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AN ACT
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relating to health care-associated infections and preventable |
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adverse events in certain health care facilities. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subsections (a), (b), and (c), Section 98.103, |
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Health and Safety Code, as added by Chapter 359 (S.B. 288), Acts of |
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the 80th Legislature, Regular Session, 2007, are amended to read as |
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follows: |
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(a) A health care facility, other than a pediatric and |
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adolescent hospital, shall report to the department the incidence |
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of surgical site infections, including the causative pathogen if |
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the infection is laboratory-confirmed, occurring in the following |
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procedures: |
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(1) colon surgeries; |
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(2) hip arthroplasties; |
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(3) knee arthroplasties; |
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(4) abdominal hysterectomies; |
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(5) vaginal hysterectomies; |
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(6) coronary artery bypass grafts; and |
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(7) vascular procedures. |
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(b) A pediatric and adolescent hospital shall report the |
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incidence of surgical site infections, including the causative |
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pathogen if the infection is laboratory-confirmed, occurring in the |
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following procedures to the department: |
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(1) cardiac procedures, excluding thoracic cardiac |
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procedures; |
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(2) ventriculoperitoneal shunt procedures; and |
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(3) spinal surgery with instrumentation. |
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(c) A general hospital shall report the following to the |
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department: |
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(1) the incidence of laboratory-confirmed central |
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line-associated primary bloodstream infections, including the |
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causative pathogen, occurring in any special care setting in the |
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hospital; and |
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(2) the incidence of respiratory syncytial virus |
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occurring in any pediatric inpatient unit in the hospital. |
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SECTION 2. (a) The heading to Chapter 98, Health and |
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Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th |
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Legislature, Regular Session, 2007, is amended to read as follows: |
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CHAPTER 98. REPORTING OF HEALTH CARE-ASSOCIATED INFECTIONS AND |
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PREVENTABLE ADVERSE EVENTS |
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(b) Subdivisions (1) and (11), Section 98.001, Health and |
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Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th |
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Legislature, Regular Session, 2007, are amended to read as follows: |
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(1) "Advisory panel" means the Advisory Panel on |
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Health Care-Associated Infections and Preventable Adverse Events. |
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(11) "Reporting system" means the Texas Health |
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Care-Associated Infection and Preventable Adverse Events Reporting |
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System. |
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(c) Section 98.051, Health and Safety Code, as added by |
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Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular |
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Session, 2007, is amended to read as follows: |
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Sec. 98.051. ESTABLISHMENT. The commissioner shall |
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establish the Advisory Panel on Health Care-Associated Infections |
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and Preventable Adverse Events within [the infectious disease
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surveillance and epidemiology branch of] the department to guide |
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the implementation, development, maintenance, and evaluation of |
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the reporting system. The commissioner may establish one or more |
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subcommittees to assist the advisory panel in addressing health |
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care-associated infections and preventable adverse events relating |
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to hospital care provided to children or other special patient |
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populations. |
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(d) Subsection (a), Section 98.052, Health and Safety Code, |
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as added by Chapter 359 (S.B. 288), Acts of the 80th Legislature, |
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Regular Session, 2007, is amended to read as follows: |
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(a) The advisory panel is composed of 18 [16] members as |
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follows: |
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(1) two infection control professionals who: |
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(A) are certified by the Certification Board of |
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Infection Control and Epidemiology; and |
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(B) are practicing in hospitals in this state, at |
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least one of which must be a rural hospital; |
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(2) two infection control professionals who: |
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(A) are certified by the Certification Board of |
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Infection Control and Epidemiology; and |
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(B) are nurses licensed to engage in professional |
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nursing under Chapter 301, Occupations Code; |
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(3) three board-certified or board-eligible |
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physicians who: |
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(A) are licensed to practice medicine in this |
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state under Chapter 155, Occupations Code, at least two of whom have |
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active medical staff privileges at a hospital in this state and at |
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least one of whom is a pediatric infectious disease physician with |
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expertise and experience in pediatric health care epidemiology; |
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(B) are active members of the Society for |
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Healthcare Epidemiology of America; and |
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(C) have demonstrated expertise in quality |
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assessment and performance improvement or infection control in |
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health care facilities; |
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(4) four additional [two] professionals in quality |
