HBA-RBT, NLM H.B. 1677 76(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 1677
By: Janek
Human Services
7/13/1999
Enrolled




BACKGROUND AND PURPOSE 

Currently, two vaccines are available which can decrease morbidity and
mortality due to pneumonia in the elderly. The influenza and  pneumococcal
vaccines are both covered by Medicare and Medicaid for anyone over the age
of 65. Despite their availability, many elderly adults do not receive these
recommended immunizations. As adults become older and more susceptible to
infections the vaccines become less effective; therefore, it is recommended
to immunize elderly persons in nursing homes as well as persons who reside
or work in the same environment.  

H.B. 1677  authorizes the Texas Board of Health (board), by rule, to
require nursing homes to offer immunizations to elderly residents or to
staff who are in contact with elderly residents against diseases that the
board determines to be caused by infectious agents, potentially deadly, and
preventable by vaccine. This bill also requires the board to require
nursing homes to offer pneumococcal vaccine to elderly residents and
influenza vaccine to residents and staff.   

This bill requires the Texas Board of Human Services, which regulates
nursing homes, to adopt the Texas Board of Health's licensing rules and
standards for nursing homes.  

H.B. 1677 also requires the Texas Department of Health (TDH) to coordinate
with the Texas Department of Human Services (TDHS) in developing rules to
ensure consistency with federal and state laws and regulations relating to
nursing home infection control programs.  This bill requires TDH or TDHS to
develop new nursing facility documentation requirements with the input from
the nursing home industry. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Board of Health in SECTION 1
(Section 161.0051, Health and Safety Code) and to the Texas Board of Human
Services in SECTION 2 (Section 242.037, Health and Safety Code) of  this
bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter A, Chapter 161, Health and Safety Code, by
adding Section 161.0051, as follows: 

Sec.  161.0051.  REQUIRED IMMUNIZATIONS FOR NURSING HOMES.  Provides that
this section only applies to a nursing home that is an institution licensed
under Chapter 242 (Convalescent and Nursing Homes and Related
Institutions), and serves residents who are elderly persons as defined by
Section 242.002 (Definitions). Section 242.002 defines elderly person as an
individual who is 65 years of age or older. Authorizes the Texas Board of
Health (board), by rule, to require nursing homes to offer, in accordance
with an immunization schedule adopted by the board, immunizations to
elderly residents or to staff who are in contact with elderly residents
against diseases that the board determines to be caused by infectious
agents, potentially deadly, and preventable by vaccine. Requires the board,
by rule, to require nursing homes to offer, in accordance with an
immunization schedule adopted by the board, pneumococcal vaccine to elderly
residents, and influenza  vaccine to elderly residents and to staff who are
in contact with elderly residents. 

SECTION 2.  Amends Section 242.037, Health and Safety Code, by adding
Subsection (h), to require the Texas Board of Human Services to adopt each
rule adopted by the Texas Board of Health under Section 161.0051 as part of
the rules and standards adopted under this chapter that apply to
institutions serving residents who are elderly persons. 

SECTION 3.  Requires the Texas Department of Health (TDH) to coordinate
with the Texas Department of Human Services (TDHS) in developing the rules
needed to implement the provisions of this Act, to ensure: 

_TDH rules related to immunization schedules for nursing home residents and
staff are not inconsistent with federal and state laws and regulations
relating to nursing home infection control programs; and 

_new nursing facility documentation requirements by TDH or TDHS resulting
from the implementation of this Act are developed with nursing home
industry input and are promptly disseminated to nursing homes upon adoption
by the agencies. 

SECTION 4.  Effective date: September 1, 1999.

SECTION 5.  Emergency clause.