    HEALTH AND SAFETY CODE
    TITLE 7. MENTAL HEALTH AND INTELLECTUAL DISABILITY
    SUBTITLE B. STATE FACILITIES
    CHAPTER 551.  GENERAL PROVISIONS
    SUBCHAPTER A.  GENERAL POWERS AND DUTIES RELATING TO STATE FACILITIES
    Sec. 551.001.  DEFINITIONS.  In this subtitle:(1)  "Commission" means the Health and Human Services Commission.(2)  "Commissioner" means:(A)  the commissioner of state health services in relation to mental health services; and(B)  the commissioner of aging and disability services in relation to intellectual disability services.(3)  "Department" means:(A)  the Department of State Health Services in relation to mental health services; and(B)  the Department of Aging and Disability Services in relation to intellectual disability services.(4)  "Department facility" means:(A)  a facility for persons with mental illness under the jurisdiction of the Department of State Health Services; and(B)  a facility for persons with an intellectual disability under the jurisdiction of the Department of Aging and Disability Services.(5)  "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.002.  PROHIBITION OF INTEREST.  The superintendent or director of a department facility or a person connected with that department facility may not:(1)  sell or have a concern in the sale of merchandise, supplies, or other items to a department facility; or(2)  have an interest in a contract with a department facility.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.003.  DEPOSIT OF PATIENT OR CLIENT FUNDS.  (a)  The superintendent or director of a department facility is the custodian of the personal funds that belong to a facility patient or client and that are on deposit with the institution.(b)  The superintendent or director may deposit or invest those funds in:(1)  a bank in this state;(2)  federal bonds or obligations; or(3)  bonds or obligations for which the faith and credit of the United States are pledged.(c)  The superintendent or director may combine the funds of facility patients or clients only to deposit or invest the funds.(d)  The person performing the function of business manager at that facility shall maintain records of the amount of funds on deposit for each facility patient or client.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.004.  BENEFIT FUND.  (a)  The superintendent or director may deposit the interest or increment accruing from funds deposited or invested under Section 551.003 into a fund to be known as the benefit fund.  The superintendent or director is the trustee of the fund.(b)  The superintendent or director may spend money from the benefit fund for:(1)  educating or entertaining the patients or clients;(2)  barber or cosmetology services for the patients or clients; and(3)  the actual expense incurred in maintaining the fund.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.005.  DISBURSEMENT OF PATIENT OR CLIENT FUNDS.  Funds in the benefit fund or belonging to a facility patient or client may be disbursed only on the signatures of both the facility's superintendent or director and the person performing the function of business manager at that facility.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.006.  FACILITY STANDARDS.  (a)  The executive commissioner by rule shall prescribe standards for department facilities relating to building safety and the number and quality of staff.  The staff standards must provide that adequate staff exist to ensure a continuous plan of adequate medical, psychiatric, nursing, and social work services for patients and clients of a department facility.(b)  Each department shall approve facilities of that department that meet applicable standards and, when requested, shall certify the approval to the Centers for Medicare and Medicaid Services.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.007.  BUILDING AND IMPROVEMENT PROGRAM.  (a)  The executive commissioner, in coordination with the appropriate department, shall design, construct, equip, furnish, and maintain buildings and improvements authorized by law at department facilities.(b)  The executive commissioner may employ architects and engineers to prepare plans and specifications and to supervise construction of buildings and improvements.  The executive commissioner shall employ professional, technical, and clerical personnel to carry out the design and construction functions prescribed by this section, subject to the General Appropriations Act and other applicable law.(c)  If the legislature appropriates money to the commission for the purpose of the construction, expansion, or operation of certain inpatient mental health facilities under authority conferred by Sections 2155.144(b-2) and 2166.251, Government Code, the commission may award the money as a one-time grant directly to an entity for that purpose.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.Acts 2025, 89th Leg., R.S., Ch. 367 (H.B. 109), Sec. 1, eff. September 1, 2025.

    Sec. 551.008.  REGIONAL LAUNDRY CENTERS.  A regional laundry center operated by the commission to provide laundry services to department facilities may contract with federal agencies, other state agencies, or local political subdivisions to provide or receive laundry services.
    Added by Acts 2019, 86th Leg., R.S., Ch. 111 (S.B. 1234), Sec. 1, eff. May 22, 2019.

    Sec. 551.009.  HILL COUNTRY LOCAL MENTAL HEALTH AUTHORITY CRISIS STABILIZATION UNIT.  (a)  In this section, "department" means the Department of State Health Services.(a-1)  The department shall contract with the local mental health authority serving the Hill Country area, including Kerr County, to operate a crisis stabilization unit on the grounds of the Kerrville State Hospital as provided by this section.  The unit must be a 16-bed facility separate from the buildings used by the Kerrville State Hospital.(b)  The department shall include provisions in the contract requiring the local mental health authority to ensure that the crisis stabilization unit provides short-term residential treatment, including medical and nursing services, designed to reduce a patient's acute symptoms of mental illness and prevent a patient's admission to an inpatient mental health facility.(c)  The local mental health authority shall contract with Kerrville State Hospital to provide food service, laundry service, and lawn care to the local mental health authority operating a crisis stabilization unit on the grounds of the Kerrville State Hospital as provided by this section.(d)  The crisis stabilization unit may not be used to provide care to:(1)  children; or(2)  adults committed to or court ordered to a department facility as provided by Chapter 46C, Code of Criminal Procedure.(e)  The local mental health authority operating the crisis stabilization unit under contract shall use, for the purpose of operating the 16-bed unit, the money appropriated to the department for operating 16 beds in state hospitals that is allocated to the local mental health authority.  The department shall ensure that the local mental health authority retains the remainder of the local authority's state hospital allocation that is not used for operating the 16-bed unit.  The department may allocate additional funds appropriated to the department for state hospitals to the crisis stabilization unit.(f)  The department shall reduce the number of beds the department operates in the state hospital system by 16.  The department, in collaboration with the local mental health authority, shall ensure that the 16 beds in the crisis stabilization unit are made available to other mental health authorities for use as designated by the department.
    Added by Acts 2007, 80th Leg., R.S., Ch. 1188 (H.B. 654), Sec. 1, eff. June 15, 2007.Amended by: Acts 2009, 81st Leg., R.S., Ch. 83 (S.B. 1054), Sec. 2, eff. May 20, 2009.Acts 2009, 81st Leg., R.S., Ch. 83 (S.B. 1054), Sec. 3, eff. May 20, 2009.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.Acts 2019, 86th Leg., R.S., Ch. 111 (S.B. 1234), Sec. 2, eff. May 22, 2019.

