Interim Study Recommendations for the 82nd Legislature

Between Texas legislative sessions, senate and house committees are assigned certain topics to study --referred to as interim charges. The committees develop comprehensive reports with recommendations to be considered during the following legislative session. This is an opportunity for advocates and other stakeholders to have input into policy direction. Hundreds of ideas are submitted to legislators for consideration and from these only a select few are forwarded to the lieutenant governor and speaker. From those recommendations, the final charges are selected. The benefit of having an issue addressed during the interim is that it heightens visibility and improves chances for the issue to be on the policy agenda for the next session.

Recently, the Hogg Foundation for Mental Health submitted three recommendations for interim studies:

Child Relinquishment to Obtain Mental Health Services for Children with Serious Emotional Disturbance
Expanding the Use of School-wide Positive Behavior Interventions and Supports
Competency Restoration and Jail Diversion

Child Relinquishment to Obtain Mental Health Services for Children with Serious Emotional Disturbance

Issue:
Intensive mental health services and treatment for children with serious emotional disturbance or significant behavior challenges are often inaccessible to the children and families who need them. A very real consequence of not providing these services to youth with serious emotional disturbance is that loving parents are sometimes forced to make heart-wrenching decisions. At times, parents are faced with the choice of placing their child in the custody of Child Protective Services or turning their child over to the juvenile justice system in order to obtain the mental health services or treatment the child needs.

When parents “relinquish custody” of their child to Child Protective Services, the child is considered to have been abused or neglected and the parents are deemed as having “refused to accept parental responsibility,” referred to by the agency as “RAPR.” The parents’ names are added to the “abuse and neglect” registry which has both internal and external consequences that can affect them for the rest of their lives as they will be prohibited from working in many professions that support children (teaching, child care, Sunday school, etc.). This can be devastating to the child and to the family. These parents have typically done all that is humanly possible to obtain services for their child and are “relinquishing custody” solely to obtain the mental health services their child needs. They are not refusing to accept parental responsibility; they are doing what they need to do as parents, often at great personal cost.

Systems changes are needed to ensure that these children/youth get the intensive services they need without requiring parental relinquishment and without “criminalizing” the child or the parent. Policy changes are needed to prevent the designation of the parents as “refusing to accept parental responsibility” when the sole reason for relinquishment is to obtain mental health services when no abuse or neglect has occurred.

Study:
The Senate Health and Human Services Committee should study options for systems improvement to prevent the need for parental relinquishment to obtain mental health services, to end criminalization of relinquishment when done solely to obtain mental health services, and to make alternative options available. The study should include:

Data collection on the number of parents relinquishing custody to obtain mental health services for their child with serious emotional disturbance.
Evaluation of alternatives to relinquishment including joint conservatorship.
Identification of barriers to coordination of services between agencies to improve access to the crisis services needed to prevent relinquishment.
Analysis of the impact of the current practice of “criminalizing” (adding parents to the abuse/neglect registry) relinquishment and options for improved policies.
Analysis of other states’ policies on relinquishment including cost data for states that allow voluntary relinquishment.

Expanding the Use of School-wide Positive Behavior Interventions and Supports

Issue:
Implementation of positive behavior interventions and supports (PBIS) has proven successful in improving the mental health and well-being of both students and educators by changing the culture of campus environments. Numerous studies have evidenced the effectiveness of school-wide positive behavior support programs in reducing challenging behaviors of individual students as well as creating more respectful campus environments. While the evidence exists, only a limited number of Texas schools have embraced PBIS practices.

PBIS requires the commitment of administrators, teachers, and the entire campus staff. Underlying expectations for all students must be consistent whether students are in a classroom, the cafeteria, the library, or anywhere else on campus. While planning and training time are a necessary piece of successful implementation, the payoff is significant reductions in referrals, bullying, ticketing, and suspensions creating more time and space for meaningful learning.

Schools in Texas that have made the commitment and invested the time and energy into creating new environments by using PBIS, have shown some incredible results. Expanding the use of PBIS philosophy and practices across Texas could make resources currently being spent on discipline and behavior management available for more positive learning experiences.

Study:
The Senate Education Committee should study options and opportunities for expanding the use of PBIS in Texas public schools. The following components could be included in the study.

Collection of data determining the number of school-wide positive behavior intervention support programs that have been implemented in Texas public schools.
Identification of areas in the state that are more likely to adopt PBIS values and practices.
Analysis of data from districts that have implemented school-wide PBIS particularly focusing on before and after statistics relating to number of referrals, tickets issued, suspensions, bullying incidents, etc.
Study various models used by different districts (and in other states) to determine if outcomes are significantly different.
Identify resources needed to assist districts in adopting school-wide PBIS.
Identify barriers that may deter some districts from embracing PBIS.

Competency Restoration and Jail Diversion

Issue:
City and county jails across Texas carry the financial burden of inadequate competency restoration services. Additionally, many individuals charged with crimes unnecessarily remain incarcerated for extended periods of time while awaiting competency restoration services.

Individuals charged with a crime have the right to an evaluation of their competency before proceeding to trial. These evaluations measure the individual’s ability to consult with an attorney and to have a rational and factual understanding of the charges he or she faces. In cases where an individual is deemed incompetent the state must restore that person to competency before a trial begins. The state’s current method of competency evaluation and restoration often comes at significant economic and human costs.

In many cases non-violent defendants remain in jail for extended periods while waiting for competency restoration services. This practice consumes valuable resources and violates our basic notions of justice, particularly in the case of defendants who might otherwise receive non-incarceration sentences or be found not-guilty. House Bill 748 (Menendez) passed during the 82nd legislative session addressed maximum incarceration times for misdemeanor crimes and ensured credit for time incarcerated while awaiting restoration services. This was an important step in addressing the systemic problems, but more issues relating to competency restoration need to be studied.

Once an individual is found to be incompetent to stand trial, restoration services are required and are typically provided in state-run psychiatric hospitals. Often these individuals experience extended stays in jail until a hospital bed becomes available. When a bed does become available, it may be in a hospital across the state requiring the use of significant local resources to transport the individual. Those waiting admission to state psychiatric hospitals for competency restoration have priority over others seeking services (civil patients). The percentage of forensic commitments to state hospitals doubled from 2001 to 2007, but the number of hospital beds has not significantly increased. Consequently, fewer and fewer inpatient beds are available for civil commitments. This creates a significant disadvantage for individuals who may be in crisis, but have not been charged with a crime. Inpatient mental health and restoration services can be as much as three times more costly than outpatient services which, in the case of non-violent offenders, is often a more appropriate alternative.

Study:
The Senate Criminal Justice Committee should conduct a study to determine the cost and the effectiveness of various models of competency restoration procedures available in Texas. The study could include:

Collection of data on the number of individuals:
- incarcerated while awaiting competency evaluations,
- deemed incompetent to stand trial, waiting inpatient competency restoration services,
- receiving competency restoration services in jail,
- receiving inpatient restoration services (state or privately operated psychiatric facilities), and
- receiving out-patient community restoration services.
Percentage of individuals awaiting competency restoration that have committed misdemeanor or non-violent felony violations compared to violent felonies.
Comparison of the cost and effectiveness of the various methods of competency restoration including jail restoration, inpatient hospital restoration, and the Texas outpatient competency restoration pilot programs. The comparison should analyze costs of restoration and mental health services, recidivism rates, restoration rates, public safety, effectiveness of the mental health services provided in various settings, rates of restoration and other outcome data that may be available.
Effective models of competency restoration used in other states.
Identification of resources needed to improve current competency restoration procedures and/or adopt alternative procedures.

For additional information contact Hogg Foundation for Mental Health staff Colleen Horton, policy program officer, at colleen.horton@austin.utexas.edu or 512/471-2988, or Peter McGraw, policy fellow, at peter.mcgraw@austin.utexas.edu or 512/471-7627.