83R1103 JSC-F
By: Zaffirini S.B. No. 35
A BILL TO BE ENTITLED
AN ACT
relating to the pro re nata administration of psychoactive
medication in certain residential health care facilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 576.025(a), Health and Safety Code, is
amended to read as follows:
(a) Subject to Section 576.0255, a [A] person may not
administer a psychoactive medication to a patient receiving
voluntary or involuntary mental health services who refuses the
administration unless:
(1) the patient is having a medication-related
emergency;
(2) the patient is younger than 16 years of age, or the
patient is younger than 18 years of age and is a patient admitted
for voluntary mental health services under Section 572.002(3)(B),
and the patient's parent, managing conservator, or guardian
consents to the administration on behalf of the patient;
(3) the refusing patient's representative authorized
by law to consent on behalf of the patient has consented to the
administration;
(4) the administration of the medication regardless of
the patient's refusal is authorized by an order issued under
Section 574.106; or
(5) the administration of the medication regardless of
the patient's refusal is authorized by an order issued under
Article 46B.086, Code of Criminal Procedure.
SECTION 2. Subchapter B, Chapter 576, Health and Safety
Code, is amended by adding Section 576.0255 to read as follows:
Sec. 576.0255. PRO RE NATA ADMINISTRATION OF PSYCHOACTIVE
MEDICATION IN CERTAIN RESIDENTIAL HEALTH CARE FACILITIES. (a) 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 medication to
facility residents.
(b) The rules adopted under Subsection (a) must:
(1) allow for the pro re nata administration of a
psychoactive medication by injection:
(A) in a medication-related emergency;
(B) under a court order, such as an order
described by Section 576.025(a)(4) or (5); or
(C) on a per request basis by a facility
resident, subject to Subsection (d);
(2) require a practitioner who administers
psychoactive medication in a medication-related emergency to
document in the resident's clinical record the administration,
including the reason for the administration and the effect of the
administration, using specific medical and behavioral terms;
(3) prescribe training on the criteria that must be
met to administer psychoactive medication pro re nata in a
medication-related emergency; and
(4) 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 information instructing staff
on:
(A) identification of behaviors signifying a
resident's refusal to consent to administration of medication; and
(B) effective intermediate measures to calm
residents in distress by the use of methods other than control and
intervention.
(c) A nurse licensed in this state and employed by a
facility may not in a medication-related emergency administer
psychoactive medication pro re nata by injection unless the nurse
has attended the training under Subsection (b)(3).
(d) Except as otherwise provided by Section 576.025 or rules
adopted under this section, before each individual pro re nata
administration of a psychoactive medication by injection, the
facility must first obtain from the resident a signed consent. The
signed consent must indicate that the resident prefers
administration of the medication by injection over oral
administration.
(e) In this section:
(1) "Facility" and "health and human services agency"
have the meanings assigned by Section 322.001.
(2) "Medication-related emergency" and "psychoactive
medication" have the meanings assigned by Section 574.101.
SECTION 3. (a) Not later than January 1, 2014, the
executive commissioner of the Health and Human Services Commission
shall adopt the rules required by Section 576.0255, Health and
Safety Code, as added by this Act.
(b) A health care practitioner subject to Section 576.0255,
Health and Safety Code, as added by this Act, is not required to
comply with that section until January 1, 2014.
SECTION 4. This Act takes effect September 1, 2013.