Texas 2009 - 81st Regular

Texas Senate Bill SB203 Compare Versions

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1	1	S.B. No. 203
2	2
3	3
4	4	AN ACT
5	5	relating to health care-associated infections and preventable
6	6	adverse events in certain health care facilities.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. Subsections (a), (b), and (c), Section 98.103,
9	9	Health and Safety Code, as added by Chapter 359 (S.B. 288), Acts of
10	10	the 80th Legislature, Regular Session, 2007, are amended to read as
11	11	follows:
12	12	(a) A health care facility, other than a pediatric and
13	13	adolescent hospital, shall report to the department the incidence
14	14	of surgical site infections, including the causative pathogen if
15	15	the infection is laboratory-confirmed, occurring in the following
16	16	procedures:
17	17	(1) colon surgeries;
18	18	(2) hip arthroplasties;
19	19	(3) knee arthroplasties;
20	20	(4) abdominal hysterectomies;
21	21	(5) vaginal hysterectomies;
22	22	(6) coronary artery bypass grafts; and
23	23	(7) vascular procedures.
24	24	(b) A pediatric and adolescent hospital shall report the
25	25	incidence of surgical site infections, including the causative
26	26	pathogen if the infection is laboratory-confirmed, occurring in the
27	27	following procedures to the department:
28	28	(1) cardiac procedures, excluding thoracic cardiac
29	29	procedures;
30	30	(2) ventriculoperitoneal shunt procedures; and
31	31	(3) spinal surgery with instrumentation.
32	32	(c) A general hospital shall report the following to the
33	33	department:
34	34	(1) the incidence of laboratory-confirmed central
35	35	line-associated primary bloodstream infections, including the
36	36	causative pathogen, occurring in any special care setting in the
37	37	hospital; and
38	38	(2) the incidence of respiratory syncytial virus
39	39	occurring in any pediatric inpatient unit in the hospital.
40	40	SECTION 2. (a) The heading to Chapter 98, Health and
41	41	Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th
42	42	Legislature, Regular Session, 2007, is amended to read as follows:
43	43	CHAPTER 98. REPORTING OF HEALTH CARE-ASSOCIATED INFECTIONS AND
44	44	PREVENTABLE ADVERSE EVENTS
45	45	(b) Subdivisions (1) and (11), Section 98.001, Health and
46	46	Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th
47	47	Legislature, Regular Session, 2007, are amended to read as follows:
48	48	(1) "Advisory panel" means the Advisory Panel on
49	49	Health Care-Associated Infections and Preventable Adverse Events.
50	50	(11) "Reporting system" means the Texas Health
51	51	Care-Associated Infection and Preventable Adverse Events Reporting
52	52	System.
53	53	(c) Section 98.051, Health and Safety Code, as added by
54	54	Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular
55	55	Session, 2007, is amended to read as follows:
56	56	Sec. 98.051. ESTABLISHMENT. The commissioner shall
57	57	establish the Advisory Panel on Health Care-Associated Infections
58	58	and Preventable Adverse Events within [the infectious disease
59	59	surveillance and epidemiology branch of] the department to guide
60	60	the implementation, development, maintenance, and evaluation of
61	61	the reporting system. The commissioner may establish one or more
62	62	subcommittees to assist the advisory panel in addressing health
63	63	care-associated infections and preventable adverse events relating
64	64	to hospital care provided to children or other special patient
65	65	populations.
66	66	(d) Subsection (a), Section 98.052, Health and Safety Code,
67	67	as added by Chapter 359 (S.B. 288), Acts of the 80th Legislature,
68	68	Regular Session, 2007, is amended to read as follows:
69	69	(a) The advisory panel is composed of 18 [16] members as
70	70	follows:
71	71	(1) two infection control professionals who:
72	72	(A) are certified by the Certification Board of
73	73	Infection Control and Epidemiology; and
74	74	(B) are practicing in hospitals in this state, at
75	75	least one of which must be a rural hospital;
76	76	(2) two infection control professionals who:
77	77	(A) are certified by the Certification Board of
78	78	Infection Control and Epidemiology; and
79	79	(B) are nurses licensed to engage in professional
80	80	nursing under Chapter 301, Occupations Code;
81	81	(3) three board-certified or board-eligible
82	82	physicians who:
83	83	(A) are licensed to practice medicine in this
84	84	state under Chapter 155, Occupations Code, at least two of whom have
85	85	active medical staff privileges at a hospital in this state and at
86	86	least one of whom is a pediatric infectious disease physician with
87	87	expertise and experience in pediatric health care epidemiology;
88	88	(B) are active members of the Society for
89	89	Healthcare Epidemiology of America; and
90	90	(C) have demonstrated expertise in quality
91	91	assessment and performance improvement or infection control in
92	92	health care facilities;
93	93	(4) four additional [two] professionals in quality
94	94	assessment and performance improvement[, one of whom is employed by
95	95	a general hospital and one of whom is employed by an ambulatory
96	96	surgical center];
97	97	(5) one officer of a general hospital;
98	98	(6) one officer of an ambulatory surgical center;
99	99	(7) three nonvoting members who are department
100	100	employees representing the department in epidemiology and the
101	101	licensing of hospitals or ambulatory surgical centers; and
102	102	(8) two members who represent the public as consumers.
103	103	(e) Subsections (a) and (c), Section 98.102, Health and
104	104	Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th
105	105	Legislature, Regular Session, 2007, are amended to read as follows:
106	106	(a) The department shall establish the Texas Health
107	107	Care-Associated Infection and Preventable Adverse Events Reporting
108	108	System within the [infectious disease surveillance and
109	109	epidemiology branch of the] department. The purpose of the
110	110	reporting system is to provide for:
111	111	(1) the reporting of health care-associated
112	112	infections by health care facilities to the department;
113	113	(2) the reporting of health care-associated
114	114	preventable adverse events by health care facilities to the
115	115	department;
116	116	(3) the public reporting of information regarding the
117	117	health care-associated infections by the department;
118	118	(4) the public reporting of information regarding
119	119	health care-associated preventable adverse events by the
120	120	department; and
121	121	(5) [(3)] the education and training of health care
122	122	facility staff by the department regarding this chapter.
123	123	(c) The data reported by health care facilities to the
124	124	department must contain sufficient patient identifying information
125	125	to:
126	126	(1) avoid duplicate submission of records;
127	127	(2) allow the department to verify the accuracy and
128	128	completeness of the data reported; and
129	129	(3) for data reported under Section 98.103 or 98.104,
130	130	allow the department to risk adjust the facilities' infection
131	131	rates.
132	132	(f) Subchapter C, Chapter 98, Health and Safety Code, as
133	133	added by Chapter 359 (S.B. 288), Acts of the 80th Legislature,
134	134	Regular Session, 2007, is amended by adding Section 98.1045 to read
135	135	as follows:
136	136	Sec. 98.1045. REPORTING OF PREVENTABLE ADVERSE EVENTS.
137	137	(a) Each health care facility shall report to the department the
138	138	occurrence of any of the following preventable adverse events
139	139	involving the facility's patient:
140	140	(1) a health care-associated adverse condition or
141	141	event for which the Medicare program will not provide additional
142	142	payment to the facility under a policy adopted by the federal
143	143	Centers for Medicare and Medicaid Services; and
144	144	(2) subject to Subsection (b), an event included in
145	145	the list of adverse events identified by the National Quality Forum
146	146	that is not included under Subdivision (1).
147	147	(b) The executive commissioner may exclude an adverse event
148	148	described by Subsection (a)(2) from the reporting requirement of
149	149	Subsection (a) if the executive commissioner, in consultation with
150	150	the advisory panel, determines that the adverse event is not an
151	151	appropriate indicator of a preventable adverse event.
152	152	(g) Subsections (a), (b), and (g), Section 98.106, Health
153	153	and Safety Code, as added by Chapter 359 (S.B. 288), Acts of the
154	154	80th Legislature, Regular Session, 2007, are amended to read as
155	155	follows:
156	156	(a) The department shall compile and make available to the
157	157	public a summary, by health care facility, of:
158	158	(1) the infections reported by facilities under
159	159	Sections 98.103 and 98.104; and
160	160	(2) the preventable adverse events reported by
161	161	facilities under Section 98.1045.
162	162	(b) Information included in the [The] departmental summary
163	163	with respect to infections reported by facilities under Sections
164	164	98.103 and 98.104 must be risk adjusted and include a comparison of
165	165	the risk-adjusted infection rates for each health care facility in
166	166	this state that is required to submit a report under Sections 98.103
167	167	and 98.104.
168	168	(g) The department shall make the departmental summary
169	169	available on an Internet website administered by the department and
170	170	may make the summary available through other formats accessible to
171	171	the public. The website must contain a statement informing the
172	172	public of the option to report suspected health care-associated
173	173	infections and preventable adverse events to the department.
174	174	(h) Section 98.108, Health and Safety Code, as added by
175	175	Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular
176	176	Session, 2007, is amended to read as follows:
177	177	Sec. 98.108. FREQUENCY OF REPORTING. In consultation with
178	178	the advisory panel, the executive commissioner by rule shall
179	179	establish the frequency of reporting by health care facilities
180	180	required under Sections 98.103, [and] 98.104, and 98.1045.
181	181	Facilities may not be required to report more frequently than
182	182	quarterly.
183	183	(i) Section 98.109, Health and Safety Code, as added by
184	184	Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular
185	185	Session, 2007, is amended by adding Subsection (b-1) and amending
186	186	Subsection (e) to read as follows:
187	187	(b-1) A state employee or officer may not be examined in a
188	188	civil, criminal, or special proceeding, or any other proceeding,
189	189	regarding the existence or contents of information or materials
190	190	obtained, compiled, or reported by the department under this
191	191	chapter.
