SECTION 3.801. Legally Adequate Consent or Authorization for Non-Emergency Administration of Psychotropic Medication

(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.

Source Note: The provisions of this §3.801 adopted to be effective April 7, 2015, 40 TexReg 1988