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
1-25 subtitle.
2-1 (8) [(6)] "ICF-MR" means the medical assistance
2-2 program serving persons with mental retardation who receive care in
2-3 intermediate care facilities.
2-4 (9) [(7)] "Local agency" means:
2-5 (A) a municipality, county, hospital district,
2-6 rehabilitation district, school district, state-supported
2-7 institution of higher education, or state-supported medical school;
2-8 or
2-9 (B) any organizational combination of two or
2-10 more of those entities.
2-11 (10) [(8)] "Local mental health authority" means an
2-12 entity to which the board delegates its authority and
2-13 responsibility within a specified region for planning, policy
2-14 development, coordination, including coordination with criminal
2-15 justice entities, and resource development and allocation and for
2-16 supervising and ensuring the provision of mental health services to
2-17 persons with mental illness in the most appropriate and available
2-18 setting to meet individual needs in one or more local service
2-19 areas.
2-20 (11) [(9)] "Local mental retardation authority" means
2-21 an entity to which the board delegates its authority and
2-22 responsibility within a specified region for planning, policy
2-23 development, coordination, including coordination with criminal
2-24 justice entities, and resource development and allocation and for
2-25 supervising and ensuring the provision of mental retardation
2-26 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
4-1 boundaries of the local agencies participating in the operation of
4-2 community centers established under Subchapter A, Chapter 534.
4-3 (17) [(15)] "State school" means a state-supported and
4-4 structured residential facility operated by the department to
4-5 provide to clients with mental retardation a variety of services,
4-6 including medical treatment, specialized therapy, and training in
4-7 the acquisition of personal, social, and vocational skills.
4-8 [(16) "Business entity" means a sole proprietorship,
4-9 partnership, firm, corporation, holding company, joint-stock
4-10 company, receivership, trust, or any other entity recognized by
4-11 law.]
4-12 [(17) "Chemical dependency" has the meaning assigned
4-13 by Section 461.002.]
4-14 SECTION 2. Section 533.014, Health and Safety Code, is
4-15 amended to read as follows:
4-16 Sec. 533.014. RESPONSIBILITY OF LOCAL MENTAL HEALTH
4-17 AUTHORITIES IN MAKING TREATMENT RECOMMENDATIONS [DESIGNATION OF
4-18 SINGLE PORTAL AUTHORITIES]. (a) The board shall adopt rules that:
4-19 (1) relate to the responsibility of the [designation
4-20 of] local mental health authorities to make recommendations
4-21 relating to the most appropriate and available treatment
4-22 alternatives for individuals in need of mental health services [as
4-23 single portal authorities];
4-24 (2) govern commitments to a local mental health
4-25 [single portal] authority;
4-26 (3) govern transfers of patients that involve a local
5-1 mental health [single portal] authority; and
5-2 (4) provide for emergency admission to a department
5-3 mental health facility if obtaining approval from the authority
5-4 could result in a delay that might endanger the patient or others.
5-5 (b) The board's first consideration in developing rules
5-6 under this section must be to satisfy individual patient treatment
5-7 needs in the most appropriate setting. The board shall also
5-8 consider reducing patient inconvenience resulting from admissions
5-9 and transfers between providers.
5-10 (c) The [If the board designates a local mental health
5-11 authority as a single portal authority, the] department shall
5-12 notify each judge who has probate jurisdiction in the service area
5-13 and any other person the local mental health [single portal]
5-14 authority considers necessary of the responsibility of the local
5-15 mental health authority to make recommendations relating to the
5-16 most appropriate and available treatment alternatives [designation]
5-17 and the [new] procedures required in the area.
5-18 SECTION 3. Subsections (a) and (c), Section 533.035, Health
5-19 and Safety Code, are amended to read as follows:
5-20 (a) The commissioner shall designate a local mental health
5-21 authority and a local mental retardation authority in one or more
5-22 local service areas. The board may delegate to the local
5-23 authorities the board's authority and responsibility for the
5-24 planning, policy development, coordination, including coordination
5-25 with criminal justice entities, resource allocation, and resource
5-26 development for and oversight of mental health and mental
6-1 retardation services in the most appropriate and available setting
6-2 to meet individual needs in that service area. The commissioner
6-3 may designate a single entity as the local mental health authority
6-4 and the local mental retardation authority for a service area.
6-5 (c) A local mental health and mental retardation authority,
6-6 with the department's approval, shall use the funds received under
6-7 Subsection (b) to ensure mental health, mental retardation, and
6-8 chemical dependency services are provided in the local service
6-9 area. The local authority shall consider public input, ultimate
6-10 cost-benefit, and client care issues to ensure consumer choice and
6-11 the best use of public money in:
6-12 (1) assembling a network of service providers; [and]
6-13 (2) determining whether to become a provider of a
6-14 service or to contract that service to another organization; and
6-15 (3) making recommendations relating to the most
6-16 appropriate and available treatment alternatives for individuals in
6-17 need of mental health or mental retardation services.
6-18 SECTION 4. Subdivisions (9) and (11), Section 571.003,
6-19 Health and Safety Code, are amended to read as follows:
6-20 (9) "Inpatient mental health facility" means a mental
6-21 health facility that can provide 24-hour residential and
6-22 psychiatric services and that is:
6-23 (A) a facility operated by the department;
6-24 (B) a private mental hospital licensed by the
6-25 Texas Department of Health;
6-26 (C) a community center, facility operated by or
7-1 under contract with a community center or other entity the
7-2 department designates to provide mental health services;
7-3 (D) a local mental health authority or a
7-4 facility operated by or under contract with a local mental health
7-5 authority [facility operated by a community center or other entity
7-6 the department designates to provide mental health services];
7-7 (E) an identifiable part of a general hospital
7-8 in which diagnosis, treatment, and care for persons with mental
7-9 illness is provided and that is licensed by the Texas Department of
7-10 Health; or
7-11 (F) a hospital operated by a federal agency.
7-12 (11) "Local mental ["Mental] health authority" means
7-13 an entity to which the board delegates its authority and
7-14 responsibility within a specified region for planning, policy
7-15 development, coordination, including coordination with criminal
7-16 justice entities, and resource development and allocation and for
7-17 supervising and ensuring the provision of mental health services to
7-18 persons with mental illness in the most appropriate and available
7-19 setting to meet individual needs in one or more local service areas
7-20 [agency designated by the commissioner to direct, operate,
7-21 facilitate, or coordinate services for persons with mental illness
7-22 in a service area].
7-23 SECTION 5. Subsection (d), Section 573.001, Health and
7-24 Safety Code, is amended to read as follows:
7-25 (d) A peace officer who takes a person into custody under
7-26 Subsection (a) shall immediately transport the apprehended person
8-1 to:
8-2 (1) the nearest appropriate inpatient mental health
8-3 facility; or
8-4 (2) a mental health facility deemed suitable by the
8-5 local [county's] mental health authority, if an appropriate
8-6 inpatient mental health facility is not available.
8-7 SECTION 6. Subsection (e), Section 573.012, Health and
8-8 Safety Code, is amended to read as follows:
8-9 (e) A person apprehended under this section shall be
8-10 transported for a preliminary examination in accordance with
8-11 Section 573.021 to:
8-12 (1) the nearest appropriate inpatient mental health
8-13 facility; or
8-14 (2) a mental health facility deemed suitable by the
8-15 local [county's] mental health authority, if an appropriate
8-16 inpatient mental health facility is not available.
8-17 SECTION 7. Subsection (b), Section 573.022, Health and
8-18 Safety Code, is amended to read as follows:
8-19 (b) A [county] mental health facility that has admitted a
8-20 person for emergency detention under this section may transport the
8-21 person to[:]
8-22 [(1) a facility of the single portal authority for the
8-23 area;]
8-24 [(2) an appropriate inpatient mental health facility,
8-25 if no single portal authority serves the area; or]
8-26 [(3)] a mental health facility deemed suitable by the
9-1 local [county's] mental health authority for the area. On the
9-2 request of the local mental health authority, the judge may order
9-3 that the proposed patient be detained in a department mental health
9-4 facility[, if no single portal authority serves the area and an
9-5 appropriate inpatient mental health facility is not available].
9-6 SECTION 8. Section 574.012, Health and Safety Code, is
9-7 amended to read as follows:
9-8 Sec. 574.012. RECOMMENDATION FOR TREATMENT. (a) The local
9-9 mental health authority [commissioner shall designate a facility or
9-10 provider] in the county in which an application is filed shall [to]
9-11 file with the court a recommendation for the most appropriate
9-12 treatment alternative for the proposed patient.
9-13 (b) [The facility or provider that is designated must be:]
9-14 [(1) the single portal authority for the county; or]
9-15 [(2) a community center or any other appropriate
9-16 facility or provider in the county if the county is not served by a
9-17 single portal authority.]
9-18 [(c)] The court shall direct the local mental health
9-19 authority [designated entity] to file, before the date set for the
9-20 hearing, its recommendation for the proposed patient's treatment.
9-21 (c) [(d)] If outpatient treatment is recommended, the local
9-22 mental health authority [entity] will also file a statement as to
9-23 whether the proposed mental health services are available [through:]
9-24 [(1) the local mental health authority because:]
9-25 [(A) the proposed patient is a member of a
9-26 priority population identified for those mental health services in
10-1 the department's long-range plan; and]
10-2 [(B) that sufficient resources to provide the
10-3 necessary services are available; and]
10-4 [(2) another mental health services provider and that
10-5 sufficient resources to provide the necessary services are
10-6 available].
10-7 (d) [(e)] The hearing on an application may not be held
10-8 before the recommendation for treatment is filed unless the court
10-9 determines that an emergency exists.
10-10 (e) [(f)] This section does not relieve a county of its
10-11 responsibility under other provisions of this subtitle to diagnose,
10-12 care for, or treat persons with mental illness.
10-13 (f) [(g)] This section does not apply to a person for whom
10-14 treatment in a private mental health facility is proposed.
10-15 SECTION 9. Section 574.023, Health and Safety Code, is
10-16 amended to read as follows:
10-17 Sec. 574.023. APPREHENSION UNDER ORDER. (a) A protective
10-18 custody order shall direct a person authorized to transport
10-19 patients under Section 574.045 to take the proposed patient into
10-20 protective custody and transport the person immediately to[:]
10-21 [(1) a facility of the single portal authority for the
10-22 area;]
10-23 [(2) an appropriate inpatient mental health facility,
10-24 if no single portal authority serves the area; or]
10-25 [(3)] a mental health facility deemed suitable by the
10-26 local [county's] mental health authority for the area. On request
11-1 of the local mental health authority, the judge may order that the
11-2 proposed patient be detained in an inpatient mental health facility
11-3 operated by the department[, if no single portal authority serves
11-4 the area and an appropriate inpatient mental health facility is not
11-5 available].
11-6 (b) The proposed patient shall be detained in the facility
11-7 until a hearing is held under Section 574.025.
11-8 (c) [If a single portal authority lacks the local resources
11-9 to care for a proposed patient, the authority shall transfer the
11-10 proposed patient to a state hospital or, on the request of the
11-11 authority, the judge may order that the proposed patient be
11-12 detained in a state hospital.]
11-13 [(d)] A facility must comply with this section only to the
11-14 extent that the commissioner determines that the facility has
11-15 sufficient resources to perform the necessary services.
11-16 (d) [(e)] A person may not be detained in a private mental
11-17 health facility without the consent of the facility administrator.
11-18 SECTION 10. Subsection (a), Section 574.027, Health and
11-19 Safety Code, is amended to read as follows:
11-20 (a) A person under a protective custody order shall be
11-21 detained in[:]
11-22 [(1) a facility of the single portal authority for the
11-23 area;]
11-24 [(2) an appropriate inpatient mental health facility,
11-25 if no single portal authority serves the area; or]
11-26 [(3)] a mental health facility deemed suitable by the
12-1 local [county's] mental health authority for the area. On request
12-2 of the local mental health authority, the judge may order that the
12-3 proposed patient be detained in an inpatient mental health facility
12-4 operated by the department[, if no single portal authority serves
12-5 the area and an appropriate inpatient mental health facility is not
12-6 available].
12-7 SECTION 11. Section 574.041, Health and Safety Code, is
12-8 amended to read as follows:
12-9 Sec. 574.041. DESIGNATION OF FACILITY. (a) In an order for
12-10 temporary or extended mental health services specifying inpatient
12-11 care, the court shall commit the patient to a designated inpatient
12-12 mental health facility. The court shall commit the patient to:
12-13 (1) a mental health facility deemed suitable by the
12-14 local mental health [of a single portal] authority for the area[,
12-15 if an authority has been designated for the area];
12-16 (2) a private mental hospital under Section 574.042;
12-17 (3) a hospital operated by a federal agency under
12-18 Section 574.043; or
12-19 (4) an inpatient mental health facility of the
12-20 institutional division of the Texas Department of Criminal Justice
12-21 under Section 574.044.
12-22 (b) On [If a single portal authority lacks the local
12-23 resources to care for a patient, the authority shall transfer the
12-24 patient to a state mental hospital or, on the] request of the local
12-25 mental health authority, the judge may commit the patient directly
12-26 to an inpatient mental health facility operated by the department
13-1 [a state mental hospital].
13-2 (c) A court may not commit a patient to an inpatient mental
13-3 health facility operated by a community center or other entity
13-4 designated by the department to provide mental health services
13-5 unless the facility is licensed under Chapter 577 and the court
13-6 notifies the local mental health authority serving the region in
13-7 which the commitment is made.
13-8 [(d) In this section, "facility of a single portal
13-9 authority" includes a private mental hospital under contract with a
13-10 single portal authority.]
13-11 SECTION 12. Subsection (c), Section 574.043, Health and
13-12 Safety Code, is amended to read as follows:
13-13 (c) The hospital administrator has the same authority and
13-14 responsibility with respect to the patient as the facility
13-15 [hospital] administrator of an inpatient mental health facility
13-16 operated by the department [a state mental hospital].
13-17 SECTION 13. Subsection (a), Section 574.064, Health and
13-18 Safety Code, is amended to read as follows:
13-19 (a) A temporary detention order shall direct a peace officer
13-20 or other designated person to take the patient into custody and
13-21 transport the patient immediately to:
13-22 (1) the nearest appropriate inpatient mental health
13-23 facility; or
13-24 (2) a mental health facility deemed suitable by the
13-25 local [county's] mental health authority for the area, if an
13-26 appropriate inpatient mental health facility is not available.
14-1 SECTION 14. Subsection (b), Section 574.081, Health and
14-2 Safety Code, is amended to read as follows:
14-3 (b) The physician shall prepare the plan as prescribed by
14-4 department rules and shall consult the patient and the local mental
14-5 health authority in the area in which the patient will reside
14-6 before preparing the plan. The local mental health authority is
14-7 not required to participate in preparing a plan for a patient
14-8 furloughed or discharged from a private mental health facility.
14-9 SECTION 15. Subsection (g), Section 574.083, Health and
14-10 Safety Code, is amended to read as follows:
14-11 (g) The local mental [county] health authority shall ensure
14-12 that a patient detained in a nonmedical facility under Subsection
14-13 (f) receives proper care and medical attention.
14-14 SECTION 16. Section 575.011, Health and Safety Code, is
14-15 amended to read as follows:
14-16 Sec. 575.011. TRANSFER TO DEPARTMENT MENTAL HEALTH FACILITY
14-17 [STATE MENTAL HOSPITAL] OR LOCAL MENTAL HEALTH [SINGLE PORTAL]
14-18 AUTHORITY. (a) The department may transfer a patient, if the
14-19 transfer is considered advisable, from an inpatient mental health
14-20 facility operated by the department [a state mental hospital] to:
14-21 (1) another inpatient mental health facility operated
14-22 by the department [state mental hospital]; or
14-23 (2) a mental health facility deemed suitable by the
14-24 local mental health [of a single portal] authority if the authority
14-25 consents.
14-26 (b) A local mental health [single portal] authority may
15-1 transfer a patient from one authority facility to another if the
15-2 transfer is considered advisable.
15-3 (c) A voluntary patient may not be transferred under
15-4 Subsection (a) or (b) without the patient's consent.
15-5 (d) The facility administrator of an inpatient mental health
15-6 facility may, for any reason, transfer an involuntary patient to[:]
15-7 [(1)] a mental health facility deemed suitable by the
15-8 local mental health [of a single portal] authority for the area[;
15-9 or]
15-10 [(2) a state mental hospital designated by the
15-11 department if there is no designated single portal authority for
15-12 the area].
15-13 (e) The facility administrator shall notify the committing
15-14 court and the local mental health [single portal] authority [or
15-15 department, as appropriate,] before transferring a patient under
15-16 Subsection (d).
15-17 SECTION 17. Section 575.012, Health and Safety Code, is
15-18 amended to read as follows:
15-19 Sec. 575.012. TRANSFER OF PERSON WITH MENTAL RETARDATION TO
15-20 AN INPATIENT MENTAL HEALTH FACILITY OPERATED BY THE DEPARTMENT
15-21 [STATE HOSPITAL]. (a) An inpatient mental health facility may not
15-22 transfer a patient who is also a person with mental retardation to
15-23 a department mental health facility unless, before initiating the
15-24 transfer, the facility administrator of the inpatient mental health
15-25 facility obtains from the commissioner a determination that space
15-26 is available in a department facility unit that is specifically
16-1 designed to serve such a person.
16-2 (b) The department shall maintain an appropriate number of
16-3 hospital-level beds for persons with mental retardation who are
16-4 committed for court-ordered mental health services to meet the
16-5 needs of the local mental health [single portal] authorities. The
16-6 number of beds the department maintains must be determined
16-7 according to the previous year's need.
16-8 SECTION 18. Subsections (a) and (b), Section 575.013, Health
16-9 and Safety Code, are amended to read as follows:
16-10 (a) The facility [hospital] administrator of an inpatient
16-11 mental health facility operated by the department [a state mental
16-12 hospital] may transfer an involuntary patient in the facility
16-13 [hospital] to a state school for persons with mental retardation if
16-14 an examination of the patient indicates that the patient has
16-15 symptoms of mental retardation to the extent that training,
16-16 education, rehabilitation, care, treatment, and supervision in a
16-17 state school are in the patient's best interest.
16-18 (b) A certificate containing the diagnosis and the facility
16-19 [hospital] administrator's recommendation of transfer to a specific
16-20 state school shall be furnished to the committing court.
16-21 SECTION 19. Subdivision (22), Section 571.003, and
16-22 Subsection (e), Section 574.027, Health and Safety Code, are
16-23 repealed.
16-24 SECTION 20. This Act takes effect September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 1386 passed the Senate on
April 26, 2001, by the following vote: Yeas 30, Nays 0, one
present, not voting.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 1386 passed the House on
May 11, 2001, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor