OFFltE OFTHEATTORNEY GENERAL.

STATE OFnx*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 ofthe 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 isresponsible 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, ifno such procedures
are initiated, the county that accepts an application for court-ordered mental health services, issues
an order forprotective 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 ofthose proceedings from the responsible county. Acounty’s responsibility forpaying 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 theresponsible county include, but are not limited to, those enumerated in section 571.018(c).

You inform us ofthe following facts giving rise toyour request: San Antonio State Hospital (SASH) in Bexar County serves asthe regional hospital providing inpatient care for various Texas counties, including Webb County. Bexar County, using itsresources, conducts hearings formental health services forpatients committed to SASH by Webb County orpatients admitted to SASH from Webb County under the emergency detention procedures asset out in subchapters AorBofchapter 573 ofthe Health and Safety Code. Examples of such proceedings include petitions for an order to administer psychoactive medication, applications for atemporary mental health services order, and applications for extended mental health services. Bexar County sends Webb County bills ofcosts 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, toHonorable 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 arethe costs for which itisresponsible. See Request Letter, supra note 1, at 2-3; Webb Brief at 2-5$ Telephone Conversation with Honorable Homer0 Ramirez, Webb County Attorney (Aug. 31,200O).
The Texas Mental Health Code, codified as subtitle C of title 7, Health and Safety Code, provides for access tocare and treatment formentally illpersons. 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. Acounty ordistrict attorney orother adult may tile an application for court-ordered mental health services for an individual. See id. 4574.001 (Vernon Supp. 2000). The application must be tiled with the county clerk in the county inwhich the proposed patient resides, isfound, orisreceiving mental health services by court order
orpursuant to apprehension by apolice officer under subchapter Aofchapter 573 ofthe Health and Safety Code. See id. 5574.001(b).
Section 571.018 of the Health and Safety Code deals with the mental health services proceeding costs, and subsection (a) ofthat 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 areinitiated, the county that accepts an application for court-ordered mental health services, issues an order forprotective custody, orissues 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)isresponsible forpaying the costs ofallsubsequent hearings orproceedings for that person until he orshe isdischarged. Id. 5571.018(b). Aproposed patient’s county ofresidence, however, must pay certain court-approved expenses for an indigent patient ifordered 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 “aperson or estate liable for the patient’s support in adepartment[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, ifno 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 fromHonorable

Homero Ram&z, Webb County Attorney, toHonorable 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 amental healthservicesproceeding. See-id. 4571.018(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. 5574.001(b) (application for court-ordered mental health services must be filed in the county inwhich person resides, is found, or isreceiving mental health services by court order or pursuant to apprehension by police officer). If ordered by a court, however, the county ofthe proposed patient’s residence isresponsible 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 isthe 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 ofeach case, we cannot advise you, asamatter oflaw, whether Bexar County orWebb County isresponsible for the costs ofmental health services proceedings.or hearings conducted in Bexar County. Relying on Attorney General Opinion JC-0088 (1999), you appear to suggest that acounty is responsible under section 571.018 only for “derivative proceedings” to the commitment proceedings initiated by orconducted inthat county. Webb Brief, supra note 2,at2-5. 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, orissues an order for temporary mental health services isresponsible for mental health services proceeding costs; and that county is also responsible for the costs of all subsequent mental health services proceedings under subtitle Coftitle 7ofthe Health and Safety Code until the person who is the subject ofthese proceedings is discharged. TEX.HEALTH & SAFETY CODE ANN. 5571.018(a), (b) (Vernon Supp. 2000). Subtitle C oftitle 7comprises chapters 571 through 577 of the Health and Safety Code. Ifno emergency detention proceedings are initiated, the county that conducts the hearing on the application forcourt-ordered mental health services for aperson, 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 isinapposite. 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) at2;see also Tex. Att’y Gen. Op. No. DM-174 (1992) at2 (“The fee collected by acounty clerk for filing of an original action underThe 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 forwhich
acounty is responsible under section 571.018.

You also appear to suggest that the nonresponsible county conducting the mental health services proceedings isnot authorized to collect the costs ofthose 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&SAFETYCODEANN.5571.018(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 ofall 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 ofthe 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 tobill the responsible county for the costs ofthe mental health services proceedings.“).

You next ask about themental health services proceeding costs which the responsible county isrequired to pay under section 571.018. As discussed above, the responsible county isrequired 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& SAFETYCODEANN.§571.018(a), (b) (Vernon Supp. 2000). The costs ofmental 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 amental health facility
or to a federal agency not to exceed $50 iftransporting within the
same county and not to exceed the reasonable cost oftransportation iftransporting between counties;
(5) costs and salary supplements authorized under Section 574.031(i) and (j) [for ajudge who holds hearings atlocations 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 ofenlargement and not oflimitation orexclusive enumeration, and use ofthe terms does not create apresumption that components not expressed are excluded.” TEX. GOV’T CODE ANN. 5 311.005(13) (Vernon 1998); see also id. (these definitions apply unless statute or context requires adifferent definition). Accordingly, the enumerated costs in section 571.018 are not exclusive. Additionally, apatient’s county ofresidence, 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. 5571.018(f) (Vernon Supp. 2000). Section 574.010 authorizes the court to order an independent psychiatric evaluation ofaproposed patient by apsychiatrist chosen by the patient; and to order the patient’s county ofresidence to pay for cow-approved expenses for expert testimony ifthe court determines that the proposed patient is indigent. Id. 5574.010 (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 forprotective custody, orissues anorder fortemporary 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 ofTexas

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