LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION May 18, 2009 TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:SB1663 by Wentworth (Relating to the disregard or violation of a resident's advance directive by a nursing institution; providing penalties.), As Engrossed No significant fiscal implication to the State is anticipated. The bill would amend the Health and Safety Code as it relates to the disregard or violation of a residents advance directive by a nursing institution and provide penalties. The bill would require the Department of Aging and Disability Services (DADS) to assess an administrative penalty against an institution that knowingly employs or has on staff a health care practitioner who knowingly disregards or violates a residents advance directive if the institution has included a statement in its written policies maintained under Section 166.004 that the institution would follow a residents advance directive. A person who has cause to believe that a residents advance directive has been or may be knowingly disregarded in violation of a written policy maintained under Section 166.004 would be required to report the violation. If an institution, its owner, employees, agents, or physicians in good faith attempt to resuscitate a resident because the institution, its owners, employees, agents, or physicians reasonably believe that the process of dying appears to be the results of an accident, unnatural causes, or suspicious circumstances, it would not be considered a violation. To the extent consistent with federal law, an institution is authorized to object to honoring an advance directive if the institution includes in its policies and explains to each prospective resident before admission to the institution the circumstances under which the institution would not follow instructions of an advanced directive. DADS, after providing notice and opportunity for a hearing to a license holder, would be required to suspend or revoke a license if the department finds that the license holder has been assessed three or more administrative penalties for violating the provisions of the bill. According to DADS, the provisions of the bill that relate to administrative penalties would likely not result in any significant fiscal impact on revenue. The bill would take effect September 1, 2009. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies:539 Aging and Disability Services, Department of LBB Staff: JOB, SJ, CL, LR
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION
May 18, 2009
TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services FROM: John S. O'Brien, Director, Legislative Budget Board IN RE:SB1663 by Wentworth (Relating to the disregard or violation of a resident's advance directive by a nursing institution; providing penalties.), As Engrossed
TO: Honorable Patrick M. Rose, Chair, House Committee on Human Services
FROM: John S. O'Brien, Director, Legislative Budget Board
IN RE: SB1663 by Wentworth (Relating to the disregard or violation of a resident's advance directive by a nursing institution; providing penalties.), As Engrossed
Honorable Patrick M. Rose, Chair, House Committee on Human Services
Honorable Patrick M. Rose, Chair, House Committee on Human Services
John S. O'Brien, Director, Legislative Budget Board
John S. O'Brien, Director, Legislative Budget Board
SB1663 by Wentworth (Relating to the disregard or violation of a resident's advance directive by a nursing institution; providing penalties.), As Engrossed
SB1663 by Wentworth (Relating to the disregard or violation of a resident's advance directive by a nursing institution; providing penalties.), As Engrossed
No significant fiscal implication to the State is anticipated.
No significant fiscal implication to the State is anticipated.
The bill would amend the Health and Safety Code as it relates to the disregard or violation of a residents advance directive by a nursing institution and provide penalties. The bill would require the Department of Aging and Disability Services (DADS) to assess an administrative penalty against an institution that knowingly employs or has on staff a health care practitioner who knowingly disregards or violates a residents advance directive if the institution has included a statement in its written policies maintained under Section 166.004 that the institution would follow a residents advance directive. A person who has cause to believe that a residents advance directive has been or may be knowingly disregarded in violation of a written policy maintained under Section 166.004 would be required to report the violation. If an institution, its owner, employees, agents, or physicians in good faith attempt to resuscitate a resident because the institution, its owners, employees, agents, or physicians reasonably believe that the process of dying appears to be the results of an accident, unnatural causes, or suspicious circumstances, it would not be considered a violation. To the extent consistent with federal law, an institution is authorized to object to honoring an advance directive if the institution includes in its policies and explains to each prospective resident before admission to the institution the circumstances under which the institution would not follow instructions of an advanced directive. DADS, after providing notice and opportunity for a hearing to a license holder, would be required to suspend or revoke a license if the department finds that the license holder has been assessed three or more administrative penalties for violating the provisions of the bill. According to DADS, the provisions of the bill that relate to administrative penalties would likely not result in any significant fiscal impact on revenue. The bill would take effect September 1, 2009.
The bill would amend the Health and Safety Code as it relates to the disregard or violation of a residents advance directive by a nursing institution and provide penalties. The bill would require the Department of Aging and Disability Services (DADS) to assess an administrative penalty against an institution that knowingly employs or has on staff a health care practitioner who knowingly disregards or violates a residents advance directive if the institution has included a statement in its written policies maintained under Section 166.004 that the institution would follow a residents advance directive.
A person who has cause to believe that a residents advance directive has been or may be knowingly disregarded in violation of a written policy maintained under Section 166.004 would be required to report the violation. If an institution, its owner, employees, agents, or physicians in good faith attempt to resuscitate a resident because the institution, its owners, employees, agents, or physicians reasonably believe that the process of dying appears to be the results of an accident, unnatural causes, or suspicious circumstances, it would not be considered a violation. To the extent consistent with federal law, an institution is authorized to object to honoring an advance directive if the institution includes in its policies and explains to each prospective resident before admission to the institution the circumstances under which the institution would not follow instructions of an advanced directive. DADS, after providing notice and opportunity for a hearing to a license holder, would be required to suspend or revoke a license if the department finds that the license holder has been assessed three or more administrative penalties for violating the provisions of the bill. According to DADS, the provisions of the bill that relate to administrative penalties would likely not result in any significant fiscal impact on revenue. The bill would take effect September 1, 2009.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: 539 Aging and Disability Services, Department of
539 Aging and Disability Services, Department of
LBB Staff: JOB, SJ, CL, LR
JOB, SJ, CL, LR