By McDonald, et al. H.B. No. 1551
Substitute the following for H.B. No. 1551:
By McDonald C.S.H.B. No. 1551
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to home care and community support services.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. The chapter heading of Chapter 142, Health and
1-5 Safety Code, is amended to read as follows:
1-6 CHAPTER 142. HOME CARE AND COMMUNITY SUPPORT <HEALTH> SERVICES
1-7 SECTION 2. The heading of Subchapter A, Chapter 142, Health
1-8 and Safety Code, is amended to read as follows:
1-9 SUBCHAPTER A. HOME CARE AND COMMUNITY SUPPORT <HEALTH>
1-10 SERVICES LICENSES
1-11 SECTION 3. Section 142.001, Health and Safety Code, is
1-12 amended to read as follows:
1-13 Sec. 142.001. Definitions. In this chapter:
1-14 (1) "Certified agency" means a person who:
1-15 (A) provides a home health and/or hospice
1-16 service; and
1-17 (B) is certified by an official of the United
1-18 States Department of Health and Human Services as in compliance
1-19 with conditions of participation in Title XVIII, Social Security
1-20 Act (42 U.S.C. Section 1395 et seq.).
1-21 (2) "Council" means the Home Care and Community
1-22 Support <Health Services> Advisory Council.
1-23 (3) "Home Health service" means provision of one or
1-24 more of the following health services required by an individual
2-1 within a residence or independent living environment:
2-2 (A) nursing;
2-3 (B) physical, occupational, speech, or
2-4 respiratory therapy;
2-5 (C) a medical social service;
2-6 (D) services provided by unlicensed personnel
2-7 under the delegation of a registered nurse or physical therapist
2-8 <the service of a home health aide>;
2-9 (E) the furnishing of medical equipment and
2-10 supplies, excluding drugs and medicines; or
2-11 (F) nutritional counseling.
2-12 (4) "Home care and community support <health> agency"
2-13 means a place of business, <including a hospice,> that provides <a>
2-14 home health, hospice, or personal assistance service for pay or
2-15 other consideration in a client's residence or independent living
2-16 environment <service>.
2-17 (5) "Hospice" is a specialized concept of care that
2-18 uses an interdisciplinary approach to deliver medical, social,
2-19 psychological, emotional, spiritual, and bereavement care to the
2-20 terminally ill client and the client's family <"Home health
2-21 service" means the provision, for pay or other consideration, of a
2-22 health service in a patient's residence. The term does not include
2-23 the provision of care under an attendant care program administered
2-24 by the Texas Department of Human Services>.
2-25 (6) "Independent living environment" means:
2-26 (A) a client's individual residence which may
2-27 include a group home or foster home; and
3-1 (B) other settings in which the client
3-2 participates in activities including, but not limited to, school,
3-3 work, or church.
3-4 (7) "Person" means an individual, partnership,
3-5 corporation, or association.
3-6 (8) "Personal assistance service" means routine
3-7 ongoing care or services required by an individual in a residence
3-8 or independent living environment to engage in the activities of
3-9 daily living or to perform the physical functions required for
3-10 independent living, including respite services. The term includes
3-11 health related services performed under circumstances defined as
3-12 not constituting the practice of professional nursing by the Board
3-13 of Nurse Examiners through memorandum of understanding with the
3-14 Department in accordance with Section 142.016 of this Act and
3-15 health related tasks provided by unlicensed personnel under the
3-16 delegation of a registered nurse.
3-17 (9) <(7)> "Place of business" means an office of a
3-18 home care and community support <health> agency that maintains
3-19 client <patient> records or directs home health, hospice, or
3-20 personal assistance services. The term includes a suboffice, a
3-21 branch office, a workroom, or any other subsidiary location.
3-22 (10) <(8)> "Residence" means a place where a person
3-23 resides and includes a home, a nursing home, or a convalescent home
3-24 <for the disabled or aged>.
3-25 (11) "Respite" services are any support options
3-26 provided on a short term basis for the purpose of relief to the
3-27 primary caregiver in providing care to individuals of all ages with
4-1 disabilities and/or children or adults at risk of abuse or neglect.
