| (a) A facility must obtain legally adequate consent
or authorization for non-emergency administration of psychotropic
medication in accordance with subsection (b) or (c) of this section,
unless the administration of the medication is authorized by an order
issued under THSC §592.156:
(1) before the initial administration of each class
of psychotropic medication and annually thereafter; and
(2) before the administration of a dosage of psychotropic
medication that is not within the dosage range for which consent or
authorization has been given.
(b) Legally adequate consent for the administration
of psychotropic medication to an individual may be provided in accordance
with subsection (a) of this section by the following:
(1) the individual, if the individual has capacity
to provide consent; or
(2) the individual's LAR, if the individual has an
LAR.
(c) The director of the facility in which the individual
resides may authorize the administration of psychotropic medication
to an individual if the individual:
(1) has been:
(A) committed to a facility involuntarily under:
(i) THSC, Chapter 593, Subchapter C;
(ii) Texas Code of Criminal Procedure, Chapter 46B
or 46C; or
(iii) Texas Family Code, Chapter 55; or
(B) transferred to a facility under the Texas Mental
Health Code, THSC, Title 7, Subtitle C;
(2) does not have capacity to provide legally adequate
consent for the administration of psychotropic medication;
(3) does not have an LAR; and
(4) has not refused to take the medication, as described
in §3.803(b) of this subchapter (relating to Refusal of Psychotropic
Medication).
(d) Before obtaining legally adequate consent or authorization
to administer psychotropic medication to an individual in accordance
with subsection (b) or (c) of this section, the individual's treating
physician, or the treating physician's designee, must provide the
following information in simple, non-technical terms in the primary
language or mode of communication of the individual, the individual's
LAR, or the director:
(1) the name of the psychotropic medication;
(2) the class of psychotropic medication, the dosage
range, the route of administration, and proposed course of the medication;
(3) the indication for the medication's use, including
the rationale for using the psychotropic medication if the medication
is being used for a purpose or in a manner that has not been approved
by the FDA;
(4) the diagnosis that is the specific condition to
be treated by the psychotropic medication;
(5) the symptoms of the condition being treated and
the target symptoms that the facility will monitor;
(6) the beneficial effects expected from the psychotropic
medication;
(7) the probable, clinically significant side effects
and risks associated with the psychotropic medication;
(8) the generally accepted alternative treatments to
the psychotropic medication, if any, and an explanation of why the
treating physician recommends that the alternatives be rejected;
(9) an explanation of the probable health care consequences
of not consenting to the psychotropic medication;
(10) an explanation that the individual, LAR, or director
has the right to refuse or revoke consent to or authorization for
the administration of the psychotropic medication at any time;
(11) an explanation that refusal or revocation of consent
or authorization will not prevent the individual from receiving care
and services in the future; and
(12) an offer to answer any questions from the individual,
LAR, or director concerning treatment with the psychotropic medication.
(e) The consent of an individual or LAR or the authorization
of the director must be evidenced in the individual's active record
by a completed and signed consent form, in a format approved by DADS.
(f) If the treating physician designates another person
to provide the information specified in subsection (d) of this section,
then no later than two days, excluding Saturday, Sunday, and a national
or state holiday listed in Texas Government Code §662.003(a)
or (b), after the designee provides the information, the treating
physician must meet with the individual and, if appropriate, with
the individual's LAR who provided the consent or the director who
provided the authorization, to review the information and answer any
questions.
(g) A facility must review a consent to or authorization
for psychotropic medication given in accordance with subsection (b)
or (c) of this section with an individual, an individual's LAR, or
the director at least annually. The review must include a discussion
of the information specified in subsection (d) of this section, as
well as a discussion of the individual's, LAR's, or director's decision
regarding continuation of the psychotropic medication.
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