89R2473 KKR-D
	By: Hall	S.B. No. 124

	A BILL TO BE ENTITLED
	AN ACT
	relating to hospital patients' rights and hospital policies and
	procedures; providing an administrative penalty.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Chapter 241, Health and Safety Code, is amended
	by adding Subchapter N to read as follows:
	SUBCHAPTER N. HOSPITAL PATIENTS' RIGHTS; HOSPITAL POLICIES AND
	PROCEDURES RELATED TO PATIENTS' RIGHTS
	Sec. 241.451.  DEFINITION. In this subchapter, "hospital"
	includes a hospital providing comprehensive medical rehabilitation
	services, chemical dependency services, and mental health
	services.
	Sec. 241.452.  PATIENTS' RIGHTS POLICY. (a) Each hospital
	shall adopt, implement, and enforce a written policy to ensure the
	rights of the hospital's patients. The policy must provide that
	each patient has a right to:
	(1)  the hospital's reasonable response to the
	patient's requests and needs for treatment or service, to the
	extent the request or need is within the hospital's capacity and
	stated mission and is allowed by law;
	(2)  considerate and respectful care that accounts for
	the psychosocial, spiritual, and cultural variables influencing
	the perceptions of illness without any bullying or shaming by
	hospital or medical staff;
	(3)  to the extent feasible, treatment by the patient's
	choice of physician;
	(4)  unrestricted visitation by at least one individual
	at any given time, including during a qualifying period of disaster
	as defined by Section 241.012;
	(5)  use as prescribed by the patient's physician of
	choice of:
	(A)  a prescription drug the United States Food
	and Drug Administration has approved for use but prescribed for a
	use other than the approved use; or
	(B)  a complementary or alternative medical
	treatment, regardless of the United States Food and Drug
	Administration's approval of the treatment;
	(6)  for terminally ill patients, access and use
	certain investigational drugs, biological products, and devices
	that are in clinical trials in accordance with this state's Right to
	Try Act under Chapter 489, including to the extent allowed by
	federal law during a qualifying period of disaster as defined by
	Section 241.012;
	(7)  care that optimizes the comfort and dignity of a
	patient who is dying through:
	(A)  treating primary and secondary symptoms that
	are responsive to treatment as the patient or the patient's
	surrogate decision-maker determines;
	(B)  effectively managing pain; and
	(C)  acknowledging the psychosocial and spiritual
	concerns of the patient and the patient's family regarding dying
	and the expression of grief by the patient and the patient's family;
	(8)  in collaboration with the patient's physician,
	make decisions involving the patient's health care, including the
	right to:
	(A)  accept or refuse treatment to the extent
	permitted by law and be informed of the medical consequence of
	refusing treatment;
	(B)  execute an advanced directive and
	periodically review the directive as provided by Section 241.457;
	(C)  appoint a surrogate to make health care
	decisions on the patient's behalf; and
	(D)  receive care that is not conditioned on the
	existence of the directive;
	(9)  be provided information necessary for the patient
	to make informed treatment decisions that reflect the patient's
	wishes;
	(10)  be provided at the time of admission information
	about the hospital's:
	(A)  patients' rights policy; and
	(B)  process for initiating, reviewing, and
	resolving as feasible patient complaints about quality of care;
	(11)  participate or have the patient's designated
	surrogate decision-maker participate in the consideration of
	ethical issues arising in the patient's care;
	(12)  be informed of any human experimentation or other
	research or educational project that affects the patient's care or
	treatment;
	(13)  personal privacy and confidentiality of the
	patient's information to the extent permitted by law; and
	(14)  access the information contained in the patient's
	medical records.
	(b)  To the extent allowed by law, a patient's guardian, next
	of kin, or other legally authorized surrogate decision-maker has
	the right to exercise the patient's rights under Subsection (a) if
	the patient:
	(1)  has been found to be incompetent by a court of law;
	(2)  is found by the patient's physician to be medically
	incapable of understanding the proposed procedure or treatment;
	(3)  is unable to communicate the patient's wishes
	regarding treatment; or
	(4)  is a minor.
	Sec. 241.453.  PATIENTS' RIGHTS POLICY FOR HOSPITALS
	PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. A
	hospital providing comprehensive medical rehabilitation services
	must include in the hospital's patients' rights policy adopted
	under Section 241.452 that each minor patient has the right to:
	(1)  appropriate treatment in the least restrictive
	setting available;
	(2)  decline unnecessary or excessive medication;
	(3)  an individualized treatment plan that is developed
	with the patient's participation;
	(4)  a humane treatment environment that provides
	reasonable protection from harm and appropriate privacy for
	personal needs;
	(5)  accommodations separated from adult patient
	accommodations; and
	(6)  regular communication with the patient's family.
	Sec. 241.454.  EFFECT ON OTHER REQUIREMENTS FOR CERTAIN
	HOSPITALS. A hospital patients' rights policy adopted under this
	subchapter by a hospital providing chemical dependency services or
	mental health services is in addition to any other patients' rights
	policy required by law or commission rules.
	Sec. 241.455.  REQUIRED DISPLAY OF PATIENTS' RIGHTS POLICY.
	(a) A hospital shall prominently and conspicuously display the
	hospital's patients' rights policy in a public area readily
	accessible to hospital patients, residents, visitors, and
	employees.
	(b)  A hospital that provides comprehensive medical
	rehabilitation services, chemical dependency services, or mental
	health services must display the patients' rights policy in English
	and in a language other than English that is appropriate to the
	demographic composition of the community the hospital serves.
	Sec. 241.456.  NOTICE OF PATIENTS' RIGHTS BY HOSPITAL
	PROVIDING COMPREHENSIVE MEDICAL REHABILITATION SERVICES. (a) This
	section applies only to a hospital that provides comprehensive
	medical rehabilitation services.
	(b)  Before admitting or accepting for evaluation any
	patient, a hospital to which this section applies shall provide to
	the patient and, if applicable, to the patient's parent, managing
	conservator, or guardian, a written copy of the hospital's
	patients' rights policy and as feasible provide the copy in the
	patient's primary language.
	(c)  The hospital shall ensure that within two hours, or as
	soon as reasonably possible within eight hours, after the time a
	patient is admitted to the hospital, the hospital's patients'
	rights policy is orally explained to the patient or, if
	appropriate, the patient's parent, managing conservator, or
	guardian. The explanation must be given in simple nontechnical
	terms and as feasible in the individual's primary language. The
	hospital may use other reasonable means to explain the policy to an
	individual with a vision or hearing impairment.
	(d)  Except as provided by Subsection (e), the hospital shall
	obtain a copy of the hospital's patients' rights policy signed by
	the patient or, if appropriate, the patient's parent, managing
	conservator, or guardian. The signed copy must:
	(1)  include a statement by the patient or other
	individual acknowledging the patient or individual read the policy
	and understands the specified rights; and
	(2)  be placed in the patient's medical record.
	(e)  If a patient is unable to comprehend the information
	contained in the hospital's patients' rights policy because of
	illness, age, or other factors, an emergency precludes a timely
	explanation of the policy, or the patient refuses to sign the policy
	as required under Subsection (d), the hospital may satisfy the
	requirements of Subsections (c) and (d) by:
	(1)  explaining the policy to the patient with two
	hospital staff members serving as witnesses; and
	(2)  placing the unsigned copy in the patient's medical
	record with a written notation signed by the witnesses explaining
	the reason the patient did not sign the policy.
	Sec. 241.457.  ADVANCED DIRECTIVE PROCEDURES. A hospital
	shall:
	(1)  establish procedures for:
	(A)  determining at the time a patient is admitted
	to the hospital whether the patient has executed an advanced
	directive; and
	(B)  if appropriate, assisting in the development
	of an advanced directive for the patient;
	(2)  include any executed advanced directive in the
	patient's medical record; and
	(3)  periodically review the patient's advanced
	directive with the patient or the patient's surrogate
	decision-maker, as appropriate.
	Sec. 241.458.  POLICY ON INFORMED TREATMENT DECISIONS. A
	hospital shall adopt, implement, and enforce a written policy for
	ensuring a patient makes informed treatment decisions. The policy
	must be consistent with state and federal law and any other
	applicable legal requirements.
	Sec. 241.459.  ETHICAL ISSUES FOR PATIENT CARE. A hospital
	shall establish procedures for considering ethical issues that
	arise in a patient's care and provide education on health care
	ethical issues to patients and their caregivers.
	Sec. 241.460.  ADMINISTRATIVE PENALTY. (a) The commission
	shall assess an administrative penalty in the amount of $1,000
	against a hospital for each violation of this subchapter or rules
	adopted under this subchapter. Each day a violation continues or
	occurs may be considered a separate violation for purposes of
	imposing a penalty.
	(b)  The enforcement of the penalty may be stayed during the
	time the order is under judicial review if the hospital pays the
	penalty to the clerk of the court or files a supersedeas bond with
	the court in the amount of the penalty.
	(c)  The attorney general may sue to collect the penalty.
	(d)  A proceeding to impose the penalty is considered to be a
	contested case under Chapter 2001, Government Code.
	Sec. 241.461.  RULES. The executive commissioner shall
	adopt rules to implement this subchapter.
	SECTION 2.  Section 164.009(a), Health and Safety Code, is
	amended to read as follows:
	(a)  A treatment facility may not admit a patient to its
	facilities without fully disclosing to the patient or, if the
	patient is a minor, the patient's parent, managing conservator, or
	guardian, in, if possible, the primary language of the patient,
	managing conservator, or guardian, as the case may be, the
	following information in writing before admission:
	(1)  the treatment facility's estimated average daily
	charge for inpatient treatment with an explanation that the patient
	may be billed separately for services provided by mental health
	professionals;
	(2)  the name of the attending physician, if the
	treatment facility is a mental health facility, or the name of the
	attending mental health professional, if the facility is a chemical
	dependency facility; and
	(3)  the current patients' rights policy as required
	under Subchapter N, Chapter 241, and any ["patient's bill of
	rights" as adopted by the executive commissioner that sets out]
	restrictions to the patient's freedom that may be imposed on the
	patient during the patient's stay in a treatment facility.
	SECTION 3.  Section 241.004, Health and Safety Code, is
	amended to read as follows:
	Sec. 241.004.  EXEMPTIONS. Except as otherwise provided by
	Subchapter N, this [This] chapter does not apply to a facility:
	(1)  licensed under Chapter 242 or 577;
	(2)  maintained or operated by the federal government
	or an agency of the federal government; or
	(3)  maintained or operated by this state or an agency
	of this state.
	SECTION 4.  Sections 321.002(a) and (b), Health and Safety
	Code, are amended to read as follows:
	(a)  The executive commissioner by rule shall adopt a
	"patient's bill of rights" that includes the applicable rights
	included in this chapter, the rights described by Subchapter N,
	Chapter 241, and other rights provided by Subtitle C of Title 7,
	Chapters 241, 462, 464, and 466, and any other provisions the
	executive commissioner considers necessary to protect the health,
	safety, and rights of a patient receiving voluntary or involuntary
	mental health, chemical dependency, or comprehensive medical
	rehabilitation services in an inpatient facility.  In addition,
	the executive commissioner shall adopt rules that[:
	[(1)]  provide standards to prevent the admission of a
	minor to a facility for treatment of a condition that is not
	generally recognized as responsive to treatment in an inpatient
	treatment setting[; and
	[(2)  prescribe the procedure for presenting the
	applicable bill of rights and obtaining each necessary signature
	if:
	[(A)  the patient cannot comprehend the
	information because of illness, age, or other factors; or
	[(B)  an emergency exists that precludes
	immediate presentation of the information].
	(b)  The executive commissioner by rule shall adopt a
	"children's bill of rights" for a minor receiving treatment in a
	child-care facility for an emotional, mental health, or chemical
	dependency problem that includes the rights described by Subchapter
	N, Chapter 241.
	SECTION 5.  Sections 321.002(c), (d), and (f), Health and
	Safety Code, are repealed.
	SECTION 6.  (a) Notwithstanding Subchapter N, Chapter 241,
	Health and Safety Code, as added by this Act, a hospital is not
	required to comply with that subchapter until January 1, 2026.
	(b)  As soon as practicable after the effective date of this
	Act, the executive commissioner of the Health and Human Services
	Commission shall adopt the rules necessary to implement Subchapter
	N, Chapter 241, 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.