I've located that form; now my question is whether the form can be completed by the county where the patient/state hospital is located, or must it be completed by the county where the application is filed? Sure looks to me as though the "local" refers to the filing county, and not the state hospital's county?

Your assumption is the same as ours. The recommendation for treatment in our mental commitment cases comes from our local "portal" MHMR agency. They make the recommendation to send our patients to Wichita Falls State Hospital, keep them in our short-term facility or furlough them. Of course, when they recommend a trip to the state hospital, the patient usually beats the van back to Amarillo.

H&S 574.012 states that the "local mental health authority" shall make a recommendation for treatment.

The reason this is oft troubling for the portal authority is that there is a line item amount for bed days in the state hospital -- and no local authority wants to use these up too quickly. Moreover, the state hospital will also (and I think not rightly) charge the local authority for bed days for comptency related confinement in any facility other than Vernon, i.e. if they are "not manifestly dangerous" and transferred to Rusk, Terrell, Big Spring for continued care, then the local authority gets the bill. NGRI's are similarly charged though sometimes their confinement may be quite lengthy.

flj