OFFltE OF THE ATTORNEY GENERAL. STATE OF nx*s 

JOHN CORNYN 

October 3,200O 

The Honorable Homer0 Ramirez 

Webb County Attorney 

1110 Victoria, Suite 403 

Laredo, Texas 78040 

Opinion No. JC-0287 

Re: Which county is responsible for mental 

health services proceeding costs under section 

571 .018 of the Texas Health and Safety Code and 

related question (RQ-0227-JC) 

Dear Mr. Ramirez: 

You ask about the collection of mental health services proceeding costs under section 

571.018 ofthe Health and Safety Code. We understand you to ask which county is responsible for 

mental health services proceeding costs under section 571.018, and the costs for which it is 

responsible. Because you do not ask about a particular situation, we answer your questions in 

general terms. The county that initiates emergency detention procedures or, if no such procedures 

are initiated, the county that accepts an application for court-ordered mental health services, issues 

an order for protective custody, or issues an order for temporary mental health services is generally 

responsible for paying mental health services proceeding costs under section 571.018. A 

nonresponsible county conducting mental health services proceedings is authorized to collect the 

cost of those proceedings from the responsible county. A county’s responsibility for paying mental 

health services proceeding costs is not limited to actions that are “derivative” of the initial 

commitment proceeding. The costs ofmental health services proceedings payable by the responsible 

county include, but are not limited to, those enumerated in section 571.018(c). 

You inform us ofthe following facts giving rise to your request: San Antonio State Hospital 

(SASH) in Bexar County serves as the regional hospital providing inpatient care for various Texas 

counties, including Webb County. Bexar County, using its resources, conducts hearings for mental 

health services for patients committed to SASH by Webb County or patients admitted to SASH from 

Webb County under the emergency detention procedures as set out in subchapters A or B of chapter 

573 of the Health and Safety Code. Examples of such proceedings include petitions for an order to 

administer psychoactive medication, applications for a temporary mental health services order, and 

applications for extended mental health services. Bexar County sends Webb County bills of costs 

for these proceedings. Webb County has not entered into any local intergovernmental agreement 

with Bexar County agreeing to be responsible for these mental health services proceeding costs.’ 

‘Letter fromHonorable Homero Ramirez, Webb County Attorney, to Honorable John Comyn, Texas Attorney 

General at 2 (Apr. 28,200O) (on tile with Opinion Committee) [hereinafter Request Letter]. 
The Honorable Homer0 Ramirez - Page 2 (X-0287) 

We understand you to ask, first, which county is responsible for mental health services 

proceeding costs under section 571.018 and, second, what are the costs for which it is responsible. 

See Request Letter, supra note 1, at 2-3; Webb Brief at 2-5$ Telephone Conversation with 

Honorable Homer0 Ramirez, Webb County Attorney (Aug. 3 1,200O). 

The Texas Mental Health Code, codified as subtitle C of title 7, Health and Safety Code, 

provides for access to care and treatment for mentally ill persons. See TEX. HEALTH & SAFETY CODE 

ANN. chs. 571 - 577 (Vernon 1992 & Supp. 2000). Chapter 574 of the Health and Safety Code 

governs proceedings for court-ordered mental health services. A county or district attorney or other 

adult may tile an application for court-ordered mental health services for an individual. See id. 

4 574.001 (Vernon Supp. 2000). The application must be tiled with the county clerk in the county 

in which the proposed patient resides, is found, or is receiving mental health services by court order 

or pursuant to apprehension by a police officer under subchapter A of chapter 573 of the Health and 

Safety Code. See id. 5 574.001(b). 

Section 571.018 of the Health and Safety Code deals with the mental health services 

proceeding costs, and subsection (a) of that section provides that they shall be paid by: 

(1) the county that initiates emergency detention 

procedures under Subchapter A or B, Chapter 573 [for temporary 

detention of a person believed to be mentally ill, where there is a 

substantial risk of serious harm to the person or others]; or 

(2) ifno emergency detention procedures are initiated, the 

county that accepts an application for court-ordered mental health 

services, issues an order for protective custody, or issues an order for 

temporary mental health services. 

Id. 5 571.018(a)(l), (2). The county responsible for the mental health services proceeding costs 

under subsection (a) is responsible for paying the costs of all subsequent hearings or proceedings for 

that person until he or she is discharged. Id. 5 571 .018(b). A proposed patient’s county of residence, 

however, must pay certain court-approved expenses for an indigent patient if ordered by the court 

under section 574.010. Id. $5 571.018(f) (Vernon Supp. 2000), 574.010 (Vernon 1992). A county 

is entitled to reimbursement for costs actually paid by the county from the patient or “a person or 

estate liable for the patient’s support in a department[al] mental health facility.” Id. 5 571.018(d) 

(Vernon Supp. 2000). 

With this background, we turn to your first question regarding the county responsible for 

mental health services proceeding costs under section 571 ,018. The county that initiates emergency 

detention procedures or, if no such procedures are initiated, the county that accepts an application 

for court-ordered mental health services, issues an order for protective custody, or issues an order 

2Brief from Honorable Homero Ram&z, Webb County Attorney, to Honorable John Comyn, Texas Attorney 

General (Apr. 28,200O) (on file with Opinion Committee) [hereinafter Webb Brief]. 
The Honorable Homer0 Ramirez - Page 3 (X-0287) 

for temporary mental health services is generally responsible for paying for the costs of a mental 

healthservicesproceeding. See-id. 4 571.018(a),(b). Responsibilityundersection 571.018(a)isnot 

based on residency. See id. The responsible county may be, but is not necessarily, the proposed 

patient’s county ofresidence. See id.; id. 5 574.001(b) (application for court-ordered mental health 

services must be filed in the county in which person resides, is found, or is receiving mental health 

services by court order or pursuant to apprehension by police officer). If ordered by a court, 

however, the county of the proposed patient’s residence is responsible for court-approved expenses 

incurred for psychiatric evaluation and expert testimony for an indigent person. See id. 

$5 571.018(f) (Vernon Supp. 2000), 574.010 (Vernon 1992). 

Which county is the responsible county will vary in each case and will depend upon how the 

case was initiated. Webb County would generally be the responsibIe county for mental health 

services proceeding costs if it initiated the emergency detention proceedings, accepted a courtordered mental health services application, or issued an order for protective custody or temporary 

mental health services. Because responsibility for the mental health services proceedings will vary 

with the facts of each case, we cannot advise you, as a matter of law, whether Bexar County or Webb 

County is responsible for the costs of mental health services proceedings.or hearings conducted in 

Bexar County. 

Relying on Attorney General Opinion JC-0088 (1999), you appear to suggest that a county 

is responsible under section 571.018 only for “derivative proceedings” to the commitment 

proceedings initiated by or conducted in that county. Webb Brief, supra note 2, at 2-5. We disagree. 

Section 571.018 does not allocate responsibility based on the “derivative” or “original” 

nature of the mental health services hearings or proceedings. Again, under section 571 ,018, the 

county that initiates emergency detention procedures or, if no such procedures are initiated, the 

county that accepts an application for court-ordered mental health services, issues an order for 

protective custody, or issues an order for temporary mental health services is responsible for mental 

health services proceeding costs; and that county is also responsible for the costs of all subsequent 

mental health services proceedings under subtitle C of title 7 of the Health and Safety Code until the 

person who is the subject of these proceedings is discharged. TEX. HEALTH & SAFETY CODE ANN. 

5 571.018(a), (b) (Vernon Supp. 2000). Subtitle C oftitle 7 comprises chapters 571 through 577 of 

the Health and Safety Code. If no emergency detention proceedings are initiated, the county that 

conducts the hearing on the application for court-ordered mental health services for a person, see id. 

$5 574.031, ,034, ,035, which we assume is ihe “commitment hearing” to which you refer, is 

responsible for the costs of all subsequent proceedings under these chapters for that person. That 

county would be responsible, for instance, for paying the costs of a hearing on a petition to 

administer psychoactive medication under section 574.106 of the Health and Safety Code. 

Attorney General Opinion JC-0088 is inapposite. Attorney General Opinion JC-0088 deals 

with whether a county clerk under the clerk’s statutory authority to assess a separate filing 

fee only for each “original action” is permitted to charge a separate fee for a section 574.106 

medication hearing. See Tex. Att’y Gen. Op. No. JC-0088 (1999) at 2; see also Tex. Att’y Gen. Op. 

No. DM-174 (1992) at 2 (“The fee collected by a county clerk for filing of an original action under 
The Honorable Homer0 Ramirez - Page 4 (Jc-0287) 

section 118.052 [of the Local Government Code] is intended to cover ‘all clerical duties in 

connection with an original action tiled in a county civil court.“‘). The opinion concludes that a 

section 574.106 medication hearing is not a derivative or ancillary proceeding to the initial 

involuntary mental health commitment action, but a separate original action for which the county 

clerk is permitted to charge an additional fee. See Tex. Att’y Gen. Op. No. JC-0088 (1999). 

Attorney General Opinion K-0088 does not speak to the mental health proceedings costs for which 

a county is responsible under section 571.018. 

You also appear to suggest that the nonresponsible county conducting the mental health 

services proceedings is not authorized to collect the costs of those proceedings from the responsible 

county in the absence of an agreement by the responsible county to pay those costs. We disagree. 

First, the responsible county by definition is statutorily obligated to pay the mental health services 

proceeding costs. See TEX. HEALTH & SAFETY CODE ANN. 5 571 .018(a), (b) (Vernon Supp. 2000). 

Second, a nonresponsible county conducting the mental health services proceedings is clearly 

authorized to bill the responsible county for those costs under section 571.018(b): 

The county responsible for the costs of a hearing or 

proceeding under Subsection (a) shall pay the costs of all subsequent 

hearings or proceedings for that person under this subtitle until the 

person is discharged from mental health services. The costs shall be 

billed by the clerk of the court conducting the hearings. 

Id. 5 571.018(b) (emphasis added); see also Tex. Att’y Gen. Op. No. JC-0222 (2000) at 3 

(concluding that “section 571 ,018 now expressly requires the clerk ofthe court to bill the responsible 

county for the costs of the mental health services proceedings.“). 

You next ask about the mental health services proceeding costs which the responsible county 

is required to pay under section 571.018. As discussed above, the responsible county is required to 

pay the costs of all mental health services proceedings relating to a proposed patient that are 

provided for under chapters 571 through 577 of the Health and Safety Code until that person is 

discharged. See TEX. HEALTH & SAFETY CODE ANN. § 571 .018(a), (b) (Vernon Supp. 2000). The 

costs of mental health services proceedings payable by the responsible county include, but are not 

limited to, those enumerated in section 571.018(c), which provides that: 

Costs under this section include: 

(1) attorney’s fees; 

(2) physician examination fees; 

(3) compensation for court-appointed personnel listed 

under Section 571.017 [court shall order payment of reasonable 

compensation to attorneys, physicians, language interpreters, sign 

interpreters, and masters]; 
The Honorable Homer0 Ramirez - Page 5 (K-0287) 

(4) expenses of transportation to a mental health facility 

or to a federal agency not to exceed $50 if transporting within the 

same county and not to exceed the reasonable cost of transportation 

if transporting between counties; 

(5) costs and salary supplements authorized under Section 

574.031(i) and (j) [for a judge who holds hearings at locations other 

than the county courthouse]; and 

(6) prosecutor’s fees authorized under Section 574.031(k). 

Id. 3 571.018(c) (emphasis added). The Code Construction Act provides that “‘includes’ and 

‘including’ are terms of enlargement and not of limitation or exclusive enumeration, and use of the 

terms does not create a presumption that components not expressed are excluded.” TEX. GOV’T 

CODE ANN. 5 3 11.005(13) (Vernon 1998); see also id. (these definitions apply unless statute or 

context requires a different definition). Accordingly, the enumerated costs in section 571.018 are 

not exclusive. 

Additionally, a patient’s county of residence, rather than the responsible county, must pay 

court-approved expenses incurred for psychiatric evaluation and expert testimony for an indigent 

patient if ordered by the court under section 574.010. TEX. HEALTH & SAFETY CODE ANN. 

5 571.018(f) (Vernon Supp. 2000). Section 574.010 authorizes the court to order an independent 

psychiatric evaluation of a proposed patient by a psychiatrist chosen by the patient; and to order the 

patient’s county of residence to pay for cow-approved expenses for expert testimony if the court 

determines that the proposed patient is indigent. Id. 5 574.010 (Vernon 1992). 
The Honorable Homer0 Ramirez - Page 6 (X-0287) 

SUMMARY 

The county that initiates emergency detention procedures or, 

if no such procedures are initiated, the county that accepts an 

application for court-ordered mental health services, issues an order 

for protective custody, or issues an order for temporary mental health 

services is generally responsible for paying mental health services 

proceeding costs under section 571.018 of the Health and Safety 

Code. A nonresponsible county conducting mental health services 

proceedings is authorized to collect the costs of those proceedings 

from the responsible county regardless of whether the responsible 

county has agreed to pay those costs. A county’s responsibility for 

paying mental health services proceeding costs is not limited to 

actions that are “derivative” of the initial commitment proceeding. 

The costs of mental health services proceedings payable by the 

responsible county include, but are not limited to, those enumerated 

in section 571.018(c) ofthe Health and Safety Code. 

Attorney General of Texas 

ANDY TAYLOR 

First Assistant Attorney General 

CLARK KENT ERVJN 

Deputy Attorney General - General Counsel 

SUSAN D. GUSKY 

Chair, Opinion Committee 

Sheela Rai 

Assistant Attorney General - Opinion Committee