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.