S.B. No. 25
 
 
 
 
AN ACT
  relating to the right of certain residents to designate an
  essential caregiver for in-person visitation.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  It is the intent of the legislature to ensure
  that residents of long-term care facilities and other residences
  have a guaranteed right to visitation by family members, friends,
  caregivers, and other individuals. The legislature expects
  facilities and program providers to ensure that the guaranteed
  visitation rights are available to residents every day of each
  year, consistent with existing resident rights. The legislature
  intends for facilities and program providers to temporarily limit a
  resident's guaranteed visitation rights to in-person visitation by
  essential caregivers only during a declared public health
  emergency.
         SECTION 2.  Subtitle B, Title 4, Health and Safety Code, is
  amended by adding Chapter 260B to read as follows:
  CHAPTER 260B. RIGHT TO ESSENTIAL CAREGIVER VISITS 
  FOR CERTAIN RESIDENTS
         Sec. 260B.0001.  DEFINITIONS. In this chapter:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Essential caregiver" means a family member,
  friend, guardian, or other individual selected by a resident,
  resident's guardian, or resident's legally authorized
  representative for in-person visits.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4)  "Facility" means:
                     (A)  a nursing facility licensed under Chapter
  242;
                     (B)  an assisted living facility licensed under
  Chapter 247; or
                     (C)  an intermediate care facility for
  individuals with an intellectual disability licensed under Chapter
  252.
               (5)  "Program provider" means a person that provides
  services through the home and community-based services (HCS) waiver
  program in a residence.
               (6)  "Residence" means a three-person or four-person
  residence, as defined by the home and community-based services
  (HCS) waiver program billing guidelines, that is leased or owned by
  a program provider.  The term does not include a host home or
  companion care.
               (7)  "Resident" means:
                     (A)  an individual, including a patient, who
  resides in a facility; or
                     (B)  an individual enrolled in the home and
  community-based services (HCS) waiver program who resides in a
  residence.
         Sec. 260B.0002.  RESIDENT'S RIGHT TO ESSENTIAL CAREGIVER
  VISITS.  (a)  A resident, resident's guardian, or resident's legally
  authorized representative has the right to designate an essential
  caregiver with whom the facility or program provider may not
  prohibit in-person visitation.
         (b)  Notwithstanding Subsection (a), the executive
  commissioner by rule shall develop guidelines to assist facilities
  and program providers in establishing essential caregiver
  visitation policies and procedures.  The guidelines must require
  the facilities and program providers to:
               (1)  allow a resident, resident's guardian, or
  resident's legally authorized representative to designate for
  in-person visitation an essential caregiver in the same manner that
  a resident would designate a power of attorney;
               (2)  establish a visitation schedule allowing the
  essential caregiver to visit the resident for at least two hours
  each day;
               (3)  establish procedures to enable physical contact
  between the resident and essential caregiver; and
               (4)  obtain the signature of the essential caregiver
  certifying that the caregiver will follow the facility's or program
  provider's safety protocols and any other rules adopted under this
  section.
         (c)  A facility or program provider may revoke an
  individual's designation as an essential caregiver if the caregiver
  violates the facility's or provider's safety protocols or rules
  adopted under this section. If a facility or program provider
  revokes an individual's designation as an essential caregiver under
  this subsection, the resident, resident's guardian, or resident's
  legally authorized representative has the right to immediately
  designate another individual as the resident's essential
  caregiver. The commission by rule shall establish an appeals
  process to evaluate the revocation of an individual's designation
  as an essential caregiver under this subsection.
         (d)  Safety protocols adopted by a facility or program
  provider for an essential caregiver under this section may not be
  more stringent than safety protocols for the staff of the facility
  or residence.
         (e)  A facility or program provider may petition the
  commission to suspend in-person essential caregiver visits for not
  more than seven days if in-person visitation poses a serious
  community health risk. The commission may deny the facility's or
  program provider's request to suspend in-person essential
  caregiver visitation if the commission determines that in-person
  visitation does not pose a serious community health risk. A
  facility or program provider may request an extension from the
  commission to suspend in-person essential caregiver visitation for
  more than seven days. The commission may not approve an extension
  under this subsection for a period that exceeds seven days, and a
  facility or program provider must separately request each
  extension. A facility or program provider may not suspend
  in-person essential caregiver visitation in any year for a number
  of days that exceeds 14 consecutive days or a total of 45 days.
         (f)  This section may not be construed as requiring an
  essential caregiver to provide necessary care to a resident, and a
  facility or program provider may not require an essential caregiver
  to provide necessary care.
         SECTION 3.  Chapter 555, Health and Safety Code, is amended
  by adding Subchapter F to read as follows:
  SUBCHAPTER F. RIGHT TO ESSENTIAL CAREGIVER VISITS
         Sec. 555.201.  DEFINITION. In this chapter, "essential
  caregiver" means a family member, friend, guardian, or other
  individual selected by a resident, resident's guardian, or
  resident's legally authorized representative for in-person visits.
         Sec. 555.202.  RESIDENT'S RIGHT TO ESSENTIAL CAREGIVER
  VISITS.  (a)  A resident of a state supported living center, the
  resident's guardian, or the resident's legally authorized
  representative has the right to designate an essential caregiver
  with whom the center may not prohibit in-person visitation.
         (b)  Notwithstanding Subsection (a), the executive
  commissioner by rule shall develop guidelines to assist state
  supported living centers in establishing essential caregiver
  visitation policies and procedures.  The guidelines must require
  the centers to:
               (1)  allow a resident, resident's guardian, or
  resident's legally authorized representative to designate for
  in-person visitation an essential caregiver;
               (2)  establish a visitation schedule allowing the
  essential caregiver to visit the resident for at least two hours
  each day;
               (3)  establish procedures to enable physical contact
  between the resident and essential caregiver; and
               (4)  obtain the signature of the essential caregiver
  certifying that the caregiver will follow the center's safety
  protocols and any other rules adopted under this section.
         (c)  A state supported living center may revoke an
  individual's designation as an essential caregiver if the essential
  caregiver violates the center's safety protocols or rules adopted
  under this section. If a state supported living center revokes an
  individual's designation as an essential caregiver under this
  subsection, the resident, resident's guardian, or resident's
  legally authorized representative has the right to immediately
  designate another individual as the resident's essential
  caregiver. The commission by rule shall establish an appeals
  process to evaluate the revocation of an individual's designation
  as an essential caregiver under this subsection.
         (d)  Safety protocols adopted by a state supported living
  center for an essential caregiver under this section may not be more
  stringent than safety protocols for center staff.
         (e)  A state supported living center may petition the
  commission to suspend in-person essential caregiver visits for not
  more than seven days if in-person visitation poses a serious
  community health risk. The commission may deny the state supported
  living center's request to suspend in-person essential caregiver
  visitation if the commission determines that in-person visitation
  does not pose a serious community health risk. A state supported
  living center may request an extension from the commission to
  suspend in-person essential caregiver visitation for more than
  seven days. The commission may not approve an extension under this
  subsection for a period that exceeds seven days, and a state
  supported living center must separately request each extension. A
  state supported living center may not suspend in-person essential
  caregiver visitation in any year for a number of days that exceeds
  14 consecutive days or a total of 45 days. 
         (f)  This section may not be construed as requiring an
  essential caregiver to provide necessary care to a resident, and a
  state supported living center may not require an essential
  caregiver to provide necessary care.
         SECTION 4.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall prescribe the guidelines and adopt the
  rules required by Sections 260B.0002 and 555.202, Health and Safety
  Code, as added by this Act.
         SECTION 5.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 6.  This Act takes effect September 1, 2021.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 25 passed the Senate on    
  March 17, 2021, by the following vote: Yeas 29, Nays 0; and that
  the Senate concurred in House amendments on May 28, 2021, by the
  following vote: Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 25 passed the House, with
  amendments, on May 24, 2021, by the following vote: Yeas 144,
  Nays 0, one present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor