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SB1164

Regular Session

Relating to emergency detention of certain persons evidencing mental illness and to court-ordered inpatient and extended mental health services.

Critical
Low Cost
Effective:2025-09-01
Enforcing Agencies

County Courts / Magistrates • Hospital Emergency Departments • Inpatient Mental Health Facilities • Texas Peace Officers / Law Enforcement Agencies

SB1164
Critical
Relating to emergency detention of certain persons evidencing mental illness and to court-ordered inpatient and extended mental health services.
Critical Compliance Urgency
Requires immediate attention
Cost Impact
Low
Effective
2025-09-01
Enforcing Agencies
County Courts / MagistratesHospital Emergency DepartmentsInpatient Mental Health FacilitiesTexas Peace Officers / Law Enfor...
Primary Author: Sen. Judith Zaffirini
89th Texas Legislature
jdkey.com
01

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

  • Effective Date: September 1, 2025
  • Compliance Deadline: September 1, 2025
  • *Note:* There is no phase-in period. Detentions initiated at 12:01 AM on this date must utilize the new forms and legal criteria.
  • Agency Rulemaking: While the statute is self-executing, the Texas Health and Human Services Commission (HHSC) is expected to update administrative rules regarding facility intake standards. Expect a "regulatory gray zone" between the effective date and the publication of final agency guidance.

Immediate Action Plan

  • 1. Immediate: Instruct General Counsel to draft updated "Notification of Emergency Detention" and "Certificate of Medical Examination" forms.
  • 2. Q2 2025: Meet with local law enforcement leadership to establish protocols for the "drop and go" hand-off to ensure facility security is not compromised.
  • 3. Q3 2025: Reprogram EMR intake modules to force selection of the new legal criteria for involuntary holds.
  • 4. August 2025: Conduct "tabletop" drills with intake staff to practice immediate custody transfer without police support.

Operational Changes Required

Contracts

  • EMS Memoranda of Understanding (MOUs): Review all agreements with private EMS providers operating under Section 573.005. Amendments must specify that EMS personnel are authorized to execute the *law enforcement* notification form and transfer custody immediately upon arrival.
  • Physician Agreements: Update employment contracts and Medical Staff Bylaws to require adherence to the new statutory definition of mental illness (anosognosia) to prevent dismissal of court applications.

Hiring/Training

  • Intake Security: You must staff intake areas with personnel capable of assuming immediate physical custody of potentially aggressive patients. Law enforcement is no longer required to remain on-site for medical clearance or registration.
  • Clinical Training: Psychiatrists and examining physicians require training on the new legal standard: "inability to recognize symptoms or appreciate the risks and benefits of treatment." Documentation must support this specific finding to survive judicial review.

Reporting & Record-Keeping

  • Mandatory Form Replacement: You must purge existing "Notification of Emergency Detention" forms. Replace them with versions containing the new statutory checkboxes regarding symptom recognition.
  • EMR Updates: Electronic Medical Record templates for the "Certificate of Medical Examination" must be reprogrammed to include the new criteria as a selection for involuntary admission.

Fees & Costs

  • Revenue Cycle Risk: Because officers are not required to wait for insurance verification, facilities assume financial risk immediately upon patient hand-off. Budget for a potential increase in uncompensated care for emergency psychiatric admissions.

Strategic Ambiguities & Considerations

  • "Appropriate Facility Staff": The statute permits officers to leave once the patient is delivered to "appropriate facility staff," but fails to define the credentials of such staff.
  • *Risk:* Law enforcement may attempt to hand off patients to security guards or registration clerks rather than clinical staff.
  • *Advice:* Define "appropriate staff" in your internal policy immediately (e.g., RN or Intake Coordinator) to establish a clear chain of custody.
  • Threshold for "Inability to Recognize Symptoms": This is a subjective standard without a statutory definition.
  • *Risk:* Over-utilization of this criteria may lead to habeas corpus challenges; under-utilization may lead to negligence claims for failure to detain.
  • *Advice:* Develop internal clinical guidelines citing specific behavioral markers (e.g., refusal of medication due to delusion) to standardize this finding until case law provides clarity.

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Information presented is for general knowledge only and is provided without warranty, express or implied. Consult qualified government affairs professionals and legal counsel before making compliance decisions.

02

Legislative Timeline

This bill's path through the Texas Legislature

Filed
Feb 7, 2025
Passed Senate
Apr 24, 2025
Passed House
May 28, 2025
Signed
Jun 20, 2025
TopicsCriminal ProcedureCriminal Procedure--generalHealthHealth--emergency Services & PersonnelMental Health & Substance AbuseGuardians & WardsIncapacitated PersonsPeace Officers
03

Senate Authors

Sen. Judith ZaffiriniDemocrat · Primary Author
Coauthors (1)

House Sponsor

Rep. Joseph MoodyDemocrat · Primary Sponsor

Bill Text(with markup)

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Quick Reference

Frequently Asked Questions

Common questions about SB1164

Q

What does Texas SB1164 do?

SB1164 fundamentally alters the intake process for emergency mental health detentions by codifying a "drop and go" policy for law enforcement and expanding involuntary commitment criteria to include patients lacking symptom awareness (anosognosia). Inpatient mental health facilities and hospital emergency departments must assume immediate custodial responsibility upon police arrival and update all legal filings to reflect the new statutory standards. Implementation Timeline Effective Date: September 1, 2025 Compliance Deadline: September 1, 2025 Note: There is no phase-in period.

Q

Who authored SB1164?

SB1164 was authored by Texas Senator Judith Zaffirini during the Regular Session.

Q

When was SB1164 signed into law?

SB1164 was signed into law by Governor Greg Abbott on June 20, 2025.

Q

Which agencies enforce SB1164?

SB1164 is enforced by County Courts / Magistrates, Hospital Emergency Departments, Inpatient Mental Health Facilities and Texas Peace Officers / Law Enforcement Agencies.

Q

How urgent is compliance with SB1164?

The compliance urgency for SB1164 is rated as "critical". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

Q

What is the cost impact of SB1164?

The cost impact of SB1164 is estimated as "low". This may vary based on industry and implementation requirements.

Q

What topics does SB1164 address?

SB1164 addresses topics including criminal procedure, criminal procedure--general, health, health--emergency services & personnel and mental health & substance abuse.

Legislative data provided by LegiScanLast updated: November 25, 2025

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