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assessment and performance improvement[, one of whom is employed by
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a general hospital and one of whom is employed by an ambulatory
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surgical center]; |
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(5) one officer of a general hospital; |
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(6) one officer of an ambulatory surgical center; |
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(7) three nonvoting members who are department |
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employees representing the department in epidemiology and the |
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licensing of hospitals or ambulatory surgical centers; and |
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(8) two members who represent the public as consumers. |
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(e) Subsections (a) and (c), Section 98.102, Health and |
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Safety Code, as added by Chapter 359 (S.B. 288), Acts of the 80th |
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Legislature, Regular Session, 2007, are amended to read as follows: |
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(a) The department shall establish the Texas Health |
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Care-Associated Infection and Preventable Adverse Events Reporting |
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System within the [infectious disease surveillance and
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epidemiology branch of the] department. The purpose of the |
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reporting system is to provide for: |
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(1) the reporting of health care-associated |
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infections by health care facilities to the department; |
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(2) the reporting of health care-associated |
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preventable adverse events by health care facilities to the |
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department; |
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(3) the public reporting of information regarding the |
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health care-associated infections by the department; |
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(4) the public reporting of information regarding |
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health care-associated preventable adverse events by the |
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department; and |
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(5) [(3)] the education and training of health care |
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facility staff by the department regarding this chapter. |
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(c) The data reported by health care facilities to the |
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department must contain sufficient patient identifying information |
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to: |
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(1) avoid duplicate submission of records; |
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(2) allow the department to verify the accuracy and |
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completeness of the data reported; and |
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(3) for data reported under Section 98.103 or 98.104, |
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allow the department to risk adjust the facilities' infection |
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rates. |
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(f) Subchapter C, Chapter 98, Health and Safety Code, as |
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added by Chapter 359 (S.B. 288), Acts of the 80th Legislature, |
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Regular Session, 2007, is amended by adding Section 98.1045 to read |
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as follows: |
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Sec. 98.1045. REPORTING OF PREVENTABLE ADVERSE EVENTS. |
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(a) Each health care facility shall report to the department the |
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occurrence of any of the following preventable adverse events |
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involving the facility's patient: |
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(1) a health care-associated adverse condition or |
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event for which the Medicare program will not provide additional |
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payment to the facility under a policy adopted by the federal |
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Centers for Medicare and Medicaid Services; and |
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(2) subject to Subsection (b), an event included in |
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the list of adverse events identified by the National Quality Forum |
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that is not included under Subdivision (1). |
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(b) The executive commissioner may exclude an adverse event |
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described by Subsection (a)(2) from the reporting requirement of |
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Subsection (a) if the executive commissioner, in consultation with |
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the advisory panel, determines that the adverse event is not an |
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appropriate indicator of a preventable adverse event. |
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(g) Subsections (a), (b), and (g), Section 98.106, Health |
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and Safety Code, as added by Chapter 359 (S.B. 288), Acts of the |
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80th Legislature, Regular Session, 2007, are amended to read as |
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follows: |
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(a) The department shall compile and make available to the |
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public a summary, by health care facility, of: |
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(1) the infections reported by facilities under |
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Sections 98.103 and 98.104; and |
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(2) the preventable adverse events reported by |
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facilities under Section 98.1045. |
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(b) Information included in the [The] departmental summary |
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with respect to infections reported by facilities under Sections |
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98.103 and 98.104 must be risk adjusted and include a comparison of |
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the risk-adjusted infection rates for each health care facility in |
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this state that is required to submit a report under Sections 98.103 |
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and 98.104. |
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(g) The department shall make the departmental summary |
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available on an Internet website administered by the department and |
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may make the summary available through other formats accessible to |
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the public. The website must contain a statement informing the |
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public of the option to report suspected health care-associated |
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infections and preventable adverse events to the department. |
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(h) Section 98.108, Health and Safety Code, as added by |
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Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular |
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Session, 2007, is amended to read as follows: |
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Sec. 98.108. FREQUENCY OF REPORTING. In consultation with |
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the advisory panel, the executive commissioner by rule shall |
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establish the frequency of reporting by health care facilities |
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required under Sections 98.103, [and] 98.104, and 98.1045. |
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Facilities may not be required to report more frequently than |
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quarterly. |
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(i) Section 98.109, Health and Safety Code, as added by |
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Chapter 359 (S.B. 288), Acts of the 80th Legislature, Regular |
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Session, 2007, is amended by adding Subsection (b-1) and amending |
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Subsection (e) to read as follows: |
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(b-1) A state employee or officer may not be examined in a |
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civil, criminal, or special proceeding, or any other proceeding, |
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regarding the existence or contents of information or materials |
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obtained, compiled, or reported by the department under this |
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chapter. |
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(e) A department summary or disclosure may not contain |
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information identifying a [facility] patient, employee, |
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contractor, volunteer, consultant, health care professional, |
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student, or trainee in connection with a specific [infection] |
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incident. |
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(j) Sections 98.110 and 98.111, Health and Safety Code, as |
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added by Chapter 359 (S.B. 288), Acts of the 80th Legislature, |
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Regular Session, 2007, are amended to read as follows: |
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Sec. 98.110. DISCLOSURE AMONG CERTAIN AGENCIES [WITHIN
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DEPARTMENT]. Notwithstanding any other law, the department may |
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disclose information reported by health care facilities under |
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Section 98.103, [or] 98.104, or 98.1045 to other programs within |
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the department, to the Health and Human Services Commission, and to |
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other health and human services agencies, as defined by Section |
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531.001, Government Code, for public health research or analysis |
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purposes only, provided that the research or analysis relates to |
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health care-associated infections or preventable adverse events. |
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The privilege and confidentiality provisions contained in this |
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chapter apply to such disclosures. |
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Sec. 98.111. CIVIL ACTION. Published infection rates or |
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preventable adverse events may not be used in a civil action to |
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establish a standard of care applicable to a health care facility. |
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(k) As soon as possible after the effective date of this |
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Act, the commissioner of state health services shall appoint two |
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additional members to the advisory panel who meet the |
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qualifications prescribed by Subdivision (4), Subsection (a), |
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Section 98.052, Health and Safety Code, as amended by this section. |
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(l) Not later than February 1, 2010, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt rules and procedures necessary to implement the reporting of |
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health care-associated preventable adverse events as required |
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under Chapter 98, Health and Safety Code, as amended by this |
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section. |
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SECTION 3. (a) Subchapter B, Chapter 32, Human Resources |
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Code, is amended by adding Section 32.0312 to read as follows: |
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Sec. 32.0312. REIMBURSEMENT FOR SERVICES ASSOCIATED WITH |
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PREVENTABLE ADVERSE EVENTS. The executive commissioner of the |
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Health and Human Services Commission shall adopt rules regarding |
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the denial or reduction of reimbursement under the medical |
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assistance program for preventable adverse events that occur in a |
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hospital setting. In adopting the rules, the executive |
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commissioner: |
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(1) shall ensure that the commission imposes the same |
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reimbursement denials or reductions for preventable adverse events |
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as the Medicare program imposes for the same types of health |
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care-associated adverse conditions and the same types of health |
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care providers and facilities under a policy adopted by the federal |
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Centers for Medicare and Medicaid Services; |
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(2) shall consult an advisory committee on health care |
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quality, if established by the executive commissioner, to obtain |
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the advice of that committee regarding denial or reduction of |
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reimbursement claims for any other preventable adverse events that |
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cause patient death or serious disability in health care settings, |
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including events on the list of adverse events identified by the |
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National Quality Forum; and |
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(3) may allow the commission to impose reimbursement |
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denials or reductions for preventable adverse events described by |
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Subdivision (2). |
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(b) Not later than September 1, 2010, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt the rules required by Section 32.0312, Human Resources Code, |
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as added by this section. |
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(c) Rules adopted by the executive commissioner of the |
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Health and Human Services Commission under Section 32.0312, Human |
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Resources Code, as added by this section, may apply only to a |
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preventable adverse event occurring on or after the effective date |
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of the rules. |
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SECTION 4. This Act takes effect September 1, 2009. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 203 passed the Senate on |
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April 16, 2009, by the following vote: Yeas 31, Nays 0; and that |
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the Senate concurred in House amendment on May 29, 2009, by the |
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following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 203 passed the House, with |
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amendment, on May 27, 2009, by the following vote: Yeas 148, |
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Nays 0, one present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |