By Craddick, Oliveira, et al. H.B. No. 1592
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of hospices; providing civil penalties.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Subtitle G, Title 2, Health and Safety Code, is
1-5 amended by adding Chapter 146 to read as follows:
1-6 CHAPTER 146. HOSPICE PROGRAM OF CARE
1-7 SUBCHAPTER A. GENERAL PROVISIONS
1-8 Sec. 146.001. SHORT TITLE. This chapter may be cited as the
1-9 Texas Hospice Act.
1-10 Sec. 146.002. DEFINITIONS. In this chapter:
1-11 (1) "Alternate delivery site" means a location or site
1-12 from which a hospice agency provides services within a portion of
1-13 the total geographical area served by that hospice.
1-14 (2) "Bereavement" means the process by which survivors
1-15 mourn and experience their grief.
1-16 (3) "Bereavement services" means support services
1-17 offered to the family during the period of bereavement.
1-18 (4) "Certified hospice provider" means a provider who
1-19 offers a hospice program of care and is certified by an official of
1-20 the United States Department of Health and Human Services as being
1-21 in compliance with conditions of participation adopted under Title
1-22 XVIII, Social Security Act (42 U.S.C. Section 1395 et seq.).
1-23 (5) "Council" means the Hospice Advisory Council.
1-24 (6) "Counselor" means a person qualified under
2-1 Medicare standards to provide counseling services to both the
2-2 patient and the family, including bereavement, dietary, spiritual,
2-3 and other counseling services.
2-4 (7) "Director" means the executive head of the Texas
2-5 Department of Health.
2-6 (8) "Home" means the patient's place of residence.
2-7 (9) "Hospice program of care" means a coordinated
2-8 program consistent with the standards and rules adopted under this
2-9 chapter that provides palliative care to terminally ill patients
2-10 and provides supportive services to patients and their families,
2-11 and that:
2-12 (A) is available 24 hours a day, seven days a
2-13 week, during the last stages of illness, during death, and during
2-14 bereavement;
2-15 (B) is provided by a medically directed
2-16 interdisciplinary team; and
2-17 (C) may be provided in a home, nursing home,
2-18 residential unit, or inpatient unit according to need.
2-19 (10) "Hospice services" means those services provided
2-20 to a patient or the patient's family as part of a hospice program
2-21 of care.
2-22 (11) "Inpatient unit" means a facility owned or
2-23 operated by a licensed hospice and located within the geographical
2-24 area served by the hospice that provides a continuum of medical or
2-25 nursing care or services to hospice patients admitted into the unit
2-26 and that is in compliance with the conditions of participation for
2-27 inpatient units adopted under Title XVIII, Social Security Act (42
3-1 U.S.C. Section 1395 et seq.), and standards adopted under this
3-2 chapter.
3-3 (12) "Interdisciplinary team" means a group of
3-4 individuals that work together in a coordinated manner to provide a
3-5 hospice program of care and that includes a physician, registered
3-6 nurse, social worker, and counselor.
3-7 (13) "Investigation" means an inspection or survey
3-8 conducted by a representative of the department to determine
3-9 whether a licensee is in compliance with this chapter and rules
3-10 adopted under this chapter or with Title XVIII, Social Security Act
3-11 (42 U.S.C. Section 1395 et seq.), and regulations adopted under
3-12 that Act.
3-13 (14) "Nurse" means a person licensed by the Board of
3-14 Nurse Examiners or the Board of Vocational Nurse Examiners.
3-15 (15) "Palliative care" means those services of
3-16 intervention that focus primarily on the reduction or abatement of
3-17 physical, psychosocial, and spiritual symptoms of terminal illness.
3-18 (16) "Physician" means a person licensed by the Texas
3-19 State Board of Medical Examiners.
3-20 (17) "Residential unit" means a facility owned or
3-21 operated by a licensed hospice and located within the geographical
3-22 area served by the hospice that provides living quarters and
3-23 hospice services to patients admitted into the unit and that is in
3-24 compliance with standards adopted under this chapter.
3-25 (18) "Social worker" means a person certified as a
3-26 social worker under Chapter 50, Human Resources Code.