4-2 SECTION 4. Section 142.002(a), Health and Safety Code, is
4-3 amended to read as follows:
4-4 (a) A person may not engage in the business of providing
4-5 home health, hospice, or personal assistance services without an
4-6 appropriate license issued by the department for each place of
4-7 business from which the <home health> services are directed. A
4-8 certified agency must have a Class A license, and any other person
4-9 must have a Class B license.
4-10 SECTION 5. Section 142.0025, Health and Safety Code, is
4-11 amended to read as follows:
4-12 Sec. 142.0025. Temporary License. If a person is in the
4-13 process of becoming certified by the United States Department of
4-14 Health and Human Services to qualify as a certified agency, the
4-15 department may issue a temporary Class A home care and community
4-16 support <health> service license to the person. A temporary
4-17 license is effective as provided by board rules.
4-18 SECTION 6. Section 142.003, Health and Safety Code, is
4-19 amended to read as follows:
4-20 Sec. 142.003. Exemptions From Licensing Requirement. The
4-21 following persons need not be licensed under this chapter:
4-22 (1) a physician, dentist, registered nurse, or
4-23 physical therapist licensed under the laws of this state who
4-24 provides home health services to a patient only as a part of and
4-25 incidental to that person's private office practice;
4-26 (2) a registered nurse, licensed vocational nurse,
4-27 physical therapist, occupational therapist, speech therapist,
5-1 medical social worker, or any other health care professional as
5-2 determined by the department who provides home health services as a
5-3 sole practitioner;
5-4 (3) a <nonprofit> registry <operated by a national or
5-5 state professional association or society of licensed health care
5-6 practitioners, or a subdivision of the association or society,>
5-7 that operates solely as a clearinghouse to put consumers in contact
5-8 with persons who provide home health, hospice, or personal
5-9 assistance services <licensed health care practitioners who give
5-10 care in a patient's residence> and that does not maintain official
5-11 client <patient> records, <or> direct client <patient> services
5-12 compensate the person providing the service;
5-13 (4) an individual whose permanent residence is in the
5-14 client's <patient's> residence;
5-15 (5) an employee of a person licensed under this
5-16 chapter who provides home health, hospice, or personal assistance
5-17 services only as an employee of the license holder and who receives
5-18 no benefit for providing the services, other than wages from the
5-19 license holder;
5-20 (6) a home, nursing home, convalescent home, personal
5-21 care facility or other institution for individuals who are elderly
5-22 or who have disabilities <the disabled or aged> that provides home
5-23 health, hospice or personal assistance services only to residents
5-24 of the home or institution;
5-25 (7) a person who provides one health service through a
5-26 contract with a person licensed under this chapter;
5-27 (8) a durable medical equipment supply company;
6-1 (9) a pharmacy or wholesale medical supply company
6-2 that does not furnish services, other than supplies, to a person at
6-3 the person's house;
6-4 (10) a hospital or other licensed health care facility
6-5 that serves only inpatient residents;
6-6 (11) a person providing home health or personal
6-7 assistance services to an injured employee under the Texas Workers'
6-8 Compensation Act (Article 8308-1.01 et seq., Vernon's Texas Civil
6-9 Statutes) <workers' compensation laws of this state (Article 8306
6-10 et seq., Revised Statutes)>; <or>
6-11 (12) a visiting nurse service that:
6-12 (A) is conducted by and for the adherents of a
6-13 well-recognized church or religious denomination; and
6-14 (B) provides nursing services by a person exempt
6-15 from licensing by Article 4528, Revised Statutes, because the
6-16 person furnished nursing care in which treatment is only by prayer
6-17 or spiritual means;
6-18 (13) an individual hired and paid directly by the
6-19 client or the client's family or legal guardian to provide home
6-20 health or personal assistance services;
6-21 (14) a business, school, camp or other organization
6-22 that provides home health or personal assistance services solely to
6-23 its employees, students, or persons with a similar relationship to
6-24 the business, camp, or school;
6-25 (15) a person or organization providing
6-26 sitter/companion services, chore or household services and not
6-27 involving personal care, health or health-related services; and
7-1 (16) state agencies and each Mental Retardation
7-2 Authority and Mental Health Authority providing the direct delivery
7-3 of home health, hospice or personal assistance services. This
7-4 provision is in effect until August 31, 1995.
7-5 SECTION 7. Section 142.004, Health and Safety Code, is
7-6 amended to read as follows:
7-7 Sec. 142.004. License Application. (a) An applicant for a
7-8 license to provide a home health, hospice, or personal assistance
7-9 service must:
7-10 (1) file a written application on a form prescribed by
7-11 department;
7-12 (2) file with the application:
7-13 (A) the name of the owner of the service or a
7-14 list of the names of persons who own an interest in the service;
7-15 and
7-16 (B) a list of any businesses with which the
7-17 service subcontracts and in which the owner or owners of the
7-18 service hold at least five percent of the ownership;
7-19 (3) cooperate with any inspections required by the
7-20 department for a license; and
7-21 (4) pay the license fee prescribed by this chapter.
7-22 (b) In addition to the requirements of Subsection (a), if
7-23 the applicant is a certified agency when the application for a
7-24 Class A license is filed, the applicant must maintain its Medicare
7-25 certification. If the applicant is not a certified agency when the
7-26 application for a Class A license is filed, the applicant must
7-27 establish that it is in the process of receiving its certification
8-1 from the United States Department of Health and Human Services.
8-2 (c) The board by rule shall require that, at a minimum,
8-3 before the department may approve a license application, other than
8-4 an application for a renewal or branch office license, the
8-5 applicant must provide to the department:
8-6 (1) documentation establishing that, at a minimum, the
8-7 applicant has sufficient financial resources to provide the
8-8 services required by this chapter and by the department during the
8-9 term of the license;
8-10 (2) a list of the management personnel for the
8-11 proposed home care and community support <health> agency, a
8-12 description of personnel qualifications, and a plan for providing
8-13 continuing training and education for the personnel during the term
8-14 of the license;
8-15 (3) documentation establishing that the applicant is
8-16 capable of meeting the minimum standards established by the board
8-17 relating to the quality of care; and
8-18 (4) a plan that provides for the orderly transfer of
8-19 care of the applicant's clients if the applicant cannot maintain or
8-20 deliver home health, hospice, or personal assistance services under
8-21 the license.
8-22 SECTION 8. Section 142.005(a), Health and Safety Code, is
8-23 amended to read as follows:
8-24 (a) If an applicant for a license, other than a renewal or
8-25 branch office license, proposes to operate a home care and
8-26 community support <health> agency through a partnership,
8-27 corporation, or other business entity that includes members that
9-1 are not individuals, or through a corporation in which any of the
9-2 shares <of which> are owned by another corporation, the applicant
9-3 must:
9-4 (1) establish a corporation under the laws of this
9-5 state if the applicant is not a corporation organized under the
9-6 laws of this state;
9-7 (2) allow the department to review the competence and
9-8 financial resources of any shareholder who holds at least 10
9-9 percent of the shares of the Texas corporation;
9-10 (3) allow the department to review the history and
9-11 financial resources of each parent or health-related subsidiary of
9-12 the Texas corporation;
9-13 (4) grant the Texas corporation full authority to
9-14 operate the home care and community support <health> agency and
9-15 any subsequent home care and community support <health> agencies
9-16 for which the applicant may seek licensing under the chapter;
9-17 (5) disclose to the department any information the
9-18 department needs to conduct the reviews authorized by this
9-19 subsection; and
9-20 (6) establish a registered agent as required by
9-21 Article 2.09, Texas Business Corporation Act, to receive service of
9-22 process in this state.
9-23 SECTION 9. Section 142.006, Health and Safety Code, is
9-24 amended by amending Subsection (a) and adding Subsections (c), (d),
9-25 and (e) to read as follows:
9-26 (a) The department shall issue a Class A or Class B home
9-27 care and community support <health> service license for each place
10-1 of business to each applicant who:
10-2 (1) qualifies for the type of license requested;
10-3 (2) submits an application and license fee as required
10-4 by this chapter; and
10-5 (3) complies with all licensing standards required or
10-6 adopted by the board under this chapter.
10-7 (c) The department may find that a home care and community
10-8 support agency has satisfied the requirements for license renewal
10-9 if the agency is accredited by a national organization, such as the
10-10 Joint Commission on Accreditation of Health Organizations or the
10-11 Community Health Care Accreditation Program, and the department
10-12 finds that the accreditation organization has standards that meet
10-13 or exceed the requirements for licensure under this chapter. A
10-14 renewal fee is required of the home care and community support
10-15 agency at the time of license renewal.
10-16 (d) The department may find that a home care and community
10-17 support agency has satisfied the requirements for license renewal
10-18 if the agency is certified by any state agency that has
10-19 certification standards that meet or exceed the requirements for
10-20 licensure under this chapter.
10-21 (e) The license must designate the type of services that the
10-22 place of business is authorized to perform.
10-23 SECTION 10. Section 142.007, Health and Safety Code, is
10-24 amended by deleting the section as follows:
10-25 <Sec. 142.007. HOSPICE. If the agency meets the standards
10-26 adopted by the board for hospice services, a home health service
10-27 license may state that a home health agency is a hospice.>
11-1 SECTION 11. Sections 142.009, Health and Safety Code, are
11-2 amended by amending Subsections (b), (c), and (e), and by adding
11-3 Subsections (f) and (g) to read as follows:
11-4 (b) A home care and community support <health> agency shall
11-5 provide each person who receives home health, hospice, or personal
11-6 assistance services with a written statement that contains the
11-7 name, address, and telephone number of the department and a
11-8 statement that informs consumers that a complaint against a home
11-9 care and community support <health> agency may be directed to the
11-10 department.
11-11 (c) The department or its authorized representative shall
11-12 investigate each complaint received regarding the provision of home
11-13 health, hospice, or personal assistance services and may, as a part
11-14 of the investigation:
11-15 (1) conduct an unannounced inspection of a place of
11-16 business, including an inspection of medical and personnel records,
11-17 if the department has reasonable cause to believe that the place of
11-18 business is in violation of this chapter or a rule adopted under
11-19 this chapter;
11-20 (2) conduct an interview with a recipient of home
11-21 health, hospice, or personal assistance services, which may be
11-22 conducted in the recipient's home if the recipient consents; or
11-23 (3) interview a physician or other health care
11-24 practitioner, including a member of the personnel of a home care
11-25 and community support <health> agency, who cares for a recipient of
11-26 home health, hospice, or personal assistance services.
11-27 (d) The reports, records, and working papers used or
12-1 developed in an investigation made under this section are
12-2 confidential and may not be released or made public except as
12-3 follows:
12-4 (1) to state and federal agencies;
12-5 (2) to federal, state, or local law enforcement
12-6 personnel;
12-7 (3) with the consent of each person identified in the
12-8 information released;
12-9 (4) in civil or criminal litigation matters or
12-10 licensure proceedings as otherwise allowed by law or judicial rule;
12-11 or
12-12 (5) on a form developed by the department which
12-13 identifies the deficiencies found, if any, without identifying any
12-14 person, other than the agency.
12-15 (e) The department's representative shall hold a conference
12-16 with the person in charge of the home care and community support
12-17 <health> agency before beginning the on-site inspection to explain
12-18 the nature and scope of the inspection. When the inspection is
12-19 completed, the department's representative shall hold a conference
12-20 with the person who is in charge of the agency and shall identify
12-21 any records that were duplicated. Agency records may be removed
12-22 from an agency only with the agency's consent.
12-23 (f) An agency licensed by the Department as a home care and
12-24 community support agency is not subject to additional licensure
12-25 inspections relative to home health, hospice or personal assistance
12-26 services while the agency maintains accreditation for the
12-27 applicable service(s) from the Joint Commission for Accreditation
13-1 of Health Care Organizations (JCAHO), Community Health
13-2 Accreditation Program (CHAP) or other national accreditation
13-3 organizations which meet or exceed the regulations under the Home
13-4 Care and Community Support Act. Documentation from the accrediting
13-5 body indicating that the provider is accredited must be submitted
13-6 to the Department at the time of the initial licensure and annually
13-7 upon license renewal.
13-8 (g) The Department and other state agencies under the Texas
13-9 Health and Human Services Commission contracting with Home Care and
13-10 Community Support Agencies to deliver services covered under this
13-11 Act, shall execute a memorandum of understanding that establishes
13-12 procedures to eliminate or reduce duplication of standards or
13-13 conflicts between standards and in functions in license,
13-14 certification or compliance surveys and complaint investigations.
13-15 The Texas Health and Human Services Commission shall approve the
13-16 memorandum of understanding and review the recommendations of the
13-17 Home Care and Community Support Services Advisory Council
13-18 pertaining to the memorandum of understanding prior to its
13-19 approval.
13-20 SECTION 12. Section 142.010(a), Health and Safety Code, is
13-21 amended to read as follows:
13-22 (a) The board shall set the home care and community support
13-23 <health> service license fees in amounts that are reasonable to
13-24 meet the costs of administering this chapter, except that the fees
13-25 may not be:
13-26 (1) less than $200 <$600> or more than $1,000 <$1,200>
13-27 for an initial Class A or Class B license;
14-1 (2) less than $200 or more than $300 for renewal of a
14-2 branch office license;
14-3 (b) the board shall consider the size of the home care and
14-4 community support agency, the number of clients served and other
14-5 accreditation documentation when determining the initial and
14-6 renewal license fee.
14-7 SECTION 13. Section 142.011(c), Health and Safety Code, is
14-8 amended to read as follows:
14-9 (c) The department may suspend or revoke the license of a
14-10 Class A home care and community support <health> agency that fails
14-11 to maintain its certification qualifying the agency as a certified
14-12 agency. A Class A <home health> agency that submits a request for a
14-13 hearing as provided by Subsection (d) is subject to the
14-14 requirements of this chapter relating to a Class B <home health>
14-15 agency until the suspension or revocation is finally determined by
14-16 the department or, if the license is suspended or revoked, until
14-17 the last day for seeking review of the department order or a later
14-18 date fixed by order of the reviewing court.
14-19 SECTION 14. Sections 142.012(a), (b) and (d), Health and
14-20 Safety Code, are amended to read as follows:
14-21 (a) The board with recommendations of the Home Care and
14-22 Community Support Advisory Council shall adopt rules necessary to
14-23 implement this chapter.
14-24 (b) The board by rule shall set minimum standards for home
14-25 care and community support <health> agencies licensed under this
14-26 chapter that relate to:
14-27 (1) qualifications for professional and
15-1 nonprofessional personnel;
15-2 (2) supervision of professional and nonprofessional
15-3 personnel;
15-4 (3) the provision and coordination of treatment and
15-5 services;
15-6 (4) the management, ownership, and organizational
15-7 structure, including lines of authority and delegation of
15-8 responsibility;
15-9 (5) clinical and business records;
15-10 (6) financial ability to carry out the functions as
15-11 proposed; and
15-12 (7) any other aspects of home health, hospice or
15-13 personal assistance services as necessary to protect the public.
15-14 (d) The department shall require each person or home care
15-15 and community support <health> agency providing home health,
15-16 hospice, or personal assistance services to implement and enforce
15-17 the applicable provisions of Chapter 102, Human Resources Code.
15-18 SECTION 15. Section 142.014(a), Health and Safety Code, is
15-19 amended to read as follows:
15-20 (a) A person who operates a home care and community support
15-21 <health> agency without a license issued under this chapter
15-22 authorizing it to perform such services is liable for civil penalty
15-23 of not less than $100 or more than $500 for each day of violation.
15-24 SECTION 16. Section 142.015(a), Health and Safety Code, is
15-25 amended to read as follows:
15-26 (a) The Home Care and Community Support <Health> Services
15-27 Advisory Council is composed of the following 12 <11> members,
16-1 appointed by the governor:
16-2 (1) three consumer representatives <one representative
16-3 of the department>;
16-4 (2) one representative of the Texas Association for
16-5 Home Care, Incorporated, or its successor <two representatives of
16-6 consumers of home health agency and hospice services>;
16-7 (3) two representatives of Class A agencies providing
16-8 home health services <one representative of the Texas Department of
16-9 Human Services>;
16-10 (4) two representatives of Class B agencies providing
16-11 home health services <one representative of the Texas Association
16-12 of Home Health Agencies, Inc.>;
16-13 (5) two representatives of agencies providing hospice
16-14 services <one representative of private nonprofit home health
16-15 agencies>
16-16 (6) two representatives of agencies providing personal
16-17 assistance services <one representative of voluntary nonprofit home
16-18 health agencies>.
16-19 <(7) one representative of proprietary home health
16-20 agencies;>
16-21 <(8) one representative of an official department home
16-22 health agency;>
16-23 <(9) one member to represent Medicare-certified Class A
16-24 hospice providers affiliated with a home health agency, hospital,
16-25 or other health service provider; and>
16-26 <(10) one member to represent Medicare-certified Class
16-27 A hospice providers not affiliated with a home health agency,
17-1 hospital, or other health service provider.>
17-2 SECTION 17. Subchapter A, Chapter 142, Health and Safety
17-3 Code, is amended by adding Section 142.016 to read as follows:
17-4 Sec. 142.016. Memorandum of Understanding RELATING TO
17-5 NURSING SERVICES; GUIDELINES. (a) The Board of Nurse Examiners
17-6 and the department shall adopt a memorandum of understanding
17-7 governing the circumstances under which the provision of
17-8 health-related tasks or services do not constitute the practice of
17-9 professional nursing. The agencies shall annually review and renew
17-10 or modify the memorandum as necessary.
17-11 (b) In developing, modifying, or renewing the memorandum of
17-12 understanding, the Board of Nurse Examiners and the department
17-13 shall consult with an advisory committee appointed by the board and
17-14 the department and composed of at least the following:
17-15 (1) one representative of the Board of Nurse Examiners
17-16 and (1) one representative from the Texas Department of Health to
17-17 serve as co-chair;
17-18 (2) one representative from the Texas Department of
17-19 Mental Health and Mental Retardation;
17-20 (3) one representative from The Texas Department of
17-21 Human Services;
17-22 (4) one representative from the Texas Nurses
17-23 Association;
17-24 (5) one representative from the Texas Association of
17-25 Home Care, Incorporated;
17-26 (6) one representative of the Texas Respite Resource
17-27 Network; and
18-1 (7) two representatives of organizations that advocate
18-2 for clients in community-based settings, (e.g., the Personal
18-3 Assistance Task Force, the Disability Policy Consortium).
18-4 (c) The department shall prepare guidelines based on the
18-5 memorandum of understanding for agencies licensed under this
18-6 chapter to use in providing personal assistance services to
18-7 clients.
18-8 SECTION 18. Section 142.021, Health and Safety Code, is
18-9 amended to read as follows:
18-10 Sec. 142.021. ADMINISTRATION OF <Permits to Administer>
18-11 Medications. A person may not administer medication to a client
18-12 <patient> of a home care and community support <health> agency
18-13 unless the person:
18-14 (1) holds a license under state law that authorizes
18-15 the person to administer medication;
18-16 (2) holds a permit issued under Section 142.025 and
18-17 acts under the delegated authority of a person who holds a license
18-18 under state law that authorizes the person to administer
18-19 medication;
18-20 (3) performs duties as a qualified dialysis technician
18-21 within the scope authorized by board rules;
18-22 (4) administers a medication to a client in accordance
18-23 with rules of the Board of Nurse Examiners permitting the
18-24 delegation of the administration to persons not holding permits
18-25 under 142.025 of this Act; or
18-26 (5) administers noninjectable medication under
18-27 circumstances defined by the memorandum of understanding adopted
19-1 under Section 142.016 as not constituting the practice of
19-2 professional nursing.
19-3 SECTION 19. Section 142.023, Health and Safety Code, is
19-4 amended to read as follows:
19-5 Sec. 142.023. Rules for Administration of Medication. The
19-6 board by rule shall establish:
19-7 (1) minimum requirements for the issuance, denial,
19-8 renewal, suspension, emergency suspension, and revocation of a
19-9 permit to a home health <administer> medication aide <to a patient
19-10 of a home health agency>;
19-11 (2) curricula to train a home health <persons to
19-12 administer> medication aide <to a patient of a home health agency>;
19-13 (3) minimum standards for the approval of home health
19-14 medication aide training programs <to train persons to administer
19-15 medication to patients of home health agencies> and for rescinding
19-16 approval;
19-17 (4) the acts and practices that are allowed or
19-18 prohibited to a permit holder; and
19-19 (5) minimum standards for on-site supervision of a
19-20 permit holder by a registered nurse.
19-21 SECTION 20. Section 142.024, Health and Safety Code, is
19-22 amended to read as follows:
19-23 Sec. 142.024. HOME HEALTH MEDICATION AIDE Training Programs
19-24 <to Administer Medication>. (a) An application for the approval
19-25 of a home health medication aide training program must be made to
19-26 the department on a form and under rules prescribed by the board.
19-27 (b) The department shall approve a home health medication
20-1 aide training program that meets the minimum standards adopted
20-2 under Section 142.023. The department may review the approval
20-3 annually.
20-4 SECTION 21. Section 142.025, Health and Safety Code, is
20-5 amended to read as follows:
20-6 Sec. 142.025. Issuance and Renewal of HOME HEALTH MEDICATION
20-7 AIDE Permit <to Administer Medication>. (a) To be issued or to
20-8 have renewed a home health medication aide permit <to administer
20-9 medication>, a person shall apply to the department on a form
20-10 prescribed and under the rules adopted by the board.
20-11 (b) The department shall prepare and conduct an examination
20-12 for the issuance of a permit.
20-13 (c) The department shall require a permit holder to
20-14 satisfactorily complete a continuing education course approved by
20-15 the department for renewal of the permit.
20-16 (d) The department shall issue a permit or renew a permit to
20-17 an applicant who:
20-18 (1) meets the minimum requirements adopted under
20-19 Section 142.023;
20-20 (2) successfully completes the examination or the
20-21 continuing education requirements; and
20-22 (3) pays a nonrefundable application fee determined by
20-23 the board.
20-24 (e) A permit is valid for one year and is not transferable,
20-25 SECTION 22. The section heading to Section 142.026, Health
20-26 and Safety Code, is amended to read as follows:
20-27 Sec. 142.026. Fees for Issuance and Renewal of HOME HEALTH
21-1 MEDICATION AIDE Permit <to Administer Medication>.
21-2 SECTION 23. The section heading to Section 142.027, Health
21-3 and Safety Code, is amended to read as follows:
21-4 Sec. 142.027. Violation of HOME HEALTH MEDICATION AIDE
21-5 Permits <to Administer Medication>.
21-6 SECTION 24. The section heading to Section 142.028, Health
21-7 and Safety Code, is amended to read as follows:
21-8 Sec. 142.028. Emergency Suspension of HOME HEALTH MEDICATION
21-9 AIDE Permits <to Administer Medication>.
21-10 SECTION 25. Section 142.029(a), Health and Safety Code, is
21-11 amended to read as follows:
21-12 (a) A person commits an offense if the person knowingly
21-13 administers medication to a client <patient> of a home care and
21-14 community support <health> agency and the person is not authorized
21-15 to administer medication under Section 142.021 or 142.022<.>
21-16 <(1) does not hold a license under state law that
21-17 authorizes the person to administer medication; or>
21-18 <(2) does not hold a permit issued by the department
21-19 under Section 142.025>.
21-20 SECTION 26. Section 142.030(a), Health and Safety Code, is
21-21 amended to read as follows:
21-22 (a) A person authorized by this subchapter to administer
21-23 medication to a client <patient> of a home care and community
21-24 support <health> agency may not dispense dangerous drugs or
21-25 controlled substances without complying with the Texas Pharmacy Act
21-26 (Article 4542a-1, Vernon's Texas Civil Statutes).
