By: Moncrief S.B. No. 86
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the licensing of hospitals by the Texas Department of
1-2 Health including the provision and appropriation of fees and the
1-3 assessment of civil penalties and administrative penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subsections (c) and (d), Section 241.022, Health
1-6 and Safety Code, are amended to read as follows:
1-7 (c) The department shall require that each hospital show
1-8 evidence that:
1-9 (1) at least one physician is on the medical staff of
1-10 the hospital, including evidence that the physician is currently
1-11 licensed; <and>
1-12 (2) the governing body of the hospital<:>
1-13 <(A)> has adopted and implemented a patient
1-14 transfer policy in accordance with Section 241.027; and
1-15 (3) if the governing body has chosen to implement
1-16 patient transfer agreements, it <(B)> has implemented the <patient
1-17 transfer> agreements in accordance with Section 241.028 <or has
1-18 complied with rules adopted under Section 241.029>.
1-19 (d) The application must be accompanied by:
1-20 (1) a copy of the hospital's current patient transfer
1-21 policy; <and>
1-22 (2) a nonrefundable license fee;
1-23 (3) copies of the hospital's patient transfer
2-1 agreements, unless the filing of copies has been waived by the
2-2 director in accordance with the rules adopted under this chapter;
2-3 and
2-4 (4) a copy of the most recent annual fire safety
2-5 inspection report from the fire marshal in whose jurisdiction the
2-6 hospital is located<, which shall be refunded to the applicant if
2-7 the application is denied>.
2-8 SECTION 2. Subchapter B, Chapter 241, Health and Safety
2-9 Code, is amended by adding Section 241.0231 to read as follows:
2-10 Sec. 241.0231. TEMPORARY INITIAL LICENSE. (a) During the
2-11 pendency of an application for an initial license, the department
2-12 may grant a temporary initial license to the applicant.
2-13 (b) The temporary initial license is valid until the
2-14 department issues or denies the initial license, but in no case for
2-15 longer than six months from the date of issuance.
2-16 (c) The board shall adopt rules to govern the issuance of a
2-17 temporary initial license.
2-18 SECTION 3. Section 241.025, Health and Safety Code, is
2-19 amended to read as follows:
2-20 Sec. 241.025. LICENSE FEES. (a) The department shall
2-21 charge each hospital an annual license fee for an initial license
2-22 or a license renewal.
2-23 (b) The board by rule shall adopt the fees authorized by
2-24 Subsection (a) according to a schedule in which the number of beds
2-25 in the hospital determines the amount of the fee. The fee may not
3-1 exceed $10 <$3> a bed, and the total fee may not be less than $200
3-2 <$100> or more than $10,000 <$3,000>.
3-3 (c) The board by rule shall adopt a temporary initial
3-4 license fee in an amount sufficient to cover the expense to the
3-5 department of issuing the license.
3-6 (d) All license fees collected shall be deposited in the
3-7 state treasury to the credit of the department <board> to
3-8 administer and enforce this chapter. These fees are hereby
3-9 appropriated to the department.
3-10 SECTION 4. Subsections (a), (b), and (c), Section 241.026,
3-11 Health and Safety Code, are amended to read as follows:
3-12 (a) The board, with the advice of the council, shall adopt
3-13 and enforce rules <and minimum standards> to further the purposes
3-14 of this chapter. The rules at a <and> minimum shall address
3-15 <standards may relate only to>:
3-16 (1) minimum requirements for staffing by physicians
3-17 and nurses;
3-18 (2) hospital services relating to patient care; <and>
3-19 (3) fire prevention, safety, and sanitation
3-20 requirements in <sanitary provisions of> hospitals;
3-21 (4) patient care and a patient bill of rights; and
3-22 (5) compliance with other state and federal laws
3-23 affecting the health, safety, and rights of hospital patients.
