[
Advance Directives
|
Nursing Home Reports
|
Other Long-Term Care Legislation
]
ADVANCE DIRECTIVES
Texas' existing advance directives
legislation has been in effect since 1999, and experience has
exposed a few minor problems with the specific language in the
statute. In response to concerns expressed by physicians and
hospitals, the diverse stakeholder group that developed the
original statute was reconvened last year to negotiate some
possible language revisions. Senate Bill 1320 by Sen. Jane Nelson
(R-Flower Mound) and Rep. Jaime Capelo (D-Corpus Christi) is the
product of that process and includes the following
provisions:
Allows staff in nursing homes and other
outpatient settings to honor physician do not resuscitate (DNR)
orders,
Clarifies that the statutory protections
apply to decisions about children,
Allows hospitals to discontinue care
without having to repeat ethical reviews for patients readmitted
within six months in unchanged or worsened condition,
Requires some specific patient notification
language about patient rights,
Requires the Texas Health Care Information
Council to maintain a Web page listing providers and referral
groups that have volunteered to help patients find appropriate
transfers, and
Provides that applicable federal law
applies to cases of child abuse and neglect.
The negotiated bill also included language
clarifying that life-prolonging measures are not required in
cases where death is imminent anyway, but that language was
removed before the bill was passed. In response to pressure from
advocacy organizations, the bill also was amended to prohibit a
parent or guardian from executing an out-of-hospital DNR order
for a child unless the child has a terminal or irreversible fatal
illness.
NURSING HOME REPORTS
SB 1074 by Sen. Royce West (D-Dallas)
requires that all reports of abuse or neglect made by nursing
home staff must be made both to the Department of Human Services
(DHS) and to local law enforcement agencies. It further requires
that DHS coordinate investigations with law enforcement agencies
and expands the list of complaints that must be investigated
within 24 hours. TMA expressed concerns that the current
procedures for DHS investigations are effective, that the
required dual reporting was unnecessary, and that unnecessary law
enforcement investigations would disrupt patient care. Law
enforcement agencies argued that they should always be informed
of alleged crimes. The bill language was revised to require law
enforcement agencies to defer to DHS investigations unless
specific crimes are alleged, offering some protection from
unnecessary disruption of the facility.
OTHER LONG-TERM CARE LEGISLATION
House Bill 3486 by Rep. Dianne Delisi
(R-Temple) allows a nursing home pharmacist to return sealed and
unused medications to stock for reuse.
HB 776 by Rep. Eliot Naishtat (D-Austin)
and SB 1549 by Senator Nelson require nursing homes to provide
annually to all nursing staff one hour of training in caring for
people with dementia.
SB 313 by Sen. Chris Harris (R-Arlington)
establishes that civil damages awarded against a nonprofit
nursing institution may not be recovered from a tax-exempt
endowment or fund that is used to fund care.
SB 421 by Sen. John Carona (R-Dallas)
allows assisted living facilities to obtain professional
liability insurance through the Texas Medical Liability Insurance
Underwriting Association.
SB 826 by Sen. John Whitmire (D-Houston)
requires that deaths in an institution where the physician is
unable to certify the cause of death and requests an inquest must
be reported to the attorney general.
SB 923 by Sen. Judith Zaffirini (D-Laredo)
prohibits nursing homes from hiring anyone with certain criminal
convictions and requires criminal history checks within 24 hours
employment.
SB 1012 by Sen. Royce West (D-Dallas)
allows electronic monitoring devices in assisted living
facilities.
SB 1073 by Senator West prohibits
facilities serving the elderly or persons with disabilities from
hiring anyone with certain criminal convictions.
Relevant bills not passed or vetoed
were:
HB 1694 by Rep. Norma Chavez (D-El Paso)
would have required gerontology training as part of physician
licensing requirements. TMA opposes any state-mandated curricula
for CME. The bill died in the House.
SB 827 by Senator Whitmire would have
imposed criminal penalties on anyone who had custody care or
control of an elderly person and failed to provide him or her
with food, medical care, or shelter. The bill language would have
prohibited hospitals from honoring advance directives, so the
governor vetoed it at the hospitals' request.
Long-term care TMA staff
contacts:
-Donna Kinney, manager, Regulatory
Analysis and Advocacy, (512) 370-1422
-C.J. Francisco, JD, senior counsel, Office of the
General Counsel, (512) 370-1339
-Yvonne Barton, associate director, Legislative Affairs
Department, (512) 370-1359
|
[
Overview
|
Professional Liability Reform
|
Patient Safety/Quality Improvement
|
Managed Care/Insurance Reform
|
Health Care Funding
|
Health and Human Services
Reorganization
|
Scope of Practice
|
Public Health
|
Rural Health
|
Mental Health
|
Medical Science
|
Workers' Compensation
|
Tax Reform
|
Workforce/Medical Education
|
Abortion and Related Legislation
|
Health Facility Regulation
|
Transplantation/Organ Donation
]