LSL H.B. 911 75(R) BILL ANALYSIS
PUBLIC HEALTH
H.B. 911
By: Hirschi
3-5-97
Committee Report (Unamended)
BACKGROUND
Tuberculosis (TB), a highly infectious airborne disease, has become
epidemic in Texas. In 1994, 2,542 cases were reported, which is a
significant increase over the number of cases reported in the 1970s and
1980s. In fact, case incidence of TB has risen by 44 percent since 1987.
A significant threat to public health is posed by a small percentage of
the TB cases in which an afflicted person has a strain of TB that is
resistant to two or more drug treatments and in which a person is unable
or unwilling to comply with prescribed therapy.
Chapter 81 of the Health and Safety Code provides for court-ordered
management of the case in order to deal with such circumstances.
Typically, only about one percent of TB cases are managed by court order
each year. There are, however, inconsistencies and conflicts in the
current state statute which have made it confusing and cumbersome.
PURPOSE
HB 911 streamlines the process for court-ordered management of
hard-to-treat TB cases and clarifies the manner by which court associated
costs are to be reimbursed.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency or
institution.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 81.151, Health and Safety Code, as follows:
Subsection (a) changes current permissive language to require that
municipal, county or district attorneys file a sworn written application
for court-ordered management of a person with an infectious disease, at
the request of a local health authority. Requires the attorney general to
file sworn written application if the request is made by TDH.
Subsection (d) allows an application for outpatient treatment to be filed
without a copy of the written orders specified under Sec. 81.083.
SECTION 2. Amends Section 81.152, Health and Safety Code, as follows:
Subsection (c)(4) adds that the statement regarding an individual's
noncompliance with the written orders of health authorities is to be
included only with an application for inpatient treatment.
SECTION 3. Amends Section 81.154, Health and Safety Code, as follows:
Subsection (a) changes the time setting requirement of a hearing date to
be within 14 days after the serving of the application on the person,
instead of 14 days after the original filing.
Subsection (c) changes the time setting requirement of a granting of a
hearing for a continuance to be not later than the 30th day after service
is made on the person instead of within 30 days of filing.
SECTION 4. Amends 81.156, Health and Safety Code, as follows:
Subsection (a) adds the attorney general as someone from whom the
person's attorney may request information if it is appropriate and in
accordance with this section.
Subsection (b) adds the attorney general to the municipal, county or
district attorney as the persons who are required, within reasonable time
before the hearing, to provide the attorney with a statement, as specified
by this section.
SECTION 5. Amends Section 81.157, Health and Safety Code, as follows:
Subsection (a) is added to clarify that a proceeding, under this chapter,
must be held in a district court of the county in which the person is
found, resides, or receives court-ordered health services.
Subsection (b) is added to require the county issuing a temporary order to
pay the expenses of transporting the person back for the hearing, if that
person is receiving services in an outside county and is in need of
extended management. Allows for an exception if arrangements are made
between both counties whereby the application for extended order is heard
before the expiration of the temporary order.
SECTION 6. Amends Section 81.159, Health and Safety Code, by changing its
heading from "Recommendation for Treatment" to be retitled "DESIGNATION
OF FACILITY," and as follows:
Subsection (c) deletes the requirement for a health care facility to file
a treatment recommendation prior to the hearing date and the prohibition
against holding a hearing before the recommendation is filed. Makes
conforming changes.
SECTION 7. Amends Section 81.161, Health and Safety Code, as follows:
Subsection (b) changes the permissive language regarding motions filed on
behalf of TDH; requires that the attorney general file the motion if
requested by TDH.
SECTION 8. Amends Section 81.167, Health and Safety Code, as follows:
Subsection (c) allows the detention of a person under protective custody
in a jail or law enforcement facility only with the consent of the
facility's medical director and only if the facility has respiratory
isolation capability. Prohibits detention in a nonmedical facility for
longer than 72 hours, as specified in this subchapter.
SECTION 9. Amends Section 81.170, Health and Safety Code, as follows:
Subsection (f) adds the prerequisite that an application for court-ordered
management be for inpatient treatment to the requirement of jury
determination regarding whether a person has been compliant with health
authority orders.
SECTION 10. Amends Section 81.171 Health and Safety Code, as follows:
Subsection (a) adds the prerequisite that the application for
court-ordered management be for inpatient treatment to the requirement
that the court deny the order if there is failure to find that the person
meets applicable criteria for court ordered management, presents a public
health threat, and is noncompliant with health authority orders. Makes
conforming changes.
SECTION 11. Amends Section 81.172, Health and Safety Code, as follows:
Subsection (a)(1) specifies that application for inpatient treatment is a
prerequisite for a determination regarding failure or refusal to follow
health authority orders.
Subsection (e) is added. Requires TDH, in cooperation with the head of the
health care facility, to submit a general program of the proposed
treatment to the court. Requires that such treatment program be submitted
no later than 14 days after the order is issued and requires that it be
incorporated into the court order.
SECTION 12. Amends Section 81.173, Health and Safety Code, as follows:
Subsection (a)(1) specifies that application for inpatient treatment is a
prerequisite for a determination regarding failure or refusal to follow
health authority orders.
Subsection (e) is added. Requires TDH, in cooperation with the head of
the health care facility, to submit a general program of the proposed
treatment to the court. Requires that such treatment program be submitted
no later than 14 days after the order is issued and requires that it be
incorporated into the court order.
SECTION 13. Amends Section 81.174, Health and Safety Code, as follows:
Subsection (a) specifies that application for inpatient treatment is a
prerequisite for a determination regarding failure or refusal to follow
health authority orders and jury dismissal by the judge. Makes conforming
changes.
SECTION 14. Amends Section 81.179, Health and Safety Code, as follows:
Subsection (a) changes current permissive language to require the court to
order the sheriff or constable to transport the person to the designated
health care facility.
SECTION 15. Amends Section 81.182, Health and Safety Code, as follows:
Subsection (a) changes current permissive language to require that a
municipal, county, or district attorney, request court modification of the
commitment order in order to provide outpatient care if requested by the
health authority. Requires the attorney general to take the same action
at TDH's request.
SECTION 16. Amends Section 81.183, Health and Safety Code, as follows:
Subsection (a) allows the court to set a hearing to modify the order on
the motion of a municipal, county or district attorney, or on the motion
of the attorney general.
SECTION 17. Amends Section 81.184, Health and Safety Code, as follows:
Subsection (a) changes current permissive language to require that a
municipal, county or district attorney, at a health authority's request,
file a sworn application for temporary detention pending a modification
hearing. Requires the attorney general to take the same action at TDH's
request.
SECTION 18. Amends Section 81.187, Health and Safety Code, as follows:
Subsection (a) changes current permissive language to require that a
municipal, county or district attorney file an application for renewal of
an order for extended management per the health authority's request.
Requires the attorney general to take the same action at TDH's request.
SECTION 19. Amends Subchapter G, Chapter 81, Health and Safety Code, by
adding Sec. 81.210, entitled "COSTS", as follows:
Subsection (a) requires a county to pay the costs of a proceeding under
this subchapter if a health authority initiates an application for the
court order as per Sec. 81.151 or has an application for the transfer of
court-ordered management per Sec. 81.157.
Subsection (b) establishes that such costs include attorney's fees,
physician examination fees, compensation for court-ordered personal
services, security, and transportation to a designated facility.
Subsection (c) entitles a county to reimbursement from the person who is
the subject of the application or from a person or estate liable for the
person's support.
Subsection (d) requires TDH to pay the costs of returning a person absent
without authorization unless the person is able to pay.
SECTION 20. Establishes applicability only to court-ordered management
applications filed on or after this Act's effective date.
SECTION 21. Emergency clause. Establishes that this Act is effective
immediately upon passage.