to all of the following
5-60 standards:
5-61 (1) the referral service does not exclude as a
5-62 participant in the referral service an individual who meets the
5-63 qualifications for participation and qualifications for
5-64 participation cannot be based in whole or in part on an
5-65 individual's or entity's affiliation or nonaffiliation with other
5-66 participants in the referral service;
5-67 (2) a payment the participant makes to the referral
5-68 service is assessed equally against and collected equally from all
5-69 participants, and is only based on the cost of operating the
5-70 referral service and not on the volume or value of any referrals to
6-1 or business otherwise generated by the participants of the referral
6-2 service;
6-3 (3) the referral service imposes no requirements on
6-4 the manner in which the participant provides services to a referred
6-5 person, except that the referral service may require that the
6-6 participant charge the person referred at the same rate as it
6-7 charges other persons not referred by the referral service, or that
6-8 these services be furnished free of charge or at a reduced charge;
6-9 (4) a referral made to a mental health professional or
6-10 chemical dependency treatment facility is made only in accordance
6-11 with Subdivision (1) and the referral service does not make
6-12 referrals to mental health facilities other than facilities
6-13 maintained or operated by the Texas Department of Mental Health and
6-14 Mental Retardation, community mental health and mental retardation
6-15 centers, or other political subdivisions, provided that a physician
6-16 may make a referral directly to any mental health facility;
6-17 (5) the referral service is staffed by appropriately
6-18 licensed and trained mental health professionals and a person who
6-19 makes assessments for the need for treatment of mental illness or
6-20 chemical dependency is a mental health professional as defined by
6-21 this chapter;
6-22 (6) in response to each inquiry or after personal
6-23 assessment, the referral service makes referrals, on a clinically
6-24 appropriate, rotational basis, to at least three mental health
6-25 professionals or chemical dependency treatment facilities whose
6-26 practice addresses or facilities are located in the county of
6-27 residence of the person seeking the referral or assessment, but if
6-28 there are not three providers in the inquirer's county of
6-29 residence, the referral service may include additional providers
6-30 from other counties nearest the inquirer's county of residence;
6-31 (7) no information that identifies the person seeking
6-32 a referral, such as name, address, or telephone number, is used,
6-33 maintained, distributed, or provided for a purpose other than
6-34 making the requested referral or for administrative functions
6-35 necessary to operating the referral service;
6-36 (8) the referral service makes the following
6-37 disclosures to each person seeking a referral:
6-38 (A) the manner in which the referral service
6-39 selects the group of providers participating in the referral
6-40 service;
6-41 (B) whether the provider participant has paid a
6-42 fee to the referral service;
6-43 (C) the manner in which the referral service
6-44 selects a particular provider from its list of provider
6-45 participants to which to make a referral;
6-46 (D) the nature of the relationship or any
6-47 affiliation between the referral service and the group of provider
6-48 participants to whom it could make a referral; and
6-49 (E) the nature of any restriction that would
6-50 exclude a provider from continuing as a provider participant;
6-51 (9) the referral service maintains each disclosure in
6-52 a written record certifying that the disclosure has been made and
6-53 the record certifying that the disclosure has been made is signed
6-54 by either the person seeking a referral or by the person making the
6-55 disclosure on behalf of the referral service; and
6-56 (10) if the referral service refers callers to a 1-900
6-57 telephone number or another telephone number that requires the
6-58 payment of a toll or fee payable to or collected by the referral
6-59 service, the referral service discloses the per minute charge.
6-60 (b) A qualified mental health referral service may not limit
6-61 participation by a person for a reason other than:
6-62 (1) failure to have a current, valid license without
6-63 limitation to practice in this state;
6-64 (2) failure to maintain professional liability
6-65 insurance while participating in the service;
6-66 (3) a decision by a peer review committee that the
6-67 person has failed to meet prescribed standards or has not acted in
6-68 a professional or ethical manner;
6-69 (4) termination of the contract between the
6-70 participant and the qualified mental health referral service by
7-1 either party under the terms of the contract; or
7-2 (5) significant dissatisfaction of consumers that is
7-3 documented and verifiable.
7-4 Sec. 164.008. OPERATING AN INTERVENTION AND ASSESSMENT
7-5 SERVICE. A treatment facility may not own, operate, manage, or
7-6 control an intervention and assessment service that makes referrals
7-7 to a treatment facility for inpatient treatment of mental illness
7-8 or chemical dependency unless the intervention and assessment
7-9 service:
7-10 (1) is a qualified mental health referral service
7-11 under Section 164.007;
7-12 (2) discloses in all advertising the relationship
7-13 between the treatment facility and the intervention and assessment
7-14 service; and
7-15 (3) discloses to each person contacting the service,
7-16 at the time of initial contact, the relationship between the
7-17 treatment facility and the intervention and assessment service.
7-18 Sec. 164.009. DISCLOSURES AND REPRESENTATIONS. (a) A
7-19 treatment facility may not admit a patient to its facilities
7-20 without fully disclosing to the patient or, if the patient is a
7-21 minor, the patient's parent, managing conservator, or guardian, in,
7-22 if possible, the primary language of the patient, managing
7-23 conservator, or guardian, as the case may be, the following
7-24 information in writing before admission:
7-25 (1) the treatment facility's estimated average daily
7-26 charge for inpatient treatment with an explanation that the patient
7-27 may be billed separately for services provided by mental health
7-28 professionals;
7-29 (2) the name of the attending physician, if the
7-30 treatment facility is a mental health facility, or the name of the
7-31 attending mental health professional, if the facility is a chemical
7-32 dependency facility; and
7-33 (3) the current "patient's bill of rights" as adopted
7-34 by the Texas Department of Mental Health and Mental Retardation,
7-35 the Texas Commission on Alcohol and Drug Abuse, or the Texas
7-36 Department of Health that sets out restrictions to the patient's
7-37 freedom that may be imposed on the patient during the patient's
7-38 stay in a treatment facility.
7-39 (b) A treatment facility may not misrepresent to a patient
7-40 or the parent, guardian, managing conservator, or spouse of a
7-41 patient, the availability or amount of insurance coverage available
7-42 to the prospective patient or the amount and percentage of a charge
7-43 for which the patient will be responsible.
7-44 (c) A treatment facility may not represent to a patient who
7-45 requests to leave a treatment facility against medical advice that:
7-46 (1) the patient will be subject to an involuntary
7-47 commitment proceeding or subsequent emergency detention unless that
7-48 representation is made by a physician or on the written instruction
7-49 of a physician who has evaluated the patient within 48 hours of the
7-50 representation; or
7-51 (2) the patient's insurance company will refuse to pay
7-52 all or any portion of the medical expenses previously incurred.
7-53 (d) A mental health facility may not represent or recommend
7-54 that a prospective patient should be admitted for inpatient
7-55 treatment unless the representation is made by a licensed physician
7-56 or, subsequent to evaluation by a licensed physician, by a mental
7-57 health professional.
7-58 (e) A chemical dependency facility may not represent or
7-59 recommend that a prospective patient should be admitted to a
7-60 facility for treatment unless and until:
7-61 (1) the prospective patient has been evaluated, in
7-62 person, by a mental health professional; and
7-63 (2) the mental health professional determines that the
7-64 patient meets the facility's admission standards.
7-65 Sec. 164.010. PROHIBITED ACTS. It is a violation of this
7-66 chapter, in connection with the marketing of mental health
7-67 services, for a person to:
7-68 (1) advertise, expressly or impliedly, the services of
7-69 a treatment facility through the use of:
7-70 (A) promises of cure or guarantees of treatment
8-1 results that cannot be substantiated; or
8-2 (B) any unsubstantiated claims;
8-3 (2) advertise, expressly or impliedly, the
8-4 availability of intervention and assessment services unless and
8-5 until the services are available and are provided by mental health
8-6 professionals licensed or certified to provide the particular
8-7 service;
8-8 (3) fail to disclose before soliciting a referral
8-9 source or prospective patient to induce a person to use the
8-10 services of the treatment facility an affiliation between a
8-11 treatment facility and its soliciting agents, employees, or
8-12 contractors;
8-13 (4) obtain information considered confidential by
8-14 state or federal law regarding a person for the purpose of
8-15 soliciting that person to use the services of a treatment facility
8-16 unless and until consent is obtained from the person or, in the
8-17 case of a minor, the person's parent, managing conservator, or
8-18 legal guardian or another person with authority to give that
8-19 authorization; or
8-20 (5) represent that a referral service is a qualified
8-21 mental health referral service unless and until the referral
8-22 service complies with Section 164.007.
8-23 Sec. 164.011. INJUNCTION. (a) If it appears that a person
8-24 is in violation of this chapter, the attorney general, a district
8-25 attorney, or a county attorney may institute an action for
8-26 injunctive relief to restrain the person from continuing the
8-27 violation and for civil penalties of not less than $1,000 and not
8-28 more than $25,000 per violation.
8-29 (b) A civil action filed under this section shall be filed
8-30 in a district court in Travis County or in the county in which the
8-31 defendant resides.
8-32 (c) The attorney general, a district attorney, or a county
8-33 attorney may recover reasonable expenses incurred in obtaining
8-34 injunctive relief, civil penalties, or both, under this section,
8-35 including court costs, reasonable attorney fees, investigative
8-36 costs, witness fees, and deposition expenses.
8-37 (d) A civil penalty recovered in a suit instituted by a
8-38 local government under this chapter shall be paid to that local
8-39 government.
8-40 Sec. 164.012. PENALTIES. In addition to the penalties
8-41 prescribed by this chapter, a violation of a provision of this
8-42 chapter by an individual or treatment facility that is licensed by
8-43 a state health care regulatory agency is subject to the same
8-44 consequences as a violation of the licensing law applicable to the
8-45 individual or treatment facility or of a rule adopted under that
8-46 licensing law.
8-47 Sec. 164.013. DECEPTIVE TRADE PRACTICES. A violation of
8-48 this chapter constitutes a false, misleading, or deceptive act or
8-49 practice within the meaning of Subchapter E, Chapter 17, Business &
8-50 Commerce Code, and a public or private right or remedy prescribed
8-51 by that subchapter may be used to enforce this chapter.
8-52 Sec. 164.014. RULE-MAKING AUTHORITY. The Texas Commission
8-53 on Alcohol and Drug Abuse and Texas Board of Mental Health and
8-54 Mental Retardation may adopt rules interpreting the provisions of
8-55 this chapter relating to the activities of a chemical dependency
8-56 facility or mental health facility under its jurisdiction.
8-57 ARTICLE 3
8-58 SECTION 3.01. Subsection (b), Section 241.053, Health and
8-59 Safety Code, is amended to read as follows:
8-60 (b) A hospital whose license is suspended or revoked may
8-61 apply to the department for the reissuance of a license. The
8-62 department may reissue the license if the department determines
8-63 that the hospital has corrected the conditions that led to the
8-64 suspension or revocation. A hospital whose license is suspended or
8-65 revoked may not admit new patients until the license is reissued.
