The section allows for forced medication only if:
(a) defendant is determined, under Chapter 46B, to be incompetent to stand trial;
(b) has a continuity of care plan; and
(c) has had a 574.106 hearing

My question is under 46B.086(c) how can I get medication to a defendant? When;

committing court is in another county,
doctor's who examined are not present in the county,

Have you asked your jail to send the records on?

This section of 46B requires testimony from a physician in the facility in which the def is confined (by the way though in the civil forum, this is not civil, but court ordered Rx under a criminal commitment, albeit that the criteria as well as some procedures rely on civil statutes). Having such a physician participate insures that there will be cooperation between the desires of the commiting court and the facility providing care. In the absence of such, you are in an awkward position as some physician may say, "Look, I don't feel it is in the patient (def's) best interest to be on that medication and I cannot, in good conscience, support it.." In which case you are in a difficult circumstance. If it is only a matter of physically getting the preparation to the def, then a doctor to doctor communication would assist. As I write, I realize that more information about the facts is necessary to adequately resolve the matter. Feel free to contact me back channel. Do you agree, Etta?

I always defer to your superior knowledge and expertise, Dr. Jennings, as I am a wise woman.
Is it the case, then, that medication can't just be transferred with the patient, and dispensed by a jail, without the actual testimony of a physician in the confining county (as opposed to a jail doctor's recommendation)? What if the patient begins voluntarily taking the medication (as so many will do after being stabilized)? I, too, would like more facts.

The issue is not that of an inmate who voluntarily takes meds - but one who does not and requires such to maintain restoration. The involuntary meds can be ordered through a 46B proceeding. In the jail, absent a 46B hearing, many jails tend to simply allow the inmate to be psychotic. A better procedure is a Washington v. Harper hearing - which is internal, but involves administrative review and medical necessity and meds can be given "for the orderly maintenance of a penal institution." Generally after stabilization, the mentally ill inmate will then be voluntary.

One always learns a great deal from you. I guess my question is about how to ensure that the meds are dispensed upon transfer. What a shame to "simply allow the inmate to be psychotic".

Okay. Let's see if I can muddy this up some.

The question is one for a State Hospital environment.

Defendant comes into a State Hospital and has been declared incompetent to stand trial. (Not a class b misdemeanor because we can't medicate them anymore under Sell v. U.S.)

Defendant refuses meds and requires medication to become competent.

How does 46B.086 affect his treament?

Okay. First, this is not an ordinary Health & Safety Code commitment under Chapter 574. Were it so, and if, (this is a significant "if"), the attending physician were supporting involuntary or forced meds, then a 576.106 hearing would be necessary. It may yet be sufficient, as will be noted.

Second, this is a criminal commitment under 46B, albeit that because it is not a felony the def goes to - in your case - Rusk and not Vernon.

Third, I would generally seek a 46B.086 hearing. One issue is whether the commiting county has transferred jurisdiction to Cherokee County or it was yours initially. Note that there are several requisites in these hearings,
..a plan of care from the institution in which the def is confined.
..two physician's certificates
..the standard is the Sell standard, however: Best interest, medically appropriate, no less invasive means of obtaining and maintaining restoration exists.

Fourth, you could seek a 574.106 hearing, if the def meets the standard of having been previously confined for mental health reasons in the preceding 6 months, and meets the dangerousness standard, either to self or others, from his/her lack of willingness to voluntarily accept the medications. In Harris County, we do 574.106 hearings all the time, generally contiguous with, but subsequent to, the civil commitment procedure.

Fifth, in smaller counties the same judge handles both types of cases, but in our large area, there are two differing courts that handle these matters.

Sixth, the support and involvement of the treatment team is essential, and a sine qua non.

Finally, if I have left something out - just google me or use the state bar list and call me.