S.B. No. 465




AN ACT
relating to the administration of psychoactive medication to certain patients. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 574.102, Health and Safety Code, is amended to read as follows: Sec. 574.102. APPLICATION OF SUBCHAPTER. This subchapter applies [only] to the application of medication to a patient subject to an order for inpatient mental health services under this chapter or other law [Section 574.034 or 574.035]. SECTION 2. Subsections (a) and (b), Section 574.104, Health and Safety Code, are amended to read as follows: (a) A physician who is treating a patient may, on behalf of the state, file an application in a probate court or a court with probate jurisdiction for an order to authorize the administration of a psychoactive medication regardless of the patient's refusal if: (1) the physician believes that the patient lacks the capacity to make a decision regarding the administration of the psychoactive medication; (2) the physician determines that the medication is the proper course of treatment for the patient; (3) the patient is under an order for inpatient [temporary or extended] mental health services under this chapter or other law [Section 574.034 or 574.035] or an application for court-ordered mental health services under Section 574.034 or 574.035 has been filed for the patient; and (4) the patient, verbally or by other indication, refuses to take the medication voluntarily. (b) An application filed under this section must state: (1) that the physician believes that the patient lacks the capacity to make a decision regarding administration of the psychoactive medication and the reasons for that belief; (2) each medication the physician wants the court to compel the patient to take; (3) whether an application for court-ordered mental health services under Section 574.034 or 574.035 has been filed; (4) whether a court [or the current] order for inpatient mental health services for the patient has been [was] issued and, if so, under what authority it was issued [under Section 574.034 or under Section 574.035]; [and] (5) [(4)] the physician's diagnosis of the patient; and (6) the proposed method for administering the medication and, if the method is not customary, an explanation justifying the departure from the customary methods. SECTION 3. The heading to Section 574.106, Health and Safety Code, is amended to read as follows: Sec. 574.106. HEARING [ON PATIENT'S CAPACITY] AND ORDER AUTHORIZING PSYCHOACTIVE MEDICATION. SECTION 4. Section 574.106, Health and Safety Code, is amended by amending Subsections (a) and (b) and adding Subsections (a-1) and (k) to read as follows: (a) The court may issue an order authorizing the administration of one or more classes of psychoactive medication to a patient who: (1) is under a court order to receive inpatient mental health services; or (2) is in custody awaiting trial in a criminal proceeding and was ordered to receive inpatient mental health services in the six months preceding a hearing under this section. (a-1) The court may issue an order under this section only if the court finds by clear and convincing evidence after the hearing: (1) that[: [(1) the patient is under an order for temporary or extended mental health services under Section 574.034 or 574.035; [(2)] the patient lacks the capacity to make a decision regarding the administration of the proposed medication[;] and [(3)] treatment with the proposed medication is in the best interest of the patient; or (2) if the patient was ordered to receive inpatient mental health services by a criminal court with jurisdiction over the patient, that: (A) the patient presents a danger to the patient or others in the inpatient mental health facility in which the patient is being treated as a result of a mental disorder or mental defect as determined under Section 574.1065; and (B) treatment with the proposed medication is in the best interest of the patient. (b) In making the finding that treatment with the proposed medication is in the best interest of the patient [its findings], the court shall consider: (1) the patient's expressed preferences regarding treatment with psychoactive medication; (2) the patient's religious beliefs; (3) the risks and benefits, from the perspective of the patient, of taking psychoactive medication; (4) the consequences to the patient if the psychoactive medication is not administered; (5) the prognosis for the patient if the patient is treated with psychoactive medication; [and] (6) alternative, less intrusive treatments that are likely to produce the same results as [alternatives to] treatment with psychoactive medication; and (7) less intrusive treatments likely to secure the patient's agreement to take the psychoactive medication. (k) This section does not apply to a patient who receives services under an order of protective custody under Section 574.021. SECTION 5. Subchapter G, Chapter 574, Health and Safety Code, is amended by adding Section 574.1065 to read as follows: Sec. 574.1065. FINDING THAT PATIENT PRESENTS A DANGER. In making a finding under Section 574.106 (a-1)(2) that the patient presents a danger to the patient or others in the inpatient mental health facility in which the patient is being treated as a result of a mental disorder or mental defect the court shall consider: (1) an assessment of the patient's present mental condition; (2) whether the patient has inflicted, attempted to inflict, or made a serious threat of inflicting substantial physical harm to the patient's self or to another while in the facility; and (3) whether the patient, in the six months preceding the date the patient was placed in the facility, has inflicted, attempted to inflict, or made a serious threat of inflicting substantial physical harm to another that resulted in the patient being placed in the facility. SECTION 6. Section 574.110, Health and Safety Code, is amended to read as follows: Sec. 574.110. EXPIRATION OF ORDER. (a) Except as provided by Subsection (b), an [An] order issued under Section 574.106 expires on the expiration or termination date of the order for temporary or extended mental health services in effect when the order for psychoactive medication is issued. (b) An order issued under Section 574.106 for a patient awaiting trial in a criminal proceeding expires on the date the defendant is acquitted, is convicted, or enters a plea of guilty or the date on which charges in the case are dismissed. An order continued under this subsection shall be reviewed by the issuing court every six months. SECTION 7. Subsection (a), Section 576.025, Health and Safety Code, is amended to read as follows: (a) A person may not administer a psychoactive medication to a patient receiving voluntary or involuntary mental health services who refuses the administration unless: (1) the patient is having a medication-related emergency; (2) the patient is younger than 16 years of age and the patient's parent, managing conservator, or guardian consents to the administration on behalf of the patient; (3) the refusing patient's representative authorized by law to consent on behalf of the patient has consented to the administration; (4) the administration of the medication regardless of the patient's refusal is authorized by an order issued under Section 574.106; or (5) the administration of the medication regardless of the patient's refusal is [patient is receiving court-ordered mental health services] authorized by an order issued under Article 46B.086[: [(A) Chapter 46B or Article 46.03], Code of Criminal Procedure[; or [(B) Chapter 55, Family Code]. SECTION 8. Subsections (a), (b), and (d), Article 46B.086, Code of Criminal Procedure, are amended to read as follows: (a) This article applies only to a defendant: (1) who is [after having been] determined under this chapter to be incompetent to stand trial [is subsequently determined to be competent to stand trial]; [and] (2) for whom a continuity of care plan has been prepared by a facility that requires the defendant to take psychoactive medications; and (3) who, after a hearing held under Section 574.106, Health and Safety Code, has been found not to meet the criteria prescribed by Sections 574.106(a) and (a-1), Health and Safety Code, for court-ordered administration of psychoactive medications. (b) If a defendant described by Subsection (a) refuses to take psychoactive medications as required by the defendant's continuity of care plan, the director of the correctional facility shall notify the court in which the criminal proceedings are pending of that fact not later than the end of the next business day following the refusal. The court shall promptly notify the attorney representing the state and the attorney representing the defendant of the defendant's refusal. The attorney representing the state may file a written motion to compel medication. The motion to compel medication must be filed not later than the 15th day after the date a judge issues an order stating that the defendant does not meet the criteria for court-ordered administration of psychoactive medications under Section 574.106, Health and Safety Code. The court, after notice and after a hearing [that is] held not later than the fifth day after the defendant is returned to the committing court [as soon as practicable], may authorize the director of a correctional facility to have the medication administered to the defendant, by reasonable force if necessary. (d) The court may issue an order under this article if the court finds by clear and convincing evidence that: (1) the prescribed medication is medically appropriate, is in the best medical interest of the defendant, and does not present side effects that cause harm to the defendant that is greater than the medical benefit to the defendant; (2) the state has a clear and compelling interest in the defendant obtaining and maintaining competency to stand trial; (3) no other less invasive means of obtaining and maintaining the defendant's competency exists; and (4) the prescribed medication will not unduly prejudice the defendant's rights or use of defensive theories at trial. SECTION 9. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2005.
______________________________ ______________________________ President of the Senate Speaker of the House
I hereby certify that S.B. No. 465 passed the Senate on April 26, 2005, by the following vote: Yeas 31, Nays 0. ______________________________ Secretary of the Senate I hereby certify that S.B. No. 465 passed the House on May 25, 2005, by the following vote: Yeas 144, Nays 0, two present not voting. ______________________________ Chief Clerk of the House Approved: ______________________________ Date ______________________________ Governor