1-1  By:  Berlanga (Senate Sponsor - Madla)                H.B. No. 1835
    1-2        (In the Senate - Received from the House May 5, 1993;
    1-3  May 6, 1993, read first time and referred to Committee on Health
    1-4  and Human Services; May 20, 1993, reported favorably by the
    1-5  following vote:  Yeas 8, Nays 0; May 20, 1993, sent to printer.)
    1-6                            COMMITTEE VOTE
    1-7                          Yea     Nay      PNV      Absent 
    1-8        Zaffirini          x                               
    1-9        Ellis              x                               
   1-10        Madla              x                               
   1-11        Moncrief           x                               
   1-12        Nelson             x                               
   1-13        Patterson          x                               
   1-14        Shelley            x                               
   1-15        Truan              x                               
   1-16        Wentworth                                      x   
   1-17                         A BILL TO BE ENTITLED
   1-18                                AN ACT
   1-19  relating to the regulation of the practice of perfusion; providing
   1-20  a penalty.
   1-21        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-22        SECTION 1.  Title 71, Revised Statutes, is amended by adding
   1-23  Chapter 7A and Article 4529e to read as follows:
   1-24                      CHAPTER 7A.  PERFUSIONISTS
   1-25        Art. 4529e.  LICENSED PERFUSIONISTS
   1-26        Sec. 1.  SHORT TITLE.  This article may be cited as the
   1-27  Licensed Perfusionists Act.
   1-28        Sec. 2.  LEGISLATIVE FINDINGS; PURPOSE.  (a)  The legislature
   1-29  finds that:
   1-30              (1)  the citizens of this state are entitled to the
   1-31  protection of their health, safety, and welfare from the
   1-32  unqualified or unprofessional practice of perfusion;
   1-33              (2)  the practice of perfusion by unauthorized,
   1-34  unqualified, unprofessional, or incompetent persons is a threat to
   1-35  the public; and
   1-36              (3)  the practice of perfusion is a dynamic and
   1-37  changing health care field which is continually evolving to include
   1-38  more sophisticated and demanding patient care activities.
   1-39        (b)  The purpose of this article is to protect the public
   1-40  from the dangers described by Subsection (a) of this section by:
   1-41              (1)  establishing minimum standards of education,
   1-42  training, and competency for persons engaged in the practice of
   1-43  perfusion and of the performance of perfusion services in a manner
   1-44  that provides for the continued evolution of the practice of
   1-45  perfusion; and
   1-46              (2)  ensuring that the privilege of practicing in the
   1-47  field of perfusion is entrusted only to those licensed and
   1-48  regulated under this article.
   1-49        Sec. 3.  DEFINITIONS.  In this article:
   1-50              (1)  "Board" means the Texas State Board of Examiners
   1-51  of Perfusionists.
   1-52              (2)  "Board of health" means the Texas Board of Health.
   1-53              (3)  "Department" means the Texas Department of Health.
   1-54              (4)  "Commissioner" means the commissioner of health.
   1-55              (5)  "Extracorporeal circulation" means the diversion
   1-56  of a patient's blood through a heart-lung machine or a similar
   1-57  device that assumes the functions of the patient's heart, lungs, or
   1-58  both.
   1-59              (6)  "Licensed perfusionist" means a person licensed
   1-60  under this article.
   1-61              (7)  "Perfusion" means the functions necessary for the
   1-62  support, treatment, measurement, or supplementation of the
   1-63  cardiovascular, circulatory, or respiratory system, or a
   1-64  combination of those activities, and to ensure the safe management
   1-65  of physiologic functions by monitoring the parameters of the
   1-66  systems under an order and under the supervision of a licensed
   1-67  physician, including:
   1-68                    (A)  the use of extracorporeal circulation,
    2-1  cardiopulmonary support techniques, and other therapeutic and
    2-2  diagnostic technologies;
    2-3                    (B)  counterpulsation, ventricular assistance, or
    2-4  autotransfusion (including blood conservation techniques),
    2-5  administration of cardioplegia, and isolated limb perfusion;
    2-6                    (C)  the use of techniques involving blood
    2-7  management, advanced life support, and other related functions; and
    2-8                    (D)  in the performance of the acts described in
    2-9  this subsection:
   2-10                          (i)  the administration of:
   2-11                                (aa)  pharmacological and therapeutic
   2-12  agents; or
   2-13                                (bb)  blood products or anesthetic
   2-14  agents through the extracorporeal circuit or through an intravenous
   2-15  line as ordered by a physician;
   2-16                          (ii)  the performance and use of:
   2-17                                (aa)  anticoagulation analysis;
   2-18                                (bb)  physiologic analysis;
   2-19                                (cc)  blood gas and chemistry
   2-20  analysis;
   2-21                                (dd)  hematocrit analysis;
   2-22                                (ee)  hypothermia;
   2-23                                (ff)  hyperthermia;
   2-24                                (gg)  hemoconcentration; and
   2-25                                (hh)  hemodilution; and
   2-26                          (iii)  the observation of signs and
   2-27  symptoms related to perfusion services, the determination of
   2-28  whether the signs and symptoms exhibit abnormal characteristics,
   2-29  and the implementation of appropriate reporting, perfusion
   2-30  protocols, or changes in or the initiation of emergency procedures.
   2-31              (8)  "Perfusion protocols" means perfusion-related
   2-32  policies and protocols developed or approved by a licensed health
   2-33  facility or a physician through collaboration with administrators,
   2-34  licensed perfusionists, and other health professionals.
   2-35              (9)  "Provisional licensed perfusionist" means a person
   2-36  provisionally licensed under this article.
   2-37        Sec. 4.  BOARD; MEMBERSHIP.  (a)  The Texas State Board of
   2-38  Examiners of Perfusionists is created.
   2-39        (b)  The board is composed of nine members.  Three members
   2-40  must be members of the general public.  Five members must be
   2-41  perfusionists licensed under this article.  One member must be a
   2-42  physician licensed by the Texas State Board of Medical Examiners
   2-43  who is also board certified in cardiovascular surgery.
   2-44        (c)  The governor with the advice and consent of the senate
   2-45  shall appoint the board members, who shall serve staggered terms of
   2-46  six years with three members' terms expiring February 1 of each
   2-47  odd-numbered year.
   2-48        (d)  A license holder eligible for appointment as a licensed
   2-49  perfusionist board member must have been licensed under this
   2-50  article for at least three years before appointment to the board.
   2-51        (e)  An officer, employee, or paid consultant of a Texas
   2-52  trade association in the field of health care may not be a member
   2-53  or employee of the board who is exempt from the state's position
   2-54  classification plan or is compensated at or above the amount
   2-55  prescribed by the General Appropriations Act for step 1, salary
   2-56  group 17, of the position classification salary schedule.
   2-57        (f)  A person who is the spouse of an officer, manager, or
   2-58  paid consultant of a Texas trade association in the field of health
   2-59  care may not be a board member and may not be an employee of the
   2-60  board who is exempt from the state's position classification plan
   2-61  or is compensated at or above the amount prescribed by the General
   2-62  Appropriations Act for step 1, salary group 17, of the position
   2-63  classification salary schedule.  For the purposes of this
   2-64  subsection and Subsection (e) of this section, a Texas trade
   2-65  association is a nonprofit, cooperative, and voluntarily joined
   2-66  association of business or professional competitors in this state
   2-67  designed to assist its members and its industry or profession in
   2-68  dealing with mutual business or professional problems and in
   2-69  promoting their common interests.
   2-70        (g)  It is the intent of the legislature that the membership
    3-1  of the board reflect the historical and cultural diversity of the
    3-2  inhabitants of this state.  Appointments to the board should be
    3-3  made without discrimination based on race, creed, sex, religion,
    3-4  national origin, or geographical distribution of the appointees.
    3-5        (h)  A person may not serve as a member of the board or act
    3-6  as general counsel to the board if the person is required to
    3-7  register as a lobbyist under Chapter 305, Government Code, and its
    3-8  subsequent amendments, because of the person's activities for
    3-9  compensation on behalf of a profession related to the operation of
   3-10  the board.
   3-11        Sec. 5.  GROUNDS FOR REMOVAL.  (a)  It is a ground for
   3-12  removal from the board if a member:
   3-13              (1)  does not have at the time of appointment the
   3-14  qualifications required for appointment to the board;
   3-15              (2)  does not maintain during service on the board the
   3-16  qualifications required for appointment to the board;
   3-17              (3)  violates a prohibition established by this
   3-18  article;
   3-19              (4)  cannot discharge the member's term for a
   3-20  substantial part of the term for which the member is appointed
   3-21  because of illness or disability; or
   3-22              (5)  is absent from more than half of the regularly
   3-23  scheduled board meetings that the member is eligible to attend
   3-24  during a calendar year unless the absence is excused by majority
   3-25  vote of the board.
   3-26        (b)  The validity of an action of the board is not affected
   3-27  by the fact that it is taken when a ground for removal of a member
   3-28  of the board exists.
   3-29        (c)  If the executive director has knowledge that a potential
   3-30  ground for removal exists, the executive director shall notify the
   3-31  presiding officer of the board of the ground.  The presiding
   3-32  officer shall then notify the governor that a potential ground for
   3-33  removal exists.
   3-34        Sec. 6.  OFFICERS; MEETINGS; QUORUM; EXPENSES.  (a)  Not
   3-35  later than the 30th day after the day its new members are appointed
   3-36  by the governor, the board shall meet to elect a chairman and
   3-37  vice-chairman who shall hold office according to rules adopted by
   3-38  the board.
   3-39        (b)  The board shall hold at least two regular meetings each
   3-40  year as provided by rules adopted by the board.  The rules may not
   3-41  be inconsistent with present rules of the department relating to
   3-42  meetings of boards.
   3-43        (c)  A majority of the members constitutes a quorum.
   3-44        (d)  A member of the board is entitled to a per diem as set
   3-45  by the General Appropriations Act for each day that the member
   3-46  engages in the business of the board.  A member is entitled to
   3-47  compensation for travel expenses as provided by the General
   3-48  Appropriations Act.
   3-49        Sec. 7.  POWERS AND DUTIES OF BOARD.  (a)  The board may
   3-50  adopt rules not inconsistent with this article as are necessary for
   3-51  the governing of its own proceedings, the performance of its
   3-52  duties, the regulation of the practice of perfusion in this state,
   3-53  and the enforcement of this article.  In adopting rules, the board
   3-54  shall consider the rules and procedures of the board of health and
   3-55  the department and shall adopt procedural rules not inconsistent
   3-56  with existing rules and procedures of the board of health or the
   3-57  department.
   3-58        (b)  The board shall:
   3-59              (1)  adopt and publish a code of ethics and adopt an
   3-60  official seal;
   3-61              (2)  establish the qualifications and fitness of
   3-62  applicants for licenses, renewal of licenses, and reciprocal
   3-63  licenses;
   3-64              (3)  revoke, suspend, or deny a license, probate a
   3-65  license suspension, or reprimand a license holder for a violation
   3-66  of this article, the code of ethics, or the rules of the board;
   3-67              (4)  spend funds necessary for the proper
   3-68  administration of its assigned duties;
   3-69              (5)  establish reasonable and necessary fees for the
   3-70  administration and implementation of this article;
    4-1              (6)  comply with the open meetings law, Chapter 271,
    4-2  Acts of the 60th Legislature, Regular Session, 1967 (Article
    4-3  6252-17, Vernon's Texas Civil Statutes), and its subsequent
    4-4  amendments, and the Administrative Procedure and Texas Register Act
    4-5  (Article 6252-13a, Vernon's Texas Civil Statutes) and its
    4-6  subsequent amendments;
    4-7              (7)  provide to its members and employees, as often as
    4-8  necessary, information regarding their qualifications for office or
    4-9  employment under this article and their responsibilities under
   4-10  applicable laws relating to standards of conduct for state officers
   4-11  or employees;
   4-12              (8)  develop and implement policies that provide the
   4-13  public with a reasonable opportunity to appear before the board and
   4-14  to speak on any issue under the jurisdiction of the board;
   4-15              (9)  develop and implement policies that clearly define
   4-16  the respective responsibilities of the board and the staff of the
   4-17  board;
   4-18              (10)  prepare and maintain a written plan that
   4-19  describes how a person who does not speak English or who has a
   4-20  physical, mental, or developmental disability can be provided
   4-21  reasonable access to the board's programs and comply with federal
   4-22  and state laws for program and facility accessibility;
   4-23              (11)  comply with the board member training
   4-24  requirements established by any other state agency that is given
   4-25  authority to establish the requirements for the board; and
   4-26              (12)  establish continuing professional education
   4-27  programs for licensed perfusionists and provisional licensed
   4-28  perfusionists under this chapter, the standards of which shall be
   4-29  at least as stringent as those of the American Board of
   4-30  Cardiovascular Perfusion or its successor agency, and shall:
   4-31                    (A)  establish a minimum number of hours of
   4-32  continuing education required to renew a license under this
   4-33  article;
   4-34                    (B)  develop a process to evaluate and approve
   4-35  continuing education courses;
   4-36                    (C)  identify the key factors for the competent
   4-37  performance by a license holder of the license holder's
   4-38  professional duties; and
   4-39                    (D)  adopt a procedure to assess a license
   4-40  holder's participation in continuing education programs.
   4-41        (c)  The board may not adopt rules restricting competitive
   4-42  bidding or advertising by a person regulated by the board except to
   4-43  prohibit false, misleading, or deceptive practices.  The board may
   4-44  not include in its rules to prohibit false, misleading, or
   4-45  deceptive practices by a person regulated by the board a rule that:
   4-46              (1)  restricts the person's use of any medium for
   4-47  advertising;
   4-48              (2)  restricts the person's personal appearance or use
   4-49  of the person's personal voice in an advertisement;
   4-50              (3)  relates to the size or duration of any
   4-51  advertisement by the person; or
   4-52              (4)  restricts the person's advertisement under a trade
   4-53  name.
   4-54        (d)  The board by rule shall establish methods by which
   4-55  consumers and service recipients are notified of the name, mailing
   4-56  address, and telephone number of the board for directing complaints
   4-57  to the board.  The board may provide for that notification:
   4-58              (1)  on each license form, application, or written
   4-59  contract for services of a person licensed under this article;
   4-60              (2)  on a sign prominently displayed in the place of
   4-61  business of each person licensed under this article; or
   4-62              (3)  in a bill for services provided by a person
   4-63  licensed under this article.
   4-64        (e)  The board shall list along with its regular telephone
   4-65  number the toll-free telephone number that may be called to present
   4-66  a complaint about a health professional if the toll-free number is
   4-67  established under other state law.
   4-68        Sec. 8.  ADMINISTRATIVE FUNCTION; PERSONNEL.  (a)  The basic
   4-69  personnel and necessary facilities required to administer this
   4-70  article shall be the personnel and facilities of the department.
    5-1  The department personnel shall act as the agents of the board.  If
    5-2  necessary to the administration or implementation of this article,
    5-3  the department by agreement may secure and provide for compensation
    5-4  for services that it considers necessary and may employ and
    5-5  compensate within available appropriations professional
    5-6  consultants, technical assistants, and employees on a full-time or
    5-7  part-time basis.
    5-8        (b)  The commissioner shall designate an employee to serve as
    5-9  executive secretary of the board.  The executive secretary shall be
   5-10  an employee of the department.  The executive secretary shall be
   5-11  the administrator of the licensing activities for the board.
   5-12        (c)  In addition to other duties prescribed by this article
   5-13  and by the department, the executive secretary shall:
   5-14              (1)  keep full and accurate minutes of the transactions
   5-15  and proceedings of the board;
   5-16              (2)  be the custodian of the files and records of the
   5-17  board;
   5-18              (3)  prepare and recommend to the board plans and
   5-19  procedures necessary to implement the purposes and objectives of
   5-20  this article, including rules and proposals on administrative
   5-21  procedures consistent with this article;
   5-22              (4)  exercise general supervision over persons employed
   5-23  by the department in the administration of this article;
   5-24              (5)  be responsible for the investigation of complaints
   5-25  and for the presentation of formal complaints;
   5-26              (6)  attend all meetings of the board as a nonvoting
   5-27  participant;
   5-28              (7)  handle the correspondence of the board and obtain,
   5-29  assemble, or prepare the reports and information that the board may
   5-30  direct or authorize;
   5-31              (8)  develop an intra-agency career ladder program
   5-32  which shall require intra-agency posting of all nonentry level
   5-33  positions concurrently with any public posting;
   5-34              (9)  develop a system of annual performance evaluations
   5-35  based on measurable job tasks, which shall be the basis for all
   5-36  merit pay for board employees; and
   5-37              (10)  prepare and maintain a written policy statement
   5-38  to ensure implementation of a program of equal employment
   5-39  opportunity under which all personnel transactions are made without
   5-40  regard to race, color, disability, sex, religion, age, or natural
   5-41  origin, which policy statement must cover an annual period, be
   5-42  updated annually, be reviewed by the Commission on Human Rights for
   5-43  compliance with Paragraph (A) of this subdivision, and be filed
   5-44  with the governor's office and that must include:
   5-45                    (A)  personnel policies, including policies
   5-46  relating to recruitment, evaluation, selection, application,
   5-47  training, and promotion of personnel that are in compliance with
   5-48  the Commission on Human Rights Act (Article 5221k, Vernon's Texas
   5-49  Civil Statutes) and its subsequent amendments;
   5-50                    (B)  a comprehensive analysis of the board
   5-51  workforce that meets federal and state guidelines;
   5-52                    (C)  procedures by which a determination can be
   5-53  made of significant underuse in the board workforce of all persons
   5-54  for whom federal or state guidelines encourage a more equitable
   5-55  balance; and
   5-56                    (D)  reasonable methods to appropriately address
   5-57  those areas of underuse.
   5-58        Sec. 9.  FEES; FUNDS; ANNUAL REPORT; AUDIT.  (a)  After
   5-59  consultation with the commissioner or the department, the board
   5-60  shall set the fees imposed by this article in amounts so that the
   5-61  fees in the aggregate produce sufficient revenue to cover the cost
   5-62  of administering this article without accumulating an unnecessary
   5-63  surplus in the licensed perfusionists fund created by this section.
   5-64        (b)  The amount of the fees that may be imposed in connection
   5-65  with a license under this article may not exceed the following:
   5-66              (1)  application fee:                        $75;
   5-67              (2)  examination fee:                        $100;
   5-68              (3)  initial license fee:                    $75;
   5-69              (4)  initial provisional license fee:        $75;
   5-70              (5)  license renewal fee:                    $75;
    6-1              (6)  delinquency fee:                        $50; and
    6-2              (7)  duplicate license fee:                  $10.
    6-3        (c)  The fees set by the board may be adjusted so that the
    6-4  total fees collected are sufficient to meet the expenses of
    6-5  administering this article.
    6-6        (d)  The department shall receive and account for funds
    6-7  derived under this article.  The funds shall be deposited in the
    6-8  state treasury to the credit of a special fund to be known as the
    6-9  licensed perfusionists fund to be used only for the administration
   6-10  of this article.
   6-11        (e)  The board shall make a complete and detailed written
   6-12  report to the governor, lieutenant governor, and speaker of the
   6-13  house of representatives accounting for all funds received and
   6-14  disbursed by the board or the department for the administration of
   6-15  this article during the preceding year.  The annual report must be
   6-16  in the form and reported in the time provided by the General
   6-17  Appropriations Act.
   6-18        (f)  The financial transactions of the board or the
   6-19  department in relation to the administration of this article are
   6-20  subject to audit by the state auditor in accordance with Chapter
   6-21  321, Government Code, and its subsequent amendments.
   6-22        Sec. 10.  APPLICANT QUALIFICATIONS; APPLICATION REVIEW.
   6-23  (a)  An applicant for a perfusionist license must submit a sworn
   6-24  application accompanied by an application fee.
   6-25        (b)  The board shall prescribe the form of the application
   6-26  and by rule may establish dates by which applications and fees must
   6-27  be received.  These rules must not be inconsistent with present
   6-28  rules of the department related to application dates of other
   6-29  licenses.
   6-30        (c)  To qualify for the licensing examination, the applicant
   6-31  must have successfully completed a perfusion education program
   6-32  approved by the board.
   6-33        (d)  In approving perfusion education programs necessary for
   6-34  qualification for licensing examination, the board shall approve
   6-35  only a program that has educational standards that are at least as
   6-36  stringent as those established by the Accreditation Committee for
   6-37  Perfusion Education and approved by the Committee on Allied Health
   6-38  Education and Accreditation of the American Medical Association or
   6-39  their successors.
   6-40        (e)  Not later than the 45th day after the date of receipt of
   6-41  a properly submitted and timely application and not later than the
   6-42  30th day before the next examination date, the department shall
   6-43  notify an applicant in writing that the applicant's application and
   6-44  any other relevant evidence pertaining to applicant qualifications
   6-45  established by the board by rule have been received and
   6-46  investigated.  The notice shall state whether the application and
   6-47  other evidence submitted have qualified the applicant for
   6-48  examination.  If the applicant has not qualified for examination,
   6-49  the notice shall state the reasons for the lack of qualification.
   6-50        Sec. 11.  EXAMINATION.  (a)  To qualify for a license, an
   6-51  applicant must pass a competency examination.  Examinations shall
   6-52  be prepared or approved by the board and administered to qualified
   6-53  applicants at least once each calendar year.
   6-54        (b)  An examination prescribed by the board may be or may
   6-55  include the written and oral examinations given by the American
   6-56  Board of Cardiovascular Perfusion or by a national or state testing
   6-57  service in lieu of an examination prepared by the board.  The board
   6-58  shall have the written portion of the examination, if any,
   6-59  validated by an independent testing professional.
   6-60        (c)  Not later than the 30th day after the date on which a
   6-61  licensing examination is administered under this article, the
   6-62  department shall notify each examinee of the results of the
   6-63  examination.  If an examination is graded or reviewed by a national
   6-64  or state testing service, the department shall notify examinees of
   6-65  the results of the examination within two weeks after the date the
   6-66  department receives the results from the testing service.  If the
   6-67  notice of the examination results will be delayed for more than 90
   6-68  days after the examination date, the department shall notify the
   6-69  examinee of the reason for the delay before the 90th day.
   6-70        (d)  If requested in writing by a person who fails the
    7-1  licensing examination, the department shall furnish the person with
    7-2  an analysis of the person's performance on the examination.
    7-3        (e)  The board by rule shall establish:
    7-4              (1)  a limit on the number of times an applicant who
    7-5  fails an examination may retake the examination;
    7-6              (2)  requirements for retaking an examination; and
    7-7              (3)  alternative methods of examining competency.
    7-8        Sec. 12.  LICENSE.  (a)  A person who meets the licensing
    7-9  qualifications under this article is entitled to receive a license
   7-10  as a licensed perfusionist.
   7-11        (b)  The license holder must:
   7-12              (1)  display the license certificate in an appropriate
   7-13  and public manner; or
   7-14              (2)  maintain on file at all times during which the
   7-15  license holder provides services in a health care facility a true
   7-16  and correct copy of the license certificate in the appropriate
   7-17  records of the facility; and
   7-18              (3)  keep the department informed of any change of
   7-19  address.
   7-20        (c)  A license certificate issued by the board is the
   7-21  property of the board and shall be surrendered on demand.
   7-22        Sec. 13.  LICENSE EXPIRATION; RENEWAL.  (a)  A license is
   7-23  valid for one year from the date it is issued and may be renewed
   7-24  annually.
   7-25        (b)  The board of health by rule may adopt a system under
   7-26  which licenses expire on various dates during the year.
   7-27        (c)  A person may renew an unexpired license by submitting
   7-28  proof satisfactory to the board of compliance with the continuing
   7-29  professional education requirements prescribed by the board and
   7-30  paying the required renewal fee to the department before the
   7-31  expiration date of the license.
   7-32        (d)  If a person's license has been expired for not more than
   7-33  90 days, the person may renew the license by submitting proof
   7-34  satisfactory to the board of compliance with the continuing
   7-35  professional education requirements prescribed by the board and
   7-36  paying to the department the required renewal fee and a penalty fee
   7-37  that is one-half of the renewal fee.
   7-38        (e)  If a person's license has been expired for more than 90
   7-39  days but less than two years, the person may renew the license by
   7-40  submitting proof satisfactory to the board of compliance with the
   7-41  continuing professional education requirements prescribed by the
   7-42  board and paying to the department all unpaid renewal fees and a
   7-43  penalty fee that is equal to the renewal fee.
   7-44        (f)  If a person's license has been expired two years or
   7-45  more, the person may not renew the license.  The person may obtain
   7-46  a new license by submitting to reexamination and complying with the
   7-47  current requirements and procedures for obtaining a license.
   7-48        (g)  The board may renew without reexamination an expired
   7-49  license of a person who was licensed in this state, moved to
   7-50  another state, and is currently appropriately licensed or certified
   7-51  and has been in practice in the other state for the two years
   7-52  preceding application.  The person must pay to the board a fee that
   7-53  is equal to the examination fee for the license.
   7-54        (h)  The department shall notify each license holder in
   7-55  writing of the license expiration date before the 30th day before
   7-56  that date by notice to the license holder at the license holder's
   7-57  last known address according to the records of the board.
   7-58        Sec. 14.  PROVISIONAL LICENSE.  (a)  A license as a
   7-59  provisional licensed perfusionist may be issued by the board to a
   7-60  person who has successfully completed an approved perfusion
   7-61  education program on the filing of an application, payment of an
   7-62  application fee, and the submission of evidence satisfactory to the
   7-63  board of the successful completion of the education requirement set
   7-64  forth in Section 10 of this article.
   7-65        (b)  A provisional licensed perfusionist shall be under the
   7-66  supervision and direction of a licensed perfusionist at all times
   7-67  during which the provisional licensed perfusionist performs
   7-68  perfusion.  Rules adopted by the board governing such supervision
   7-69  and direction may not require the immediate physical presence of
   7-70  the supervising licensed perfusionist.
    8-1        (c)  A person qualified for a provisional license under this
    8-2  article is entitled to receive a license as a provisional licensed
    8-3  perfusionist.  A provisional licensed perfusionist shall comply
    8-4  with Sections 12(b) and (c) of this article.
    8-5        (d)  A provisional license is valid for one year from the
    8-6  date it is issued and may be renewed annually not more than five
    8-7  times by the same procedures established for renewal under Section
    8-8  13 of this article if the application for renewal is signed by a
    8-9  supervising licensed perfusionist.
   8-10        Sec. 15.  ENDORSEMENT.  On receipt of an application and
   8-11  application fee, the board shall waive the examination requirement
   8-12  for an applicant who at the time of application:
   8-13              (1)  is appropriately licensed or certified by another
   8-14  state, territory, or possession of the United States if the
   8-15  requirements of that state, territory, or possession for the
   8-16  license or certificate are the substantial equivalent of the
   8-17  requirements of this article as determined by the board; or
   8-18              (2)  holds a certificate as a certified clinical
   8-19  perfusionist issued by the American Board of Cardiovascular
   8-20  Perfusion prior to January 1, 1994, and who may practice perfusion
   8-21  in another state, territory, or possession of the United States
   8-22  which does not credential perfusionists.
   8-23        Sec. 16.  PROHIBITED ACTS; PENALTY.  (a)  A person may not
   8-24  engage or offer to engage in perfusion, as defined in this article,
   8-25  for compensation or use the title or represent or imply that the
   8-26  person has the title of "licensed perfusionist" or "provisional
   8-27  licensed perfusionist" or use the letters "LP" or "PLP" and may not
   8-28  use any facsimile of those titles in any manner to indicate or
   8-29  imply that the person is a licensed perfusionist or provisional
   8-30  licensed perfusionist unless the person holds an appropriate
   8-31  license issued under this article.
   8-32        (b)  A person may not use the title or represent or imply
   8-33  that the person has the title of "certified clinical perfusionist"
   8-34  or use the letters "CCP" and may not use any facsimile of those
   8-35  titles in any manner to indicate or imply that the person is a
   8-36  certified clinical perfusionist by the American Board of
   8-37  Cardiovascular Perfusion unless the person holds a certificate as a
   8-38  certified clinical perfusionist issued by the American Board of
   8-39  Cardiovascular Perfusion.
   8-40        (c)  A person commits an offense if the person knowingly or
   8-41  intentionally violates Subsection (a) or (b) of this section.  An
   8-42  offense under this section is a Class B misdemeanor.
   8-43        Sec. 17.  EXEMPTIONS.  This article does not apply to:
   8-44              (1)  a person licensed by another health professional
   8-45  licensing board if:
   8-46                    (A)  the person does not represent to the public,
   8-47  directly or indirectly, that the person is licensed under this
   8-48  article, and does not use any name, title, or designation
   8-49  indicating that the person is licensed under this article; and
   8-50                    (B)  the person confines the person's acts or
   8-51  practice to the scope of practice authorized by the other health
   8-52  professional licensing laws;
   8-53              (2)  a student enrolled in an accredited perfusion
   8-54  education program if perfusion services performed by the student:
   8-55                    (A)  are an integral part of the student's course
   8-56  of study; and
   8-57                    (B)  are performed under the direct supervision
   8-58  of a licensed perfusionist assigned to supervise the student and
   8-59  who is on duty and immediately available in the assigned patient
   8-60  care area;
   8-61              (3)  a person who has successfully completed an
   8-62  approved perfusion education program but who has not been issued a
   8-63  license as a provisional licensed perfusionist in accordance with
   8-64  the provisions of Section 14 of this article and:
   8-65                    (A)  is at all times in compliance with the
   8-66  provisions of Section 14(b) of this article; and
   8-67                    (B)  receives a license as a provisional licensed
   8-68  perfusionist within 180 days of the date upon which the person
   8-69  successfully completed an approved perfusion education program;
   8-70              (4)  the practice of any legally qualified perfusionist
    9-1  employed by the United States government while in the discharge of
    9-2  official duties; or
    9-3              (5)  a person who is not a resident of this state if:
    9-4                    (A)  the person is authorized to perform the
    9-5  activities and services of perfusion under the laws of the state of
    9-6  the person's residence; and
    9-7                    (B)  such activities and services are performed
    9-8  for not more than 30 days in any one year; or
    9-9              (6)  a person performing autotransfusion or blood
   9-10  conservation techniques under the supervision of a licensed
   9-11  physician.
   9-12        Sec. 18.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The board
   9-13  shall keep an information file about each complaint filed with the
   9-14  board.  The board's information file shall be kept current and
   9-15  contain a record for each complaint of:
   9-16              (1)  all persons contacted in relation to the
   9-17  complaint;
   9-18              (2)  a summary of findings made at each step of the
   9-19  complaint process;
   9-20              (3)  an explanation of the legal basis and reason for a
   9-21  complaint that is dismissed; and
   9-22              (4)  other relevant information.
   9-23        (b)  If written complaint is filed with the board that the
   9-24  board has authority to resolve, the board, at least as frequently
   9-25  as quarterly and until final disposition of the complaint, shall
   9-26  notify the parties to the complaint of the status of the complaint
   9-27  unless the notice would jeopardize an undercover investigation.
   9-28        (c)  The board by rule shall adopt a form to standardize
   9-29  information concerning complaints made to the board.  The board by
   9-30  rule shall prescribe information to be provided to a person when
   9-31  the person files a complaint with the board.
   9-32        (d)  The board shall provide reasonable assistance to a
   9-33  person who wishes to file a complaint with the board.
   9-34        Sec. 19.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
   9-35  board shall adopt rules concerning the investigation of a complaint
   9-36  filed with the board.  The rules adopted under this subsection
   9-37  shall:
   9-38              (1)  distinguish between categories of complaints;
   9-39              (2)  ensure that complaints are not dismissed without
   9-40  appropriate consideration;
   9-41              (3)  require that the board be advised of a complaint
   9-42  that is dismissed and that a letter be sent to the person who filed
   9-43  the complaint explaining the action taken on the dismissed
   9-44  complaint;
   9-45              (4)  ensure that the person who filed the complaint has
   9-46  an opportunity to explain the allegations made in the complaint;
   9-47  and
   9-48              (5)  prescribe guidelines concerning the categories of
   9-49  complaints that require the use of a private investigator and the
   9-50  procedures for the board to obtain the services of a private
   9-51  investigator.
   9-52        (b)  The board shall dispose of all complaints in a timely
   9-53  manner.  The board shall establish a schedule for conducting each
   9-54  phase of a complaint that is under the control of the board not
   9-55  later than the 30th day after the date the complaint is received by
   9-56  the board.  The schedule shall be kept in the information file for
   9-57  the complaint and all parties shall be notified of the projected
   9-58  time requirements for pursuing the complaint.  A change in the
   9-59  schedule must be noted in the complaint information file and all
   9-60  parties to the complaint must be notified not later than the
   9-61  seventh day after the date the change is made.
   9-62        (c)  The executive director of the board shall notify the
   9-63  board of a complaint that extends beyond the time prescribed by the
   9-64  board for resolving the complaint so that the board may take
   9-65  necessary action on the complaint.
   9-66        Sec. 20.  INFORMAL PROCEEDINGS.  (a)  The board by rule shall
   9-67  adopt procedures governing:
   9-68              (1)  informal disposition of a contested case under
   9-69  Section 13(e), Administrative Procedure and Texas Register Act
   9-70  (Article 6252-13a, Vernon's Texas Civil Statutes); and
   10-1              (2)  informal proceedings held in compliance with
   10-2  Section 18(c), Administrative Procedure and Texas Register Act
   10-3  (Article 6252-13a, Vernon's Texas Civil Statutes).
   10-4        (b)  Rules adopted under this section must provide the
   10-5  complainant and the license holder an opportunity to be heard and
   10-6  must require the presence of a representative of the office of the
   10-7  attorney general to advise the board or the board's employees.
   10-8        Sec. 21.  MONITORING OF LICENSE HOLDER.  The board by rule
   10-9  shall develop a system for monitoring license holders' compliance
  10-10  with the requirements of this article.  Rules adopted under this
  10-11  section shall include procedures for monitoring a license holder
  10-12  who is ordered by the board to perform certain acts to ascertain
  10-13  that the license holder performs the required acts and to identify
  10-14  and monitor license holders who represent a risk to the public.
  10-15        Sec. 22.  REVOCATION AND SUSPENSION; EX PARTE COMMUNICATION.
  10-16  (a)  The board shall revoke or suspend a license, place on
  10-17  probation a person whose license has been suspended, or reprimand a
  10-18  license holder on proof of:
  10-19              (1)  any violation of this article; or
  10-20              (2)  any violation of a rule or code of ethics adopted
  10-21  by the board.
  10-22        (b)  If a license suspension is probated, the board may
  10-23  require the license holder:
  10-24              (1)  to report regularly to the board on matters that
  10-25  are the basis of the probation;
  10-26              (2)  to limit practice to the areas prescribed by the
  10-27  board; or
  10-28              (3)  to continue the person's professional education
  10-29  until the license holder attains a degree of skill satisfactory to
  10-30  the board in those areas that are the basis of the probation.
  10-31        (c)  If the board proposes to suspend or revoke a person's
  10-32  license, the person is entitled to a hearing before a hearings
  10-33  officer appointed by the State Office of Administrative Hearings.
  10-34  The board shall prescribe procedures by which all decisions to
  10-35  suspend or revoke a license are appealable to the board.
  10-36        (d)  Proceedings for the suspension or revocation of a
  10-37  license are governed by the Administrative Procedure and Texas
  10-38  Register Act (Article 6252-13a, Vernon's Texas Civil Statutes) and
  10-39  its subsequent amendments.
  10-40        (e)  The board by rule shall adopt a broad schedule of
  10-41  sanctions for violations under this article.  The State Office of
  10-42  Administrative Hearings shall use the schedule for any sanction
  10-43  imposed as the result of a hearing conducted by that office.
  10-44        (f)  A member of the board or hearings examiner may not
  10-45  communicate with a party to a proceeding pending before the board
  10-46  or the hearings examiner or with a party's representative unless
  10-47  notice and an opportunity to participate are given to each party to
  10-48  the proceeding if the member or hearings examiner proposes to make
  10-49  a decision, a finding of fact, or a conclusion of law in the
  10-50  proceeding.
  10-51        Sec. 23.  DUTIES OF THE BOARD.  For the purposes of this
  10-52  article, the board:
  10-53              (1)  shall request and receive necessary assistance
  10-54  from state educational institutions or other state agencies;
  10-55              (2)  shall prepare information of consumer interest
  10-56  describing the regulatory functions of the board, the procedures by
  10-57  which consumer complaints are filed and resolved, and the
  10-58  profession of perfusion and shall make the information available to
  10-59  the public and appropriate state agencies;
  10-60              (3)  shall prepare a registry of licensed perfusionists
  10-61  and provisional licensed perfusionists and make this information
  10-62  available to the general public, license holders, and appropriate
  10-63  state agencies; and
  10-64              (4)  may request the attorney general or the
  10-65  appropriate county or district attorney to institute a suit to
  10-66  enjoin a violation of this article in addition to any other action,
  10-67  proceeding, or remedy authorized by law.
  10-68        Sec. 24.  SUNSET PROVISION.  The Texas State Board of
  10-69  Examiners of Perfusionists is subject to Chapter 325, Government
  10-70  Code (Texas Sunset Act), and its subsequent amendments.  Unless
   11-1  continued in existence as provided by that chapter, the board is
   11-2  abolished September 1, 2005.
   11-3        SECTION 2.  (a)  Notwithstanding Section 4, Article 4529e,
   11-4  Revised Statutes, as added by this Act, not later than December 31,
   11-5  1993, the governor shall make the initial appointments to the Texas
   11-6  State Board of Examiners of Perfusionists as follows:
   11-7              (1)  one member engaged in the practice of perfusion,
   11-8  the physician member, and one public member, who shall serve until
   11-9  February 1, 1995;
  11-10              (2)  two members engaged in the practice of perfusion
  11-11  and one public member, who shall serve until February 1, 1997; and
  11-12              (3)  two members engaged in the practice of perfusion
  11-13  and one public member, who shall serve until February 1, 1999.
  11-14        (b)  A person actively engaged in the practice of perfusion
  11-15  consistent with applicable law on or prior to January 1, 1993,
  11-16  shall receive a license as a licensed perfusionist without
  11-17  examination if application is made before September 1, 1995, so
  11-18  long as the person submits proof satisfactory to the board that the
  11-19  person meets one of the following requirements:
  11-20              (1)  the person, as of the effective date of this Act,
  11-21  was operating cardiopulmonary bypass systems during cardiopulmonary
  11-22  surgery in a health care facility licensed in the United States as
  11-23  the person's primary function and had been operating the systems
  11-24  since January 1, 1989;
  11-25              (2)  the person has had at least five years' experience
  11-26  operating cardiopulmonary bypass systems during cardiopulmonary
  11-27  surgery in a health care facility licensed in the United States
  11-28  since January 1, 1986; or
  11-29              (3)  the person has successfully completed a perfusion
  11-30  education program approved by the Committee on Allied Health
  11-31  Education and Accreditation of the American Medical Association, or
  11-32  their successors, after January 1, 1989, and holds a certificate as
  11-33  a certified clinical perfusionist issued by the American Board of
  11-34  Cardiovascular Perfusion.
  11-35        (c)  Notwithstanding Section 4, Article 4529e, Revised
  11-36  Statutes, as added by this Act, a perfusionist member of the Texas
  11-37  State Board of Examiners of Perfusionists:
  11-38              (1)  is not required to be licensed if the member was
  11-39  appointed to the board before January 1, 1995; and
  11-40              (2)  is not required to be licensed under Article
  11-41  4529e, Revised Statutes, as added by this Act, for three years or
  11-42  more if the member was appointed to the board within four years
  11-43  following the effective date of this Act.
  11-44        SECTION 3.  This Act takes effect January 1, 1994.
  11-45        SECTION 4.  The importance of this legislation and the
  11-46  crowded condition of the calendars in both houses create an
  11-47  emergency and an imperative public necessity that the
  11-48  constitutional rule requiring bills to be read on three several
  11-49  days in each house be suspended, and this rule is hereby suspended.
  11-50                               * * * * *
  11-51                                                         Austin,
  11-52  Texas
  11-53                                                         May 20, 1993
  11-54  Hon. Bob Bullock
  11-55  President of the Senate
  11-56  Sir:
  11-57  We, your Committee on Health and Human Services to which was
  11-58  referred H.B. No. 1835, have had the same under consideration, and
  11-59  I am instructed to report it back to the Senate with the
  11-60  recommendation that it do pass and be printed.
  11-61                                                         Zaffirini,
  11-62  Chair
  11-63                               * * * * *
  11-64                               WITNESSES
  11-65                                                  FOR   AGAINST  ON
  11-66  ___________________________________________________________________
  11-67  Name:  Homer Arnold, MD                          x
  11-68  Representing:  Self
  11-69  City:  Austin
  11-70  -------------------------------------------------------------------
   12-1  Name:  Greg Hooser                               x
   12-2  Representing:  Tx Asso of Perfusionists
   12-3  City:  Austin
   12-4  -------------------------------------------------------------------
   12-5  Name:  David Marwitz                             x
   12-6  Representing:  Tx Hospital Asso
   12-7  City:  Austin
   12-8  -------------------------------------------------------------------
   12-9  Name:  Shannon Ballard                           x
  12-10  Representing:  Tx Asso of Perfusionists
  12-11  City:  Austin
  12-12  -------------------------------------------------------------------
  12-13  Name:  Kathy Craft                                             x
  12-14  Representing:  Tx Dept of Health
  12-15  City:  Austin
  12-16  -------------------------------------------------------------------