Bill Text: TX SB1507 | 2015-2016 | 84th Legislature | Enrolled
Bill Title: Relating to the statewide coordination and oversight of forensic mental health services overseen by the Department of State Health Services, including the appointment of a forensic director.
Spectrum: Slight Partisan Bill (Democrat 3-1)
Status: (Passed) 2015-05-28 - Effective immediately [SB1507 Detail]
Download: Texas-2015-SB1507-Enrolled.html
S.B. No. 1507 |
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relating to the statewide coordination and oversight of forensic | ||
mental health services overseen by the Department of State Health | ||
Services, including the appointment of a forensic director. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 532, Health and Safety Code, is amended | ||
by adding Sections 532.013 and 532.0131 to read as follows: | ||
Sec. 532.013. FORENSIC DIRECTOR. (a) In this section: | ||
(1) "Forensic patient" means a person with mental | ||
illness who is: | ||
(A) examined on the issue of competency to stand | ||
trial by an expert appointed under Subchapter B, Chapter 46B, Code | ||
of Criminal Procedure; | ||
(B) found incompetent to stand trial under | ||
Subchapter C, Chapter 46B, Code of Criminal Procedure; | ||
(C) committed to court-ordered mental health | ||
services under Subchapter E, Chapter 46B, Code of Criminal | ||
Procedure; or | ||
(D) found not guilty by reason of insanity under | ||
Chapter 46C, Code of Criminal Procedure. | ||
(2) "Forensic services" means a competency | ||
examination, competency restoration services, or mental health | ||
services provided to a current or former forensic patient in the | ||
community or at a department facility. | ||
(b) The commissioner shall appoint a forensic director. | ||
(c) To be qualified for appointment as forensic director, a | ||
person must have proven expertise in the social, health, and legal | ||
systems for forensic patients, and in the intersection of those | ||
systems. | ||
(d) The forensic director reports to the commissioner and is | ||
responsible for: | ||
(1) statewide coordination and oversight of forensic | ||
services; | ||
(2) coordination of programs operated by the | ||
department relating to evaluation of forensic patients, transition | ||
of forensic patients from inpatient to outpatient or | ||
community-based services, community forensic monitoring, or | ||
forensic research and training; and | ||
(3) addressing issues with the delivery of forensic | ||
services in the state, including: | ||
(A) significant increases in populations with | ||
serious mental illness and criminal justice system involvement; | ||
(B) adequate availability of department | ||
facilities for civilly committed forensic patients; | ||
(C) wait times for forensic patients who require | ||
competency restoration services; | ||
(D) interruption of mental health services of | ||
recently released forensic patients; | ||
(E) coordination of services provided to | ||
forensic patients by state agencies; | ||
(F) provision of input regarding the regional | ||
allocation of mental health beds for certain forensic patients and | ||
other patients with mental illness under Section 533.0515; and | ||
(G) provision of input regarding the development | ||
and maintenance of a training curriculum for judges and attorneys | ||
for treatment alternatives to inpatient commitment to a state | ||
hospital for certain forensic patients under Section 1001.086. | ||
Sec. 532.0131. FORENSIC WORK GROUP. (a) In this section, | ||
"forensic patient" and "forensic services" have the meanings | ||
assigned by Section 532.013. | ||
(b) The commissioner shall establish a work group of experts | ||
and stakeholders to make recommendations concerning the creation of | ||
a comprehensive plan for the effective coordination of forensic | ||
services. | ||
(c) The work group must have not fewer than nine members, | ||
with the commissioner selecting the total number of members at the | ||
time the commissioner establishes the work group. | ||
(d) The executive commissioner of the Health and Human | ||
Services Commission shall appoint as members of the work group: | ||
(1) a representative of the department; | ||
(2) a representative of the Texas Department of | ||
Criminal Justice; | ||
(3) a representative of the Texas Juvenile Justice | ||
Department; | ||
(4) a representative of the Texas Correctional Office | ||
on Offenders with Medical or Mental Impairments; | ||
(5) a representative of the Sheriff's Association of | ||
Texas; | ||
(6) a superintendent of a state hospital with a | ||
maximum security forensic unit; | ||
(7) a representative of a local mental health | ||
authority; | ||
(8) a representative of the protection and advocacy | ||
system of this state established in accordance with 42 U.S.C. | ||
Section 15043, appointed by the administrative head of that system; | ||
and | ||
(9) additional members as needed to comply with the | ||
number of members selected by the commissioner, who must be | ||
recognized experts in forensic patients or persons who represent | ||
the interests of forensic patients, and who may be advocates, | ||
family members, psychiatrists, psychologists, social workers, | ||
psychiatric nurses, or representatives of hospitals licensed under | ||
Chapter 241 or 577. | ||
(e) In developing recommendations, the work group may use | ||
information compiled by other work groups in the state, especially | ||
work groups for which the focus is mental health issues. | ||
(f) Not later than July 1, 2016, the work group established | ||
under this section shall send a report describing the work group's | ||
recommendations to the lieutenant governor, the speaker of the | ||
house of representatives, and the standing committees of the senate | ||
and the house of representatives with primary jurisdiction over | ||
forensic services. | ||
(g) The executive commissioner of the Health and Human | ||
Services Commission may adopt rules as necessary to implement this | ||
section. | ||
(h) The work group established under this section is | ||
dissolved and this section expires November 1, 2019. | ||
SECTION 2. Subchapter B, Chapter 533, Health and Safety | ||
Code, is amended by adding Section 533.0515 to read as follows: | ||
Sec. 533.0515. REGIONAL ALLOCATION OF MENTAL HEALTH BEDS. | ||
(a) In this section, "inpatient mental health facility" has the | ||
meaning assigned by Section 571.003. | ||
(b) The commission, with input from local mental health | ||
authorities, local behavioral health authorities, stakeholders, | ||
and the forensic director appointed under Section 532.013, and | ||
after considering any plan developed under Section 533.051, shall | ||
divide the state into regions for the purpose of allocating to each | ||
region state-funded beds in the state hospitals and other inpatient | ||
mental health facilities for patients who are: | ||
(1) voluntarily admitted to a state hospital or other | ||
inpatient mental health facility under Subchapter B, Chapter 462, | ||
or Chapter 572; | ||
(2) admitted to a state hospital or other inpatient | ||
mental health facility for emergency detention under Subchapter C, | ||
Chapter 462, or Chapter 573; | ||
(3) ordered by a court to receive at a state hospital | ||
or other inpatient mental health facility inpatient chemical | ||
dependency treatment under Subchapter D, Chapter 462, or inpatient | ||
mental health services under Chapter 574; | ||
(4) committed to a state hospital or other inpatient | ||
mental health facility to attain competency to stand trial under | ||
Chapter 46B, Code of Criminal Procedure; or | ||
(5) committed to a state hospital or other inpatient | ||
mental health facility to receive inpatient mental health services | ||
following an acquittal by reason of insanity under Chapter 46C, | ||
Code of Criminal Procedure. | ||
(c) The department, in conjunction with the commission, | ||
shall convene the advisory panel described by Section 533.051(c) at | ||
least quarterly in order for the advisory panel to: | ||
(1) develop, make recommendations to the executive | ||
commissioner or department, as appropriate, and monitor the | ||
implementation of updates to: | ||
(A) a bed day allocation methodology for | ||
allocating to each region designated under Subsection (b) a certain | ||
number of state-funded beds in state hospitals and other inpatient | ||
mental health facilities for the patients described by Subsection | ||
(b) based on the identification and evaluation of factors that | ||
impact the use of state-funded beds by patients in a region, | ||
including clinical acuity, the prevalence of serious mental | ||
illness, and the availability of resources in the region; and | ||
(B) a bed day utilization review protocol that | ||
includes a peer review process to: | ||
(i) evaluate: | ||
(a) the use of state-funded beds in | ||
state hospitals and other inpatient mental health facilities by | ||
patients described by Subsection (b); | ||
(b) alternatives to hospitalization | ||
for those patients; | ||
(c) the readmission rate for those | ||
patients; and | ||
(d) the average length of admission | ||
for those patients; and | ||
(ii) conduct a review of the diagnostic and | ||
acuity profiles of patients described by Subsection (b) for the | ||
purpose of assisting the department, commission, and advisory panel | ||
in making informed decisions and using available resources | ||
efficiently and effectively; and | ||
(2) receive and review status updates from the | ||
department regarding the implementation of the bed day allocation | ||
methodology and the bed day utilization review protocol. | ||
(d) Not later than December 1 of each even-numbered year, | ||
the advisory panel shall submit to the executive commissioner for | ||
consideration a proposal for an updated bed day allocation | ||
methodology and bed day utilization review protocol, and the | ||
executive commissioner shall adopt an updated bed day allocation | ||
methodology and bed day utilization review protocol. | ||
(e) Not later than December 1 of each even-numbered year, | ||
the department, in conjunction with the commission and the advisory | ||
panel, shall prepare and submit to the governor, the lieutenant | ||
governor, the speaker of the house of representatives, the senate | ||
finance committee, the house appropriations committee, and the | ||
standing committees of the legislature having jurisdiction over | ||
mental health and human services a report that includes: | ||
(1) a summary of the activities of the commission, | ||
department, and advisory panel to develop or update the bed day | ||
allocation methodology and bed day utilization review protocol; | ||
(2) the outcomes of the implementation of the bed day | ||
allocation methodology by region, including an explanation of how | ||
the actual outcomes aligned with or differed from the expected | ||
outcomes; | ||
(3) for planning purposes, for each region, the actual | ||
value of a bed day for the two years preceding the date of the report | ||
and the projected value of a bed day for the five years following | ||
the date of the report, as calculated by the department; | ||
(4) for each region, an evaluation of the factors in | ||
Subsection (c)(1)(A), including the availability of resources in | ||
the region, that impact the use of state-funded beds in state | ||
hospitals and other inpatient mental health facilities by the | ||
patients described by Subsection (b); | ||
(5) the outcomes of the implementation of the bed day | ||
utilization review protocol and the impact of the use of the | ||
protocol on the use of state-funded beds in state hospitals and | ||
other inpatient mental health facilities by the patients described | ||
by Subsection (b); and | ||
(6) any recommendations of the department, | ||
commission, or advisory panel to enhance the effective and | ||
efficient allocation of state-funded beds in state hospitals and | ||
other inpatient mental health facilities for the patients described | ||
by Subsection (b). | ||
(f) Notwithstanding Subsection (d), not later than March 1, | ||
2016, the advisory panel, with assistance from the department, | ||
shall submit to the executive commissioner an initial proposal for | ||
a bed day allocation methodology and bed day utilization review | ||
protocol for review. The executive commissioner shall adopt an | ||
initial bed day allocation methodology and bed day utilization | ||
review protocol not later than June 1, 2016. Before the commission | ||
adopts the initial bed day allocation methodology, the department | ||
shall continue to allocate state-funded beds in the state hospitals | ||
and other inpatient mental health facilities according to the | ||
department's policy as it existed immediately before September 1, | ||
2015, and the policy is continued in effect for that purpose. This | ||
subsection expires September 1, 2017. | ||
SECTION 3. Subchapter D, Chapter 1001, Health and Safety | ||
Code, is amended by adding Sections 1001.086, 1001.087, and | ||
1001.088 to read as follows: | ||
Sec. 1001.086. TREATMENT ALTERNATIVES TRAINING CURRICULUM | ||
FOR JUDGES AND ATTORNEYS. (a) The department, with input from the | ||
court of criminal appeals and the forensic director appointed under | ||
