BILL ANALYSIS H.B. 1575 By: Maxey 04-25-95 Committee Report (Unamended) BACKGROUND While nursing homes aspire to bring the best possible care to their patients, many homes are unable to do so due to severe understaffing of nurses and nurse aides. Nurse aides provide 90 percent of the direct personal care to patients under the instruction of either registered or licensed nurses. The lack of nurse aides places a burden on licensed and registered nurses that can result in lower quality care than would otherwise be provided. Consistently good care is not possible without adequate staffing. The Nursing Home Reform Act of 1987 attempted to improve the quality of care that long-term patients receive in nursing homes by mandating a minimal presence of nurses (at least one licensed nurse on duty 24 hours a day and one registered nurse for at least eight hours a day). Unfortunately, these measures did not outline specific ratios and guidelines for staffing nurse aides at nursing homes. PURPOSE H.B. 1575 establishes specific nurse-aide-to-patient ratios to maintain better quality care in certain nursing facilities funded through the state Medicaid program. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Adds Sec. 32.0212 to Subchapter B, Chapter 32, Human Resources Code, mandating that the department require, through a contract for medical assistance, that nursing facilities maintain a minimum of one nurse aide for each eight residents during a morning shift, one to 10 for an afternoon shift, and one to 14 for a night shift. Sec. 32.0212 also prohibits a nurse aide from performing specified tasks unrelated to direct care, except as approved by the facility's nursing director in emergency situations. The section also defines nurse aide. SECTION 2. States that in the event that the Texas Department of Human Services determines that a waiver or authorization from a federal agency is necessary for implementation of Section 32.0212 as added by this Act, implementation may be delayed until the waiver or authorization is granted. SECTION 3. Emergency clause. Effective upon passage. SUMMARY OF COMMITTEE ACTION H.B. 1575 was considered by the Public Health Committee in a public hearing on April 25, 1995. The following persons testified in favor of the bill: Gay Nell Harper, representing self. Donna Buchanan, representing self and TANHR. David Latimer, representing Texas Association of Homes and Services for the Aging. Lindsay Thorpe, representing self and Chartwell Healthcare Group of Companies. Connie Bell, representing Texas Advocates for Nursing Home Residents. Lou O'Reilly, representing self and Richardson TANHR Unit and S.W. Dallas Co. TANHR Unit. Jean Langendorf, representing Service Employees International Union. Herman Tex Moten Sr., representing self. Sara Speights, representing Texas Health Care Assn. The bill was reported favorably without amendment, with the recommendation that it do pass and be printed, by a record vote of 6 Ayes, 0 Nays, 0 PNV, and 3 Absent.