H.B. No. 1835 1-1 AN ACT 1-2 relating to the regulation of the practice of perfusion; providing 1-3 a penalty. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Title 71, Revised Statutes, is amended by adding 1-6 Chapter 7A and Article 4529e to read as follows: 1-7 CHAPTER 7A. PERFUSIONISTS 1-8 Art. 4529e. LICENSED PERFUSIONISTS 1-9 Sec. 1. SHORT TITLE. This article may be cited as the 1-10 Licensed Perfusionists Act. 1-11 Sec. 2. LEGISLATIVE FINDINGS; PURPOSE. (a) The legislature 1-12 finds that: 1-13 (1) the citizens of this state are entitled to the 1-14 protection of their health, safety, and welfare from the 1-15 unqualified or unprofessional practice of perfusion; 1-16 (2) the practice of perfusion by unauthorized, 1-17 unqualified, unprofessional, or incompetent persons is a threat to 1-18 the public; and 1-19 (3) the practice of perfusion is a dynamic and 1-20 changing health care field which is continually evolving to include 1-21 more sophisticated and demanding patient care activities. 1-22 (b) The purpose of this article is to protect the public 1-23 from the dangers described by Subsection (a) of this section by: 1-24 (1) establishing minimum standards of education, 2-1 training, and competency for persons engaged in the practice of 2-2 perfusion and of the performance of perfusion services in a manner 2-3 that provides for the continued evolution of the practice of 2-4 perfusion; and 2-5 (2) ensuring that the privilege of practicing in the 2-6 field of perfusion is entrusted only to those licensed and 2-7 regulated under this article. 2-8 Sec. 3. DEFINITIONS. In this article: 2-9 (1) "Board" means the Texas State Board of Examiners 2-10 of Perfusionists. 2-11 (2) "Board of health" means the Texas Board of Health. 2-12 (3) "Department" means the Texas Department of Health. 2-13 (4) "Commissioner" means the commissioner of health. 2-14 (5) "Extracorporeal circulation" means the diversion 2-15 of a patient's blood through a heart-lung machine or a similar 2-16 device that assumes the functions of the patient's heart, lungs, or 2-17 both. 2-18 (6) "Licensed perfusionist" means a person licensed 2-19 under this article. 2-20 (7) "Perfusion" means the functions necessary for the 2-21 support, treatment, measurement, or supplementation of the 2-22 cardiovascular, circulatory, or respiratory system, or a 2-23 combination of those activities, and to ensure the safe management 2-24 of physiologic functions by monitoring the parameters of the 2-25 systems under an order and under the supervision of a licensed 2-26 physician, including: 2-27 (A) the use of extracorporeal circulation, 3-1 cardiopulmonary support techniques, and other therapeutic and 3-2 diagnostic technologies; 3-3 (B) counterpulsation, ventricular assistance, or 3-4 autotransfusion (including blood conservation techniques), 3-5 administration of cardioplegia, and isolated limb perfusion; 3-6 (C) the use of techniques involving blood 3-7 management, advanced life support, and other related functions; and 3-8 (D) in the performance of the acts described in 3-9 this subsection: 3-10 (i) the administration of: 3-11 (aa) pharmacological and therapeutic 3-12 agents; or 3-13 (bb) blood products or anesthetic 3-14 agents through the extracorporeal circuit or through an intravenous 3-15 line as ordered by a physician; 3-16 (ii) the performance and use of: 3-17 (aa) anticoagulation analysis; 3-18 (bb) physiologic analysis; 3-19 (cc) blood gas and chemistry 3-20 analysis; 3-21 (dd) hematocrit analysis; 3-22 (ee) hypothermia; 3-23 (ff) hyperthermia; 3-24 (gg) hemoconcentration; and 3-25 (hh) hemodilution; and 3-26 (iii) the observation of signs and 3-27 symptoms related to perfusion services, the determination of 4-1 whether the signs and symptoms exhibit abnormal characteristics, 4-2 and the implementation of appropriate reporting, perfusion 4-3 protocols, or changes in or the initiation of emergency procedures. 4-4 (8) "Perfusion protocols" means perfusion-related 4-5 policies and protocols developed or approved by a licensed health 4-6 facility or a physician through collaboration with administrators, 4-7 licensed perfusionists, and other health professionals. 4-8 (9) "Provisional licensed perfusionist" means a person 4-9 provisionally licensed under this article. 4-10 Sec. 4. BOARD; MEMBERSHIP. (a) The Texas State Board of 4-11 Examiners of Perfusionists is created. 4-12 (b) The board is composed of nine members. Three members 4-13 must be members of the general public. Five members must be 4-14 perfusionists licensed under this article. One member must be a 4-15 physician licensed by the Texas State Board of Medical Examiners 4-16 who is also board certified in cardiovascular surgery. 4-17 (c) The governor with the advice and consent of the senate 4-18 shall appoint the board members, who shall serve staggered terms of 4-19 six years with three members' terms expiring February 1 of each 4-20 odd-numbered year. 4-21 (d) A license holder eligible for appointment as a licensed 4-22 perfusionist board member must have been licensed under this 4-23 article for at least three years before appointment to the board. 4-24 (e) An officer, employee, or paid consultant of a Texas 4-25 trade association in the field of health care may not be a member 4-26 or employee of the board who is exempt from the state's position 4-27 classification plan or is compensated at or above the amount 5-1 prescribed by the General Appropriations Act for step 1, salary 5-2 group 17, of the position classification salary schedule. 5-3 (f) A person who is the spouse of an officer, manager, or 5-4 paid consultant of a Texas trade association in the field of health 5-5 care may not be a board member and may not be an employee of the 5-6 board who is exempt from the state's position classification plan 5-7 or is compensated at or above the amount prescribed by the General 5-8 Appropriations Act for step 1, salary group 17, of the position 5-9 classification salary schedule. For the purposes of this 5-10 subsection and Subsection (e) of this section, a Texas trade 5-11 association is a nonprofit, cooperative, and voluntarily joined 5-12 association of business or professional competitors in this state 5-13 designed to assist its members and its industry or profession in 5-14 dealing with mutual business or professional problems and in 5-15 promoting their common interests. 5-16 (g) It is the intent of the legislature that the membership 5-17 of the board reflect the historical and cultural diversity of the 5-18 inhabitants of this state. Appointments to the board should be 5-19 made without discrimination based on race, creed, sex, religion, 5-20 national origin, or geographical distribution of the appointees. 5-21 (h) A person may not serve as a member of the board or act 5-22 as general counsel to the board if the person is required to 5-23 register as a lobbyist under Chapter 305, Government Code, and its 5-24 subsequent amendments, because of the person's activities for 5-25 compensation on behalf of a profession related to the operation of 5-26 the board. 5-27 Sec. 5. GROUNDS FOR REMOVAL. (a) It is a ground for 6-1 removal from the board if a member: 6-2 (1) does not have at the time of appointment the 6-3 qualifications required for appointment to the board; 6-4 (2) does not maintain during service on the board the 6-5 qualifications required for appointment to the board; 6-6 (3) violates a prohibition established by this 6-7 article; 6-8 (4) cannot discharge the member's term for a 6-9 substantial part of the term for which the member is appointed 6-10 because of illness or disability; or 6-11 (5) is absent from more than half of the regularly 6-12 scheduled board meetings that the member is eligible to attend 6-13 during a calendar year unless the absence is excused by majority 6-14 vote of the board. 6-15 (b) The validity of an action of the board is not affected 6-16 by the fact that it is taken when a ground for removal of a member 6-17 of the board exists. 6-18 (c) If the executive director has knowledge that a potential 6-19 ground for removal exists, the executive director shall notify the 6-20 presiding officer of the board of the ground. The presiding 6-21 officer shall then notify the governor that a potential ground for 6-22 removal exists. 6-23 Sec. 6. OFFICERS; MEETINGS; QUORUM; EXPENSES. (a) Not 6-24 later than the 30th day after the day its new members are appointed 6-25 by the governor, the board shall meet to elect a chairman and 6-26 vice-chairman who shall hold office according to rules adopted by 6-27 the board. 7-1 (b) The board shall hold at least two regular meetings each 7-2 year as provided by rules adopted by the board. The rules may not 7-3 be inconsistent with present rules of the department relating to 7-4 meetings of boards. 7-5 (c) A majority of the members constitutes a quorum. 7-6 (d) A member of the board is entitled to a per diem as set 7-7 by the General Appropriations Act for each day that the member 7-8 engages in the business of the board. A member is entitled to 7-9 compensation for travel expenses as provided by the General 7-10 Appropriations Act. 7-11 Sec. 7. POWERS AND DUTIES OF BOARD. (a) The board may 7-12 adopt rules not inconsistent with this article as are necessary for 7-13 the governing of its own proceedings, the performance of its 7-14 duties, the regulation of the practice of perfusion in this state, 7-15 and the enforcement of this article. In adopting rules, the board 7-16 shall consider the rules and procedures of the board of health and 7-17 the department and shall adopt procedural rules not inconsistent 7-18 with existing rules and procedures of the board of health or the 7-19 department. 7-20 (b) The board shall: 7-21 (1) adopt and publish a code of ethics and adopt an 7-22 official seal; 7-23 (2) establish the qualifications and fitness of 7-24 applicants for licenses, renewal of licenses, and reciprocal 7-25 licenses; 7-26 (3) revoke, suspend, or deny a license, probate a 7-27 license suspension, or reprimand a license holder for a violation 8-1 of this article, the code of ethics, or the rules of the board; 8-2 (4) spend funds necessary for the proper 8-3 administration of its assigned duties; 8-4 (5) establish reasonable and necessary fees for the 8-5 administration and implementation of this article; 8-6 (6) comply with the open meetings law, Chapter 271, 8-7 Acts of the 60th Legislature, Regular Session, 1967 (Article 8-8 6252-17, Vernon's Texas Civil Statutes), and its subsequent 8-9 amendments, and the Administrative Procedure and Texas Register