89R12586 MCF-D

By: Hall S.B. No. 1472

A BILL TO BE ENTITLED

AN ACT

relating to assisted living facilities allowing residents to designate an advocate.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 247.0011(b), Health and Safety Code, is amended to read as follows:

(b) The executive commissioner shall protect residents of assisted living facilities by:

(1) adopting rules relating to quality of care and quality of life; and

(2) adopting rules relating to the assessment of the condition and service needs of each resident, including the designation of an advocate for the resident.

SECTION 2. Section 247.002, Health and Safety Code, is amended by amending Subdivision (1) and adding Subdivision (1-a) to read as follows:

(1) "Advocate" means an individual who advocates on behalf of a resident, including:

(A) the resident's spouse, family member, companion, or guardian;

(B) the parent, legal custodian, or guardian of a resident under 18 years of age;

(C) an agent the resident designates under a durable power of attorney for health care; and

(D) an individual a court appoints to act as the resident's guardian.

(1-a) "Assisted living facility" means an establishment that:

(A) furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to the proprietor of the establishment;

(B) provides:

(i) personal care services; or

(ii) administration of medication by a person licensed or otherwise authorized in this state to administer the medication;

(C) may provide assistance with or supervision of the administration of medication;

(D) may provide skilled nursing services for the following limited purposes:

(i) coordination of resident care with outside home and community support services agencies and other health care professionals;

(ii) provision or delegation of personal care services and medication administration as described by this subdivision;

(iii) assessment of residents to determine the care required; and

(iv) for periods of time as established by department rule, delivery of temporary skilled nursing treatment for a minor illness, injury, or emergency; and

(E) may provide health maintenance activities as defined by rule by the Texas Board of Nursing.

SECTION 3. Section 247.021(d), Health and Safety Code, is amended to read as follows:

(d) The executive commissioner by rule shall establish procedures to issue a six-month provisional license to existing facilities with residents. The department may issue a provisional license if:

(1) the facility is in compliance with resident care standards;

(2) the facility voluntarily discloses that the facility needs additional time to comply with life safety code and physical plant standards;

(3) the disclosure is made in writing by certified mail to the department;

(4) an investigation of the violation was not initiated and the violation was not independently detected by the department; [and]

(5) the disclosure is made promptly after knowledge of the information disclosed is obtained by the facility; and

(6) the facility adopts advocate policies and procedures in accordance with Section 247.073 and rules adopted under that section.

SECTION 4. Section 247.064(b), Health and Safety Code, is amended to read as follows:

(b) The residents' bill of rights must provide that each resident in the assisted living facility has the right to:

(1) manage the resident's financial affairs;

(2) determine the resident's dress, hair style, or other personal effects according to individual preference, except that the resident has the responsibility to maintain personal hygiene;

(3) retain and use personal property in the resident's immediate living quarters and to have an individual locked cabinet in which to keep personal property;

(4) receive and send unopened mail;

(5) unaccompanied access to a telephone at a reasonable hour or in case of an emergency or personal crisis;

(6) privacy;

(7) unrestricted communication, including personal visitation with any person of the resident's choice, at any reasonable hour, including family members and representatives of advocacy groups and community service organizations;

(8) make contacts with the community and to achieve the highest level of independence, autonomy, and interaction with the community of which the resident is capable;

(9) present grievances on behalf of the resident or others to the operator, state agencies, or other persons without threat of reprisal in any manner;

(10) a safe and decent living environment and considerate and respectful care that recognizes the dignity and individuality of the resident;

(11) refuse to perform services for the facility, except as contracted for by the resident and operator;

(12) practice the religion of the resident's choice;

(13) leave the facility temporarily or permanently, subject to contractual or financial obligations; [and]

(14) not be deprived of any constitutional, civil, or legal right solely by reason of residence in an assisted living facility; and

(15) designate an advocate in accordance with Section 247.073 and rules adopted under that section.

SECTION 5. Subchapter D, Chapter 247, Health and Safety Code, is amended by adding Section 247.073 to read as follows:

Sec. 247.073. ADVOCATE DESIGNATION POLICIES AND PROCEDURES. (a) The executive commissioner by rule shall require each assisted living facility to develop and implement policies providing each resident an opportunity to designate an advocate for whom the facility will provide meaningful in-person access to the resident, specifically during the resident's final days of life, regardless of any declared public health disaster or emergency restricting in-person visitation.

(b) The policies and procedures described by Subsection (a) may not:

(1) require or coerce a resident to waive the resident's rights under this section;

(2) require the resident's visits with the designated advocate to be virtual; or

(3) authorize an individual to serve as an advocate for a resident if a court found the individual abused the resident or the facility determines the individual poses a serious risk to the resident.

(c) The facility shall provide and explain the policies and procedures described by Subsection (a) to each resident:

(1) during the facility's admission process; and

(2) before the facility implements any changes to the policy.

SECTION 6. As soon as practicable after the effective date of this Act, the executive commissioner of the Health and Human Services Commission shall adopt rules as necessary to implement Section 247.073, Health and Safety Code, as added by this Act.

SECTION 7. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2025.