This website will be unavailable from Thursday, May 30, 2024 at 6:00 p.m. through Monday, June 3, 2024 at 7:00 a.m. due to data center maintenance.

 
 
  S.B. No. 288
 
 
 
 
AN ACT
  relating to the reporting of health care-associated infections at
  certain health care facilities and the creation of an advisory
  panel.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle D, Title 2, Health and Safety Code, is
  amended by adding Chapter 98 to read as follows:
  CHAPTER 98.  REPORTING OF HEALTH CARE-ASSOCIATED INFECTIONS
  SUBCHAPTER A.  GENERAL PROVISIONS
         Sec. 98.001.  DEFINITIONS.  In this chapter:
               (1)  "Advisory panel" means the Advisory Panel on
  Health Care-Associated Infections.
               (2)  "Ambulatory surgical center" means a facility
  licensed under Chapter 243.
               (3)  "Commissioner" means the commissioner of state
  health services.
               (4)  "Department" means the Department of State Health
  Services.
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (6)  "General hospital" means a general hospital
  licensed under Chapter 241 or a hospital that provides surgical or
  obstetrical services and that is maintained or operated by this
  state. The term does not include a comprehensive medical
  rehabilitation hospital.
               (7)  "Health care-associated infection" means a
  localized or symptomatic condition resulting from an adverse
  reaction to an infectious agent or its toxins to which a patient is
  exposed in the course of the delivery of health care to the patient.
               (8)  "Health care facility" means a general hospital or
  an ambulatory surgical center.
               (9)  "Infection rate" means the number of health
  care-associated infections of a particular type at a health care
  facility divided by a numerical measure over time of the population
  at risk for contracting the infection, unless the term is modified
  by rule of the executive commissioner to accomplish the purposes of
  this chapter.
               (10)  "Pediatric and adolescent hospital" has the
  meaning assigned by Section 241.003.
               (11)  "Reporting system" means the Texas Health
  Care-Associated Infection Reporting System.
               (12)  "Special care setting" means a unit or service of
  a general hospital that provides treatment to inpatients who
  require extraordinary care on a concentrated and continuous basis.  
  The term includes an adult intensive care unit, a burn intensive
  care unit, and a critical care unit.
         Sec. 98.002.  APPLICABILITY OF OTHER LAW.  Chapter 2110,
  Government Code, does not apply to the advisory panel created under
  Subchapter B.
  [Sections 98.003-98.050 reserved for expansion]
  SUBCHAPTER B.  ADVISORY PANEL
         Sec. 98.051.  ESTABLISHMENT.  The commissioner shall
  establish the Advisory Panel on Health Care-Associated Infections
  within the infectious disease surveillance and epidemiology branch
  of the department to guide the implementation, development,
  maintenance, and evaluation of the reporting system.
         Sec. 98.052.  MEMBERSHIP; TERM.  (a)  The advisory panel is
  composed of 16 members as follows:
               (1)  two infection control professionals who:
                     (A)  are certified by the Certification Board of
  Infection Control and Epidemiology; and
                     (B)  are practicing in hospitals in this state, at
  least one of which must be a rural hospital;
               (2)  two infection control professionals who:
                     (A)  are certified by the Certification Board of
  Infection Control and Epidemiology; and
                     (B)  are nurses licensed to engage in professional
  nursing under Chapter 301, Occupations Code;
               (3)  three board-certified or board-eligible
  physicians who:
                     (A)  are licensed to practice medicine in this
  state under Chapter 155, Occupations Code, at least two of whom have
  active medical staff privileges at a hospital in this state and at
  least one of whom is a pediatric infectious disease physician with
  expertise and experience in pediatric health care epidemiology;
                     (B)  are active members of the Society for
  Healthcare Epidemiology of America; and
                     (C)  have demonstrated expertise in infection
  control in health care facilities;
               (4)  two professionals in quality assessment and
  performance improvement, one of whom is employed by a general
  hospital and one of whom is employed by an ambulatory surgical
  center;
               (5)  one officer of a general hospital;
               (6)  one officer of an ambulatory surgical center;
               (7)  three nonvoting members who are department
  employees representing the department in epidemiology and the
  licensing of hospitals or ambulatory surgical centers; and
               (8)  two members who represent the public as consumers.
         (b)  Members of the advisory panel serve two-year terms.
         Sec. 98.053.  MEMBER ELIGIBILITY.  (a)  A person may not be a
  member of the advisory panel if the person is required to register
  as a lobbyist under Chapter 305, Government Code, because of the
  person's activities for compensation on behalf of a profession
  related to health care.
         (b)  A person may not be a member of the advisory panel if the
  person is an officer, employee, or paid consultant of a Texas trade
  association in the field of health care.
         Sec. 98.054.  OFFICERS.  The members of the advisory panel
  shall elect a presiding officer and an assistant presiding officer
  from among the members.  The officers serve two-year terms.
         Sec. 98.055.  COMPENSATION; EXPENSES.  Members of the
  advisory panel serve without compensation but are entitled to
  reimbursement of the travel expenses incurred by the member while
  conducting the business of the advisory panel from department
  funds, in accordance with the General Appropriations Act.
         Sec. 98.056.  VACANCY.  A vacancy on the advisory panel shall
  be filled by the commissioner.
  [Sections 98.057-98.100 reserved for expansion]
  SUBCHAPTER C.  DUTIES OF DEPARTMENT AND ADVISORY PANEL; REPORTING
  SYSTEM
         Sec. 98.101.  RULEMAKING.  (a)  The executive commissioner
  may adopt rules for the department to implement this chapter.
         (b)  The executive commissioner may not adopt rules that
  conflict with or duplicate any federally mandated infection
  reporting program or requirement.
         Sec. 98.102.  DEPARTMENTAL RESPONSIBILITIES; REPORTING
  SYSTEM.  (a)  The department shall establish the Texas Health
  Care-Associated Infection Reporting System within the infectious
  disease surveillance and epidemiology branch of the department.  
  The purpose of the reporting system is to provide for:
               (1)  the reporting of health care-associated
  infections by health care facilities to the department;
               (2)  the public reporting of information regarding the
  health care-associated infections by the department; and
               (3)  the education and training of health care facility
  staff by the department regarding this chapter.
         (b)  The reporting system shall provide a mechanism for this
  state to collect data, at state expense, through a secure
  electronic interface with health care facilities.
         (c)  The data reported by health care facilities to the
  department must contain sufficient patient identifying information
  to:
               (1)  avoid duplicate submission of records;
               (2)  allow the department to verify the accuracy and
  completeness of the data reported; and
               (3)  allow the department to risk adjust the
  facilities' infection rates.
         (d)  The department shall review the infection control and
  reporting activities of health care facilities to ensure the data
  provided by the facilities is valid and does not have unusual data
  patterns or trends that suggest implausible infection rates.
         Sec. 98.103.  REPORTABLE INFECTIONS.  (a)  A health care
  facility, other than a pediatric and adolescent hospital, shall
  report to the department the incidence of surgical site infections
  occurring in the following procedures:
               (1)  colon surgeries;
               (2)  hip arthroplasties;
               (3)  knee arthroplasties;
               (4)  abdominal hysterectomies;
               (5)  vaginal hysterectomies;
               (6)  coronary artery bypass grafts; and
               (7)  vascular procedures.
         (b)  A pediatric and adolescent hospital shall report the
  incidence of surgical site infections occurring in the following
  procedures to the department:
               (1)  cardiac procedures, excluding thoracic cardiac
  procedures;
               (2)  ventriculoperitoneal shunt procedures; and
               (3)  spinal surgery with instrumentation.
         (c)  A general hospital shall report the following to the
  department:
               (1)  the incidence of laboratory-confirmed central
  line-associated primary bloodstream infections occurring in any
  special care setting in the hospital; and
               (2)  the incidence of respiratory syncytial virus
  occurring in any pediatric inpatient unit in the hospital.
         (d)  The department shall ensure that the health
  care-associated infections a health care facility is required to
  report under this section have the meanings assigned by the federal
  Centers for Disease Control and Prevention.
         Sec. 98.104.  ALTERNATIVE FOR REPORTABLE SURGICAL SITE
  INFECTIONS.  A health care facility that does not perform at least
  an average of 50 procedures per month of the procedures listed in
  Section 98.103(a) or (b), as modified under Section 98.105, is not
  required to comply with the reporting requirements of Section
  98.103 but instead shall report to the department the surgical site
  infections relating to the three surgical procedures most
  frequently performed at the facility, based on the list of surgical
  procedures promulgated by the federal Centers for Disease Control
  and Prevention's National Healthcare Safety Network or its
  successor.
         Sec. 98.105.  REPORTING SYSTEM MODIFICATIONS.  Based on the
  recommendations of the advisory panel, the executive commissioner
  by rule may modify in accordance with this chapter the list of
  procedures that are reportable under Section 98.103 or 98.104.  The
  modifications must be based on changes in reporting guidelines and
  in definitions established by the federal Centers for Disease
  Control and Prevention.
         Sec. 98.106.  DEPARTMENTAL SUMMARY.  (a)  The department
  shall compile and make available to the public a summary, by health
  care facility, of the infections reported by facilities under
  Sections 98.103 and 98.104.
         (b)  The departmental summary must be risk adjusted and
  include a comparison of the risk-adjusted infection rates for each
  health care facility in this state that is required to submit a
  report under Sections 98.103 and 98.104.
         (c)  In consultation with the advisory panel, the department
  shall publish the departmental summary in a format that is easy to
  read.
         (d)  The department shall publish the departmental summary
  at least annually and may publish the summary more frequently as the
  department considers appropriate.
         (e)  The executive commissioner by rule shall allow a health
  care facility to submit concise written comments regarding
  information contained in the departmental summary that relates to
  the facility.  The department shall attach the facility's comments
  to the public report and the comments must be in the same format as
  the summary.
