S.B. No. 29
                                        AN ACT
    1-1  relating to licenses of and complaint investigations and data
    1-2  collection on quality improvement of convalescent and nursing homes
    1-3  and related institutions.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  (a)  Subsections (d) and (e), Section 242.033,
    1-6  Health and Safety Code, are amended to read as follows:
    1-7        (d)  A license is renewable every two years <annually> after:
    1-8              (1)  an inspection, unless an inspection is not
    1-9  required as provided by Section 242.047;
   1-10              (2)  payment of the <annual> license fee; and
   1-11              (3)  department approval of the <annual> report filed
   1-12  every two years by the licensee.
   1-13        (e)  The <annual> report required for license renewal under
   1-14  Subsection (d)(3) must comply with rules adopted by the board that
   1-15  specify the date of submission of the report, the information it
   1-16  must contain, and its form.
   1-17        (b)  Section 242.034, Health and Safety Code, is amended by
   1-18  amending Subsections (a) and (b) and adding Subsection (f) to read
   1-19  as follows:
   1-20        (a)  The board may establish by rule license fees for
   1-21  institutions licensed by the department under this chapter.  The
   1-22  license fee may not exceed $150 <is $50> plus $5 <$2> for each unit
   1-23  of capacity or bed space for which a license is sought.  An
    2-1  additional license fee may be charged as provided by Section
    2-2  242.097.
    2-3        (b)  The license fee must be paid <annually> with each
    2-4  application for an initial license, a renewal <of the
    2-5  institution's> license, or a change of ownership license.
    2-6        (f)  The license fees established under this chapter are an
    2-7  allowable cost for reimbursement under the medical assistance
    2-8  program administered by the Texas Department of Human Services
    2-9  under Chapter 32, Human Resources Code.  Any fee increases shall be
   2-10  reflected in reimbursement rates prospectively.
   2-11        (c)  Section 242.044, Health and Safety Code, is amended by
   2-12  amending Subsections (a) and (b) to read as follows:
   2-13        (a)  Each licensing period <year>, the department shall
   2-14  conduct at least two unannounced inspections of each institution.
   2-15        (b)  For at least two unannounced inspections each licensing
   2-16  period <year> of an institution other than one that provides
   2-17  maternity care, the department shall invite at least one person as
   2-18  a citizen advocate from:
   2-19              (1)  the American Association of Retired Persons;
   2-20              (2)  the Texas Senior Citizen Association;
   2-21              (3)  the Texas Retired Federal Employees;
   2-22              (4)   the Texas Department on Aging Certified Long Term
   2-23  Care Ombudsman; or
   2-24              (5)  another statewide organization for the elderly.
   2-25        SECTION 2.  Subchapter B, Chapter 242, Health and Safety
    3-1  Code, is amended by adding Section 242.049 to read as follows:
    3-2        Sec. 242.049.  QUALITY IMPROVEMENT.  (a)  The department may
    3-3  evaluate data for quality of care in nursing homes.
    3-4        (b)  The department may gather data on a form or forms to be
    3-5  provided by the department to improve the quality of care in
    3-6  nursing homes and may provide information to nursing homes which
    3-7  will allow them to improve and maintain the quality of care which
    3-8  they provide.  Data referred to in this section can include
    3-9  information compiled from documents otherwise available under the
   3-10  open records law, Chapter 424, Acts of the 63rd Legislature,
   3-11  Regular Session, 1973 (Article 6252-17a, Vernon's Texas Civil
   3-12  Statutes), including but not limited to individual survey reports
   3-13  and investigation reports.
   3-14        (c)  All licensed nursing homes in the state may be required
   3-15  to submit information designated by the department as necessary to
   3-16  improve the quality of care in nursing homes.
   3-17        (d)  The collection, compilation, and analysis of the
   3-18  information and any reports produced from these sources shall be
   3-19  done in a manner that protects the privacy of any individual about
   3-20  whom information is given and is explicitly confidential.  The
   3-21  department shall protect and maintain the confidentiality of the
   3-22  information.  The information received by the department, any
   3-23  information compiled as a result of review of internal agency
   3-24  documents, and any reports, compilations, and analyses produced
   3-25  from these sources shall not be available for public inspection or
    4-1  disclosure, nor are these sources public records within the meaning
    4-2  of the open records law, Chapter 424, Acts of the 63rd Legislature,
    4-3  Regular Session, 1973 (Article 6252-17a, Vernon's Texas Civil
    4-4  Statutes).  The information and any compilations, reports, or
    4-5  analyses produced from the information shall not be subject to
    4-6  discovery, subpoena, or other means of legal compulsion for release
    4-7  to any person or entity except as provided in this section and
    4-8  shall not be admissible in any civil, administrative, or criminal
    4-9  proceeding.  This privilege shall be recognized by Rules 501 and
   4-10  502 of the Texas Rules of Civil Evidence and the Texas Rules of
   4-11  Criminal Evidence.
   4-12        (e)  The information and reports, compilations, and analyses
   4-13  developed by the department for quality improvement shall be used
   4-14  only for the evaluation and improvement of quality care in nursing
   4-15  homes.  No department proceeding or record shall be subject to
   4-16  discovery, subpoena, or other means of legal compulsion for release
   4-17  to any person or entity, and shall not be admissible in any civil,
   4-18  administrative, or criminal proceeding.  This privilege shall be
   4-19  recognized by Rules 501 and 502 of the Texas Rules of Civil
   4-20  Evidence and the Texas Rules of Criminal Evidence.
   4-21        (f)  Notwithstanding Subsection (d), the department shall
   4-22  transmit reports, compilations, and analyses of the information
   4-23  provided by a nursing home to that nursing home, and such
   4-24  disclosure shall not be violative of this section nor shall it
   4-25  constitute a waiver of confidentiality.
    5-1        (g)  A member, agent, or employee of the department may not
    5-2  disclose or be required to disclose a communication made to the
    5-3  department or a record or proceeding of the department required to
    5-4  be submitted under this section except to the nursing home in
    5-5  question or its agents or employees.
    5-6        (h)  Nothing in this section is intended to abridge the
    5-7  department's enforcement responsibilities under this chapter or
    5-8  under any other law.
    5-9        (i)  Any information, reports, and other documents produced
   5-10  which are subject to any means of legal compulsion or which are
   5-11  considered to be public information under Subchapter E and the
   5-12  rules adopted under that subchapter shall continue to be subject to
   5-13  legal compulsion and be treated as public information under
   5-14  Subchapter E after the effective date of this Act, even though such
   5-15  information, reports, and other documents may be used in the
   5-16  collection, compilation, and analysis described in Subsections (b)
   5-17  and (d).
   5-18        SECTION 3.  Section 242.094, Health and Safety Code, is
   5-19  amended by adding Subsection (e) to read as follows:
   5-20        (e)  Venue for actions brought under this section shall be in
   5-21  Travis County.
   5-22        SECTION 4.  Subsections (d) and (e), Section 242.126, Health
   5-23  and Safety Code, are amended to read as follows:
   5-24        (d)  The investigation may <shall> include a visit to the
   5-25  resident's institution and an interview with the resident if these
    6-1  actions are determined by the department to be appropriate.
    6-2        (e)  If the department attempts to carry out an on-site
    6-3  investigation and it is shown that admission to the institution, or
    6-4  any place where the resident is located, cannot be obtained, a
    6-5  probate or county court shall order the person responsible for the
    6-6  care of the resident or the person in charge of a place where the
    6-7  resident is located to allow entrance for the interview and
    6-8  investigation.
    6-9        SECTION 5.  This Act takes effect September 1, 1993.
   6-10        SECTION 6.  The importance of this legislation and the
   6-11  crowded condition of the calendars in both houses create an
   6-12  emergency and an imperative public necessity that the
   6-13  constitutional rule requiring bills to be read on three several
   6-14  days in each house be suspended, and this rule is hereby suspended.