3-24 (b) The board may <not> adopt rules <standards> that are at
3-25 least as stringent as <exceed> the conditions of participation
4-1 <minimum standards> for certification under Title XVIII of the
4-2 Social Security Act (42 U.S.C. Section 1395 et seq.).
4-3 (c) Upon the recommendation of the hospital licensing
4-4 director <and the council>, the board by order may waive or modify
4-5 the requirement of a particular provision of this Act or
4-6 requirement <minimum standard> adopted by board rule under this
4-7 section to a particular special hospital or a particular general or
4-8 special hospital serving a rural community if the board determines
4-9 that the waiver or modification will facilitate the creation or
4-10 operation of the hospital and that the waiver or modification is in
4-11 the best interests of the individuals served or to be served by the
4-12 hospital.
4-13 SECTION 5. Subsections (a) and (c), Section 241.027, Health
4-14 and Safety Code, are amended to read as follows:
4-15 Sec. 241.027. <MINIMUM STANDARDS FOR> PATIENT TRANSFERS.
4-16 (a) The board shall adopt rules to govern <implement the minimum
4-17 standards governing> the transfer of patients between hospitals
4-18 that do not have a transfer agreement and governing services not
4-19 included in transfer agreements. <The board shall base the rules
4-20 on the recommendations made by the advisory committee established
4-21 by Section 241.029.>
4-22 (c) The rules must require that a hospital take all
4-23 reasonable steps to secure the informed consent or refusal of the
4-24 patient or of a person acting on the patient's behalf to a transfer
4-25 <board may not adopt minimum standards that require the consent of
5-1 the patient or the patient's personal representative before the
5-2 patient is transferred>.
5-3 SECTION 6. Section 241.028, Health and Safety Code, is
5-4 amended by amending Subsection (c) and by adding Subsection (d) to
5-5 read as follows:
5-6 (c) At a minimum, a transfer agreement must provide that:
5-7 (1) transfers be accomplished in a medically
5-8 appropriate manner and comply with Sections 241.027(b)(2) through
5-9 (5) and Section 241.027(c);
5-10 (2) the transfer or receipt of patients in need of
5-11 emergency care not be based on the individual's inability to pay
5-12 for the services rendered by the transferring or receiving
5-13 hospital;
5-14 (3) multiple transfer agreements be entered into by a
5-15 hospital based on the type or level of medical services available
5-16 at other hospitals;
5-17 (4) the hospitals recognize the right of an individual
5-18 to request transfer to the care of a physician and hospital of the
5-19 individual's choice;
5-20 (5) the hospitals recognize and comply with the
5-21 requirements of Chapter 61 (Indigent Health Care and Treatment Act)
5-22 relating to the transfer of patients to mandated providers; and
5-23 (6) consideration be given to availability of
5-24 appropriate facilities, services, and staff for providing care to
5-25 the patient.
6-1 (d) If a hospital transfers a patient in violation of
6-2 Subsection (c)(1), (2), (4), (5), or (6), relating to required
6-3 provisions for a transfer agreement, the violation is a violation
6-4 of this chapter.
6-5 SECTION 7. Section 241.029, Health and Safety Code, is
6-6 repealed.
6-7 SECTION 8. Section 241.051, Health and Safety Code, is
6-8 amended to read as follows:
6-9 Sec. 241.051. INSPECTIONS. (a) The department may make any
6-10 inspection, survey, or investigation that it considers necessary.
6-11 A representative of the department may enter the premises of a
6-12 hospital at any reasonable time to make an inspection, a survey, or
6-13 an investigation <An officer, employee, or agent of the department
6-14 may enter and inspect a hospital at any reasonable time> to assure
6-15 compliance with or prevent a violation of this chapter, the rules
6-16 adopted under this chapter, an order or special order of the
6-17 commissioner, a special license provision, a court order granting
6-18 injunctive relief, or other enforcement procedures.
