Amend HB 3907 (Senate committee printing) on third reading by 
adding the following appropriately numbered SECTION to the bill and 
renumbering subsequent SECTIONS of the bill accordingly:
	SECTION ____.  (a) Section 592.038, Health and Safety Code, 
is amended by adding Subsection (d) to read as follows:
	(d)  Each client has the right to refuse psychoactive 
medication, as provided by Subchapter E.
	(b)  Subsection (b), Section 592.054, Health and Safety 
Code, is amended to read as follows:
	(b)  Notwithstanding Subsection (a), consent is required 
for:         
		(1)  all surgical procedures; and                               
		(2)  as provided by Section 592.083, the administration 
of psychoactive medications.
	(c)  Chapter 592, Health and Safety Code, is amended by 
adding Subchapter E to read as follows:

SUBCHAPTER E.  ADMINISTRATION OF PSYCHOACTIVE MEDICATIONS
	Sec. 592.081.  DEFINITIONS.  In this subchapter:                        
		(1)  "Capacity" means a client's ability to:                           
			(A)  understand the nature and consequences of a 
proposed treatment, including the benefits, risks, and 
alternatives to the proposed treatment; and
			(B)  make a decision whether to undergo the 
proposed treatment.     
		(2)  "Medication-related emergency" means a situation 
in which it is immediately necessary to administer medication to a 
client to prevent:
			(A)  imminent probable death or substantial 
bodily harm to the client because the client:
				(i)  overtly or continually is threatening 
or attempting to commit suicide or serious bodily harm; or
				(ii)  is behaving in a manner that indicates 
that the client is unable to satisfy the client's need for 
nourishment, essential medical care, or self-protection; or
			(B)  imminent physical or emotional harm to 
another because of threats, attempts, or other acts the client 
overtly or continually makes or commits.
		(3)  "Psychoactive medication" means a medication 
prescribed for the treatment of symptoms of psychosis or other 
severe mental or emotional disorders and that is used to exercise an 
effect on the central nervous system to influence and modify 
behavior, cognition, or the affective state when treating the 
symptoms of mental illness.  "Psychoactive medication" includes the 
following categories when used as described in this subdivision:
			(A)  antipsychotics or neuroleptics;                                  
			(B)  antidepressants;                                                 
			(C)  agents for control of mania or depression;                       
			(D)  antianxiety agents;                                              
			(E)  sedatives, hypnotics, or other 
sleep-promoting drugs; and      
			(F)  psychomotor stimulants.                                          
	Sec. 592.082.  ADMINISTRATION OF PSYCHOACTIVE MEDICATION.  
(a)  A person may not administer a psychoactive medication to a 
client receiving voluntary or involuntary residential care 
services who refuses the administration unless:
		(1)  the client is having a medication-related 
emergency;            
		(2)  the refusing client's representative authorized by 
law to consent on behalf of the client has consented to the 
administration;
		(3)  the administration of the medication regardless of 
the client's refusal is authorized by an order issued under Section 
592.086; or
		(4)  the administration of the medication regardless of 
the client's refusal is authorized by an order issued under Article 
46B.086, Code of Criminal Procedure.
	(b)  Consent to the administration of psychoactive 
medication given by a client or by a person authorized by law to 
consent on behalf of the client is valid only if:
		(1)  the consent is given voluntarily and without 
coercive or undue influence;
		(2)  the treating physician or a person designated by 
the physician provides the following information, in a standard 
format approved by the department, to the client and, if 
applicable, to the client's representative authorized by law to 
consent on behalf of the client:
			(A)  the specific condition to be treated;                            
			(B)  the beneficial effects on that condition 
expected from the medication;
			(C)  the probable health care consequences of not 
consenting to the medication;
			(D)  the probable clinically significant side 
effects and risks associated with the medication;
			(E)  the generally accepted alternatives to the 
medication, if any, and why the physician recommends that they be 
rejected; and
			(F)  the proposed course of the medication;                           
		(3)  the client and, if appropriate, the client's 
representative authorized by law to consent on behalf of the client 
are informed in writing that consent may be revoked; and
		(4)  the consent is evidenced in the client's clinical 
record by a signed form prescribed by the residential care facility 
or by a statement of the treating physician or a person designated 
by the physician that documents that consent was given by the 
appropriate person and the circumstances under which the consent 
was obtained.
