By: Burkett, Naishtat, N. Gonzalez of El Paso H.B. No. 1947
(Senate Sponsor - Zaffirini)
(In the Senate - Received from the House May 6, 2013;
May 7, 2013, read first time and referred to Committee on Health
and Human Services; May 16, 2013, reported adversely, with
favorable Committee Substitute by the following vote: Yeas 7,
Nays 0; May 16, 2013, sent to printer.)
COMMITTEE SUBSTITUTE FOR H.B. No. 1947 By: Zaffirini
A BILL TO BE ENTITLED
AN ACT
relating to the criteria for commitment or detention of a person
with mental illness.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 571.003, Health and Safety Code, is
amended by adding Subdivision (7-a) to read as follows:
(7-a) "Gravely disabled" means a person who, as a
result of mental illness, is:
(A) suffering severe and ongoing mental,
emotional, or physical distress;
(B) in danger of serious physical harm or serious
illness due to the person's inability to function independently,
which is exhibited by the person's inability due to mental illness,
except for reasons of indigence, to provide for the person's basic
needs, including food, clothing, shelter, medical care, health, or
safety; and
(C) unable to make a rational and informed
decision as to whether to submit to treatment.
SECTION 2. The heading to Subchapter A, Chapter 573, Health
and Safety Code, is amended to read as follows:
SUBCHAPTER A. APPREHENSION, [BY PEACE OFFICER OR] TRANSPORTATION,
OR DETENTION WITHOUT JUDGE'S OR MAGISTRATE'S ORDER [FOR EMERGENCY
DETENTION BY GUARDIAN]
SECTION 3. Section 573.001, Health and Safety Code, is
amended by amending Subsection (b) and adding Subsection (g) to
read as follows:
(b) A substantial risk of serious harm to the person or
others under Subsection (a)(1)(B) may be demonstrated by:
(1) the person's behavior; or
(2) evidence of the person being gravely disabled
[severe emotional distress and deterioration in the person's mental
condition] to the extent that the person cannot remain at liberty.
(g) A peace officer may take a person who has been admitted
to a facility into custody under this section. For purposes of this
subsection, "facility" has the meaning assigned by Section 573.005.
SECTION 4. Section 573.003(b), Health and Safety Code, is
amended to read as follows:
(b) A substantial risk of serious harm to the ward or others
under Subsection (a)(2) may be demonstrated by:
(1) the ward's behavior; or
(2) evidence of the ward being gravely disabled
[severe emotional distress and deterioration in the ward's mental
condition] to the extent that the ward cannot remain at liberty.
SECTION 5. Subchapter A, Chapter 573, Health and Safety
Code, is amended by adding Section 573.005 to read as follows:
Sec. 573.005. TEMPORARY DETENTION BY CERTAIN FACILITIES.
(a) In this section, "facility" means:
(1) a mental health facility;
(2) a hospital, or the emergency department of a
hospital, licensed under Chapter 241; and
(3) a freestanding emergency medical care facility
licensed under Chapter 254.
(b) This section does not apply to a person who has been
transported to a facility for emergency detention under this
chapter.
(c) A facility may detain a person who voluntarily requested
treatment from the facility or who lacks the capacity to consent to
treatment, as provided by this section, if:
(1) the person expresses a desire to leave the
facility or attempts to leave the facility before the examination
or treatment is completed; and
(2) a physician at the facility:
(A) has reason to believe and does believe that:
(i) the person has a mental illness; and
(ii) because of that mental illness there
is a substantial risk of serious harm to the person or to others
unless the person is immediately restrained; and
(B) believes that there is not sufficient time to
file an application for emergency detention or for an order of
protective custody.
(d) The facility staff or physician shall notify the person
if the facility intends to detain the person under this section.
(e) The physician shall document a decision to detain a
person under this section and place that notice of detention in the
person's medical record. The notice of detention must contain:
(1) a statement that the physician has reason to
believe and does believe that the person evidences mental illness;
(2) a statement that the physician has reason to
believe and does believe that the person evidences a substantial
risk of serious harm to the person or others;
(3) a specific description of the risk of harm;
(4) a statement that the physician has reason to
believe and does believe that the risk of harm is imminent unless
the person is immediately restrained;
(5) a statement that the physician's beliefs are
derived from specific recent behavior, overt acts, attempts, or
threats that were observed by or reliably reported to the
physician; and
(6) a detailed description of the specific behavior,
acts, attempts, or threats.
(f) The period of a person's detention authorized by this
section may not exceed four hours following the time the person
first expressed a desire to leave, or attempted to leave, the
facility. The facility shall release the person not later than the
end of the four-hour period unless the facility arranges for a peace
officer to take the person into custody under Section 573.001 or an
order of protective custody is issued.
(g) A physician, person, or facility that detains or fails
to detain a person under this section and who acts in good faith and
without malice is not civilly or criminally liable for that action.
SECTION 6. Section 573.012(c), Health and Safety Code, is
amended to read as follows:
(c) A substantial risk of serious harm to the person or
others under Subsection (b)(2) may be demonstrated by:
(1) the person's behavior; or
(2) evidence of the person being gravely disabled
[severe emotional distress and deterioration in the person's mental
condition] to the extent that the person cannot remain at liberty.
SECTION 7. Section 573.022(a), Health and Safety Code, is
amended to read as follows:
(a) A person may be admitted to a facility for emergency
detention only if the physician who conducted the preliminary
examination of the person makes a written statement that:
(1) is acceptable to the facility;
(2) states that after a preliminary examination it is
the physician's opinion that:
(A) the person is mentally ill;
(B) the person evidences a substantial risk of
serious harm to himself or others;
(C) the described risk of harm is imminent unless
the person is immediately restrained; and
(D) emergency detention is the least restrictive
means by which the necessary restraint may be accomplished; and
(3) includes:
(A) a description of the nature of the person's
mental illness;
(B) a specific description of the risk of harm
the person evidences that may be demonstrated either by the
person's behavior or by evidence of the person being gravely
disabled [severe emotional distress and deterioration in the
person's mental condition] to the extent that the person cannot
remain at liberty; and
(C) the specific detailed information from which
the physician formed the opinion in Subdivision (2).
SECTION 8. Section 574.011(d), Health and Safety Code, is
amended to read as follows:
(d) If the certificate is offered in support of a motion for
a protective custody order, the certificate must also include the
examining physician's opinion that the examined person presents a
substantial risk of serious harm to himself or others if not
immediately restrained. The harm may be demonstrated by the
examined person's behavior or by evidence of the person being
gravely disabled [severe emotional distress and deterioration in
the examined person's mental condition] to the extent that the
examined person cannot remain at liberty.
SECTION 9. Section 574.022(b), Health and Safety Code, is
amended to read as follows:
(b) The determination that the proposed patient presents a
substantial risk of serious harm may be demonstrated by the
proposed patient's behavior or by evidence of the person being
gravely disabled [severe emotional distress and deterioration in
the proposed patient's mental condition] to the extent that the
proposed patient cannot remain at liberty.
SECTION 10. Sections 574.034(a) and (d), Health and Safety
Code, are amended to read as follows:
(a) The judge may order a proposed patient to receive
court-ordered temporary inpatient mental health services only if
the judge or jury finds, from clear and convincing evidence, that:
(1) the proposed patient is mentally ill; and
(2) as a result of that mental illness the proposed
patient:
(A) is likely to cause serious harm to himself;
(B) is likely to cause serious harm to others; or
(C) is gravely disabled [:
[(i) suffering severe and abnormal mental,
emotional, or physical distress;
[(ii) experiencing substantial mental or
physical deterioration of the proposed patient's ability to
function independently, which is exhibited by the proposed
patient's inability, except for reasons of indigence, to provide
for the proposed patient's basic needs, including food, clothing,
health, or safety; and
[(iii) unable to make a rational and
informed decision as to whether or not to submit to treatment].
(d) To be clear and convincing under Subsection (a), the
evidence must include expert testimony and, unless waived, evidence
of a recent overt act or a continuing pattern of behavior that tends
to confirm:
(1) the likelihood of serious harm to the proposed
patient or others; or
(2) the proposed patient being gravely disabled
[patient's distress and the deterioration of the proposed patient's
ability to function].
SECTION 11. Sections 574.035(a) and (e), Health and Safety
Code, are amended to read as follows:
(a) The judge may order a proposed patient to receive
court-ordered extended inpatient mental health services only if the
jury, or the judge if the right to a jury is waived, finds, from
clear and convincing evidence, that:
(1) the proposed patient is mentally ill;
(2) as a result of that mental illness the proposed
patient:
(A) is likely to cause serious harm to himself;
(B) is likely to cause serious harm to others; or
(C) is gravely disabled [:
[(i) suffering severe and abnormal mental,
emotional, or physical distress;
[(ii) experiencing substantial mental or
physical deterioration of the proposed patient's ability to
function independently, which is exhibited by the proposed
patient's inability, except for reasons of indigence, to provide
for the proposed patient's basic needs, including food, clothing,
health, or safety; and
[(iii) unable to make a rational and
informed decision as to whether or not to submit to treatment];
(3) the proposed patient's condition is expected to
continue for more than 90 days; and
(4) the proposed patient has received court-ordered
inpatient mental health services under this subtitle or under
Chapter 46B, Code of Criminal Procedure, for at least 60
consecutive days during the preceding 12 months.
(e) To be clear and convincing under Subsection (a), the
evidence must include expert testimony and evidence of a recent
overt act or a continuing pattern of behavior that tends to confirm:
(1) the likelihood of serious harm to the proposed
patient or others; or
(2) the proposed patient being gravely disabled
[patient's distress and the deterioration of the proposed patient's
ability to function].
SECTION 12. This Act takes effect September 1, 2013.
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