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LAWSUIT Floyd Taylor, et al. v. David L. Lakey, M.D., et al ; No. D-1-GN-07-837, In the 250 th District Court of Travis

LAWSUIT Floyd Taylor, et al. v. David L. Lakey, M.D., et al ; No. D-1-GN-07-837, In the 250 th District Court of Travis County. The Reason for The Lawsuit.

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LAWSUIT Floyd Taylor, et al. v. David L. Lakey, M.D., et al ; No. D-1-GN-07-837, In the 250 th District Court of Travis

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  1. LAWSUITFloyd Taylor, et al. v. David L. Lakey, M.D., et al; No. D-1-GN-07-837, In the 250th District Court of Travis County

  2. The Reason for The Lawsuit • The number of persons in Texas found IST and committed to DSHS’s care (forensic commitment) almost doubled between 2001 and 2006, and it continued to increase through 2012. • To address this issue, in February 2006, DSHS implemented a policy requiring all person found IST and in need of competency restoration treatment to be placed on the DSHS State Hospital Forensic Admissions Clearinghouse waiting list. • During the latter part of 2006 DSHS capped the number of state hospitals beds that could be used for forensic commitments at or about 738 • Once placed on the Clearinghouse waiting list improperly admissions to DSHS became contingent on the availability of beds specifically designated for forensic commitment • This resulted in an average of 250 patients waiting in jails for competency restoration services for an average of 6 months

  3. The Basis of the Lawsuit Rights of Persons Found Incompetent to Stand Trial • Due process requires that the nature and duration of commitment bear some reasonable relation to the purpose for which the individual is committed. Jackson, 406 U.S. at 738. • Jackson v. Indiana, 406 U.S. 715 (1971)

  4. Purpose for Holding IST Individuals • Subchapter D of the Code of Criminal Procedure indicates the nature of detention of a person found IST: for further examination and treatment toward the specific objective of attaining competency to stand trial.

  5. Nature of Confinement • Jails • no capacity to provide restorative mental health treatment • Even if Jail has restorative treatment, duration must be brief before commitment proceeding initiated. Jackson v. Indiana • In-Patient at State Mental Health Facility • Does provide Resorative Treatment is and is obligated to provide that treatment under Article 46B.073

  6. The Court’s Finding and Order • DSHS Clearinghouse List which prevents transfer of physical custody of Plaintiffs to a state mental health facility for competency restoration treatment within a reasonable period of time after Defendant receives notice of a criminal court’s commitment order under Chapter 46B violates Plaintiffs’ due course of law rights as guaranteed by the Texas Constitution. • DSHS was enjoined from failing to make a bed available at an appropriate State Mental Hospital for an Incompetent Detainee no later than twenty one (21) days from the date the DSHS receives notice of a criminal court's commitment order. • DSHS was required to be in full compliance with this Requirement by June 2, 2012

  7. The Appeal DSHS has appealed this case, which stays this Court’s Order until a decision is reached by the Third Court of Appeals

  8. Department of State Health Services Efforts Towards More Timely Treatment of Patients Determined Incompetent to Stand Trial

  9. Types of Forensic Beds • Maximum Security • Intermediate Security • Transitional Security • Forensic • Residential Rehabilitation

  10. There are two (2) Lists of Patients Waiting to be Admitted to Forensic Beds for Treatment • Maximum Security Waiting List • Clearinghouse List

  11. MAXIMUM SECURITY WAITING LIST • Civilly committed patients who have been determined to be Manifestly Dangerous in the other state hospitals • Patients who have charges involving an act, threat or attempt of serious bodily injury, but are incompetent to stand trial • Patients who have been to trial and have been found Not Guilty by Reason of Insanity (NGRI)

  12. CLEARINGHOUSE LIST • 46 B.073 (Initial Commitment) or 46 B.102 (Extended Commitment) Patients charged with a felony or with a misdemeanor punishable by confinement and they are incompetent to stand trial if they do not have: • Sufficient present ability to consult with their lawyer with a reasonable degree of rational understanding; or • A rational as well as factual understanding of the proceedings against the person

  13. Where are Patients From That are Waiting on the Waiting Lists Persons on Clearinghouse List by Mental Health Authority: January 2010 - June 24, 2012

  14. PREVIOUS ACTIONS • May 1, 2006 – twenty four (24) Forensic Beds were added: • Austin State Hospital • San Antonio State Hospital • North Texas State Hospital • Terrell State Hospital • September 1, 2009 – Kerrville State Hospital became totally Transitional Forensic • March 1, 2011 – Montgomery County Hospital opened a One Hundred (100) bed Forensic Hospital • March 1 2011- Converted 120 beds from Civil to Residential Rehabilitation beds

  15. CURRENT ACTIONS AFTER THE LAWSUIT • Converted sixty (60) Forensic Beds at Rusk State Hospital to Maximum Security • Converting thirty seven (37) Civil Beds at Rusk State Hospital to Transitional Forensic Beds • Added eight (8) Maximum Security Beds to North Texas State Hospital – Vernon Campus • Added thirty two (32) Intermediate Security Beds to North Texas state Hospital – Wichita Falls Campus • Converting twenty (20) Civil Beds at San Antonio State Hospital to Forensic • Converting twenty (20) Civil Beds at North Texas State Hospital to Forensic Beds • Converting thirty (30) Civil Beds to Forensic as long term Civil Patients are transferred to University of Texas Health Center at Tyler (beds will be converted as patients are transferred at all hospitals except Rio Grande State Center)

  16. Additional Beds • Forty (40) new state hospital beds • Ninety (90) private hospital beds • Contracts managed through Mental Health Authorities • Tarrant County -20 Beds • Tropical Texas - 20 Beds • Tri County – 20 Beds • Contract with University of Texas Health Center Tyler – 30 Beds

  17. OTHER ACTIVITIES TO CREATE CAPACITY • Work with the courts to address forensic patients who are likely never going to regain competency by dropping charges and placing on a civil commitment • Continue to work on a guardianship program for patients who lack capacity to make decisions about their care • Attempting to get more patients directly from jail into outpatient competency restoration programs • Attempting to modify commitments from inpatient to outpatient so reasonably stable patients can complete their competency restoration in an outpatient competency restoration program.

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