87R3355 JG-D     By: Sanford H.B. No. 2324       A BILL TO BE ENTITLED   AN ACT   relating to a designated essential caregiver for residents of   certain long-term care facilities during public health   emergencies.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subtitle A, Title 4, Health and Safety Code, is   amended by adding Chapter 226 to read as follows:   CHAPTER 226. LONG-TERM CARE FACILITY ESSENTIAL CAREGIVER   DESIGNATIONS AND REQUIREMENTS          Sec. 226.001.  DEFINITIONS. In this chapter:                (1)  "Essential caregiver" means an individual   designated as a resident's essential caregiver in accordance with   Section 226.003.                (2)  "Executive commissioner" means the executive   commissioner of the Health and Human Services Commission.                (3)  "Long-term care facility" means:                      (A)  a facility licensed or regulated under   Chapter 242, 247, or 252; and                      (B)  a state supported living center as defined by   Section 531.002.                (4)  "Public health emergency" means an immediate   threat from a communicable disease as defined by Section 81.003   that:                      (A)  poses a high risk of death or serious   long-term disability to a large number of people in the general   population; and                      (B)  creates a substantial risk of public exposure   because of the disease's high level of contagion or the method by   which the disease is transmitted.                (5)  "Resident" means an individual, including a   patient or client, who resides in a long-term care facility.          Sec. 226.002.  PURPOSE. The purpose of this chapter is to   require long-term care facilities to develop and implement policies   and procedures for residents to designate an essential caregiver   and to ensure that during a public health emergency the facility   provides an essential caregiver with meaningful access to the   resident to:                (1)  detect resident concerns and advocate on behalf of   the resident;                (2)  observe and communicate to facility staff and   health care providers important details and changes related to the   resident's condition or behavior;                (3)  assist the resident in managing complex or   critical information;                (4)  provide emotional support and ensure the   resident's personal values and care preferences are considered by   facility staff and health care providers;                (5)  alleviate caregiving tasks of facility staff and   health care providers;                (6)  preserve and promote the resident's quality of   life; and                (7)  promote and help maintain a sense of continuity,   identity, and autonomy for the resident.          Sec. 226.003.  POLICIES AND PROCEDURES FOR DESIGNATION AND   USE OF ESSENTIAL CAREGIVER. (a) The executive commissioner by rule   shall require each long-term care facility to develop and implement   policies and procedures allowing each resident to designate an   essential caregiver to whom the facility will provide, in   accordance with and in the manner described by this chapter,   meaningful access to the resident during a public health emergency.          (b)  The policies and procedures must:                (1)  require long-term care facility staff and health   care providers to consult each resident to determine the most   appropriate individual to designate as the resident's essential   caregiver;                (2)  establish criteria for individuals to be   designated as a resident's essential caregiver, provided the   criteria allow the resident to designate a family member, a friend,   an outside caregiver, or a volunteer who has provided regular care   and support to the resident;                (3)  if demonstrated by one or more individuals' past   involvement with the resident or necessitated by the resident's   particular needs, allow a resident to designate more than one   essential caregiver;                (4)  authorize a resident's essential caregiver to   regularly assist facility staff and health care providers in   providing care and emotional support to the resident, including   during a public health emergency;                (5)  except as otherwise provided by Section 226.004   due to the imposition of quarantine restrictions, require facility   staff to work cooperatively with each resident and essential   caregiver to develop a visitation schedule that ensures:                      (A)  the caregiver has meaningful access to the   resident during a public health emergency;                      (B)  the caregiver is allowed access to the   resident to provide caregiving services:                            (i)  for the greater of three hours each day   or the hours necessary for the caregiver to complete the services;   and                            (ii)  in a manner, including during evening   and weekend visits, that accommodates the caregiver's work,   child-care obligations, or other schedule; and                      (C)  the number of caregivers admitted to the   facility at any given time is appropriate for maintaining the   health, safety, and security of each resident, staff member, and   health care provider; and                (6)  ensure that each essential caregiver has access to   information on the proper use of personal protective equipment   during a public health emergency.          Sec. 226.004.  REQUIREMENTS AND RESTRICTIONS FOR ESSENTIAL   CAREGIVER ACCESS DURING PUBLIC HEALTH EMERGENCY. (a) A long-term   care facility must designate a central point of entry during a   public health emergency where each essential caregiver must enter   and register. Before entering the facility, facility staff or   health care providers must properly screen each caregiver for   symptoms of a disease or disorder related to a public health   emergency in the same manner the facility staff and health care   providers are screened.          (b)  An essential caregiver admitted to a long-term care   facility during a public health emergency must wear all necessary   personal protective equipment while inside the facility, including   eye protection or a face mask as necessary, and must frequently   sanitize the caregiver's hands. The facility shall provide an   appropriate number of hand sanitizing or other stations located   throughout the facility for caregivers to maintain proper hygiene   while inside the facility.          (c)  A long-term care facility shall establish procedures   allowing an essential caregiver to walk outside with the resident   in the area surrounding the facility if the caregiver and resident   wear appropriate personal protective equipment. A caregiver may   not take a resident beyond that area other than to an essential   medical appointment with the authorization of facility staff or   health care providers.          (d)  An essential caregiver must:                (1)  visit or provide care to a resident inside the   resident's room or another area designated by facility staff or   health care providers;                (2)  while inside the facility maintain an appropriate   social distance from each individual other than the caregiver's   resident, including facility staff, health care providers, and   other residents; and                (3)  immediately notify facility staff or health care   providers if, within 14 days following the caregiver's most recent   visit, the caregiver develops a fever or experiences symptoms of a   disease or disorder related to a public health emergency.          (e)  Except for a compassionate care visit authorized by a   long-term care facility, an essential caregiver may not visit a   resident who is under quarantine restrictions imposed by the   facility due to the resident testing positive for, being exposed   to, or experiencing symptoms of a disease or disorder related to a   public health emergency.          Sec. 226.005.  RESTRICTION OR REVOCATION OF ESSENTIAL   CAREGIVER DESIGNATION. (a) A long-term care facility may restrict   an essential caregiver's access to the facility or revoke a   caregiver's designation for a violation of Section 226.004.          (b)  Before restricting an essential caregiver's access or   revoking a caregiver's designation, a long-term care facility must   provide the caregiver with an opportunity to discuss the   restriction or revocation with facility staff, health care   providers, and the resident in an attempt to correct the violation.          SECTION 2.  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   Chapter 226, Health and Safety Code, as added by this Act.          SECTION 3.  This Act takes effect September 1, 2021.