77R9418 CBH-F                           
         By Farabee                                            H.B. No. 1497
         Substitute the following for H.B. No. 1497:
         By Gray                                           C.S.H.B. No. 1497
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the provision of mental health and mental retardation
 1-3     services.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Section 531.002, Health and Safety Code, is
 1-6     amended to read as follows:
 1-7           Sec. 531.002.  DEFINITIONS. In this subtitle:
 1-8                 (1)  "Board" means the Texas Board of Mental Health and
 1-9     Mental Retardation.
1-10                 (2)  "Business entity" means a sole proprietorship,
1-11     partnership, firm, corporation, holding company, joint-stock
1-12     company, receivership, trust, or any other entity recognized by
1-13     law.
1-14                 (3)  "Chemical dependency" has the meaning assigned by
1-15     Section 461.002.
1-16                 (4)  "Commissioner" means the commissioner of mental
1-17     health and mental retardation.
1-18                 (5) [(3)]  "Community center" means a center
1-19     established under Subchapter A, Chapter 534.
1-20                 (6) [(4)]  "Department" means the Texas Department of
1-21     Mental Health and Mental Retardation.
1-22                 (7) [(5)]  "Effective administration" includes
1-23     continuous planning and evaluation within the system that result in
1-24     more efficient fulfillment of the purposes and policies of this
 2-1     subtitle.
 2-2                 (8) [(6)]  "ICF-MR" means the medical assistance
 2-3     program serving persons with mental retardation who receive care in
 2-4     intermediate care facilities.
 2-5                 (9) [(7)]  "Local agency" means:
 2-6                       (A)  a municipality, county, hospital district,
 2-7     rehabilitation district, school district, state-supported
 2-8     institution of higher education, or state-supported medical school;
 2-9     or
2-10                       (B)  any organizational combination of two or
2-11     more of those entities.
2-12                 (10) [(8)]  "Local mental health authority" means an
2-13     entity to which the board delegates its authority and
2-14     responsibility within a specified region for planning, policy
2-15     development, coordination,  including coordination with criminal
2-16     justice entities, and resource development and allocation and for
2-17     supervising and ensuring the provision of mental health services to
2-18     persons with mental illness in the most appropriate and available
2-19     setting to meet individual needs in one or more local service
2-20     areas.
2-21                 (11) [(9)]  "Local mental retardation authority" means
2-22     an entity to which the board delegates its authority and
2-23     responsibility within a specified region for planning, policy
2-24     development, coordination, including coordination with criminal
2-25     justice entities, and resource development and allocation and for
2-26     supervising and ensuring the provision of mental retardation
2-27     services to persons with mental retardation in the most appropriate
 3-1     and available setting to meet individual needs in one or more local
 3-2     service areas.
 3-3                 (12) [(10)]  "Mental health services" includes all
 3-4     services concerned with research, prevention, and detection of
 3-5     mental disorders and disabilities, and all services necessary to
 3-6     treat, care for, control, supervise, and rehabilitate persons who
 3-7     have a mental disorder or disability, including persons whose
 3-8     mental disorders or disabilities result from alcoholism or drug
 3-9     addiction.
3-10                 (13) [(11)]  "Mental retardation services" includes all
3-11     services concerned with research, prevention, and detection of
3-12     mental retardation, and all services related to the education,
3-13     training, habilitation, care, treatment, supervision, and control
3-14     of persons with mental retardation, but does not include the
3-15     education of school-age persons that the public educational system
3-16     is authorized to provide.
3-17                 (14) [(12)]  "Person with mental retardation" means a
3-18     person, other than a person with a mental disorder, whose mental
3-19     deficit requires the person to have special training, education,
3-20     supervision, treatment, care, or control in the person's home or
3-21     community or in a state school.
3-22                 (15) [(13)]  "Priority population" means those groups
3-23     of persons with mental illness or mental retardation identified by
3-24     the department as being most in need of mental health or mental
3-25     retardation services.
3-26                 (16) [(14)]  "Region" means the area within the
3-27     boundaries of the local agencies participating in the operation of
 4-1     community centers established under Subchapter A, Chapter 534.
 4-2                 (17) [(15)]  "State school" means a state-supported and
 4-3     structured residential facility operated by the department to
 4-4     provide to clients with mental retardation a variety of services,
 4-5     including medical treatment, specialized therapy, and training in
 4-6     the acquisition of personal, social, and vocational skills.
 4-7                 [(16)  "Business entity" means a sole proprietorship,
 4-8     partnership, firm, corporation, holding company, joint-stock
 4-9     company, receivership, trust, or any other entity recognized by
4-10     law.]
4-11                 [(17)  "Chemical dependency" has the meaning assigned
4-12     by Section 461.002.]
4-13           SECTION 2. Section 533.014, Health and Safety Code, is
4-14     amended to read as follows:
4-15           Sec. 533.014.  RESPONSIBILITY OF LOCAL MENTAL HEALTH
4-16     AUTHORITIES IN MAKING TREATMENT RECOMMENDATIONS [DESIGNATION OF
4-17     SINGLE PORTAL AUTHORITIES]. (a)  The board shall adopt rules that:
4-18                 (1)  relate to the responsibility of the [designation
4-19     of] local mental health authorities to make recommendations
4-20     relating to the most appropriate and available treatment
4-21     alternatives for individuals in need of mental health services [as
4-22     single portal authorities];
4-23                 (2)  govern commitments to a local mental health
4-24     [single portal] authority;
4-25                 (3)  govern transfers of patients that involve a local
4-26     mental health [single portal] authority; and
4-27                 (4)  provide for emergency admission to a department
 5-1     mental health facility if obtaining approval from the authority
 5-2     could result in a delay that might endanger the patient or others.
 5-3           (b)  The board's first consideration in developing rules
 5-4     under this section must be to satisfy individual patient treatment
 5-5     needs in the most appropriate setting.  The board shall also
 5-6     consider reducing patient inconvenience resulting from admissions
 5-7     and transfers between providers.
 5-8           (c)  The [If the board designates a local mental health
 5-9     authority as a single portal authority, the] department shall
5-10     notify each judge who has probate jurisdiction in the service area
5-11     and any other person the local mental health [single portal]
5-12     authority considers necessary of the responsibility of the local
5-13     mental health authority to make recommendations relating to the
5-14     most appropriate and available treatment alternatives [designation]
5-15     and the [new] procedures required in the area.
5-16           SECTION 3. Sections 533.035(a) and (c), Health and Safety
5-17     Code, are amended to read as follows:
5-18           (a)  The commissioner shall designate a local mental health
5-19     authority and a local mental retardation authority in one or more
5-20     local service areas.  The board may delegate to the local
5-21     authorities the board's authority and responsibility for the
5-22     planning, policy development, coordination, including coordination
5-23     with criminal justice entities, resource allocation, and resource
5-24     development for and oversight of mental health and mental
5-25     retardation services in the most appropriate and available setting
5-26     to meet individual needs in that service area.  The commissioner
5-27     may designate a single entity as the local mental health authority
 6-1     and the local mental retardation authority for a service area.
 6-2           (c)  A local mental health and mental retardation authority,
 6-3     with the department's approval, shall use the funds received under
 6-4     Subsection (b) to ensure mental health, mental retardation, and
 6-5     chemical dependency services are provided in the local service
 6-6     area.  The local authority shall consider public input, ultimate
 6-7     cost-benefit, and client care issues to ensure consumer choice and
 6-8     the best use of public money in:
 6-9                 (1)  assembling a network of service providers;  [and]
6-10                 (2)  determining whether to become a provider of a
6-11     service or to contract that service to another organization; and
6-12                 (3)  making recommendations relating to the most
6-13     appropriate and available treatment alternatives for individuals in
6-14     need of mental health or mental retardation services.
6-15           SECTION 4. Sections 571.003(9) and (11), Health and Safety
6-16     Code, are amended to read as follows:
6-17                 (9)  "Inpatient mental health facility" means a mental
6-18     health facility that can provide 24-hour residential and
6-19     psychiatric services and that is:
6-20                       (A)  a facility operated by the department;
6-21                       (B)  a private mental hospital licensed by the
6-22     Texas Department of Health;
6-23                       (C)  a community center, facility operated by or
6-24     under contract with a community center or other entity the
6-25     department designates to provide mental health services;
6-26                       (D)  a local mental health authority or a
6-27     facility operated by or under contract with a local mental health
 7-1     authority [facility operated by a community center or other entity
 7-2     the department designates to provide mental health services];
 7-3                       (E)  an identifiable part of a general hospital
 7-4     in which diagnosis, treatment, and care for persons with mental
 7-5     illness is provided and that is licensed by the Texas Department of
 7-6     Health; or
 7-7                       (F)  a hospital operated by a federal agency.
 7-8                 (11)  "Local mental ["Mental] health authority" means
 7-9     an entity to which the board delegates its authority and
7-10     responsibility within a specified region for planning, policy
7-11     development, coordination,  including coordination with criminal
7-12     justice entities, and resource development and allocation and for
7-13     supervising and ensuring the provision of mental health services to
7-14     persons with mental illness in the most appropriate and available
7-15     setting to meet individual needs in one or more local service areas
7-16     [agency designated by the commissioner to direct, operate,
7-17     facilitate, or coordinate services for persons with mental illness
7-18     in a service area].
7-19           SECTION 5. Section 573.001(d), Health and Safety Code, is
7-20     amended to read as follows:
7-21           (d)  A peace officer who takes a person into custody under
7-22     Subsection (a) shall immediately transport the apprehended person
7-23     to:
7-24                 (1)  the nearest appropriate inpatient mental health
7-25     facility; or
7-26                 (2)  a mental health facility deemed suitable by the
7-27     local [county's] mental health authority, if an appropriate
 8-1     inpatient mental health facility is not available.
 8-2           SECTION 6. Section 573.012(e), Health and Safety Code, is
 8-3     amended to read as follows:
 8-4           (e)  A person apprehended under this section shall be
 8-5     transported for a preliminary examination in accordance with
 8-6     Section 573.021 to:
 8-7                 (1)  the nearest appropriate inpatient mental health
 8-8     facility; or
 8-9                 (2)  a mental health facility deemed suitable by the
8-10     local [county's] mental health authority, if an appropriate
8-11     inpatient mental health facility is not available.
8-12           SECTION 7. Section 573.022(b), Health and Safety Code, is
8-13     amended to read as follows:
8-14           (b)  A [county] mental health facility that has admitted a
8-15     person for emergency detention under this section may transport the
8-16     person to [:]
8-17                 [(1)  a facility of the single portal authority for the
8-18     area;]
8-19                 [(2)  an appropriate inpatient mental health facility,
8-20     if no single portal authority serves the area; or]
8-21                 [(3)]  a mental health facility deemed suitable by the
8-22     local [county's] mental health authority for the area.  On the
8-23     request of the local mental health authority, the judge may order
8-24     that the proposed patient be detained in a department mental health
8-25     facility [, if no single portal authority serves the area and an
8-26     appropriate inpatient mental health facility is not available].
8-27           SECTION 8. Section 574.012, Health and Safety Code, is
 9-1     amended to read as follows:
 9-2           Sec. 574.012.  RECOMMENDATION FOR TREATMENT. (a)  The local
 9-3     mental health authority [commissioner shall designate a facility or
 9-4     provider] in the county in which an application is filed shall [to]
 9-5     file with the court a recommendation for the most appropriate
 9-6     treatment alternative for the proposed patient.
 9-7           (b)  [The facility or provider that is designated must be:]
 9-8                 [(1)  the single portal authority for the county; or]
 9-9                 [(2)  a community center or any other appropriate
9-10     facility or provider in the county if the county is not served by a
9-11     single portal authority.]
9-12           [(c)]  The court shall direct the local mental health
9-13     authority [designated entity] to file, before the date set for the
9-14     hearing, its recommendation for the proposed patient's treatment.
9-15           (c) [(d)]  If outpatient treatment is recommended, the local
9-16     mental health authority [entity] will also file a statement as to
9-17     whether the proposed mental health services are available [through:]
9-18                 [(1)  the local mental health authority because:]
9-19                       [(A)  the proposed patient is a member of a
9-20     priority population identified for those mental health services in
9-21     the department's long-range plan; and]
9-22                       [(B)  that sufficient resources to provide the
9-23     necessary services are available; and]
9-24                 [(2)  another mental health services provider and that
9-25     sufficient resources to provide the necessary services are
9-26     available].
9-27           (d) [(e)]  The hearing on an application may not be held
 10-1    before the recommendation for treatment is filed unless the court
 10-2    determines that an emergency exists.
 10-3          (e) [(f)]  This section does not relieve a county of its
 10-4    responsibility under other provisions of this subtitle to diagnose,
 10-5    care for, or treat persons with mental illness.
 10-6          (f) [(g)]  This section does not apply to a person for whom
 10-7    treatment in a private mental health facility is proposed.
 10-8          SECTION 9. Section 574.023, Health and Safety Code, is
 10-9    amended to read as follows:   
10-10          Sec. 574.023.  APPREHENSION UNDER ORDER. (a)  A protective
10-11    custody order shall direct a person authorized to transport
10-12    patients under Section 574.045 to take the proposed patient into
10-13    protective custody and transport the person immediately to[:]
10-14                [(1)  a facility of the single portal authority for the
10-15    area;]
10-16                [(2)  an appropriate inpatient mental health facility,
10-17    if no single portal authority serves the area; or]
10-18                [(3)]  a mental health facility deemed suitable by the
10-19    local [county's] mental health authority for the area.  On request
10-20    of the local mental health authority, the judge may order that the
10-21    proposed patient be detained in an inpatient mental health facility
10-22    operated by the department [, if no single portal authority serves
10-23    the area and an appropriate inpatient mental health facility is not
10-24    available].
10-25          (b)  The proposed patient shall be detained in the facility
10-26    until a hearing is held under Section 574.025.
10-27          (c)  [If a single portal authority lacks the local resources
 11-1    to care for a proposed patient, the authority shall transfer the
 11-2    proposed patient to a state hospital or, on the request of the
 11-3    authority, the judge may order that the proposed patient be
 11-4    detained in a state hospital.]
 11-5          [(d)]  A facility must comply with this section only to the
 11-6    extent that the commissioner determines that the facility has
 11-7    sufficient resources to perform the necessary services.
 11-8          (d) [(e)]  A person may not be detained in a private mental
 11-9    health facility without the consent of the facility administrator.
11-10          SECTION 10. Section 574.027(a), Health and Safety Code, is
11-11    amended to read as follows:
11-12          (a)  A person under a protective custody order shall be
11-13    detained in[:]
11-14                [(1)  a facility of the single portal authority for the
11-15    area;]
11-16                [(2)  an appropriate inpatient mental health facility,
11-17    if no single portal authority serves the area; or]
11-18                [(3)]  a mental health facility deemed suitable by the
11-19    local [county's] mental health authority for the area.  On request
11-20    of the local mental health authority, the judge may order that the
11-21    proposed patient be detained in an inpatient mental health facility
11-22    operated by the department [, if no single portal authority serves
11-23    the area and an appropriate inpatient mental health facility is not
11-24    available].
11-25          SECTION 11. Section 574.041, Health and Safety Code, is
11-26    amended to read as follows:
11-27          Sec. 574.041.  DESIGNATION OF FACILITY. (a)  In an order for
 12-1    temporary or extended mental health services specifying inpatient
 12-2    care, the court shall commit the patient to a designated inpatient
 12-3    mental health facility.  The court shall commit the patient to:
 12-4                (1)  a mental health facility deemed suitable by the
 12-5    local mental health [of a single portal] authority for the area[,
 12-6    if an authority has been designated for the area];
 12-7                (2)  a private mental hospital under Section 574.042;
 12-8                (3)  a hospital operated by a federal agency under
 12-9    Section 574.043; or
12-10                (4)  an inpatient mental health facility of the
12-11    institutional division of the Texas Department of Criminal Justice
12-12    under Section 574.044.
12-13          (b)  On [If a single portal authority lacks the local
12-14    resources to care for a patient, the authority shall transfer the
12-15    patient to a state mental hospital or, on the] request of the local
12-16    mental health authority, the judge may commit the patient directly
12-17    to an inpatient mental health facility operated by the department
12-18    [a state mental hospital].
12-19          (c)  A court may not commit a patient to an inpatient mental
12-20    health facility operated by a community center or other entity
12-21    designated by the department to provide mental health services
12-22    unless the facility is licensed under Chapter 577 and the court
12-23    notifies the local mental health authority serving the region in
12-24    which the commitment is made.
12-25          [(d)  In this section, "facility of a single portal
12-26    authority" includes a private mental hospital under contract with a
12-27    single portal authority.]
 13-1          SECTION 12. Section 574.043(c), Health and Safety Code, is
 13-2    amended to read as follows:
 13-3          (c)  The hospital administrator has the same authority and
 13-4    responsibility with respect to the patient as the facility
 13-5    [hospital] administrator of an inpatient mental health facility
 13-6    operated by the department [a state mental hospital].
 13-7          SECTION 13. Section 574.064(a), Health and Safety Code, is
 13-8    amended to read as follows:
 13-9          (a)  A temporary detention order shall direct a peace officer
13-10    or other designated person to take the patient into custody and
13-11    transport the patient immediately to:
13-12                (1)  the nearest appropriate inpatient mental health
13-13    facility; or
13-14                (2)  a mental health facility deemed suitable by the
13-15    local [county's] mental health authority for the area, if an
13-16    appropriate inpatient mental health facility is not available.
13-17          SECTION 14. Section 574.081(b), Health and Safety Code, is
13-18    amended to read as follows:
13-19          (b)  The physician shall prepare the plan as prescribed by
13-20    department rules and shall consult the patient and the local mental
13-21    health authority in the area in which the patient will reside
13-22    before preparing the plan.  The local mental health authority is
13-23    not required to participate in preparing a plan for a patient
13-24    furloughed or discharged from a private mental health facility.
13-25          SECTION 15. Section 574.083(g), Health and Safety Code, is
13-26    amended to read as follows:
13-27          (g)  The local mental [county] health authority shall ensure
 14-1    that a patient detained in a nonmedical facility under Subsection
 14-2    (f) receives proper care and medical attention.
 14-3          SECTION 16. Section 575.011, Health and Safety Code, is
 14-4    amended to read as follows:
 14-5          Sec. 575.011.  TRANSFER TO DEPARTMENT MENTAL HEALTH FACILITY
 14-6    [STATE MENTAL HOSPITAL] OR LOCAL MENTAL HEALTH [SINGLE PORTAL]
 14-7    AUTHORITY. (a)  The department may transfer a patient, if the
 14-8    transfer is considered advisable, from an inpatient mental health
 14-9    facility operated by the department [a state mental hospital] to:
14-10                (1)  another inpatient mental health facility operated
14-11    by the department [state mental hospital]; or
14-12                (2)  a mental health facility deemed suitable by the
14-13    local mental health [of a single portal] authority if the authority
14-14    consents.
14-15          (b)  A local mental health [single portal] authority may
14-16    transfer a patient from one authority facility to another if the
14-17    transfer is considered advisable.
14-18          (c)  A voluntary patient may not be transferred under
14-19    Subsection (a)  or (b) without the patient's consent.
14-20          (d)  The facility administrator of an inpatient mental health
14-21    facility may, for any reason, transfer an involuntary patient to[:]
14-22                [(1)]  a mental health facility deemed suitable by the
14-23    local mental health [of a single portal] authority for the area[;
14-24    or]
14-25                [(2)  a state mental hospital designated by the
14-26    department if there is no designated single portal authority for
14-27    the area].
 15-1          (e)  The facility administrator shall notify the committing
 15-2    court and the local mental health [single portal] authority [or
 15-3    department, as appropriate,] before transferring a patient under
 15-4    Subsection (d).
 15-5          SECTION 17. Section 575.012, Health and Safety Code, is
 15-6    amended to read as follows:
 15-7          Sec. 575.012.  TRANSFER OF PERSON WITH MENTAL RETARDATION TO
 15-8    AN INPATIENT MENTAL HEALTH FACILITY OPERATED BY THE DEPARTMENT
 15-9    [STATE HOSPITAL]. (a)  An inpatient mental health facility may not
15-10    transfer a patient who is also a person with mental retardation to
15-11    a department mental health facility unless, before initiating the
15-12    transfer, the facility administrator of the inpatient mental health
15-13    facility obtains from the commissioner a determination that space
15-14    is available in a department facility unit that is specifically
15-15    designed to serve such a person.
15-16          (b)  The department shall maintain an appropriate number of
15-17    hospital-level beds for persons with mental retardation who are
15-18    committed for court-ordered mental health services to meet the
15-19    needs of the local mental health [single portal] authorities.  The
15-20    number of beds the department maintains must be determined
15-21    according to the previous year's need.
15-22          SECTION 18. Sections 575.013(a) and (b), Health and Safety
15-23    Code, are amended to read as follows:
15-24          (a)  The facility [hospital] administrator of an inpatient
15-25    mental health facility operated by the department [a state mental
15-26    hospital] may transfer an involuntary patient in the facility
15-27    [hospital] to a state school for persons with mental retardation if
 16-1    an examination of the patient indicates that the patient has
 16-2    symptoms of mental retardation to the extent that training,
 16-3    education, rehabilitation, care, treatment, and supervision in a
 16-4    state school are in the patient's best interest.
 16-5          (b)  A certificate containing the diagnosis and the facility
 16-6    [hospital] administrator's recommendation of transfer to a specific
 16-7    state school shall be furnished to the committing court.
 16-8          SECTION 19. Sections 571.003(22) and 574.027(e), Health and
 16-9    Safety Code, are repealed.
16-10          SECTION 20.  This Act takes effect September 1, 2001.