bill requiring hospital patients’ rights policies

The text as introduced · 2,147 words

89R2473 KKR-D

By: Hall
S.B. No. 124

A BILL TO BE ENTITLED

AN ACT

relating to hospital patients' rights and hospital policies and

procedures; providing an administrative penalty.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 241, Health and Safety Code, is amended

by adding Subchapter N to read as follows:

SUBCHAPTER N. HOSPITAL PATIENTS' RIGHTS; HOSPITAL POLICIES AND

PROCEDURES RELATED TO PATIENTS' RIGHTS

Sec. 241.451. DEFINITION. In this subchapter, "hospital"

includes a hospital providing comprehensive medical rehabilitation

services, chemical dependency services, and mental health

services.

Sec. 241.452. PATIENTS' RIGHTS POLICY. (a) Each hospital

shall adopt, implement, and enforce a written policy to ensure the

rights of the hospital's patients. The policy must provide that

each patient has a right to:

(1) the hospital's reasonable response to the

patient's requests and needs for treatment or service, to the

extent the request or need is within the hospital's capacity and

stated mission and is allowed by law;

(2) considerate and respectful care that accounts for

the psychosocial, spiritual, and cultural variables influencing

the perceptions of illness without any bullying or shaming by

hospital or medical staff;

(3) to the extent feasible, treatment by the patient's

choice of physician;

(4) unrestricted visitation by at least one individual

at any given time, including during a qualifying period of disaster

as defined by Section 241.012;

(5) use as prescribed by the patient's physician of

choice of:

(A) a prescription drug the United States Food

and Drug Administration has approved for use but prescribed for a

use other than the approved use; or

(B) a complementary or alternative medical

treatment, regardless of the United States Food and Drug

Administration's approval of the treatment;

(6) for terminally ill patients, access and use

certain investigational drugs, biological products, and devices

that are in clinical trials in accordance with this state's Right to

Try Act under Chapter 489, including to the extent allowed by

federal law during a qualifying period of disaster as defined by

Section 241.012;

(7) care that optimizes the comfort and dignity of a

patient who is dying through:

(A) treating primary and secondary symptoms that

are responsive to treatment as the patient or the patient's

surrogate decision-maker determines;

(B) effectively managing pain; and

(C) acknowledging the psychosocial and spiritual

concerns of the patient and the patient's family regarding dying

and the expression of grief by the patient and the patient's family;

(8) in collaboration with the patient's physician,

make decisions involving the patient's health care, including the

right to:

(A) accept or refuse treatment to the extent

permitted by law and be informed of the medical consequence of

refusing treatment;

(B) execute an advanced directive and

periodically review the directive as provided by Section 241.457;

(C) appoint a surrogate to make health care

decisions on the patient's behalf; and

(D) receive care that is not conditioned on the

existence of the directive;

(9) be provided information necessary for the patient

to make informed treatment decisions that reflect the patient's

wishes;

(10) be provided at the time of admission information

about the hospital's:

(A) patients' rights policy; and

(B) process for initiating, reviewing, and

resolving as feasible patient complaints about quality of care;

(11) participate or have the patient's designated

surrogate decision-maker participate in the consideration of

ethical issues arising in the patient's care;

(12) be informed of any human experimentation or other

research or educational project that affects the patient's care or

treatment;

(13) personal privacy and confidentiality of the

patient's information to the extent permitted by law; and

(14) access the information contained in the patient's

medical records.

(b) To the extent allowed by law, a patient's guardian, next

of kin, or other legally authorized surrogate decision-maker has

the right to exercise the patient's rights under Subsection (a) if

the patient:

(1) has been found to be incompetent by a court of law;

(2) is found by the patient's physician to be medically

incapable of understanding the proposed procedure or treatment;

(3) is unable to communicate the patient's wishes

regarding treatment; or

(4) is a minor.

Sec. 241.453. PATIENTS' RIGHTS POLICY FOR HOSPITALS

PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. A

hospital providing comprehensive medical rehabilitation services

must include in the hospital's patients' rights policy adopted

under Section 241.452 that each minor patient has the right to:

(1) appropriate treatment in the least restrictive

setting available;

(2) decline unnecessary or excessive medication;

(3) an individualized treatment plan that is developed

with the patient's participation;

(4) a humane treatment environment that provides

reasonable protection from harm and appropriate privacy for

personal needs;

(5) accommodations separated from adult patient

accommodations; and

(6) regular communication with the patient's family.

Sec. 241.454. EFFECT ON OTHER REQUIREMENTS FOR CERTAIN

HOSPITALS. A hospital patients' rights policy adopted under this

subchapter by a hospital providing chemical dependency services or

mental health services is in addition to any other patients' rights

policy required by law or commission rules.

Sec. 241.455. REQUIRED DISPLAY OF PATIENTS' RIGHTS POLICY.

(a) A hospital shall prominently and conspicuously display the

hospital's patients' rights policy in a public area readily

accessible to hospital patients, residents, visitors, and

employees.

(b) A hospital that provides comprehensive medical

rehabilitation services, chemical dependency services, or mental

health services must display the patients' rights policy in English

and in a language other than English that is appropriate to the

demographic composition of the community the hospital serves.

Sec. 241.456. NOTICE OF PATIENTS' RIGHTS BY HOSPITAL

PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. (a) This

section applies only to a hospital that provides comprehensive

medical rehabilitation services.

(b) Before admitting or accepting for evaluation any

patient, a hospital to which this section applies shall provide to

the patient and, if applicable, to the patient's parent, managing

conservator, or guardian, a written copy of the hospital's

patients' rights policy and as feasible provide the copy in the

patient's primary language.

(c) The hospital shall ensure that within two hours, or as

soon as reasonably possible within eight hours, after the time a

patient is admitted to the hospital, the hospital's patients'

rights policy is orally explained to the patient or, if

appropriate, the patient's parent, managing conservator, or

guardian. The explanation must be given in simple nontechnical

terms and as feasible in the individual's primary language. The

hospital may use other reasonable means to explain the policy to an

individual with a vision or hearing impairment.

(d) Except as provided by Subsection (e), the hospital shall

obtain a copy of the hospital's patients' rights policy signed by

the patient or, if appropriate, the patient's parent, managing

conservator, or guardian. The signed copy must:

(1) include a statement by the patient or other

individual acknowledging the patient or individual read the policy

and understands the specified rights; and

(2) be placed in the patient's medical record.

(e) If a patient is unable to comprehend the information

contained in the hospital's patients' rights policy because of

illness, age, or other factors, an emergency precludes a timely

explanation of the policy, or the patient refuses to sign the policy

as required under Subsection (d), the hospital may satisfy the

requirements of Subsections (c) and (d) by:

(1) explaining the policy to the patient with two

hospital staff members serving as witnesses; and

(2) placing the unsigned copy in the patient's medical

record with a written notation signed by the witnesses explaining

the reason the patient did not sign the policy.

Sec. 241.457. ADVANCED DIRECTIVE PROCEDURES. A hospital

shall:

(1) establish procedures for:

(A) determining at the time a patient is admitted

to the hospital whether the patient has executed an advanced

directive; and

(B) if appropriate, assisting in the development

of an advanced directive for the patient;

(2) include any executed advanced directive in the

patient's medical record; and

(3) periodically review the patient's advanced

directive with the patient or the patient's surrogate

decision-maker, as appropriate.

Sec. 241.458. POLICY ON INFORMED TREATMENT DECISIONS. A

hospital shall adopt, implement, and enforce a written policy for

ensuring a patient makes informed treatment decisions. The policy

must be consistent with state and federal law and any other

applicable legal requirements.

Sec. 241.459. ETHICAL ISSUES FOR PATIENT CARE. A hospital

shall establish procedures for considering ethical issues that

arise in a patient's care and provide education on health care

ethical issues to patients and their caregivers.

