1-1 By: Armbrister S.B. No. 1386
1-2 (In the Senate - Filed March 8, 2001; March 13, 2001, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 11, 2001, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 6, Nays 0; April 11, 2001,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 1386 By: Gallegos
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the provision of mental health and mental retardation
1-11 services.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Section 531.002, Health and Safety Code, is
1-14 amended to read as follows:
1-15 Sec. 531.002. DEFINITIONS. In this subtitle:
1-16 (1) "Board" means the Texas Board of Mental Health and
1-17 Mental Retardation.
1-18 (2) "Business entity" means a sole proprietorship,
1-19 partnership, firm, corporation, holding company, joint-stock
1-20 company, receivership, trust, or any other entity recognized by
1-21 law.
1-22 (3) "Chemical dependency" has the meaning assigned by
1-23 Section 461.002.
1-24 (4) "Commissioner" means the commissioner of mental
1-25 health and mental retardation.
1-26 (5) [(3)] "Community center" means a center
1-27 established under Subchapter A, Chapter 534.
1-28 (6) [(4)] "Department" means the Texas Department of
1-29 Mental Health and Mental Retardation.
1-30 (7) [(5)] "Effective administration" includes
1-31 continuous planning and evaluation within the system that result in
1-32 more efficient fulfillment of the purposes and policies of this
1-33 subtitle.
1-34 (8) [(6)] "ICF-MR" means the medical assistance
1-35 program serving persons with mental retardation who receive care in
1-36 intermediate care facilities.
1-37 (9) [(7)] "Local agency" means:
1-38 (A) a municipality, county, hospital district,
1-39 rehabilitation district, school district, state-supported
1-40 institution of higher education, or state-supported medical school;
1-41 or
1-42 (B) any organizational combination of two or
1-43 more of those entities.
1-44 (10) [(8)] "Local mental health authority" means an
1-45 entity to which the board delegates its authority and
1-46 responsibility within a specified region for planning, policy
1-47 development, coordination, including coordination with criminal
1-48 justice entities, and resource development and allocation and for
1-49 supervising and ensuring the provision of mental health services to
1-50 persons with mental illness in the most appropriate and available
1-51 setting to meet individual needs in one or more local service
1-52 areas.
1-53 (11) [(9)] "Local mental retardation authority" means
1-54 an entity to which the board delegates its authority and
1-55 responsibility within a specified region for planning, policy
1-56 development, coordination, including coordination with criminal
1-57 justice entities, and resource development and allocation and for
1-58 supervising and ensuring the provision of mental retardation
1-59 services to persons with mental retardation in the most appropriate
1-60 and available setting to meet individual needs in one or more local
1-61 service areas.
1-62 (12) [(10)] "Mental health services" includes all
1-63 services concerned with research, prevention, and detection of
1-64 mental disorders and disabilities, and all services necessary to
2-1 treat, care for, control, supervise, and rehabilitate persons who
2-2 have a mental disorder or disability, including persons whose
2-3 mental disorders or disabilities result from alcoholism or drug
2-4 addiction.
2-5 (13) [(11)] "Mental retardation services" includes all
2-6 services concerned with research, prevention, and detection of
2-7 mental retardation, and all services related to the education,
2-8 training, habilitation, care, treatment, supervision, and control
2-9 of persons with mental retardation, but does not include the
2-10 education of school-age persons that the public educational system
2-11 is authorized to provide.
2-12 (14) [(12)] "Person with mental retardation" means a
2-13 person, other than a person with a mental disorder, whose mental
2-14 deficit requires the person to have special training, education,
2-15 supervision, treatment, care, or control in the person's home or
2-16 community or in a state school.
2-17 (15) [(13)] "Priority population" means those groups
2-18 of persons with mental illness or mental retardation identified by
2-19 the department as being most in need of mental health or mental
2-20 retardation services.
2-21 (16) [(14)] "Region" means the area within the
2-22 boundaries of the local agencies participating in the operation of
2-23 community centers established under Subchapter A, Chapter 534.
2-24 (17) [(15)] "State school" means a state-supported and
2-25 structured residential facility operated by the department to
2-26 provide to clients with mental retardation a variety of services,
2-27 including medical treatment, specialized therapy, and training in
2-28 the acquisition of personal, social, and vocational skills.
2-29 [(16) "Business entity" means a sole proprietorship,
2-30 partnership, firm, corporation, holding company, joint-stock
2-31 company, receivership, trust, or any other entity recognized by
2-32 law.]
2-33 [(17) "Chemical dependency" has the meaning assigned
2-34 by Section 461.002.]
2-35 SECTION 2. Section 533.014, Health and Safety Code, is
2-36 amended to read as follows:
2-37 Sec. 533.014. RESPONSIBILITY OF LOCAL MENTAL HEALTH
2-38 AUTHORITIES IN MAKING TREATMENT RECOMMENDATIONS [DESIGNATION OF
2-39 SINGLE PORTAL AUTHORITIES]. (a) The board shall adopt rules that:
2-40 (1) relate to the responsibility of the [designation
2-41 of] local mental health authorities to make recommendations
2-42 relating to the most appropriate and available treatment
2-43 alternatives for individuals in need of mental health services [as
2-44 single portal authorities];
2-45 (2) govern commitments to a local mental health
2-46 [single portal] authority;
2-47 (3) govern transfers of patients that involve a local
2-48 mental health [single portal] authority; and
2-49 (4) provide for emergency admission to a department
2-50 mental health facility if obtaining approval from the authority
2-51 could result in a delay that might endanger the patient or others.
2-52 (b) The board's first consideration in developing rules
2-53 under this section must be to satisfy individual patient treatment
2-54 needs in the most appropriate setting. The board shall also
2-55 consider reducing patient inconvenience resulting from admissions
2-56 and transfers between providers.
2-57 (c) The [If the board designates a local mental health
2-58 authority as a single portal authority, the] department shall
2-59 notify each judge who has probate jurisdiction in the service area
2-60 and any other person the local mental health [single portal]
2-61 authority considers necessary of the responsibility of the local
2-62 mental health authority to make recommendations relating to the
2-63 most appropriate and available treatment alternatives [designation]
2-64 and the [new] procedures required in the area.
2-65 SECTION 3. Subsections (a) and (c), Section 533.035, Health
2-66 and Safety Code, are amended to read as follows:
2-67 (a) The commissioner shall designate a local mental health
2-68 authority and a local mental retardation authority in one or more
2-69 local service areas. The board may delegate to the local
3-1 authorities the board's authority and responsibility for the
3-2 planning, policy development, coordination, including coordination
3-3 with criminal justice entities, resource allocation, and resource
3-4 development for and oversight of mental health and mental
3-5 retardation services in the most appropriate and available setting
3-6 to meet individual needs in that service area. The commissioner
3-7 may designate a single entity as the local mental health authority
3-8 and the local mental retardation authority for a service area.
3-9 (c) A local mental health and mental retardation authority,
3-10 with the department's approval, shall use the funds received under
3-11 Subsection (b) to ensure mental health, mental retardation, and
3-12 chemical dependency services are provided in the local service
3-13 area. The local authority shall consider public input, ultimate
3-14 cost-benefit, and client care issues to ensure consumer choice and
3-15 the best use of public money in:
3-16 (1) assembling a network of service providers; [and]
3-17 (2) determining whether to become a provider of a
3-18 service or to contract that service to another organization; and
3-19 (3) making recommendations relating to the most
3-20 appropriate and available treatment alternatives for individuals in
3-21 need of mental health or mental retardation services.
3-22 SECTION 4. Subdivisions (9) and (11), Section 571.003,
3-23 Health and Safety Code, are amended to read as follows:
3-24 (9) "Inpatient mental health facility" means a mental
3-25 health facility that can provide 24-hour residential and
3-26 psychiatric services and that is:
3-27 (A) a facility operated by the department;
3-28 (B) a private mental hospital licensed by the
3-29 Texas Department of Health;
3-30 (C) a community center, facility operated by or
3-31 under contract with a community center or other entity the
3-32 department designates to provide mental health services;
3-33 (D) a local mental health authority or a
3-34 facility operated by or under contract with a local mental health
3-35 authority [facility operated by a community center or other entity
3-36 the department designates to provide mental health services];
3-37 (E) an identifiable part of a general hospital
3-38 in which diagnosis, treatment, and care for persons with mental
3-39 illness is provided and that is licensed by the Texas Department of
3-40 Health; or
3-41 (F) a hospital operated by a federal agency.
3-42 (11) "Local mental ["Mental] health authority" means
3-43 an entity to which the board delegates its authority and
3-44 responsibility within a specified region for planning, policy
3-45 development, coordination, including coordination with criminal
3-46 justice entities, and resource development and allocation and for
3-47 supervising and ensuring the provision of mental health services to
3-48 persons with mental illness in the most appropriate and available
3-49 setting to meet individual needs in one or more local service areas
3-50 [agency designated by the commissioner to direct, operate,
3-51 facilitate, or coordinate services for persons with mental illness
3-52 in a service area].
3-53 SECTION 5. Subsection (d), Section 573.001, Health and
3-54 Safety Code, is amended to read as follows:
3-55 (d) A peace officer who takes a person into custody under
3-56 Subsection (a) shall immediately transport the apprehended person
3-57 to:
3-58 (1) the nearest appropriate inpatient mental health
3-59 facility; or
3-60 (2) a mental health facility deemed suitable by the
3-61 local [county's] mental health authority, if an appropriate
3-62 inpatient mental health facility is not available.
3-63 SECTION 6. Subsection (e), Section 573.012, Health and
3-64 Safety Code, is amended to read as follows:
3-65 (e) A person apprehended under this section shall be
3-66 transported for a preliminary examination in accordance with
3-67 Section 573.021 to:
3-68 (1) the nearest appropriate inpatient mental health
3-69 facility; or
4-1 (2) a mental health facility deemed suitable by the
4-2 local [county's] mental health authority, if an appropriate
4-3 inpatient mental health facility is not available.
4-4 SECTION 7. Subsection (b), Section 573.022, Health and
4-5 Safety Code, is amended to read as follows:
4-6 (b) A [county] mental health facility that has admitted a
4-7 person for emergency detention under this section may transport the
4-8 person to [:]
4-9 [(1) a facility of the single portal authority for the
4-10 area;]
4-11 [(2) an appropriate inpatient mental health facility,
4-12 if no single portal authority serves the area; or]
4-13 [(3)] a mental health facility deemed suitable by the
4-14 local [county's] mental health authority for the area. On the
4-15 request of the local mental health authority, the judge may order
4-16 that the proposed patient be detained in a department mental health
4-17 facility[, if no single portal authority serves the area and an
4-18 appropriate inpatient mental health facility is not available].
4-19 SECTION 8. Section 574.012, Health and Safety Code, is
4-20 amended to read as follows:
4-21 Sec. 574.012. RECOMMENDATION FOR TREATMENT. (a) The local
4-22 mental health authority [commissioner shall designate a facility or
4-23 provider] in the county in which an application is filed shall [to]
4-24 file with the court a recommendation for the most appropriate
4-25 treatment alternative for the proposed patient.
4-26 (b) [The facility or provider that is designated must be:]
4-27 [(1) the single portal authority for the county; or]
4-28 [(2) a community center or any other appropriate
4-29 facility or provider in the county if the county is not served by a
4-30 single portal authority.]
4-31 [(c)] The court shall direct the local mental health
4-32 authority [designated entity] to file, before the date set for the
4-33 hearing, its recommendation for the proposed patient's treatment.
4-34 (c) [(d)] If outpatient treatment is recommended, the local
4-35 mental health authority [entity] will also file a statement as to
4-36 whether the proposed mental health services are available [through:]
4-37 [(1) the local mental health authority because:]
4-38 [(A) the proposed patient is a member of a
4-39 priority population identified for those mental health services in
4-40 the department's long-range plan; and]
4-41 [(B) that sufficient resources to provide the
4-42 necessary services are available; and]
4-43 [(2) another mental health services provider and that
4-44 sufficient resources to provide the necessary services are
4-45 available].
4-46 (d) [(e)] The hearing on an application may not be held
4-47 before the recommendation for treatment is filed unless the court
4-48 determines that an emergency exists.
4-49 (e) [(f)] This section does not relieve a county of its
4-50 responsibility under other provisions of this subtitle to diagnose,
4-51 care for, or treat persons with mental illness.
4-52 (f) [(g)] This section does not apply to a person for whom
4-53 treatment in a private mental health facility is proposed.
4-54 SECTION 9. Section 574.023, Health and Safety Code, is
4-55 amended to read as follows:
4-56 Sec. 574.023. APPREHENSION UNDER ORDER. (a) A protective
4-57 custody order shall direct a person authorized to transport
4-58 patients under Section 574.045 to take the proposed patient into
4-59 protective custody and transport the person immediately to[:]
4-60 [(1) a facility of the single portal authority for the
4-61 area;]
4-62 [(2) an appropriate inpatient mental health facility,
4-63 if no single portal authority serves the area; or]
4-64 [(3)] a mental health facility deemed suitable by the
4-65 local [county's] mental health authority for the area. On request
4-66 of the local mental health authority, the judge may order that the
4-67 proposed patient be detained in an inpatient mental health facility
4-68 operated by the department[, if no single portal authority serves
4-69 the area and an appropriate inpatient mental health facility is not
5-1 available].
5-2 (b) The proposed patient shall be detained in the facility
5-3 until a hearing is held under Section 574.025.
5-4 (c) [If a single portal authority lacks the local resources
5-5 to care for a proposed patient, the authority shall transfer the
5-6 proposed patient to a state hospital or, on the request of the
5-7 authority, the judge may order that the proposed patient be
5-8 detained in a state hospital.]
5-9 [(d)] A facility must comply with this section only to the
5-10 extent that the commissioner determines that the facility has
5-11 sufficient resources to perform the necessary services.
5-12 (d) [(e)] A person may not be detained in a private mental
5-13 health facility without the consent of the facility administrator.
5-14 SECTION 10. Subsection (a), Section 574.027, Health and
5-15 Safety Code, is amended to read as follows:
5-16 (a) A person under a protective custody order shall be
5-17 detained in[:]
5-18 [(1) a facility of the single portal authority for the
5-19 area;]
5-20 [(2) an appropriate inpatient mental health facility,
5-21 if no single portal authority serves the area; or]
5-22 [(3)] a mental health facility deemed suitable by the
5-23 local [county's] mental health authority for the area. On request
5-24 of the local mental health authority, the judge may order that the
5-25 proposed patient be detained in an inpatient mental health facility
5-26 operated by the department[, if no single portal authority serves
5-27 the area and an appropriate inpatient mental health facility is not
5-28 available].
5-29 SECTION 11. Section 574.041, Health and Safety Code, is
5-30 amended to read as follows:
5-31 Sec. 574.041. DESIGNATION OF FACILITY. (a) In an order for
5-32 temporary or extended mental health services specifying inpatient
5-33 care, the court shall commit the patient to a designated inpatient
5-34 mental health facility. The court shall commit the patient to:
5-35 (1) a mental health facility deemed suitable by the
5-36 local mental health [of a single portal] authority for the area[,
5-37 if an authority has been designated for the area];
5-38 (2) a private mental hospital under Section 574.042;
5-39 (3) a hospital operated by a federal agency under
5-40 Section 574.043; or
5-41 (4) an inpatient mental health facility of the
5-42 institutional division of the Texas Department of Criminal Justice
5-43 under Section 574.044.
5-44 (b) On [If a single portal authority lacks the local
5-45 resources to care for a patient, the authority shall transfer the
5-46 patient to a state mental hospital or, on the] request of the local
5-47 mental health authority, the judge may commit the patient directly
5-48 to an inpatient mental health facility operated by the department
5-49 [a state mental hospital].
5-50 (c) A court may not commit a patient to an inpatient mental
5-51 health facility operated by a community center or other entity
5-52 designated by the department to provide mental health services
5-53 unless the facility is licensed under Chapter 577 and the court
5-54 notifies the local mental health authority serving the region in
5-55 which the commitment is made.
5-56 [(d) In this section, "facility of a single portal
5-57 authority" includes a private mental hospital under contract with a
5-58 single portal authority.]
5-59 SECTION 12. Subsection (c), Section 574.043, Health and
5-60 Safety Code, is amended to read as follows:
5-61 (c) The hospital administrator has the same authority and
5-62 responsibility with respect to the patient as the facility
5-63 [hospital] administrator of an inpatient mental health facility
5-64 operated by the department [a state mental hospital].
5-65 SECTION 13. Subsection (a), Section 574.064, Health and
5-66 Safety Code, is amended to read as follows:
5-67 (a) A temporary detention order shall direct a peace officer
5-68 or other designated person to take the patient into custody and
5-69 transport the patient immediately to:
6-1 (1) the nearest appropriate inpatient mental health
6-2 facility; or
6-3 (2) a mental health facility deemed suitable by the
6-4 local [county's] mental health authority for the area, if an
6-5 appropriate inpatient mental health facility is not available.
6-6 SECTION 14. Subsection (b), Section 574.081, Health and
6-7 Safety Code, is amended to read as follows:
6-8 (b) The physician shall prepare the plan as prescribed by
6-9 department rules and shall consult the patient and the local mental
6-10 health authority in the area in which the patient will reside
6-11 before preparing the plan. The local mental health authority is
6-12 not required to participate in preparing a plan for a patient
6-13 furloughed or discharged from a private mental health facility.
6-14 SECTION 15. Subsection (g), Section 574.083, Health and
6-15 Safety Code, is amended to read as follows:
6-16 (g) The local mental [county] health authority shall ensure
6-17 that a patient detained in a nonmedical facility under Subsection
6-18 (f) receives proper care and medical attention.
6-19 SECTION 16. Section 575.011, Health and Safety Code, is
6-20 amended to read as follows:
6-21 Sec. 575.011. TRANSFER TO DEPARTMENT MENTAL HEALTH FACILITY
6-22 [STATE MENTAL HOSPITAL] OR LOCAL MENTAL HEALTH [SINGLE PORTAL]
6-23 AUTHORITY. (a) The department may transfer a patient, if the
6-24 transfer is considered advisable, from an inpatient mental health
6-25 facility operated by the department [a state mental hospital] to:
6-26 (1) another inpatient mental health facility operated
6-27 by the department [state mental hospital]; or
6-28 (2) a mental health facility deemed suitable by the
6-29 local mental health [of a single portal] authority if the authority
6-30 consents.
6-31 (b) A local mental health [single portal] authority may
6-32 transfer a patient from one authority facility to another if the
6-33 transfer is considered advisable.
6-34 (c) A voluntary patient may not be transferred under
6-35 Subsection (a) or (b) without the patient's consent.
6-36 (d) The facility administrator of an inpatient mental health
6-37 facility may, for any reason, transfer an involuntary patient to[:]
6-38 [(1)] a mental health facility deemed suitable by the
6-39 local mental health [of a single portal] authority for the area[;
6-40 or]
6-41 [(2) a state mental hospital designated by the
6-42 department if there is no designated single portal authority for
6-43 the area].
6-44 (e) The facility administrator shall notify the committing
6-45 court and the local mental health [single portal] authority [or
6-46 department, as appropriate,] before transferring a patient under
6-47 Subsection (d).
6-48 SECTION 17. Section 575.012, Health and Safety Code, is
6-49 amended to read as follows:
6-50 Sec. 575.012. TRANSFER OF PERSON WITH MENTAL RETARDATION TO
6-51 AN INPATIENT MENTAL HEALTH FACILITY OPERATED BY THE DEPARTMENT
6-52 [STATE HOSPITAL]. (a) An inpatient mental health facility may not
6-53 transfer a patient who is also a person with mental retardation to
6-54 a department mental health facility unless, before initiating the
6-55 transfer, the facility administrator of the inpatient mental health
6-56 facility obtains from the commissioner a determination that space
6-57 is available in a department facility unit that is specifically
6-58 designed to serve such a person.
6-59 (b) The department shall maintain an appropriate number of
6-60 hospital-level beds for persons with mental retardation who are
6-61 committed for court-ordered mental health services to meet the
6-62 needs of the local mental health [single portal] authorities. The
6-63 number of beds the department maintains must be determined
6-64 according to the previous year's need.
6-65 SECTION 18. Subsections (a) and (b), Section 575.013, Health
6-66 and Safety Code, are amended to read as follows:
6-67 (a) The facility [hospital] administrator of an inpatient
6-68 mental health facility operated by the department [a state mental
6-69 hospital] may transfer an involuntary patient in the facility
7-1 [hospital] to a state school for persons with mental retardation if
7-2 an examination of the patient indicates that the patient has
7-3 symptoms of mental retardation to the extent that training,
7-4 education, rehabilitation, care, treatment, and supervision in a
7-5 state school are in the patient's best interest.
7-6 (b) A certificate containing the diagnosis and the facility
7-7 [hospital] administrator's recommendation of transfer to a specific
7-8 state school shall be furnished to the committing court.
7-9 SECTION 19. Subdivision (22), Section 571.003, and
7-10 Subsection (e), Section 574.027, Health and Safety Code, are
7-11 repealed.
7-12 SECTION 20. This Act takes effect September 1, 2001.
7-13 * * * * *