TEXAS MENTAL HEALTH CODE PROJECT

1. TEXAS MENTAL HEALTH CODE PROJECT Susan A. Stone, JD, MD Susan Stone and Associates PO Box 220, 180 Bradley Lane Rosanky, TX 78953 512-360-3557; fax 512-360-5062 Email: sstonejdmd@me.com

2. Background • Continuity of Care Task Force • Hogg Foundation RFP • Texas Appleseed • Disability Rights, Texas • Title C; Sections 571-578, Health and Safety Code

3. Fundamental Issues • Virtual unanimous vote for change • Areas of consensus • Areas of non-consensus • Not “drafting” legislation, but some legislative constructs contained in Appendices

4. Organization • Total Repeal • Exception: Section 577 • Organizational Structure

5. Title and Purpose • No Change to Title • Purpose: • Clarify the preference for voluntary services over involuntary. • Move Least Restrictive Alternative provisions to this section of the Code. • Move Rights of Patients provisions to this section of the Code. • Incorporate language around informed consent and shared decision-making into the purpose section of the mental health code.

6. Definitions • Eliminate references to the Texas Department of Mental Health and Mental Retardation and its Board functions; • Carefully examine ways to define “community centers,” “facility adminitrator,” “general hospital,” “inpatient mental health facility,” “local mental health authorities,” and “mental health facilities;” • Consolidate definitions of hazardous weather and disaster conditions into the definition and promote consistency • Revise the definition of Mental Illness under the Mental Health Code to eliminate references to epilepsy and alcoholism. Revise references to “mental deficiency” with the term “intellectual disability.”

7. Voluntary Mental Health Services • Consolidate references for request for admission and rights of patients into the purpose section of the new Code structure. • Clarify that the age of consent for mental health services in Texas is for both inpatient and outpatient mental health services is 16. • Children under the age of 16 should not be involuntarily committed under the Mental Health Code unless required by other State law or Texas Department of State Health Services Rules.

8. Emergency Detention • No change to Emergency Detention Time Periods. • Emergency Detention Training Modules • Standardized Forms and Manuals • Clarify need for Warrants and Medical Clearance • Implement new provisions to the Emergency Detention section of the Mental Health Code Related to Securing Dangerous Weapons. • Disposition of Weapons • Four Hour “Hold”

9. Court Ordered Mental Health Services • Use of para-professionals • Inpatient Commitment Criteria • Assisted Outpatient Treatment • Involuntary Medication Orders • ECT

10. Court Processes • Notice • Associate Judges • Court Fees • Attorney Roles • Video-Conferencing • Cross-County Jurisdiction

11. Appendices: Suggested Legislative Language • Appendix 1: Confiscation of Weapons • Appendix 2: Inpatient Commitment Criteria • Appendix 3: Assisted Outpatient Treatment • Appendix 4: ECT

12. Next Steps • Comment Period: May 15, 2012 • Crosswalk of Current Provisions into New Framework • Legislative Drafting and Consultation