Section 532.013, shall develop and maintain a training curriculum | ||
for judges and attorneys that provides information on inpatient and | ||
outpatient treatment alternatives to inpatient commitment to a | ||
state hospital for a patient whom a court is ordering to receive | ||
mental health services: | ||
(1) to attain competency to stand trial under Chapter | ||
46B, Code of Criminal Procedure; or | ||
(2) following an acquittal by reason of insanity under | ||
Chapter 46C, Code of Criminal Procedure. | ||
(b) The training curriculum developed and maintained under | ||
Subsection (a) must include a guide to treatment alternatives, | ||
other than inpatient treatment at a state hospital, from which a | ||
patient described by Subsection (a) may receive mental health | ||
services. | ||
Sec. 1001.087. CONTRACTING FOR AND ADMINISTRATION OF | ||
CERTAIN FUNCTIONS RELATING TO SUBSTANCE ABUSE. (a) The department | ||
may contract only with local mental health authorities and local | ||
behavioral health authorities to administer outreach, screening, | ||
assessment, and referral functions relating to the provision of | ||
substance abuse services. A local mental health authority or local | ||
behavioral health authority may subcontract with a substance abuse | ||
or behavioral health service provider to provide those services. | ||
(b) A local mental health authority or local behavioral | ||
health authority who contracts with the department to administer | ||
outreach, screening, assessment, and referral functions relating | ||
to the provision of substance abuse services shall develop an | ||
integrated service delivery model that, to the extent feasible, | ||
uses providers who have historically administered outreach, | ||
screening, assessment, and referral functions. | ||
Sec. 1001.088. MENTAL HEALTH AND SUBSTANCE ABUSE HOTLINES. | ||
The department shall ensure that each local mental health authority | ||
and local behavioral health authority operates a toll-free | ||
telephone hotline that enables a person to call a single hotline | ||
number to obtain information from the authority about mental health | ||
services, substance abuse services, or both. | ||
SECTION 4. (a) Not later than November 1, 2015, the | ||
commissioner of state health services shall establish a forensic | ||
work group, and the executive commissioner of the Health and Human | ||
Services Commission shall appoint members of that work group, as | ||
required by Section 532.0131, Health and Safety Code, as added by | ||
this Act. | ||
(b) Not later than November 1, 2015, the executive | ||
commissioner of the Health and Human Services Commission shall | ||
adopt any rules necessary for the implementation of Section 532.013 | ||
or 532.0131, Health and Safety Code, as added by this Act. | ||
SECTION 5. The commissioner of state health services shall | ||
appoint a forensic director as required by Section 532.013, Health | ||
and Safety Code, as added by this Act, as soon as practicable after | ||
the effective date of this Act. | ||
SECTION 6. Not later than March 1, 2016, the Department of | ||
State Health Services shall develop the training curriculum | ||
required by Section 1001.086, Health and Safety Code, as added by | ||
this Act. | ||
SECTION 7. Section 1001.087, Health and Safety Code, as | ||
added by this Act, applies only to a contract that is entered into | ||
or renewed on or after September 1, 2015. A contract that is | ||
entered into or renewed before that date is governed by the law as | ||
it existed immediately before September 1, 2015, and that law is | ||
continued in effect for that purpose. | ||
SECTION 8. This Act takes effect immediately if it receives | ||
a vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2015. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I hereby certify that S.B. No. 1507 passed the Senate on | ||
April 15, 2015, by the following vote: Yeas 30, Nays 1; and that | ||
the Senate concurred in House amendments on May 18, 2015, by the | ||
following vote: Yeas 28, Nays 2. | ||
______________________________ | ||
Secretary of the Senate | ||
I hereby certify that S.B. No. 1507 passed the House, with | ||
amendments, on May 11, 2015, by the following vote: Yeas 127, | ||
Nays 5, one present not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
Approved: | ||
______________________________ | ||
Date | ||
______________________________ | ||
Governor |