By: Wentworth S.B. No. 1663
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the disregard or violation of a resident's advance
  directive by a nursing institution; providing penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 242.061, Health and Safety Code, is
  amended by adding Subsection (a-1) to read as follows:
         (a-1)  The department, after providing notice and
  opportunity for a hearing to a license holder, shall suspend or
  revoke a license if the department finds that the license holder has
  been assessed three or more administrative penalties for violating
  Section 242.0663(a)(2).
         SECTION 2.  Section 242.0663, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsections (d), (e),
  and (f) to read as follows:
         (a)  The department shall assess an administrative penalty
  under this subchapter against an institution that:
               (1)  violates Section 166.004; or
               (2)  knowingly employs or has on staff a health care
  practitioner who knowingly disregards or violates a resident's
  advance directive if the institution has included a statement in
  its written policies maintained under Section 166.004 that the
  institution will follow a resident's advance directive.
         (d)  A person, including an owner or employee of an
  institution, who has cause to believe that a resident's advance
  directive has been or may be knowingly disregarded in violation of a
  written policy maintained under Section 166.004 shall report such
  violation consistent with the requirements of Section 242.123.
         (e)  It is not a violation of this section or any other law if
  an institution, its owners, employees, agents, or physicians in
  good faith attempt to resuscitate a resident because the
  institution, its owners, employees, agents, or physicians who
  practice in the institution reasonably believe that the process of
  dying appears to be the result of an accident, unnatural causes, or
  suspicious circumstances.
         (f)  To the extent consistent with federal law, an
  institution may, on the basis of conscience, object to honoring an
  advanced directive if the institution includes in its policies and
  explains to each prospective resident before admission to the
  institution the circumstances under which the institution would not
  follow instructions of an advanced directive. The policies and
  explanation must include the following:
               (1)  a clear and precise statement of limitations that
  result from the institution's objection to implement advanced
  directives based on conscience;
               (2)  a description of the differences between an
  institution-wide policy of objection on the basis of conscience and
  an objection that may be raised by an individual healthcare
  provider; and
               (3)  a description of the range of medical conditions
  or procedures affected by an objection based on conscience.
         SECTION 3.  This Act takes effect September 1, 2009.