81R79 UM-D
By: Wentworth S.B. No. 1665
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.