By: Zaffirini S.B. No. 47
(In the Senate - Filed November 8, 2010; January 31, 2011,
read first time and referred to Committee on Health and Human
Services; April 11, 2011, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 8, Nays 0;
April 11, 2011, sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 47 By: Uresti
A BILL TO BE ENTITLED
AN ACT
relating to the pro re nata administration of psychoactive
medications in certain residential health care facilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 576, Health and Safety
Code, is amended by adding Section 576.0245 to read as follows:
Sec. 576.0245. ADMINISTRATION OF PSYCHOACTIVE MEDICATIONS.
(a) In this section, "facility" has the meaning assigned by
Section 322.001.
(b) For each health and human services agency that regulates
the care or treatment of a resident at a facility, the executive
commissioner of the Health and Human Services Commission shall
adopt rules to govern the pro re nata administration of
psychoactive medications to facility residents.
(c) The rules must:
(1) prohibit a health care practitioner authorized
under the laws of this state to issue a prescription drug order from
prescribing to a facility resident a standing psychoactive
medication order to be administered pro re nata by injection;
(2) allow for the use of a psychoactive medication to
be administered by injection:
(A) in a psychiatric emergency;
(B) under a court order; or
(C) on a per request basis by a facility
resident, subject to Subsection (e);
(3) require a practitioner who administers
psychoactive medication in a psychiatric emergency to document in
the resident's clinical record the administration using specific
medical and behavioral terms;
(4) require a nurse licensed in this state and
employed by a facility to attend, before administering psychoactive
medication by injection in a psychiatric emergency, training on the
criteria that must be met to administer pro re nata psychoactive
medication in a psychiatric emergency; and
(5) require a person employed by a facility to attend
training on a resident's consent to treatment and refusal of
consent to treatment that includes:
(A) information to instruct staff on
identification of behaviors signifying a resident's refusal to
consent to administration of medication; and
(B) information on effective intermediate
measures to calm residents in distress by the use of methods other
than control and intervention.
(d) A nurse licensed in this state and employed by a
facility may not in a psychiatric emergency administer psychoactive
medication by injection unless the nurse has attended the training
required under Subsection (c)(4).
(e) Before a psychoactive medication is administered by
injection on request by a facility resident, the facility must
first obtain from the resident a signed consent for the specific
administration of the medication by injection. A health care
practitioner authorized under the laws of this state to issue the
prescription drug order may issue a prescription drug order that
authorizes psychoactive medication to be administered by injection
on request of a facility resident only if the order is limited to a
single administration of the medication at the resident's request.
SECTION 2. (a) Not later than January 1, 2012, the
executive commissioner of the Health and Human Services Commission
shall adopt the rules required by Section 576.0245, Health and
Safety Code, as added by this Act.
(b) A health care practitioner subject to Section 576.0245,
Health and Safety Code, as added by this Act, is not required to
comply with that section until January 1, 2012.
SECTION 3. This Act takes effect September 1, 2011.
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