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A BILL TO BE ENTITLED
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AN ACT
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relating to the pro re nata administration of psychoactive |
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medication in certain residential health care facilities. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 576.025(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) Subject to Section 576.0255, a [A] person may not |
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administer a psychoactive medication to a patient receiving |
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voluntary or involuntary mental health services who refuses the |
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administration unless: |
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(1) the patient is having a medication-related |
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emergency; |
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(2) the patient is younger than 16 years of age, or the |
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patient is younger than 18 years of age and is a patient admitted |
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for voluntary mental health services under Section 572.002(3)(B), |
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and the patient's parent, managing conservator, or guardian |
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consents to the administration on behalf of the patient; |
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(3) the refusing patient's representative authorized |
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by law to consent on behalf of the patient has consented to the |
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administration; |
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(4) the administration of the medication regardless of |
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the patient's refusal is authorized by an order issued under |
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Section 574.106; or |
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(5) the administration of the medication regardless of |
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the patient's refusal is authorized by an order issued under |
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Article 46B.086, Code of Criminal Procedure. |
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SECTION 2. Subchapter B, Chapter 576, Health and Safety |
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Code, is amended by adding Section 576.0255 to read as follows: |
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Sec. 576.0255. PRO RE NATA ADMINISTRATION OF PSYCHOACTIVE |
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MEDICATION IN CERTAIN RESIDENTIAL HEALTH CARE FACILITIES. (a) For |
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each health and human services agency that regulates the care or |
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treatment of a resident at a facility, the executive commissioner |
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of the Health and Human Services Commission shall adopt rules to |
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govern the pro re nata administration of psychoactive medication to |
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facility residents. |
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(b) The rules adopted under Subsection (a) must: |
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(1) allow for the pro re nata administration of a |
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psychoactive medication by injection: |
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(A) in a medication-related emergency; |
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(B) under a court order, such as an order |
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described by Section 576.025(a)(4) or (5); or |
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(C) on a per request basis by a facility |
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resident, subject to Subsection (d); |
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(2) require a practitioner who administers |
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psychoactive medication in a medication-related emergency to |
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document in the resident's clinical record the administration, |
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including the reason for the administration and the effect of the |
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administration, using specific medical and behavioral terms; |
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(3) prescribe training on the criteria that must be |
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met to administer psychoactive medication pro re nata in a |
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medication-related emergency; and |
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(4) require a person employed by a facility to attend |
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training on a resident's consent to treatment and refusal of |
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consent to treatment that includes information instructing staff |
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on: |
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(A) identification of behaviors signifying a |
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resident's refusal to consent to administration of medication; and |
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(B) effective intermediate measures to calm |
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residents in distress by the use of methods other than control and |
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intervention. |
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(c) A nurse licensed in this state and employed by a |
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facility may not in a medication-related emergency administer |
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psychoactive medication pro re nata by injection unless the nurse |
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has attended the training under Subsection (b)(3). |
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(d) Except as otherwise provided by Section 576.025 or rules |
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adopted under this section, before each individual pro re nata |
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administration of a psychoactive medication by injection, the |
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facility must first obtain from the resident a signed consent. The |
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signed consent must indicate that the resident prefers |
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administration of the medication by injection over oral |
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administration. |
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(e) In this section: |
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(1) "Facility" and "health and human services agency" |
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have the meanings assigned by Section 322.001. |
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(2) "Medication-related emergency" and "psychoactive |
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medication" have the meanings assigned by Section 574.101. |
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SECTION 3. (a) Not later than January 1, 2014, the |
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executive commissioner of the Health and Human Services Commission |
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shall adopt the rules required by Section 576.0255, Health and |
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Safety Code, as added by this Act. |
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(b) A health care practitioner subject to Section 576.0255, |
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Health and Safety Code, as added by this Act, is not required to |
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comply with that section until January 1, 2014. |
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SECTION 4. This Act takes effect September 1, 2013. |