    SUBCHAPTER B.  PROVISIONS APPLICABLE TO FACILITY SUPERINTENDENT OR DIRECTOR
    Sec. 551.022.  POWERS AND DUTIES OF SUPERINTENDENT.  (a)  The superintendent of a department facility for persons with mental illness is the administrative head of that facility.(b)  The superintendent has the custody of and responsibility to care for the buildings, grounds, furniture, and other property relating to the facility.(c)  The superintendent shall:(1)  oversee the admission and discharge of patients;(2)  keep a register of all patients admitted to or discharged from the facility;(3)  supervise repairs and improvements to the facility;(4)  ensure that facility money is spent judiciously and economically;(5)  keep an accurate and detailed account of all money received and spent, stating the source of the money and to whom and the purpose for which the money is spent; and(6)  keep a full record of the facility's operations.(d)  In accordance with department rules and departmental operating procedures, the superintendent may:(1)  establish policy to govern the facility that the superintendent considers will best promote the patients' interest and welfare;(2)  appoint subordinate officers, teachers, and other employees and set their salaries, in the absence of other law; and(3)  remove an officer, teacher, or employee for good cause.(e)  This section does not apply to a state supported living center or the director of a state supported living center.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.  Amended by Acts 1995, 74th Leg., ch. 821, Sec. 17, eff. Sept. 1, 1995.Amended by: Acts 2009, 81st Leg., R.S., Ch. 284 (S.B. 643), Sec. 20, eff. June 11, 2009.Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.0225.  POWERS AND DUTIES OF STATE SUPPORTED LIVING CENTER DIRECTOR.  (a)  The director of a state supported living center is the administrative head of the center.(b)  The director of a state supported living center has the custody of and responsibility to care for the buildings, grounds, furniture, and other property relating to the center.(c)  The director of a state supported living center shall:(1)  oversee the admission and discharge of residents and clients;(2)  keep a register of all residents and clients admitted to or discharged from the center;(3)  ensure that the civil rights of residents and clients of the center are protected;(4)  ensure the health, safety, and general welfare of residents and clients of the center;(5)  supervise repairs and improvements to the center;(6)  ensure that center money is spent judiciously and economically;(7)  keep an accurate and detailed account of all money received and spent, stating the source of the money and on whom and the purpose for which the money is spent;(8)  keep a full record of the center's operations;(9)  monitor the arrival and departure of individuals to and from the center as appropriate to ensure the safety of residents; and(10)  ensure that residents' family members and legally authorized representatives are notified of serious events that may indicate problems in the care or treatment of residents.(d)  In accordance with department rules and operating procedures, the director of a state supported living center may:(1)  establish policy to govern the center that the director considers will best promote the residents' interest and welfare;(2)  hire subordinate officers, teachers, and other employees and set their salaries, in the absence of other law; and(3)  dismiss a subordinate officer, teacher, or employee for good cause.(e)  The Department of Aging and Disability Services shall, with input from residents of a state supported living center, and the family members and legally authorized representatives of those residents, develop a policy that defines "serious event" for purposes of Subsection (c)(10).
    Added by Acts 2009, 81st Leg., R.S., Ch. 284 (S.B. 643), Sec. 21, eff. June 11, 2009.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.024.  SUPERINTENDENT'S OR DIRECTOR'S DUTY TO ADMIT COMMISSIONER AND EXECUTIVE COMMISSIONER.  (a)  The superintendent or director shall admit into every part of the department facility the commissioner of that department and the executive commissioner.(b)  The superintendent or director shall on request show any book, paper, or account relating to the department facility's business, management, discipline, or government to the commissioner of that department or the executive commissioner.(c)  The superintendent or director shall give to the commissioner of that department or the executive commissioner any requested copy, abstract, or report.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.025.  DUTY TO REPORT MISSING PATIENT OR CLIENT.  If a person receiving inpatient intellectual disability services or court-ordered inpatient mental health services leaves a department facility without notifying the facility or without the facility's consent, the facility director or superintendent shall immediately report the person as a missing person to an appropriate law enforcement agency in the area in which the facility is located.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.026.  PERSON PERFORMING BUSINESS MANAGER FUNCTION.  (a)  The person performing the function of business manager of a department facility is the chief disbursing officer of the department facility.(b)  The person performing the function of business manager of a department facility is directly responsible to the superintendent or director.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    SUBCHAPTER C.  POWERS AND DUTIES RELATING TO PATIENT OR CLIENT CARE
    Sec. 551.041.  MEDICAL AND DENTAL TREATMENT.  (a)  Each department shall provide or perform recognized medical and dental treatment or services to a person admitted or committed to that department's care.  Each department may perform this duty through an authorized agent.(b)  Each department may contract for the support, maintenance, care, or medical or dental treatment or service with a municipal, county, or state hospital, a private physician, a licensed nursing facility or hospital, or a hospital district.  The authority to contract provided by this subsection is in addition to other contractual authority granted to the department.  A contract entered into under this subsection may not assign a lien accruing to this state.(c)  If a department requests consent to perform medical or dental treatment or services from a person or the guardian of the person whose consent is considered necessary and a reply is not obtained immediately, or if there is no guardian or responsible relative of the person to whom a request can be made, the superintendent or director of a department facility shall order:(1)  medical treatment or services for the person on the advice and consent of three primary care providers, at least two of whom are physicians licensed by the Texas Medical Board; or(2)  dental treatment or services for the person on the advice and consent of two dentists licensed by the State Board of Dental Examiners and of one physician licensed by the Texas Medical Board.(d)  This section does not authorize the performance of an operation involving sexual sterilization or a frontal lobotomy.(e)  For purposes of this section, "primary care provider" means a health care professional who provides health care services to a defined population of residents.  The term includes a physician licensed by the Texas Medical Board, an advanced practice registered nurse licensed by the Texas Board of Nursing, and a physician assistant licensed by the Texas Physician Assistant Board.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.Acts 2017, 85th Leg., R.S., Ch. 437 (S.B. 1565), Sec. 1, eff. September 1, 2017.

    Sec. 551.042.  OUTPATIENT CLINICS.  (a)  If funds are available, the Department of State Health Services may establish in locations the department considers necessary outpatient clinics to treat persons with mental illness.(b)  As necessary to establish and operate the clinics:(1)  the department may:(A)  acquire facilities;(B)  hire personnel; and(C)  contract with persons, corporations, and local, state, and federal agencies; and(2)  the executive commissioner may adopt rules.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.

    Sec. 551.044.  OCCUPATIONAL THERAPY PROGRAMS.  (a)  Each department may provide equipment, materials, and merchandise for occupational therapy programs at department facilities.(b)  The superintendent or director of a department facility may, in accordance with rules of that department, contract for the provision of equipment, materials, and merchandise for occupational therapy programs.  If the contractor retains the finished or semi-finished product, the contract shall provide for a fair and reasonable rental payment to the applicable department by the contractor for the use of facility premises or equipment.  The rental payment is determined by the amount of time the facility premises or equipment is used in making the products.(c)  The finished products made in an occupational therapy program may be sold and the proceeds placed in the patients' or clients' benefit fund, the patients' or clients' trust fund, or a revolving fund for use by the patients or clients.  A patient or client may keep the finished product if the patient or client purchases the material for the product from the state.(d)  Each department may accept donations of money or materials for use in occupational therapy programs and may use a donation in the manner requested by the donor if not contrary to the policy of that department.
    Added by Acts 1991, 72nd Leg., ch. 76, Sec. 1, eff. Sept. 1, 1991.Amended by: Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1337, eff. April 2, 2015.