77R15721 JJT-F
By Moncrief, et al. S.B. No. 876
Substitute the following for S.B. No. 876:
By Capelo C.S.S.B. No. 876
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the administration of restraint, seclusion, and
1-3 emergency psychoactive medication to residents of certain health
1-4 care facilities.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subtitle G, Title 4, Health and Safety Code, is
1-7 amended by adding Chapter 322 to read as follows:
1-8 CHAPTER 322. ADMINISTRATION OF RESTRAINT, SECLUSION, AND EMERGENCY
1-9 PSYCHOACTIVE MEDICATION IN CERTAIN
1-10 HEALTH CARE FACILITIES
1-11 Sec. 322.001. FINDINGS. (a) The legislature finds that:
1-12 (1) an individual has the right to be free from the
1-13 imposition of restraint or seclusion for management of the
1-14 individual's behavior unless the individual is presenting an
1-15 imminent risk of harm to self or others;
1-16 (2) an individual has the right to be free from the
1-17 imposition of restraint or seclusion as a means of coercion or
1-18 discipline of, or retaliation against, the individual and free from
1-19 the imposition of restraint or coercion for the convenience of a
1-20 health care worker;
1-21 (3) an individual has the right to an individualized
1-22 plan for the individual's treatment or care that provides for
1-23 freedom of movement in a safe environment; and
1-24 (4) an individual should not be restrained or secluded
2-1 except in accordance with safe and appropriate techniques
2-2 corresponding to the individual's condition.
2-3 (b) This section is not intended to contravene federal
2-4 guidelines regarding the use of restraints or seclusion.
2-5 Sec. 322.002. DEFINITIONS. In this chapter:
2-6 (1) "Facility" means:
2-7 (A) a child-care institution, as defined by
2-8 Section 42.002, Human Resources Code, that is licensed by the
2-9 Department of Protective and Regulatory Services as a residential
2-10 treatment center or an institution serving children with mental
2-11 retardation;
2-12 (B) an intermediate care facility licensed by
2-13 the Texas Department of Human Services under Chapter 252 or
2-14 operated by the Texas Department of Mental Health and Mental
2-15 Retardation and exempt under Section 252.003 from the licensing
2-16 requirements of that chapter;
2-17 (C) a mental hospital or mental health facility,
2-18 as defined by Section 571.003;
2-19 (D) a nursing facility, as defined by Section
2-20 242.301; or
2-21 (E) an assisted living facility, as defined by
2-22 Section 247.002.
2-23 (2) "Health and human services agency" means an agency
2-24 listed in Section 531.001, Government Code.
2-25 (3) "Resident" means a person who receives care or
2-26 treatment in a facility.
2-27 Sec. 322.003. APPLICABILITY. This chapter applies to a
3-1 health and human services agency that regulates the care or
3-2 treatment of a resident.
3-3 Sec. 322.004. ADOPTION OF PROCEDURES. (a) A health and
3-4 human services agency by rule shall adopt procedures for
3-5 administering to a resident:
3-6 (1) mechanical restraint;
3-7 (2) personal restraint;
3-8 (3) seclusion;
3-9 (4) emergency psychoactive medication; and
3-10 (5) supportive and protective devices.
3-11 (b) The procedures must be consistent with this chapter and
3-12 with the right of a resident to be free from:
3-13 (1) physical or mental abuse;
3-14 (2) corporal punishment; and
3-15 (3) the use of restraints or seclusion:
3-16 (A) as punishment;
3-17 (B) as a substitute for treatment or
3-18 habilitation;
3-19 (C) for the convenience of facility staff; or
3-20 (D) to compensate for a lack of facility staff.
3-21 Sec. 322.005. STAFF TRAINING. A facility shall provide to
3-22 its staff, annually or more frequently if necessary,
3-23 competency-based training on:
3-24 (1) the prevention and de-escalation of a resident's
3-25 aggressive behavior; and
3-26 (2) the safe administration of mechanical and personal
3-27 restraints.
4-1 Sec. 322.006. REPORT OF DEATH OR INJURY DURING OR AFTER
4-2 RESTRAINT, SECLUSION, OR EMERGENCY PSYCHOACTIVE MEDICATION. (a) A
4-3 facility shall report to the appropriate law enforcement or
4-4 regulatory agencies for investigation each death of or serious
4-5 injury to a resident that occurs during the administration of, or
4-6 less than 48 hours after the termination of the administration of,
4-7 restraint, seclusion, or emergency psychoactive medication to the
4-8 resident.
4-9 (b) Each health and human services agency by rule shall
4-10 adopt methods and procedures for reports required by Subsection (a)
4-11 to be made by a facility under the agency's jurisdiction.
4-12 Sec. 322.007. REPORTS ON ADMINISTRATION OF RESTRAINT,
4-13 SECLUSION, AND PSYCHOACTIVE MEDICATION. (a) Each quarter, a health
4-14 and human services agency that regulates a facility shall collect
4-15 information related to the facility's administration to the
4-16 facility's residents in emergencies of mechanical restraint,
4-17 seclusion, and psychoactive medication.
4-18 (b) The information must include:
4-19 (1) the age, race, sex, and number of residents on
4-20 whom the restraint, seclusion, or psychoactive medication is
4-21 administered; and
4-22 (2) autopsy findings for each death of a resident that
4-23 occurs before the 15th day after the date of the use of the
4-24 restraint, seclusion, or psychoactive medication, if an autopsy is
4-25 performed.
4-26 (c) The agency annually shall submit an analysis of the
4-27 information collected under this section to the Health and Human
5-1 Services Commission, the governor, and the presiding officer of
5-2 each house of the legislature.
5-3 (d) Each health and human services agency by rule shall
5-4 adopt methods and procedures for reporting the analysis required by
5-5 Subsection (c). The agency must de-identify any information
5-6 regarding individual residents or facilities.
5-7 Sec. 322.008. CERTAIN RESTRAINTS PROHIBITED. A person may
5-8 not administer a physical or mechanical restraint to a resident
5-9 that:
5-10 (1) maintains the resident in a face-down posture
5-11 while pressure is placed on the resident's back;
5-12 (2) obstructs the resident's airway;
5-13 (3) impairs the resident's breathing; or
5-14 (4) restricts the resident's ability to communicate.
5-15 Sec. 322.009. NEGOTIATED RULEMAKING. A health and human
5-16 services agency in adopting rules under this chapter that affect a
5-17 facility under the jurisdiction of the agency shall use the
5-18 procedures provided by Chapter 2008, Government Code.
5-19 Sec. 322.010. MEMORANDUM OF UNDERSTANDING. (a) The
5-20 commissioner of health and human services and the health and human
5-21 services agencies required to adopt rules under this chapter shall
5-22 execute a memorandum of understanding to ensure that procedures and
5-23 definitions of terms adopted by the agencies in rules under this
5-24 chapter are consistent:
5-25 (1) among the agencies; and
5-26 (2) with federal and state laws and rules regarding
5-27 the use of restraint, seclusion, or emergency psychoactive
6-1 medication.
6-2 (b) The Health and Human Services Commission shall adopt the
6-3 memorandum by rule.
6-4 (c) The commissioner of health and human services and the
6-5 health and human services agencies shall review the memorandum
6-6 annually and revise the memorandum as necessary.
6-7 SECTION 2. (a) The commissioner of health and human
6-8 services and the health and human services agencies required by
6-9 Section 322.010, Health and Safety Code, as added by this Act, to
6-10 execute a memorandum of understanding shall execute the initial
6-11 memorandum not later than March 1, 2002.
6-12 (b) A health and human services agency described by Section
6-13 322.003, Health and Safety Code, as added by this Act, shall adopt
6-14 rules as necessary to implement Chapter 322, Health and Safety
6-15 Code, as added by this Act, not later than December 31, 2002.
6-16 (c) This Act takes effect September 1, 2001, except that
6-17 Sections 322.001-322.008, Health and Safety Code, as added by this
6-18 Act, take effect December 31, 2002.