192	192	(e) A department summary or disclosure may not contain
193	193	information identifying a [facility] patient, employee,
194	194	contractor, volunteer, consultant, health care professional,
195	195	student, or trainee in connection with a specific [infection]
196	196	incident.
197	197	(j) Sections 98.110 and 98.111, Health and Safety Code, as
198	198	added by Chapter 359 (S.B. 288), Acts of the 80th Legislature,
199	199	Regular Session, 2007, are amended to read as follows:
200	200	Sec. 98.110. DISCLOSURE AMONG CERTAIN AGENCIES [WITHIN
201	201	DEPARTMENT]. Notwithstanding any other law, the department may
202	202	disclose information reported by health care facilities under
203	203	Section 98.103, [or] 98.104, or 98.1045 to other programs within
204	204	the department, to the Health and Human Services Commission, and to
205	205	other health and human services agencies, as defined by Section
206	206	531.001, Government Code, for public health research or analysis
207	207	purposes only, provided that the research or analysis relates to
208	208	health care-associated infections or preventable adverse events.
209	209	The privilege and confidentiality provisions contained in this
210	210	chapter apply to such disclosures.
211	211	Sec. 98.111. CIVIL ACTION. Published infection rates or
212	212	preventable adverse events may not be used in a civil action to
213	213	establish a standard of care applicable to a health care facility.
214	214	(k) As soon as possible after the effective date of this
215	215	Act, the commissioner of state health services shall appoint two
216	216	additional members to the advisory panel who meet the
217	217	qualifications prescribed by Subdivision (4), Subsection (a),
218	218	Section 98.052, Health and Safety Code, as amended by this section.
219	219	(l) Not later than February 1, 2010, the executive
220	220	commissioner of the Health and Human Services Commission shall
221	221	adopt rules and procedures necessary to implement the reporting of
222	222	health care-associated preventable adverse events as required
223	223	under Chapter 98, Health and Safety Code, as amended by this
224	224	section.
225	225	SECTION 3. (a) Subchapter B, Chapter 32, Human Resources
226	226	Code, is amended by adding Section 32.0312 to read as follows:
227	227	Sec. 32.0312. REIMBURSEMENT FOR SERVICES ASSOCIATED WITH
228	228	PREVENTABLE ADVERSE EVENTS. The executive commissioner of the
229	229	Health and Human Services Commission shall adopt rules regarding
230	230	the denial or reduction of reimbursement under the medical
231	231	assistance program for preventable adverse events that occur in a
232	232	hospital setting. In adopting the rules, the executive
233	233	commissioner:
234	234	(1) shall ensure that the commission imposes the same
235	235	reimbursement denials or reductions for preventable adverse events
236	236	as the Medicare program imposes for the same types of health
237	237	care-associated adverse conditions and the same types of health
238	238	care providers and facilities under a policy adopted by the federal
239	239	Centers for Medicare and Medicaid Services;
240	240	(2) shall consult an advisory committee on health care
241	241	quality, if established by the executive commissioner, to obtain
242	242	the advice of that committee regarding denial or reduction of
243	243	reimbursement claims for any other preventable adverse events that
244	244	cause patient death or serious disability in health care settings,
245	245	including events on the list of adverse events identified by the
246	246	National Quality Forum; and
247	247	(3) may allow the commission to impose reimbursement
248	248	denials or reductions for preventable adverse events described by
249	249	Subdivision (2).
250	250	(b) Not later than September 1, 2010, the executive
251	251	commissioner of the Health and Human Services Commission shall
252	252	adopt the rules required by Section 32.0312, Human Resources Code,
253	253	as added by this section.
254	254	(c) Rules adopted by the executive commissioner of the
255	255	Health and Human Services Commission under Section 32.0312, Human
256	256	Resources Code, as added by this section, may apply only to a
257	257	preventable adverse event occurring on or after the effective date
258	258	of the rules.
259	259	SECTION 4. This Act takes effect September 1, 2009.
260	260	______________________________ ______________________________
261	261	President of the Senate Speaker of the House
262	262	I hereby certify that S.B. No. 203 passed the Senate on
263	263	April 16, 2009, by the following vote: Yeas 31, Nays 0; and that
264	264	the Senate concurred in House amendment on May 29, 2009, by the
265	265	following vote: Yeas 31, Nays 0.
266	266	______________________________
267	267	Secretary of the Senate
268	268	I hereby certify that S.B. No. 203 passed the House, with
269	269	amendment, on May 27, 2009, by the following vote: Yeas 148,
270	270	Nays 0, one present not voting.
271	271	______________________________
272	272	Chief Clerk of the House
273	273	Approved:
274	274	______________________________
275	275	Date
276	276	______________________________
277	277	Governor