87R3355 JG-D
By: Sanford H.B. No. 2324
A BILL TO BE ENTITLED
AN ACT
relating to a designated essential caregiver for residents of
certain long-term care facilities during public health
emergencies.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle A, Title 4, Health and Safety Code, is
amended by adding Chapter 226 to read as follows:
CHAPTER 226. LONG-TERM CARE FACILITY ESSENTIAL CAREGIVER
DESIGNATIONS AND REQUIREMENTS
Sec. 226.001. DEFINITIONS. In this chapter:
(1) "Essential caregiver" means an individual
designated as a resident's essential caregiver in accordance with
Section 226.003.
(2) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(3) "Long-term care facility" means:
(A) a facility licensed or regulated under
Chapter 242, 247, or 252; and
(B) a state supported living center as defined by
Section 531.002.
(4) "Public health emergency" means an immediate
threat from a communicable disease as defined by Section 81.003
that:
(A) poses a high risk of death or serious
long-term disability to a large number of people in the general
population; and
(B) creates a substantial risk of public exposure
because of the disease's high level of contagion or the method by
which the disease is transmitted.
(5) "Resident" means an individual, including a
patient or client, who resides in a long-term care facility.
Sec. 226.002. PURPOSE. The purpose of this chapter is to
require long-term care facilities to develop and implement policies
and procedures for residents to designate an essential caregiver
and to ensure that during a public health emergency the facility
provides an essential caregiver with meaningful access to the
resident to:
(1) detect resident concerns and advocate on behalf of
the resident;
(2) observe and communicate to facility staff and
health care providers important details and changes related to the
resident's condition or behavior;
(3) assist the resident in managing complex or
critical information;
(4) provide emotional support and ensure the
resident's personal values and care preferences are considered by
facility staff and health care providers;
(5) alleviate caregiving tasks of facility staff and
health care providers;
(6) preserve and promote the resident's quality of
life; and
(7) promote and help maintain a sense of continuity,
identity, and autonomy for the resident.
Sec. 226.003. POLICIES AND PROCEDURES FOR DESIGNATION AND
USE OF ESSENTIAL CAREGIVER. (a) The executive commissioner by rule
shall require each long-term care facility to develop and implement
policies and procedures allowing each resident to designate an
essential caregiver to whom the facility will provide, in
accordance with and in the manner described by this chapter,
meaningful access to the resident during a public health emergency.
(b) The policies and procedures must:
(1) require long-term care facility staff and health
care providers to consult each resident to determine the most
appropriate individual to designate as the resident's essential
caregiver;
(2) establish criteria for individuals to be
designated as a resident's essential caregiver, provided the
criteria allow the resident to designate a family member, a friend,
an outside caregiver, or a volunteer who has provided regular care
and support to the resident;
(3) if demonstrated by one or more individuals' past
involvement with the resident or necessitated by the resident's
particular needs, allow a resident to designate more than one
essential caregiver;
(4) authorize a resident's essential caregiver to
regularly assist facility staff and health care providers in
providing care and emotional support to the resident, including
during a public health emergency;
(5) except as otherwise provided by Section 226.004
due to the imposition of quarantine restrictions, require facility
staff to work cooperatively with each resident and essential
caregiver to develop a visitation schedule that ensures:
(A) the caregiver has meaningful access to the
resident during a public health emergency;
(B) the caregiver is allowed access to the
resident to provide caregiving services:
(i) for the greater of three hours each day
or the hours necessary for the caregiver to complete the services;
and
(ii) in a manner, including during evening
and weekend visits, that accommodates the caregiver's work,
child-care obligations, or other schedule; and
(C) the number of caregivers admitted to the
facility at any given time is appropriate for maintaining the
health, safety, and security of each resident, staff member, and
health care provider; and
(6) ensure that each essential caregiver has access to
information on the proper use of personal protective equipment
during a public health emergency.
Sec. 226.004. REQUIREMENTS AND RESTRICTIONS FOR ESSENTIAL
CAREGIVER ACCESS DURING PUBLIC HEALTH EMERGENCY. (a) A long-term
care facility must designate a central point of entry during a
public health emergency where each essential caregiver must enter
and register. Before entering the facility, facility staff or
health care providers must properly screen each caregiver for
symptoms of a disease or disorder related to a public health
emergency in the same manner the facility staff and health care
providers are screened.
(b) An essential caregiver admitted to a long-term care
facility during a public health emergency must wear all necessary
personal protective equipment while inside the facility, including
eye protection or a face mask as necessary, and must frequently
sanitize the caregiver's hands. The facility shall provide an
appropriate number of hand sanitizing or other stations located
throughout the facility for caregivers to maintain proper hygiene
while inside the facility.
(c) A long-term care facility shall establish procedures
allowing an essential caregiver to walk outside with the resident
in the area surrounding the facility if the caregiver and resident
wear appropriate personal protective equipment. A caregiver may
not take a resident beyond that area other than to an essential
medical appointment with the authorization of facility staff or
health care providers.
(d) An essential caregiver must:
(1) visit or provide care to a resident inside the
resident's room or another area designated by facility staff or
health care providers;
(2) while inside the facility maintain an appropriate
social distance from each individual other than the caregiver's
resident, including facility staff, health care providers, and
other residents; and
(3) immediately notify facility staff or health care
providers if, within 14 days following the caregiver's most recent
visit, the caregiver develops a fever or experiences symptoms of a
disease or disorder related to a public health emergency.
(e) Except for a compassionate care visit authorized by a
long-term care facility, an essential caregiver may not visit a
resident who is under quarantine restrictions imposed by the
facility due to the resident testing positive for, being exposed
to, or experiencing symptoms of a disease or disorder related to a
public health emergency.
Sec. 226.005. RESTRICTION OR REVOCATION OF ESSENTIAL
CAREGIVER DESIGNATION. (a) A long-term care facility may restrict
an essential caregiver's access to the facility or revoke a
caregiver's designation for a violation of Section 226.004.
(b) Before restricting an essential caregiver's access or
revoking a caregiver's designation, a long-term care facility must
provide the caregiver with an opportunity to discuss the
restriction or revocation with facility staff, health care
providers, and the resident in an attempt to correct the violation.
SECTION 2. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt rules as necessary to implement
Chapter 226, Health and Safety Code, as added by this Act.
SECTION 3. This Act takes effect September 1, 2021.