6-19 (b) The department or a representative of the department is
6-20 entitled to access to all books, records, or other documents
6-21 maintained by or on behalf of the hospital to the extent necessary
6-22 to enforce this chapter, the rules adopted under this chapter, an
6-23 order or special order of the commissioner, a special license
6-24 provision, a court order granting injunctive relief, or other
6-25 enforcement procedures.
7-1 (c) By applying for or holding a hospital license, the
7-2 hospital consents to entry and inspection of the hospital by the
7-3 department or a representative of the department in accordance with
7-4 this chapter and the rules adopted under this chapter.
7-5 SECTION 9. Section 241.053, Health and Safety Code, is
7-6 amended to read as follows:
7-7 Sec. 241.053. DENIAL OF APPLICATION, SUSPENSION, REVOCATION,
7-8 OR REISSUANCE OF LICENSE. (a) The department, after providing
7-9 notice and an opportunity for a hearing to the applicant or license
7-10 holder, may deny, suspend, or revoke a hospital's license if the
7-11 department finds that the hospital:
7-12 (1) failed <substantially> to comply with:
7-13 (A) a provision of this chapter;
7-14 (B) <or> a rule <or standard> adopted under this
7-15 chapter;
7-16 (C) a special license condition;
7-17 (D) an order or emergency order by the
7-18 commissioner; or
7-19 (E) another enforcement procedure permitted
7-20 under this chapter;
7-21 (2) has a history of noncompliance with the rules
7-22 adopted under this chapter relating to patient health, safety, and
7-23 rights; or
7-24 (3) has aided, abetted, or permitted the commission of
7-25 an illegal act.
8-1 (b) A hospital whose license is suspended or revoked may
8-2 apply to the department for the reissuance of a license. The
8-3 department may reissue the license if the department determines
8-4 that the hospital has corrected the conditions that led to the
8-5 suspension or revocation of the hospital's license, the initiation
8-6 of enforcement action against the hospital, the assessment of
8-7 administrative penalties, or the issuance of a court order
8-8 enjoining the hospital from violations or assessing civil penalties
8-9 against the hospital.
8-10 (c) A hospital must apply for reissuance in the form and
8-11 manner required in the rules adopted under this chapter <by the
8-12 department>.
8-13 (d) Administrative hearings required under this section
8-14 shall be conducted under the board's formal hearing rules and the
8-15 contested case provisions of the Administrative Procedure and Texas
8-16 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes).
8-17 (e) Judicial review of a final decision by the department is
8-18 governed by the substantial evidence rule <by trial de novo in the
8-19 same manner as a case appealed from the justice court to the county
8-20 court. The substantial evidence rule does not apply>.
8-21 SECTION 10. Chapter 241, Health and Safety Code, is amended
8-22 by adding Section 241.0531 to read as follows:
8-23 Sec. 241.0531. COMMISSIONER'S EMERGENCY ORDERS. (a) The
8-24 commissioner or a person designated by the commissioner may issue
8-25 an emergency order, either mandatory or prohibitory in nature, in
9-1 relation to the operation of a hospital licensed under this chapter
9-2 if the commissioner or the commissioner's designee determines that:
9-3 (1) the hospital is violating or threatening to
9-4 violate this chapter, a rule adopted pursuant to this chapter, a
9-5 special license provision, injunctive relief issued pursuant to
9-6 Section 241.054, an order of the commissioner or the commissioner's
9-7 designee, or another enforcement procedure permitted under this
9-8 chapter and the provision, rule, license provision, injunctive
9-9 relief, or order relates to the health, safety, or rights of the
9-10 hospital's patients; and
9-11 (2) the other procedures available to the department
9-12 to remedy or prevent the violation or threatened violation will
9-13 result in unreasonable delay.
9-14 (b) The commissioner or the commissioner's designee may
9-15 issue an emergency order without notice and hearing if the
9-16 commissioner or the commissioner's designee determines that the
9-17 circumstances necessitate such action. The order shall be
9-18 effective on delivery to the hospital or at a later date specified
9-19 in the order.
9-20 (c) If an emergency order is issued without a hearing, the
9-21 department shall determine a time and place for a hearing at which
9-22 the emergency order may be affirmed, modified, or set aside. The
9-23 hearing must be held within 10 days after the day on which the
9-24 emergency order became effective.
9-25 (d) The hearing required shall be held under the contested
10-1 case provisions of the Administrative Procedure and Texas Register
10-2 Act (Article 6252-13a, Vernon's Texas Civil Statutes) and the
10-3 board's formal hearing rules.
10-4 SECTION 11. Section 241.054, Health and Safety Code, is
10-5 amended to read as follows:
10-6 Sec. 241.054. INJUNCTION; CIVIL PENALTY. (a) If it appears
10-7 that a hospital has violated, is violating, or is threatening to
10-8 violate this chapter or a rule or order issued under this chapter,
10-9 the commissioner may request the attorney general or a district,
10-10 county, or city attorney of the city or county in which the
10-11 violation has occurred, is occurring, or may occur to institute a
10-12 civil suit for:
10-13 (1) injunctive relief to restrain the hospital from
10-14 continuing the violation or threat of violation;
10-15 (2) the assessment and recovery of a civil penalty for
10-16 a violation or continuing violation; or
10-17 (3) both injunctive relief and civil penalty.
10-18 (b) For a hospital with more than 100 beds, the penalty may
10-19 not exceed $50,000 for each violation. For a hospital with fewer
10-20 than 100 beds, the penalty may not exceed $25,000 for each
10-21 violation. Each day of a continuing violation may be considered a
10-22 separate violation for the purpose of penalty assessment.
10-23 (c) In determining the amount of the penalty, the court
10-24 shall consider:
10-25 (1) the hospital's previous violations;
11-1 (2) the seriousness of the violation;
11-2 (3) any threat to the health, safety, or rights of the
11-3 hospital's patients;
11-4 (4) the demonstrated good faith of the hospital; and
11-5 (5) such other matters as justice may require.
11-6 (d) Any civil penalty recovered in a suit instituted by the
11-7 attorney general under this chapter shall be deposited in the state
11-8 treasury to the credit of the general revenue fund. Any civil
11-9 penalty recovered in a suit instituted by a district, county, or
11-10 city attorney under this chapter shall be paid to the local
11-11 government.
11-12 (e) Venue for a suit brought under this section is in the
11-13 county in which the violation or threat of violation occurred or in
11-14 Travis County.
11-15 (f) The commissioner, the attorney general, or a district,
11-16 county, or city attorney may each recover reasonable expenses
11-17 incurred in obtaining injunctive relief or civil penalties under
11-18 this section. Expenses include investigative costs, court costs,
11-19 reasonable attorney fees, witness fees, and deposition expenses.
11-20 The expenses recovered by the commissioner are hereby appropriated
11-21 to the department for the administration and enforcement of this
11-22 chapter. The expenses recovered by the attorney general, a
11-23 district attorney, county attorney, or city attorney are hereby
11-24 appropriated to the office that initiated the cause of action.
11-25 <VIOLATIONS; INJUNCTIONS. (a) The department shall:>
12-1 <(1) notify a hospital of a finding by the department
12-2 that the hospital is violating or has violated this chapter or a
12-3 rule or standard adopted under this chapter; and>
12-4 <(2) provide the hospital an opportunity to correct
12-5 the violation.>
12-6 <(b) After the notice and opportunity to comply, the
12-7 department may petition a district court in the county in which a
12-8 violation occurs for assessment and recovery of the civil penalty
12-9 provided by Section 241.055, for injunctive relief, or both.>
12-10 <(c) The department may petition a district court for a
12-11 temporary restraining order to restrain a continuing violation if
12-12 the department finds that the violation creates an immediate threat
12-13 to the health and safety of the patients of a hospital.>
12-14 <(d) The district court shall grant the injunctive relief
12-15 warranted by the facts.>
12-16 <(e) The attorney general or the appropriate district or
12-17 county attorney shall initiate and conduct the suit at the request
12-18 of the commissioner of health.>
12-19 SECTION 12. Chapter 241, Health and Safety Code, is amended
12-20 by amending Section 241.055 and by adding Sections 241.0551 through
12-21 241.0554 to read as follows:
12-22 Sec. 241.055. ADMINISTRATIVE <CIVIL> PENALTY. (a) The
12-23 commissioner may assess an administrative penalty against a
12-24 hospital that violates this chapter, a rule adopted pursuant to
12-25 this chapter, a special license provision, an order or emergency
13-1 order issued by the commissioner or the commissioner's designee, or
13-2 another enforcement procedure permitted under this chapter.
13-3 (b) In determining the amount of the penalty, the
13-4 commissioner shall consider:
13-5 (1) the hospital's previous violations;
13-6 (2) the seriousness of the violation;
13-7 (3) any threat to the health, safety, or rights of the
13-8 hospital's patients;
13-9 (4) the demonstrated good faith of the hospital; and
13-10 (5) such other matters as justice may require.
13-11 (c) For a hospital with more than 100 beds, the penalty may
13-12 not exceed $50,000 for each violation. For a hospital with fewer
13-13 than 100 beds, the penalty may not exceed $25,000 for each
13-14 violation. Each day of a continuing violation may be considered a
13-15 separate violation. <A hospital shall:>
13-16 <(1) timely adopt, implement, and enforce a patient
13-17 transfer policy in accordance with Section 241.027; and>
13-18 <(2) implement patient transfer agreements in
13-19 accordance with Section 241.028 or comply with rules adopted under
13-20 Section 241.029.>
13-21 <(b) A hospital that violates Subsection (a) is liable for a
13-22 civil penalty of not more than $1,000 for each day of violation and
13-23 for each act of violation.>
13-24 <(c) In determining the amount of the penalty, the district
13-25 court shall consider:>
14-1 <(1) the hospital's previous violations;>
14-2 <(2) the seriousness of the violation;>
14-3 <(3) whether the health and safety of the public was
14-4 threatened by the violation; and>
14-5 <(4) the demonstrated good faith of the hospital.>
14-6 Sec. 241.0551. ADMINISTRATIVE PENALTY ASSESSMENT PROCEDURE.
14-7 (a) An administrative penalty may be assessed only after a
14-8 hospital charged with a violation is provided notice and given an
14-9 opportunity to request a hearing.
14-10 (b) If a hearing is held, the commissioner shall make
14-11 findings of fact and shall issue a written decision regarding the
14-12 occurrence of the violation and the amount of any penalty that may
14-13 be warranted.
14-14 (c) If the hospital charged with the violation does not
14-15 request a hearing, the commissioner may assess a penalty after
14-16 determining that a violation has occurred and the amount of any
14-17 penalty that may be warranted.
14-18 (d) After making a determination under this section that a
14-19 penalty is to be assessed against a hospital, the commissioner
14-20 shall issue an order requiring that the hospital pay the penalty.
14-21 (e) The commissioner may consolidate a hearing held under
14-22 this section with another proceeding.
14-23 Sec. 241.0552. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
14-24 later than the 30th day after the date an order finding that a
14-25 violation has occurred is issued, the commissioner shall inform the
15-1 hospital against which the order is issued of the amount of the
15-2 penalty for the violation.
15-3 (b) Not later than the 30th day after the date on which a
15-4 decision or order charging a hospital with a penalty is final, the
15-5 hospital shall:
15-6 (1) pay the penalty in full; or
15-7 (2) if the hospital seeks judicial review of the
15-8 amount of the penalty or the fact of the violation,
15-9 (A) send the amount of the penalty to the
15-10 commissioner for placement in an escrow account; or
15-11 (B) post with the commissioner a bond for the
15-12 amount of the penalty.
15-13 (c) A bond posted under this section must be in a form
15-14 approved by the commissioner and be effective until judicial review
15-15 of the order or decision is final.
15-16 (d) A hospital that does not send the amount of the penalty
15-17 to the commissioner or post the bond within the period prescribed
15-18 by Subsection (b) waives all rights to contest the violation or the
15-19 amount of the penalty.
15-20 Sec. 241.0553. REFUND OF ADMINISTRATIVE PENALTY. Not later
15-21 than the 30th day after the date of a judicial determination that
15-22 an administrative penalty against a hospital should be reduced or
15-23 not assessed, the commissioner shall:
15-24 (1) remit to the hospital the appropriate portion of
15-25 any penalty payment plus accrued interest; or
16-1 (2) execute a release of the bond if the hospital has
16-2 posted a bond.
16-3 Sec. 241.0554. RECOVERY OF ADMINISTRATIVE PENALTY BY
16-4 ATTORNEY GENERAL. The attorney general at the request of the
16-5 commissioner may bring a civil action to recover an administrative
16-6 penalty assessed under this chapter.
16-7 SECTION 13. Subsection (a), Section 241.056, Health and
16-8 Safety Code, is amended to read as follows:
16-9 (a) A person who is harmed by a violation under Section
16-10 241.027 or 241.028 <241.055> may petition a district court for
16-11 appropriate injunctive relief.
16-12 SECTION 14. Chapter 241, Health and Safety Code, is amended
16-13 by adding Section 241.058 to read as follows:
16-14 Sec. 241.058. MINOR VIOLATIONS. (a) This chapter does not
16-15 require the commissioner or a designee of the commissioner to
16-16 report a minor violation for prosecution or the institution of any
16-17 other enforcement proceeding authorized under this chapter, if the
16-18 commissioner or a designee of the commissioner determines that
16-19 prosecution or enforcement is in the best interests of the persons
16-20 served or to be served by the hospital.
16-21 (b) For the purpose of this section, a "minor violation"
16-22 means a violation of this chapter, the rules adopted under this
16-23 chapter, a special license provision, an order or emergency order
16-24 issued by the commissioner or the commissioner's designee, or
16-25 another enforcement procedure permitted under this chapter by a
17-1 hospital that does not constitute a threat to the health, safety,
17-2 and rights of the hospital's patients or other persons.
17-3 SECTION 15. Section 241.104, Health and Safety Code, is
17-4 amended to read as follows:
17-5 Sec. 241.104. HOSPITAL PLAN REVIEWS. (a) The board by rule
17-6 shall adopt fees for hospital plan reviews according to a schedule
17-7 based on the estimated construction costs. If an estimated
17-8 construction cost cannot be established, the estimated cost is $105
17-9 per square foot.
17-10 (b) The fee schedule may not exceed the following:
17-11 Cost of Construction Fee
17-12 (1) $ 600,000 or less $ 500 <250>
17-13 (2) $ 600,001 - $ 2,000,000 1,000 <500>
17-14 (3) $ 2,000,001 - $ 5,000,000 1,500 <750>
17-15 (4) $ 5,000,001 - $10,000,000 2,000 <1,000>
17-16 (5) $10,000,001 and over 3,000 <1,500>
17-17 (c) The department shall charge a fee for field surveys of
17-18 construction plans reviewed under this section. The board by rule
17-19 shall adopt a fee schedule for the surveys that provides a minimum
17-20 fee of $100 and a maximum fee of $400 for each survey conducted.