21-27 SECTION 27. Section 248.003, Health and Safety Code, is
22-1 amended to read as follows:
22-2 Sec. 248.003. Exemptions. This chapter does not apply to:
22-3 (1) a home care and community <health> agency required
22-4 to be licensed under Chapter 142;
22-5 (2) a person required to be licensed under Chapter 241
22-6 (Texas Hospital Licensing Law);
22-7 (3) an institution required to be licensed under
22-8 Chapter 242;
22-9 (4) an ambulatory surgical center required to be
22-10 licensed under Chapter 243 (Texas Ambulatory Surgical Center
22-11 Licensing Act);
22-12 (5) a birthing center required to be licensed under
22-13 Chapter 244 (Texas Birthing Center Licensing Act);
22-14 (6) a facility required to be licensed under Chapter
22-15 245 (Texas Abortion Facility Reporting and Licensing Act); or
22-16 (7) a person providing medical or nursing care or
22-17 services under a license or permit issued under other state law.
22-18 SECTION 28. (a) The changes in law made to Sections 142.028
22-19 and 142.030, Health and Safety Code, by this Act apply only to an
22-20 offense committed on or after July 1, 1994.
22-21 (b) An offense committed before the effective date of this
22-22 Act is covered by the law in effect when the offense was committed,
22-23 and the former law is continued in effect for this purpose.
22-24 SECTION 29. The change made by this Act in the
22-25 qualifications of members of the Home Care and Community Support
22-26 Advisory Council (formerly the Home Health Care Advisory Council)
22-27 does not affect the ability of a member serving immediately before
23-1 the effective date of this Act to continue to serve for the term
23-2 for which the member was appointed.
23-3 SECTION 30. Not later than January 31, 1994, the Board of
23-4 Nurse Examiners and the Texas Department of Health shall adopt the
23-5 initial memorandum of understanding required by Section 142.016,
23-6 Health and Safety Code, as added by this Act.
23-7 SECTION 31. The changes in law made by this Act do not
23-8 affect the validity of a license or a permit to administer
23-9 medication issued by the department before the effective date of
23-10 this Act. Regardless of the changes in law made by this Act, the
23-11 department shall continue to issue licenses to qualified home
23-12 health agencies and the prior law is continued in effect for that
23-13 purpose until final rules to implement this Act are adopted by the
23-14 department and become effective. On or following the effective
23-15 date of the rules and on renewal of a license or permit to
23-16 administer medication issued by the department under the Health and
23-17 Safety Code, Chapter 142, the license or permit shall be conformed
23-18 to the requirement of the Health and Safety Code, Chapter 142, as
23-19 amended by this Act.
23-20 SECTION 32. The department shall propose rules to implement
23-21 this Act by January 1, 1994. The department shall adopt rules to
23-22 implement this Act by June 1, 1994.
23-23 SECTION 33. The department and other state agencies under
23-24 the Texas Health and Human Services Commission shall distribute to
23-25 interested persons a draft of the memorandum of understanding
23-26 required by the Health and Safety Code, Section 142.009(g), as
23-27 added by this Act, by January 1, 1994, and shall execute the
24-1 initial memorandum of understanding required by that section by
24-2 June 1, 1994.
24-3 SECTION 33. The changes in law made to the Health and Safety
24-4 Code, Section 142.014, by this Act apply only to violations
24-5 occurring on or after July 1, 1994.
24-6 SECTION 34. A license as a home care and community support
24-7 agency providing home health, hospice or personal assistance
24-8 services shall not be required under the Health and Safety Code,
24-9 Section 142.002, as amended by this Act, until July 1, 1994.
24-10 SECTION 35. This Act takes effect September 1, 1993.
24-11 SECTION 36. The importance of this legislation and the
24-12 crowded condition of the calendars in both houses create an
24-13 emergency and an imperative public necessity that the
24-14 constitutional rule requiring bills to be read on three several
24-15 days in each house be suspended, and this rule is hereby suspended.