Relating to inpatient competency restoration services.

Contracts

• Local Governance MOUs: You are legally required to negotiate and execute three distinct MOUs defining "powers and duties" with:
• 1. The County where the facility is located.
• 2. The Municipality (City) where the facility is located.
• 3. The Local Mental Health Authority (LMHA) serving the area.
• HHSC Master Contract: Expect your state contract to be amended to include compliance with Chapter 580 as a material term. Failure to secure local MOUs may constitute a breach of your state contract.

Hiring/Training

• Intake & Discharge Coordinators: Staff must be retrained to capture specific legal data points at admission (e.g., citizenship/country of origin, specific offense level) and discharge (exact transfer dates).
• Legal/Compliance: In-house counsel must allocate significant hours to negotiating the required MOUs with local government attorneys.

Reporting & Record-Keeping

• EHR Configuration: Your Electronic Health Records system must be updated to automatically track and aggregate:
• Restoration velocity (patients restored in $\le$ 60 days vs. $>60$ days).
• Failed restorations where extensions were sought.
• Transfer Lag Time: The specific number of days between a non-restoration finding and the patient's physical transfer.
• Demographic Segmentation: Data must be segmentable by felony vs. misdemeanor charges and country of origin.

Fees & Costs

• Administrative Costs: While there are no new statutory fees, facilities will incur legal costs for MOU negotiations and IT costs for EHR reconfiguration.
• Fiscal Note: The Legislative Budget Board anticipates no significant fiscal implication to the State, shifting the administrative burden entirely to providers.