	(c)  If the treating physician designates another person to 
provide the information under Subsection (b), then, not later than 
two working days after that person provides the information, 
excluding weekends and legal holidays, the physician shall meet 
with the client and, if appropriate, the client's representative 
who provided the consent, to review the information and answer any 
questions.
	(d)  A client's refusal or attempt to refuse to receive 
psychoactive medication, whether given verbally or by other 
indications or means, shall be documented in the client's clinical 
record.
	(e)  In prescribing psychoactive medication, a treating 
physician shall:
		(1)  prescribe, consistent with clinically appropriate 
medical care, the medication that has the fewest side effects or the 
least potential for adverse side effects, unless the class of 
medication has been demonstrated or justified not to be effective 
clinically; and
		(2)  administer the smallest therapeutically 
acceptable dosages of medication for the client's condition.
	(f)  If a physician issues an order to administer 
psychoactive medication to a client without the client's consent 
because the client is having a medication-related emergency:
		(1)  the physician shall document in the client's 
clinical record in specific medical or behavioral terms the 
necessity of the order and that the physician has evaluated but 
rejected other generally accepted, less intrusive forms of 
treatment, if any; and
		(2)  treatment of the client with the psychoactive 
medication shall be provided in the manner, consistent with 
clinically appropriate medical care, least restrictive of the 
client's personal liberty.
	Sec. 592.083.  ADMINISTRATION OF MEDICATION TO CLIENT 
COMMITTED TO RESIDENTIAL CARE FACILITY.  (a)  In this section, 
"ward" has the meaning assigned by Section 601, Texas Probate Code.
	(b)  A person may not administer a psychoactive medication to 
a client who refuses to take the medication voluntarily unless:
		(1)  the client is having a medication-related 
emergency;            
		(2)  the client is under an order issued under Section 
592.086 authorizing the administration of the medication 
regardless of the client's refusal; or
		(3)  the client is a ward who is 18 years of age or older 
and the guardian of the person of the ward consents to the 
administration of psychoactive medication regardless of the ward's 
expressed preferences regarding treatment with psychoactive 
medication.
	Sec. 592.084.  PHYSICIAN'S APPLICATION FOR ORDER TO 
AUTHORIZE PSYCHOACTIVE MEDICATION; DATE OF HEARING.  (a)  A 
physician who is treating a client may file an application in a 
probate court or a court with probate jurisdiction on behalf of the 
state for an order to authorize the administration of a 
psychoactive medication regardless of the client's refusal if:
		(1)  the physician believes that the client lacks the 
capacity to make a decision regarding the administration of the 
psychoactive medication;
		(2)  the physician determines that the medication is 
the proper course of treatment for the client; and
		(3)  the client has been committed to a residential 
care facility under Subchapter C, Chapter 593, or other law or an 
application for commitment to a residential care facility under 
Subchapter C, Chapter 593, has been filed for the client.
	(b)  An application filed under this section must state:                
		(1)  that the physician believes that the client lacks 
the capacity to make a decision regarding administration of the 
psychoactive medication and the reasons for that belief;
		(2)  each medication the physician wants the court to 
compel the client to take;
		(3)  whether an application for commitment to a 
residential care facility under Subchapter C, Chapter 593, has been 
filed;
		(4)  whether an order committing the client to a 
residential care facility has been issued and, if so, under what 
authority it was issued;
		(5)  the physician's diagnosis of the client; and                      
		(6)  the proposed method for administering the 
medication and, if the method is not customary, an explanation 
justifying the departure from the customary methods.
	(c)  An application filed under this section must be filed 
separately from an application for commitment to a residential care 
facility.
	(d)  The hearing on the application may be held on the same 
date as a hearing on an application for commitment to a residential 
care facility under Subchapter C, Chapter 593, but the hearing must 
be held not later than 30 days after the filing of the application 
for the order to authorize psychoactive medication.  If the hearing 
is not held on the same date as the application for commitment to a 
residential care facility under Subchapter C, Chapter 593, and the 
client is transferred to a residential care facility in another 
county, the court may transfer the application for an order to 
authorize psychoactive medication to the county where the client 
has been transferred.
