AN ACT
1-1 relating to the use of a declaration for mental health treatment.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 SECTION 1. Subdivisions (4) through (7), Section 137.001,
1-4 Civil Practice and Remedies Code, are amended to read as follows:
1-5 (4) "Emergency" means a situation in which it is
1-6 immediately necessary to treat a patient to prevent:
1-7 (A) probable imminent death or serious bodily
1-8 injury to the patient because the patient:
1-9 (i) overtly or continually is threatening
1-10 or attempting to commit suicide or serious bodily injury to the
1-11 patient; or
1-12 (ii) is behaving in a manner that
1-13 indicates that the patient is unable to satisfy the patient's need
1-14 for nourishment, essential medical care, or self-protection; or
1-15 (B) imminent physical or emotional harm to
1-16 another because of threats, attempts, or other acts of the patient.
1-17 (5) "Health care provider" means an individual or
1-18 facility licensed, certified, or otherwise authorized to administer
1-19 health care or treatment, for profit or otherwise, in the ordinary
1-20 course of business or professional practice and includes a
1-21 physician or other health care provider, a residential care
1-22 provider, or an inpatient mental health facility as defined by
1-23 Section 571.003, Health and Safety Code.
1-24 (6) [(5)] "Incapacitated" means that, in the opinion
2-1 of the court in a guardianship proceeding under Chapter XIII, Texas
2-2 Probate Code, or in a medication hearing under Section 574.106,
2-3 Health and Safety Code, a person lacks the ability to understand
2-4 the nature and consequences of a proposed treatment, including the
2-5 benefits, risks, and alternatives to the proposed treatment, and
2-6 lacks the ability to make mental health treatment decisions because
2-7 of impairment.
2-8 (7) [(6)] "Mental health treatment" means
2-9 electroconvulsive or other convulsive treatment, treatment of
2-10 mental illness with psychoactive medication as defined by Section
2-11 574.101, Health and Safety Code, or emergency mental health
2-12 treatment.
2-13 (8) [(7)] "Principal" means a person who has executed
2-14 a declaration for mental health treatment.
2-15 SECTION 2. Section 137.007, Civil Practice and Remedies
2-16 Code, is amended to read as follows:
2-17 Sec. 137.007. USE AND EFFECT OF DECLARATION FOR MENTAL
2-18 HEALTH TREATMENT. (a) On being presented with a declaration for
2-19 mental health treatment, a physician or other health care provider
2-20 shall make the declaration a part of the principal's medical
2-21 record. When acting in accordance with a declaration for mental
2-22 health treatment, a physician or other health care provider shall
2-23 comply with the declaration to the fullest extent possible.
2-24 (b) If a [the] physician or other provider is unwilling at
2-25 any time to comply with a [the] declaration for mental health
2-26 treatment, the physician or provider may withdraw from providing
3-1 treatment consistent with the exercise of independent medical
3-2 judgment and must promptly:
3-3 (1) make a reasonable effort to transfer care for the
3-4 principal to a physician or provider who is willing to comply with
3-5 the declaration;
3-6 (2) notify the principal, or principal's guardian, if
3-7 appropriate, of the decision to withdraw [that action]; and
3-8 (3) record in the principal's medical record [(2)
3-9 document] the notification and, if applicable, the name of the
3-10 physician or provider to whom the principal is transferred [in the
3-11 principal's medical record].
3-12 SECTION 3. Section 137.008, Civil Practice and Remedies
3-13 Code, is amended to read as follows:
3-14 Sec. 137.008. DISREGARD OF DECLARATION FOR MENTAL HEALTH
3-15 TREATMENT. (a) A physician or other health care provider may
3-16 subject the principal to mental health treatment in a manner
3-17 contrary to the principal's wishes as expressed in a declaration
3-18 for mental health treatment only:
3-19 (1) if the principal is under an order for temporary
3-20 or extended mental health services under Section 574.034 or
3-21 574.035, Health and Safety Code, and treatment is authorized in
3-22 compliance with Section 574.106, Health and Safety Code; or
3-23 (2) in case of an emergency when the principal's
3-24 instructions have not been effective in reducing the severity of
3-25 the behavior that has caused [avoiding] the emergency.
3-26 (b) [For purposes of Subsection (a), "emergency" means a
4-1 situation in which it is immediately necessary to treat a patient
4-2 to prevent:]
4-3 [(1) probable imminent death or serious bodily injury
4-4 to the patient because the patient:]
4-5 [(A) overtly or continually is threatening or
4-6 attempting to commit suicide or serious bodily injury to the
4-7 patient; or]
4-8 [(B) is behaving in a manner that indicates that
4-9 the patient is unable to satisfy the patient's need for
4-10 nourishment, essential medical care, or self-protection; or]
4-11 [(2) imminent physical or emotional harm to another
4-12 because of threats, attempts, or other acts of the patient.]
4-13 [(c)] A declaration for mental health treatment does not
4-14 limit any authority provided by Chapter 573 or 574, Health and
4-15 Safety Code:
4-16 (1) to take a person into custody; or
4-17 (2) to admit or retain a person in a mental health
4-18 treatment facility.
4-19 (c) [(d)] This section does not apply to the use of
4-20 electroconvulsive treatment or other convulsive treatment.
4-21 SECTION 4. Subsection (a), Section 137.010, Civil Practice
4-22 and Remedies Code, is amended to read as follows:
4-23 (a) A declaration for mental health treatment is revoked
4-24 when a principal who is not incapacitated [by]:
4-25 (1) notifies [notification at any time by a principal,
4-26 when competent, to] a licensed or certified health or residential
5-1 care provider of the revocation;
5-2 (2) acts in a manner [any act of the principal] that
5-3 demonstrates a specific intent to revoke the declaration; or
5-4 (3) executes [the principal executing] a later
5-5 declaration for mental health treatment.
5-6 SECTION 5. The importance of this legislation and the
5-7 crowded condition of the calendars in both houses create an
5-8 emergency and an imperative public necessity that the
5-9 constitutional rule requiring bills to be read on three several
5-10 days in each house be suspended, and this rule is hereby suspended,
5-11 and that this Act take effect and be in force from and after its
5-12 passage, and it is so enacted.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 1361 passed the Senate on
April 15, 1999, by the following vote: Yeas 30, Nays 0.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 1361 passed the House on
May 22, 1999, by the following vote: Yeas 144, Nays 0, two present
not voting.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor