Bill of the Week HB 892

This graphic has a blue capitol building on the left. The blue text on the banner reads Bill of The Week House Bill 892

For this weekly feature, the Texas Council for Developmental Disabilities (TCDD) profiles a noteworthy bill that is currently going through the legislative process. The bill may relate directly to TCDD’s Public Policy Priorities or another disability-related issue.

Bill: House Bill (HB) 892, relating to the right of certain facility residents to designate an essential caregiver for in-person visitation.

Bill Author: Rep. James Frank, Texas House District 69 (Wichita Falls)

What does the bill do?
HB 892 would provide residents of long-term care facilities such as nursing homes, assisted-living facilities, and state-supported living centers (SSLCs) the right to designate at least one essential caregiver with whom the facility may not prohibit in-person visitation. The bill defines an essential caregiver as a family member, friend, or other individual selected by the facility resident for in-person visits.

Under the terms of the bill, the executive commissioner of the Texas Health and Human Services Commission would assist facilities in establishing visitation policies, including:

  • Allowing residents to designate at least one essential caregiver for in-person visits and more than one if needed
  • Establishing a schedule that allows the caregiver to visit the resident for two hours each day or the necessary amount of time to complete caregiving tasks
  • Establishing procedures to enable personal contact between the resident and essential caregiver while still requiring social distancing between the caregiver and facility staff
  • Obtaining a signed acknowledgment from the essential caregiver stating they agree to the facility’s safety protocols, including: wearing personal protective equipment during the visit; completing a health screening before entering the facility; submitting to regular viral testing; and monitoring symptoms, practicing social distancing, and limiting contact with individuals outside of the facility
  • Establishing a visitors log for contact tracing

If passed, the bill would take effect on Sept. 1, 2021.

Background information:
In March 2020, shortly after the onset of the COVID-19 pandemic, the state’s long-term care facilities were abruptly closed to in-person visitors. Instituted as a safety precaution to help prevent the spread of the virus throughout the facilities, the closures generally prevented residents from seeing family members and loved ones for months. Visitation was restored for nursing homes and assisted-living facilities in August 2020, but such restoration did not occur in SSLCs for a number of weeks after that. The impacts of the isolation were of great concern to family members and advocates. One TCDD Council Member was unable to visit his daughter, an SSLC resident, for over five months. He indicated that “the length of time had … surpassed what is mentally acceptable in my opinion,” and described the situation as “inhumane.”

Statement from the bill author, Rep. James Frank: 

Photo of Representative James Frank smiling, wearing a yellow tie shirt and black blazer.

“I was heartbroken at the dozens of stories I have heard over the last year of a spouse, parent, or child who died after living their final months in isolation or who was the victim of abuse or neglect in a facility because no one could physically gain access to them. The Legislature can ensure that this type of isolation is not allowed again in our great state.

Where is the bill in the process?
On March 9, 2021, HB 892 was heard by the House Committee on Human Services and was left pending. When a bill is left pending, this means that the committee did not vote on the bill and it could be considered again at a future committee meeting. You can watch the discussion on the bill here, beginning at the 01:08:00 mark.

Who supports the bill and why?
The following comments were taken from the March 9, 2021, public hearing of the House Committee on Human Services:

  • Independent Coalition of Nursing Home Providers: Kendra King, speaking in her role as executive director of the Duncanville Healthcare & Rehabilitation Center, a Nexion Health affiliate: “We believe [this bill] is a reasonable and necessary step to ensure our patients are able to bond with their families. Quality of life is so important for our residents.”

The following groups registered their support for the legislation but did not provide testimony: The Texas Catholic Conference of Bishops, Texas Right to Life, and the Citizens Commission on Human Rights.

Who opposes the bill and why?
No opposition to the bill was registered at the March 9 public hearing.

Additional testimony:
At the March 9 hearing, a number of organizations provided testimony on HB 892 while not supporting nor opposing the bill.

  • Long-term Care (LTC) Ombudsman: Patricia Ducayet offered remarks in her role as the LTC Ombudsman: “One thing the pandemic has really taught me is that family members visit for social reasons but there is also a significant number of family members that provide daily hands-on support in a long-term care facility. That was so extremely disrupted. The concept of essential caregiving is … grounded in our Office of Civil Rights in the federal level and tied to the Americans with Disabilities Act. It says that a person may need and may designate a person to act as their support person to receive health care services, for example.”
  • Texas Assisted Living Association (TALA): Diana Martinez spoke in her capacity as president and CEO of TALA. “This issue [has been] probably the most difficult issue that our members faced during the pandemic. At the end of the day, we need to remember that circumstances always dictate what the requirements are of communities. … One of our concerns [with the bill] is that there’s no flexibility to suspend visitation. This might not be the last emergency that our assisted living community will face. We don’t know what’s out there next time. Another [concern] is that there’s no mechanisms for preventing a specific designated visitor. The two hours per day, per visitor, is super staff-intensive, and you have to schedule it so they’re not all bunching up.”
  • Family Member: Genny Lutzel shared her perspective as the daughter of a facility resident: “On a good day, my mother would raise her hand to meet mine on the door. This was not a visit. … Every freedom and first line of defense was stripped from persons living in long-term care facilities. A new form of discrimination for persons with physical and mental challenges was born. … [While she did recover], it did not prevent my mom from getting COVID-19, but it erased 243 days of her freedom to live out her life with those who love her most.”
  • TCDD: Lauren Gerken, public policy analyst for TCDD, submitted written comments on the bill: “Due to COVID-19, the facility-imposed visitation restrictions exacerbated the isolation some people with disabilities already experience when living in a facility. … Over the last year, we have all learned the toll not seeing our loved ones takes, but for some people in long-term care facilities, there is nothing new about this normal.”

The following organizations also provided testimony on the bill: LeadingAge Texas, Texas Caregivers for Compromise, the Texas Medical Association, the Texas Health Care Association, and the American Association for Retired Persons.

How much will the bill cost?
The Legislative Budget Board (LBB) determined the bill would not increase the state’s budget in a significant way.

Is there a Senate companion to the bill?
Sen. Lois Kolkhorst has filed Senate Bill (SB) 25, an identical Senate companion to HB 892. The low bill number indicates that the measure is a priority item for Lt. Gov. Dan Patrick.

Related bills:
House Joint Resolution (HJR) 46, also by Rep. James Frank, would propose a constitutional amendment establishing a right for residents of long-term care facilities to designate an essential caregiver for in-person visitation. If approved by voters, it would enshrine the essential goal of HB 892 in the Texas Constitution. The companion for this bill is Senate Joint Resolution (SJR) 19.

Additionally, Rep. Ana Hernandez has filed HB 2897, which is identical to HB 892.

SB 1195 and SJR 48, both by Sen. Angela Paxton, would provide hospital patients with a similar right to designate an essential caregiver.

Stay informed:
For the latest information about where HB 892 is in the process, follow the bill on the Texas Legislature Online. To receive future legislative updates from TCDD, subscribe to TCDD eNews or follow us on Twitter.




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