By Craddick, Oliveira, et al.                         H.B. No. 1592
          Substitute the following for H.B. No. 1592:
          By Berlanga                                       C.S.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)  "Family" means those persons sharing housing,
    2-7  common ancestry, or a common personal commitment with the patient.
    2-8              (9)  "Home" means the patient's place of residence.
    2-9              (10)  "Hospice program of care" means a coordinated
   2-10  program consistent with the standards and rules adopted under this
   2-11  chapter that provides palliative care to terminally ill patients
   2-12  and provides supportive services to patients and their families,
   2-13  and that:
   2-14                    (A)  is available 24 hours a day, seven days a
   2-15  week, during the last stages of illness, during death, and during
   2-16  bereavement;
   2-17                    (B)  is provided by a medically directed
   2-18  interdisciplinary team; and
   2-19                    (C)  may be provided in a home, nursing home,
   2-20  residential unit, or inpatient unit according to need.
   2-21              (11)  "Hospice services" means those services provided
   2-22  to a patient or the patient's family as part of a hospice program
   2-23  of care.
   2-24              (12)  "Inpatient unit" means a facility owned or
   2-25  operated by a licensed hospice and located within the geographical
   2-26  area served by the hospice that provides a continuum of medical or
   2-27  nursing care or services to hospice patients admitted into the unit
    3-1  and that is in compliance with the conditions of participation for
    3-2  inpatient units adopted under Title XVIII, Social Security Act 42
    3-3  U.S.C. Section 1395 et seq.), and standards adopted under this
    3-4  chapter.
    3-5              (13)  "Interdisciplinary team" means a group of
    3-6  individuals that work together in a coordinated manner to provide a
    3-7  hospice program of care and that includes a physician, registered
    3-8  nurse, social worker, and counselor.
    3-9              (14)  "Investigation" means an inspection or survey
   3-10  conducted by a representative of the department to determine
   3-11  whether a licensee is in compliance with this chapter and rules
   3-12  adopted under this chapter or with Title XVIII, Social Security Act
   3-13  (42 U.S.C. Section 1395 et seq.), and regulations adopted under
   3-14  that Act.
   3-15              (15)  "Nurse" means a person licensed by the Board of
   3-16  Nurse Examiners or the Board of Vocational Nurse Examiners.
   3-17              (16)  "Palliative care" means those services of
   3-18  intervention that focus primarily on the reduction or abatement of
   3-19  physical, psychosocial, and spiritual symptoms of terminal illness.
   3-20              (17)  "Physician" means a person licensed by the Texas
   3-21  State Board of Medical Examiners.
   3-22              (18)  "Residential unit" means a facility owned or
   3-23  operated by a licensed hospice and located within the geographical
   3-24  area served by the hospice that provides living quarters and
   3-25  hospice services to patients admitted into the unit and that is in
   3-26  compliance with standards adopted under this chapter.
   3-27              (19)  "Social worker" means a person certified as a
    4-1  social worker under Chapter 50, Human Resources Code.
    4-2              (20)  "Supportive services" means social, spiritual,
    4-3  and emotional care provided to the patient and the patient's
    4-4  family.
    4-5              (21)  "Terminal illness" means an illness for which
    4-6  there is a limited prognosis if the illness runs its usual course.
    4-7              (22)  "Volunteer" means a person who provides
    4-8  assistance to a hospice program of care without compensation other
    4-9  than actual expenses incurred.
   4-10           (Sections 146.003-146.010 reserved for expansion
   4-11                        SUBCHAPTER B.  LICENSES
   4-12        Sec. 146.011.  LICENSE REQUIRED.  (a)  Except as provided by
   4-13  Section 146.012, a person, including a health care facility
   4-14  licensed under this code, may not establish, conduct, or operate a
   4-15  hospice program of care or hold the person out to the public as a
   4-16  provider of hospice services unless the person holds a hospice
   4-17  license issued under this chapter.
   4-18        (b)  A person who is not licensed under this chapter may not
   4-19  use the word "hospice," use any title or description of a facility,
   4-20  organization, program, service provider, or services incorporating
   4-21  the word "hospice," or use any other words, letters, abbreviations,
   4-22  or insignia indicating or implying that the person holds a hospice
   4-23  license.
   4-24        (c)  A license issued under this chapter includes authority
   4-25  granted to the licensee to own or operate a residential unit or
   4-26  inpatient unit in compliance with standards and rules adopted under
   4-27  this chapter.
    5-1        Sec. 146.012.  EXEMPTIONS.  (a)  A health care facility
    5-2  licensed under this code that provides hospice services under a
    5-3  contract with a person holding a hospice license issued under this
    5-4  chapter is not required to obtain a license under this chapter.
    5-5        (b)  Subsection (a) of Section 146.011 of this chapter does
    5-6  not apply to a person delivering residential AIDS hospice care who
    5-7  is licensed and designated a residential AIDS hospice under chapter
    5-8  248 of this code.
    5-9        Sec. 146.013.  NONTRANSFERABILITY.  (a)  A license issued
   5-10  under this chapter may not be transferred to another person but may
   5-11  be transferred from one location to another location.
   5-12        (b)  A change of ownership or location shall be reported to
   5-13  the department.
   5-14        Sec. 146.014.  TEMPORARY LICENSE.  The department may issue a
   5-15  nonrenewable temporary hospice license to a person who is in the
   5-16  process of becoming licensed by the department as a hospice.  A
   5-17  temporary license is valid for six months from the date of its
   5-18  issuance and is effective as provided by board rules.
   5-19        Sec. 146.015.  LICENSE APPLICATION.  (a)  An applicant for a
   5-20  hospice license must:
   5-21              (1)  file a written application on a form prescribed by
   5-22  the department;
   5-23              (2)  file with the application:
   5-24                    (A)  the name of the owner of the hospice or a
   5-25  list of the names of persons, if any, who own at least a 10 Percent
   5-26  interest in the hospice; and
   5-27                    (B)  a list of any businesses with which the
    6-1  hospice subcontracts and in which the owner or owners of the
    6-2  hospice hold at least five percent of the ownership; or
    6-3                    (C)  if the applicant is a direct or indirect
    6-4  subsidiary of a publicly-held corporation, the name of the
    6-5  publicly-held corporation of which the applicant is a subsidiary
    6-6  and the names of any subsidiaries of the publicly-held corporation
    6-7  owning an interest in the applicant.
    6-8              (3)  cooperate with any inspections required by the
    6-9  department for a license; and
   6-10              (4)  pay the license fee prescribed by this chapter.
   6-11        (b)  The board by rule shall require that, at a minimum,
   6-12  before the department may approve a license application other than
   6-13  an application for a renewal or alternate delivery site license,
   6-14  the applicant must provide to the department:
   6-15              (1)  documentation establishing that, at a minimum, the
   6-16  applicant has sufficient financial resources to provide the
   6-17  services required by this chapter and by the department during the
   6-18  term of the license;
   6-19              (2)  a list of the management personnel for the
   6-20  proposed hospice, a description of personnel qualifications, and a
   6-21  plan for providing continuing training and education for personnel
   6-22  during the term of the license;
   6-23              (3)  documentation establishing that the applicant is
   6-24  capable of meeting the minimum standards established by the board
   6-25  relating to the quality of care; and
   6-26              (4)  a plan that provides for the orderly transfer of
   6-27  care of the applicant's patients if the applicant cannot maintain
    7-1  or deliver hospice services under the license.
    7-2        (c)  Information received by the department relating to the
    7-3  competence and financial resources of the applicant is confidential
    7-4  and may not be disclosed to the public.
    7-5        Sec. 146.016.  LICENSE ISSUANCE.  The department shall issue
    7-6  a hospice license to each applicant who:
    7-7              (1)  qualifies for the type of license requested;
    7-8              (2)  submits an application and license fee as required
    7-9  by this chapter; and
   7-10              (3)  complies with all licensing standards adopted by
   7-11  the board or required under this chapter.
   7-12        Sec. 146.017.  TERM OF LICENSE.  (a)  Except as provided by
   7-13  Subsection (b), a hospice license expires on the first anniversary
   7-14  of the date of issuance.
   7-15        (b)  The department may issue an initial license for a term
   7-16  of less than one year to conform with the expiration dates of other
   7-17  licenses held by the licensee under this chapter.
   7-18        (c)  The department, in accordance with board rules, may
   7-19  issue a temporary license to an applicant for an initial license.
