By: McDonald H.B. No. 1551
73R4467 DLF-F
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 or hospice service;
1-16 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 <Health> service" means provision of
1-24 one or more of the following health services required by an
2-1 individual in 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 an unlicensed person
2-7 under the supervision of a registered nurse <the service of a home
2-8 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 services for pay or
2-15 other consideration in a client's residence or independent living
2-16 environment <service>.
2-17 (5) "Hospice" means 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 a
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, including a
2-27 group home or foster home; and
3-1 (B) other settings in which the client
3-2 participates in activities including school, work, or church.
3-3 (7) "Person" means an individual, partnership,
3-4 corporation, or association.
3-5 (8) "Personal assistance service" means routine
3-6 ongoing care or services required by an individual in a residence
3-7 or independent living environment to engage in the activities of
3-8 daily living or to perform the physical functions required for
3-9 independent living. The term includes health-related services
3-10 performed under circumstances defined as not constituting the
3-11 practice of professional nursing by the Board of Nurse Examiners
3-12 through a memorandum of understanding with the department under
3-13 Section 142.016.
3-14 (9) <(7)> "Place of business" means an office of a
3-15 home care and community support <health> agency that maintains
3-16 client <patient> records or directs home health, hospice, or
3-17 personal assistance services. The term includes a suboffice, a
3-18 branch office, a workroom, or any other subsidiary location.
3-19 (10) <(8)> "Residence" means a place where a person
3-20 resides and includes a home, a nursing home, or a convalescent home
3-21 <for the disabled or aged>.
3-22 SECTION 4. Section 142.002(a), Health and Safety Code, is
3-23 amended to read as follows:
3-24 (a) A person may not engage in the business of providing
3-25 home health, hospice, or personal assistance services without an
3-26 appropriate license issued by the department for each place of
3-27 business from which the <home health> services are directed. A
4-1 certified agency must have a Class A license, and any other person
4-2 must have a Class B license.
4-3 SECTION 5. Section 142.0025, Health and Safety Code, is
4-4 amended to read as follows:
4-5 Sec. 142.0025. Temporary License. If a person is in the
4-6 process of becoming certified by the United States Department of
4-7 Health and Human Services to qualify as a certified agency, the
4-8 department may issue a temporary Class A home health or hospice
4-9 service license to the person. A temporary license is effective as
4-10 provided by board rules.
4-11 SECTION 6. Section 142.003, Health and Safety Code, is
4-12 amended to read as follows:
4-13 Sec. 142.003. Exemptions From Licensing Requirement. The
4-14 following persons need not be licensed under this chapter:
4-15 (1) a physician, dentist, registered nurse, or
4-16 physical therapist licensed under the laws of this state who
4-17 provides home health services to a patient only as a part of and
4-18 incidental to that person's private office practice;
4-19 (2) a registered nurse, licensed vocational nurse,
4-20 physical therapist, occupational therapist, speech therapist,
4-21 medical social worker, or any other health care professional as
4-22 determined by the department who provides home health services as a
4-23 sole practitioner;
4-24 (3) a <nonprofit> registry <operated by a national or
4-25 state professional association or society of licensed health care
4-26 practitioners, or a subdivision of the association or society,>
4-27 that operates solely as a clearinghouse to put consumers in contact
5-1 with persons who provide home health, hospice, or personal
5-2 assistance services <licensed health care practitioners who give
5-3 care in a patient's residence> and that does not maintain official
5-4 client <patient> records, <or> direct client <patient> services
5-5 compensate the person providing the service;
5-6 (4) an individual whose permanent residence is in the
5-7 client's <patient's> residence;
5-8 (5) an employee of a person licensed under this
5-9 chapter who provides home health, hospice, or personal assistance
5-10 services only as an employee of the license holder and who receives
5-11 no benefit for providing the services, other than wages from the
5-12 license holder;
5-13 (6) a home, nursing home, convalescent home, or other
5-14 institution for the disabled or aged that provides home health or
5-15 personal assistance services only to residents of the home or
5-16 institution;
5-17 (7) a person who provides one health service through a
5-18 contract with a person licensed under this chapter;
5-19 (8) a durable medical equipment supply company;
5-20 (9) a pharmacy or wholesale medical supply company
5-21 that does not furnish services, other than supplies, to a person at
5-22 the person's house;
5-23 (10) a hospital or other licensed health care facility
5-24 that serves only inpatient residents;
5-25 (11) a person providing home health or personal
5-26 assistance services to an injured employee under the Texas Workers'
5-27 Compensation Act (Article 8308-1.01 et seq., Vernon's Texas Civil
6-1 Statutes) <workers' compensation laws of this state (Article 8306
6-2 et seq., Revised Statutes)>; <or>
6-3 (12) a visiting nurse service that:
6-4 (A) is conducted by and for the adherents of a
6-5 well-recognized church or religious denomination; and
6-6 (B) provides nursing services by a person exempt
6-7 from licensing by Article 4528, Revised Statutes, because the
6-8 person furnishes nursing care in which treatment is only by prayer
6-9 or spiritual means;
6-10 (13) an individual hired and paid directly by the
6-11 client or the client's family or legal guardian to provide home
6-12 health or personal assistance services; and
6-13 (14) a business, camp, or school that provides home
6-14 health or personal assistance services only to its employees or
6-15 students, or to other persons with a similar relationship to the
6-16 business, camp, or school.
6-17 SECTION 7. Section 142.004, Health and Safety Code, is
6-18 amended to read as follows:
6-19 Sec. 142.004. License Application. (a) An applicant for a
6-20 license to provide a home health, hospice, or personal assistance
6-21 service must:
6-22 (1) file a written application on a form prescribed by
6-23 the department;
6-24 (2) file with the application:
6-25 (A) the name of the owner of the service or a
6-26 list of the names of persons who own an interest in the service;
6-27 and
7-1 (B) a list of any businesses with which the
7-2 service subcontracts and in which the owner or owners of the
7-3 service hold at least five percent of the ownership;
7-4 (3) cooperate with any inspections required by the
7-5 department for a license; and
7-6 (4) pay the license fee prescribed by this chapter.
7-7 (b) In addition to the requirements of Subsection (a), if
7-8 the applicant is a certified agency when the application for a
7-9 Class A license is filed, the applicant must maintain its Medicare
7-10 certification. If the applicant is not a certified agency when the
7-11 application for a Class A license is filed, the applicant must
7-12 establish that it is in the process of receiving its certification
7-13 from the United States Department of Health and Human Services.
7-14 (c) The board by rule shall require that, at a minimum,
7-15 before the department may approve a license application, other than
7-16 an application for a renewal or branch office license, the
7-17 applicant must provide to the department:
7-18 (1) documentation establishing that, at a minimum, the
7-19 applicant has sufficient financial resources to provide the
7-20 services required by this chapter and by the department during the
7-21 term of the license;
7-22 (2) a list of the management personnel for the
7-23 proposed home care and community support <health> agency, a
7-24 description of personnel qualifications, and a plan for providing
7-25 continuing training and education for the personnel during the term
7-26 of the license;
7-27 (3) documentation establishing that the applicant is
8-1 capable of meeting the minimum standards established by the board
8-2 relating to the quality of care; and
8-3 (4) a plan that provides for the orderly transfer of
8-4 care of the applicant's clients if the applicant cannot maintain or
8-5 deliver home health, hospice, or personal assistance services under
8-6 the license.
8-7 SECTION 8. Section 142.005(a), Health and Safety Code, is
8-8 amended to read as follows:
8-9 (a) If an applicant for a license, other than a renewal or
8-10 branch office license, proposes to operate a home care and
8-11 community support <health> agency through a partnership,
8-12 corporation, or other business entity that includes members that
8-13 are not individuals, or through a corporation the shares of which
8-14 are owned by another corporation, the applicant must:
8-15 (1) establish a corporation under the laws of this
8-16 state if the applicant is not a corporation organized under the
8-17 laws of this state;
8-18 (2) allow the department to review the competence and
8-19 financial resources of any shareholder who holds at least 10
8-20 percent of the shares of the Texas corporation;
8-21 (3) allow the department to review the history and
8-22 financial resources of each parent or health-related subsidiary of
8-23 the Texas corporation;
8-24 (4) grant the Texas corporation full authority to
8-25 operate the home care and community support <health> agency and
8-26 any subsequent home care and community support <health> agencies
8-27 for which the applicant may seek licensing under this chapter;
9-1 (5) disclose to the department any information the
9-2 department needs to conduct the reviews authorized by this
9-3 subsection; and
9-4 (6) establish a registered agent as required by
9-5 Article 2.09, Texas Business Corporation Act, to receive service of
9-6 process in this state.
9-7 SECTION 9. Section 142.006, Health and Safety Code, is
9-8 amended by amending Subsection (a) and adding Subsections (c), (d),
9-9 and (e) to read as follows:
9-10 (a) The department shall issue a Class A or Class B home
9-11 care and community support <health> service license for each place
9-12 of business to each applicant who:
9-13 (1) qualifies for the type of license requested;
9-14 (2) submits an application and license fee as required
9-15 by this chapter; and
9-16 (3) complies with all licensing standards required or
9-17 adopted by the board under this chapter.
9-18 (c) The department may find that a home care and community
9-19 support agency has satisfied the requirements for license renewal
9-20 if the agency is accredited by a national accreditation
9-21 organization, such as the Joint Commission on Accreditation of
9-22 Health Organizations or the Community Health Care Accreditation
9-23 Program, and the department finds that the accreditation
9-24 organization has standards that meet or exceed the requirements for
9-25 licensure under this chapter.
9-26 (d) The department may find that a home care and community
9-27 support agency has satisfied the requirements for license renewal
10-1 if the agency is certified by another state agency that has
10-2 certification standards that meet or exceed the requirements for
10-3 licensure under this chapter.
10-4 (e) The license must designate the type of services that the
10-5 place of business is authorized to perform.
10-6 SECTION 10. Section 142.007, Health and Safety Code, is
10-7 amended to read as follows:
10-8 Sec. 142.007. HOSPICE. If the agency meets the standards
10-9 adopted by the board for hospice services, a home care and
10-10 community support <health> service license may state that the <a
10-11 home health> agency is a hospice. A business may not use the term
10-12 "hospice" in its name or to describe its services unless it is
10-13 licensed under this chapter.
10-14 SECTION 11. Sections 142.009(b), (c), and (e), Health and
10-15 Safety Code, are amended to read as follows:
10-16 (b) A home care and community support <health> agency shall
10-17 provide each person who receives home health, hospice, or personal
10-18 assistance services with a written statement that contains the
10-19 name, address, and telephone number of the department and a
10-20 statement that informs consumers that a complaint against a home
10-21 care and community support <health> agency may be directed to the
10-22 department.
10-23 (c) The department or its authorized representative shall
10-24 investigate each complaint received regarding the provision of home
10-25 health, hospice, or personal assistance services and may, as a part
10-26 of the investigation:
10-27 (1) conduct an unannounced inspection of a place of
11-1 business, including an inspection of medical and personnel records,
11-2 if the department has reasonable cause to believe that the place of
11-3 business is in violation of this chapter or a rule adopted under
11-4 this chapter;
11-5 (2) conduct an interview with a recipient of home
11-6 health, hospice, or personal assistance services, which may be
11-7 conducted in the recipient's home if the recipient consents; or
11-8 (3) interview a physician or other health care
11-9 practitioner, including a member of the personnel of a home care
11-10 and community support <health> agency, who cares for a recipient of
11-11 home health, hospice, or personal assistance services.
11-12 (e) The department's representative shall hold a conference
11-13 with the person in charge of the home care and community support
11-14 <health> agency before beginning the on-site inspection to explain
11-15 the nature and scope of the inspection. When the inspection is
11-16 completed, the department's representative shall hold a conference
11-17 with the person who is in charge of the agency and shall identify
11-18 any records that were duplicated. Agency records may be removed
11-19 from an agency only with the agency's consent.
11-20 SECTION 12. Section 142.010(a), Health and Safety Code, is
11-21 amended to read as follows:
11-22 (a) The board shall set the home care and community support
11-23 <health> service license fees in amounts that are reasonable to
11-24 meet the costs of administering this chapter, except that the fees
11-25 may not be:
11-26 (1) less than $600 or more than $1,200 for an initial
11-27 Class A or Class B license; or
12-1 (2) less than $200 or more than $300 for renewal of a
12-2 branch office license.
12-3 SECTION 13. Section 142.011(c), Health and Safety Code, is
12-4 amended to read as follows:
12-5 (c) The department may suspend or revoke the license of a
12-6 Class A home care and community support <health> agency that fails
12-7 to maintain its certification qualifying the agency as a certified
12-8 agency. A Class A <home health> agency that submits a request for
12-9 a hearing as provided by Subsection (d) is subject to the
12-10 requirements of this chapter relating to a Class B <home health>
12-11 agency until the suspension or revocation is finally determined by
12-12 the department or, if the license is suspended or revoked, until
12-13 the last day for seeking review of the department order or a later
12-14 date fixed by order of the reviewing court.
12-15 SECTION 14. Sections 142.012(b) and (d), Health and Safety
12-16 Code, are amended to read as follows:
12-17 (b) The board by rule shall set minimum standards for home
12-18 care and community support <health> agencies licensed under this
12-19 chapter that relate to:
12-20 (1) qualifications for professional and
12-21 nonprofessional personnel;
12-22 (2) supervision of professional and nonprofessional
12-23 personnel;
12-24 (3) the provision and coordination of treatment and
12-25 services;
12-26 (4) the organizational structure, including lines of
12-27 authority and delegation of responsibility;
13-1 (5) clinical and business records;
13-2 (6) financial ability to carry out the functions as
13-3 proposed; and
13-4 (7) any other aspects of home health, hospice, or
13-5 personal assistance services as necessary to protect the public.
13-6 (d) The department shall require each person or home care
13-7 and community support <health> agency providing home health,
13-8 hospice, or personal assistance services to implement and enforce
13-9 the applicable provisions of Chapter 102, Human Resources Code.
13-10 SECTION 15. Section 142.014(a), Health and Safety Code, is
13-11 amended to read as follows:
13-12 (a) A person who operates a home care and community support
13-13 <health> agency without a license issued under this chapter is
13-14 liable for a civil penalty of not less than $100 or more than $500
13-15 for each day of violation.
13-16 SECTION 16. Section 142.015(a), Health and Safety Code, is
13-17 amended to read as follows:
13-18 (a) The Home Care and Community Support <Health> Services
13-19 Advisory Council is composed of the following 11 members, appointed
13-20 by the governor:
13-21 (1) one representative of the department;
13-22 (2) two representatives of consumers of home health,
13-23 <agency and> hospice, or personal assistance services;
13-24 (3) one representative of the Texas Department of
13-25 Human Services;
13-26 (4) one representative of the Texas Association for
13-27 <of> Home Care <Health Agencies>, Incorporated or its successor;
14-1 (5) one representative of private nonprofit home care
14-2 and community support <health> agencies;
14-3 (6) one representative of voluntary nonprofit home
14-4 care and community support <health> agencies;
14-5 (7) one representative of proprietary home care and
14-6 community support <health> agencies;
14-7 (8) one representative of an official department home
14-8 care and community support <health> agency;
14-9 (9) one member to represent Medicare-certified Class A
14-10 hospice providers affiliated with a home care and community support
14-11 <health> agency, hospital, or other health service provider; and
14-12 (10) one member to represent Medicare-certified Class
14-13 A hospice providers not affiliated with a home care and community
14-14 support <health> agency, hospital, or other health service
14-15 provider.
14-16 SECTION 17. Subchapter A, Chapter 142, Health and Safety
14-17 Code, is amended by adding Section 142.016 to read as follows:
14-18 Sec. 142.016. MEMORANDUM OF UNDERSTANDING RELATING TO
14-19 NURSING SERVICES; GUIDELINES. (a) The Board of Nurse Examiners
14-20 and the department shall adopt a memorandum of understanding
14-21 governing the circumstances under which the provision of
14-22 health-related services do not constitute the practice of
14-23 professional nursing. The agencies shall annually review and renew
14-24 or modify the memorandum as necessary.
14-25 (b) In developing, modifying, or renewing the memorandum of
14-26 understanding, the Board of Nurse Examiners and the department
14-27 shall consult with an advisory committee appointed by the board and
15-1 the department and composed of:
15-2 (1) representatives of home care and community support
15-3 agencies;
15-4 (2) professional nurses;
15-5 (3) persons with disabilities;
15-6 (4) respite providers; and
15-7 (5) other persons selected by the board and
15-8 department.
