Texas 2025 - 89th Regular

Texas Senate Bill SB124 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R2473 KKR-D
2	2	By: Hall S.B. No. 124
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to hospital patients' rights and hospital policies and
10	10	procedures; providing an administrative penalty.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 241, Health and Safety Code, is amended
13	13	by adding Subchapter N to read as follows:
14	14	SUBCHAPTER N. HOSPITAL PATIENTS' RIGHTS; HOSPITAL POLICIES AND
15	15	PROCEDURES RELATED TO PATIENTS' RIGHTS
16	16	Sec. 241.451. DEFINITION. In this subchapter, "hospital"
17	17	includes a hospital providing comprehensive medical rehabilitation
18	18	services, chemical dependency services, and mental health
19	19	services.
20	20	Sec. 241.452. PATIENTS' RIGHTS POLICY. (a) Each hospital
21	21	shall adopt, implement, and enforce a written policy to ensure the
22	22	rights of the hospital's patients. The policy must provide that
23	23	each patient has a right to:
24	24	(1) the hospital's reasonable response to the
25	25	patient's requests and needs for treatment or service, to the
26	26	extent the request or need is within the hospital's capacity and
27	27	stated mission and is allowed by law;
28	28	(2) considerate and respectful care that accounts for
29	29	the psychosocial, spiritual, and cultural variables influencing
30	30	the perceptions of illness without any bullying or shaming by
31	31	hospital or medical staff;
32	32	(3) to the extent feasible, treatment by the patient's
33	33	choice of physician;
34	34	(4) unrestricted visitation by at least one individual
35	35	at any given time, including during a qualifying period of disaster
36	36	as defined by Section 241.012;
37	37	(5) use as prescribed by the patient's physician of
38	38	choice of:
39	39	(A) a prescription drug the United States Food
40	40	and Drug Administration has approved for use but prescribed for a
41	41	use other than the approved use; or
42	42	(B) a complementary or alternative medical
43	43	treatment, regardless of the United States Food and Drug
44	44	Administration's approval of the treatment;
45	45	(6) for terminally ill patients, access and use
46	46	certain investigational drugs, biological products, and devices
47	47	that are in clinical trials in accordance with this state's Right to
48	48	Try Act under Chapter 489, including to the extent allowed by
49	49	federal law during a qualifying period of disaster as defined by
50	50	Section 241.012;
51	51	(7) care that optimizes the comfort and dignity of a
52	52	patient who is dying through:
53	53	(A) treating primary and secondary symptoms that
54	54	are responsive to treatment as the patient or the patient's
55	55	surrogate decision-maker determines;
56	56	(B) effectively managing pain; and
57	57	(C) acknowledging the psychosocial and spiritual
58	58	concerns of the patient and the patient's family regarding dying
59	59	and the expression of grief by the patient and the patient's family;
60	60	(8) in collaboration with the patient's physician,
61	61	make decisions involving the patient's health care, including the
62	62	right to:
63	63	(A) accept or refuse treatment to the extent
64	64	permitted by law and be informed of the medical consequence of
65	65	refusing treatment;
66	66	(B) execute an advanced directive and
67	67	periodically review the directive as provided by Section 241.457;
68	68	(C) appoint a surrogate to make health care
69	69	decisions on the patient's behalf; and
70	70	(D) receive care that is not conditioned on the
71	71	existence of the directive;
72	72	(9) be provided information necessary for the patient
73	73	to make informed treatment decisions that reflect the patient's
74	74	wishes;
75	75	(10) be provided at the time of admission information
76	76	about the hospital's:
77	77	(A) patients' rights policy; and
78	78	(B) process for initiating, reviewing, and
79	79	resolving as feasible patient complaints about quality of care;
80	80	(11) participate or have the patient's designated
81	81	surrogate decision-maker participate in the consideration of
82	82	ethical issues arising in the patient's care;
83	83	(12) be informed of any human experimentation or other
84	84	research or educational project that affects the patient's care or
85	85	treatment;
86	86	(13) personal privacy and confidentiality of the
87	87	patient's information to the extent permitted by law; and
88	88	(14) access the information contained in the patient's
89	89	medical records.
90	90	(b) To the extent allowed by law, a patient's guardian, next
91	91	of kin, or other legally authorized surrogate decision-maker has
92	92	the right to exercise the patient's rights under Subsection (a) if
93	93	the patient:
94	94	(1) has been found to be incompetent by a court of law;
95	95	(2) is found by the patient's physician to be medically
96	96	incapable of understanding the proposed procedure or treatment;
97	97	(3) is unable to communicate the patient's wishes
98	98	regarding treatment; or
99	99	(4) is a minor.
100	100	Sec. 241.453. PATIENTS' RIGHTS POLICY FOR HOSPITALS
101	101	PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. A
102	102	hospital providing comprehensive medical rehabilitation services
103	103	must include in the hospital's patients' rights policy adopted
104	104	under Section 241.452 that each minor patient has the right to:
105	105	(1) appropriate treatment in the least restrictive
106	106	setting available;
107	107	(2) decline unnecessary or excessive medication;
108	108	(3) an individualized treatment plan that is developed
109	109	with the patient's participation;
110	110	(4) a humane treatment environment that provides
111	111	reasonable protection from harm and appropriate privacy for
112	112	personal needs;
113	113	(5) accommodations separated from adult patient
114	114	accommodations; and
115	115	(6) regular communication with the patient's family.
116	116	Sec. 241.454. EFFECT ON OTHER REQUIREMENTS FOR CERTAIN
117	117	HOSPITALS. A hospital patients' rights policy adopted under this
118	118	subchapter by a hospital providing chemical dependency services or
119	119	mental health services is in addition to any other patients' rights
120	120	policy required by law or commission rules.
121	121	Sec. 241.455. REQUIRED DISPLAY OF PATIENTS' RIGHTS POLICY.
122	122	(a) A hospital shall prominently and conspicuously display the
123	123	hospital's patients' rights policy in a public area readily
124	124	accessible to hospital patients, residents, visitors, and
125	125	employees.
126	126	(b) A hospital that provides comprehensive medical
127	127	rehabilitation services, chemical dependency services, or mental
128	128	health services must display the patients' rights policy in English
129	129	and in a language other than English that is appropriate to the
130	130	demographic composition of the community the hospital serves.
131	131	Sec. 241.456. NOTICE OF PATIENTS' RIGHTS BY HOSPITAL
132	132	PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. (a) This
133	133	section applies only to a hospital that provides comprehensive
134	134	medical rehabilitation services.
135	135	(b) Before admitting or accepting for evaluation any
136	136	patient, a hospital to which this section applies shall provide to
137	137	the patient and, if applicable, to the patient's parent, managing
138	138	conservator, or guardian, a written copy of the hospital's
139	139	patients' rights policy and as feasible provide the copy in the
140	140	patient's primary language.
141	141	(c) The hospital shall ensure that within two hours, or as
142	142	soon as reasonably possible within eight hours, after the time a
143	143	patient is admitted to the hospital, the hospital's patients'
144	144	rights policy is orally explained to the patient or, if
145	145	appropriate, the patient's parent, managing conservator, or
146	146	guardian. The explanation must be given in simple nontechnical
147	147	terms and as feasible in the individual's primary language. The
148	148	hospital may use other reasonable means to explain the policy to an
149	149	individual with a vision or hearing impairment.
150	150	(d) Except as provided by Subsection (e), the hospital shall
151	151	obtain a copy of the hospital's patients' rights policy signed by
152	152	the patient or, if appropriate, the patient's parent, managing
153	153	conservator, or guardian. The signed copy must:
154	154	(1) include a statement by the patient or other
155	155	individual acknowledging the patient or individual read the policy
156	156	and understands the specified rights; and
157	157	(2) be placed in the patient's medical record.
158	158	(e) If a patient is unable to comprehend the information
159	159	contained in the hospital's patients' rights policy because of
160	160	illness, age, or other factors, an emergency precludes a timely
161	161	explanation of the policy, or the patient refuses to sign the policy
162	162	as required under Subsection (d), the hospital may satisfy the
163	163	requirements of Subsections (c) and (d) by:
164	164	(1) explaining the policy to the patient with two
165	165	hospital staff members serving as witnesses; and
166	166	(2) placing the unsigned copy in the patient's medical
167	167	record with a written notation signed by the witnesses explaining
168	168	the reason the patient did not sign the policy.
169	169	Sec. 241.457. ADVANCED DIRECTIVE PROCEDURES. A hospital
170	170	shall:
171	171	(1) establish procedures for:
172	172	(A) determining at the time a patient is admitted
173	173	to the hospital whether the patient has executed an advanced
174	174	directive; and
175	175	(B) if appropriate, assisting in the development
176	176	of an advanced directive for the patient;
177	177	(2) include any executed advanced directive in the
178	178	patient's medical record; and
179	179	(3) periodically review the patient's advanced
180	180	directive with the patient or the patient's surrogate
181	181	decision-maker, as appropriate.
182	182	Sec. 241.458. POLICY ON INFORMED TREATMENT DECISIONS. A
183	183	hospital shall adopt, implement, and enforce a written policy for
184	184	ensuring a patient makes informed treatment decisions. The policy
185	185	must be consistent with state and federal law and any other
186	186	applicable legal requirements.
187	187	Sec. 241.459. ETHICAL ISSUES FOR PATIENT CARE. A hospital
188	188	shall establish procedures for considering ethical issues that
189	189	arise in a patient's care and provide education on health care
190	190	ethical issues to patients and their caregivers.
