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 -------------------------------------------------------------------