BILL ANALYSIS |
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C.S.S.B. 646 |
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By: Deuell |
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Public Health |
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Committee Report (Substituted) |
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BACKGROUND AND PURPOSE
Studies have shown that assisted outpatient mental health treatment is effective in keeping certain patients from committing illegal activities and from going to or returning to prison, and Texas is one of many states that permit this type of court-ordered treatment for patients who have a history of not complying with taking prescribed medications.
Because current Texas law authorizes a judge to "advise but not compel" certain patients to receive treatment with psychoactive medication, some judges are reluctant to order the use of assisted outpatient mental health treatment because these judges believe they do not have the authority to require these patients to take their medications. Interested parties contend that this was not the original intent of the law.
C.S.S.B. 646, among other items, seeks to address this issue and to clarify certain statutory provisions relating to court-ordered outpatient mental health services.
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RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
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ANALYSIS
C.S.S.B. 646 amends the Health and Safety Code to require a judge, not later than the third day before the date of a hearing that may result in the judge ordering a patient to receive court-ordered outpatient mental health services, to identify the person the judge intends to designate to be responsible for those services. The bill specifies that, in an order that directs a patient to participate in outpatient mental health services, the court is required to designate the person previously identified by the court as responsible for those services and authorizes the court to designate a different person if necessary. The bill specifies that the court is required to designate, rather than identify, a person to be responsible for the outpatient services if the court modifies an order for inpatient treatment.
C.S.S.B. 646 removes the requirement that the person responsible for the outpatient mental health services submit to the court a general program of the treatment within two weeks after the court enters an order for outpatient mental health services and instead requires the person to submit the program to the court before the hearing for an order for temporary mental health services, before the hearing for an order for extended mental health services, or before the court modifies an order for inpatient treatment, as appropriate. The bill requires the program to include services to provide care coordination and any other treatment or services, including medication and supported housing, that are available and considered clinically necessary by a treating physician or the person responsible for the services to assist the patient in functioning safely in the community. The bill requires the person responsible for the services, if the patient is receiving inpatient mental health services at the time the program is being prepared, to seek input from the patient's inpatient treatment providers in preparing the program. The bill authorizes a patient subject to court-ordered outpatient services to petition the court for specific enforcement of the court order and authorizes a court, on its own motion, to set a status conference with the person responsible for the services, the patient, and the patient's attorney. The bill requires the court to order the patient to participate in the program but prohibits the court from compelling performance. The bill authorizes the court, if the court receives information from the person responsible for the services that a patient is not complying with the court's order, to set a modification hearing and to issue an order for temporary detention if an application is filed for temporary detention. The bill establishes that the failure of a patient to comply with the program incorporated into a court order is not grounds for punishment for contempt of court.
C.S.S.B. 646 requires a physician to evaluate a patient as soon as possible within 24 hours after the time detention under a temporary detention order begins to determine whether the patient, due to mental illness, presents a substantial risk of serious harm to the patient or others so that the patient cannot be at liberty pending a probable cause hearing. The bill establishes that a determination that the patient presents a substantial risk of serious harm to the patient or others may be demonstrated by the patient's behavior or evidence of severe emotional distress and deterioration in the patient's mental condition to the extent that the patient cannot live safely in the community. The bill requires an application for a patient's temporary detention to state the applicant's opinion and detail the reasons for the applicant's opinion that the patient meets the criteria for such a determination, rather than the criteria described by statutory provisions relating to an order for temporary mental health services or an order for extended mental health services.
C.S.S.B. 646 requires the facility treating a patient under a temporary detention order, if the physician who conducted the evaluation determines that the patient does not present a substantial risk of serious harm to the patient or others, to notify the person designated as responsible for providing outpatient mental health services or the facility administrator of the outpatient facility treating the patient and the court that entered the order directing the patient to receive court-ordered outpatient mental health services and requires the facility to release the patient. The bill establishes that a patient released from an inpatient mental health facility under such circumstances continues to be subject to the order for court-ordered outpatient services if the order has not expired. The bill specifies that a person who is not released from a facility is authorized to be detained under a temporary detention order for more than 72 hours, with certain exceptions, for an extreme emergency only if, after a hearing held before the expiration of that period, it is found that there is probable cause to believe that the patient, due to mental illness, presents a substantial risk of serious harm to the patient or others to the extent that the patient cannot be at liberty pending the final hearing regarding the modification of an order for outpatient treatment, rather than there being probable cause to believe that the patient meets the criteria described by statutory provisions relating to an order for temporary mental health services or an order for extended mental health services.
C.S.S.B. 646 prohibits a person from administering a psychoactive medication to a patient under court-ordered inpatient mental health services who refuses to take the medication voluntarily unless the patient is having a medication-related emergency, the patient is under an order authorizing the administration of the medication regardless of the patient's refusal, or the patient is a ward who is 18 years of age or older and the guardian of the person of the ward consents to the administration of psychoactive medication regardless of the ward's expressed preferences regarding treatment with psychoactive medication.
C.S.S.B. 646, in a temporary provision set to expire September 1, 2017, requires the Department of State Health Services, not later than December 1, 2016, to prepare and submit to the legislature a report containing information about persons receiving court-ordered outpatient mental health services in Texas and the effectiveness of those services.
C.S.S.B. 646 repeals provisions of the Health and Safety Code relating to a judge's authority to advise, but not compel, a proposed patient for specified treatments to receive treatment with psychoactive medication as specified by the outpatient mental health services treatment plan, participate in counseling, and refrain from the use of alcohol or illicit drugs.
C.S.S.B. 646 repeals Sections 574.034(i) and 574.035(j), Health and Safety Code.
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EFFECTIVE DATE
September 1, 2013.
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COMPARISON OF ORIGINAL AND SUBSTITUTE
While C.S.S.B. 646 may differ from the engrossed version in minor or nonsubstantive ways, the following comparison is organized and highlighted in a manner that indicates the substantial differences between the engrossed and committee substitute versions of the bill.
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