1-1 By: Cuellar of Hidalgo, et al. H.B. No. 1483
1-2 (Senate Sponsor - Lucio)
1-3 (In the Senate - Received from the House May 3, 1993;
1-4 May 4, 1993, read first time and referred to Committee on Health
1-5 and Human Services; May 19, 1993, reported favorably by the
1-6 following vote: Yeas 8, Nays 0; May 19, 1993, sent to printer.)
1-7 COMMITTEE VOTE
1-8 Yea Nay PNV Absent
1-9 Zaffirini x
1-10 Ellis x
1-11 Madla x
1-12 Moncrief x
1-13 Nelson x
1-14 Patterson x
1-15 Shelley x
1-16 Truan x
1-17 Wentworth x
1-18 A BILL TO BE ENTITLED
1-19 AN ACT
1-20 relating to the regulation of women's service centers; providing
1-21 civil and criminal penalties.
1-22 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-23 SECTION 1. Subtitle B, Title 4, Health and Safety Code, is
1-24 amended by adding Chapter 249 to read as follows:
1-25 CHAPTER 249. WOMEN'S SERVICE CENTER
1-26 Sec. 249.001. DEFINITION. In this chapter, "women's service
1-27 center" means a facility that offers services, facilities, and beds
1-28 for two or more unrelated individuals who may require a stay of
1-29 longer than 24 hours but not longer than three days and who are
1-30 solely admitted, treated, and discharged for women's services
1-31 related to education, outreach, support services, nursery,
1-32 obstetrical care, gynecological care, and surgery.
1-33 Sec. 249.002. LICENSE REQUIRED. (a) A person may not
1-34 establish or operate a women's service center in this state without
1-35 an appropriate license issued under this chapter.
1-36 (b) Each women's service center must have a separate
1-37 license.
1-38 (c) A license is not transferable or assignable.
1-39 (d) The department may issue a temporary license pending the
1-40 completion of the application procedures under Section 249.004 if
1-41 the issuance is appropriate to safeguard the health and safety of
1-42 the patients in the women's service center.
1-43 Sec. 249.003. EXEMPTIONS FROM LICENSING REQUIREMENT. The
1-44 following facilities need not be licensed under this chapter:
1-45 (1) a hospital licensed under Chapter 241;
1-46 (2) an ambulatory surgical center licensed under
1-47 Chapter 243;
1-48 (3) a birthing center licensed under Chapter 244;
1-49 (4) an office or clinic of a licensed physician,
1-50 certified nurse midwife, or certified nurse practitioner;
1-51 (5) a facility maintained or operated by the federal
1-52 government or an agency of the federal government; or
1-53 (6) a facility maintained or operated by this state or
1-54 an agency of this state.
1-55 Sec. 249.004. LICENSE APPLICATION AND ISSUANCE. (a) An
1-56 applicant for a women's service center license must submit an
1-57 application to the department on a form prescribed by the
1-58 department.
1-59 (b) Each application must be accompanied by a nonrefundable
1-60 license fee in an amount set by the board.
1-61 (c) The department shall issue the appropriate license if,
1-62 after inspection and investigation, it finds that the applicant and
1-63 the center meet the requirements of this chapter and the standards
1-64 adopted under this chapter.
1-65 (d) The license fee shall be paid annually on renewal of the
1-66 license.
1-67 Sec. 249.005. INSPECTIONS. The department may inspect a
1-68 women's service center at reasonable times as necessary to assure
2-1 compliance with this chapter.
2-2 Sec. 249.006. FEES. The board shall set fees imposed by
2-3 this chapter in amounts reasonable and necessary to defray the cost
2-4 of administering this chapter.
2-5 Sec. 249.007. PROVISIONS RELATING TO PATIENTS. (a) A
2-6 women's service center may require a patient to stay in the center
2-7 longer than three days if a physician determines that a longer stay
2-8 is medically necessary and appropriate for that patient. A women's
2-9 service center that requires a longer stay under this subsection
2-10 does not thereby lose its status as a women's service center and is
2-11 not required to obtain any additional licenses based solely on that
2-12 fact.
2-13 (b) A woman who has received prenatal care at a women's
2-14 service center is eligible for delivery services at that center.
2-15 However, emergency delivery services shall not be denied.
2-16 Sec. 249.008. ADOPTION OF RULES. (a) The board shall adopt
2-17 rules necessary to implement this chapter.
2-18 (b) The board shall adopt rules that provide requirements
2-19 for the issuance, renewal, denial, suspension, and revocation of a
2-20 license.
2-21 Sec. 249.009. MINIMUM STANDARDS. The board shall adopt
2-22 rules that provide minimum standards for a women's service center,
2-23 including standards that relate to:
2-24 (1) the protection of the health and safety of a
2-25 patient;
2-26 (2) the construction and design, including plumbing,
2-27 heating, lighting, ventilation, and other design standards
2-28 necessary to ensure the health and safety of patients;
2-29 (3) construction plan approval and inspection;
2-30 (4) the sanitary and hygienic conditions in the center
2-31 and its surroundings;
2-32 (5) the equipment essential to the health and safety
2-33 of the patients;
2-34 (6) the qualifications of the professional staff and
2-35 other personnel;
2-36 (7) minimum requirements for staffing by physicians
2-37 and nurses;
2-38 (8) a quality assurance program for patient care;
2-39 (9) the organizational structure, including the lines
2-40 of authority and delegation of responsibility;
2-41 (10) clinical records of care and services, including
2-42 the disposal or destruction of those records;
2-43 (11) written agreements for contractual services with
2-44 general hospitals;
2-45 (12) the provision and coordination of treatment and
2-46 services;
2-47 (13) minimum requirements for entering into a written
2-48 agreement with a general hospital for an immediate transfer of
2-49 patients when special services are needed but are not available at
2-50 the women's service center;
2-51 (14) the issuance, renewal, denial, suspension,
2-52 emergency suspension, and revocation of a license required by this
2-53 chapter; and
2-54 (15) any other aspect of the operation of a women's
2-55 service center that the board considers necessary to protect the
2-56 public.
2-57 Sec. 249.010. MINIMUM STANDARDS FOR PATIENT TRANSFERS.
2-58 (a) The board shall adopt rules to implement the minimum standards
2-59 governing the transfer of patients from women's service centers to
2-60 hospitals.
2-61 (b) The rules must provide that patient transfers to
2-62 hospitals be accomplished through women's service center policies
2-63 that result in medically appropriate transfers from physician to
2-64 physician and from women's service centers to hospitals by
2-65 providing:
2-66 (1) for notification to the receiving hospital before
2-67 the patient is transferred and confirmation by the receiving
2-68 hospital that the patient meets the receiving hospital's admissions
2-69 criteria relating to appropriate bed, physician, and other services
2-70 necessary to treat the patient;
3-1 (2) for the use of medically appropriate life support
3-2 measures that a reasonable and prudent physician exercising
3-3 ordinary care in the same or a similar locality would use to
3-4 stabilize the patient before the transfer and to sustain the
3-5 patient during the transfer;
3-6 (3) for the provision of appropriate personnel and
3-7 equipment that a reasonable and prudent physician exercising
3-8 ordinary care in the same or a similar locality would use for the
3-9 transfer;
3-10 (4) for the transfer of all necessary records for
3-11 continuing the care for the patient; and
3-12 (5) that the transfer of a patient not be predicated
3-13 on arbitrary, capricious, or unreasonable discrimination because of
3-14 race, religion, national origin, age, sex, physical condition, or
3-15 economic status.
3-16 Sec. 249.011. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
3-17 (a) The department may deny, suspend, or revoke a license for a
3-18 violation of this chapter or a rule adopted under this chapter.
3-19 (b) The denial, suspension, or revocation of a license by
3-20 the department and the appeal from that action are governed by the
3-21 procedures for a contested case hearing under the Administrative
3-22 Procedure and Texas Register Act (Article 6252-13a, Vernon's Texas
3-23 Civil Statutes).
3-24 Sec. 249.012. INJUNCTION. (a) The department may petition
3-25 a district court for a temporary restraining order to restrain a
3-26 continuing violation of the standards or licensing requirements
3-27 provided under this chapter if the department finds that the
3-28 violation creates an immediate threat to the health and safety of
3-29 the patients of a women's service center.
3-30 (b) A district court, on petition of the department and on a
3-31 finding by the court that a person is violating the standards or
3-32 licensing requirements provided under this chapter, may by
3-33 injunction:
3-34 (1) prohibit a person from continuing a violation of
3-35 the standards or licensing requirements provided under this
3-36 chapter;
3-37 (2) restrain or prevent the establishment or operation
3-38 of a women's service center without a license issued under this
3-39 chapter; or
3-40 (3) grant any other injunctive relief warranted by the
3-41 facts.
3-42 (c) The attorney general shall institute and conduct a suit
3-43 authorized by this section at the request of the department.
3-44 (d) Venue for a suit brought under this section is in the
3-45 county in which the women's service center is located or in Travis
3-46 County.
3-47 Sec. 249.013. CRIMINAL PENALTY. (a) A person commits an
3-48 offense if the person violates Section 249.002.
3-49 (b) An offense under this section is a Class C misdemeanor.
3-50 (c) Each day of a continuing violation constitutes a
3-51 separate offense.
3-52 Sec. 249.014. CIVIL PENALTY. (a) A person who violates
3-53 this chapter or who fails to comply with a rule adopted under this
3-54 chapter is liable for a civil penalty of not less than $100 or more
3-55 than $500 for each violation if the department determines the
3-56 violation threatens the health and safety of a patient.
3-57 (b) Each day of a continuing violation constitutes a
3-58 separate ground for recovery.
3-59 SECTION 2. The importance of this legislation and the
3-60 crowded condition of the calendars in both houses create an
3-61 emergency and an imperative public necessity that the
3-62 constitutional rule requiring bills to be read on three several
3-63 days in each house be suspended, and this rule is hereby suspended,
3-64 and that this Act take effect and be in force from and after its
3-65 passage, and it is so enacted.
3-66 * * * * *
3-67 Austin,
3-68 Texas
3-69 May 19, 1993
3-70 Hon. Bob Bullock
4-1 President of the Senate
4-2 Sir:
4-3 We, your Committee on Health and Human Services to which was
4-4 referred H.B. No. 1483, have had the same under consideration, and
4-5 I am instructed to report it back to the Senate with the
4-6 recommendation that it do pass and be printed.
4-7 Truan,
4-8 Acting Chair
4-9 * * * * *
4-10 WITNESSES
4-11 FOR AGAINST ON
4-12 ___________________________________________________________________
4-13 Name: Julia R. Bechinor x
4-14 Representing: TDH
4-15 City: Austin
4-16 -------------------------------------------------------------------
4-17 Name: Harold Freeman x
4-18 Representing: Texas Medical Associates
4-19 City: Austin
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