Sec. 241.460. ADMINISTRATIVE PENALTY. (a) The commission

shall assess an administrative penalty in the amount of $1,000

against a hospital for each violation of this subchapter or rules

adopted under this subchapter. Each day a violation continues or

occurs may be considered a separate violation for purposes of

imposing a penalty.

(b) The enforcement of the penalty may be stayed during the

time the order is under judicial review if the hospital pays the

penalty to the clerk of the court or files a supersedeas bond with

the court in the amount of the penalty.

(c) The attorney general may sue to collect the penalty.

(d) A proceeding to impose the penalty is considered to be a

contested case under Chapter 2001, Government Code.

Sec. 241.461. RULES. The executive commissioner shall

adopt rules to implement this subchapter.

SECTION 2. Section 164.009(a), Health and Safety Code, is

amended to read as follows:

(a) A treatment facility may not admit a patient to its

facilities without fully disclosing to the patient or, if the

patient is a minor, the patient's parent, managing conservator, or

guardian, in, if possible, the primary language of the patient,

managing conservator, or guardian, as the case may be, the

following information in writing before admission:

(1) the treatment facility's estimated average daily

charge for inpatient treatment with an explanation that the patient

may be billed separately for services provided by mental health

professionals;

(2) the name of the attending physician, if the

treatment facility is a mental health facility, or the name of the

attending mental health professional, if the facility is a chemical

dependency facility; and

(3) the current patients' rights policy as required

under Subchapter N, Chapter 241, and any [ "patient's bill of

rights" as adopted by the executive commissioner that sets out ]

restrictions to the patient's freedom that may be imposed on the

patient during the patient's stay in a treatment facility.

SECTION 3. Section 241.004, Health and Safety Code, is

amended to read as follows:

Sec. 241.004. EXEMPTIONS. Except as otherwise provided by

Subchapter N, this [ This ] chapter does not apply to a facility:

(1) licensed under Chapter 242 or 577;

(2) maintained or operated by the federal government

or an agency of the federal government; or

(3) maintained or operated by this state or an agency

of this state.

SECTION 4. Sections 321.002(a) and (b), Health and Safety

Code, are amended to read as follows:

(a) The executive commissioner by rule shall adopt a

"patient's bill of rights" that includes the applicable rights

included in this chapter, the rights described by Subchapter N,

Chapter 241, and other rights provided by Subtitle C of Title 7,

Chapters 241, 462, 464, and 466, and any other provisions the

executive commissioner considers necessary to protect the health,

safety, and rights of a patient receiving voluntary or involuntary

mental health, chemical dependency, or comprehensive medical

rehabilitation services in an inpatient facility. In addition,

the executive commissioner shall adopt rules that[ :

[ (1) ] provide standards to prevent the admission of a

minor to a facility for treatment of a condition that is not

generally recognized as responsive to treatment in an inpatient

treatment setting[ ; and

[ (2) prescribe the procedure for presenting the

applicable bill of rights and obtaining each necessary signature

if:

[ (A) the patient cannot comprehend the

information because of illness, age, or other factors; or

[ (B) an emergency exists that precludes

immediate presentation of the information ].

(b) The executive commissioner by rule shall adopt a

"children's bill of rights" for a minor receiving treatment in a

child-care facility for an emotional, mental health, or chemical

dependency problem that includes the rights described by Subchapter

N, Chapter 241 .

SECTION 5. Sections 321.002(c), (d), and (f), Health and

Safety Code, are repealed.

SECTION 6. (a) Notwithstanding Subchapter N, Chapter 241,

Health and Safety Code, as added by this Act, a hospital is not

required to comply with that subchapter until January 1, 2026.

(b) As soon as practicable after the effective date of this

Act, the executive commissioner of the Health and Human Services

Commission shall adopt the rules necessary to implement Subchapter

N, Chapter 241, Health and Safety Code, as added by this Act.

SECTION 7. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.