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