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A BILL TO BE ENTITLED
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AN ACT
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relating to post-commitment treatment and supervision of persons |
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with mental illness who are manifestly dangerous. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 574.036, Health and Safety Code, is |
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amended by adding Subsection (f) to read as follows: |
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(f) In an order committing a person to a mental health |
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facility for extended inpatient mental health services, the judge |
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may include a finding that the person is manifestly dangerous. The |
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judge may include the finding only if the criterion specified by the |
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jury or judge under Section 574.035(c) is that the proposed patient |
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is likely to cause serious harm to others. |
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SECTION 2. Chapter 574, Health and Safety Code, is amended |
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by adding Subchapter F-1 to read as follows: |
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SUBCHAPTER F-1. PROCEEDINGS INVOLVING MANIFESTLY DANGEROUS |
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PATIENTS |
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Sec. 574.091. APPLICABILITY. This subchapter applies only |
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to a patient receiving court-ordered inpatient mental health |
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services at an inpatient mental health facility who is: |
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(1) found to be manifestly dangerous in an order |
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committing the person to extended inpatient mental health services |
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under Section 574.036(f); |
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(2) committed to a maximum security unit in accordance |
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with Article 46B.104, Code of Criminal Procedure; or |
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(3) the subject of an affirmative determination under |
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Article 46C.157, Code of Criminal Procedure. |
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Sec. 574.092. RELEASE OF PATIENT. (a) Notwithstanding any |
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other provision of this chapter or of Chapter 46B or 46C, Code of |
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Criminal Procedure, a facility administrator may not permit a |
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patient to leave the inpatient mental health facility to receive |
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outpatient mental health services or under a pass or furlough |
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unless the administrator: |
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(1) submits to the review board established under |
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Section 574.093 a continuing care plan prepared by the physician |
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responsible for the patient's treatment; and |
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(2) receives: |
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(A) a determination from the review board that a |
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treatment and supervision plan is not necessary; or |
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(B) a court order in accordance with Section |
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574.094, if the review board determines that a treatment and |
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supervision plan is necessary. |
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(b) A facility administrator shall, not later than the 90th |
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day before the scheduled discharge date, submit to the review board |
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established under Section 574.093 a continuing care plan for a |
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patient scheduled to be discharged. |
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Sec. 574.093. REVIEW BOARD. (a) The executive |
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commissioner of the Health and Human Services Commission shall |
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appoint a five-member review board to determine whether a patient |
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who has had a continuing care plan forwarded to the review board |
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would be manifestly dangerous if the patient did not follow the |
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continuing care plan after leaving the inpatient mental health |
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facility. A review board must include at least one psychiatrist |
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licensed to practice medicine in this state and two persons who work |
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directly with persons with mental illness or mental retardation. |
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(b) In determining whether a patient would be manifestly |
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dangerous if the patient did not follow the patient's continuing |
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care plan, the review board shall consider: |
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(1) an assessment of the patient's present mental |
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condition; |
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(2) whether the patient has inflicted, attempted to |
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inflict, or made a serious threat of inflicting substantial |
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physical harm to another while in the facility; |
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(3) whether the patient, in the six months preceding |
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the date the patient was placed in the facility, has inflicted, |
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attempted to inflict, or made a serious threat of inflicting |
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substantial physical harm to another; |
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(4) whether the patient during a period of release |
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from an inpatient mental health facility under the current order or |
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a prior order for inpatient mental health services has inflicted, |
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attempted to inflict, or made a serious threat of inflicting |
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substantial physical harm to another; and |
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(5) whether the patient is likely to follow the |
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continuing care plan on release from the facility without a |
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treatment and supervision plan. |
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(c) If the review board determines that a patient would be |
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manifestly dangerous if the patient did not follow the continuing |
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care plan after leaving the inpatient mental health facility, the |
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review board shall recommend to the court that ordered the |
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patient's inpatient mental health services a treatment and |
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supervision plan that may include: |
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(1) provisions requiring the patient to submit to: |
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(A) tracking under a particular type of tracking |
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service or any other appropriate supervision; |
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(B) access to and tracking of the patient's |
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prescription records; or |
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(C) a continuous automated delivery system for |
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necessary medications; |
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(2) provisions prohibiting the patient from changing |
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the patient's residence without first obtaining authorization from |
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the court and from leaving the state without first obtaining |
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authorization from the court; |
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(3) provisions requiring the patient to notify the |
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court immediately or within 24 hours of any change in the patient's |
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status that affects proper treatment and supervision, including: |
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(A) a change in the patient's physical health or |
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job status; and |
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(B) any incarceration of the patient; or |
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(4) any other provision that the review board finds |
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necessary to ensure that the patient follows the continuing care |
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plan. |
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(d) If the review board determines that a patient would not |
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be manifestly dangerous if the patient did not follow the |
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continuing care plan after leaving the inpatient mental health |
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facility, the review board shall inform the facility administrator |
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and the court that ordered the patient's inpatient mental health |
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services of the review board's determination that a treatment and |
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supervision plan is not necessary. |
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Sec. 574.094. HEARING AND ORDER AUTHORIZING TREATMENT AND |
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SUPERVISION PLAN. (a) A court that receives a recommended |
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treatment and supervision plan from the review board may: |
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(1) enter an order modifying the order for inpatient |
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mental health services to allow the patient to leave the inpatient |
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mental health facility to receive outpatient mental health services |
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or under a pass or furlough subject to the conditions provided by |
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the treatment and supervision plan; |
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(2) enter an order requiring the patient to comply |
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with the recommended treatment and supervision plan after the |
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patient is discharged from the facility; or |
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(3) enter an order stating that the treatment and |
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supervision plan is not necessary. |
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(b) The court may enter an order under Subsection (a)(1) or |
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(3) without a hearing or with a hearing as prescribed by Section |
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574.061(d). If a hearing is not requested, the court may enter the |
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order based solely on the recommendation of the review board and any |
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supporting information. |
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(c) The court may enter an order under Subsection (a)(2) |
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only if the court finds by clear and convincing evidence after a |
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hearing that: |
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(1) the patient would be manifestly dangerous if the |
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patient did not follow the patient's continuing care plan after |
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leaving the inpatient mental health facility; and |
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(2) the treatment and supervision plan recommended by |
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the review board is necessary to ensure that the patient follows the |
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patient's continuing care plan. |
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(d) In making a finding under Subsection (c) that the |
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patient would be manifestly dangerous if the patient did not follow |
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the patient's continuing care plan, the court shall consider: |
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(1) an assessment of the patient's present mental |
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condition; |
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(2) whether the patient has inflicted, attempted to |
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inflict, or made a serious threat of inflicting substantial |
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physical harm to another while in the facility; |
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(3) whether the patient, in the six months preceding |
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the date the patient was placed in the facility, has inflicted, |
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attempted to inflict, or made a serious threat of inflicting |
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substantial physical harm to another; |
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(4) whether the patient during a period of release |
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from an inpatient mental health facility under the current order or |
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a prior order for inpatient mental health services has inflicted, |
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attempted to inflict, or made a serious threat of inflicting |
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substantial physical harm to another; |
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(5) whether the patient is likely to follow the |
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continuing care plan on release from the facility without a |
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treatment and supervision plan; |
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(6) the testimony of the patient and any expert |
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testifying on behalf of the patient; and |
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(7) the availability of an alternative, less intrusive |
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treatment and supervision plan likely to result in the patient's |
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compliance with the patient's continuing care plan. |
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(e) A court may modify any order under this section on |
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receipt of a recommendation from the review board, after a biennial |
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review under Section 574.095, or after a hearing on a petition for |
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removal of all or part of the treatment and supervision conditions. |
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(f) A court that receives a determination from the review |
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board that a treatment and supervision plan is not necessary: |
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(1) shall enter the review board's determination in |
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the patient's court record; and |
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(2) may conduct further proceedings as otherwise |
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provided by this chapter. |
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(g) A patient is entitled to be present and to have the |
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benefit of all constitutional protections provided to the patient |
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at a hearing under this section. |
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Sec. 574.095. BIENNIAL REVIEW. (a) The review board shall |
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conduct a biennial review of the status of a patient who is released |
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subject to a recommended treatment and supervision plan ordered |
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under Section 574.094(a)(2). |
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(b) The patient may be represented by counsel at the |
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biennial review. |
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(c) If the patient has a treating physician, the physician |
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shall provide a report to the review board regarding whether a |
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requirement imposed by the treatment and supervision plan should be |
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modified or removed. |
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(d) The review board may: |
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(1) recommend that the court modify or remove a |
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requirement imposed by the treatment and supervision plan if the |
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review board finds that the requirement is no longer necessary to |
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ensure that the patient does not become manifestly dangerous; or |
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(2) recommend that the court extend and, if necessary, |
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modify the order requiring a treatment and supervision plan if the |
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review board finds that the plan and any modifications are |
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necessary to ensure that the patient does not become manifestly |
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dangerous. |
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Sec. 574.096. PETITION FOR REMOVAL OF TREATMENT AND |
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SUPERVISION CONDITIONS. (a) A patient subject to an order entered |
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under Section 574.094(a)(1) or (2) requiring the patient to comply |
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with a treatment and supervision plan may file with the court a |
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petition for removal of all or part of the conditions imposed under |
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that order. |
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(b) If the patient files a petition for removal of all or |
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part of the treatment and supervision conditions, the patient shall |
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serve the petition on the court, the review board, and the county |
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attorney or district attorney with jurisdiction in that court. |
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(c) On receipt of a petition for removal of all or part of |
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the treatment and supervision conditions, the court shall attempt |
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as soon as practicable to review the petition. |
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(d) The court may deny without a hearing a petition for |
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removal of all or part of the treatment and supervision conditions |
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if the court finds that the petition is frivolous. |
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(e) If the court does not deny a petition for removal of all |
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or part of the treatment and supervision conditions filed by the |
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patient, the court shall conduct as soon as practicable a hearing on |
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the petition. |
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(f) The patient and the attorney representing the state are |
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entitled to an immediate examination of the patient by an expert. |
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(g) On request of the patient or the attorney representing |
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the state, the court shall conduct the hearing before a jury. |
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(h) The burden of proof at the hearing is on the state to |
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prove by clear and convincing evidence that all or the relevant part |
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of the treatment and supervision plan is necessary to ensure that |
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the patient does not become manifestly dangerous. |
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(i) A patient is entitled to be present and to have the |
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benefit of all constitutional protections provided to the patient |
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at a hearing under this section. |
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SECTION 3. The change in law made by this Act applies only |
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to persons: |
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(1) committed to temporary or extended inpatient |
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mental health services under Chapter 574, Health and Safety Code, |
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on or after the effective date of this Act; |
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(2) found manifestly dangerous in an order committing |
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the person to extended inpatient mental health services under |
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Section 574.036(f), Health and Safety Code, as added by this Act, on |
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or after the effective date of this Act; |
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(3) committed to a maximum security unit in accordance |
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with Article 46B.104, Code of Criminal Procedure, on or after the |
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effective date of this Act; or |
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(4) subject to an affirmative determination made under |
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Article 46C.157, Code of Criminal Procedure, on or after the |
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effective date of this Act. |
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SECTION 4. This Act takes effect September 1, 2009. |