New Laws: Understanding House Bill 3595

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Assisted Living communities are required to have individualized emergency preparedness policies that reflect the specific needs of the building’s residents, the risks present in the community’s geographic area, local regulations/local government rules, and the company’s policies and procedures. Due to several recent widespread weather events, the Texas Health and Human Services has determined that all communities need to prepare for the risk of an extended power outage.

This explainer is not an exhaustive resource, and it should not be used to replace existing emergency preparedness policies and procedures.

Background

Texas’s extensive emergency preparedness regulations are found in 26 Part 1 Tex. Admin. Code §553.275. The Health and Human Services Commission has a checklist review here.

During the 89^th Texas Legislative Session, House Bill 3595 created additional requirements and added clarification to the state’s regulations for managing power outages and sheltering in place. These changes focus on improving and increasing communication, clearer standards around safe temperatures, and anticipating coordination with local and state authorities.

Communication

Before an outage: Every assisted living community should have a conversation with both prospective families/residents as well as current residents and their emergency contacts regarding emergency preparedness and how the community handles evacuations and sheltering in place situations.

Required documents: Every assisted living community is required to create a summary of the community’s emergency preparedness policy to provide to residents and families upon request.

What is in the summary?

You can organize the information in whichever way makes the most sense for your community, but it should include at a minimum the following items:

Evacuation Summary described in 26 Texas Admin Code §553.275(a)(5)

Name, address, and information for the evacuation destination(s)
Procedure for safely transporting residents
Name or title, and contact information, of the facility staff member to contact
The primary and back-up modes of communication

Shelter-in-Place Summary

Location of area of refuge on the property
Name or title, and contact information, of the facility staff member to contact
The primary and back-up modes of communication
How the community maintains safe temperatures for both residents and medications

During a power outage: Notify the Texas Health and Human Services Commission (HHSC) of any outage lasting longer than 12 hours. If you receive a message via AlertMedia from HHSC, and the message requests your response, you are required to either call or email your program manager or regional director and respond.

Emergency Preparedness Policies

Emergency Plans and Government Officials

AL communities are required to attempt to obtain feedback on their emergency preparedness plans from their local Emergency Management Coordinators (designated by the county). AL communities may be asked to share their emergency preparedness plans with their local fire marshals. A fire marshal has the authority to request this information, and the building is required to comply.

A surveyor from the Texas Health and Human Services Commission is permitted and often encouraged by their supervisors to request your emergency preparedness plans or their review. They can cite for any deficiencies identified.

A long-term care ombudsman is entitled to any information, which is available publicly or which is made available to your residents. Current regulations require you to provide residents with a summary upon request (at a minimum); you may provide your residents with the full plan if you choose to do so. An ombudsman does not have the authority to issue a citation or apply an administrative penalty.

Building needs: House Bill 3595 requires every assisted living community to know what kind of backup power system or systems it uses (batteries, portable generators, installed equipment, contracts for equipment to be brought in, etc.). The emergency preparedness plan should also include information about any installed connections such as transfer switches, general electrical usage information or how much generation would be needed to support designated circuits, any fuel stored on-site, and the location of and access information to any and all main electrical equipment.

Resident needs: The emergency preparedness plan needs to address the specific needs of residents currently in the building. As residents’ needs fluctuate, the emergency preparedness plan should be updated to reflect related changes. House Bill 3595 requires the plans to focus on the electricity needs of residents, this would include both information about and a plan for equipment such as oxygen concentrators and necessary mobility equipment, information about the residents’ conditions such as temperature sensitivities, and information about pharmaceutical or food products such as medication which much be kept within limited temperature ranges and residents on limited/restricted diets.

Staffing during Emergencies

One of the more common citations issued by the Health and Human Services Commission related to emergency preparedness plans has to do with staffing during emergencies, specifically overnight staffing.

The number of staff in building overnight needs to account for residents who need a one or two-person assist to get out of bed, residents with a Dementia or Alzheimer’s and who would need to be continually supervised, the total number of residents who would need to be alerted and accompanied, and any building design challenges such as multiple floors.

Sheltering-in-place: House Bill 3595 requires every assisted living community in the state to maintain an area (or multiple areas) of refuge, which provide at least 15 square feet per resident. This space requirement is roughly the same square footage as your community’s dining room (or dining room + adjacent activity room if a very large community). The new law doesn’t require the area of refuge to be a single very large space; you can break it up into multiple areas as long as the total space meets the requirement. Communities are of course encouraged to exceed the state-established minimum.

If you have any residents who are bedbound and unable to be moved to the designated area of refuge, then the community needs to have a strategy for ensuring that the bedbound residents are in a heated and cooled environment.

Climate control: Under existing regulations, assisted living communities are required to ensure that residents are not living in unsafe conditions. HHSC defines a “safe temperature” as no colder than 68 degrees and no warmer than 82. Under House Bill 3595, the area of refuge must be maintained at a safe temperature. If the building cannot maintain a safe temperature in the area of refuge, the community should evacuate residents. Assisted living communities should have a plan for checking and re-checking ambient temperatures in their areas of refuge and documenting the results with a timestamp.

Local and State Agency Requirements

New construction: The Texas Health and Human Services Commission is directed by HB 3595 to develop additional construction requirements for new assisted living communities which receive a permit to begin construction on or after September 1, 2026. The bill directs the agency to integrate a backup power system into the building’s design. For situations in which multiple buildings are on the same property, the agency is directed to develop regulatory standards, which would allow residents to consolidate at a shared space on the premises.

Local ordinances and requirements: House Bill 3595 limits the adoption of local ordinances related to emergency preparedness and contingency operations which conflict with these new state standards. In practice, TALA believes that this new state standard will act as a consistent framework. Local jurisdictions will continue to have the authority to provide additional clarity such as requiring a building to put up a sign designating the area of refuge or requiring that the local fire marshal review the inspection paperwork for the community’s on-site generator annually. House Bill 3595 would preempt a local jurisdiction which attempts to require an ALF to providing heating and cooling to an entire building.

Conclusion

The types of natural and man-made disasters that impact Texas’ residents and businesses are ever-changing. Despite multiple major disasters, long-term care communities in Texas have continued to demonstrate resiliency, adaptability, and safety. Deaths and injuries have been rare.

Texas’ providers are charged to not just respond to what has happened before, but to look ahead and prepare for the future. House Bill 3595 does just this. The bill addresses weaknesses identified by Hurricane Beryl and Winter Storm Uri, it requires existing providers to more thoroughly plan out and prepare for power outage events, and it directs the state’s regulatory agency to incorporate backup power into new building design.

House Bill 3595 is a new law, and new laws require agency interpretation and occasionally legal clarification. This explainer is TALA’s best attempt to prepare assisted living communities for the changes to come. If at any point, we receive new direction from the Health and Human Services Commission, the Texas Legislature, or the Office of the Attorney General, we will update this explainer to reflect the new guidance.

Quick Tips for this Explainer

This explainer is not an exhaustive resource, and it should not be used to replace existing emergency preparedness policies and procedures.