HBA-NMO H.B. 1270 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1270
By: Lewis, Glenn
Public Health
3/8/1999
Introduced





BACKGROUND AND PURPOSE 

Currently, if an adult patient fails to designate someone to make health
care decisions for the patient in the case of incapacity, the law provides
a prioritized list of surrogate decision makers.  Problems may occur when
no family member is able or willing to make health care decisions, no other
person is clearly identified prior to incapacitation to act for the
patient, and the last priority, a member of the clergy, is not willing to
make health care decisions.   

H.B. 1270 adds to the prioritized list of health care decision-making
surrogates, before a member of the clergy, an adult who the attending
physician determines has had substantial past contact with the patient
sufficient to warrant decision-making; and, after a member of the clergy, a
surrogate decision-making committee established by a hospital or nursing
home.  This bill further authorizes a hospital or nursing home to establish
such a committee, and requires the Texas Board of Human Services to adopt
rules governing the appointment of such a committee. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Board of Human Services in
SECTION 3 (Section 313.008, Health and Safety Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 313.004(a), Health and Safety Code, by adding to
the prioritized list of persons who are authorized to consent to medical
treatment on behalf of an incapacitated adult patient in a hospital or
nursing home, before the last priority member of the clergy, another adult
who the attending physician determines has had substantial past contact
with the patient sufficient to warrant standing to such consent; and, after
a member of the clergy, the surrogate decision-making committee established
by the hospital or nursing home under Section 313.008, Health and Safety
Code. 

SECTION 2.  Amends Section 313.007(a), Health and Safety Code, to make a
conforming change. 

SECTION 3.  Amends Chapter 313, Health and Safety Code, by adding Section
313.008, as follows: 

Sec. 313.008.  SURROGATE DECISION-MAKING COMMITTEE.  Authorizes a hospital
or nursing home to establish an independent surrogate decision-making
committee to act on behalf of a patient under Section 313.004.  Requires
the Texas Board of Human Services to adopt rules governing the appointment
of a surrogate decision-making committee.  Provides that the rules must
govern the appointment of committee members and ensure the independence of
each committee member and govern the minimum number of committee members. 

SECTION 4.  Effective date: September 1, 1999.  
            Makes application of this Act prospective to January 1, 2000.

 SECTION 5.  Requires the Texas Board of Human Services to adopt rules as
required by Section 313.008, Health and Safety Code, not later than
December 15, 1999. 

SECTION 6.  Emergency clause.