BILL ANALYSIS

 

 

Senate Research Center

H.B. 2187

89R20769 KRM-F

By: Howard et al. (Perry)

 

Health & Human Services

 

5/12/2025

 

Engrossed

 

 

 

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

 

According to surveys by the Texas Nurses Association of their membership, staffing is the number one issue nurses identify as contributing to burnout and a cause for leaving the profession. Nurse staffing committees are fundamental to ensuring the safety and working conditions in the hospital are optimized for patient care.

 

Current law requires hospital to report compliance with the statute to the Department of State Health Services (DSHS). However, a challenge to implementation is that while the compliance reporting is made to DSHS, the actual regulation of hospitals is conducted by the Health and Human Services Commission (HHSC). Further, there is no current mechanism for sharing the data between two agencies. Therefore any nurse who has concerns about the operation of the nurse staffing committee is forced to report their employer to the regulatory agency before any review can be conducted.

 

Furthermore, the Governor's Healthcare Workforce Task Force found that, since the pandemic, the implementation of the staffing committee process has suffered and is used inconsistently.

 

H.B. 2187 strengthens protections for nurses by prohibiting retaliation for reporting staffing concerns or refusing mandatory overtime, requiring hospitals to verify and report accurate nurse staffing data, and directing HHSC to establish a formal complaint resolution process to enforce compliance.

 

H.B. 2187 amends current law relating to hospital staffing report and complaint processes and to retaliation and mandatory overtime protections for nurses.

 

RULEMAKING AUTHORITY

 

Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 7 of this bill.

 

SECTION BY SECTION ANALYSIS

 

SECTION 1. Amends Section 257.001, Health and Safety Code, by amending Subdivision (1) and adding Subdivision (1-a) to define "commission."

 

SECTION 2. Amends Section 257.005, Health and Safety Code, by adding Subsections (a-1), as follows:

 

(a-1) Requires the chief nursing officer of each hospital to attest to the accuracy of information reported under Subsection (a) (relating to requiring a hospital to annually report certain staffing information to the Department of State Health Services (DSHS)).

 

(d)� Requires DSHS to provide the information reported under Subsection (a) to the Health and Human Services Commission (HHSC).

 

SECTION 3. Amends Chapter 257, Health and Safety Code, by adding Sections 257.006 and 257.007, as follows:

 

Sec. 257.006. PROHIBITED RETALIATION. Prohibits a hospital from retaliating against a nurse who provides information to the nurse staffing committee or reports violations of Chapter 257 (Nurse Staffing) to hospital management or HHSC.

 

Sec. 257.007.� ENFORCEMENT; COMPLAINT RESOLUTION.� (a) Requires HHSC to enforce this chapter in accordance with Subchapter C (Enforcement), Chapter 241 (Hospitals), against a hospital licensed under that chapter as if the hospital violated that chapter and Chapter 577 (Private Mental Hospitals and Other Mental Health Facilities) and rules adopted under Sections 577.010 (Rules and Standards) and 577.013 (Investigations), against a hospital licensed under Chapter 577 as if the hospital violated that chapter, and rules adopted under Section 241.026(a) (relating to the minimum standards a hospital is required to meet to obtain a license).

 

(b) Requires HHSC to establish a process to provide prompt review and timely resolution of each complaint submitted under this chapter.� Requires HHSC to:

 

(1) develop a procedure, or designate an existing procedure, through which a party is authorized to submit a written or verbal complaint;

 

(2) establish a time to review and respond to the complaint; and

 

(3) provide the complainant written notice of HHSC's decision regarding the complaint, including certain information about the complaint.

 

(c) Provides that all information and materials in the possession of or obtained or compiled by HHSC in connection with a complaint and investigation are confidential and not subject to disclosure in accordance with Section 241.051(d) (relating to circumstances when information within a hospital's complaint investigation is authorized to be disclosed) for a complaint submitted against a hospital licensed under Chapter 241 or Section 577.013(e) (relating to information from an investigation that is authorized to be disclosed if personal information of patients and providers are redacted) for a complaint submitted against a hospital licensed under Chapter 577.

 

SECTION 4. Amends Section 258.001, Health and Safety Code, by amending Subdivision (1) and adding Subdivision (1-a) to define "commission."

 

SECTION 5. Amends Section 258.005, Health and Safety Code, to prohibit a hospital from suspending, terminating, or otherwise disciplining or discriminating against a nurse who refuses to work mandatory overtime or reports violations of this chapter to hospital management or HHSC.

 

SECTION 6. Amends Chapter 258, Health and Safety Code, by adding Section 258.006, as follows:

 

Sec. 258.006.� ENFORCEMENT; COMPLAINT RESOLUTION.� (a)� Requires HHSC to enforce this chapter in accordance with Subchapter C, Chapter 241, against a hospital licensed under that chapter as if the hospital violated that chapter, Chapter 577 and rules adopted under Sections 577.010 and 577.013, against a hospital licensed under Chapter 577 as if the hospital violated that chapter, and rules adopted under Section 241.026(a).

 

(b) Requires HHSC to establish a process to provide prompt review and timely resolution of each complaint submitted under this chapter.� Requires HHSC to:

 

(1)� develop a procedure, or designate an existing procedure, through which a party is authorized to submit a written or verbal complaint;

 

(2)� establish a time to review and respond to the complaint; and

 

(3)� provide the complainant written notice of HHSC's decision regarding the complaint, including certain information about the complaint.

 

(c) Provides that all information and materials in the possession of or obtained or compiled by HHSC in connection with a complaint and investigation are confidential and not subject to disclosure in accordance with Section 241.051(d) for a complaint submitted against a hospital licensed under Chapter 241 or �577.013(e) for a complaint submitted against a hospital licensed under Chapter 577.

 

SECTION 7. Requires the executive commissioner of HHSC, not later than December 31, 2025, to adopt any rules necessary to implement the changes in law made by this Act.

 

SECTION 8.� Effective date: September 1, 2025.