1-1     By:  Patterson                                        S.B. No. 1309

 1-2           (In the Senate - Filed March 12, 1997; March 18, 1997, read

 1-3     first time and referred to Committee on Health and Human Services;

 1-4     May 5, 1997, reported adversely, with favorable Committee

 1-5     Substitute by the following vote:  Yeas 9, Nays 1; May 5, 1997,

 1-6     sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 1309               By:  Patterson

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to the regulation of the use of electroconvulsive therapy.

1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-12           SECTION 1.  Section 578.003, Health and Safety Code, is

1-13     amended by amending Subsections (b) and (c) and by adding

1-14     Subsection (e) to read as follows:

1-15           (b)  The written consent form must clearly and explicitly

1-16     state:

1-17                 (1)  the nature and purpose of the procedure;

1-18                 (2)  the nature, degree, duration, and probability of

1-19     the side effects and significant risks of the treatment commonly

1-20     known by the medical profession, especially noting the possible

1-21     degree and duration of memory loss, the possibility of permanent

1-22     irrevocable memory loss, and the [remote] possibility of death;

1-23                 (3)  that there is a division of opinion as to the

1-24     efficacy of the procedure; and

1-25                 (4)  the probable degree and duration of improvement or

1-26     remission expected with or without the procedure.

1-27           (c)  Before a patient receives each electroconvulsive

1-28     treatment, the hospital, facility, or physician administering the

1-29     therapy shall ensure that:

1-30                 (1)  the patient and the patient's guardian of the

1-31     person, if any, receives a written copy of the consent form that is

1-32     in the person's primary language, if possible;

1-33                 (2)  the patient and the patient's guardian of the

1-34     person, if any, receives a written supplement that contains related

1-35     information that pertains to the particular patient being treated;

1-36                 (3)  the contents of the consent form and the written

1-37     supplement are explained to the patient and the patient's guardian

1-38     of the person, if any:

1-39                       (A)  orally, in simple, nontechnical terms in the

1-40     person's primary language, if possible; or

1-41                       (B)  through the use of a means reasonably

1-42     calculated to communicate with a hearing impaired or visually

1-43     impaired person, if applicable;

1-44                 (4)  the patient or the patient's guardian of the

1-45     person, as appropriate, signs a copy of the consent form stating

1-46     that the person has read the consent form and the written

1-47     supplement and understands the information included in the

1-48     documents; and

1-49                 (5)  the signed copy of the consent form is made a part

1-50     of the patient's clinical record.

1-51           (e)  For a patient 65 years of age or older, before each

1-52     treatment series begins, the hospital, facility, or physician

1-53     administering the procedure shall:

1-54                 (1)  ensure that two physicians have signed an

1-55     appropriate form that states the procedure is medically necessary;

1-56                 (2)  make the form described by Subdivision (1)

1-57     available to the patient or the patient's guardian; and

1-58                 (3)  inform the patient or the patient's guardian of

1-59     any current medical condition that may increase the possibility of

1-60     injury or death as a result of the treatment.

1-61           SECTION 2.  Subsection (b), Section 578.007, Health and

1-62     Safety Code, is amended to read as follows:

1-63           (b)  A report must state for each quarter:

1-64                 (1)  the number of patients who received the therapy,

 2-1     including:

 2-2                       (A)  the number of persons voluntarily receiving

 2-3     mental health services who consented to the therapy;

 2-4                       (B)  the number of involuntary patients who

 2-5     consented to the therapy; and

 2-6                       (C)  the number of involuntary patients for whom

 2-7     a guardian of the person consented to the therapy;

 2-8                 (2)  the age, sex, and race of the persons receiving

 2-9     the therapy;

2-10                 (3)  the source of the treatment payment;

2-11                 (4)  the average number of nonelectroconvulsive

2-12     treatments;

2-13                 (5)  the average number of electroconvulsive treatments

2-14     administered for each complete series of treatments, but not

2-15     including maintenance treatments;

2-16                 (6)  the average number of maintenance

2-17     electroconvulsive treatments administered per month;

2-18                 (7)  the number of fractures, reported memory losses,

2-19     incidents of apnea, and cardiac arrests without death;

2-20                 (8)  autopsy findings, with emphasis on brain tissue

2-21     findings, if death followed within 14 days after the date of the

2-22     administration of the therapy; [and]

2-23                 (9)  the number of deaths following electroconvulsive

2-24     therapy at 14 days, one month, and three months after the date of

2-25     the therapy; and

2-26                 (10)  any other information required by the department.

2-27           SECTION 3.  This Act takes effect September 1, 1997.

2-28           SECTION 4.  The importance of this legislation and the

2-29     crowded condition of the calendars in both houses create an

2-30     emergency and an imperative public necessity that the

2-31     constitutional rule requiring bills to be read on three several

2-32     days in each house be suspended, and this rule is hereby suspended.

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