17-21 SECTION 16. Section 222.024, Health and Safety Code, is
17-22 amended to read as follows:
17-23 Sec. 222.024. CERTIFICATION OR ACCREDITATION INSTEAD OF
17-24 INSPECTION. (a) A hospital licensed by the Texas Department of
17-25 Health or the Texas Department of Mental Health and Mental
18-1 Retardation is not subject to additional annual licensing
18-2 inspections before the agency issues the hospital a license under
18-3 Chapter 241 (Texas Hospital Licensing Law) or by the licensing
18-4 agency while the hospital maintains:
18-5 (1) certification under Title XVIII of the Social
18-6 Security Act (42 U.S.C. Section 1395 et seq.); or
18-7 (2) accreditation from the Joint Commission on
18-8 Accreditation of Healthcare <Health> Organizations, the American
18-9 Osteopathic Association, or other national accreditation
18-10 organization for the offered services.
18-11 (b) If the Texas Department of Mental Health and Mental
18-12 Retardation licenses <An agency licensing> a hospital exempt from a
18-13 licensing inspection under Subsection (a), that agency shall issue
18-14 a renewal license to the hospital if the hospital annually remits
18-15 any applicable fees and submits a copy of the most recent
18-16 inspection results report from the certification or accreditation
18-17 body.
18-18 (c) If the Texas Department of Health licenses a hospital
18-19 exempt from a licensing inspection under Subsection (a), that
18-20 agency shall issue a renewal license to the hospital if the
18-21 hospital annually:
18-22 (1) submits a complete application required by the
18-23 department;
18-24 (2) remits any applicable fees;
18-25 (3) submits a copy of the most recent inspection
19-1 results report from the certification or accreditation body; and
19-2 (4) submits a copy of the most recent fire safety
19-3 inspection report from the fire marshal in whose jurisdiction the
19-4 hospital is located.
19-5 SECTION 17. Section 222.026, Health and Safety Code, is
19-6 amended to read as follows:
19-7 Sec. 222.026. COMPLAINT INVESTIGATIONS AND ENFORCEMENT
19-8 AUTHORITY <PATIENT TRANSFER AUTHORITY NOT AFFECTED>. (a) Sections
19-9 222.024, 222.025, and 222.0255 do not affect the authority of the
19-10 Texas Department of Health to implement and enforce the provisions
19-11 of Chapter 241 (Texas Hospital Licensing Law) to:
19-12 (1) reinspect a hospital if a hospital applies for the
19-13 reissuance of its license after a final ruling upholding the
19-14 suspension or revocation of a hospital's license, the assessment of
19-15 administrative or civil penalties, or the issuance of an injunction
19-16 against the hospital for violations of provisions of the licensing
19-17 law, rules adopted under the licensing law, special license
19-18 conditions, or orders of the commissioner; or
19-19 (2) investigate a complaint against a hospital and, if
19-20 appropriate, enforce the provisions of the licensing law on a
19-21 finding by the department that reasonable cause exists to believe
19-22 that the hospital has violated provisions of the licensing law,
19-23 rules adopted under the licensing law, special license conditions,
19-24 or orders of the commissioner <relating to the transfer of hospital
19-25 patients or the department's means of implementing and enforcing
20-1 those provisions>.
20-2 SECTION 18. This Act takes effect September 1, 1993.
20-3 SECTION 19. If on the effective date of this legislation the
20-4 powers and duties of the Texas Board of Health, the commissioner of
20-5 health, and the Texas Department of Health have been transferred to
20-6 the Department of Public Health as provided for in Chapter 15, Acts
20-7 of the 72nd Legislature, 1st Called Session, 1991, each reference
20-8 in this Act to the Texas Board of Health, the commissioner of
20-9 health, or the Texas Department of Health means the Board of Public
20-10 Health, the director of the Department of Public Health, or the
20-11 Department of Public Health, respectively.
20-12 SECTION 20. The importance of this legislation and the
20-13 crowded condition of the calendars in both houses create an
20-14 emergency and an imperative public necessity that the
20-15 constitutional rule requiring bills to be read on three several
20-16 days in each house be suspended, and this rule is hereby suspended.