Some people living in a community-based intermediate care facility (ICF/IID) have been assessed to lack the capacity to make medical treatment decisions for themselves. If they have no legal guardian or surrogate decision maker to make major medical and major dental treatment decisions on their behalf, those decision are then made by a surrogate consent committee (SCC).
An SCC is a group of 3 to 5 trained volunteers who convene at a pre-determined location, date and time (known as a hearing) to review written documentation and hear oral testimony about the need for the proposed treatment.
The SCC makes a determination based on clear and convincing evidence of whether or not the proposed treatment promotes the individual's best interest. If it is determined the proposed treatment is in the individual's best interest, then consent is given. The SCC decides the date the consent becomes effective and the date it expires.
A SCC is authorized to make the following treatment decisions:
- Major medical treatment;
- Major dental treatment;
- Administration of psychoactive medication;
- Use of a highly restrictive behavior procedure:
- Release of records and other information relevant to the treatment or condition necessary to facilitate the process of obtaining consent for treatment; and
- Consent decisions which the IDT agrees involve risk to the individual's protection and rights which are not specifically reserved to a SDM or SCC.
Anyone interested in becoming an SCC volunteer must attend a 4-hour training provided by the Texas Department of Aging and Disability Services (DADS). Training for new volunteers is free and held at least annually in Austin. If there are enough people in a particular region who are interested in becoming volunteers, it's possible arrangements can be made for a training to be held locally.