191	191	Sec. 241.460. ADMINISTRATIVE PENALTY. (a) The commission
192	192	shall assess an administrative penalty in the amount of $1,000
193	193	against a hospital for each violation of this subchapter or rules
194	194	adopted under this subchapter. Each day a violation continues or
195	195	occurs may be considered a separate violation for purposes of
196	196	imposing a penalty.
197	197	(b) The enforcement of the penalty may be stayed during the
198	198	time the order is under judicial review if the hospital pays the
199	199	penalty to the clerk of the court or files a supersedeas bond with
200	200	the court in the amount of the penalty.
201	201	(c) The attorney general may sue to collect the penalty.
202	202	(d) A proceeding to impose the penalty is considered to be a
203	203	contested case under Chapter 2001, Government Code.
204	204	Sec. 241.461. RULES. The executive commissioner shall
205	205	adopt rules to implement this subchapter.
206	206	SECTION 2. Section 164.009(a), Health and Safety Code, is
207	207	amended to read as follows:
208	208	(a) A treatment facility may not admit a patient to its
209	209	facilities without fully disclosing to the patient or, if the
210	210	patient is a minor, the patient's parent, managing conservator, or
211	211	guardian, in, if possible, the primary language of the patient,
212	212	managing conservator, or guardian, as the case may be, the
213	213	following information in writing before admission:
214	214	(1) the treatment facility's estimated average daily
215	215	charge for inpatient treatment with an explanation that the patient
216	216	may be billed separately for services provided by mental health
217	217	professionals;
218	218	(2) the name of the attending physician, if the
219	219	treatment facility is a mental health facility, or the name of the
220	220	attending mental health professional, if the facility is a chemical
221	221	dependency facility; and
222	222	(3) the current patients' rights policy as required
223	223	under Subchapter N, Chapter 241, and any ["patient's bill of
224	224	rights" as adopted by the executive commissioner that sets out]
225	225	restrictions to the patient's freedom that may be imposed on the
226	226	patient during the patient's stay in a treatment facility.
227	227	SECTION 3. Section 241.004, Health and Safety Code, is
228	228	amended to read as follows:
229	229	Sec. 241.004. EXEMPTIONS. Except as otherwise provided by
230	230	Subchapter N, this [This] chapter does not apply to a facility:
231	231	(1) licensed under Chapter 242 or 577;
232	232	(2) maintained or operated by the federal government
233	233	or an agency of the federal government; or
234	234	(3) maintained or operated by this state or an agency
235	235	of this state.
236	236	SECTION 4. Sections 321.002(a) and (b), Health and Safety
237	237	Code, are amended to read as follows:
238	238	(a) The executive commissioner by rule shall adopt a
239	239	"patient's bill of rights" that includes the applicable rights
240	240	included in this chapter, the rights described by Subchapter N,
241	241	Chapter 241, and other rights provided by Subtitle C of Title 7,
242	242	Chapters 241, 462, 464, and 466, and any other provisions the
243	243	executive commissioner considers necessary to protect the health,
244	244	safety, and rights of a patient receiving voluntary or involuntary
245	245	mental health, chemical dependency, or comprehensive medical
246	246	rehabilitation services in an inpatient facility. In addition,
247	247	the executive commissioner shall adopt rules that[:
248	248	[(1)] provide standards to prevent the admission of a
249	249	minor to a facility for treatment of a condition that is not
250	250	generally recognized as responsive to treatment in an inpatient
251	251	treatment setting[; and
252	252	[(2) prescribe the procedure for presenting the
253	253	applicable bill of rights and obtaining each necessary signature
254	254	if:
255	255	[(A) the patient cannot comprehend the
256	256	information because of illness, age, or other factors; or
257	257	[(B) an emergency exists that precludes
258	258	immediate presentation of the information].
259	259	(b) The executive commissioner by rule shall adopt a
260	260	"children's bill of rights" for a minor receiving treatment in a
261	261	child-care facility for an emotional, mental health, or chemical
262	262	dependency problem that includes the rights described by Subchapter
263	263	N, Chapter 241.
264	264	SECTION 5. Sections 321.002(c), (d), and (f), Health and
265	265	Safety Code, are repealed.
266	266	SECTION 6. (a) Notwithstanding Subchapter N, Chapter 241,
267	267	Health and Safety Code, as added by this Act, a hospital is not
268	268	required to comply with that subchapter until January 1, 2026.
269	269	(b) As soon as practicable after the effective date of this
270	270	Act, the executive commissioner of the Health and Human Services
271	271	Commission shall adopt the rules necessary to implement Subchapter
272	272	N, Chapter 241, Health and Safety Code, as added by this Act.
273	273	SECTION 7. This Act takes effect immediately if it receives
274	274	a vote of two-thirds of all the members elected to each house, as
275	275	provided by Section 39, Article III, Texas Constitution. If this
276	276	Act does not receive the vote necessary for immediate effect, this
277	277	Act takes effect September 1, 2025.