3-27 (19) "Supportive services" means social, spiritual,
4-1 and emotional care provided to the patient and the patient's
4-2 family.
4-3 (20) "Terminal illness" means an illness for which
4-4 there is a limited prognosis if the illness runs its usual course.
4-5 (21) "Volunteer" means a person who provides
4-6 assistance to a hospice program of care without compensation other
4-7 than actual expenses incurred.
4-8 (Sections 146.003-146.010 reserved for expansion
4-9 SUBCHAPTER B. LICENSES
4-10 Sec. 146.011. LICENSE REQUIRED. (a) Except as provided by
4-11 Section 146.012, a person, including a health care facility
4-12 licensed under this code, may not establish, conduct, or operate a
4-13 hospice program of care or hold the person out to the public as a
4-14 provider of hospice services unless the person holds a hospice
4-15 license issued under this chapter.
4-16 (b) A person who is not licensed under this chapter may not
4-17 use the word "hospice," use any title or description of a facility,
4-18 organization, program, service provider, or services incorporating
4-19 the word "hospice," or use any other words, letters, abbreviations,
4-20 or insignia indicating or implying that the person holds a hospice
4-21 license.
4-22 (c) A license issued under this chapter includes authority
4-23 granted to the licensee to own or operate a residential unit or
4-24 inpatient unit in compliance with standards and rules adopted under
4-25 this chapter.
4-26 Sec. 146.012. EXEMPTIONS. (a) A health care facility
4-27 licensed under this code that provides hospice services under a
5-1 contract with a person holding a hospice license issued under this
5-2 chapter is not required to obtain a license under this chapter.
5-3 (b) Subsection (a) of Section 146.011 does not apply to a
5-4 person delivering residential AIDS hospice care who is licensed and
5-5 designated a residential AIDS hospice under Chapter 248.
5-6 Sec. 146.013. NONTRANSFERABILITY. (a) A license issued
5-7 under this chapter may not be transferred to another person but may
5-8 be transferred from one location to another location.
5-9 (b) A change of ownership or location shall be reported to
5-10 the department.
5-11 Sec. 146.014. TEMPORARY LICENSE. The department may issue a
5-12 nonrenewable temporary hospice license to a person who is in the
5-13 process of becoming licensed by the department as a hospice. A
5-14 temporary license is valid for six months from the date of its
5-15 issuance and is effective as provided by board rules.
5-16 Sec. 146.015. LICENSE APPLICATION. (a) An applicant for a
5-17 hospice license must:
5-18 (1) file a written application on a form prescribed by
5-19 the department;
5-20 (2) file with the application:
5-21 (A) the name of the owner of the hospice or a
5-22 list of the names of persons, if any, who own at least a 10 percent
5-23 interest in the hospice; and
5-24 (B) a list of any businesses with which the
5-25 hospice subcontracts and in which the owner or owners of the
5-26 hospice hold at least five percent of the ownership; or
5-27 (C) if the applicant is a direct or indirect
6-1 subsidiary of a publicly held corporation, the name of the publicly
6-2 held corporation of which the applicant is a subsidiary and the
6-3 names of any subsidiaries of the publicly held corporation owning
6-4 an interest in the applicant;
6-5 (3) cooperate with any inspections required by the
6-6 department for a license; and
6-7 (4) pay the license fee prescribed by this chapter.
6-8 (b) The board by rule shall require that, at a minimum,
6-9 before the department may approve a license application other than
6-10 an application for a renewal or alternate delivery site license,
6-11 the applicant must provide to the department:
6-12 (1) documentation establishing that, at a minimum, the
6-13 applicant has sufficient financial resources to provide the
6-14 services required by this chapter and by the department during the
6-15 term of the license;
6-16 (2) a list of the management personnel for the
6-17 proposed hospice, a description of personnel qualifications, and a
6-18 plan for providing continuing training and education for personnel
6-19 during the term of the license;
6-20 (3) documentation establishing that the applicant is
6-21 capable of meeting the minimum standards established by the board
6-22 relating to the quality of care; and
6-23 (4) a plan that provides for the orderly transfer of
6-24 care of the applicant's patients if the applicant cannot maintain
6-25 or deliver hospice services under the license.
