73R6089 KLL-D
By Cuellar of Hidalgo, Gutierrez, H.B. No. 1483
De La Garza, Munoz, et al.
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of women's service centers; providing
1-3 civil and criminal penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle B, Title 4, Health and Safety Code, is
1-6 amended by adding Chapter 249 to read as follows:
1-7 CHAPTER 249. WOMEN'S SERVICE CENTER
1-8 Sec. 249.001. DEFINITION. In this chapter, "women's service
1-9 center" means a facility that offers services, facilities, and beds
1-10 for two or more unrelated individuals who may require a stay of
1-11 longer than 24 hours but not longer than three days and who are
1-12 solely admitted, treated, and discharged for women's services
1-13 related to education, outreach, support services, nursery,
1-14 obstetrical care, gynecological care, and surgery.
1-15 Sec. 249.002. LICENSE REQUIRED. (a) A person may not
1-16 establish or operate a women's service center in this state without
1-17 an appropriate license issued under this chapter.
1-18 (b) Each women's service center must have a separate
1-19 license.
1-20 (c) A license is not transferable or assignable.
1-21 (d) The department may issue a temporary license pending the
1-22 completion of the application procedures under Section 249.004 if
1-23 the issuance is appropriate to safeguard the health and safety of
1-24 the patients in the women's service center.
2-1 Sec. 249.003. EXEMPTIONS FROM LICENSING REQUIREMENT. The
2-2 following facilities need not be licensed under this chapter:
2-3 (1) a hospital licensed under Chapter 241;
2-4 (2) an ambulatory surgical center licensed under
2-5 Chapter 243;
2-6 (3) a birthing center licensed under Chapter 244;
2-7 (4) an office or clinic of a licensed physician,
2-8 certified nurse midwife, or certified nurse practitioner;
2-9 (5) a facility maintained or operated by the federal
2-10 government or an agency of the federal government; or
2-11 (6) a facility maintained or operated by this state or
2-12 an agency of this state.
2-13 Sec. 249.004. LICENSE APPLICATION AND ISSUANCE. (a) An
2-14 applicant for a women's service center license must submit an
2-15 application to the department on a form prescribed by the
2-16 department.
2-17 (b) Each application must be accompanied by a nonrefundable
2-18 license fee in an amount set by the board.
2-19 (c) The department shall issue the appropriate license if,
2-20 after inspection and investigation, it finds that the applicant and
2-21 the center meet the requirements of this chapter and the standards
2-22 adopted under this chapter.
2-23 (d) The license fee shall be paid annually on renewal of the
2-24 license.
2-25 Sec. 249.005. INSPECTIONS. The department may inspect a
2-26 women's service center at reasonable times as necessary to assure
2-27 compliance with this chapter.
3-1 Sec. 249.006. FEES. The board shall set fees imposed by
3-2 this chapter in amounts reasonable and necessary to defray the cost
3-3 of administering this chapter.
3-4 Sec. 249.007. PROVISIONS RELATING TO PATIENTS. (a) A
3-5 women's service center may require a patient to stay in the center
3-6 longer than three days if a physician determines that a longer stay
3-7 is medically necessary and appropriate for that patient. A women's
3-8 service center that requires a longer stay under this subsection
3-9 does not thereby lose its status as a women's service center and is
3-10 not required to obtain any additional licenses based solely on that
3-11 fact.
3-12 (b) A woman who has not received prenatal care at a women's
3-13 service center is not eligible for delivery services at that
3-14 center.
3-15 Sec. 249.008. ADOPTION OF RULES. (a) The board shall adopt
3-16 rules necessary to implement this chapter.
3-17 (b) The board shall adopt rules that provide requirements
3-18 for the issuance, renewal, denial, suspension, and revocation of a
3-19 license.
3-20 Sec. 249.009. MINIMUM STANDARDS. The board shall adopt
3-21 rules that provide minimum standards for a women's service center,
3-22 including standards that relate to:
3-23 (1) the protection of the health and safety of a
3-24 patient;
3-25 (2) the construction and design, including plumbing,
3-26 heating, lighting, ventilation, and other design standards
3-27 necessary to ensure the health and safety of patients;
4-1 (3) construction plan approval and inspection;
4-2 (4) the sanitary and hygienic conditions in the center
4-3 and its surroundings;
4-4 (5) the equipment essential to the health and safety
4-5 of the patients;
4-6 (6) the qualifications of the professional staff and
4-7 other personnel;
4-8 (7) minimum requirements for staffing by physicians
4-9 and nurses;
4-10 (8) a quality assurance program for patient care;
4-11 (9) the organizational structure, including the lines
4-12 of authority and delegation of responsibility;
4-13 (10) clinical records of care and services, including
4-14 the disposal or destruction of those records;
4-15 (11) written agreements for contractual services with
4-16 general hospitals;
4-17 (12) the provision and coordination of treatment and
4-18 services;
4-19 (13) minimum requirements for entering into a written
4-20 agreement with a general hospital for an immediate transfer of
4-21 patients when special services are needed but are not available at
4-22 the women's service center;
4-23 (14) the issuance, renewal, denial, suspension,
4-24 emergency suspension, and revocation of a license required by this
4-25 chapter; and
4-26 (15) any other aspect of the operation of a women's
4-27 service center that the board considers necessary to protect the
5-1 public.
5-2 Sec. 249.010. MINIMUM STANDARDS FOR PATIENT TRANSFERS.
5-3 (a) The board shall adopt rules to implement the minimum standards
5-4 governing the transfer of patients from women's service centers to
5-5 hospitals.
5-6 (b) The rules must provide that patient transfers to
5-7 hospitals be accomplished through women's service center policies
5-8 that result in medically appropriate transfers from physician to
5-9 physician and from women's service centers to hospitals by
5-10 providing:
5-11 (1) for notification to the receiving hospital before
5-12 the patient is transferred and confirmation by the receiving
5-13 hospital that the patient meets the receiving hospital's admissions
5-14 criteria relating to appropriate bed, physician, and other services
5-15 necessary to treat the patient;
5-16 (2) for the use of medically appropriate life support
5-17 measures that a reasonable and prudent physician exercising
5-18 ordinary care in the same or a similar locality would use to
5-19 stabilize the patient before the transfer and to sustain the
5-20 patient during the transfer;
5-21 (3) for the provision of appropriate personnel and
5-22 equipment that a reasonable and prudent physician exercising
5-23 ordinary care in the same or a similar locality would use for the
5-24 transfer;
5-25 (4) for the transfer of all necessary records for
5-26 continuing the care for the patient; and
5-27 (5) that the transfer of a patient not be predicated
6-1 on arbitrary, capricious, or unreasonable discrimination because of
6-2 race, religion, national origin, age, sex, physical condition, or
6-3 economic status.
6-4 Sec. 249.011. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
6-5 (a) The department may deny, suspend, or revoke a license for a
6-6 violation of this chapter or a rule adopted under this chapter.
6-7 (b) The denial, suspension, or revocation of a license by
6-8 the department and the appeal from that action are governed by the
6-9 procedures for a contested case hearing under the Administrative
6-10 Procedure and Texas Register Act (Article 6252-13a, Vernon's Texas
6-11 Civil Statutes).
6-12 Sec. 249.012. INJUNCTION. (a) The department may petition
6-13 a district court for a temporary restraining order to restrain a
6-14 continuing violation of the standards or licensing requirements
6-15 provided under this chapter if the department finds that the
6-16 violation creates an immediate threat to the health and safety of
6-17 the patients of a women's service center.
6-18 (b) A district court, on petition of the department and on a
6-19 finding by the court that a person is violating the standards or
6-20 licensing requirements provided under this chapter, may by
6-21 injunction:
6-22 (1) prohibit a person from continuing a violation of
6-23 the standards or licensing requirements provided under this
6-24 chapter;
6-25 (2) restrain or prevent the establishment or operation
6-26 of a women's service center without a license issued under this
6-27 chapter; or
7-1 (3) grant any other injunctive relief warranted by the
7-2 facts.
7-3 (c) The attorney general shall institute and conduct a suit
7-4 authorized by this section at the request of the department.
7-5 (d) Venue for a suit brought under this section is in the
7-6 county in which the women's service center is located or in Travis
7-7 County.
7-8 Sec. 249.013. CRIMINAL PENALTY. (a) A person commits an
7-9 offense if the person violates Section 249.002.
7-10 (b) An offense under this section is a Class C misdemeanor.
7-11 (c) Each day of a continuing violation constitutes a
7-12 separate offense.
7-13 Sec. 249.014. CIVIL PENALTY. (a) A person who violates
7-14 this chapter or who fails to comply with a rule adopted under this
7-15 chapter is liable for a civil penalty of not less than $100 or more
7-16 than $500 for each violation if the department determines the
7-17 violation threatens the health and safety of a patient.
7-18 (b) Each day of a continuing violation constitutes a
7-19 separate ground for recovery.
7-20 SECTION 2. The importance of this legislation and the
7-21 crowded condition of the calendars in both houses create an
7-22 emergency and an imperative public necessity that the
7-23 constitutional rule requiring bills to be read on three several
7-24 days in each house be suspended, and this rule is hereby suspended,
7-25 and that this Act take effect and be in force from and after its
7-26 passage, and it is so enacted.
7-27 COMMITTEE AMENDMENT NO. 1
8-1 Amend HB 1483, Section 249.007 by deleting subsection (b) and
8-2 replacing it with the following:
8-3 (b) a woman who has received prenatal care at a women's service
8-4 center is eligible for delivery services at that center. However,
8-5 emergency delivery services shall not be denied.
8-6 Maxey