8-66 SECTION 3.02. Section 241.054, Health and Safety Code, is
8-67 amended by amending Subsections (b), (d), and (e) and adding
8-68 Subsections (f), (g), (h), and (i) to read as follows:
8-69 (b) After the notice and opportunity to comply, the
8-70 commissioner of health <department> may request the attorney
9-1 general or the appropriate district or county attorney to institute
9-2 and conduct a suit for a violation of this chapter or a rule
9-3 adopted under this chapter <petition a district court in the county
9-4 in which a violation occurs for assessment and recovery of the
9-5 civil penalty provided by Section 241.055, for injunctive relief,
9-6 or both>.
9-7 (d) On his own initiative, the attorney general, a district
9-8 attorney, or a county attorney may maintain an action in the name
9-9 of the state for a violation of this chapter or a rule adopted
9-10 under this chapter.
9-11 (e) The district court shall assess the civil penalty
9-12 authorized by Section 241.055, grant <the> injunctive relief, or
9-13 both, as warranted by the facts. The injunctive relief may include
9-14 any prohibitory or mandatory injunction warranted by the facts,
9-15 including a temporary restraining order, temporary injunction, or
9-16 permanent injunction.
9-17 (f) The department and the party bringing the suit may
9-18 recover reasonable expenses incurred in obtaining injunctive
9-19 relief, civil penalties, or both, including investigation costs,
9-20 court costs, reasonable attorney fees, witness fees, and deposition
9-21 expenses <(e) The attorney general or the appropriate district or
9-22 county attorney shall initiate and conduct the suit at the request
9-23 of the commissioner of health>.
9-24 (g) Venue may be maintained in Travis County or in the
9-25 county in which the violation occurred.
9-26 (h) Not later than the seventh day before the date on which
9-27 the attorney general intends to bring suit on his own initiative,
9-28 the attorney general shall provide to the department notice of the
9-29 suit. The attorney general is not required to provide notice of a
9-30 suit if the attorney general determines that waiting to bring suit
9-31 until the notice is provided will create an immediate threat to the
9-32 health and safety of a patient. This section does not create a
9-33 requirement that the attorney general obtain the permission of a
9-34 referral from the department before filing suit.
9-35 (i) The injunctive relief and civil penalty authorized by
9-36 this section and Section 241.055 are in addition to any other
9-37 civil, administrative, or criminal penalty provided by law.
9-38 SECTION 3.03. Section 241.055, Health and Safety Code, is
9-39 amended by amending Subsections (b) and (c) and adding Subsection
9-40 (d) to read as follows:
9-41 (b) A hospital that violates Subsection (a), another
9-42 provision of this chapter, or a rule adopted or enforced under this
9-43 chapter is liable for a civil penalty of not more than $25,000
9-44 <$1,000> for each day of violation and for each act of violation.
9-45 (c) In determining the amount of the penalty, the district
9-46 court shall consider:
9-47 (1) the hospital's previous violations;
9-48 (2) the seriousness of the violation, including the
9-49 nature, circumstances, extent, and gravity of the violation;
9-50 (3) whether the health and safety of the public was
9-51 threatened by the violation; <and>
9-52 (4) the demonstrated good faith of the hospital; and
9-53 (5) the amount necessary to deter future violations.
9-54 (d) A penalty collected under this section by the attorney
9-55 general shall be deposited to the credit of the general revenue
9-56 fund. A penalty collected under this section by a district or
9-57 county attorney shall be deposited to the credit of the general
9-58 fund of the county in which the suit was heard.
9-59 SECTION 3.04. Subchapter C, Chapter 241, Health and Safety
9-60 Code, is amended by adding Section 241.058 to read as
9-61 follows:
9-62 Sec. 241.058. ADMINISTRATIVE PENALTY. (a) The board may
9-63 impose an administrative penalty against a person licensed or
9-64 regulated under this chapter who violates this chapter or a rule or
9-65 order adopted under this chapter.
9-66 (b) The penalty for a violation may be in an amount not to
9-67 exceed $25,000. Each day a violation continues or occurs is a
9-68 separate violation for purposes of imposing a penalty.
9-69 (c) The amount of the penalty shall be based on:
9-70 (1) the seriousness of the violation, including the
10-1 nature, circumstances, extent, and gravity of any prohibited acts,
10-2 and the hazard or potential hazard created to the health, safety,
10-3 or economic welfare of the public;
10-4 (2) enforcement costs relating to the violation;
10-5 (3) the history of previous violations;
10-6 (4) the amount necessary to deter future
10-7 violations;
10-8 (5) efforts to correct the violation; and
10-9 (6) any other matter that justice may require.
10-10 (d) If the commissioner determines that a violation
10-11 has occurred, the commissioner may issue to the board a report that
10-12 states the facts on which the determination is based and the
10-13 commissioner's recommendation on the imposition of a penalty,
10-14 including a recommendation on the amount of the penalty.
10-15 (e) Within 14 days after the date the report is issued, the
10-16 commissioner shall give written notice of the report to the person.
10-17 The notice may be given by certified mail. The notice must include
10-18 a brief summary of the alleged violation and a statement of the
10-19 amount of the recommended penalty and must inform the person that
10-20 the person has a right to a hearing on the occurrence of the
10-21 violation, the amount of the penalty, or both the occurrence of the
10-22 violation and the amount of the penalty.
10-23 (f) Within 20 days after the date the person receives the
10-24 notice, the person in writing may accept the determination and
10-25 recommended penalty of the commissioner or may make a written
10-26 request for a hearing on the occurrence of the violation, the
10-27 amount of the penalty, or both the occurrence of the violation and
10-28 the amount of the penalty.
10-29 (g) If the person accepts the determination and recommended
10-30 penalty of the commissioner, the board by order shall approve the
10-31 determination and impose the recommended penalty.
10-32 (h) If the person requests a hearing or fails to respond
10-33 timely to the notice, the commissioner shall set a hearing and give
10-34 notice of the hearing to the person. The administrative law judge
10-35 shall make findings of fact and conclusions of law and promptly
10-36 issue to the board a proposal for a decision about the occurrence
10-37 of the violation and the amount of a proposed penalty. Based on
10-38 the findings of fact, conclusions of law, and proposal for a
10-39 decision, the board by order may find that a violation has occurred
10-40 and impose a penalty or may find that no violation occurred.
10-41 (i) The notice of the board's order given to the person
10-42 under the Administrative Procedure and Texas Register Act (Article
10-43 6252-13a, Vernon's Texas Civil Statutes) must include a statement
10-44 of the right of the person to judicial review of the order.
10-45 (j) Within 30 days after the date the board's order is final
10-46 as provided by Section 16(c), Administrative Procedure and Texas
10-47 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), the
10-48 person shall:
10-49 (1) pay the amount of the penalty;
10-50 (2) pay the amount of the penalty and file a petition
10-51 for judicial review contesting the occurrence of the violation, the
10-52 amount of the penalty, or both the occurrence of the violation and
10-53 the amount of the penalty; or
10-54 (3) without paying the amount of the penalty, file a
10-55 petition for judicial review contesting the occurrence of the
10-56 violation, the amount of the penalty, or both the occurrence of the
10-57 violation and the amount of the penalty.
10-58 (k) Within the 30-day period, a person who acts under
10-59 Subsection (j)(3) may:
10-60 (1) stay enforcement of the penalty by:
10-61 (A) paying the amount of the penalty to the
10-62 court for placement in an escrow account; or
10-63 (B) giving to the court a supersedeas bond that
10-64 is approved by the court for the amount of the penalty and that is
10-65 effective until all judicial review of the board's order is final;
10-66 or
10-67 (2) request the court to stay enforcement of the
10-68 penalty by:
10-69 (A) filing with the court a sworn affidavit of
10-70 the person stating that the person is financially unable to pay the
11-1 amount of the penalty and is financially unable to give the
11-2 supersedeas bond; and
11-3 (B) giving a copy of the affidavit to the
11-4 commissioner by certified mail.
11-5 (l) The commissioner on receipt of a copy of an affidavit
11-6 under Subsection (k)(2) may file with the court within five days
11-7 after the date the copy is received a contest to the affidavit.
11-8 The court shall hold a hearing on the facts alleged in the
11-9 affidavit as soon as practicable and shall stay the enforcement of
11-10 the penalty on finding that the alleged facts are true. The person
11-11 who files an affidavit has the burden of proving that the person is
11-12 financially unable to pay the amount of the penalty and to give a
11-13 supersedeas bond.
11-14 (m) If the person does not pay the amount of the penalty and
11-15 the enforcement of the penalty is not stayed, the commissioner may
11-16 refer the matter to the attorney general for collection of the
11-17 amount of the penalty.
11-18 (n) Judicial review of the order of the board:
11-19 (1) is instituted by filing a petition as provided by
11-20 Section 19, Administrative Procedure and Texas Register Act
11-21 (Article 6252-13a, Vernon's Texas Civil Statutes); and
11-22 (2) is under the substantial evidence rule.
11-23 (o) If the court sustains the occurrence of the violation,
11-24 the court may uphold or reduce the amount of the penalty and order
11-25 the person to pay the full or reduced amount of the penalty. If
11-26 the court does not sustain the occurrence of the violation, the
11-27 court shall order that no penalty is owed.
11-28 (p) When the judgment of the court becomes final, the court
11-29 shall proceed under this subsection. If the person paid the amount
11-30 of the penalty and if that amount is reduced or is not upheld by
11-31 the court, the court shall order that the appropriate amount plus
11-32 accrued interest be remitted to the person. The rate of the
11-33 interest is the rate charged on loans to depository institutions by
11-34 the New York Federal Reserve Bank, and the interest shall be paid
11-35 for the period beginning on the date the penalty was paid and
11-36 ending on the date the penalty is remitted. If the person gave a
11-37 supersedeas bond and if the amount of the penalty is not upheld by
11-38 the court, the court shall order the release of the bond. If the
11-39 person gave a supersedeas bond and if the amount of the penalty is
11-40 reduced, the court shall order the release of the bond after the
11-41 person pays the amount.
11-42 (q) A penalty collected under this section shall be remitted
11-43 to the comptroller for deposit in the general revenue fund.
11-44 (r) All proceedings under this section are subject to the
11-45 Administrative Procedure and Texas Register Act (Article 6252-13a,
11-46 Vernon's Texas Civil Statutes).
11-47 SECTION 3.041. Subchapter C, Chapter 241, Health and Safety
11-48 Code, is amended by adding Section 241.0585 to read as follows:
11-49 Sec. 241.0585. RECOVERY OF COSTS. If the attorney general
11-50 brings an action to enforce an administrative penalty assessed
11-51 under Section 241.058 and the court orders the payment of the
11-52 penalty, the attorney general may recover reasonable expenses
11-53 incurred in the investigation, initiation, or prosecution of the
11-54 enforcement suit, including investigative costs, court costs,
11-55 reasonable attorney fees, witness fees, and deposition expenses.
11-56 SECTION 3.05. Section 462.008, Health and Safety Code, is
11-57 amended by amending Subsections (c) and (d) and adding Subsections
11-58 (e) through (g) to read as follows:
11-59 (c) An individual who commits an offense under this section
11-60 is subject on conviction to:
11-61 (1) a fine of not less than $50 or more than $25,000
11-62 for each violation and each day of a continuing violation;
11-63 (2) confinement in jail for not more than two years
11-64 for each violation and each day of a continuing violation; or
11-65 (3) both fine and confinement.
11-66 (d) A person other than an individual who commits an offense
11-67 under this section is subject on conviction to a fine of not less
11-68 than $500 or more than $100,000 for each violation and each day of
11-69 a continuing violation.
11-70 (e) If it is shown on the trial of an individual that the
12-1 individual has previously been convicted of an offense under this
12-2 section, the offense is punishable by:
12-3 (1) a fine of not less than $100 or more than $50,000
12-4 for each violation and each day of a continuing violation;
12-5 (2) confinement in jail for not more than four years
12-6 for each violation and each day of a continuing violation; or
12-7 (3) both fine and confinement.
12-8 (f) If it is shown on the trial of a person other than an
12-9 individual that the person previously has been convicted of an
12-10 offense under this section, the offense is punishable by a fine of
12-11 not less than $1,000 or more than $200,000 for each violation and
12-12 each day of a continuing violation.
12-13 (g) <An offense under this section is a misdemeanor
12-14 punishable by a fine of not more than $5,000, confinement in the
12-15 county jail for not more than one year, or both.>
12-16 <(d)> The appropriate district or county attorney shall
12-17 prosecute violations of this chapter.
12-18 SECTION 3.06. Section 464.014, Health and Safety Code, is
12-19 amended to read as follows:
12-20 Sec. 464.014. Denial, Revocation, SUSPENSION, or Nonrenewal
12-21 of License. (a) The executive director of the commission may
12-22 deny, revoke, suspend, or refuse to renew a license if the
12-23 applicant, license holder, or owner, director, administrator, or
12-24 clinical staff member of the facility:
12-25 (1) has a documented history of client abuse or
12-26 neglect; or
12-27 (2) fails to comply with this subchapter or with a
12-28 rule of the commission adopted under this subchapter.
12-29 (b) The denial, revocation, suspension, or nonrenewal takes
12-30 effect on the 30th day after the date on which the notice was
12-31 mailed unless:
12-32 (1) the commission secures an injunction under Section
12-33 464.015; or
12-34 (2) an administrative appeal is requested.
12-35 (c) If an administrative appeal is requested, the effective
12-36 date of the commission's original decision must be postponed to
12-37 allow the person whose license was denied, revoked, suspended, or
12-38 not renewed to participate in the appeal. The commission shall
12-39 provide an opportunity for the affected person to present
12-40 additional evidence or testimony to the commission.
12-41 (d) A person whose license is denied, revoked, suspended, or
12-42 not renewed is entitled to:
12-43 (1) appeal that decision at a hearing before the
12-44 commission or a hearings officer appointed by the commission; and
12-45 (2) receive notice of the date, time, and place of the
12-46 hearing not later than the 15th day before the date of the hearing.
12-47 (e) A request for a hearing must be received by the
12-48 commission not later than the 15th day after the date on which the
12-49 notice of denial, revocation, suspension, or nonrenewal is mailed
12-50 to the applicant or license holder.
12-51 (f) The commission may restrict attendance at an appeals
12-52 hearing to the parties and their agents.
12-53 (g) If a license is denied, revoked, suspended, or not
12-54 renewed after a hearing, the commission shall send to the applicant
12-55 or license holder a copy of the commission's findings and grounds
12-56 for the decision.
12-57 (h) An order denying, revoking, suspending, or refusing to
12-58 renew a license takes effect on the 31st day after the date on
12-59 which the applicant or license holder receives final notice of the
12-60 denial, revocation, suspension, or nonrenewal. A license holder
12-61 whose license is suspended or revoked may not admit new clients
12-62 until the license is reissued.
12-63 (i) The Administrative Procedure and Texas Register Act
12-64 (Article 6252-13a, Vernon's Texas Civil Statutes) applies to a
12-65 judicial review of a commission appeals hearing under this
12-66 subchapter.
12-67 SECTION 3.07. Section 464.015, Health and Safety Code, is
12-68 amended by amending Subsections (b) through (e) and adding
12-69 Subsections (f) and (g) to read as follows:
12-70 (b) A suit for injunctive relief, civil penalties authorized
13-1 by Section 464.017, or both, must be brought in Travis County or
13-2 the county in which the violation occurs.
13-3 (c) A district court, on petition of the commission, the
13-4 attorney general, or a district or county attorney, and on a
13-5 finding by the court that a person or facility is violating or has
13-6 violated this subchapter or a standard adopted under this
13-7 subchapter, shall grant any prohibitory or mandatory injunctive
13-8 relief warranted by the facts, including a temporary restraining
13-9 order, temporary injunction, or permanent injunction.
13-10 (d) The court granting <the> injunctive relief shall order
13-11 the person or facility to reimburse the commission and the party
13-12 bringing the suit for all costs of investigation and litigation,
13-13 including reasonable attorney's fees, reasonable investigative
13-14 expenses, court costs, witness fees, deposition expenses, and civil
13-15 administrative costs.
13-16 (e) At the request of the commission, the attorney general
13-17 or the appropriate district or county attorney shall institute and
13-18 conduct a suit authorized by Subsection (a) in the name of this
13-19 state.
13-20 (f) On his own initiative, the attorney general or a
13-21 district attorney or county attorney may maintain an action for
13-22 injunctive relief in the name of the state for a violation of this
13-23 subchapter or a standard adopted under this subchapter.
13-24 (g) The injunctive relief and civil penalty authorized by
13-25 this section and Section 464.017 are in addition to any other
13-26 civil, administrative, or criminal penalty provided by law.
13-27 SECTION 3.08. Section 464.017, Health and Safety Code, is
13-28 amended by amending Subsections (a), (c), and (e) and adding
13-29 Subsections (f) and (g) to read as follows:
13-30 (a) A person or facility is subject to a civil penalty of
13-31 not <less than $10 or> more than $25,000 <$200> for each day of
13-32 violation and for each act of violation of this subchapter or a
13-33 rule adopted under this subchapter. In determining the amount of
13-34 the civil penalty, the court shall consider:
13-35 (1) the person or facility's previous violations;
13-36 (2) the seriousness of the violation, including the
13-37 nature, circumstances, extent, and gravity of the violation;
13-38 (3) whether the health and safety of the public was
13-39 threatened by the violation;
13-40 (4) the demonstrated good faith of the person or
13-41 facility; and
13-42 (5) the amount necessary to deter future violations.
13-43 (c) At the request of the commission, the attorney general
13-44 or the appropriate district or county attorney shall institute and
13-45 conduct the suit authorized by Subsection (b) in the name of this
13-46 state. The commission and the party bringing the suit may recover
13-47 reasonable expenses incurred in obtaining civil penalties,
13-48 including investigation costs, court costs, reasonable attorney
13-49 fees, witness fees, and deposition expenses.
13-50 (e) On his own initiative, the attorney general, a district
13-51 attorney, or a county attorney may maintain an action for civil
13-52 penalties in the name of the state for a violation of this
13-53 subchapter or a standard adopted under this subchapter.
13-54 (f) Penalties collected under this section by the attorney
13-55 general shall be deposited to the credit of the alcohol and drug
13-56 abuse treatment licensure fund. Penalties collected under this
13-57 section by a district or county attorney shall be deposited to the
13-58 credit of the general fund of the county in which the suit was
13-59 heard.
13-60 (g) The commission and the party bringing the suit may
13-61 recover reasonable expenses incurred in obtaining civil penalties,
13-62 including investigation costs, court costs, reasonable attorney
13-63 fees, witness fees, and deposition expenses.
13-64 SECTION 3.09. Subchapter A, Chapter 464, Health and Safety
13-65 Code, is amended by adding Sections 464.018 and 464.019 to read as
13-66 follows:
13-67 Sec. 464.018. NOTICE OF SUIT. Not later than the seventh
13-68 day before the date on which the attorney general intends to bring
13-69 suit on his own initiative under Section 464.015 or 464.017, the
13-70 attorney general shall provide to the commission notice of the
14-1 suit. The attorney general is not required to provide notice of a
14-2 suit if the attorney general determines that waiting to bring suit
14-3 until the notice is provided will create an immediate threat to the
14-4 health and safety of a client. This section does not create a
14-5 requirement that the attorney general obtain the permission of or a
14-6 referral from the commission before filing suit.
14-7 Sec. 464.019. ADMINISTRATIVE PENALTY. (a) The commission
14-8 may impose an administrative penalty against a person licensed or
14-9 regulated under this chapter who violates this chapter or a rule or
14-10 order adopted under this chapter.
14-11 (b) The penalty for a violation may be in an amount not to
14-12 exceed $25,000. Each day a violation continues or occurs is a
14-13 separate violation for purposes of imposing a penalty.
14-14 (c) The amount of the penalty shall be based on:
14-15 (1) the seriousness of the violation, including the
14-16 nature, circumstances, extent, and gravity of any prohibited acts,
14-17 and the hazard or potential hazard created to the health, safety,
14-18 or economic welfare of the public;
14-19 (2) enforcement costs relating to the violation;
14-20 (3) the history of previous violations;
14-21 (4) the amount necessary to deter future violations;
14-22 (5) efforts to correct the violation; and
14-23 (6) any other matter that justice may require.
14-24 (d) If the executive director determines that a violation
14-25 has occurred, the director may issue to the commission a report
14-26 that states the facts on which the determination is based and the
14-27 director's recommendation on the imposition of a penalty, including
14-28 a recommendation on the amount of the penalty.
14-29 (e) Within 14 days after the date the report is issued, the
14-30 executive director shall give written notice of the report to the
14-31 person. The notice may be given by certified mail. The notice
14-32 must include a brief summary of the alleged violation and a
14-33 statement of the amount of the recommended penalty and must inform
14-34 the person that the person has a right to a hearing on the
14-35 occurrence of the violation, the amount of the penalty, or both the
14-36 occurrence of the violation and the amount of the penalty.
14-37 (f) Within 20 days after the date the person receives the
14-38 notice, the person in writing may accept the determination and
14-39 recommended penalty of the commissioner or may make a written
14-40 request for a hearing on the occurrence of the violation, the
14-41 amount of the penalty, or both the occurrence of the violation and
14-42 the amount of the penalty.
14-43 (g) If the person accepts the determination and recommended
14-44 penalty of the commissioner, the board by order shall approve the
14-45 determination and impose the recommended penalty.
14-46 (h) If the person requests a hearing or fails to respond
14-47 timely to the notice, the commissioner shall set a hearing and give
14-48 notice of the hearing to the person. The administrative law judge
14-49 shall make findings of fact and conclusions of law and promptly
14-50 issue to the board a proposal for a decision about the occurrence
14-51 of the violation and the amount of a proposed penalty. Based on
14-52 the findings of fact, conclusions of law, and proposal for a
14-53 decision, the board by order may find that a violation has occurred
14-54 and impose a penalty or may find that no violation occurred.
