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.