	(e)  Subject to the requirement in Subsection (d) that the 
hearing shall be held not later than 30 days after the filing of the 
application, the court may grant one continuance on a party's 
motion and for good cause shown.  The court may grant more than one 
continuance only with the agreement of the parties.
	Sec. 592.085.  RIGHTS OF CLIENT.  A client for whom an 
application for an order to authorize the administration of a 
psychoactive medication is filed is entitled:
		(1)  to be represented by a court-appointed attorney 
who is knowledgeable about issues to be adjudicated at the hearing;
		(2)  to meet with that attorney as soon as is 
practicable to prepare for the hearing and to discuss any of the 
client's questions or concerns;
		(3)  to receive, immediately after the time of the 
hearing is set, a copy of the application and written notice of the 
time, place, and date of the hearing;
		(4)  to be informed, at the time personal notice of the 
hearing is given, of the client's right to a hearing and right to 
the assistance of an attorney to prepare for the hearing and to 
answer any questions or concerns;
		(5)  to be present at the hearing;                                     
		(6)  to request from the court an independent expert; 
and            
		(7)  to be notified orally, at the conclusion of the 
hearing, of the court's determinations of the client's capacity and 
best interest.
	Sec. 592.086.  HEARING AND ORDER AUTHORIZING PSYCHOACTIVE 
MEDICATION.  (a)  The court may issue an order authorizing the 
administration of one or more classes of psychoactive medication to 
a client who:
		(1)  has been committed to a residential care facility; 
or           
		(2)  is in custody awaiting trial in a criminal 
proceeding and was committed to a residential care facility in the 
six months preceding a hearing under this section.
	(b)  The court may issue an order under this section only if 
the court finds by clear and convincing evidence after the hearing:
		(1)  that the client lacks the capacity to make a 
decision regarding the administration of the proposed medication 
and that treatment with the proposed medication is in the best 
interest of the client; or
		(2)  if the client was committed to a residential care 
facility by a criminal court with jurisdiction over the client, 
that:
			(A)  the client presents a danger to the client or 
others in the residential care facility in which the client is being 
treated as a result of a mental disorder or mental defect as 
determined under Section 592.087; and
			(B)  treatment with the proposed medication is in 
the best interest of the client.
	(c)  In making the finding that treatment with the proposed 
medication is in the best interest of the client, the court shall 
consider:
		(1)  the client's expressed preferences regarding 
treatment with psychoactive medication;
		(2)  the client's religious beliefs;                                   
		(3)  the risks and benefits, from the perspective of 
the client, of taking psychoactive medication;
		(4)  the consequences to the client if the psychoactive 
medication is not administered;
		(5)  the prognosis for the client if the client is 
treated with psychoactive medication;
		(6)  alternative, less intrusive treatments that are 
likely to produce the same results as treatment with psychoactive 
medication; and
		(7)  less intrusive treatments likely to secure the 
client's consent to take the psychoactive medication.
	(d)  A hearing under this subchapter shall be conducted on 
the record by the probate judge or judge with probate jurisdiction, 
except as provided by Subsection (e).
	(e)  A judge may refer a hearing to a magistrate or 
court-appointed master who has training regarding psychoactive 
medications.  The magistrate or master may effectuate the notice, 
set hearing dates, and appoint attorneys as required by this 
subchapter.  A record is not required if the hearing is held by a 
magistrate or court-appointed master.
	(f)  A party is entitled to a hearing de novo by the judge if 
an appeal of the magistrate's or master's report is filed with the 
court before the fourth day after the date the report is issued.  
The hearing de novo shall be held not later than the 30th day after 
the date the application for an order to authorize psychoactive 
medication was filed.
	(g)  If a hearing or an appeal of a master's or magistrate's 
report is to be held in a county court in which the judge is not a 
licensed attorney, the proposed client or the proposed client's 
attorney may request that the proceeding be transferred to a court 
with a judge who is licensed to practice law in this state.  The 
county judge shall transfer the case after receiving the request, 
and the receiving court shall hear the case as if it had been 
originally filed in that court.
	(h)  As soon as practicable after the conclusion of the 
hearing, the client is entitled to have provided to the client and 
the client's attorney written notification of the court's 
determinations under this section.  The notification shall include 
a statement of the evidence on which the court relied and the 
reasons for the court's determinations.
	(i)  An order entered under this section shall authorize the 
administration to a client, regardless of the client's refusal, of 
one or more classes of psychoactive medications specified in the 
application and consistent with the client's diagnosis.  The order 
shall permit an increase or decrease in a medication's dosage, 
restitution of medication authorized but discontinued during the 
period the order is valid, or the substitution of a medication 
within the same class.
	(j)  The classes of psychoactive medications in the order 
must conform to classes determined by the department.
	(k)  An order issued under this section may be reauthorized 
or modified on the petition of a party.  The order remains in effect 
pending action on a petition for reauthorization or modification.  
For the purpose of this subsection, "modification" means a change 
of a class of medication authorized in the order.
	Sec. 592.087.  FINDING THAT CLIENT PRESENTS A DANGER.  In 
making a finding under Section 592.086(b)(2) that the client 
presents a danger to the client or others in the residential care 
facility in which the client is being treated as a result of a 
mental disorder or mental defect the court shall consider:
		(1)  an assessment of the client's present mental 
condition; and     
		(2)  whether the client has inflicted, attempted to 
inflict, or made a serious threat of inflicting substantial 
physical harm to the client's self or to another while in the 
facility.
	Sec. 592.088.  APPEAL.  (a)  A client may appeal an order 
under this subchapter in the manner provided by Section 593.056 for 
an appeal of an order committing the client to a residential care 
facility.
	(b)  An order authorizing the administration of medication 
regardless of the refusal of the client is effective pending an 
appeal of the order.
	Sec. 592.089.  EFFECT OF ORDER.  (a)  A person's consent to 
take a psychoactive medication is not valid and may not be relied on 
if the person is subject to an order issued under Section 592.086.
	(b)  The issuance of an order under Section 592.086 is not a 
determination or adjudication of mental incompetency and does not 
limit in any other respect that person's rights as a citizen or the 
person's property rights or legal capacity.
	Sec. 592.090.  EXPIRATION OF ORDER.  (a)  Except as provided 
by Subsection (b), an order issued under Section 592.086 expires on 
the anniversary of the date the order was issued.
	(b)  An order issued under Section 592.086 for a client 
awaiting trial in a criminal proceeding expires on the date the 
defendant is acquitted, is convicted, or enters a plea of guilty or 
the date on which charges in the case are dismissed.  An order 
continued under this subsection shall be reviewed by the issuing 
court every six months.
	(d)  Subsections (a) and (b), Article 46B.086, Code of 
Criminal Procedure, are amended to read as follows:
	(a)  This article applies only to a defendant:                                 
		(1)  who is determined under this chapter to be 
incompetent to stand trial; 
		(2)  for whom an inpatient mental health facility, 
residential care facility, or outpatient treatment program 
provider has prepared a continuity of care plan that requires the 
defendant to take psychoactive medications; and
		(3)  who, after a hearing held under Section 574.106 or 
592.086, Health and Safety Code, has been found not to meet the 
criteria prescribed by Sections 574.106(a) and (a-1), or Sections 
592.086(a) and (b), Health and Safety Code, for court-ordered 
administration of psychoactive medications; or
		(4)  who is subject to Article 46B.072.                                       
	(b)  If a defendant described by Subsection (a) refuses to 
take psychoactive medications as required by the defendant's 
continuity of care plan, the director of the correctional facility 
or outpatient treatment provider shall notify the court in which 
the criminal proceedings are pending of that fact not later than the 
end of the next business day following the refusal.  The court shall 
promptly notify the attorney representing the state and the 
attorney representing the defendant of the defendant's refusal.  
The attorney representing the state may file a written motion to 
compel medication.  The motion to compel medication must be filed 
not later than the 15th day after the date a judge issues an order 
stating that the defendant does not meet the criteria for 
court-ordered administration of psychoactive medications under 
Section 574.106 or 592.086, Health and Safety Code.  The motion to 
compel medication for a defendant in an outpatient treatment 
program may be filed at any time.
	(e)  Notwithstanding any other provision of this Act, this 
section takes effect September 1, 2009.