15-9 (c) The department shall prepare guidelines based on the
15-10 memorandum of understanding for agencies licensed under this
15-11 chapter to use in providing personal assistance services to
15-12 clients.
15-13 SECTION 18. Section 142.021, Health and Safety Code, is
15-14 amended to read as follows:
15-15 Sec. 142.021. ADMINISTRATION OF <Permits to Administer>
15-16 Medication. A person may not administer medication to a client
15-17 <patient> of a home care and community support <health> agency
15-18 unless the person:
15-19 (1) holds a license under state law that authorizes
15-20 the person to administer medication;
15-21 (2) holds a permit issued under Section 142.025 and
15-22 acts under the delegated authority of a person who holds a license
15-23 under state law that authorizes the person to administer
15-24 medication; <or>
15-25 (3) performs duties as a qualified dialysis technician
15-26 within the scope authorized by board rules;
15-27 (4) administers a medication to a client in accordance
16-1 with rules of the Board of Nurse Examiners permitting the
16-2 delegation of the administration to a person not holding a permit
16-3 under Section 142.025; or
16-4 (5) administers noninjectable medication under
16-5 circumstances defined by the memorandum of understanding adopted
16-6 under Section 142.016 as not constituting the practice of
16-7 professional nursing.
16-8 SECTION 19. Section 142.023, Health and Safety Code, is
16-9 amended to read as follows:
16-10 Sec. 142.023. Rules for Administration of Medication. The
16-11 board by rule shall establish:
16-12 (1) minimum requirements for the issuance, denial,
16-13 renewal, suspension, emergency suspension, and revocation of a
16-14 permit to a home health <administer> medication aide <to a patient
16-15 of a home health agency>;
16-16 (2) curricula to train a home health <persons to
16-17 administer> medication aide <to a patient of a home health agency>;
16-18 (3) minimum standards for the approval of home health
16-19 medication aide training programs <to train persons to administer
16-20 medication to patients of home health agencies> and for rescinding
16-21 approval;
16-22 (4) the acts and practices that are allowed or
16-23 prohibited to a permit holder; and
16-24 (5) minimum standards for on-site supervision of a
16-25 permit holder by a registered nurse.
16-26 SECTION 20. Section 142.024, Health and Safety Code, is
16-27 amended to read as follows:
17-1 Sec. 142.024. HOME HEALTH MEDICATION AIDE Training Programs
17-2 <to Administer Medication>. (a) An application for the approval
17-3 of a home health medication aide training program must be made to
17-4 the department on a form and under rules prescribed by the board.
17-5 (b) The department shall approve a home health medication
17-6 aide training program that meets the minimum standards adopted
17-7 under Section 142.023. The department may review the approval
17-8 annually.
17-9 SECTION 21. Section 142.025, Health and Safety Code, is
17-10 amended to read as follows:
17-11 Sec. 142.025. Issuance and Renewal of HOME HEALTH MEDICATION
17-12 AIDE Permit <to Administer Medication>. (a) To be issued or to
17-13 have renewed a home health medication aide permit <to administer
17-14 medication>, a person shall apply to the department on a form
17-15 prescribed and under rules adopted by the board.
17-16 (b) The department shall prepare and conduct an examination
17-17 for the issuance of a permit.
17-18 (c) The department shall require a permit holder to
17-19 satisfactorily complete a continuing education course approved by
17-20 the department for renewal of the permit.
17-21 (d) The department shall issue a permit or renew a permit to
17-22 an applicant who:
17-23 (1) meets the minimum requirements adopted under
17-24 Section 142.023;
17-25 (2) successfully completes the examination or the
17-26 continuing education requirements; and
17-27 (3) pays a nonrefundable application fee determined by
18-1 the board.
18-2 (e) A permit is valid for one year and is not transferable.
18-3 SECTION 22. The section heading to Section 142.026, Health
18-4 and Safety Code, is amended to read as follows:
18-5 Sec. 142.026. Fees for Issuance and Renewal of HOME HEALTH
18-6 MEDICATION AIDE Permit <to Administer Medication>.
18-7 SECTION 23. The section heading to Section 142.027, Health
18-8 and Safety Code, is amended to read as follows:
18-9 Sec. 142.027. Violation of HOME HEALTH MEDICATION AIDE
18-10 Permits <to Administer Medication>.
18-11 SECTION 24. The section heading to Section 142.028, Health
18-12 and Safety Code, is amended to read as follows:
18-13 Sec. 142.028. Emergency Suspension of HOME HEALTH MEDICATION
18-14 AIDE Permits <to Administer Medication>.
18-15 SECTION 25. Section 142.029(a), Health and Safety Code, is
18-16 amended to read as follows:
18-17 (a) A person commits an offense if the person knowingly
18-18 administers medication to a client <patient> of a home care and
18-19 community support <health> agency and the person is not authorized
18-20 to administer the medication under Section 142.021 or 142.022<:>
18-21 <(1) does not hold a license under state law that
18-22 authorizes the person to administer medication; or>
18-23 <(2) does not hold a permit issued by the department
18-24 under Section 142.025>.
18-25 SECTION 26. Section 142.030(a), Health and Safety Code, is
18-26 amended to read as follows:
18-27 (a) A person authorized by this subchapter to administer
19-1 medication to a client <patient> of a home care and community
19-2 support <health> agency may not dispense dangerous drugs or
19-3 controlled substances without complying with the Texas Pharmacy Act
19-4 (Article 4542a-1, Vernon's Texas Civil Statutes).
19-5 SECTION 27. Section 248.003, Health and Safety Code, is
19-6 amended to read as follows:
19-7 Sec. 248.003. Exemptions. This chapter does not apply to:
19-8 (1) a home care and community support <health> agency
19-9 required to be licensed under Chapter 142;
19-10 (2) a person required to be licensed under Chapter 241
19-11 (Texas Hospital Licensing Law);
19-12 (3) an institution required to be licensed under
19-13 Chapter 242;
19-14 (4) an ambulatory surgical center required to be
19-15 licensed under Chapter 243 (Texas Ambulatory Surgical Center
19-16 Licensing Act);
19-17 (5) a birthing center required to be licensed under
19-18 Chapter 244 (Texas Birthing Center Licensing Act);
19-19 (6) a facility required to be licensed under Chapter
19-20 245 (Texas Abortion Facility Reporting and Licensing Act); or
19-21 (7) a person providing medical or nursing care or
19-22 services under a license or permit issued under other state law.
19-23 SECTION 28. (a) The changes in law made to Sections 142.028
19-24 and 142.030, Health and Safety Code, by this Act apply only to an
19-25 offense committed on or after the effective date of this Act. For
19-26 purposes of this section, an offense is committed before the
19-27 effective date of this Act if any element of the offense occurs
20-1 before the effective date.
20-2 (b) An offense committed before the effective date of this
20-3 Act is covered by the law in effect when the offense was committed,
20-4 and the former law is continued in effect for this purpose.
20-5 SECTION 29. The change made by this Act in the
20-6 qualifications of members of the Home Care and Community Support
20-7 Advisory Council (formerly the Home Health Care Advisory Council)
20-8 does not affect the ability of a member serving immediately before
20-9 the effective date of this Act to continue to serve for the term
20-10 for which the member was appointed.
20-11 SECTION 30. Not later than November 30, 1993, the Board of
20-12 Nurse Examiners and the Texas Department of Health shall adopt the
20-13 initial memorandum of understanding required by Section 142.016,
20-14 Health and Safety Code, as added by this Act.
20-15 SECTION 31. The changes in law made by this Act do not
20-16 affect the validity of a license or a permit to administer
20-17 medication issued by the department under Chapter 142, Health and
20-18 Safety Code, before the effective date of this Act. On renewal, a
20-19 license issued to a home health agency before the effective date of
20-20 this Act shall be conformed to the requirements of Chapter 142,
20-21 Health and Safety Code, as amended by this Act.
20-22 SECTION 32. This Act takes effect September 1, 1993.
20-23 SECTION 33. The importance of this legislation and the
20-24 crowded condition of the calendars in both houses create an
20-25 emergency and an imperative public necessity that the
20-26 constitutional rule requiring bills to be read on three several
20-27 days in each house be suspended, and this rule is hereby suspended.