Surrogate Decision-making Program

The Surrogate Decision-making Program (SDMP) is a legislatively mandated process authorizing actively involved family members known as Surrogate Decision Makers (SDMs) and Surrogate Consent Committees (SCCs) comprised of trained volunteers to provide written informed consent for individuals residing in community-based ICF/IID who have been assessed to lack the capacity to make certain treatment decisions for themselves and have no legal guardian.

The SDMP provides a mechanism for obtaining informed consent for individuals who lack capacity to make treatment decisions, promotes and encourages individual empowerment and the preservation of dignity, and facilitates compliance with Code of Federal Regulations (CFR) Title 42 and state ICF/IID rules regarding protection of individuals rights.

In order for the SCC program to continue to successfully fulfill its mandate, additional trained volunteers are needed to serve on SCCs. At least one volunteer in each committee must be a health care professional who is licensed or registered in Texas and who has specialized training in medicine, psychopharmacology, nursing, or psychology, or has demonstrated expertise or interest in the care and treatment of individuals with intellectual or developmental disabilities.

SCC hearings are held via Microsoft Teams. Ideally, SCC members will work for the same provider or be associated with the provider, such as a volunteer, as the SCC will need to be in the same room when making treatment decisions. The SDMP manager will appoint one of the volunteers on each SCC to be chairperson of the committee. Hearings take approximately 30 minutes for each individual and are held separately (i.e., if three individuals need to have treatment decisions made for them there will be three separate hearings).

The following treatment decisions are authorized for SDMs:

  1. Major medical treatment.
  2. Major dental treatment.
  3. Release of records and other information relevant to the treatment or condition necessary to facilitate the process of obtaining consent for treatment.
  4. Consent decisions which the interdisciplinary team (IDT) agrees involve risk to individual protection and rights which are not specially reserved to a SDM or SCC.

The following treatment decisions are authorized for SCCs:

  1. Major medical treatment.
  2. Major dental treatment.
  3. Administration of psychoactive medication.
  4. Use of a highly restrictive behavior procedure.
  5. Release of records and other information relevant to the treatment or condition necessary to facilitate the process of obtaining consent for treatment.
  6. Consent decisions which the IDT agrees involve risk to individual protection and rights which are not specially reserved to a SDM or SCC.

The following treatment decisions are excluded under the SDMP:

  1. Abortion.
  2. Sterilization.
  3. Experimental research.
  4. Electroconvulsive therapy.
  5. Funds management.

If you have any questions pertaining to the SDMP or would like to volunteer to serve on a SCC, contact Randy Rowley, SDMP Manager, at randall.rowley@hhs.texas.gov or (512) 438-4306.