SRC-CTC C.S.S.B. 1386 77(R)BILL ANALYSIS Senate Research CenterC.S.S.B. 1386 77R9418 CBH-FBy: Armbrister Health & Human Services 4/10/2001 Committee Report (Substituted) DIGEST AND PURPOSE Since the laws creating the state and local mental health authority structure were originally passed, conflicting and confusing provisions have developed. These developments limit the courts' authority and make it difficult to order people to mental health treatment in less-restrictive settings than state hospitals, even when such a setting is more appropriate. C.S.S.B. 1386 addresses these statutory difficulties to improve the diversion of individuals with serious mental illness or mental retardation from incarceration in local jails when mental health treatment is necessary. RULEMAKING AUTHORITY This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 531.002, Health and Safety Code, to define "business entity" and "chemical dependency." Redefines "local mental health authority" and "local mental retardation authority." Deletes wording related to the definitions of "business entity" and "chemical dependency." SECTION 2. Amends Section 533.014, Health and Safety Code, as follows: Sec. 533.014. New heading: RESPONSIBILITY OF LOCAL MENTAL HEALTH AUTHORITIES IN MAKING TREATMENT RECOMMENDATIONS. Requires the Texas Board of Mental Health and Retardation (board) to adopt rules that: _relate to the responsibility, rather than the designation, of the mental health authorities to make recommendations relating to the most appropriate and available treatment alternatives for individuals in need of mental health services, rather than as single portal authorities; _govern commitments to a local mental health, rather than a single portal, authority; _govern transfers of patients that involve a local mental health, rather than a single portal, authority; _provide for emergency admission to a department mental health facility if obtaining approval from the authority could result in a delay that might endanger the patient or others. Deletes wording related to designation of a single portal authority. Makes conforming changes. SECTION 3. Amends Sections 533.035(a) and (c), Health and Safety Code, to authorize the board to delegate to the local authorities the board's authority and responsibility for, among other things, coordination with criminal justice entities of mental health and mental retardation services in the most appropriate and available setting to meet individual needs in that service area. Authorizes the commissioner of mental health and mental retardation (commissioner) to designate a single entity as the local mental health authority and the local mental retardation authority for a service area. (c) Requires the local authority to consider public input, ultimate cost-benefit, and client care issues to ensure consumer choice and the best use of public money in making recommendations relating to the most appropriate and available treatment alternatives for individuals in need of mental health or mental retardation services. SECTION 4. Amends Sections 571.003(9) and (11), Health and Safety Code, to redefine "inpatient mental health facility." Deletes wording related to the definition of "inpatient mental health facility." Defines "local mental health authority," rather than "mental health authority." Redefines "mental health facility." SECTION 5. Amends Section 573.001(d), Health and Safety Code, to require a peace officer who takes a person into custody under Subsection (a) to immediately transport the apprehended person to a mental health facility deemed suitable by the local, rather than the county's, mental health authority, if an appropriate inpatient mental health facility is not available. SECTION 6. Amends Section 573.012(e), Health and Safety Code, to make conforming changes. SECTION 7. Amends Section 573.022(b), Health and Safety Code, to authorize a mental health facility, rather than a county mental health facility, that has admitted a person for emergency detention under this section to transport the person to a mental health facility, rather than a facility, deemed suitable by the local, rather than the county's, mental health authority for the area. Authorizes the judge, on the request of the local mental health authority, to order that the proposed patient be detained in a department mental health facility. Deletes wording related to facilities to which and under what circumstances a person may be transported. SECTION 8. Amends Section 574.012, Health and Safety Code, to require the local mental health authority, rather than the commissioner to designate a facility or provider, in the county in which an application is filed to file a recommendation with the court for the most appropriate treatment alternative for the proposed patient. Deletes wording related to requirements of the facility or provider designated under this section and the facilities from which proposed mental health services are available. Makes conforming changes. SECTION 9. Amends Section 574.023, Health and Safety Code, to delete wording relating to locations to which certain persons under a protective custody order are to be transported. Requires a protective custody order to direct a person authorized to transport patients under Section 574.045 to take the proposed patient into protective custody and immediately transport the person to a mental health facility deemed suitable by the local, rather than county's, mental health authority for the area. Authorizes the judge, on request of the local mental health authority, to order that the proposed patient be detained in an inpatient mental health facility operated by the department. Deletes wording relating to a condition of detaining a proposed patient in a department facility and requirements of a single portal authority. SECTION 10. Amends Section 574.027(a), Health and Safety Code, to delete wording relating to locations in which a person under a protective custody order is to be detained. Requires a person under a protective custody order to be detained in a mental health facility deemed suitable by the local, rather than the county's, mental health authority for the area. Authorizes the judge, on request of the local mental health authority, to order that the proposed patient be detained in an inpatient mental health facility operated by the department. Deletes wording related to a condition of detaining a proposed patient in a department facility. SECTION 11. Amends Section 574.041, Health and Safety Code, to require the court, in an order for temporary or extended mental health services specifying inpatient care, to commit the patient to a designated inpatient mental health facility, rather than a designated mental health facility. Requires the court to commit the patient to a mental health facility deemed suitable by the local mental health authority, rather than of a single portal authority, for the area. Deletes wording relating to designation of an authority for the area. Authorizes the judge, on request of the local mental health authority, to commit the patient directly to an inpatient mental health facility operated by the department, rather than a state mental hospital. Deletes wording related to resources of a single portal authority. Deletes wording relating to the definition of "facility of a single portal authority." Makes a conforming change. SECTION 12. Amends Section 574.043(c), Health and Safety Code, to provide that the hospital authority has the same authority and responsibility with respect to the patient as the facility, rather than hospital, administrator of an inpatient mental health facility operated by the department, rather than a state mental hospital. SECTION 13. Amends Section 574.064(a), Health and Safety Code, to make conforming changes. SECTION 14. Amends Section 574.081(b), Health and Safety Code, to make conforming changes. SECTION 15. Amends Section 574.083(g), Health and Safety Code, to make a conforming change. SECTION 16. Amends Section 575.011, Health and Safety Code, as follows: Sec. 575.011. New heading: TRANSFER TO DEPARTMENT MENTAL HEALTH FACILITY OR LOCAL MENTAL HEALTH AUTHORITY. Makes conforming changes. SECTION 17. Amends Section 575.012, Health and Safety Code, as follows: Sec. 575.012. New heading: TRANSFER OF PERSON WITH MENTAL RETARDATION TO AN INPATIENT MENTAL HEALTH FACILITY OPERATED BY THE DEPARTMENT. Makes a conforming change. SECTION 18. Amends Sections 575.013(a) and (b), Health and Safety Code, to make conforming changes. SECTION 19. Repealer: Sections 571.003(22) and 574.027(e), Health and Safety Code. SECTION 20. Effective date: September 1, 2001. SUMMARY OF COMMITTEE CHANGES Amends As Filed S.B. 1386 as follows: SECTION 1. Removes proposed definitions of "department facility" and "facility." Redefines "local mental health authority" and "local mental retardation authority." SECTION 2. Removes proposed text relating to mental retardation authorities and adds text relating to recommendations made by the local mental health authorities. Makes conforming changes. SECTION 3. Makes conforming changes. SECTION 4. Removes proposed definition of "department mental health facility." Redefines "inpatient mental health facility" and "local mental health authority." Maintains existing definitions of "mental health facility," "state mental hospital," and "single portal authority." Removes proposed SECTION 5 amending Section 571.018(j), Health and Safety Code. SECTION 5. Redesignates SECTION 6 as SECTION 5. SECTION 6. Redesignates SECTION 7 as SECTION 6. SECTION 7. Redesignates SECTION 8 as SECTION 7. SECTION 8. Redesignates SECTION 9 as SECTION 8. SECTION 9. Redesignates SECTION 10 as SECTION 9. Adds text relating to the authority of a judge to order that a proposed patient be detained in an inpatient mental health facility operated by the department. SECTION 10. Redesignates SECTION 11 as SECTION 10. Makes conforming changes. SECTION 11. Redesignates SECTION 12 as SECTION 11. Makes conforming changes. SECTION 12. Redesignates SECTION 13 as SECTION 12. Makes conforming changes. SECTION 13. Redesignates SECTION 14 as SECTION 13. SECTION 14. Redesignates SECTION 15 as SECTION 14. SECTION 15. Redesignates SECTION 16 as SECTION 15. SECTION 16. Redesignates SECTION 17 as SECTION 16. Makes conforming changes. SECTION 17. Redesignates SECTION 18 as SECTION 17. Makes conforming changes. SECTION 18. Redesignates SECTION 19 as SECTION 18. Makes conforming changes. Removes proposed SECTION 20 amending Section 531.0345(a), Government Code. SECTION 19. Redesignates SECTION 21 as SECTION 19. Repeals Section 571.003(22), Health and Safety Code. SECTION 20. Redesignates SECTION 22 as SECTION 20.