By: Zaffirini S.B. No. 47

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.