Act 8-10 (Article 6252-13a, Vernon's Texas Civil Statutes) and its 8-11 subsequent amendments; 8-12 (7) provide to its members and employees, as often as 8-13 necessary, information regarding their qualifications for office or 8-14 employment under this article and their responsibilities under 8-15 applicable laws relating to standards of conduct for state officers 8-16 or employees; 8-17 (8) develop and implement policies that provide the 8-18 public with a reasonable opportunity to appear before the board and 8-19 to speak on any issue under the jurisdiction of the board; 8-20 (9) develop and implement policies that clearly define 8-21 the respective responsibilities of the board and the staff of the 8-22 board; 8-23 (10) prepare and maintain a written plan that 8-24 describes how a person who does not speak English or who has a 8-25 physical, mental, or developmental disability can be provided 8-26 reasonable access to the board's programs and comply with federal 8-27 and state laws for program and facility accessibility; 9-1 (11) comply with the board member training 9-2 requirements established by any other state agency that is given 9-3 authority to establish the requirements for the board; and 9-4 (12) establish continuing professional education 9-5 programs for licensed perfusionists and provisional licensed 9-6 perfusionists under this chapter, the standards of which shall be 9-7 at least as stringent as those of the American Board of 9-8 Cardiovascular Perfusion or its successor agency, and shall: 9-9 (A) establish a minimum number of hours of 9-10 continuing education required to renew a license under this 9-11 article; 9-12 (B) develop a process to evaluate and approve 9-13 continuing education courses; 9-14 (C) identify the key factors for the competent 9-15 performance by a license holder of the license holder's 9-16 professional duties; and 9-17 (D) adopt a procedure to assess a license 9-18 holder's participation in continuing education programs. 9-19 (c) The board may not adopt rules restricting competitive 9-20 bidding or advertising by a person regulated by the board except to 9-21 prohibit false, misleading, or deceptive practices. The board may 9-22 not include in its rules to prohibit false, misleading, or 9-23 deceptive practices by a person regulated by the board a rule that: 9-24 (1) restricts the person's use of any medium for 9-25 advertising; 9-26 (2) restricts the person's personal appearance or use 9-27 of the person's personal voice in an advertisement; 10-1 (3) relates to the size or duration of any 10-2 advertisement by the person; or 10-3 (4) restricts the person's advertisement under a trade 10-4 name. 10-5 (d) The board by rule shall establish methods by which 10-6 consumers and service recipients are notified of the name, mailing 10-7 address, and telephone number of the board for directing complaints 10-8 to the board. The board may provide for that notification: 10-9 (1) on each license form, application, or written 10-10 contract for services of a person licensed under this article; 10-11 (2) on a sign prominently displayed in the place of 10-12 business of each person licensed under this article; or 10-13 (3) in a bill for services provided by a person 10-14 licensed under this article. 10-15 (e) The board shall list along with its regular telephone 10-16 number the toll-free telephone number that may be called to present 10-17 a complaint about a health professional if the toll-free number is 10-18 established under other state law. 10-19 Sec. 8. ADMINISTRATIVE FUNCTION; PERSONNEL. (a) The basic 10-20 personnel and necessary facilities required to administer this 10-21 article shall be the personnel and facilities of the department. 10-22 The department personnel shall act as the agents of the board. If 10-23 necessary to the administration or implementation of this article, 10-24 the department by agreement may secure and provide for compensation 10-25 for services that it considers necessary and may employ and 10-26 compensate within available appropriations professional 10-27 consultants, technical assistants, and employees on a full-time or 11-1 part-time basis. 11-2 (b) The commissioner shall designate an employee to serve as 11-3 executive secretary of the board. The executive secretary shall be 11-4 an employee of the department. The executive secretary shall be 11-5 the administrator of the licensing activities for the board. 11-6 (c) In addition to other duties prescribed by this article 11-7 and by the department, the executive secretary shall: 11-8 (1) keep full and accurate minutes of the transactions 11-9 and proceedings of the board; 11-10 (2) be the custodian of the files and records of the 11-11 board; 11-12 (3) prepare and recommend to the board plans and 11-13 procedures necessary to implement the purposes and objectives of 11-14 this article, including rules and proposals on administrative 11-15 procedures consistent with this article; 11-16 (4) exercise general supervision over persons employed 11-17 by the department in the administration of this article; 11-18 (5) be responsible for the investigation of complaints 11-19 and for the presentation of formal complaints; 11-20 (6) attend all meetings of the board as a nonvoting 11-21 participant; 11-22 (7) handle the correspondence of the board and obtain, 11-23 assemble, or prepare the reports and information that the board may 11-24 direct or authorize; 11-25 (8) develop an intra-agency career ladder program 11-26 which shall require intra-agency posting of all nonentry level 11-27 positions concurrently with any public posting; 12-1 (9) develop a system of annual performance evaluations 12-2 based on measurable job tasks, which shall be the basis for all 12-3 merit pay for board employees; and 12-4 (10) prepare and maintain a written policy statement 12-5 to ensure implementation of a program of equal employment 12-6 opportunity under which all personnel transactions are made without 12-7 regard to race, color, disability, sex, religion, age, or natural 12-8 origin, which policy statement must cover an annual period, be 12-9 updated annually, be reviewed by the Commission on Human Rights for 12-10 compliance with Paragraph (A) of this subdivision, and be filed 12-11 with the governor's office and that must include: 12-12 (A) personnel policies, including policies 12-13 relating to recruitment, evaluation, selection, application, 12-14 training, and promotion of personnel that are in compliance with 12-15 the Commission on Human Rights Act (Article 5221k, Vernon's Texas 12-16 Civil Statutes) and its subsequent amendments; 12-17 (B) a comprehensive analysis of the board 12-18 workforce that meets federal and state guidelines; 12-19 (C) procedures by which a determination can be 12-20 made of significant underuse in the board workforce of all persons 12-21 for whom federal or state guidelines encourage a more equitable 12-22 balance; and 12-23 (D) reasonable methods to appropriately address 12-24 those areas of underuse. 12-25 Sec. 9. FEES; FUNDS; ANNUAL REPORT; AUDIT. (a) After 12-26 consultation with the commissioner or the department, the board 12-27 shall set the fees imposed by this article in amounts so that the 13-1 fees in the aggregate produce sufficient revenue to cover the cost 13-2 of administering this article without accumulating an unnecessary 13-3 surplus in the licensed perfusionists fund created by this section. 13-4 (b) The amount of the fees that may be imposed in connection 13-5 with a license under this article may not exceed the following: 13-6 (1) application fee: $75; 13-7 (2) examination fee: $100; 13-8 (3) initial license fee: $75; 13-9 (4) initial provisional license fee: $75; 13-10 (5) license renewal fee: $75; 13-11 (6) delinquency fee: $50; and 13-12 (7) duplicate license fee: $10. 13-13 (c) The fees set by the board may be adjusted so that the 13-14 total fees collected are sufficient to meet the expenses of 13-15 administering this article. 13-16 (d) The department shall receive and account for funds 13-17 derived under this article. The funds shall be deposited in the 13-18 state treasury to the credit of a special fund to be known as the 13-19 licensed perfusionists fund to be used only for the administration 13-20 of this article. 13-21 (e) The board shall make a complete and detailed written 13-22 report to the governor, lieutenant governor, and speaker of the 13-23 house of representatives accounting for all funds received and 13-24 disbursed by the board or the department for the administration of 13-25 this article during the preceding year. The annual report must be 13-26 in the form and reported in the time provided by the General 13-27 Appropriations Act. 14-1 (f) The financial transactions of the board or the 14-2 department in relation to the administration of this article are 14-3 subject to audit by the state auditor in accordance with Chapter 14-4 321, Government Code, and its subsequent amendments. 14-5 Sec. 10. APPLICANT QUALIFICATIONS; APPLICATION REVIEW. (a) 14-6 An applicant for a perfusionist license must submit a sworn 14-7 application accompanied by an application fee. 14-8 (b) The board shall prescribe the form of the application 14-9 and by rule may establish dates by which applications and fees must 14-10 be received. These rules must not be inconsistent with present 14-11 rules of the department related to application dates of other 14-12 licenses. 14-13 (c) To qualify for the licensing examination, the applicant 14-14 must have successfully completed a perfusion education program 14-15 approved by the board. 14-16 (d) In approving perfusion education programs necessary for 14-17 qualification for licensing examination, the board shall approve 14-18 only a program that has educational standards that are at least as 14-19 stringent as those established by the Accreditation Committee for 14-20 Perfusion Education and approved by the Committee on Allied Health 14-21 Education and Accreditation of the American Medical Association or 14-22 their successors. 14-23 (e) Not later than the 45th day after the date of receipt of 14-24 a properly submitted and timely application and not later than the 14-25 30th day before the next examination date, the department shall 14-26 notify an applicant in writing that the applicant's application and 14-27 any other relevant evidence pertaining to applicant qualifications 15-1 established by the board by rule have been received and 15-2 investigated. The notice shall state whether the application and 15-3 other evidence submitted have qualified the applicant for 15-4 examination. If the applicant has not qualified for examination, 15-5 the notice shall state the reasons for the lack of qualification. 15-6 Sec. 11. EXAMINATION. (a) To qualify for a license, an 15-7 applicant must pass a competency examination. Examinations shall 15-8 be prepared or approved by the board and administered to qualified 15-9 applicants at least once each calendar year. 15-10 (b) An examination prescribed by the board may be or may 15-11 include the written and oral examinations given by the American 15-12 Board of Cardiovascular Perfusion or by a national or state testing 15-13 service in lieu of an examination prepared by the board. The board 15-14 shall have the written portion of the examination, if any, 15-15 validated by an independent testing professional. 15-16 (c) Not later than the 30th day after the date on which a 15-17 licensing examination is administered under this article, the 15-18 department shall notify each examinee of the results of the 15-19 examination. If an examination is graded or reviewed by a national 15-20 or state testing service, the department shall notify examinees of 15-21 the results of the examination within two weeks after the date the 15-22 department receives the results from the testing service. If the 15-23 notice of the examination results will be delayed for more than 90 15-24 days after the examination date, the department shall notify the 15-25 examinee of the reason for the delay before the 90th day. 15-26 (d) If requested in writing by a person who fails the 15-27 licensing examination, the department shall furnish the person with 16-1 an analysis of the person's performance on the examination. 16-2 (e) The board by rule shall establish: 16-3 (1) a limit on the number of times an applicant who 16-4 fails an examination may retake the examination; 16-5 (2) requirements for retaking an examination; and 16-6 (3) alternative methods of examining competency. 16-7 Sec. 12. LICENSE. (a) A person who meets the licensing 16-8 qualifications under this article is entitled to receive a license 16-9 as a licensed perfusionist. 16-10 (b) The license holder must: 16-11 (1) display the license certificate in an appropriate 16-12 and public manner; or 16-13 (2) maintain on file at all times during which the 16-14 license holder provides services in a health care facility a true 16-15 and correct copy of the license certificate in the appropriate 16-16 records of the facility; and 16-17 (3) keep the department informed of any change of 16-18 address. 16-19 (c) A license certificate issued by the board is the 16-20 property of the board and shall be surrendered on demand. 16-21 Sec. 13. LICENSE EXPIRATION; RENEWAL. (a) A license is 16-22 valid for one year from the date it is issued and may be renewed 16-23 annually. 16-24 (b) The board of health by rule may adopt a system under 16-25 which licenses expire on various dates during the year. 16-26 (c) A person may renew an unexpired license by submitting 16-27 proof satisfactory to the board of compliance with the continuing 17-1 professional education requirements prescribed by the board and 17-2 paying the required renewal fee to the department before the 17-3 expiration date of the license. 17-4 (d) If a person's license has been expired for not more than 17-5 90 days, the person may renew the license by submitting proof 17-6 satisfactory to the board of compliance with the continuing 17-7 professional education requirements prescribed by the board and 17-8 paying to the department the required renewal fee and a penalty fee 17-9 that is one-half of the renewal fee. 17-10 (e) If a person's license has been expired for more than 90 17-11 days but less than two years, the person may renew the license by 17-12 submitting proof satisfactory to the board of compliance with the 17-13 continuing professional education requirements prescribed by the 17-14 board and paying to the department all unpaid renewal fees and a 17-15 penalty fee that is equal to the renewal fee. 17-16 (f) If a person's license has been expired two years or 17-17 more, the person may not renew the license. The person may obtain 17-18 a new license by submitting to reexamination and complying with the 17-19 current requirements and procedures for obtaining a license. 17-20 (g) The board may renew without reexamination an expired 17-21 license of a person who was licensed in this state, moved to 17-22 another state, and is currently appropriately licensed or certified 17-23 and has been in practice in the other state for the two years 17-24 preceding application. The person must pay to the board a fee that 17-25 is equal to the examination fee for the license. 17-26 (h) The department shall notify each license holder in 17-27 writing of the license expiration date before the 30th day before 18-1 that date by notice to the license holder at the license holder's 18-2 last known address according to the records of the board. 18-3 Sec. 14. PROVISIONAL LICENSE. (a) A license as a 18-4 provisional licensed perfusionist may be issued by the board to a 18-5 person who has successfully completed an approved perfusion 18-6 education program on the filing of an application, payment of an 18-7 application fee, and the submission of evidence satisfactory to the 18-8 board of the successful completion of the education requirement set 18-9 forth in Section 10 of this article. 18-10 (b) A provisional licensed perfusionist shall be under the 18-11 supervision and direction of a licensed perfusionist at all times 18-12 during which the provisional licensed perfusionist performs 18-13 perfusion. Rules adopted by the board governing such supervision 18-14 and direction may not require the immediate physical presence of 18-15 the supervising licensed perfusionist. 18-16 (c) A person qualified for a provisional license under this 18-17 article is entitled to receive a license as a provisional licensed 18-18 perfusionist. A provisional licensed perfusionist shall comply 18-19 with Sections 12(b) and (c) of this article. 18-20 (d) A provisional license is valid for one year from the 18-21 date it is issued and may be renewed annually not more than five 18-22 times by the same procedures established for renewal under Section 18-23 13 of this article if the application for renewal is signed by a 18-24 supervising licensed perfusionist. 18-25 Sec. 15. ENDORSEMENT. On receipt of an application and 18-26 application fee, the board shall waive the examination requirement 18-27 for an applicant who at the time of application: 19-1 (1) is appropriately licensed or certified by another 19-2 state, territory, or possession of the United States if the 19-3 requirements of that state, territory, or possession for the 19-4 license or certificate are the substantial equivalent of the 19-5 requirements of this article as determined by the board; or 19-6 (2) holds a certificate as a certified clinical 19-7 perfusionist issued by the American Board of Cardiovascular 19-8 Perfusion prior to January 1, 1994, and who may practice perfusion 19-9 in another state, territory, or possession of the United States 19-10 which does not credential perfusionists. 19-11 Sec. 16. PROHIBITED ACTS; PENALTY. (a) A person may not 19-12 engage or offer to engage in perfusion, as defined in this article, 19-13 for compensation or use the title or represent or imply that the 19-14 person has the title of "licensed perfusionist" or "provisional 19-15 licensed perfusionist" or use the letters "LP" or "PLP" and may not 19-16 use any facsimile of those titles in any manner to indicate or 19-17 imply that the person is a licensed perfusionist or provisional 19-18 licensed perfusionist unless the person holds an appropriate 19-19 license issued under this article. 19-20 (b) A person may not use the title or represent or imply 19-21 that the person has the title of "certified clinical perfusionist" 19-22 or use the letters "CCP" and may not use any facsimile of those 19-23 titles in any manner to indicate or imply that the person is a 19-24 certified clinical perfusionist by the American Board of 19-25 Cardiovascular Perfusion unless the person holds a certificate as a 19-26 certified clinical perfusionist issued by the American Board of 19-27 Cardiovascular Perfusion. 20-1 (c) A person commits an offense if the person knowingly or 20-2 intentionally violates Subsection (a) or (b) of this section. An 20-3 offense under this section is a Class B misdemeanor. 20-4 Sec. 17. EXEMPTIONS. This article does not apply to: 20-5 (1) a person licensed by another health professional 20-6 licensing board if: 20-7 (A) the person does not represent to the public, 20-8 directly or indirectly, that the person is licensed under this 20-9 article, and does not use any name, title, or designation 20-10 indicating that the person is licensed under this article; and 20-11 (B) the person confines the person's acts or 20-12 practice to the scope of practice authorized by the other health 20-13 professional licensing laws; 20-14 (2) a student enrolled in an accredited perfusion 20-15 education program if perfusion services performed by the student: 20-16 (A) are an integral part of the student's course 20-17 of study; and 20-18 (B) are performed under the direct supervision 20-19 of a licensed perfusionist assigned to supervise the student and 20-20 who is on duty and immediately available in the assigned patient 20-21 care area; 20-22 (3) a person who has successfully completed an 20-23 approved perfusion education program but who has not been issued a 20-24 license as a provisional licensed perfusionist in accordance with 20-25 the provisions of Section 14 of this article and: 20-26 (A) is at all times in compliance with the 20-27 provisions of Section 14(b) of this article; and 21-1 (B) receives a license as a provisional licensed 21-2 perfusionist within 180 days of the date upon which the person 21-3 successfully completed an approved perfusion education program; 21-4 (4) the practice of any legally qualified perfusionist 21-5 employed by the United States government while in the discharge of 21-6 official duties; or 21-7 (5) a person who is not a resident of this state if: 21-8 (A) the person is authorized to perform the 21-9 activities and services of perfusion under the laws of the state of 21-10 the person's residence; and 21-11 (B) such activities and services are performed 21-12 for not more than 30 days in any one year; or 21-13 (6) a person performing autotransfusion or blood 21-14 conservation techniques under the supervision of a licensed 21-15 physician. 21-16 Sec. 18. COMPLAINT PROCEDURE IN GENERAL. (a) The board 21-17 shall keep an information file about each complaint filed with the 21-18 board. The board's information file shall be kept current and 21-19 contain a record for each complaint of: 21-20 (1) all persons contacted in relation to the 21-21 complaint; 21-22 (2) a summary of findings made at each step of the 21-23 complaint process; 21-24 (3) an explanation of the legal basis and reason for a 21-25 complaint that is dismissed; and 21-26 (4) other relevant information. 21-27 (b) If written complaint is filed with the board that the 22-1 board has authority to resolve, the board, at least as frequently 22-2 as quarterly and until final disposition of the complaint, shall 22-3 notify the parties to the complaint of the status of the complaint 22-4 unless the notice would jeopardize an undercover investigation. 22-5 (c) The board by rule shall adopt a form to standardize 22-6 information concerning complaints made to the board. The board by 22-7 rule shall prescribe information to be provided to a person when 22-8 the person files a complaint with the board. 22-9 (d) The board shall provide reasonable assistance to a 22-10 person who wishes to file a complaint with the board. 22-11 Sec. 19. COMPLAINT INVESTIGATION AND DISPOSITION. (a) The 22-12 board shall adopt rules concerning the investigation of a complaint 22-13 filed with the board. The rules adopted under this subsection 22-14 shall: 22-15 (1) distinguish between categories of complaints; 22-16 (2) ensure that complaints are not dismissed without 22-17 appropriate consideration; 22-18 (3) require that the board be advised of a complaint 22-19 that is dismissed and that a letter be sent to the person who filed 22-20 the complaint explaining the action taken on the dismissed 22-21 complaint; 22-22 (4) ensure that the person who filed the complaint has 22-23 an opportunity to explain the allegations made in the complaint; 22-24 and 22-25 (5) prescribe guidelines concerning the categories of 22-26 complaints that require the use of a private investigator and the 22-27 procedures for the board to obtain the services of a private 23-1 investigator. 23-2 (b) The board shall dispose of all complaints in a timely 23-3 manner. The board shall establish a schedule for conducting each 23-4 phase of a complaint that is under the control of the board not 23-5 later than the 30th day after the date the complaint is received by 23-6 the board. The schedule shall be kept in the information file for 23-7 the complaint and all parties shall be notified of the projected 23-8 time requirements for pursuing the complaint. A change in the 23-9 schedule must be noted in the complaint information file and all 23-10 parties to the complaint must be notified not later than the 23-11 seventh day after the date the change is made. 23-12 (c) The executive director of the board shall notify the 23-13 board of a complaint that extends beyond the time prescribed by the 23-14 board for resolving the complaint so that the board may take 23-15 necessary action on the complaint. 23-16 Sec. 20. INFORMAL PROCEEDINGS. (a) The board by rule shall 23-17 adopt procedures governing: 23-18 (1) informal disposition of a contested case under 23-19 Section 13(e), Administrative Procedure and Texas Register Act 23-20 (Article 6252-13a, Vernon's Texas Civil Statutes); and 23-21 (2) informal proceedings held in compliance with 23-22 Section 18(c), Administrative Procedure and Texas Register Act 23-23 (Article 6252-13a, Vernon's Texas Civil Statutes). 23-24 (b) Rules adopted under this section must provide the 23-25 complainant and the license holder an opportunity to be heard and 23-26 must require the presence of a representative of the office of the 23-27 attorney general to advise the board or the board's employees. 24-1 Sec. 21. MONITORING OF LICENSE HOLDER. The board by rule 24-2 shall develop a system for monitoring license holders' compliance 24-3 with the requirements of this article. Rules adopted under this 24-4 section shall include procedures for monitoring a license holder 24-5 who is ordered by the board to perform certain acts to ascertain 24-6 that the license holder performs the required acts and to identify 24-7 and monitor license holders who represent a risk to the public. 24-8 Sec. 22. REVOCATION AND SUSPENSION; EX PARTE COMMUNICATION. 24-9 (a) The board shall revoke or suspend a license, place on 24-10 probation a person whose license has been suspended, or reprimand a 24-11 license holder on proof of: 24-12 (1) any violation of this article; or 24-13 (2) any violation of a rule or code of ethics adopted 24-14 by the board. 24-15 (b) If a license suspension is probated, the board may 24-16 require the license holder: 24-17 (1) to report regularly to the board on matters that 24-18 are the basis of the probation; 24-19 (2) to limit practice to the areas prescribed by the 24-20 board; or 24-21 (3) to continue the person's professional education 24-22 until the license holder attains a degree of skill satisfactory to 24-23 the board in those areas that are the basis of the probation. 24-24 (c) If the board proposes to suspend or revoke a person's 24-25 license, the person is entitled to a hearing before a hearings 24-26 officer appointed by the State Office of Administrative Hearings. 24-27 The board shall prescribe procedures by which all decisions to 25-1 suspend or revoke a license are appealable to the board. 25-2 (d) Proceedings for the suspension or revocation of a 25-3 license are governed by the Administrative Procedure and Texas 25-4 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes) and 25-5 its subsequent amendments. 25-6 (e) The board by rule shall adopt a broad schedule of 25-7 sanctions for violations under this article. The State Office of 25-8 Administrative Hearings shall use the schedule for any sanction 25-9 imposed as the result of a hearing conducted by that office. 25-10 (f) A member of the board or hearings examiner may not 25-11 communicate with a party to a proceeding pending before the board 25-12 or the hearings examiner or with a party's representative unless 25-13 notice and an opportunity to participate are given to each party to 25-14 the proceeding if the member or hearings examiner proposes to make 25-15 a decision, a finding of fact, or a conclusion of law in the 25-16 proceeding. 25-17 Sec. 23. DUTIES OF THE BOARD. For the purposes of this 25-18 article, the board: 25-19 (1) shall request and receive necessary assistance 25-20 from state educational institutions or other state agencies; 25-21 (2) shall prepare information of consumer interest 25-22 describing the regulatory functions of the board, the procedures by 25-23 which consumer complaints are filed and resolved, and the 25-24 profession of perfusion and shall make the information available to 25-25 the public and appropriate state agencies; 25-26 (3) shall prepare a registry of licensed perfusionists 25-27 and provisional licensed perfusionists and make this information 26-1 available to the general public, license holders, and appropriate 26-2 state agencies; and 26-3 (4) may request the attorney general or the 26-4 appropriate county or district attorney to institute a suit to 26-5 enjoin a violation of this article in addition to any other action, 26-6 proceeding, or remedy authorized by law. 26-7 Sec. 24. SUNSET PROVISION. The Texas State Board of 26-8 Examiners of Perfusionists is subject to Chapter 325, Government 26-9 Code (Texas Sunset Act), and its subsequent amendments. Unless 26-10 continued in existence as provided by that chapter, the board is 26-11 abolished September 1, 2005. 26-12 SECTION 2. (a) Notwithstanding Section 4, Article 4529e, 26-13 Revised Statutes, as added by this Act, not later than December 31, 26-14 1993, the governor shall make the initial appointments to the Texas 26-15 State Board of Examiners of Perfusionists as follows: 26-16 (1) one member engaged in the practice of perfusion, 26-17 the physician member, and one public member, who shall serve until 26-18 February 1, 1995; 26-19 (2) two members engaged in the practice of perfusion 26-20 and one public member, who shall serve until February 1, 1997; and 26-21 (3) two members engaged in the practice of perfusion 26-22 and one public member, who shall serve until February 1, 1999. 26-23 (b) A person actively engaged in the practice of perfusion 26-24 consistent with applicable law on or prior to January 1, 1993, 26-25 shall receive a license as a licensed perfusionist without 26-26 examination if application is made before September 1, 1995, so 26-27 long as the person submits proof satisfactory to the board that the 27-1 person meets one of the following requirements: 27-2 (1) the person, as of the effective date of this Act, 27-3 was operating cardiopulmonary bypass systems during cardiopulmonary 27-4 surgery in a health care facility licensed in the United States as 27-5 the person's primary function and had been operating the systems 27-6 since January 1, 1989; 27-7 (2) the person has had at least five years' experience 27-8 operating cardiopulmonary bypass systems during cardiopulmonary 27-9 surgery in a health care facility licensed in the United States 27-10 since January 1, 1986; or 27-11 (3) the person has successfully completed a perfusion 27-12 education program approved by the Committee on Allied Health 27-13 Education and Accreditation of the American Medical Association, or 27-14 their successors, after January 1, 1989, and holds a certificate as 27-15 a certified clinical perfusionist issued by the American Board of 27-16 Cardiovascular Perfusion. 27-17 (c) Notwithstanding Section 4, Article 4529e, Revised 27-18 Statutes, as added by this Act, a perfusionist member of the Texas 27-19 State Board of Examiners of Perfusionists: 27-20 (1) is not required to be licensed if the member was 27-21 appointed to the board before January 1, 1995; and 27-22 (2) is not required to be licensed under Article 27-23 4529e, Revised Statutes, as added by this Act, for three years or 27-24 more if the member was appointed to the board within four years 27-25 following the effective date of this Act. 27-26 SECTION 3. This Act takes effect January 1, 1994. 27-27 SECTION 4. The importance of this legislation and the 28-1 crowded condition of the calendars in both houses create an 28-2 emergency and an imperative public necessity that the 28-3 constitutional rule requiring bills to be read on three several 28-4 days in each house be suspended, and this rule is hereby suspended.