79R1843 MCK-D
By:  Van de Putte                                                 S.B. No. 357
A BILL TO BE ENTITLED
AN ACT
relating to infection rates at hospitals; providing a civil 
penalty.        
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subtitle D, Title 2, Health and Safety Code, is 
amended by adding Chapter 96 to read as follows:
	CHAPTER 96.  HOSPITAL-ACQUIRED INFECTION RATES
	Sec. 96.001.  DEFINITIONS.  In this chapter:                            
		(1)  "Department" means the Department of State Health 
Services.     
		(2)  "Hospital" means a public, for-profit, or 
nonprofit institution licensed or owned by this state that is a 
general or special hospital, private mental hospital, chronic 
disease hospital, or other type of hospital.
		(3)  "Hospital-acquired infection" means a localized 
or systemic condition that results from adverse reaction to the 
presence of an infectious agent or its toxin that was not present or 
incubating at the time of admission to the hospital.
	Sec. 96.002.  COLLECTION OF HOSPITAL-ACQUIRED INFECTION 
RATE DATA.  Each hospital shall collect data on the 
hospital-acquired infection rate related to specific clinical 
procedures.  The hospital shall report the hospital-acquired 
infection rate for the following categories:
		(1)  surgical site infections;                                         
		(2)  ventilator-associated pneumonia;                                  
		(3)  central line-related bloodstream infections;                      
		(4)  urinary tract infections; and                                     
		(5)  any other category the department determines is 
necessary after consulting with the advisory committee.
	Sec. 96.003.  QUARTERLY REPORTS.  (a)  Not later than the 
last day of the month following each calendar quarter, each 
hospital shall report to the department the hospital-acquired 
infection rates for that particular hospital.
	(b)  If the hospital is a division or subsidiary of another 
entity that owns or operates other hospitals or related 
organizations, a quarterly report must be made for each specific 
hospital.
	(c)  The department shall prescribe the form of the quarterly 
report to be made under this section.
	(d)  Each hospital shall make its quarterly reports 
available to the public.
	Sec. 96.004.  ANNUAL REPORT TO LEGISLATURE.  (a)  Not later 
than January 31 of each year, the department shall submit to the 
legislature a report summarizing the hospital quarterly reports.
	(b)  The annual report must compare the risk-adjusted 
hospital-acquired infection rates for each individual hospital in 
the state.  The department, in consultation with the advisory 
committee, shall make this comparison as easy to comprehend as 
possible.
	(c)  The report must include an executive summary, written in 
plain language, that includes a discussion of findings, 
conclusions, and trends concerning the overall state of 
hospital-acquired infections in the state, including a comparison 
to prior years.
	(d)  The report may include policy recommendations, as 
appropriate.   
	Sec. 96.005.  PUBLICATION OF INFORMATION.  (a)  The 
department shall publish each quarterly report and the annual 
report on the department's Internet website.
	(b)  The department may issue quarterly information 
bulletins at its discretion, summarizing all or part of the 
information submitted in the hospital quarterly reports.
	(c)  The department shall publicize the availability of the 
reports as widely as practicable to interested parties, including 
hospitals, health care providers, media organizations, health 
insurers, health maintenance organizations, purchasers of health 
insurance, organized labor, consumer or patient advocacy groups, 
and individual consumers.
	(d)  The department shall make the annual report available to 
any person upon request.
	Sec. 96.006.  ADVISORY COMMITTEE.  (a)  The commissioner of 
the department shall appoint an advisory committee to assist the 
department in the development of all aspects of the department's 
methodology for collecting, analyzing, and disclosing the 
information collected under this chapter, including collection 
methods, formatting, and methods and means for release and 
dissemination of the information.
	(b)  The advisory committee must include representatives 
from public and private hospitals, including a representative from 
a hospital's infection control department, consumer organizations, 
health insurers and health maintenance organizations, and 
organized labor.  The advisory committee must also include at least 
one representative who is:
		(1)  a nurse providing direct nursing care;                            
		(2)  a physician;                                                      
		(3)  an epidemiologist with expertise in 
hospital-acquired infections;
		(4)  an academic researcher; and                                       
		(5)  a purchaser of group health coverage, such as an 
employer.      
	(c)  A majority of the members of the advisory committee must 
represent interests other than hospitals.
	(d)  In developing the methodology for collecting and 
analyzing the infection rate data, the department and advisory 
committee shall consider existing methodologies and systems for 
data collection, including the Centers for Disease Control's 
National Nosocomial Infections Surveillance System, or its 
successor.  The data collection and analysis methodology shall be 
disclosed to the public prior to any public disclosure of 
hospital-acquired infection rates.
	(e)  The department and the advisory committee shall 
evaluate on a regular basis the quality and accuracy of hospital 
information reported under this chapter and the data collection, 
analysis, and dissemination methodologies.
	(f)  Chapter 2110, Government Code, applies to the advisory 
committee except that Sections 2110.002 and 2110.008, Government 
Code, do not apply to the committee.
	Sec. 96.007.  PRIVACY.  A hospital report or department 
disclosure may not contain information identifying a patient, 
employee, or licensed health care professional in connection with a 
specific infection incident.
	Sec. 96.008.  CIVIL PENALTY.  (a)  A hospital that violates 
this chapter or a rule adopted under this chapter is liable to the 
state for a civil penalty in an amount not to exceed $1,000 for each 
violation.
	(b)  Each day a violation occurs constitutes a separate 
violation.    
	(c)  The attorney general shall bring an action in the name 
of the state at the department's request to collect a civil penalty 
under this section.
	(d)  The attorney general may recover reasonable expenses 
incurred in obtaining a civil penalty under this section, including 
court costs, reasonable attorney's fees, reasonable investigative 
costs, witness fees, and deposition expenses.
	SECTION 2.  Section 241.053(a), Health and Safety Code, is 
amended to read as follows:
	(a)  The department, after providing notice and an 
opportunity for a hearing to the applicant or license holder, may 
deny, suspend, or revoke a hospital's license if the department 
finds that the hospital:
		(1)  failed to comply with:                                                   
			(A)  a provision of this chapter;                                            
			(B)  a rule adopted under this chapter;                                      
			(C)  a special license condition;                                            
			(D)  an order or emergency order by the 
commissioner of health; [or]
			(E)  another enforcement procedure permitted 
under this chapter; or 
			(F)  a provision of Chapter 96 or a rule adopted 
under Chapter 96;  
		(2)  has a history of noncompliance with the rules 
adopted under this chapter relating to patient health, safety, and 
rights which reflects more than nominal noncompliance; or
		(3)  has aided, abetted, or permitted the commission of 
an illegal act.     
	SECTION 3.  The executive commissioner of the Health and 
Human Services Commission shall adopt any rules necessary to 
implement Chapter 96, Health and Safety Code, as added by this Act, 
not later than January 1, 2006, and shall require submission of the 
initial reports required to be made under that chapter not later 
than April 30, 2006.
	SECTION 4.  This Act takes effect September 1, 2005.