TEXAS MENTAL HEALTH CODE PROJECT Susan A. Stone, JD, MD Susan Stone and Associates PO Box 220, 180 Bradley Lane Rosanky, TX ; fax

Background Continuity of Care Task Force Hogg Foundation RFP Texas Appleseed Disability Rights, Texas Title C; Sections , 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 State Health Services Rules.

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