BILL ANALYSIS


HUMAN SERVICES
C.S.H.B. 2510
By: Hilderbran
4-9-97
Committee Report (Substituted)



BACKGROUND

This bill would implement recommendations from the Committee on Human
Services Interim Report.  The Committee was charged with studying
long-term care for Texans.  Personal care is the description used in
Chapter 247 of the Health and Safety Code to characterize custodial care.
This type of setting is likely to be commonly referred to as assisted
living. 

Many clients live in personal care facilities, including patients who
suffer from Alzheimer's disease. Alzheimer's patients have special needs,
because they are unable to complain about inadequate services.  They may
be constrained to avoid their wandering, to prevent danger to themselves,
or for other reasons, including convenience.  There are no guidelines for
facilities that specialize in care of Alzheimer's patients.  

PURPOSE

This bill would establish guidelines for facilities regarding persons with
Alzheimer's disease or other related dementia. 

RULEMAKING AUTHORITY

The Texas Department of Human Services is directed in section 1(a)  to
establish, by rule, a classification and license for a facility to provide
personal care services to residents with Alzheimer's or other related
dementia; and to require constant staff assistance or supervision.  The
board is directed in section 1 (d) to adopt, by rule, minimum standards
for personal care facilities classified under the section.  

SECTION BY SECTION ANALYSES

SECTION 1:This bill amends Subchapter B, Chapter 247, Health and Safety
Code, by adding Section 247.029, Facilities For Persons With Alzheimer's
Disease. 

 (a)Directs the Texas Department of Human Services, by rule, to: establish
a classification and license for a facility to provide personal care
services to residents with Alzheimer's or other related dementia; and to
require constant staff assistance or supervision. 

(b)These facilities are restricted from keeping residents in a locked room
or other environment except during nighttime sleeping hours or in a ward
or facility where all residents are in the advanced stage of dementia.  

  (c)A facility is directed to electronically monitor residents when
appropriate; however, residents may only be chemically or physically
restrained in emergencies. 

(d)Directs DHS to adopt minimum standards to address staff-resident and
staff training ratios, personnel and duties, activity and social programs,
care and assessments of residents with dementia, admissions, operations,
record-keeping, administering of medications, advertising, and facility
construction. 

 SECTION 2:The act takes effect September 1, 1997, and the Texas
Department of Human Services should adopt appropriate rules by December 1,
1997. 

SECTION 3:Emergency clause. 


COMPARISON OF ORIGINAL TO SUBSTITUTE

The bill grants rulemaking authority to the Department of Human Services.
The original bill granted this authority to the Department of Health.