6-26 (c) Information received by the department relating to the
6-27 competence and financial resources of the applicant is confidential
7-1 and may not be disclosed to the public.
7-2 Sec. 146.016. LICENSE ISSUANCE. The department shall issue
7-3 a hospice license to each applicant who:
7-4 (1) qualifies for the type of license requested;
7-5 (2) submits an application and license fee as required
7-6 by this chapter; and
7-7 (3) complies with all licensing standards adopted by
7-8 the board or required under this chapter.
7-9 Sec. 146.017. TERM OF LICENSE. (a) Except as provided by
7-10 Subsection (b), a hospice license expires on the first anniversary
7-11 of the date of issuance.
7-12 (b) The department may issue an initial license for a term
7-13 of less than one year to conform with the expiration dates of other
7-14 licenses held by the licensee under this chapter.
7-15 (c) The department, in accordance with board rules, may
7-16 issue a temporary license to an applicant for an initial license.
7-17 Sec. 146.018. DISPLAY OF LICENSE. A hospice license shall
7-18 contain the following information and shall be displayed in a
7-19 conspicuous place in the hospice office:
7-20 (1) the name and address of the hospice;
7-21 (2) the name of the owner or owners, if different from
7-22 the information provided under Subdivision (1); and
7-23 (3) the license expiration date.
7-24 Sec. 146.019. ALTERNATE DELIVERY SITE LICENSE. (a) The
7-25 board by rule shall establish standards required for the issuance
7-26 of an alternate delivery site license.
7-27 (b) The department shall issue an alternate delivery site
8-1 license to a qualified person who holds a hospice license.
8-2 (c) An alternate delivery site license expires on the same
8-3 date as the hospice license held by that person.
8-4 Sec. 146.020. FEES. (a) The board shall adopt hospice
8-5 license fees in amounts that are reasonable to meet the cost of
8-6 administering this chapter, except that the fees may not be:
8-7 (1) less than $600 or more than $1,000 for a temporary
8-8 or initial hospice license or an initial alternate delivery site
8-9 license; or
8-10 (2) less than $300 or more than $600 for renewal of a
8-11 hospice license or an alternate delivery site license.
8-12 (b) A fee charged under this section is nonrefundable.
8-13 Sec. 146.021. RULES. The board shall adopt rules necessary
8-14 to implement this chapter.
8-15 Sec. 146.022. MINIMUM STANDARDS. (a) The board, on the
8-16 recommendation of the council, shall adopt minimum standards for
8-17 hospices licensed under this chapter that are at least as stringent
8-18 as those required for certification as a certified hospice provider
8-19 under federal law.
8-20 (b) Standards adopted under Subsection (a) may relate to:
8-21 (1) qualifications for professional and
8-22 nonprofessional personnel, including volunteers;
8-23 (2) supervision of professional and nonprofessional
8-24 personnel, including volunteers;
8-25 (3) the provision and coordination of treatment and
8-26 services, including supportive and bereavement services;
8-27 (4) the organizational structure, including the lines
9-1 of authority, the delegation of responsibility, and the composition
9-2 of the interdisciplinary team;
9-3 (5) clinical and business records;
9-4 (6) financial ability to carry out the functions as
9-5 proposed;
9-6 (7) safety, fire prevention, and sanitary standards
9-7 for residential units and inpatient units; and
9-8 (8) any other aspect of hospice services necessary for
9-9 a hospice to perform its duties.
9-10 Sec. 146.023. FORMS. The department shall prescribe forms
9-11 necessary to perform its duties under this chapter.
9-12 Sec. 146.024. ENFORCEMENT OF OTHER LAW. The department
9-13 shall require a hospice to implement and enforce the applicable
9-14 provisions of Chapter 102, Human Resources Code.
9-15 (Sections 146.025-146.030 reserved for expansion
9-16 SUBCHAPTER C. ENFORCEMENT
9-17 Sec. 146.031. INSPECTIONS. The department or its authorized
9-18 representative may enter the premises of a license applicant or
9-19 licensee at reasonable times to conduct an inspection incidental to
9-20 the issuance of a license and at other times as the department
9-21 considers necessary to ensure compliance with this chapter and
9-22 rules adopted under this chapter.
9-23 Sec. 146.032. COMPLAINTS. A hospice shall provide each
9-24 person who receives hospice services with a written statement that
9-25 contains the name, address, and telephone number of the department
9-26 and a statement that informs recipients that a complaint against a
9-27 hospice may be directed to the department.
10-1 Sec. 146.033. INVESTIGATION OF COMPLAINT. (a) The
10-2 department or its authorized representative shall investigate each
10-3 complaint received regarding the provision of hospice services and
10-4 may as a part of the investigation:
10-5 (1) conduct an unannounced inspection of a place of
10-6 business, including an inspection of medical and personnel records,
10-7 if the department has reasonable cause to believe that the place of
10-8 business is in violation of this chapter or a rule adopted under
10-9 this chapter;
10-10 (2) conduct an interview with a recipient of hospice
10-11 services, which may be conducted in the recipient's home;
10-12 (3) if the recipient of hospice services is deceased,
10-13 conduct an interview with a family member or other person who would
10-14 have knowledge of the care received from the hospice; and
10-15 (4) interview a health care practitioner or any
10-16 hospice personnel who care for a recipient of hospice services.
10-17 (b) The reports, records, and working papers used or
10-18 developed in an investigation under this section are confidential
10-19 and may be disclosed only in accordance with rules adopted by the
10-20 board.
10-21 Sec. 146.034. CONFERENCE CONCERNING SURVEY. (a) The
10-22 department's authorized representative shall hold a conference with
10-23 the individual in charge of a hospice to explain the nature and
10-24 scope of the survey before beginning an on-site survey.
10-25 (b) When the survey is complete, the representative shall
10-26 hold a conference with the individual in charge of the hospice.
10-27 (c) The individual in charge of the hospice shall be fully
11-1 informed of the preliminary findings of the survey and shall be
11-2 given a reasonable opportunity to submit additional facts or other
11-3 information to the department's representative in response to those
11-4 findings. The response shall be made a part of the record of the
11-5 survey for all purposes.
11-6 (d) During the conference concluding a survey, the
11-7 department's representative shall identify any records that were
11-8 duplicated during the survey. Original hospice records may be
11-9 removed from a hospice only with the hospice's consent.
11-10 Sec. 146.035. RESULTS OF SURVEY. After a survey of a
11-11 licensee by the department, the department shall provide to the
11-12 chief executive officer of the hospice:
11-13 (1) specific and timely written notice of the
11-14 preliminary findings of the survey, including the specific nature
11-15 of the survey, the specific statute or rule allegedly violated, if
11-16 any, the specific nature of any finding regarding the alleged
11-17 violation or deficiency and, if a deficiency is alleged, the
11-18 severity of the deficiency alleged;
11-19 (2) information on the identity, including the
11-20 signature, of each department representative conducting, reviewing,
11-21 or approving the results of the survey and the date on which the
11-22 department representative acted on the matter; and
11-23 (3) on the request of the licensee, copies of all
11-24 documents relating to the survey maintained by the department or
11-25 provided by the department to any other state or federal agency not
11-26 made confidential by state law.
11-27 Sec. 146.036. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
12-1 (a) The department may deny a license application or suspend or
12-2 revoke or probate the revocation of the license of a person who
12-3 fails to comply with this chapter or rules adopted under this
12-4 chapter.
12-5 (b) The department may immediately suspend or revoke a
12-6 license when the health and safety of persons are threatened. On
12-7 the issuance of an order of immediate suspension or revocation, the
12-8 department shall immediately provide to the chief executive officer
12-9 of the hospice adequate notice of the action taken, the legal basis
12-10 for the action, and the procedure governing appeal of the action.
12-11 A person whose license is suspended or revoked under this
12-12 subsection is entitled to a hearing not later than the seventh day
12-13 after the effective date of the suspension or revocation.
12-14 (c) A person whose application is denied or whose license is
12-15 suspended or revoked is entitled to a hearing before the department
12-16 if the person submits a written request to the department. The
12-17 Administrative Procedure and Texas Register Act (Article 6252-13a,
12-18 Vernon's Texas Civil Statutes) and the department's rules for
12-19 contested case hearings apply to hearings conducted under this
12-20 section and to appeals from department decisions.
12-21 Sec. 146.037. INJUNCTION. (a) A district court, on
12-22 petition of the department and on a finding by the court that a
12-23 person is violating this chapter, may by injunction:
12-24 (1) prohibit the person from continuing the violation;
12-25 or
12-26 (2) grant any other injunctive relief warranted by the
12-27 facts.
13-1 (b) The attorney general shall institute and conduct a suit
13-2 authorized by this section at the request of the department and in
13-3 the name of the state.
13-4 (c) A suit for injunctive relief must be brought in Travis
13-5 County.
13-6 Sec. 146.038. CIVIL PENALTY. (a) A person who establishes,
13-7 conducts, or operates a hospice program of care or holds the person
13-8 out to the public as a provider of hospice services without a
13-9 license issued under this chapter is liable for a civil penalty of
13-10 not less than $1,000 or more than $2,500 for each day of violation.
13-11 (b) The attorney general shall bring suit on behalf of the
13-12 state to collect the civil penalty. An action to recover a civil
13-13 penalty is in addition to an action brought for injunctive relief
13-14 under Section 146.037 or any other remedy provided by law.
13-15 (Sections 146.039-146.050 reserved for expansion
13-16 SUBCHAPTER D. HOSPICE ADVISORY COUNCIL
13-17 Sec. 146.051. DUTIES. The Hospice Advisory Council shall
13-18 consider the needs for hospice services in this state and shall
13-19 recommend for the board's consideration rules to implement
13-20 standards adopted under this chapter and other appropriate rules,
13-21 procedures, and actions regarding all matters relating to hospice
13-22 services.
13-23 Sec. 146.052. COMPOSITION. The council is composed of nine
13-24 members appointed by the director as follows:
13-25 (1) one member to represent the department;
13-26 (2) two members to represent consumers of hospice
13-27 services;
14-1 (3) one member to represent the Texas Department of
14-2 Human Services;
14-3 (4) two members to represent a statewide organization
14-4 the membership of which is primarily composed of providers of
14-5 hospice services;
14-6 (5) one member to represent private, nonprofit
14-7 providers of hospice services;
14-8 (6) one member to represent proprietary providers of
14-9 hospice services; and
14-10 (7) one member to represent a hospital-based provider
14-11 of hospice services.
14-12 Sec. 146.053. TERMS. Members of the council serve staggered
14-13 three-year terms, with the terms of three members expiring January
14-14 31 of each year.
14-15 Sec. 146.054. PRESIDING OFFICER. (a) The council shall
14-16 elect a presiding officer from among its members to preside at
14-17 meetings and to notify members of meetings.
14-18 (b) The presiding officer shall serve for one year and may
14-19 not serve in that capacity for more than two years.
14-20 Sec. 146.055. MEETINGS. The council shall meet at least
14-21 twice a year and at other times at the call of the presiding
14-22 officer, any three members of the council, or the director.
14-23 Sec. 146.056. COMPENSATION. Members of the council serve
14-24 without compensation but are entitled to reimbursement for expenses
14-25 incurred as provided by the General Appropriations Act for members
14-26 of boards of state agencies.
14-27 SECTION 2. Sections 142.001(4) and (5), Health and Safety
15-1 Code, are amended to read as follows:
15-2 (4) "Home health agency" means a place of business<,
15-3 including a hospice,> that provides a home health service. The
15-4 term does not include a person licensed under Chapter 146.
15-5 (5) "Home health service" means the provision, for pay
15-6 or other consideration, of a health service in a patient's
15-7 residence. The term does not include the provision of care under
15-8 an attendant care program administered by the Texas Department of
15-9 Human Services or the provision of hospice services by a person
15-10 licensed under Chapter 146.
15-11 SECTION 3. Sections 142.015(a) and (d), Health and Safety
15-12 Code, are amended to read as follows:
15-13 (a) The Home Health Services Advisory Council is composed of
15-14 the following nine <11> members, appointed by the governor:
15-15 (1) one representative of the department;
15-16 (2) two representatives of consumers of home health
15-17 agency <and hospice> services;
15-18 (3) one representative of the Texas Department of
15-19 Human Services;
15-20 (4) one representative of the Texas Association of
15-21 Home Health Agencies, Incorporated;
15-22 (5) one representative of private nonprofit home
15-23 health agencies;
15-24 (6) one representative of voluntary nonprofit home
15-25 health agencies;
15-26 (7) one representative of proprietary home health
15-27 agencies; and
16-1 (8) one representative of an official department home
16-2 health agency<;>
16-3 <(9) one member to represent Medicare-certified Class
16-4 A hospice providers affiliated with a home health agency, hospital,
16-5 or other health service provider; and>
16-6 <(10) one member to represent Medicare-certified Class
16-7 A hospice providers not affiliated with a home health agency,
16-8 hospital, or other health service provider>.
16-9 (d) Members of the council serve staggered two-year terms,
16-10 with the terms of five <six> members expiring on January 31 of each
16-11 even-numbered year and the terms of four <five> members expiring on
16-12 January 31 of each odd-numbered year.
16-13 SECTION 4. Section 142.021, Health and Safety Code, is
16-14 amended to read as follows:
16-15 Sec. 142.021. Permits to Administer Medication. A person
16-16 may not administer medication to a patient of a home health agency
16-17 or hospice unless the person:
16-18 (1) holds a license under state law that authorizes
16-19 the person to administer medication;
16-20 (2) holds a permit issued under Section 142.025 and
16-21 acts under the delegated authority of a person who holds a license
16-22 under state law that authorizes the person to administer
16-23 medication; or
16-24 (3) performs duties as a qualified dialysis technician
16-25 within the scope authorized by board rules.
16-26 SECTION 5. Section 142.023, Health and Safety Code, is
16-27 amended to read as follows:
17-1 Sec. 142.023. Rules for Administration of Medication. The
17-2 board by rule shall establish:
17-3 (1) minimum requirements for the issuance, denial,
17-4 renewal, suspension, emergency suspension, and revocation of a
17-5 permit to administer medication to a patient of a home health
17-6 agency or hospice;
17-7 (2) curricula to train persons to administer
17-8 medication to a patient of a home health agency or hospice;
17-9 (3) minimum standards for the approval of programs to
17-10 train persons to administer medication to patients of home health
17-11 agencies or hospices and for rescinding approval;
17-12 (4) the acts and practices that are allowed or
17-13 prohibited to a permit holder; and
17-14 (5) minimum standards for on-site supervision of a
17-15 permit holder by a registered nurse.
17-16 SECTION 6. Section 142.029(a), Health and Safety Code, is
17-17 amended to read as follows:
17-18 (a) A person commits an offense if the person knowingly
17-19 administers medication to a patient of a home health agency or
17-20 hospice and the person:
17-21 (1) does not hold a license under state law that
17-22 authorizes the person to administer medication; or
17-23 (2) does not hold a permit issued by the department
17-24 under Section 142.025.
17-25 SECTION 7. Section 142.030(a), Health and Safety Code, is
17-26 amended to read as follows:
17-27 (a) A person authorized by this subchapter to administer
18-1 medication to a patient of a home health agency or hospice may not
18-2 dispense dangerous drugs or controlled substances without complying
18-3 with the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
18-4 Statutes).
18-5 SECTION 8. Section 248.002, Health and Safety Code, is
18-6 amended by adding Subdivisions (9), (10), (11), (12), and (13) to
18-7 read as follows:
18-8 (9) "Bereavement services" has the meaning assigned by
18-9 Section 146.002(3).
18-10 (10) "Palliative care" has the meaning assigned by
18-11 Section 146.002(15).
18-12 (11) "Supportive services" has the meaning assigned by
18-13 Section 146.002(19).
18-14 (12) "Residential AIDS hospice" means a facility
18-15 licensed and designated as a residential AIDS hospice under this
18-16 chapter.
18-17 (13) "Residential AIDS hospice care" means hospice
18-18 services provided in a residential AIDS hospice.
18-19 SECTION 9. Subchapter B, Chapter 248, Health and Safety
18-20 Code, is amended by adding Section 248.029 to read as follows:
18-21 Sec. 248.029. RESIDENTIAL AIDS HOSPICE DESIGNATION. (a)
18-22 The board by rule shall adopt standards for the designation of a
18-23 special care facility licensed under this chapter as a residential
18-24 AIDS hospice. These standards shall be consistent with other
18-25 standards adopted under this chapter and consistent with the
18-26 purposes for which special care facilities were created.
18-27 (b) In adopting such standards, the board shall consider
19-1 rules adopted for the designation of a hospice under Chapter 142
19-2 and shall establish specific standards requiring:
19-3 (1) the provision of exclusively palliative care by
19-4 such facilities;
19-5 (2) the provision of bereavement services;
19-6 (3) the provision of supportive services to the family
19-7 of a patient;
19-8 (4) the participation of a registered nurse in the
19-9 development of an initial plan of care for a patient and periodic
19-10 review of the plan of care by the interdisciplinary team of the
19-11 facility; and
19-12 (5) clinical and medical review of patient care
19-13 services by a physician who acts as a medical consultant.
19-14 (c) A special care facility licensed under this chapter
19-15 which satisfies the standards adopted pursuant to this section
19-16 shall be issued a designation as a residential AIDS hospice.
19-17 (d) Notwithstanding the provisions of Chapter 146, a special
19-18 care facility licensed and issued a designation as a residential
19-19 AIDS hospice under this chapter may use the term "residential AIDS
19-20 hospice" or similar term or language in its title or in a
19-21 description or representation of the facility, so long as such
19-22 similar term or language clearly identifies the facility as a
19-23 facility regulated under this chapter and clearly distinguishes the
19-24 facility from a hospice regulated under Chapter 146.
19-25 (e) A special care facility licensed under this chapter on
19-26 December 31, 1993, upon notice to the department that it is in
19-27 compliance with the standards adopted for designation as a
20-1 residential AIDS hospice, shall be issued such designation by the
20-2 department, which designation shall be valid until the date upon
20-3 which the license of the facility expires or is renewed.
20-4 SECTION 10. In making initial appointments to the Hospice
20-5 Advisory Council established under Chapter 146, Health and Safety
20-6 Code, as added by this Act, the director of the Texas Department of
20-7 Health shall designate three members to serve terms expiring
20-8 January 31, 1995, three members to serve terms expiring January 31,
20-9 1996, and three members to serve terms expiring January 31, 1997.
20-10 SECTION 11. A certified hospice provider holding a license
20-11 on January 1, 1994, as a hospice issued under Chapter 142, Health
20-12 and Safety Code, shall be licensed as a hospice under Chapter 146,
20-13 Health and Safety Code, as added by this Act, without payment of
20-14 any additional fee. The license expires on the same date as the
20-15 license granted under Chapter 142, Health and Safety Code. The
20-16 hospice shall provide a hospice program of care in accordance with
20-17 Chapter 146, Health and Safety Code, as added by this Act.
20-18 SECTION 12. Section 142.007, Health and Safety Code, is
20-19 repealed.
20-20 SECTION 13. The terms of the members of the Home Health
20-21 Services Advisory Council whose positions are eliminated by this
20-22 Act expire on the effective date of this Act. In making
20-23 appointments to the council for terms beginning February 1, 1994,
20-24 and February 1, 1995, the governor shall appoint the appropriate
20-25 number of members to one-year terms to satisfy the staggered-term
20-26 requirements of Section 142.015(d), Health and Safety Code, as
20-27 amended by this Act. Thereafter, members serve two-year terms.
21-1 SECTION 14. This Act takes effect January 1, 1994.
21-2 SECTION 15. The importance of this legislation and the
21-3 crowded condition of the calendars in both houses create an
21-4 emergency and an imperative public necessity that the
21-5 constitutional rule requiring bills to be read on three several
21-6 days in each house be suspended, and this rule is hereby suspended.