   7-20        Sec. 146.018.  DISPLAY OF LICENSE.  A hospice license shall
   7-21  contain the following information and shall be displayed in a
   7-22  conspicuous place in the hospice office:
   7-23              (1)  the name and address of the hospice;
   7-24              (2)  the name of the owner or owners, if different from
   7-25  the information provided under Subdivision (l); and
   7-26              (3)  the license expiration date.
   7-27        Sec. 146.019.  ALTERNATE DELIVERY SITE LICENSE.  (a)  The
    8-1  board by rule shall establish standards required for the issuance
    8-2  of an alternate delivery site license.
    8-3        (b)  The department shall issue an alternate delivery site
    8-4  license to a qualified person who holds a hospice license.
    8-5        (c)  An alternate delivery site license expires on the same
    8-6  date as the hospice license held by that person.
    8-7        Sec. 146.020.  FEES.  (a)  The board shall adopt hospice
    8-8  license fees in amounts that are reasonable to meet the cost of
    8-9  administering this chapter, except that the fees may not be:
   8-10              (1)  less than $600 or more than $1,000 for a temporary
   8-11  or initial hospice license or an initial alternate delivery site
   8-12  license; or
   8-13              (2)  less than $300 or more than $600 for renewal of a
   8-14  hospice license or an alternate delivery site license.
   8-15        (b)  A fee charged under this section is nonrefundable.
   8-16        Sec. 146.021.  RULES.  The board shall adopt rules necessary
   8-17  to implement this chapter.
   8-18        Sec. 146.022.  MINIMUM STANDARDS.  (a)  The board, on the
   8-19  recommendation of the council, shall adopt minimum standards for
   8-20  hospices licensed under this chapter that are at least as stringent
   8-21  as those required for certification as a certified hospice provider
   8-22  under federal law.
   8-23        (b)  Standards adopted under Subsection (a) may relate to:
   8-24              (1)  qualifications for professional and
   8-25  nonprofessional personnel, including volunteers;
   8-26              (2)  supervision of professional and nonprofessional
   8-27  personnel, including volunteers;
    9-1              (3)  the provision and coordination of treatment and
    9-2  services, including supportive and bereavement services;
    9-3              (4)  the organizational structure, including the lines
    9-4  of authority, the delegation of responsibility, and the composition
    9-5  of the interdisciplinary team;
    9-6              (5)  clinical and business records;
    9-7              (6)  financial ability to carry out the functions as
    9-8  proposed;
    9-9              (7)  safety, fire prevention, and sanitary standards
   9-10  for residential units and inpatient units; and
   9-11              (8)  any other aspect of hospice services necessary for
   9-12  a hospice to perform its duties.
   9-13        Sec. 146.023.  FORMS.  The department shall prescribe forms
   9-14  necessary to perform its duties under this chapter.
   9-15        Sec. 146.024.  ENFORCEMENT OF OTHER LAW.  The department
   9-16  shall require a hospice to implement and enforce the applicable
   9-17  provisions of Chapter 102, Human Resources Code.
   9-18           (Sections 146.025-146.030 reserved for expansion
   9-19                      SUBCHAPTER C.  ENFORCEMENT
   9-20        Sec. 146.031.  INSPECTIONS.  The department or its authorized
   9-21  representative may enter the premises of a license applicant or
   9-22  licensee at reasonable times to conduct an inspection incidental to
   9-23  the issuance of a license and at other times as the department
   9-24  considers necessary to ensure compliance with this chapter and
   9-25  rules adopted under this chapter.
   9-26        Sec. 146.032.  COMPLAINTS.  A hospice shall provide each
   9-27  person who receives hospice services with a written statement that
   10-1  contains the name, address, and telephone number of the department
   10-2  and a statement that informs recipients that a complaint against a
   10-3  hospice may be directed to the department.
   10-4        Sec. 146.033.  INVESTIGATION OF COMPLAINT.  (a)  The
   10-5  department or its authorized representative shall investigate each
   10-6  complaint received regarding the provision of hospice services and
   10-7  may as a part of the investigation:
   10-8              (1)  conduct an unannounced inspection of a place of
   10-9  business, including an inspection of medical and personnel records,
  10-10  if the department has reasonable cause to believe that the place of
  10-11  business is in violation of this chapter or a rule adopted under
  10-12  this chapter;
  10-13              (2)  conduct an interview with a recipient of hospice
  10-14  services, which may be conducted in the recipient's home;
  10-15              (3)  if the recipient of hospice services is deceased,
  10-16  conduct an interview with a family member or other person who would
  10-17  have knowledge of the care received from the hospice; and
  10-18              (4)  interview a health care practitioner or any
  10-19  hospice personnel who care for a recipient of hospice services.
  10-20        (b)  The reports, records, and working papers used or
  10-21  developed in an investigation under this section are confidential
  10-22  and may be disclosed only in accordance with rules adopted by the
  10-23  board.
  10-24        Sec. 146.034.  CONFERENCE CONCERNING SURVEY.  (a)  The
  10-25  department's authorized representative shall hold a conference with
  10-26  the individual in charge of a hospice to explain the nature and
  10-27  scope of the survey before beginning an on-site survey.
   11-1        (b)  When the survey is complete, the representative shall
   11-2  hold a conference with the individual in charge of the hospice.
   11-3        (c)  The individual in charge of the hospice shall be fully
   11-4  informed of the preliminary findings of the survey and shall be
   11-5  given a reasonable opportunity to submit additional facts or other
   11-6  information to the department's representative in response to those
   11-7  findings.  The response shall be made a part of the record of the
   11-8  survey for all purposes.
   11-9        (d)  During the conference concluding a survey, the
  11-10  department's representative shall identify any records that were
  11-11  duplicated during the survey.  Original hospice records may be
  11-12  removed from a hospice only with the hospice's consent.
  11-13        Sec. 146.035.  RESULTS OF SURVEY.  After a survey of a
  11-14  licensee by the department, the department shall provide to the
  11-15  chief executive officer of the hospice:
  11-16              (1)  specific and timely written notice of the
  11-17  preliminary findings of the survey, including the specific nature
  11-18  of the survey, the specific statute or rule allegedly violated, if
  11-19  any, the specific nature of any finding regarding the alleged
  11-20  violation or deficiency and, if a deficiency is alleged, the
  11-21  severity of the deficiency alleged;
  11-22              (2)  information on the identity, including the
  11-23  signature, of each department representative conducting, reviewing,
  11-24  or approving the results of the survey and the date on which the
  11-25  department representative acted on the matter; and
  11-26              (3)  on the request of the licensee, copies of all
  11-27  documents relating to the survey maintained by the department or
   12-1  provided by the department to any other state or federal agency not
   12-2  made confidential by state law.
   12-3        Sec. 146.036.  DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
   12-4  (a)  The department may deny a license application or suspend or
   12-5  revoke or probate the revocation of the license of a person who
   12-6  fails to comply with this chapter or rules adopted under this
   12-7  chapter.
   12-8        (b)  The department may immediately suspend or revoke a
   12-9  license when the health and safety of persons are threatened.  On
  12-10  the issuance of an order of immediate suspension or revocation, the
  12-11  department shall immediately provide to the chief executive officer
  12-12  of the hospice adequate notice of the action taken, the legal basis
  12-13  for the action, and the procedure governing appeal of the action.
  12-14  A person whose license is suspended or revoked under this
  12-15  subsection is entitled to a hearing not later than the seventh day
  12-16  after the effective date of the suspension or revocation.
  12-17        (c)  A person whose application is denied or whose license is
  12-18  suspended or revoked is entitled to a hearing before the department
  12-19  if the person submits a written request to the department.  The
  12-20  Administrative Procedure and Texas Register Act (Article 6252-13a,
  12-21  Vernon's Texas Civil Statutes) and the department's rules for
  12-22  contested case hearings apply to hearings conducted under this
  12-23  section and to appeals from department decisions.
  12-24        Sec. 146.037.  INJUNCTION.  (a)  A district court, on
  12-25  petition of the department and on a finding by the court that a
  12-26  person is violating this chapter, may by injunction:
  12-27              (1)  prohibit the person from continuing the violation;
   13-1  or
   13-2              (2)  grant any other injunctive relief warranted by the
   13-3  facts.
   13-4        (b)  The attorney general shall institute and conduct a suit
   13-5  authorized by this section at the request of the department and in
   13-6  the name of the state.
   13-7        (c)  A suit for injunctive relief must be brought in Travis
   13-8  County.
   13-9        Sec. 146.038.  CIVIL PENALTY.  (a)  A person who establishes,
  13-10  conducts, or operates a hospice program of care or holds the person
  13-11  out to the public as a provider of hospice services without a
  13-12  license issued under this chapter is liable for a civil penalty of
  13-13  not less than $1,000 or more than $2,500 for each day of violation.
  13-14        (b)  The attorney general shall bring suit on behalf of the
  13-15  state to collect the civil penalty.  An action to recover a civil
  13-16  penalty is in addition to an action brought for injunctive relief
  13-17  under Section 146.037 or any other remedy provided by law.
  13-18           (Sections 146.039-146.050 reserved for expansion
  13-19                SUBCHAPTER D.  HOSPICE ADVISORY COUNCIL
  13-20        Sec. 146.051.  DUTIES.  The Hospice Advisory Council shall
  13-21  consider the needs for hospice services in this state and shall
  13-22  recommend for the board's consideration rules to implement
  13-23  standards adopted under this chapter and other appropriate rules,
  13-24  procedures, and actions regarding all matters relating to hospice
  13-25  services.
  13-26        Sec. 146.052.  COMPOSITION.  The council is composed of nine
  13-27  members appointed by the director as follows:
   14-1              (1)  one member to represent the department;
   14-2              (2)  two members to represent consumers of hospice
   14-3  services;
   14-4              (3)  one member to represent the Texas Department of
   14-5  Human Services;
   14-6              (4)  two members to represent a statewide organization
   14-7  the membership of which is primarily composed of providers of
   14-8  hospice services;
   14-9              (5)  one member to represent private, nonprofit
  14-10  providers of hospice services;
  14-11              (6)  one member to represent proprietary providers of
  14-12  hospice services; and
  14-13              (7)  one member to represent a hospital-based provider
  14-14  of hospice services.
  14-15        Sec. 146.053.  TERMS.  Members of the council serve staggered
  14-16  three-year terms, with the terms of three members expiring January
  14-17  31 of each year.
  14-18        Sec. 146.054.  PRESIDING OFFICER.  (a)  The council shall
  14-19  elect a presiding officer from among its members to preside at
  14-20  meetings and to notify members of meetings.
  14-21        (b)  The presiding officer shall serve for one year and may
  14-22  not serve in that capacity for more than two years.
  14-23        Sec. 146.055.  MEETINGS.  The council shall meet at least
  14-24  twice a year and at other times at the call of the presiding
  14-25  officer, any three members of the council, or the director.
  14-26        Sec. 146.056.  COMPENSATION.  Members of the council serve
  14-27  without compensation but are entitled to reimbursement for expenses
   15-1  incurred as provided by the General Appropriations Act for members
   15-2  of boards of state agencies.
   15-3        SECTION 2.  Sections 142.001(4) and (5), Health and Safety
   15-4  Code, are amended to read as follows:
   15-5              (4)  "Home health agency" means a place of business<,
   15-6  including a hospice,> that provides a home health service.  The
   15-7  term does not include a person licensed under Chapter 146.
   15-8              (5)  "Home health service" means the provision, for pay
   15-9  or other consideration, of a health service in a patient's
  15-10  residence.  The term does not include the provision of care under
  15-11  an attendant care program administered by the Texas Department of
  15-12  Human Services or the provision of hospice services by a person
  15-13  licensed under Chapter 146.
  15-14        SECTION 3.  Sections 142.015(a) and (d), Health and Safety
  15-15  Code, are amended to read as follows:
  15-16        (a)  The Home Health Services Advisory Council is composed of
  15-17  the following nine <11> members, appointed by the governor:
  15-18              (1)  one representative of the department;
  15-19              (2)  two representatives of consumers of home health
  15-20  agency <and hospice> services;
  15-21              (3)  one representative of the Texas Department of
  15-22  Human Services;
  15-23              (4)  one representative of the Texas Association of
  15-24  Home Health Agencies, Incorporated;
  15-25              (5)  one representative of private nonprofit home
  15-26  health agencies;
  15-27              (6)  one representative of voluntary nonprofit home
   16-1  health agencies;
   16-2              (7)  one representative of proprietary home health
   16-3  agencies; and
   16-4              (8)  one representative of an official department home
   16-5  health agency<;>
   16-6              <(9)  one member to represent Medicare-certified Class
   16-7  A hospice providers affiliated with a home health agency, hospital,
   16-8  or other health service provider; and>
   16-9              <(10)  one member to represent Medicare-certified Class
  16-10  A hospice providers not affiliated with a home health agency,
  16-11  hospital, or other health service provider>.
  16-12        (d)  Members of the council serve staggered two-year terms,
  16-13  with the terms of five <six> members expiring on January 31 of each
  16-14  even-numbered year and the terms of four <five> members expiring on
  16-15  January 31 of each odd-numbered year.
  16-16        SECTION 4.  Section 142.021, Health and Safety Code, is
  16-17  amended to read as follows:
  16-18        Sec. 142.021.  Permits to Administer Medication.  A person
  16-19  may not administer medication to a patient of a home health agency
  16-20  or hospice unless the person:
  16-21              (1)  holds a license under state law that authorizes
  16-22  the person to administer medication;
  16-23              (2)  holds a permit issued under Section 142.025 and
  16-24  acts under the delegated authority of a person who holds a license
  16-25  under state law that authorizes the person to administer
  16-26  medication; or
  16-27              (3)  performs duties as a qualified dialysis technician
   17-1  within the scope authorized by board rules.
   17-2        SECTION 5.  Section 142.023, Health and Safety Code, is
   17-3  amended to read as follows:
   17-4        Sec. 142.023.  Rules for Administration of Medication.  The
   17-5  board by rule shall establish:
   17-6              (1)  minimum requirements for the issuance, denial,
   17-7  renewal, suspension, emergency suspension, and revocation of a
   17-8  permit to administer medication to a patient of a home health
   17-9  agency or hospice;
  17-10              (2)  curricula to train persons to administer
  17-11  medication to a patient of a home health agency or hospice;
  17-12              (3)  minimum standards for the approval of programs to
  17-13  train persons to administer medication to patients of home health
  17-14  agencies or hospices and for rescinding approval;
  17-15              (4)  the acts and practices that are allowed or
  17-16  prohibited to a permit holder; and
  17-17              (5)  minimum standards for on-site supervision of a
  17-18  permit holder by a registered nurse.
  17-19        SECTION 6.  Section 142.029(a), Health and Safety Code, is
  17-20  amended to read as follows:
  17-21        (a)  A person commits an offense if the person knowingly
  17-22  administers medication to a patient of a home health agency or
  17-23  hospice and the person:
  17-24              (1)  does not hold a license under state law that
  17-25  authorizes the person to administer medication; or
  17-26              (2)  does not hold a permit issued by the department
  17-27  under Section 142.025.
   18-1        SECTION 7.  Section 142.030(a), Health and Safety Code, is
   18-2  amended to read as follows:
   18-3        (a)  A person authorized by this subchapter to administer
   18-4  medication to a patient of a home health agency or hospice may not
   18-5  dispense dangerous drugs or controlled substances without complying
   18-6  with the Texas Pharmacy Act (Article 4542a-1, Vernon's Texas Civil
   18-7  Statutes).
   18-8        SECTION 8.  Section 248.002, Health and Safety Code, is
   18-9  amended by adding subdivisions (9), (10), (11), (12), (13), and
  18-10  (14), to read as follows:
  18-11              (9)  "Bereavement services" has the meaning assigned by
  18-12  Section 146.002(3), Health and Safety Code.
  18-13              (10)  "Family" has the meaning assigned by Section
  18-14  146.002(8), Health and Safety Code.
  18-15              (11)  "Palliative care" has the meaning assigned by
  18-16  Section 146.002(16), Health and Safety Code.
  18-17              (12)  "Supportive services" has the meaning assigned by
  18-18  Section 146.002(20), Health and Safety Code.
  18-19              (13)  "Residential AIDS hospice" means a facility
  18-20  licensed and designated as a residential AIDS hospice under this
  18-21  chapter.
  18-22              (14)  "Residential AIDS hospice care" means hospice
  18-23  services provided in a residential AIDS hospice.
  18-24        SECTION 9.  Section 248.002, Health and Safety Code, is
  18-25  amended by adding section 1.031, to read as follows:
  18-26        Sec. 1.031.  RESIDENTIAL AIDS HOSPICE DESIGNATION.  (a)  The
  18-27  board by rule shall adopt standards for the designation of a
   19-1  special care facility licensed under this chapter as a residential
   19-2  AIDS hospice.  These standards shall be consistent with other
   19-3  standards adopted under this chapter and consistent with the
   19-4  purposes for which special care facilities were created.
   19-5        (b)  In adopting such standards, the board shall consider
   19-6  rules adopted for the designation of a hospice under Chapter 142 of
   19-7  this code, and shall establish specific standards requiring:
   19-8              (1)  the provision of exclusively palliative care by
   19-9  such facilities;
  19-10              (2)  the provision of bereavement services;
  19-11              (3)  the provision of supportive services to the family
  19-12  of a patient;
  19-13              (4)  the participation of a registered nurse in the
  19-14  development of an initial plan of care for a patient and periodic
  19-15  review of the plan of care by the interdisciplinary team of the
  19-16  facility; and
  19-17              (5)  clinical and medical review of patient care
  19-18  services by a physician who acts as a medical consultant.
  19-19        (c)  A special care facility licensed under this chapter
  19-20  which satisfies the standards adopted pursuant to this section
  19-21  shall be issued a designation as a residential AIDS hospice.
  19-22        (d)  Notwithstanding the provisions of Chapter 146, Health
  19-23  and Safety Code, a special care facility licensed and issued a
  19-24  designation as a residential AIDS hospice under this chapter may
  19-25  use the term "residential AIDS hospice" or similar term or language
  19-26  in its title or in a description or representation of the facility,
  19-27  so long as such similar term or language clearly identifies the
   20-1  facility as a facility regulated under this chapter and clearly
   20-2  distinguishes the facility from a hospice regulated under Chapter
   20-3  146 of this code.
   20-4        (e)  A special care facility licensed under this chapter on
   20-5  December 31, 1993, upon notice to the department that it is in
   20-6  compliance with the standards adopted for designation as a
   20-7  residential AIDS hospice, shall be issued such designation by the
   20-8  department, which designation shall be valid until the date upon
   20-9  which the license of the facility expires or is renewed.
  20-10        SECTION 10.  In making initial appointments to the Hospice
  20-11  Advisory Council established under Chapter 146, Health and Safety
  20-12  Code, as added by this Act, the director of the Texas Department of
  20-13  Health shall designate three members to serve terms expiring
  20-14  January 31, 1995, three members to serve terms expiring January 31,
  20-15  1996, and three members to serve terms expiring January 31, 1997.
  20-16        SECTION 11.  A certified hospice provider holding a license
  20-17  on January 1, 1994, as a hospice issued under Chapter 142, Health
  20-18  and Safety Code, shall be licensed as a hospice under Chapter 146,
  20-19  Health and Safety Code, as added by this Act, without payment of
  20-20  any additional fee.  The license expires on the same date as the
  20-21  license granted under Chapter 142, Health and Safety Code.  The
  20-22  hospice shall provide a hospice program of care in accordance with
  20-23  Chapter 146, Health and Safety Code, as added by this Act.
  20-24        SECTION 11.  Section 142.007, Health and Safety Code, is
  20-25  repealed.
  20-26        SECTION 12.  The terms of the members of the Home Health
  20-27  Services Advisory Council whose positions are eliminated by this
   21-1  Act expire on the effective date of this Act.   In making
   21-2  appointments to the council for terms beginning February 1, 1994,
   21-3  and February 1, 1995, the governor shall appoint the appropriate
   21-4  number of members to one-year terms to satisfy the staggered-term
   21-5  requirements of Section 142.015(d), Health and Safety Code, as
   21-6  amended by this Act.  Thereafter, members serve two-year terms.
   21-7        SECTION 13.  This Act takes effect January 1, 1994.
   21-8        SECTION 14.  The importance of this legislation and the
   21-9  crowded condition of the calendars in both houses create an
  21-10  emergency and an imperative public necessity that the
  21-11  constitutional rule requiring bills to be read on three several
  21-12  days in each house be suspended, and this rule is hereby suspended.