S.B. No. 1876
 
 
 
 
AN ACT
  relating to emergency planning for the continued treatment and
  safety of end stage renal disease facility patients.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 251, Health and Safety
  Code, is amended by adding Sections 251.016 and 251.017 to read as
  follows:
         Sec. 251.016.  EMERGENCY PREPAREDNESS AND CONTINGENCY
  OPERATIONS PLANNING. (a) In this section and Section 251.017,
  "emergency" means an incident likely to threaten the health,
  welfare, or safety of end stage renal disease facility patients or
  staff or the public, including a fire, equipment failure, power
  outage, flood, interruption in utility service, medical emergency,
  or natural or other disaster.
         (b)  Each end stage renal disease facility shall adopt a
  written emergency preparedness and contingency operations plan to
  address the provision of care during an emergency. The plan must:
               (1)  be updated annually and approved by the facility's
  leadership each time the plan is updated;
               (2)  include procedures for notifying each of the
  following entities as soon as practicable regarding the closure or
  reduction in hours of operation of the facility due to an emergency:
                     (A)  the department;
                     (B)  each hospital with which the facility has a
  transfer agreement;
                     (C)  the trauma service area regional advisory
  council that serves the geographic area in which the facility is
  located; and
                     (D)  each applicable local emergency management
  agency;
               (3)  except as provided by Subsection (d), require the
  facility to execute a contract with another end stage renal disease
  facility located within a 100-mile radius of the facility
  stipulating that the other end stage renal disease facility will
  provide dialysis treatment to facility patients who are unable to
  receive scheduled dialysis treatment due to the facility's closure
  or reduction in hours; and
               (4)  include a documented patient communications plan
  that includes procedures for notifying a patient when that
  patient's scheduled dialysis treatment is interrupted.
         (c)  As part of the emergency preparedness and contingency
  operations plan adopted under Subsection (b), each end stage renal
  disease facility shall develop and the facility's leadership must
  approve a continuity of care plan for the provision of dialysis
  treatment to facility patients during an emergency. The facility
  must provide a copy of the plan to each patient before providing or
  scheduling dialysis treatment. The plan must include:
               (1)  procedures for distributing written materials to
  facility patients that specifically describe the facility's
  emergency preparedness and contingency operations plan adopted
  under Subsection (b); and
               (2)  detailed procedures, based on the facility's
  patient population, on the facility's contingency plans, including
  transportation options, for patients to access dialysis treatment
  at each end stage renal disease facility with which the facility has
  an agreement or made advance preparations to ensure that the
  facility's patients have the option to receive dialysis treatment.
         (d)  An end stage renal disease facility is not required to
  contract with another end stage renal disease facility under
  Subsection (b)(3) if:
               (1)  no other end stage renal disease facility is
  located within a 100-mile radius of the facility; and
               (2)  the facility obtains written approval from the
  department exempting the facility from that requirement.
         (e)  On request, an end stage renal disease facility shall
  provide the facility's emergency preparedness and contingency
  operations plan adopted under Subsection (b) to:
               (1)  the department;
               (2)  each hospital with which the facility has a
  transfer agreement;
               (3)  the trauma service area regional advisory council
  that serves the geographic area in which the facility is located;
  and
               (4)  each applicable local emergency management
  agency.
         (f)  Each end stage renal disease facility shall provide
  annual training to facility staff on the facility's emergency
  preparedness and contingency operations plan under this section.
         (g)  Each end stage renal disease facility shall annually
  contact a local and state disaster management representative, an
  emergency operations center, and a trauma service area regional
  advisory council to:
               (1)  request comments on whether the emergency
  preparedness and contingency operations plan adopted by the
  facility under Subsection (b) should be modified; and
               (2)  ensure that local agencies, regional agencies,
  state agencies, and hospitals are aware of the facility, the
  facility's policy on provision of life-saving treatment, the
  facility's patient population and potential transportation needs,
  and the anticipated number of patients affected.
         Sec. 251.017.  EMERGENCY CONTINGENCY PLAN FOR POWER AND
  POTABLE WATER. (a) Each end stage renal disease facility shall
  adopt an emergency contingency plan for the continuity of essential
  building systems during an emergency. A plan adopted by a facility
  under this subsection must meet the requirements described by
  Subsection (b), (d), or (e).
         (b)  Unless the facility adopts a plan described by
  Subsection (d) or (e), an end stage renal disease facility must
  adopt an emergency contingency plan as required by Subsection (a)
  under which the facility is required:
               (1)  to have an on-site emergency generator that:
                     (A)  has a type 2 essential electrical
  distribution system in accordance with the National Fire Protection
  Association 99, Section 4.5, and the National Fire Protection
  Association 110;
                     (B)  is installed, tested, and maintained in
  accordance with the National Fire Protection Association 99,
  Section 4.5.4, and the National Fire Protection Association 110;
  and
                     (C)  is kept at all times not less than 10 feet
  from the electrical transformer;
               (2)  except as provided by Subsection (c), to maintain
  an on-site fuel source that contains enough fuel capacity to power
  the on-site generator for not less than 24 hours, as determined by
  the electrical load demand on the emergency generator for that
  period;
               (3)  to maintain a sufficient quantity of potable water
  on-site to operate the facility's water treatment system for not
  less than 24 hours; and
               (4)  to maintain a water valve connection that allows
  an outside vendor to provide potable water to operate the
  facility's water treatment system.
         (c)  An end stage renal disease facility that adopts an
  emergency contingency plan under Subsection (b) is not required to
  maintain an on-site fuel source described by Subsection (b)(2) if
  the facility's on-site emergency generator uses a vapor liquefied
  petroleum gas system with a dedicated fuel supply.
         (d)  Unless the facility adopts a plan described by
  Subsection (b) or (e), an end stage renal disease facility must
  adopt an emergency contingency plan as required by Subsection (a)
  under which the facility is required:
               (1)  to maintain sufficient resources to provide on
  demand or to execute a contract with an outside supplier or vendor
  to provide on demand:
                     (A)  a portable emergency generator that:
                           (i)  has an electrical transfer switch with
  a plug-in device to provide emergency power for patient care areas
  and complies with National Fire Protection Association 99, Section
  4.5.2.2.2; and
                           (ii)  has a water valve connection that
  allows for the use of potable water to operate the facility's water
  treatment system;
                     (B)  an alternate power source for light,
  including battery-powered light, that:
                           (i)  is separate and independent from the
  normal electrical power source;
                           (ii)  is capable of providing light for not
  less than one and a half hours;
                           (iii)  is capable of providing a sufficient
  amount of light to allow for the safe evacuation of the building;
  and
                           (iv)  is maintained and tested not less than
  four times each year; and
                     (C)  potable water;
               (2)  to implement the plan when the facility loses
  electrical power due to a natural or man-made event during which the
  electrical power may not be restored within 24 hours; and
               (3)  to contact the outside supplier or vendor with
  which the facility contracts under Subdivision (1), if applicable,
  not later than 36 hours after the facility loses electrical power.
         (e)  Unless the facility adopts a plan described by
  Subsection (b) or (d), an end stage renal disease facility must
  adopt an emergency contingency plan as required by Subsection (a)
  under which the facility is required to execute a contract with
  another end stage renal disease facility that is located within a
  100-mile radius of the facility stipulating that the other end
  stage renal disease facility will provide emergency contingency
  care to the facility's patients. The other end stage renal disease
  facility with which the facility contracts must have an alternate
  power source for light, including battery-powered light, that:
               (1)  is separate and independent from the normal
  electrical power source;
               (2)  is capable of providing light for not less than one
  and a half hours;
               (3)  is capable of providing a sufficient amount of
  light to allow for the safe evacuation of the building; and
               (4)  is maintained and tested not less than four times
  each year.
         SECTION 2.  Section 773.112, Health and Safety Code, is
  amended by adding Subsection (d) to read as follows:
         (d)  Consistent with rules adopted under this section, the
  executive commissioner by rule shall require that each applicable
  emergency medical services medical director approve protocols that
  give preference to the emergency transfer of a dialysis patient
  from the patient's location directly to an outpatient end stage
  renal disease facility during a declared disaster. For purposes of
  this subsection:
               (1)  "Disaster" has the meaning assigned by Section
  418.004, Government Code. The term includes a disaster declared
  by:
                     (A)  the president of the United States under the
  Robert T. Stafford Disaster Relief and Emergency Assistance Act (42
  U.S.C. Section 5121 et seq.); and
                     (B)  the governor under Section 418.014,
  Government Code.
               (2)  "End stage renal disease facility" has the meaning
  assigned by Section 251.001.
         SECTION 3.  Sections 38.072(a) and (b), Utilities Code, are
  amended to read as follows:
         (a)  In this section:
               (1)  "Assisted living facility" has the meaning
  assigned by Section 247.002, Health and Safety Code.
               (2)  "End stage renal disease facility" has the meaning
  assigned by Section 251.001, Health and Safety Code.
               (3)  "Extended power outage" has the meaning assigned
  by Section 13.1395, Water Code.
               (4) [(3)]  "Hospice services" has the meaning assigned
  by Section 142.001, Health and Safety Code.
               (5) [(4)]  "Nursing facility" has the meaning assigned
  by Section 242.301, Health and Safety Code.
         (b)  The commission by rule shall require an electric utility
  to give to the following the same priority that it gives to a
  hospital in the utility's emergency operations plan for restoring
  power after an extended power outage:
               (1)  a nursing facility;
               (2)  an assisted living facility; [and]
               (3)  an end stage renal disease facility; and
               (4)  a facility that provides hospice services.
         SECTION 4.  Section 13.1395, Water Code, is amended by
  adding Subsection (c-1) to read as follows:
         (c-1)  An emergency preparedness plan submitted under
  Subsection (b) may provide for the prioritization of water
  restoration to an end stage renal disease facility, as that term is
  defined by Section 251.001, Health and Safety Code, in the same
  manner as an affected utility restores service to a hospital
  following an extended power outage. The affected utility must
  restore the service in accordance with:
               (1)  the facility's needs; 
               (2)  the affected community's needs; and 
               (3)  the characteristics of the geographic area in
  which water is to be restored.
         SECTION 5.  As soon as practicable after the effective date
  of this Act:
               (1)  each end stage renal disease facility shall
  develop and implement the plans required under Sections 251.016 and
  251.017, Health and Safety Code, as added by this Act;
               (2)  the executive commissioner of the Health and Human
  Services Commission shall adopt the rules required by Section
  773.112(d), Health and Safety Code, as added by this Act; and
               (3)  the Public Utility Commission of Texas shall adopt
  the rules required by Section 38.072, Utilities Code, as amended by
  this Act.
         SECTION 6.  This Act takes effect September 1, 2021.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1876 passed the Senate on     
  May 5, 2021, by the following vote: Yeas 31, Nays 0; and that the
  Senate concurred in House amendment on May 27, 2021, by the
  following vote: Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1876 passed the House, with
  amendment, on May 23, 2021, by the following vote: Yeas 142,
  Nays 3, two present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor