1-1     By:  Hirschi (Senate Sponsor - Moncrief)               H.B. No. 911

 1-2           (In the Senate - Received from the House April 4, 1997;

 1-3     April 8, 1997, read first time and referred to Committee on Health

 1-4     and Human Services; May 1, 1997, reported favorably by the

 1-5     following vote:  Yeas 11, Nays 0; May 1, 1997, sent to printer.)

 1-6                            A BILL TO BE ENTITLED

 1-7                                   AN ACT

 1-8     relating to the management of persons with communicable diseases.

 1-9           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-10           SECTION 1.  Sections 81.151(a) and (d), Health and Safety

1-11     Code, are amended to read as follows:

1-12           (a)  At the request of the health authority [or the

1-13     department], a municipal, county, or district attorney shall [may]

1-14     file a sworn written application for a court order for the

1-15     management of a person with a communicable disease.  At the request

1-16     of the department, the attorney general shall file a sworn written

1-17     application for a court order for the management of a person with a

1-18     communicable disease.

1-19           (d)  A copy of written orders made under Section 81.083 and a

1-20     medical evaluation must be filed with the application, except that

1-21     a copy of the written orders need not be filed with an application

1-22     for outpatient treatment.

1-23           SECTION 2.  Section 81.152(c), Health and Safety Code, is

1-24     amended to read as follows:

1-25           (c)  Any application must contain the following information

1-26     according to the applicant's information and belief:

1-27                 (1)  the person's name and address;

1-28                 (2)  the person's county of residence in this state;

1-29                 (3)  a statement that the person is infected with or is

1-30     reasonably suspected of being infected with a communicable disease

1-31     that presents a threat to public health and that the person meets

1-32     the criteria of this chapter for court orders for the management of

1-33     a person with a communicable disease; and

1-34                 (4)  a statement, to be included only in an application

1-35     for inpatient treatment, that the person fails or refuses to comply

1-36     with written orders of the department or health authority under

1-37     Section 81.083.

1-38           SECTION 3.  Sections 81.154(a) and (c), Health and Safety

1-39     Code, are amended to read as follows:

1-40           (a)  The judge or a magistrate designated under this chapter

1-41     shall set a date for a hearing to be held within 14 days after the

1-42     date on which the application is served on the person [filed].

1-43           (c)  The court may grant one or more continuances of the

1-44     hearing on the motion by a party and for good cause shown or on

1-45     agreement of the parties.  However, the hearing shall be held not

1-46     later than the 30th day after the date on which the original

1-47     application is served on the person [filed].

1-48           SECTION 4.  Sections 81.156(a) and (b), Health and Safety

1-49     Code, are amended to read as follows:

1-50           (a)  The person's attorney may request information from the

1-51     attorney general or the municipal, county, or district attorney, as

1-52     appropriate, in accordance with this section if the attorney cannot

1-53     otherwise obtain the information.  The attorney must request the

1-54     information at least 48 hours before the time set for the hearing.

1-55           (b)  If the person's attorney requests the information in

1-56     accordance with Subsection (a), the attorney general or the

1-57     municipal, county, or district attorney shall, within a reasonable

1-58     time before the hearing, provide the attorney with a statement that

1-59     includes:

1-60                 (1)  the provisions of this chapter that will be relied

1-61     on at the hearing to establish that the person requires a court

1-62     order for the temporary or extended management of a person with a

1-63     communicable disease;

1-64                 (2)  the name, address, and telephone number of each

 2-1     witness who may testify at the hearing;

 2-2                 (3)  a brief description of the reasons why temporary

 2-3     or extended management is required; and

 2-4                 (4)  a list of any acts committed by the person that

 2-5     the applicant will attempt to prove at the hearing.

 2-6           SECTION 5.  Section 81.157, Health and Safety Code, is

 2-7     amended to read as follows:

 2-8           Sec. 81.157.  District Court Jurisdiction.  (a)  A proceeding

 2-9     under this chapter must be held in a district court of the county

2-10     in which the person is found, resides, or is receiving

2-11     court-ordered health services.

2-12           (b)  If a person subject to an order for temporary management

2-13     is receiving services in a county other than the county in which

2-14     the court that entered the temporary order is located and requires

2-15     extended management, the county in which the temporary order was

2-16     issued shall pay the expenses of transporting the person back to

2-17     the county for the hearing unless the court that entered the

2-18     temporary order arranges with the appropriate court in the county

2-19     in which the person is receiving services to hold the hearing on

2-20     the application for extended order before the temporary order

2-21     expires.

2-22           SECTION 6.  Section 81.159, Health and Safety Code, is

2-23     amended to read as follows:

2-24           Sec. 81.159.  DESIGNATION OF FACILITY [RECOMMENDATION FOR

2-25     TREATMENT].  (a)  The commissioner shall designate health care

2-26     facilities throughout the state that are capable of providing

2-27     services for the examination, observation, isolation, or treatment

2-28     of persons having or suspected of having a communicable disease.

2-29     However, the commissioner may not designate a nursing home or

2-30     custodial care home required to be licensed under Chapter 242.

2-31           (b)  The health authority shall select a designated facility

2-32     in the county in which the application is filed.  If no facility is

2-33     designated in the county, the commissioner shall select the

2-34     facility.

2-35           (c)  [The court shall direct the facility to file, before the

2-36     date set for the hearing, a recommendation for the person's

2-37     treatment.]

2-38           [(d)  The hearing on an application may not be held before

2-39     the recommendation for treatment is filed unless the court

2-40     determines that an emergency exists.]

2-41           [(e)]  This section does not relieve a county of its

2-42     responsibility under other provisions of this chapter or applicable

2-43     law for providing health care services.

2-44           (d) [(f)]  A designated facility must comply with this

2-45     section only to the extent that the commissioner determines that

2-46     the facility has sufficient resources to perform the necessary

2-47     services.

2-48           (e) [(g)]  This section does not apply to a person for whom

2-49     treatment in a private health facility is proposed.

2-50           SECTION 7.  Section 81.161(b), Health and Safety Code, is

2-51     amended to read as follows:

2-52           (b)  The motion may be filed by the municipal, county, or

2-53     district attorney on behalf of the [department or] health

2-54     authority.  The motion shall be filed by the attorney general at

2-55     the request of the department.

2-56           SECTION 8.  Section 81.167(c), Health and Safety Code, is

2-57     amended to read as follows:

2-58           (c)  A person under a protective custody order may [not] be

2-59     detained in a nonmedical facility used to detain persons who are

2-60     charged with or convicted of a crime only with the consent of the

2-61     medical director of the facility and only if the facility has

2-62     respiratory isolation capability for airborne communicable

2-63     diseases.  The person may not be detained in a nonmedical facility

2-64     under this subsection [unless an extreme emergency exists and in no

2-65     case] for longer than 72 hours, excluding Saturdays, Sundays, legal

2-66     holidays, and the period prescribed by Section 81.165(b) for an

2-67     extreme weather emergency.  The person must be isolated from any

2-68     person who is charged with or convicted of a crime.

2-69           SECTION 9.  Section 81.170(f), Health and Safety Code, is

 3-1     amended to read as follows:

 3-2           (f)  The jury shall determine if the person is infected with

 3-3     or is reasonably suspected of being infected with a communicable

 3-4     disease that presents a threat to the public health and, if the

 3-5     application is for inpatient treatment, has refused or failed to

 3-6     follow the orders of the health authority.  The jury may not make a

 3-7     finding about the type of services to be provided to the person.

 3-8           SECTION 10.  Section 81.171(a), Health and Safety Code, is

 3-9     amended to read as follows:

3-10           (a)  The court shall enter an order denying an application

3-11     for a court order for temporary or extended management if after a

3-12     hearing the judge or jury fails to find, from clear and convincing

3-13     evidence, that the person:

3-14                 (1)  is infected with or is reasonably suspected of

3-15     being infected with a communicable disease that presents a threat

3-16     to the public health;

3-17                 (2)  [,] has refused or failed to follow the orders of

3-18     the health authority if the application is for inpatient treatment;

3-19     and

3-20                 (3)  [, and] meets the applicable criteria for orders

3-21     for the management of a person with a communicable disease.

3-22           SECTION 11.  Section 81.172, Health and Safety Code, is

3-23     amended by amending Subsection (a) and adding Subsection (e) to

3-24     read as follows:

3-25           (a)  The judge or jury may determine that a person requires

3-26     court-ordered examination, observation, isolation, or treatment

3-27     only if the judge or jury finds, from clear and convincing

3-28     evidence, that:

3-29                 (1)  the person is infected with or is reasonably

3-30     suspected of being infected with a communicable disease that

3-31     presents a threat to the public health and, if the application is

3-32     for inpatient treatment, has failed or refused to follow the orders

3-33     of the health authority or department; and

3-34                 (2)  as a result of the communicable disease the

3-35     person:

3-36                       (A)  is likely to cause serious harm to himself;

3-37     or

3-38                       (B)  will, if not examined, observed, isolated,

3-39     or treated, continue to endanger public health.

3-40           (e)  The department, with the cooperation of the head of the

3-41     facility, shall submit to the court a general program of treatment

3-42     to be provided.  The program must be submitted not later than the

3-43     14th day after the date the order is issued and must be

3-44     incorporated into the court order.

3-45           SECTION 12.  Section 81.173, Health and Safety Code, is

3-46     amended by amending Subsection (a) and adding Subsection (e) to

3-47     read as follows:

3-48           (a)  The jury, or the judge if the right to a jury is waived,

3-49     may determine that a proposed patient requires court-ordered

3-50     examination, observation, isolation, or treatment only if the jury

3-51     or judge finds, from clear and convincing evidence, that:

3-52                 (1)  the person is infected with a communicable disease

3-53     that presents a threat to the public health and, if the application

3-54     is for inpatient treatment, has failed to follow the orders of the

3-55     health authority or department;

3-56                 (2)  as a result of that communicable disease the

3-57     person:

3-58                       (A)  is likely to cause serious harm to himself;

3-59     or

3-60                       (B)  will, if not examined, observed, isolated,

3-61     or treated, continue to endanger public health; and

3-62                 (3)  the person's condition is expected to continue for

3-63     more than 90 days.

3-64           (e)  The department, with the cooperation of the head of the

3-65     facility, shall submit to the court a general program of treatment

3-66     to be provided.  The program must be submitted not later than the

3-67     14th day after the date the order is issued and must be

3-68     incorporated into the court order.

3-69           SECTION 13.  Section 81.174(a), Health and Safety Code, is

 4-1     amended to read as follows:

 4-2           (a)  The judge shall dismiss the jury, if any, after a

 4-3     hearing in which a person is found:

 4-4                 (1)  to be infected with or reasonably suspected of

 4-5     being infected with a communicable disease;

 4-6                 (2)  [,] to have failed or refused to follow the orders

 4-7     of a health authority or the department if the application is for

 4-8     inpatient treatment;[,] and

 4-9                 (3)  to meet the criteria for orders for the management

4-10     of a patient with a communicable disease.

4-11           SECTION 14.  Section 81.179(a), Health and Safety Code, is

4-12     amended to read as follows:

4-13           (a)  The court shall order [may authorize] the sheriff or

4-14     constable to transport the person to the designated health care

4-15     facility.

4-16           SECTION 15.  Section 81.182(a), Health and Safety Code, is

4-17     amended to read as follows:

4-18           (a)  At the request of the [The] health authority, a

4-19     municipal, county, or district attorney, as appropriate, shall

4-20     [department, or head of a facility to which a person is committed

4-21     for inpatient health services may] request the court that entered

4-22     the commitment order to modify the order to provide for outpatient

4-23     care.  At the request of the department, the attorney general shall

4-24     request the court that entered the commitment order to modify the

4-25     order to provide for outpatient care.

4-26           SECTION 16.  Section 81.183(a), Health and Safety Code, is

4-27     amended to read as follows:

4-28           (a)  The court that entered an order directing a person to

4-29     participate in outpatient health services may set a hearing to

4-30     determine if the order should be modified in a way that is a

4-31     substantial deviation from the original program of treatment

4-32     incorporated in the court's order.  The court may set the hearing

4-33     on its own motion, on the motion of a municipal, county, or

4-34     district attorney at the request of the health authority, on the

4-35     motion of the attorney general at the request of the [or]

4-36     department, or at the request of any other interested person.

4-37           SECTION 17.  Section 81.184(a), Health and Safety Code, is

4-38     amended to read as follows:

4-39           (a)  At the request of the [The] health authority, a

4-40     municipal, county, or district attorney, as appropriate, shall

4-41     [department, or head of an outpatient facility in which the person

4-42     receives treatment may] file a sworn application for the person's

4-43     temporary detention pending a modification hearing under Section

4-44     81.183.  At the request of the department, the attorney general

4-45     shall file a sworn application for the person's temporary detention

4-46     pending a modification hearing under Section 81.183.

4-47           SECTION 18.  Section 81.187(a), Health and Safety Code, is

4-48     amended to read as follows:

4-49           (a)  A municipal, county, or district attorney, as

4-50     appropriate, at the request of the health authority, shall [or

4-51     department, may] file an application to renew an order for extended

4-52     management.  At the request of the department, the attorney general

4-53     shall file an application to renew an order for extended

4-54     management.

4-55           SECTION 19.  Subchapter G, Chapter 81, Health and Safety

4-56     Code, is amended by adding Section 81.210 to read as follows:

4-57           Sec. 81.210.  COSTS.  (a)  A county shall pay the costs for a

4-58     hearing or proceeding under this subchapter if a health authority:

4-59                 (1)  initiates an application for a court order under

4-60     Section 81.151; or

4-61                 (2)  has an application for court-ordered management

4-62     transferred to it under Section 81.157.

4-63           (b)  Costs under this section include:

4-64                 (1)  attorney's fees;

4-65                 (2)  physician examination fees;

4-66                 (3)  compensation for court-ordered personal services;

4-67                 (4)  security; and

4-68                 (5)  expenses of transportation to a designated

4-69     facility.

 5-1           (c)  A county is entitled to reimbursement for costs actually

 5-2     paid by the county from:

 5-3                 (1)  the person who is the subject of the application;

 5-4     or

 5-5                 (2)  a person or estate liable for the person's

 5-6     support.

 5-7           (d)  The department shall pay the costs of returning a person

 5-8     absent without authorization unless the person is able to pay the

 5-9     costs.

5-10           SECTION 20.  This Act applies only to an application for a

5-11     court order for the management of a person with a communicable

5-12     disease filed on or after the effective date of this Act.

5-13           SECTION 21.  The importance of this legislation and the

5-14     crowded condition of the calendars in both houses create an

5-15     emergency and an imperative public necessity that the

5-16     constitutional rule requiring bills to be read on three several

5-17     days in each house be suspended, and this rule is hereby suspended,

5-18     and that this Act take effect and be in force from and after its

5-19     passage, and it is so enacted.

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