S.B. No. 25
AN ACT
relating to the right of certain residents to designate an
essential caregiver for in-person visitation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. It is the intent of the legislature to ensure
that residents of long-term care facilities and other residences
have a guaranteed right to visitation by family members, friends,
caregivers, and other individuals. The legislature expects
facilities and program providers to ensure that the guaranteed
visitation rights are available to residents every day of each
year, consistent with existing resident rights. The legislature
intends for facilities and program providers to temporarily limit a
resident's guaranteed visitation rights to in-person visitation by
essential caregivers only during a declared public health
emergency.
SECTION 2. Subtitle B, Title 4, Health and Safety Code, is
amended by adding Chapter 260B to read as follows:
CHAPTER 260B. RIGHT TO ESSENTIAL CAREGIVER VISITS
FOR CERTAIN RESIDENTS
Sec. 260B.0001. DEFINITIONS. In this chapter:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Essential caregiver" means a family member,
friend, guardian, or other individual selected by a resident,
resident's guardian, or resident's legally authorized
representative for in-person visits.
(3) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(4) "Facility" means:
(A) a nursing facility licensed under Chapter
242;
(B) an assisted living facility licensed under
Chapter 247; or
(C) an intermediate care facility for
individuals with an intellectual disability licensed under Chapter
252.
(5) "Program provider" means a person that provides
services through the home and community-based services (HCS) waiver
program in a residence.
(6) "Residence" means a three-person or four-person
residence, as defined by the home and community-based services
(HCS) waiver program billing guidelines, that is leased or owned by
a program provider. The term does not include a host home or
companion care.
(7) "Resident" means:
(A) an individual, including a patient, who
resides in a facility; or
(B) an individual enrolled in the home and
community-based services (HCS) waiver program who resides in a
residence.
Sec. 260B.0002. RESIDENT'S RIGHT TO ESSENTIAL CAREGIVER
VISITS. (a) A resident, resident's guardian, or resident's legally
authorized representative has the right to designate an essential
caregiver with whom the facility or program provider may not
prohibit in-person visitation.
(b) Notwithstanding Subsection (a), the executive
commissioner by rule shall develop guidelines to assist facilities
and program providers in establishing essential caregiver
visitation policies and procedures. The guidelines must require
the facilities and program providers to:
(1) allow a resident, resident's guardian, or
resident's legally authorized representative to designate for
in-person visitation an essential caregiver in the same manner that
a resident would designate a power of attorney;
(2) establish a visitation schedule allowing the
essential caregiver to visit the resident for at least two hours
each day;
(3) establish procedures to enable physical contact
between the resident and essential caregiver; and
(4) obtain the signature of the essential caregiver
certifying that the caregiver will follow the facility's or program
provider's safety protocols and any other rules adopted under this
section.
(c) A facility or program provider may revoke an
individual's designation as an essential caregiver if the caregiver
violates the facility's or provider's safety protocols or rules
adopted under this section. If a facility or program provider
revokes an individual's designation as an essential caregiver under
this subsection, the resident, resident's guardian, or resident's
legally authorized representative has the right to immediately
designate another individual as the resident's essential
caregiver. The commission by rule shall establish an appeals
process to evaluate the revocation of an individual's designation
as an essential caregiver under this subsection.
(d) Safety protocols adopted by a facility or program
provider for an essential caregiver under this section may not be
more stringent than safety protocols for the staff of the facility
or residence.
(e) A facility or program provider may petition the
commission to suspend in-person essential caregiver visits for not
more than seven days if in-person visitation poses a serious
community health risk. The commission may deny the facility's or
program provider's request to suspend in-person essential
caregiver visitation if the commission determines that in-person
visitation does not pose a serious community health risk. A
facility or program provider may request an extension from the
commission to suspend in-person essential caregiver visitation for
more than seven days. The commission may not approve an extension
under this subsection for a period that exceeds seven days, and a
facility or program provider must separately request each
extension. A facility or program provider may not suspend
in-person essential caregiver visitation in any year for a number
of days that exceeds 14 consecutive days or a total of 45 days.
(f) This section may not be construed as requiring an
essential caregiver to provide necessary care to a resident, and a
facility or program provider may not require an essential caregiver
to provide necessary care.
SECTION 3. Chapter 555, Health and Safety Code, is amended
by adding Subchapter F to read as follows:
SUBCHAPTER F. RIGHT TO ESSENTIAL CAREGIVER VISITS
Sec. 555.201. DEFINITION. In this chapter, "essential
caregiver" means a family member, friend, guardian, or other
individual selected by a resident, resident's guardian, or
resident's legally authorized representative for in-person visits.
Sec. 555.202. RESIDENT'S RIGHT TO ESSENTIAL CAREGIVER
VISITS. (a) A resident of a state supported living center, the
resident's guardian, or the resident's legally authorized
representative has the right to designate an essential caregiver
with whom the center may not prohibit in-person visitation.
(b) Notwithstanding Subsection (a), the executive
commissioner by rule shall develop guidelines to assist state
supported living centers in establishing essential caregiver
visitation policies and procedures. The guidelines must require
the centers to:
(1) allow a resident, resident's guardian, or
resident's legally authorized representative to designate for
in-person visitation an essential caregiver;
(2) establish a visitation schedule allowing the
essential caregiver to visit the resident for at least two hours
each day;
(3) establish procedures to enable physical contact
between the resident and essential caregiver; and
(4) obtain the signature of the essential caregiver
certifying that the caregiver will follow the center's safety
protocols and any other rules adopted under this section.
(c) A state supported living center may revoke an
individual's designation as an essential caregiver if the essential
caregiver violates the center's safety protocols or rules adopted
under this section. If a state supported living center revokes an
individual's designation as an essential caregiver under this
subsection, the resident, resident's guardian, or resident's
legally authorized representative has the right to immediately
designate another individual as the resident's essential
caregiver. The commission by rule shall establish an appeals
process to evaluate the revocation of an individual's designation
as an essential caregiver under this subsection.
(d) Safety protocols adopted by a state supported living
center for an essential caregiver under this section may not be more
stringent than safety protocols for center staff.
(e) A state supported living center may petition the
commission to suspend in-person essential caregiver visits for not
more than seven days if in-person visitation poses a serious
community health risk. The commission may deny the state supported
living center's request to suspend in-person essential caregiver
visitation if the commission determines that in-person visitation
does not pose a serious community health risk. A state supported
living center may request an extension from the commission to
suspend in-person essential caregiver visitation for more than
seven days. The commission may not approve an extension under this
subsection for a period that exceeds seven days, and a state
supported living center must separately request each extension. A
state supported living center may not suspend in-person essential
caregiver visitation in any year for a number of days that exceeds
14 consecutive days or a total of 45 days.
(f) This section may not be construed as requiring an
essential caregiver to provide necessary care to a resident, and a
state supported living center may not require an essential
caregiver to provide necessary care.
SECTION 4. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall prescribe the guidelines and adopt the
rules required by Sections 260B.0002 and 555.202, Health and Safety
Code, as added by this Act.
SECTION 5. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 6. This Act takes effect September 1, 2021.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 25 passed the Senate on
March 17, 2021, by the following vote: Yeas 29, Nays 0; and that
the Senate concurred in House amendments on May 28, 2021, by the
following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 25 passed the House, with
amendments, on May 24, 2021, by the following vote: Yeas 144,
Nays 0, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor