§ 137.006.Discrimination Relating to Execution of Declaration for Mental Health Treatment

An anti-discrimination provision, and its four prohibitions cover the ways pressure could otherwise be applied.

Who is bound is broad: a health or residential care provider, health care service plan, insurer issuing disability insurance, self-insured employee benefit plan, or nonprofit hospital service plan.

The list reaches past treatment into insurance and employee benefits, which is where the financial pressure would come from.

First: no charging a person a different rate solely because the person has executed a declaration. Pricing is the quietest form of discouragement, and this closes it.

Second: no requiring a person to execute a declaration before admitting them to a hospital, nursing home, or residential care home, before insuring them, or before allowing them to receive health or residential care.

That prohibition protects the voluntariness the execution section demands. A declaration signed to obtain a hospital bed is not a free expression of preferences, and the witness statement affirming freedom from duress would be a formality.

Third: no refusing health or residential care solely because a person has executed a declaration.

Fourth: no discharging a person solely because the person has or has not executed one.

The fourth is the only prohibition drawn both ways, covering the person who made a declaration and the person who declined to — so a facility can neither punish having one nor punish refusing to sign.

"Solely" qualifies three of the four. The provisions reach decisions taken because of the declaration, leaving ordinary clinical and administrative decisions untouched.