         (f)  The disclosure of written comments to the department by
  a health care facility as provided by Subsection (e) does not
  constitute a waiver of a privilege or protection under Section
  98.109.
         (g)  The department shall make the departmental summary
  available on an Internet website administered by the department and
  may make the summary available through other formats accessible to
  the public.  The website must contain a statement informing the
  public of the option to report suspected health care-associated
  infections to the department.
         Sec. 98.107.  EDUCATION AND TRAINING REGARDING REPORTING
  SYSTEM.  The department shall provide education and training for
  health care facility staff regarding this chapter.  The training
  must be reasonable in scope and focus primarily on:
               (1)  the implementation and management of a facility
  reporting mechanism;
               (2)  characteristics of the reporting system,
  including public reporting by the department and facility reporting
  to the department;
               (3)  confidentiality; and
               (4)  legal protections.
         Sec. 98.108.  FREQUENCY OF REPORTING.  In consultation with
  the advisory panel, the executive commissioner by rule shall
  establish the frequency of reporting by health care facilities
  required under Sections 98.103 and 98.104.  Facilities may not be
  required to report more frequently than quarterly.
         Sec. 98.109.  CONFIDENTIALITY; PRIVILEGE.  (a)  Except as
  provided by Sections 98.106 and 98.110, all information and
  materials obtained or compiled or reported by the department under
  this chapter or compiled or reported by a health care facility under
  this chapter, and all related information and materials, are
  confidential and:
               (1)  are not subject to disclosure under Chapter 552,
  Government Code, or discovery, subpoena, or other means of legal
  compulsion for release to any person; and
               (2)  may not be admitted as evidence or otherwise
  disclosed in any civil, criminal, or administrative proceeding.
         (b)  The confidentiality protections under Subsection (a)
  apply without regard to whether the information or materials are
  obtained from or compiled or reported by a health care facility or
  an entity that has an ownership or management interest in a
  facility.
         (c)  The transfer of information or materials under this
  chapter is not a waiver of a privilege or protection granted under
  law.
         (d)  The provisions of this section regarding the
  confidentiality of information or materials compiled or reported by
  a health care facility in compliance with or as authorized under
  this chapter do not restrict access, to the extent authorized by
  law, by the patient or the patient's legally authorized
  representative to records of the patient's medical diagnosis or
  treatment or to other primary health records.
         (e)  A department summary or disclosure may not contain
  information identifying a facility patient, employee, contractor,
  volunteer, consultant, health care professional, student, or
  trainee in connection with a specific infection incident.
         Sec. 98.110.  DISCLOSURE WITHIN DEPARTMENT.  
  Notwithstanding any other law, the department may disclose
  information reported by health care facilities under Section 98.103
  or 98.104 to other programs within the department for public health
  research or analysis purposes only, provided that the research or
  analysis relates to health care-associated infections.  The
  privilege and confidentiality provisions contained in this chapter
  apply to such disclosures.
         Sec. 98.111.  CIVIL ACTION.  Published infection rates may
  not be used in a civil action to establish a standard of care
  applicable to a health care facility.
  [Sections 98.112-98.150 reserved for expansion]
  SUBCHAPTER D.  ENFORCEMENT
         Sec. 98.151.  VIOLATIONS. (a)  Except as provided by
  Subsection (b), a general hospital that violates this chapter or a
  rule adopted under this chapter is subject to the enforcement
  provisions of Subchapter C, Chapter 241, and rules adopted and
  enforced under that subchapter as if the hospital violated Chapter
  241 or a rule adopted under that chapter.
         (b)  Subsection (a) does not apply to a comprehensive medical
  rehabilitation hospital as defined in Section 241.003.
         (c)  An ambulatory surgical center that violates this
  chapter or a rule adopted under this chapter is subject to the
  enforcement provisions of Chapter 243 and rules adopted and
  enforced under that chapter as if the center violated Chapter 243 or
  a rule adopted under that chapter.
         SECTION 2.  Not later than June 1, 2008, the Department of
  State Health Services shall establish the Texas Health
  Care-Associated Infection Reporting System as required under
  Chapter 98, Health and Safety Code, as added by this Act.
         SECTION 3.  (a)  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 and procedures necessary
  to implement Chapter 98, Health and Safety Code, as added by this
  Act.
         (b)  As soon as practicable after the effective date of this
  Act, the commissioner of state health services shall appoint
  members to the Advisory Panel on Health Care-Associated Infections
  as required by Chapter 98, Health and Safety Code, as added by this
  Act.
         SECTION 4.  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, 2007.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 288 passed the Senate on
  April 4, 2007, by the following vote: Yeas 30, Nays 0; and that
  the Senate concurred in House amendment on May 15, 2007, by the
  following vote: Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 288 passed the House, with
  amendment, on May 3, 2007, by the following vote: Yeas 141,
  Nays 0, one present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor