HBA-NMO H.B. 3424 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 3424
By: Najera
Public Health
4/8/1999
Introduced



BACKGROUND AND PURPOSE 

Current law regulates the treatment of persons with mental illnesses.  Such
treatment includes the use of restraint, seclusion, and emergency
medication.  While some providers of mental health care are exploring and
implementing ways to reduce the use of restraint and seclusion, others see
these methods as necessary in justified situations.  H.B. 3424 regulates
the use of restraint, seclusion, and emergency medication in psychiatric
hospitals and long-term care facilities. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to an entity which regulates care and
treatment in nursing homes, public and private hospitals, intermediate care
facilities, personal care facilities, residential treatment centers, and
foster care facilities in SECTION 1 (Section 579.002, Health and Safety
Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Subtitle C, Title 7, Health and Safety Code, by adding
Chapter 579, as follows: 
 
CHAPTER 579.  USE OF RESTRAINT, SECLUSION AND EMERGENCY 
MEDICATION IN PSYCHIATRIC HOSPITALS AND 
LONG TERM CARE FACILITIES 
 
Sec. 579.001.  DEFINITIONS. Defines "chemical restraint," "emergency,"
"mechanical restraint," "seclusion," "supportive devices," "physical
restraint," "PRN," and "protective devices." 

Sec. 579.002.  IN GENERAL. Requires an entity which regulates care and
treatment in nursing homes, public and private hospitals, intermediate care
facilities, personal care facilities, residential treatment centers, and
foster care facilities to promulgate rules consistent with certain
standards under which physical restraint, mechanical restraint, seclusion,
emergency medication,  supportive devices, or protective devices can be
used. 
  
Sec. 579.003.  IMPLEMENTATION.  Sets forth the procedures for the
determination to use and the use of seclusion, physical restraint, or
mechanical restraints.   
  
Sec. 579.004.  USE OF SUPPORTIVE DEVICES.  Provides that the use of
supportive devices is considered adjunct to proper care of an individual,
but must be reviewed by the treatment team.  Provides for the development
of a plan to identify and overcome the need for the protective device.
Prohibits the use of supportive devices as a substitute for appropriate
nursing rehabilitative or habilitative care.  
 
Sec. 579.005.  USE OF PROTECTIVE DEVICES.   Authorizes the use of
protective devices to prevent self injury, but provides that the use must
be reviewed by the treatment team. Provides for the development of a plan
to identify and overcome the need for the protective device.   Prohibits
the use of  protective devices as a substitute for appropriate nursing
rehabilitative or habilitative care.  
  
Sec. 579.006.  REPORTS.  Requires the collection and analysis of data
relating to the administration of mechanical restraints, seclusion and
emergency medication by each regulating agency on a quarterly and annual
basis.  Provides for the submission of summary reports to the governor and
the presiding officer of each house of the legislature.  Requires the data
to include certain information.   
  
SECTION 2.  This Act takes effect September 1, 1999. 
 
SECTION 3.  Emergency clause.