HBA-NLM C.S.H.B. 1677 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1677 By: Janek Human Services 3/15/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Currently, two vaccines are available which can decrease morbidity and mortality due to pneumonia in the elderly. The influenza and pneumococcal vaccines are both covered by Medicare and Medicaid for anyone over the age of 65. Despite their availability, many elderly adults do not receive these recommended immunizations. As adults become older and more susceptible to infections the vaccines become less effective; therefore, it is recommended to immunize elderly persons in nursing homes as well as persons who reside or work in the same environment. C.S.H.B. 1677 authorizes the Texas Board of Health (board), by rule, to require nursing homes to offer immunizations to elderly residents or to staff who are in contact with elderly residents against diseases that the board determines to be caused by infectious agents, potentially deadly, and preventable by vaccine. This bill also requires the board to require nursing homes to offer pneumococcal vaccine to elderly residents and influenza vaccine to residents and staff. This bill requires the Texas Board of Human Services, which regulates nursing homes, to adopt the Texas Board of Health's licensing rules and standards for nursing homes. C.S.H.B. 1677 also requires the Texas Department of Health (TDH) to coordinate with the Texas Department of Human Services (TDHS) in developing rules to ensure consistency with federal and state laws and regulations relating to nursing home infection control programs. This bill requires TDH or TDHS to develop new nursing facility documentation requirements with the input from the nursing home industry. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 1 (Section 161.0051, Health and Safety Code) and to the Texas Board of Human Services in SECTION 2 (Section 242.037, Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter A, Chapter 161, Health and Safety Code, by adding Section 161.0051, as follows: Sec. 161.0051. REQUIRED IMMUNIZATIONS FOR NURSING HOMES. Provides that this section only applies to a nursing home that is an institution licensed under Chapter 242 (Convalescent and Nursing Homes and Related Institutions), and serves residents who are elderly persons as defined by Section 242.002 (Definitions). Section 242.002 defines elderly person as an individual who is 65 years of age or older. Authorizes the Texas Board of Health (board), by rule, to require nursing homes to offer, in accordance with an immunization schedule adopted by the board, immunizations to elderly residents or to staff who are in contact with elderly residents against diseases that the board determines to be caused by infectious agents, potentially deadly, and preventable by vaccine. Requires the board, by rule, to require nursing homes to offer, in accordance with an immunization schedule adopted by the board, pneumococcal vaccine to elderly residents, and influenza vaccine to elderly residents and to staff who are in contact with elderly residents. SECTION 2. Amends Section 242.037, Health and Safety Code, by adding Subsection (h), to require the Texas Board of Human Services to adopt each rule adopted by the Texas Board of Health under Section 161.0051 as part of the rules and standards adopted under this chapter that apply to institutions serving residents who are elderly persons. SECTION 3. Requires the Texas Department of Health (TDH) to coordinate with the Texas Department of Human Services (TDHS) in developing the rules needed to implement the provisions of this Act, to ensure: _TDH's rules related to immunization schedules for nursing home residents and staff are not inconsistent with federal and state laws and regulations relating to nursing home infection control programs; and _new nursing facility documentation requirements by TDH or TDHS resulting from the implementation of this Act are developed with nursing home industry input and are promptly disseminated to nursing homes upon adoption by the agencies. SECTION 4. Effective date: September 1, 1999. SECTION 5. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 1677 modifies the original by adding a new SECTION 3 to require the Texas Department of Health (TDH) to coordinate with the Texas Department of Human Services (TDHS) in developing rules for the implementation of the provisions of C.S.H.B. 1677. This is to ensure that TDH's rules related to immunization schedules for nursing home residents and staff are not inconsistent with federal and state laws and regulations related to nursing home infection control programs; and to ensure that new nursing facility documentation requirements by TDH or TDHS are developed with nursing home industry input and are promptly disseminated to nursing homes upon adoption by the agencies. C.S.H.B. 1677 modifies the original by redesignating SECTION 3 to SECTION 4 and by redesignating existing SECTION 4 to new SECTION 5.