14-55 (i) The notice of the board's order given to the person
14-56 under the Administrative Procedure and Texas Register Act (Article
14-57 6252-13a, Vernon's Texas Civil Statutes) must include a statement
14-58 of the right of the person to judicial review of the order.
14-59 (j) Within 30 days after the date the board's order is final
14-60 as provided by Section 16(c), Administrative Procedure and Texas
14-61 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), the
14-62 person shall:
14-63 (1) pay the amount of the penalty;
14-64 (2) pay the amount of the penalty and file a petition
14-65 for judicial review contesting the occurrence of the violation, the
14-66 amount of the penalty, or both the occurrence of the violation and
14-67 the amount of the penalty; or
14-68 (3) without paying the amount of the penalty, file a
14-69 petition for judicial review contesting the occurrence of the
14-70 violation, the amount of the penalty, or both the occurrence of the
15-1 violation and the amount of the penalty.
15-2 (k) Within the 30-day period, a person who acts under
15-3 Subsection (j)(3) may:
15-4 (1) stay enforcement of the penalty by:
15-5 (A) paying the amount of the penalty to the
15-6 court for placement in an escrow account; or
15-7 (B) giving to the court a supersedeas bond that
15-8 is approved by the court for the amount of the penalty and that is
15-9 effective until all judicial review of the board's order is final;
15-10 or
15-11 (2) request the court to stay enforcement of the
15-12 penalty by:
15-13 (A) filing with the court a sworn affidavit of
15-14 the person stating that the person is financially unable to pay the
15-15 amount of the penalty and is financially unable to give the
15-16 supersedeas bond; and
15-17 (B) giving a copy of the affidavit to the
15-18 commissioner by certified mail.
15-19 (l) The commissioner on receipt of a copy of an affidavit
15-20 under Subsection (k)(2) may file with the court within five days
15-21 after the date the copy is received a contest to the affidavit.
15-22 The court shall hold a hearing on the facts alleged in the
15-23 affidavit as soon as practicable and shall stay the enforcement of
15-24 the penalty on finding that the alleged facts are true. The person
15-25 who files an affidavit has the burden of proving that the person is
15-26 financially unable to pay the amount of the penalty and to give a
15-27 supersedeas bond.
15-28 (m) If the person does not pay the amount of the penalty and
15-29 the enforcement of the penalty is not stayed, the commissioner may
15-30 refer the matter to the attorney general for collection of the
15-31 amount of the penalty.
15-32 (n) Judicial review of the order of the board:
15-33 (1) is instituted by filing a petition as provided by
15-34 Section 19, Administrative Procedure and Texas Register Act
15-35 (Article 6252-13a, Vernon's Texas Civil Statutes); and
15-36 (2) is under the substantial evidence rule.
15-37 (o) If the court sustains the occurrence of the violation,
15-38 the court may uphold or reduce the amount of the penalty and order
15-39 the person to pay the full or reduced amount of the penalty. If
15-40 the court does not sustain the occurrence of the violation, the
15-41 court shall order that no penalty is owed.
15-42 (p) When the judgment of the court becomes final, the court
15-43 shall proceed under this subsection. If the person paid the amount
15-44 of the penalty and if that amount is reduced or is not upheld by
15-45 the court, the court shall order that the appropriate amount plus
15-46 accrued interest be remitted to the person. The rate of the
15-47 interest is the rate charged on loans to depository institutions by
15-48 the New York Federal Reserve Bank, and the interest shall be paid
15-49 for the period beginning on the date the penalty was paid and
15-50 ending on the date the penalty is remitted. If the person gave a
15-51 supersedeas bond and if the amount of the penalty is not upheld by
15-52 the court, the court shall order the release of the bond. If the
15-53 person gave a supersedeas bond and if the amount of the penalty is
15-54 reduced, the court shall order the release of the bond after the
15-55 person pays the amount.
15-56 (q) A penalty collected under this section shall be remitted
15-57 to the comptroller for deposit in the general revenue fund.
15-58 (r) All proceedings under this section are subject to the
15-59 Administrative Procedure and Texas Register Act (Article 6252-13a,
15-60 Vernon's Texas Civil Statutes).
15-61 SECTION 2.091. Subchapter A, Chapter 464, Health and Safety
15-62 Code, is amended by adding Section 464.0195 to read as follows:
15-63 Sec. 464.0195. RECOVERY OF COSTS. If the attorney general
15-64 brings an action to enforce an administrative penalty assessed
15-65 under Section 464.019 and the court orders the payment of the
15-66 penalty, the attorney general may recover reasonable expenses
15-67 incurred in the investigation, initiation, or prosecution of the
15-68 enforcement suit, including investigative costs, court costs,
15-69 reasonable attorney fees, witness fees, and deposition expenses.
15-70 SECTION 3.10. (a) Section 571.020, Health and Safety Code,
16-1 is amended to read as follows:
16-2 Sec. 571.020. CRIMINAL PENALTIES. (a) A person commits an
16-3 offense if the person intentionally causes, conspires with another
16-4 to cause, or assists another to cause the unwarranted commitment of
16-5 a person to a mental health facility. <An offense under this
16-6 subsection is a misdemeanor punishable by a fine of not more than
16-7 $5,000, confinement in the county jail for not more than two years,
16-8 or both.>
16-9 (b) A person commits an offense if the person knowingly
16-10 violates a provision of this subtitle. <An offense under this
16-11 subsection is a misdemeanor punishable by a fine of not more than
16-12 $5,000, confinement in the county jail for not more than one year,
16-13 or both.>
16-14 (c) An individual who commits an offense under this section
16-15 is subject on conviction to:
16-16 (1) a fine of not less than $50 or more than $25,000
16-17 for each violation and each day of a continuing violation;
16-18 (2) confinement in jail for not more than two years
16-19 for each violation and each day of a continuing violation; or
16-20 (3) both fine and confinement.
16-21 (d) A person other than an individual who commits an offense
16-22 under this section is subject on conviction to a fine of not less
16-23 than $500 or more than $100,000 for each violation and each day of
16-24 a continuing violation.
16-25 (e) If it is shown on the trial of an individual that the
16-26 individual has previously been convicted of an offense under this
16-27 section, the offense is punishable by:
16-28 (1) a fine of not less than $100 or more than $50,000
16-29 for each violation and each day of a continuing violation;
16-30 (2) confinement in jail for not more than four years
16-31 for each violation and each day of a continuing violation; or
16-32 (3) both fine and confinement.
16-33 (f) If it is shown on the trial of a person other than an
16-34 individual that the person previously has been convicted of an
16-35 offense under this section, the offense is punishable by a fine of
16-36 not less than $1,000 or more than $200,000 for each violation and
16-37 each day of a continuing violation.
16-38 (b) Section 3, Chapter 567, Acts of the 72nd Legislature,
16-39 Regular Session, 1991, is repealed.
16-40 SECTION 3.11. Chapter 571, Health and Safety Code, is
16-41 amended by adding Sections 571.022, 571.023, 571.024, and 571.025
16-42 to read as follows:
16-43 Sec. 571.022. INJUNCTION. (a) At the request of the
16-44 department, the attorney general or the appropriate district or
16-45 county attorney shall institute and conduct in the name of the
16-46 state a suit for a violation of this subtitle or a rule adopted
16-47 under this subtitle.
16-48 (b) On his own initiative, the attorney general or district
16-49 or county attorney may maintain an action for a violation of this
16-50 subtitle or a rule adopted under this subtitle in the name of the
16-51 state.
16-52 (c) Venue may be maintained in Travis County or in the
16-53 county in which the violation occurred.
16-54 (d) The district court may grant any prohibitory or
16-55 mandatory injunctive relief warranted by the facts, including a
16-56 temporary restraining order, temporary injunction, or permanent
16-57 injunction.
16-58 Sec. 571.023. CIVIL PENALTY. (a) A person is subject to a
16-59 civil penalty of not more than $25,000 for each day of violation
16-60 and for each act of violation of this subtitle or a rule adopted
16-61 under this subtitle. In determining the amount of the civil
16-62 penalty, the court shall consider:
16-63 (1) the person's or facility's previous violations;
16-64 (2) the seriousness of the violation, including the
16-65 nature, circumstances, extent, and gravity of the violation;
16-66 (3) whether the health and safety of the public was
16-67 threatened by the violation;
16-68 (4) the demonstrated good faith of the person or
16-69 facility; and
16-70 (5) the amount necessary to deter future violations.
17-1 (b) The department or party bringing the suit may:
17-2 (1) combine a suit to assess and recover civil
17-3 penalties with a suit for injunctive relief brought under Section
17-4 571.022 or 577.019; or
17-5 (2) file a suit to assess and recover civil penalties
17-6 independently of a suit for injunctive relief.
17-7 (c) At the request of the department, the attorney general
17-8 or the appropriate district or county attorney shall institute and
17-9 conduct the suit authorized by Subsection (b) in the name of the
17-10 state.
17-11 (d) On his own initiative, the attorney general, district
17-12 attorney, or county attorney may maintain an action as authorized
17-13 by Subsection (b) for a violation of this subtitle or a rule
17-14 adopted under this subtitle in the name of the state.
17-15 (e) The department and the party bringing the suit may
17-16 recover reasonable expenses incurred in obtaining injunctive
17-17 relief, civil penalties, or both, including investigation costs,
17-18 court costs, reasonable attorney fees, witness fees, and deposition
17-19 expenses.
17-20 (f) A penalty collected under this section by the attorney
17-21 general shall be deposited to the credit of the general revenue
17-22 fund. A penalty collected under this section by a district or
17-23 county attorney shall be deposited to the credit of the general
17-24 fund of the county in which the suit was heard.
17-25 (g) The civil penalty and injunctive relief authorized by
17-26 this section and Sections 571.022 and 577.019 are in addition to
17-27 any other civil, administrative, or criminal remedies provided by
17-28 law.
17-29 Sec. 571.024. NOTICE OF SUIT. Not later than the seventh
17-30 day before the date on which the attorney general intends to bring
17-31 suit on his own initiative, the attorney general shall provide to
17-32 the department notice of the suit. The attorney general is not
17-33 required to provide notice of a suit if the attorney general
17-34 determines that waiting to bring suit until the notice is provided
17-35 will create an immediate threat to the health and safety of a
17-36 patient. This section does not create a requirement that the
17-37 attorney general obtain the permission of or a referral from the
17-38 department before filing suit.
17-39 Sec. 571.025. ADMINISTRATIVE PENALTY. (a) The board may
17-40 impose an administrative penalty against a person licensed or
17-41 regulated under this subtitle who violates this subtitle or a rule
17-42 or order adopted under this subtitle.
17-43 (b) The penalty for a violation may be in an amount not to
17-44 exceed $25,000. Each day a violation continues or occurs is a
17-45 separate violation for purposes of imposing a penalty.
17-46 (c) The amount of the penalty shall be based on:
17-47 (1) the seriousness of the violation, including the
17-48 nature, circumstances, extent, and gravity of any prohibited acts,
17-49 and the hazard or potential hazard created to the health, safety,
17-50 or economic welfare of the public;
17-51 (2) enforcement costs relating to the violation,
17-52 including investigation costs, witness fees, and deposition
17-53 expenses;
17-54 (3) the history of previous violations;
17-55 (4) the amount necessary to deter future violations;
17-56 (5) efforts to correct the violation; and
17-57 (6) any other matter that justice may require.
17-58 (d) If the commissioner determines that a violation has
17-59 occurred, the commissioner may issue to the board a report that
17-60 states the facts on which the determination is based and the
17-61 commissioner's recommendation on the imposition of a penalty,
17-62 including a recommendation on the amount of the penalty.
17-63 (e) Within 14 days after the date the report is issued, the
17-64 commissioner shall give written notice of the report to the person.
17-65 The notice may be given by certified mail. The notice must include
17-66 a brief summary of the alleged violation and a statement of the
17-67 amount of the recommended penalty and must inform the person that
17-68 the person has a right to a hearing on the occurrence of the
17-69 violation, the amount of the penalty, or both the occurrence of the
17-70 violation and the amount of the penalty.
18-1 (f) Within 20 days after the date the person receives the
18-2 notice, the person in writing may accept the determination and
18-3 recommended penalty of the commissioner or may make a written
18-4 request for a hearing on the occurrence of the violation, the
18-5 amount of the penalty, or both the occurrence of the violation and
18-6 the amount of the penalty.
18-7 (g) If the person accepts the determination and recommended
18-8 penalty of the commissioner, the board by order shall approve the
18-9 determination and impose the recommended penalty.
18-10 (h) If the person requests a hearing or fails to respond
18-11 timely to the notice, the commissioner shall set a hearing and give
18-12 notice of the hearing to the person. The administrative law judge
18-13 shall make findings of fact and conclusions of law and promptly
18-14 issue to the board a proposal for a decision about the occurrence
18-15 of the violation and the amount of a proposed penalty. Based on
18-16 the findings of fact, conclusions of law, and proposal for a
18-17 decision, the board by order may find that a violation has occurred
18-18 and impose a penalty or may find that no violation occurred.
18-19 (i) The notice of the board's order given to the person
18-20 under the Administrative Procedure and Texas Register Act (Article
18-21 6252-13a, Vernon's Texas Civil Statutes) must include a statement
18-22 of the right of the person to judicial review of the order.
18-23 (j) Within 30 days after the date the board's order is final
18-24 as provided by Section 16(c), Administrative Procedure and Texas
18-25 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes), the
18-26 person shall:
18-27 (1) pay the amount of the penalty;
18-28 (2) pay the amount of the penalty and file a petition
18-29 for judicial review contesting the occurrence of the violation, the
18-30 amount of the penalty, or both the occurrence of the violation and
18-31 the amount of the penalty; or
18-32 (3) without paying the amount of the penalty, file a
18-33 petition for judicial review contesting the occurrence of the
18-34 violation, the amount of the penalty, or both the occurrence of the
18-35 violation and the amount of the penalty.
18-36 (k) Within the 30-day period, a person who acts under
18-37 Subsection (j)(3) may:
18-38 (1) stay enforcement of the penalty by:
18-39 (A) paying the amount of the penalty to the
18-40 court for placement in an escrow account; or
18-41 (B) giving to the court a supersedeas bond that
18-42 is approved by the court for the amount of the penalty and that is
18-43 effective until all judicial review of the board's order is final;
18-44 or
18-45 (2) request the court to stay enforcement of the
18-46 penalty by:
18-47 (A) filing with the court a sworn affidavit of
18-48 the person stating that the person is financially unable to pay the
18-49 amount of the penalty and is financially unable to give the
18-50 supersedeas bond; and
18-51 (B) giving a copy of the affidavit to the
18-52 commissioner by certified mail.
18-53 (l) The commissioner on receipt of a copy of an affidavit
18-54 under Subsection (k)(2) may file with the court within five days
18-55 after the date the copy is received a contest to the affidavit.
18-56 The court shall hold a hearing on the facts alleged in the
18-57 affidavit as soon as practicable and shall stay the enforcement of
18-58 the penalty on finding that the alleged facts are true. The person
18-59 who files an affidavit has the burden of proving that the person is
18-60 financially unable to pay the amount of the penalty and to give a
18-61 supersedeas bond.
18-62 (m) If the person does not pay the amount of the penalty and
18-63 the enforcement of the penalty is not stayed, the commissioner may
18-64 refer the matter to the attorney general for collection of the
18-65 amount of the penalty.
18-66 (n) Judicial review of the order of the board:
18-67 (1) is instituted by filing a petition as provided by
18-68 Section 19, Administrative Procedure and Texas Register Act
18-69 (Article 6252-13a, Vernon's Texas Civil Statutes); and
18-70 (2) is under the substantial evidence rule.
19-1 (o) If the court sustains the occurrence of the violation,
19-2 the court may uphold or reduce the amount of the penalty and order
19-3 the person to pay the full or reduced amount of the penalty. If
19-4 the court does not sustain the occurrence of the violation, the
19-5 court shall order that no penalty is owed.
19-6 (p) When the judgment of the court becomes final, the court
19-7 shall proceed under this subsection. If the person paid the amount
19-8 of the penalty and if that amount is reduced or is not upheld by
19-9 the court, the court shall order that the appropriate amount plus
19-10 accrued interest be remitted to the person. The rate of the
19-11 interest is the rate charged on loans to depository institutions by
19-12 the New York Federal Reserve Bank, and the interest shall be paid
19-13 for the period beginning on the date the penalty was paid and
19-14 ending on the date the penalty is remitted. If the person gave a
19-15 supersedeas bond and if the amount of the penalty is not upheld by
19-16 the court, the court shall order the release of the bond. If the
19-17 person gave a supersedeas bond and if the amount of the penalty is
19-18 reduced, the court shall order the release of the bond after the
19-19 person pays the amount.
19-20 (q) A penalty collected under this section shall be remitted
19-21 to the comptroller for deposit in the general revenue fund.
19-22 (r) All proceedings under this section are subject to the
19-23 Administrative Procedure and Texas Register Act (Article 6252-13a,
19-24 Vernon's Texas Civil Statutes).
19-25 SECTION 3.111. Chapter 571, Health and Safety Code, is
19-26 amended by adding Section 571.026 to read as follows:
19-27 Sec. 571.026. RECOVERY OF COSTS. If the attorney general
19-28 brings an action to enforce an administrative penalty assessed
19-29 under this chapter and the court orders the payment of the penalty,
19-30 the attorney general may recover reasonable expenses incurred in
19-31 the investigation, initiation, or prosecution of the enforcement
19-32 suit, including investigative costs, court costs, reasonable
19-33 attorney fees, witness fees, and deposition expenses.
19-34 SECTION 3.12. Section 577.016, Health and Safety Code, is
19-35 amended by adding Subsection (e) to read as follows:
19-36 (e) A license holder whose license is suspended or revoked
19-37 may not admit new patients until the license is reissued.
19-38 SECTION 3.13. Section 577.019, Health and Safety Code, is
19-39 amended to read as follows:
19-40 Sec. 577.019. INJUNCTION. (a) The department, in the name
19-41 of the state, may maintain an action in a district court of Travis
19-42 County or in the county in which the violation occurs for an
19-43 injunction or other process against any person to restrain the
19-44 person from operating a mental hospital or mental health facility
19-45 that is not licensed as required by this chapter.
19-46 (b) The district court <of Travis County, for cause shown,>
19-47 may grant any prohibitory or mandatory relief warranted by the
19-48 facts, including a temporary restraining order, temporary
19-49 injunction, or permanent injunction <restrain a violation of this
19-50 chapter>.
19-51 (c) At the request of the department or on the initiative of
19-52 the attorney general or district or county attorney, the attorney
19-53 general or the appropriate district or county attorney shall
19-54 institute and conduct a suit authorized by this section in the name
19-55 of the state. The attorney general may recover reasonable expenses
19-56 incurred in instituting and conducting a suit authorized by this
19-57 section, including investigative costs, court costs, reasonable
19-58 attorney fees, witness fees, and deposition expenses.
19-59 ARTICLE 4
19-60 SECTION 4.01. Subsection (e), Section 572.001, Health and
19-61 Safety Code, is amended to read as follows:
19-62 (e) A request for admission as a voluntary patient must
19-63 state that the person for whom admission is requested agrees to
19-64 voluntarily remain in the facility until the person's discharge and
19-65 that the person consents to the diagnosis, observation, care, and
19-66 treatment provided until the earlier of:
19-67 (1) the person's discharge; or
19-68 (2) the period prescribed <expiration of 96 hours
19-69 after the time a written request for release is filed as provided>
19-70 by Section 572.004.
20-1 SECTION 4.02. (a) Section 572.004, Health and Safety Code,
20-2 is amended to read as follows:
20-3 Sec. 572.004. DISCHARGE <OR RELEASE>. (a) A <Except as
20-4 provided by Subsection (b), a> voluntary patient is entitled to
20-5 leave an inpatient mental health facility in accordance with this
20-6 section <within 96 hours> after <the time> a written request for
20-7 discharge <release> is filed with the facility administrator or the
20-8 administrator's designee. The request must be signed, timed, and
20-9 dated by the patient or a person legally responsible for the
20-10 patient and must be made a part of the patient's clinical record.
20-11 If a patient informs an employee of or person associated with the
20-12 facility of the patient's desire to leave the facility, the
20-13 employee or person shall, as soon as possible, assist the patient
20-14 in creating the written request and present it to the patient for
20-15 the patient's signature <patient's admission>.
20-16 (b) The facility shall, within four hours after a request
20-17 for discharge is filed, notify the physician responsible for the
20-18 patient's treatment. If that physician is not available during
20-19 that period, the facility shall notify any available physician of
20-20 the request.
20-21 (c) The notified physician shall discharge the patient
20-22 before the end of the four-hour period unless the physician has
20-23 reasonable cause to believe that the patient might meet the
20-24 criteria for court-ordered mental health services or emergency
20-25 detention.
20-26 (d) A physician who has reasonable cause to believe that a
20-27 patient might meet the criteria for court-ordered mental health
20-28 services or emergency detention shall examine the patient as soon
20-29 as possible within 24 hours after the time the request for
20-30 discharge is filed. The physician shall discharge the patient on
20-31 completion of the examination unless the physician determines that
20-32 the person meets the criteria for court-ordered mental health
20-33 services or emergency detention. If the physician makes a
20-34 determination that the patient meets the criteria for court-ordered
20-35 mental health services or emergency detention, the physician shall,
20-36 not later than 4 p.m. on the next succeeding business day after the
20-37 date on which the examination occurs, either discharge the patient
20-38 or file an application for court-ordered mental health services or
20-39 emergency detention and obtain a written order for further
20-40 detention. The physician shall notify the patient if the physician
20-41 intends to detain the patient under this subsection or intends to
20-42 file an application for court-ordered mental health services or
20-43 emergency detention. A decision to detain a patient under this
20-44 subsection and the reasons for the decision shall be made a part of
20-45 the patient's clinical record.
20-46 (e) If extremely hazardous weather conditions exist or a
20-47 disaster occurs, the physician may request the judge of a court
20-48 that has jurisdiction over proceedings brought under Chapter 574 to
20-49 extend the period during which the patient may be detained. The
20-50 judge or a magistrate appointed by the judge may by written order
20-51 made each day extend the period during which the patient may be
20-52 detained until 4 p.m. on the first succeeding business day. The
20-53 written order must declare that an emergency exists because of the
20-54 weather or the occurrence of a disaster.
20-55 (f) The patient is not entitled to leave the facility if
20-56 before the end of the <96 hour> period prescribed by this section:
20-57 (1) a written withdrawal of the request for discharge
20-58 <release> is filed; or
20-59 (2) an application for court-ordered mental health
20-60 services or emergency detention is filed and the patient is
20-61 detained in accordance with this subtitle.
20-62 (g) <(c)> A plan for continuing care shall be prepared in
20-63 accordance with Section 574.081 for each patient discharged. If
20-64 sufficient time to prepare a continuing care plan before discharge
20-65 is not available, the plan may be prepared and mailed to the
20-66 appropriate person within 24 hours after the patient is discharged
20-67 <or released if sufficient time is available before release>.
20-68 (h) <(d)> The patient or other person who files a request
20-69 for discharge <release> of a patient shall be notified that the
20-70 person filing the request assumes all responsibility for the
21-1 patient on discharge.
21-2 (b) In addition to the substantive changes made by this
21-3 section, this section conforms Section 572.004, Health and Safety
21-4 Code, to Section 4, Chapter 567, Acts of the 72nd Legislature,
21-5 Regular Session, 1991.
21-6 (c) Section 4, Chapter 567, Acts of the 72nd Legislature,
21-7 Regular Session, 1991, is repealed.
21-8 SECTION 4.03. Chapter 572, Health and Safety Code, is
21-9 amended by adding Section 572.0025 to read as follows:
21-10 Sec. 572.0025. INTAKE, ASSESSMENT, AND ADMISSION. (a) The
21-11 board shall adopt rules governing the voluntary admission of a
21-12 patient to an inpatient mental health facility, including rules
21-13 governing the intake and assessment procedures of the admission
21-14 process.
21-15 (b) The rules governing the intake process shall establish
21-16 minimum standards for:
21-17 (1) reviewing a prospective patient's finances and
21-18 insurance benefits;
21-19 (2) explaining to a prospective patient the patient's
21-20 rights; and
21-21 (3) explaining to a prospective patient the facility's
21-22 services and treatment process.
21-23 (c) The assessment provided for by the rules may be
21-24 conducted only by a professional who meets the qualifications
21-25 prescribed by board rules.
21-26 (d) The rules governing the assessment process shall
21-27 prescribe:
21-28 (1) the types of professionals who may conduct an
21-29 assessment;
21-30 (2) the minimum credentials each type of professional
21-31 must have to conduct an assessment; and
21-32 (3) the type of assessment that professional may
21-33 conduct.
21-34 (e) In accordance with board rule, a facility shall provide
21-35 annually a minimum of eight hours of inservice training regarding
21-36 intake and assessment for persons who will be conducting an intake
21-37 or assessment for the facility. A person may not conduct intake or
21-38 assessments without having completed the initial and applicable
21-39 annual inservice training.
21-40 (f) A prospective voluntary patient may not be formally
21-41 accepted for treatment in a facility unless:
21-42 (1) the facility has a physician's signed order
21-43 admitting the prospective patient; and
21-44 (2) the facility administrator or a person designated
21-45 by the administrator has agreed to accept the prospective patient
21-46 and has signed a statement to that effect.
21-47 (g) An assessment conducted as required by rules adopted
21-48 under this section does not satisfy a statutory or regulatory
21-49 requirement for a personal evaluation of a patient or a prospective
21-50 patient by a physician before admission.
21-51 (h) In this section:
21-52 (1) "Admission" means the formal acceptance of a
21-53 prospective patient to a facility.
21-54 (2) "Assessment" means the administrative process a
21-55 facility uses to gather information from a prospective patient,
21-56 including a medical history and the problem for which the patient
21-57 is seeking treatment, to determine whether a prospective patient
21-58 should be examined by a physician to determine if admission is
21-59 clinically justified.
21-60 (3) "Intake" means the administrative process for
21-61 gathering information about a prospective patient and giving a
21-62 prospective patient information about the facility and the
21-63 facility's treatment and services.
21-64 SECTION 4.04. Subsections (a), (b), and (d), Section
21-65 574.081, Health and Safety Code, are amended to read as follows:
21-66 (a) The physician responsible for the patient's treatment
21-67 <facility administrator> shall prepare a continuing care plan for a
21-68 patient who is scheduled to be furloughed or discharged unless <if>
21-69 the patient does not require <requires> continuing care.
21-70 (b) The physician <facility administrator> shall prepare the
22-1 plan as prescribed by department rules and shall consult the
22-2 patient and the mental health authority in the area in which the
22-3 patient will reside before preparing the plan. The mental health
22-4 authority is not required to participate in preparing a plan for a
22-5 patient furloughed or discharged from a private mental health
22-6 facility.
22-7 (d) The physician <facility administrator> shall deliver the
22-8 plan and other appropriate information to the community center or
22-9 other provider that will deliver the services if:
22-10 (1) the services are provided by:
22-11 (A) a community center or other provider that
22-12 serves the county in which the patient will reside and that has
22-13 been designated by the commissioner to perform continuing care
22-14 services; or
22-15 (B) any other provider that agrees to accept the
22-16 referral; and
22-17 (2) the provision of care by the center or provider is
22-18 appropriate.
22-19 SECTION 4.05. Section 574.081, Health and Safety Code, is
22-20 amended by adding Subsection (f) to read as follows:
22-21 (f) A physician who believes that a patient does not require
22-22 continuing care and who does not prepare a continuing care plan
22-23 under this section shall document in the patient's treatment record
22-24 the reasons for that belief.
22-25 SECTION 4.06. Section 576.008, Health and Safety Code, is
22-26 amended to read as follows:
22-27 Sec. 576.008. NOTIFICATION OF PROTECTION AND ADVOCACY
22-28 SYSTEM. A patient shall be informed in writing, at the time of
22-29 admission and <or> discharge, of the existence, purpose, telephone
22-30 number, and address of the protection and advocacy system
22-31 established in this state under the federal Protection and Advocacy
22-32 for Mentally Ill Individuals Act of 1986 (42 U.S.C. Sec. 10801, et
22-33 seq.).
22-34 SECTION 4.07. Chapter 577, Health and Safety Code, is
22-35 amended by adding Section 577.0101 to read as follows:
22-36 Sec. 577.0101. NOTIFICATION OF TRANSFER OR REFERRAL.
22-37 (a) The board shall adopt rules governing the transfer or referral
22-38 of a patient from a private mental hospital to an inpatient mental
22-39 health facility.
22-40 (b) The rules must provide that before a private mental
22-41 hospital may transfer or refer a patient, the hospital must:
22-42 (1) provide to the receiving inpatient mental health
22-43 facility notice of the hospital's intent to transfer a patient;
22-44 (2) provide to the receiving inpatient mental health
22-45 facility information relating to the patient's diagnosis and
22-46 condition; and
22-47 (3) obtain verification from the receiving inpatient
22-48 mental health facility that the facility has the space, personnel,
22-49 and services necessary to provide appropriate care to the patient.
22-50 (c) The rules must also require that the private mental
22-51 hospital send the patient's appropriate records, or a copy of the
22-52 records, if any, to the receiving inpatient mental health facility.
22-53 SECTION 4.08. Subchapter B, Chapter 462, Health and Safety
22-54 Code, is amended by adding Section 462.025 to read as follows:
22-55 Sec. 462.025. INTAKE, ASSESSMENT, AND ADMISSION. (a) The
22-56 commission shall adopt rules governing the voluntary admission of a
22-57 patient to a treatment facility, including rules governing the
22-58 intake and assessment procedures of the admission process.
22-59 (b) The rules governing the intake process shall establish
22-60 minimum standards for:
22-61 (1) reviewing a prospective patient's finances and
22-62 insurance benefits;
22-63 (2) explaining to a prospective patient the patient's
22-64 rights; and
22-65 (3) explaining to a prospective patient the facility's
22-66 services and treatment process.
22-67 (c) The assessment provided for by the rules may be
22-68 conducted only by a professional who meets the qualifications
22-69 prescribed by commission rules.
22-70 (d) The rules governing the assessment process shall
23-1 prescribe:
23-2 (1) the types of professionals who may conduct an
23-3 assessment;
23-4 (2) the minimum credentials each type of professional
23-5 must have to conduct an assessment; and
23-6 (3) the type of assessment that professional may
23-7 conduct.
23-8 (e) In accordance with commission rule, a treatment facility
23-9 shall provide annually a minimum of eight hours of inservice
23-10 training regarding intake and assessment for persons who will be
23-11 conducting an intake or assessment for the facility. A person may
23-12 not conduct intake or assessments without having completed the
23-13 initial and applicable annual inservice training.
23-14 (f) A prospective voluntary patient may not be formally
23-15 accepted for chemical dependency treatment in a treatment facility
23-16 unless the facility's administrator or a person designated by the
23-17 administrator has agreed to accept the prospective patient and has
23-18 signed a statement to that effect.
23-19 (g) An assessment conducted as required by rules adopted
23-20 under this section does not satisfy a statutory or regulatory
23-21 requirement for a personal evaluation of a patient or a prospective
23-22 patient by a qualified professional before admission.
23-23 (h) In this section:
23-24 (1) "Admission" means the formal acceptance of a
23-25 prospective patient to a treatment facility.
23-26 (2) "Assessment" means the administrative process a
23-27 treatment facility uses to gather information from a prospective
23-28 patient, including a medical history and the problem for which the
23-29 patient is seeking treatment, to determine whether a prospective
23-30 patient should be admitted.
23-31 (3) "Intake" means the administrative process for
23-32 gathering information about a prospective patient and giving a
23-33 prospective patient information about the treatment facility and
23-34 the facility's treatment and services.
23-35 SECTION 4.09. This article takes effect immediately.
23-36 ARTICLE 5
23-37 SECTION 5.01. Subtitle C, Title 7, Health and Safety Code,
23-38 is amended by adding Chapter 578 to read as follows:
23-39 CHAPTER 578. ELECTROCONVULSIVE AND OTHER THERAPIES
23-40 Sec. 578.001. APPLICATION. This chapter applies to the use
23-41 of electroconvulsive therapy by any person, including a private
23-42 physician who uses the therapy on an outpatient basis.
23-43 Sec. 578.002. USE OF ELECTROCONVULSIVE THERAPY.
23-44 (a) Electroconvulsive therapy may not be used on a person who is
23-45 younger than 16 years of age.
23-46 (b) Unless the person consents to the use of the therapy in
23-47 accordance with Section 578.003, electroconvulsive therapy may not
23-48 be used on:
23-49 (1) a person who is 16 years of age or older and who
23-50 is voluntarily receiving mental health services; or
23-51 (2) an involuntary patient who is 16 years of age or
23-52 older and who has not been adjudicated by an appropriate court of
23-53 law as incompetent to manage the patient's personal affairs.
23-54 (c) Electroconvulsive therapy may not be used on an
23-55 involuntary patient who is 16 years of age or older and who has
23-56 been adjudicated incompetent to manage the patient's personal
23-57 affairs unless the patient's guardian of the person consents to the
23-58 treatment in accordance with Section 578.003. The decision of the
23-59 guardian must be based on knowledge of what the patient would
23-60 desire, if known.
23-61 Sec. 578.003. CONSENT TO THERAPY. (a) The board by rule
23-62 shall adopt a standard written consent form to be used when
23-63 electroconvulsive therapy is considered. The board by rule shall
23-64 also prescribe the information that must be contained in the
23-65 written supplement required under Subsection (c). In addition to
23-66 the information required under this section, the form must include
23-67 the information required by the Texas Medical Disclosure Panel for
23-68 electroconvulsive therapy. In developing the form, the board shall
23-69 consider recommendations of the panel. Use of the consent form
23-70 prescribed by the board in the manner prescribed by this section
24-1 creates a rebuttable presumption that the disclosure requirements
24-2 of Sections 6.05 and 6.06, Medical Liability and Insurance
24-3 Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
24-4 Statutes), have been met.
24-5 (b) The written consent form must clearly and explicitly
24-6 state:
24-7 (1) the nature and purpose of the procedure;
24-8 (2) the nature, degree, duration, and probability of
24-9 the side effects and significant risks of the treatment commonly
24-10 known by the medical profession, especially noting the possible
24-11 degree and duration of memory loss, the possibility of permanent
24-12 irrevocable memory loss, and the remote possibility of death;
24-13 (3) that there is a division of opinion as to the
24-14 efficacy of the procedure; and
24-15 (4) the probable degree and duration of improvement or
24-16 remission expected with or without the procedure.
24-17 (c) Before a patient receives each electroconvulsive
24-18 treatment, the hospital, facility, or physician administering the
24-19 therapy shall ensure that:
24-20 (1) the patient and the patient's guardian of the
24-21 person, if any, receives a written copy of the consent form that is
24-22 in the person's primary language, if possible;
24-23 (2) the patient and the patient's guardian of the
24-24 person, if any, receives a written supplement that contains related
24-25 information that pertains to the particular patient being treated;
24-26 (3) the contents of the consent form and the written
24-27 supplement are explained to the patient and the patient's guardian
24-28 of the person, if any:
24-29 (A) orally, in simple, nontechnical terms in the
24-30 person's primary language, if possible; or
24-31 (B) through the use of a means reasonably
24-32 calculated to communicate with a hearing impaired or visually
24-33 impaired person, if applicable;
24-34 (4) the patient or the patient's guardian of the
24-35 person, as appropriate, signs a copy of the consent form stating
24-36 that the person has read the consent form and the written
24-37 supplement and understands the information included in the
24-38 documents; and
24-39 (5) the signed copy is made a part of the patient's
24-40 clinical record.
24-41 (d) Consent given under this section is not valid unless the
24-42 person giving the consent understands the information presented and
24-43 consents voluntarily and without coercion or undue influence.
24-44 Sec. 578.004. WITHDRAWAL OF CONSENT. (a) A patient or
24-45 guardian who consents to the administration of electroconvulsive
24-46 therapy may revoke the consent for any reason and at any time.
24-47 (b) Revocation of consent is effective immediately.
24-48 Sec. 578.005. PHYSICIAN REQUIREMENT. (a) Only a physician
24-49 may administer electroconvulsive therapy.
24-50 (b) A physician may not delegate the act of administering
24-51 the therapy. A nonphysician who administers electroconvulsive
24-52 therapy is considered to be practicing medicine in violation of the
24-53 Medical Practice Act (Article 4495b, Vernon's Texas Civil
24-54 Statutes).
24-55 Sec. 578.006. REGISTRATION OF EQUIPMENT. (a) A person may
24-56 not administer electroconvulsive therapy unless the equipment used
24-57 to administer the therapy is registered with the department.
24-58 (b) A mental hospital or facility administering
24-59 electroconvulsive therapy or a private physician administering the
24-60 therapy on an outpatient basis must file an application for
24-61 registration under this section. The applicant must submit the
24-62 application to the department on a form prescribed by the
24-63 department.
24-64 (c) The application must be accompanied by a nonrefundable
24-65 application fee. The board shall set the fee in a reasonable
24-66 amount not to exceed the cost to the department to administer this
24-67 section.
24-68 (d) The application must contain:
24-69 (1) the model, manufacturer, and age of each piece of
24-70 equipment used to administer the therapy; and
25-1 (2) any other information required by the department.
25-2 (e) The department may conduct an investigation as
25-3 considered necessary after receiving the proper application and the
25-4 required fee.
25-5 (f) The board by rule may prohibit the registration and use
25-6 of equipment of a type, model, or age the board determines is
25-7 dangerous.
25-8 (g) The department may deny, suspend, or revoke a
25-9 registration if the department determines that the equipment is
25-10 dangerous. The denial, suspension, or revocation of a registration
25-11 is a contested case under the Administrative Procedure and Texas
25-12 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes).
25-13 Sec. 578.007. REPORTS. (a) A mental hospital or facility
25-14 administering electroconvulsive therapy, psychosurgery, pre-frontal
25-15 sonic sound treatment, or any other convulsive or coma-producing
25-16 therapy administered to treat mental illness or a physician
25-17 administering the therapy on an outpatient basis shall submit to
25-18 the department quarterly reports relating to the administration of
25-19 the therapy in the hospital or facility or by the physician.
25-20 (b) A report must state for each quarter:
25-21 (1) the number of patients who received the therapy,
25-22 including:
25-23 (A) the number of persons voluntarily receiving
25-24 mental health services who consented to the therapy;
25-25 (B) the number of involuntary patients who
25-26 consented to the therapy; and
25-27 (C) the number of involuntary patients for whom
25-28 a guardian of the person consented to the therapy;
25-29 (2) the age, sex, and race of the persons receiving
25-30 the therapy;
25-31 (3) the source of the treatment payment;
25-32 (4) the average number of nonelectroconvulsive
25-33 treatments;
25-34 (5) the average number of electroconvulsive treatments
25-35 administered for each complete series of treatments, but not
25-36 including maintenance treatments;
25-37 (6) the average number of maintenance
25-38 electroconvulsive treatments administered per month;
25-39 (7) the number of fractures, reported memory losses,
25-40 incidents of apnea, and cardiac arrests without death;
25-41 (8) autopsy findings if death followed within 14 days
25-42 after the date of the administration of the therapy; and
25-43 (9) any other information required by the department.
25-44 Sec. 578.008. USE OF INFORMATION; REPORT. (a) The
25-45 department shall use the information received under Sections
25-46 578.006 and 578.007 to analyze, audit, and monitor the use of
25-47 electroconvulsive therapy, psychosurgery, pre-frontal sonic sound
25-48 treatment, or any other convulsive or coma-producing therapy
25-49 administered to treat mental illness.
25-50 (b) The department shall file annually with the governor and
25-51 the presiding officer of each house of the legislature a written
25-52 report summarizing by facility the information received under
25-53 Sections 578.006 and 578.007. If the therapy is administered by a
25-54 private physician on an outpatient basis, the report must include
25-55 that information but may not identify the physician. The
25-56 department may not directly or indirectly identify in a report
25-57 issued under this section a patient who received the therapy.
25-58 SECTION 5.02. This article takes effect September 1, 1993,
25-59 except:
25-60 (1) Subsection (a), Section 578.002 and Section
25-61 578.005, Health and Safety Code, as added by this article, take
25-62 effect immediately;
25-63 (2) equipment in use to administer electroconvulsive
25-64 therapy on the effective date of Section 578.006, Health and Safety
25-65 Code, as added by this article, is not required to be registered
25-66 under that section before January 1, 1994;
25-67 (3) a person administering electroconvulsive therapy
25-68 shall file an initial report as prescribed by Section 578.007,
25-69 Health and Safety Code, as added by this article, not later than
25-70 September 15, 1993, for the period beginning June 1, 1993, and
26-1 ending August 31, 1993; and
26-2 (4) the Texas Department of Mental Health and Mental
26-3 Retardation shall file the initial report required under Subsection
26-4 (b), Section 578.008, Health and Safety Code, as added by this
26-5 article, not later than February 15, 1994, which report must
26-6 summarize the information the department receives on or before
26-7 January 1, 1994.
26-8 ARTICLE 6
26-9 SECTION 6.01. Subdivision (3), Section 311.031, Health and
26-10 Safety Code, is amended to read as follows:
26-11 (3) "Hospital" means:
26-12 (A) a general or special hospital licensed under
26-13 Chapter 241;
26-14 (B) a private mental hospital licensed under
26-15 Chapter 577; and
26-16 (C) a treatment facility licensed under Chapter
26-17 464 <(Texas Hospital Licensing Law)>.
26-18 SECTION 6.02. Subchapter C, Chapter 311, Health and Safety
26-19 Code, is amended by adding Section 311.0335 to read as follows:
26-20 Sec. 311.0335. MENTAL HEALTH AND CHEMICAL DEPENDENCY DATA.
26-21 (a) A hospital that provides mental health or chemical dependency
26-22 services shall submit to the department financial and utilization
26-23 data relating to the mental health and chemical dependency services
26-24 provided by the hospital, including data for inpatient and
26-25 outpatient services relating to:
26-26 (1) patient demographics, including race, ethnicity,
26-27 age, gender, and county of residence;
26-28 (2) admissions;
26-29 (3) discharges, including length of inpatient
26-30 treatment;
26-31 (4) specific diagnoses and procedures according to
26-32 criteria prescribed by the Diagnostic and Statistical Manual of
26-33 Mental Disorders, 3rd Edition, Revised, or a later version
26-34 prescribed by the department;
26-35 (5) total charges and the components of the charges;
26-36 (6) payor sources; and
26-37 (7) use of mechanical restraints.
26-38 (b) The data must be submitted in the form and at the time
26-39 established by the department.
26-40 SECTION 6.03. Section 311.035, Health and Safety Code, is
26-41 amended by adding Subsection (c) to read as follows:
26-42 (c) The department shall enter into an interagency agreement
26-43 with the Texas Department of Mental Health and Mental Retardation,
26-44 Texas Commission on Alcohol and Drug Abuse, and Texas Department of
26-45 Insurance relating to the mental health and chemical dependency
26-46 hospital discharge data collected under Section 311.0335. The
26-47 agreement shall address the collection, analysis, and sharing of
26-48 the data by the agencies.
26-49 SECTION 6.04. Subsection (b), Section 311.038, Health and
26-50 Safety Code, is amended to read as follows:
26-51 (b) The advisory committee must include representatives
26-52 from:
26-53 (1) the hospital industry, including private mental
26-54 hospitals and chemical dependency treatment facilities;
26-55 (2) private business;
26-56 (3) the insurance industry;
26-57 (4) state agencies, such as the Texas Department of
26-58 Human Services, <and> Employees Retirement System of Texas, Texas
26-59 Department of Mental Health and Mental Retardation, Texas
26-60 Commission on Alcohol and Drug Abuse, and Texas Department of
26-61 Insurance;
26-62 (5) consumer organizations; and
26-63 (6) the Statewide Health Coordinating Council.
26-64 ARTICLE 7
26-65 SECTION 7.01. Section 11.52, Education Code, is amended by
26-66 adding Subsections (p) and (q) to read as follows:
26-67 (p) The commissioner of education shall adopt rules
26-68 governing the relationship between a school district and an outside
26-69 counselor to whom a student may be referred for care or treatment
26-70 of an emotional, psychological, or chemical dependency condition,
27-1 including rules that:
27-2 (1) require the school district and the outside
27-3 counselor to disclose to the student and the parent, managing
27-4 conservator, or guardian of the student the relationship between
27-5 the district and the outside counselor to whom the student is
27-6 referred for care or treatment;
27-7 (2) require the school to inform the student and the
27-8 parent, managing conservator, or guardian of the student, as
27-9 appropriate, of any public and private alternative sources of care
27-10 or treatment reasonably available in the area;
27-11 (3) require the approval of appropriate school
27-12 district personnel before the counselor refers a student for care
27-13 or treatment or suggests to or advises a student that a referral is
27-14 warranted; and
27-15 (4) specifically prohibit the disclosure of student
27-16 records if the disclosure violates state or federal law.
27-17 (q) The commissioner of education shall adopt rules that
27-18 specify procedures to be followed in an emergency or crisis
27-19 situation in which a district may request counseling services from
27-20 a private treatment facility.
27-21 SECTION 7.02. Chapter 4, Education Code, is amended by
27-22 adding Section 4.36 to read as follows:
27-23 Sec. 4.36. ILLEGAL REFERRAL FOR CARE OR TREATMENT. A person
27-24 who violates a rule adopted under Section 11.52(p) of this code:
27-25 (1) is subject to a civil penalty of not less than $50
27-26 or more than $25,000 recoverable by an aggrieved student or parent
27-27 or by the Central Education Agency in a court located in the county
27-28 in which the student or defendant resides or in Travis County; and
27-29 (2) commits a misdemeanor offense punishable by a fine
27-30 of not less than $50 or more than $25,000, confinement in jail for
27-31 not more than one year, or both fine and confinement.
27-32 ARTICLE 8
27-33 SECTION 8.01. Except as otherwise provided by this Act, this
27-34 Act takes effect September 1, 1993.
27-35 SECTION 8.02. (a) The changes in law made by this Act apply
27-36 only to an offense committed or a violation that occurs on or after
27-37 the effective date of this Act. For the purposes of this Act, an
27-38 offense is committed or a violation occurs before the effective
27-39 date of this Act if any element of the offense or violation occurs
27-40 before that date.
27-41 (b) An offense committed or violation that occurs before the
27-42 effective date of this Act is covered by the law in effect when the
27-43 offense was committed or the violation occurred, and the former law
27-44 is continued in effect for this purpose.
27-45 SECTION 8.03. The importance of this legislation and the
27-46 crowded condition of the calendars in both houses create an
27-47 emergency and an imperative public necessity that the
27-48 constitutional rule requiring bills to be read on three several
27-49 days in each house be suspended, and this rule is hereby suspended,
27-50 and that this Act take effect and be in force according to its
27-51 terms, and it is so enacted.
27-52 * * * * *
27-53 Austin,
27-54 Texas
27-55 March 19, 1993
27-56 Hon. Bob Bullock
27-57 President of the Senate
27-58 Sir:
27-59 We, your Committee on Health and Human Services to which was
27-60 referred S.B. No. 205, have had the same under consideration, and I
27-61 am instructed to report it back to the Senate with the
27-62 recommendation that it do not pass, but that the Committee
27-63 Substitute adopted in lieu thereof do pass and be printed.
27-64 Zaffirini,
27-65 Chair
27-66 * * * * *
27-67 WITNESSES
27-68 FOR AGAINST ON
27-69 ___________________________________________________________________
27-70 Name: Dan Morales x
28-1 Representing: State of Texas
28-2 City: Austin
28-3 -------------------------------------------------------------------
28-4 Name: Dr. Charles Arnold x
28-5 Representing: Self
28-6 City: San Antonio
28-7 -------------------------------------------------------------------
28-8 Name: John D. Son x x
28-9 Representing: Self
28-10 City: Checotah
28-11 -------------------------------------------------------------------
28-12 Name: Neva Duke x
28-13 Representing: Self
28-14 City: Huntsville
28-15 -------------------------------------------------------------------
28-16 Name: Orvie Nix x
28-17 Representing: Xuest Professional Services
28-18 City: Amarillo
28-19 -------------------------------------------------------------------
28-20 Name: David F. Briones, M.D. x
28-21 Representing: TSPP & TMA
28-22 City: El Paso
28-23 -------------------------------------------------------------------
28-24 Name: Karen Wagner x
28-25 Representing: TSPP & TMA
28-26 City: Galveston
28-27 -------------------------------------------------------------------
28-28 Name: Douglas Gough Cameron x
28-29 Representing: Cmte for Truth in Psychiatry
28-30 City: San Marcos
28-31 -------------------------------------------------------------------
28-32 Name: Florence Winn-Salmon x
28-33 Representing: Texas Alliance f/t Mentally
28-34 City: Austin
28-35 -------------------------------------------------------------------
28-36 Name: Ben Marroquin x
28-37 Representing: Texas Dept MHMR
28-38 City: Austin
28-39 -------------------------------------------------------------------
28-40 Name: Venora B. Oliver x
28-41 Representing: Self
28-42 City: Dallas
28-43 -------------------------------------------------------------------
28-44 Name: Maurice Shaw x
28-45 Representing: TDH
28-46 City: Austin
28-47 -------------------------------------------------------------------
28-48 Name: Jerry Boswell x
28-49 Representing: Citzen Comm. on Human Rights
28-50 City: Austin
28-51 -------------------------------------------------------------------
28-52 Name: Matt Donaldson x
28-53 Representing: Consumer Health Services
28-54 City: Boulder
28-55 -------------------------------------------------------------------
28-56 Name: Tom Wright x
28-57 Representing: Citizens Comm on Human Rights
28-58 City: Houston
28-59 -------------------------------------------------------------------
28-60 Name: Dianna Loper x
28-61 Representing: Self
28-62 City: Houston
28-63 -------------------------------------------------------------------
28-64 Name: Mary Dees x
28-65 Representing: Tx Mental Health Consumers
28-66 City: Austin
28-67 -------------------------------------------------------------------
28-68 FOR AGAINST ON
28-69 ___________________________________________________________________
28-70 Name: Wylie Jordon x
29-1 Representing: Self
29-2 City: Austin
29-3 -------------------------------------------------------------------
29-4 Name: Dr. Alaire Lowry x
29-5 Representing: Tx Psychological Asso.
29-6 City: Austin
29-7 -------------------------------------------------------------------
29-8 Name: Don Cavness x
29-9 Representing: Tx Psychological Asso.
29-10 City: Austin
29-11 -------------------------------------------------------------------
29-12 Name: Nancy Sims x
29-13 Representing: Tx Business Group on Health
29-14 City: Houston
29-15 -------------------------------------------------------------------
29-16 Name: Paul Mascot x
29-17 Representing: TxMHMR
29-18 City: Austin
29-19 -------------------------------------------------------------------
29-20 Name: Lacey Sloan x
29-21 Representing: Tx Assoc. Against Sexual Asslt
29-22 City: Austin
29-23 -------------------------------------------------------------------
29-24 Name: Mike Ezzell x
29-25 Representing: TCACA
29-26 City: Austin
29-27 -------------------------------------------------------------------
29-28 Name: William Conrad Archer x
29-29 Representing: Self
29-30 City: Austin
29-31 -------------------------------------------------------------------
29-32 Name: Valerie Arlitt-Mead x
29-33 Representing: Tx Head Injury Asso
29-34 City: Austin
29-35 -------------------------------------------------------------------
29-36 Name: Aaryce Hayes x
29-37 Representing: Advicacy, Inc
29-38 City: Austin
29-39 -------------------------------------------------------------------
29-40 Name: Judy Cook x
29-41 Representing: MHMR
29-42 City: Hughes Springs
29-43 -------------------------------------------------------------------
29-44 Name: Joanne P. Hopkins x
29-45 Representing: National Medical Enterprise
29-46 City: Austin
29-47 -------------------------------------------------------------------
29-48 Name: Marcia Baum x
29-49 Representing: NASW
29-50 City: Austin
29-51 -------------------------------------------------------------------
29-52 Name: Christine Devall x
29-53 Representing: Mental Health Assn in Tx
29-54 City: Austin
29-55 -------------------------------------------------------------------
29-56 Name: Mark D. Chouteau x
29-57 Representing: AG's Office
29-58 City: Austin
29-59 -------------------------------------------------------------------
29-60 Name: Julie Finan x
29-61 Representing: Self
29-62 City: Houston
29-63 -------------------------------------------------------------------
29-64 Name: William Johnson x
29-65 Representing: Self
29-66 City: Austin
29-67 -------------------------------------------------------------------
29-68 FOR AGAINST ON
29-69 ___________________________________________________________________
29-70 Name: Crandall Gage x
30-1 Representing: Self
30-2 City: Houston
30-3 -------------------------------------------------------------------
30-4 Name: Christopher Zientek x
30-5 Representing: Self
30-6 City: Houston
30-7 -------------------------------------------------------------------
30-8 Name: G. K. Sprinkle x
30-9 Representing: Tx Counseling Assoc.
30-10 City: Austin
30-11 -------------------------------------------------------------------
30-12 Name: Charles Stark x
30-13 Representing: Healthsouth Rehab Fort Worth
30-14 City: North Richland Hills
30-15 -------------------------------------------------------------------
30-16 Name: Susan Medlin x
30-17 Representing: Self
30-18 City: Austin
30-19 -------------------------------------------------------------------
30-20 Name: Nicholas Weeks x
30-21 Representing: Self
30-22 City: Austin
30-23 -------------------------------------------------------------------
30-24 Name: Karen Hale x
30-25 Representing: MHMR
30-26 City: Austin
30-27 -------------------------------------------------------------------
30-28 Name: Lisa McGiffert x
30-29 Representing: Consumers Union
30-30 City: Austin
30-31 -------------------------------------------------------------------
30-32 Name: Kevin O'Hanlon x
30-33 Representing: Texas Education Agency
30-34 City: Austin
30-35 -------------------------------------------------------------------