TEXAS MENTAL HEALTH CODE PROJECT Susan A Stone

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

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

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

Organization �Total Repeal �Exception: Section 577 �Organizational Structure

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.

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. ”

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

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”

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

Court Processes �Notice �Associate Judges �Court Fees �Attorney Roles �Video-Conferencing �Cross-County Jurisdiction

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

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