Bill Text: TX SB819 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to the execution of a declaration for mental health treatment.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-02-27 - Referred to Health & Human Services [SB819 Detail]
Download: Texas-2017-SB819-Introduced.html
85R7451 GCB-F | ||
By: Rodríguez | S.B. No. 819 |
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relating to the execution of a declaration for mental health | ||
treatment. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. The heading to Section 137.003, Civil Practice | ||
and Remedies Code, is amended to read as follows: | ||
Sec. 137.003. EXECUTION AND WITNESSES; EXECUTION AND | ||
ACKNOWLEDGMENT BEFORE NOTARY PUBLIC. | ||
SECTION 2. Section 137.003(a), Civil Practice and Remedies | ||
Code, is amended to read as follows: | ||
(a) A declaration for mental health treatment must be: | ||
(1) signed by the principal in the presence of two or | ||
more subscribing witnesses; or | ||
(2) signed by the principal and acknowledged before a | ||
notary public. | ||
SECTION 3. Section 137.011, Civil Practice and Remedies | ||
Code, is amended to read as follows: | ||
Sec. 137.011. FORM OF DECLARATION FOR MENTAL HEALTH | ||
TREATMENT. The declaration for mental health treatment must be in | ||
substantially the following form: | ||
DECLARATION FOR MENTAL HEALTH TREATMENT | ||
I, __________________, being an adult of sound mind, wilfully | ||
and voluntarily make this declaration for mental health treatment | ||
to be followed if it is determined by a court that my ability to | ||
understand the nature and consequences of a proposed treatment, | ||
including the benefits, risks, and alternatives to the proposed | ||
treatment, is impaired to such an extent that I lack the capacity to | ||
make mental health treatment decisions. "Mental health treatment" | ||
means electroconvulsive or other convulsive treatment, treatment | ||
of mental illness with psychoactive medication, and preferences | ||
regarding emergency mental health treatment. | ||
(OPTIONAL PARAGRAPH) I understand that I may become | ||
incapable of giving or withholding informed consent for mental | ||
health treatment due to the symptoms of a diagnosed mental | ||
disorder. These symptoms may include: | ||
________________________________________________________________ | ||
PSYCHOACTIVE MEDICATIONS | ||
If I become incapable of giving or withholding informed | ||
consent for mental health treatment, my wishes regarding | ||
psychoactive medications are as follows: | ||
_____ I consent to the administration of the following | ||
medications: | ||
________________________________________________________________ | ||
_____ I do not consent to the administration of the following | ||
medications: | ||
________________________________________________________________ | ||
_____ I consent to the administration of a federal Food and | ||
Drug Administration approved medication that was only approved and | ||
in existence after my declaration and that is considered in the same | ||
class of psychoactive medications as stated below: | ||
________________________________________________________________ | ||
Conditions or limitations: ________________________________ | ||
CONVULSIVE TREATMENT | ||
If I become incapable of giving or withholding informed | ||
consent for mental health treatment, my wishes regarding convulsive | ||
treatment are as follows: | ||
_____ I consent to the administration of convulsive | ||
treatment. | ||
_____ I do not consent to the administration of convulsive | ||
treatment. | ||
Conditions or limitations: ________________________________ | ||
PREFERENCES FOR EMERGENCY TREATMENT | ||
In an emergency, I prefer the following treatment FIRST | ||
(circle one) Restraint/Seclusion/Medication. | ||
In an emergency, I prefer the following treatment SECOND | ||
(circle one) Restraint/Seclusion/Medication. | ||
In an emergency, I prefer the following treatment THIRD | ||
(circle one) Restraint/Seclusion/Medication. | ||
______ I prefer a male/female to administer restraint, | ||
seclusion, and/or medications. | ||
Options for treatment prior to use of restraint, seclusion, | ||
and/or medications: | ||
________________________________________________________________ | ||
Conditions or limitations: ________________________________ | ||
ADDITIONAL PREFERENCES OR INSTRUCTIONS | ||
________________________________________________________________ | ||
Conditions or limitations: ________________________________ | ||
Signature of Principal/Date: ______________________________ | ||
SIGNATURE ACKNOWLEDGED BEFORE NOTARY PUBLIC | ||
State of Texas | ||
County of_________ | ||
This instrument was acknowledged before me on ______(date) by | ||
___________(name of notary public). | ||
_____________________ | ||
NOTARY PUBLIC, State of Texas | ||
Printed name of Notary Public: | ||
_____________________________ | ||
My commission expires: | ||
_____________________________ | ||
SIGNATURE IN PRESENCE OF TWO WITNESSES | ||
STATEMENT OF WITNESSES | ||
I declare under penalty of perjury that the principal's name | ||
has been represented to me by the principal, that the principal | ||
signed or acknowledged this declaration in my presence, that I | ||
believe the principal to be of sound mind, that the principal has | ||
affirmed that the principal is aware of the nature of the document | ||
and is signing it voluntarily and free from duress, that the | ||
principal requested that I serve as witness to the principal's | ||
execution of this document, and that I am not a provider of health | ||
or residential care to the principal, an employee of a provider of | ||
health or residential care to the principal, an operator of a | ||
community health care facility providing care to the principal, or | ||
an employee of an operator of a community health care facility | ||
providing care to the principal. | ||
I declare that I am not related to the principal by blood, | ||
marriage, or adoption and that to the best of my knowledge I am not | ||
entitled to and do not have a claim against any part of the estate of | ||
the principal on the death of the principal under a will or by | ||
operation of law. | ||
Witness | ||
Signature: ______________________________________________ | ||
Name: _____________________________________________________ | ||
Date: ______________________ | ||
Address: _______________________________________________________ | ||
Witness | ||
Signature: ______________________________________________ | ||
Name: _____________________________________________________ | ||
Date: ______________________ | ||
Address: _______________________________________________________ | ||
NOTICE TO PERSON MAKING A DECLARATION FOR MENTAL HEALTH TREATMENT | ||
This is an important legal document. It creates a | ||
declaration for mental health treatment. Before signing this | ||
document, you should know these important facts: | ||
This document allows you to make decisions in advance about | ||
mental health treatment and specifically three types of mental | ||
health treatment: psychoactive medication, convulsive therapy, | ||
and emergency mental health treatment. The instructions that you | ||
include in this declaration will be followed only if a court | ||
believes that you are incapacitated to make treatment decisions. | ||
Otherwise, you will be considered able to give or withhold consent | ||
for the treatments. | ||
This document will continue in effect for a period of three | ||
years unless you become incapacitated to participate in mental | ||
health treatment decisions. If this occurs, the directive will | ||
continue in effect until you are no longer incapacitated. | ||
You have the right to revoke this document in whole or in part | ||
at any time you have not been determined to be incapacitated. YOU | ||
MAY NOT REVOKE THIS DECLARATION WHEN YOU ARE CONSIDERED BY A COURT | ||
TO BE INCAPACITATED. A revocation is effective when it is | ||
communicated to your attending physician or other health care | ||
provider. | ||
If there is anything in this document that you do not | ||
understand, you should ask a lawyer to explain it to you. This | ||
declaration is not valid unless it is either acknowledged before a | ||
notary public or signed by two qualified witnesses who are | ||
personally known to you and who are present when you sign or | ||
acknowledge your signature. | ||
SECTION 4. The changes in law made by this Act to Sections | ||
137.003 and 137.011, Civil Practice and Remedies Code, apply to a | ||
declaration for mental health treatment executed on or after the | ||
effective date of this Act. A declaration for mental health | ||
treatment executed before the effective date of this Act is | ||
governed by the law as it existed on the date the declaration for | ||
mental health treatment was executed, and the former law is | ||
continued in effect for that purpose. | ||
SECTION 5. This Act takes effect September 1, 2017. |