1-1 By: Moncrief S.B. No. 86
1-2 (In the Senate - Filed January 7, 1993; January 14, 1993,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 29, 1993, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 8, Nays 0;
1-6 April 29, 1993, sent to printer.)
1-7 COMMITTEE VOTE
1-8 Yea Nay PNV Absent
1-9 Zaffirini x
1-10 Ellis x
1-11 Madla x
1-12 Moncrief x
1-13 Nelson x
1-14 Patterson x
1-15 Shelley x
1-16 Truan x
1-17 Wentworth x
1-18 COMMITTEE SUBSTITUTE FOR S.B. No. 86 By: Moncrief
1-19 A BILL TO BE ENTITLED
1-20 AN ACT
1-21 relating to the licensing of hospitals by the Texas Department of
1-22 Health including the provision and appropriation of fees and the
1-23 assessment of civil penalties and administrative penalties.
1-24 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-25 SECTION 1. Subsections (c) and (d), Section 241.022, Health
1-26 and Safety Code, are amended to read as follows:
1-27 (c) The department shall require that each hospital show
1-28 evidence that:
1-29 (1) at least one physician is on the medical staff of
1-30 the hospital, including evidence that the physician is currently
1-31 licensed; <and>
1-32 (2) the governing body of the hospital<:>
1-33 <(A)> has adopted and implemented a patient
1-34 transfer policy in accordance with Section 241.027; and
1-35 (3) if the governing body has chosen to implement
1-36 patient transfer agreements, it <(B)> has implemented the <patient
1-37 transfer> agreements in accordance with Section 241.028 <or has
1-38 complied with rules adopted under Section 241.029>.
1-39 (d) The application must be accompanied by:
1-40 (1) a copy of the hospital's current patient transfer
1-41 policy; <and>
1-42 (2) a nonrefundable license fee;
1-43 (3) copies of the hospital's patient transfer
1-44 agreements, unless the filing of copies has been waived by the
1-45 hospital licensing director in accordance with the rules adopted
1-46 under this chapter; and
1-47 (4) a copy of the most recent annual fire safety
1-48 inspection report from the fire marshal in whose jurisdiction the
1-49 hospital is located<, which shall be refunded to the applicant if
1-50 the application is denied>.
1-51 SECTION 2. Subchapter B, Chapter 241, Health and Safety
1-52 Code, is amended by adding Section 241.0231 to read as follows:
1-53 Sec. 241.0231. TEMPORARY INITIAL LICENSE. (a) During the
1-54 pendency of an application for an initial license, the department
1-55 may grant a temporary initial license to the applicant.
1-56 (b) The temporary initial license is valid until the
1-57 department issues or denies the initial license, but in no case for
1-58 longer than six months from the date of issuance.
1-59 (c) The board shall adopt rules to govern the issuance of a
1-60 temporary initial license.
1-61 SECTION 3. Section 241.025, Health and Safety Code, is
1-62 amended to read as follows:
1-63 Sec. 241.025. LICENSE FEES. (a) The department shall
1-64 charge each hospital an annual license fee for an initial license
1-65 or a license renewal.
1-66 (b) The board by rule shall adopt the fees authorized by
1-67 Subsection (a) according to a schedule in which the number of beds
1-68 in the hospital determines the amount of the fee. The fee may not
2-1 exceed $10 <$3> a bed, and the total fee may not be less than $200
2-2 <$100> or more than $10,000 <$3,000>.
2-3 (c) The board by rule shall adopt a temporary initial
2-4 license fee in an amount sufficient to cover the reasonable expense
2-5 to the department of issuing the license.
2-6 (d) All license fees collected shall be deposited in the
2-7 state treasury to the credit of the department <board> to
2-8 administer and enforce this chapter. These fees are hereby
2-9 appropriated to the department.
2-10 SECTION 4. Subsections (a), (b), and (c), Section 241.026,
2-11 Health and Safety Code, are amended to read as follows:
2-12 (a) The board, with the advice of the council, shall adopt
2-13 and enforce rules <and minimum standards> to further the purposes
2-14 of this chapter. The rules at a <and> minimum shall address
2-15 <standards may relate only to>:
2-16 (1) minimum requirements for staffing by physicians
2-17 and nurses;
2-18 (2) hospital services relating to patient care; <and>
2-19 (3) fire prevention, safety, and sanitation
2-20 requirements in <sanitary provisions of> hospitals;
2-21 (4) patient care and a patient bill of rights; and
2-22 (5) compliance with other state and federal laws
2-23 affecting the health, safety, and rights of hospital patients.
2-24 (b) In adopting rules, the board shall consider the
2-25 conditions of participation for certification under Title XVIII of
2-26 the Social Security Act (42 U.S.C. Section 1395 et seq.) and the
2-27 standards of the Joint Commission on Accreditation of Healthcare
2-28 Organizations and will attempt to achieve consistency with those
2-29 conditions and standards. <The board may not adopt standards that
2-30 exceed the minimum standards for certification under Title XVIII of
2-31 the Social Security Act (42 U.S.C. Section 1395 et seq.).>
2-32 (c) Upon the recommendation of the hospital licensing
2-33 director <and the council>, the board by order may waive or modify
2-34 the requirement of a particular provision of this Act or
2-35 requirement <minimum standard> adopted by board rule under this
2-36 section to a particular special hospital or a particular general or
2-37 special hospital serving a rural community if the board determines
2-38 that the waiver or modification will facilitate the creation or
2-39 operation of the hospital and that the waiver or modification is in
2-40 the best interests of the individuals served or to be served by the
2-41 hospital.
2-42 SECTION 5. Section 241.027, Health and Safety Code, is
2-43 amended by amending the section heading and Subsections (a) and (c)
2-44 and adding Subsections (e) and (f) to read as follows:
2-45 Sec. 241.027. <MINIMUM STANDARDS FOR> PATIENT TRANSFERS.
2-46 (a) The board shall adopt rules to govern <implement the minimum
2-47 standards governing> the transfer of patients between hospitals
2-48 that do not have a transfer agreement and governing services not
2-49 included in transfer agreements. <The board shall base the rules
2-50 on the recommendations made by the advisory committee established
2-51 by Section 241.029.>
2-52 (c) The rules must require that if a patient at a hospital
2-53 has an emergency medical condition which has not been stabilized,
2-54 the hospital may not transfer the patient unless:
2-55 (1) the patient or a legally responsible person acting
2-56 on the patient's behalf, after being informed of the hospital's
2-57 obligations under this section and of the risk of transfer, in
2-58 writing requests transfer to another medical facility;
2-59 (2) a licensed physician has signed a certification,
2-60 which includes a summary of the risks and benefits, that, based on
2-61 the information available at the time of transfer, the medical
2-62 benefits reasonably expected from the provision of appropriate
2-63 medical treatment at another medical facility outweigh the
2-64 increased risks to the patient and, in the case of labor, to the
2-65 unborn child from effecting the transfer; or
2-66 (3) if a licensed physician is not physically present
2-67 in the emergency department at the time a patient is transferred, a
2-68 qualified medical person has signed a certification described in
2-69 Subdivision (2) after a licensed physician, in consultation with
2-70 the person, has made the determination described in such clause and
3-1 subsequently countersigns the certificate <board may not adopt
3-2 minimum standards that require the consent of the patient or the
3-3 patient's personal representative before the patient is
3-4 transferred>.
3-5 (e) The rules must require that a hospital take all
3-6 reasonable steps to secure the informed refusal of a patient or of
3-7 a person acting on the patient's behalf to a transfer or to related
3-8 examination and treatment.
3-9 (f) The rules must recognize any contractual, statutory, or
3-10 regulatory obligations that may exist between a patient and a
3-11 designated or mandated provider as those obligations apply to the
3-12 transfer of emergency or nonemergency patients.
3-13 SECTION 6. Section 241.028, Health and Safety Code, is
3-14 amended by amending Subsection (c) and adding Subsection (d) to
3-15 read as follows:
3-16 (c) At a minimum, a transfer agreement must provide that:
3-17 (1) transfers be accomplished in a medically
3-18 appropriate manner and comply with Sections 241.027(b)(2) through
3-19 (5) and Section 241.027(c);
3-20 (2) the transfer or receipt of patients in need of
3-21 emergency care not be based on the individual's inability to pay
3-22 for the services rendered by the transferring or receiving
3-23 hospital;
3-24 (3) multiple transfer agreements be entered into by a
3-25 hospital based on the type or level of medical services available
3-26 at other hospitals;
3-27 (4) the hospitals recognize the right of an individual
3-28 to request transfer to the care of a physician and hospital of the
3-29 individual's choice;
3-30 (5) the hospitals recognize and comply with the
3-31 requirements of Chapter 61 (Indigent Health Care and Treatment Act)
3-32 relating to the transfer of patients to mandated providers; and
3-33 (6) consideration be given to availability of
3-34 appropriate facilities, services, and staff for providing care to
3-35 the patient.
3-36 (d) If a hospital transfers a patient in violation of
3-37 Subsection (c)(1), (2), (4), (5), or (6), relating to required
3-38 provisions for a transfer agreement, the violation is a violation
3-39 of this chapter.
3-40 SECTION 7. Section 241.029, Health and Safety Code, is
3-41 repealed.
3-42 SECTION 8. Section 241.051, Health and Safety Code, is
3-43 amended to read as follows:
3-44 Sec. 241.051. INSPECTIONS. (a) The department may make any
3-45 inspection, survey, or investigation that it considers necessary.
3-46 A representative <An officer, employee, or agent> of the department
3-47 may enter the premises of <and inspect> a hospital at any
3-48 reasonable time to make an inspection, a survey, or an
3-49 investigation to assure compliance with or prevent a violation of
3-50 this chapter, the rules adopted under this chapter, an order or
3-51 special order of the commissioner of health, a special license
3-52 provision, a court order granting injunctive relief, or other
3-53 enforcement procedures. The department shall maintain the
3-54 confidentiality of hospital records as applicable under state or
3-55 federal law.
3-56 (b) The department or a representative of the department is
3-57 entitled to access to all books, records, or other documents
3-58 maintained by or on behalf of the hospital to the extent necessary
3-59 to enforce this chapter, the rules adopted under this chapter, an
3-60 order or special order of the commissioner of health, a special
3-61 license provision, a court order granting injunctive relief, or
3-62 other enforcement procedures.
3-63 (c) By applying for or holding a hospital license, the
3-64 hospital consents to entry and inspection of the hospital by the
3-65 department or a representative of the department in accordance with
3-66 this chapter and the rules adopted under this chapter.
3-67 SECTION 9. Section 241.053, Health and Safety Code, is
3-68 amended to read as follows:
3-69 Sec. 241.053. DENIAL OF APPLICATION, SUSPENSION, REVOCATION,
3-70 OR REISSUANCE OF LICENSE. (a) The department, after providing
4-1 notice and an opportunity for a hearing to the applicant or license
4-2 holder, may deny, suspend, or revoke a hospital's license if the
4-3 department finds that the hospital:
4-4 (1) failed <substantially> to comply with:
4-5 (A) a provision of this chapter;
4-6 (B) <or> a rule <or standard> adopted under this
4-7 chapter;
4-8 (C) a special license condition;
4-9 (D) an order or emergency order by the
4-10 commissioner of health; or
4-11 (E) another enforcement procedure permitted
4-12 under this chapter;
4-13 (2) has a history of noncompliance with the rules
4-14 adopted under this chapter relating to patient health, safety, and
4-15 rights which reflects more than nominal noncompliance; or
4-16 (3) has aided, abetted, or permitted the commission of
4-17 an illegal act.
4-18 (b) A hospital whose license is suspended or revoked may
4-19 apply to the department for the reissuance of a license. The
4-20 department may reissue the license if the department determines
4-21 that the hospital has corrected the conditions that led to the
4-22 suspension or revocation of the hospital's license, the initiation
4-23 of enforcement action against the hospital, the assessment of
4-24 administrative penalties, or the issuance of a court order
4-25 enjoining the hospital from violations or assessing civil penalties
4-26 against the hospital.
4-27 (c) A hospital must apply for reissuance in the form and
4-28 manner required in the rules adopted under this chapter <by the
4-29 department>.
4-30 (d) Administrative hearings required under this section
4-31 shall be conducted under the board's formal hearing rules and the
4-32 contested case provisions of the Administrative Procedure and Texas
4-33 Register Act (Article 6252-13a, Vernon's Texas Civil Statutes) and
4-34 its subsequent amendments.
4-35 (e) Judicial review of a final decision by the department is
4-36 by trial de novo in the same manner as a case appealed from the
4-37 justice court to the county court. The substantial evidence rule
4-38 does not apply.
4-39 SECTION 10. Subchapter C, Chapter 241, Health and Safety
4-40 Code, is amended by adding Section 241.0531 to read as follows:
4-41 Sec. 241.0531. COMMISSIONER'S EMERGENCY ORDERS.
4-42 (a) Following notice to the hospital and opportunity for hearing,
4-43 the commissioner of health or a person designated by the
4-44 commissioner may issue an emergency order, either mandatory or
4-45 prohibitory in nature, in relation to the operation of a hospital
4-46 licensed under this chapter if the commissioner or the
4-47 commissioner's designee determines that the hospital is violating
4-48 or threatening to violate this chapter, a rule adopted pursuant to
4-49 this chapter, a special license provision, injunctive relief issued
4-50 pursuant to Section 241.054, an order of the commissioner or the
4-51 commissioner's designee, or another enforcement procedure permitted
4-52 under this chapter and the provision, rule, license provision,
4-53 injunctive relief, order, or enforcement procedure relates to the
4-54 health or safety of the hospital's patients.
4-55 (b) The department shall send written notice of the hearing
4-56 and shall include within the notice the time and place of the
4-57 hearing. The hearing must be held within 10 days after the date of
4-58 the hospital's receipt of the notice.
4-59 (c) The hearing shall not be governed by the contested case
4-60 provisions of the Administrative Procedure and Texas Register Act
4-61 (Article 6252-13a, Vernon's Texas Civil Statutes) and its
4-62 subsequent amendments but shall instead be held in accordance with
4-63 the board's informal hearing rules.
4-64 (d) The order shall be effective on delivery to the hospital
4-65 or at a later date specified in the order.
4-66 SECTION 11. Section 241.055, Health and Safety Code, is
4-67 amended to read as follows:
4-68 Sec. 241.055. CIVIL PENALTY. (a) A hospital shall<: (1)>
4-69 timely adopt, implement, and enforce a patient transfer policy in
4-70 accordance with Section 241.027. A hospital may<; and (2)>
5-1 implement patient transfer agreements in accordance with Section
5-2 241.028 <or comply with rules adopted under Section 241.029>.
5-3 (b) A hospital that violates Subsection (a) is liable for a
5-4 civil penalty of not more than $1,000 for each day of violation and
5-5 for each act of violation.
5-6 (c) In determining the amount of the penalty, the district
5-7 court shall consider:
5-8 (1) the hospital's previous violations;
5-9 (2) the seriousness of the violation;
5-10 (3) whether the health and safety of the public was
5-11 threatened by the violation; and
5-12 (4) the demonstrated good faith of the hospital.
5-13 SECTION 12. Subsection (a), Section 241.056, Health and
5-14 Safety Code, is amended to read as follows:
5-15 (a) A person who is harmed by a violation under Section
5-16 241.028 or 241.055 may petition a district court for appropriate
5-17 injunctive relief.
5-18 SECTION 13. Subchapter C, Chapter 241, Health and Safety
5-19 Code, is amended by adding Section 241.058 to read as follows:
5-20 Sec. 241.058. MINOR VIOLATIONS. (a) This chapter does not
5-21 require the commissioner of health or a designee of the
5-22 commissioner to report a minor violation for prosecution or the
5-23 institution of any other enforcement proceeding authorized under
5-24 this chapter, if the commissioner or a designee of the commissioner
5-25 determines that prosecution or enforcement is not in the best
5-26 interests of the persons served or to be served by the hospital.
5-27 (b) For the purpose of this section, a "minor violation"
5-28 means a violation of this chapter, the rules adopted under this
5-29 chapter, a special license provision, an order or emergency order
5-30 issued by the commissioner of health or the commissioner's
5-31 designee, or another enforcement procedure permitted under this
5-32 chapter by a hospital that does not constitute a threat to the
5-33 health, safety, and rights of the hospital's patients or other
5-34 persons.
5-35 SECTION 14. Subchapter C, Chapter 241, Health and Safety
5-36 Code, is amended by adding Section 241.059 to read as follows:
5-37 Sec. 241.059. ADMINISTRATIVE PENALTY. (a) The commissioner
5-38 of health may assess an administrative penalty against a hospital
5-39 that violates this chapter, a rule adopted pursuant to this
5-40 chapter, a special license provision, an order or emergency order
5-41 issued by the commissioner or the commissioner's designee, or
5-42 another enforcement procedure permitted under this chapter.
5-43 (b) In determining the amount of the penalty, the
5-44 commissioner of health shall consider:
5-45 (1) the hospital's previous violations;
5-46 (2) the seriousness of the violation;
5-47 (3) any threat to the health, safety, or rights of the
5-48 hospital's patients;
5-49 (4) the demonstrated good faith of the hospital; and
5-50 (5) such other matters as justice may require.
5-51 (c) The penalty may not exceed $1,000 for each violation.
5-52 Each day of a continuing violation may be considered a separate
5-53 violation.
5-54 (d) When it is determined that a violation has occurred the
5-55 commissioner of health shall issue a report that states the facts
5-56 on which the determination is based and the commissioner's
5-57 recommendation on the imposition of a penalty, including a
5-58 recommendation on the amount of the penalty.
5-59 (e) Within 14 days after the date the report is issued, the
5-60 commissioner of health shall give written notice of the report to
5-61 the person, delivered by certified mail. The notice must include a
5-62 brief summary of the alleged violation and a statement of the
5-63 amount of the recommended penalty and must inform the person that
5-64 the person has a right to a hearing on the occurrence of the
5-65 violation, the amount of the penalty, or both the occurrence of the
5-66 violation and the amount of the penalty.
5-67 (f) Within 20 days after the date the person receives the
5-68 notice, the person in writing may accept the determination and
5-69 recommended penalty of the commissioner of health or may make a
5-70 written request for a hearing on the occurrence of the violation,
6-1 the amount of the penalty, or both the occurrence of the violation
6-2 and the amount of the penalty.
6-3 (g) If the person accepts the determination and recommended
6-4 penalty of the commissioner of health, the commissioner by order
6-5 shall impose the recommended penalty.
6-6 (h) If the person requests a hearing or fails to respond
6-7 timely to the notice, the commissioner of health shall set a
6-8 hearing and give notice of the hearing to the person. The hearing
6-9 shall be held by the department. The person conducting the hearing
6-10 shall make findings of fact and conclusions of law and promptly
6-11 issue to the commissioner a proposal for a decision about the
6-12 occurrence of the violation and the amount of the penalty. Based
6-13 on the findings of fact, conclusions of law, and proposal for a
6-14 decision, the commissioner by order may find that a violation has
6-15 occurred and impose a penalty or may find that no violation
6-16 occurred.
6-17 (i) The notice of the commissioner of health's order given
6-18 to the person under the Administrative Procedure and Texas Register
6-19 Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
6-20 subsequent amendments must include a statement of the right of the
6-21 person to judicial review of the order.
6-22 (j) Within 30 days after the date the commissioner of
6-23 health's order is final as provided by Section 16(c),
6-24 Administrative Procedure and Texas Register Act (Article 6252-13a,
6-25 Vernon's Texas Civil Statutes), and its subsequent amendments, the
6-26 person shall:
6-27 (1) pay the amount of the penalty;
6-28 (2) pay the amount of the penalty and file a petition
6-29 for judicial review contesting the occurrence of the violation, the
6-30 amount of the penalty, or both the occurrence of the violation and
6-31 the amount of the penalty; or
6-32 (3) without paying the amount of the penalty, file a
6-33 petition for judicial review contesting the occurrence of the
6-34 violation, the amount of the penalty, or both the occurrence of the
6-35 violation and the amount of the penalty.
6-36 (k) Within the 30-day period, a person who acts under
6-37 Subsection (j)(3) may:
6-38 (1) stay enforcement of the penalty by:
6-39 (A) paying the amount of the penalty to the
6-40 court for placement in an escrow account; or
6-41 (B) giving to the court a supersedeas bond that
6-42 is approved by the court for the amount of the penalty and that is
6-43 effective until all judicial review of the board's order is final;
6-44 or
6-45 (2) request the court to stay enforcement of the
6-46 penalty by:
6-47 (A) filing with the court a sworn affidavit of
6-48 the person stating that the person is financially unable to pay the
6-49 amount of the penalty and is financially unable to give the
6-50 supersedeas bond; and
6-51 (B) giving a copy of the affidavit to the
6-52 commissioner of health by certified mail.
6-53 (l) When the commissioner of health receives a copy of an
6-54 affidavit under Subsection (k)(2), he may file with the court,
6-55 within five days after the date the copy is received, a contest to
6-56 the affidavit. The court shall hold a hearing on the facts alleged
6-57 in the affidavit as soon as practicable and shall stay the
6-58 enforcement of the penalty on finding that the alleged facts are
6-59 true. The person who files an affidavit has the burden of proving
6-60 that the person is financially unable to pay the amount of the
6-61 penalty and to give a supersedeas bond.
6-62 (m) If the person does not pay the amount of the penalty and
6-63 the enforcement of the penalty is not stayed, the commissioner of
6-64 health may refer the matter to the attorney general for collection
6-65 of the amount of the penalty.
6-66 (n) Judicial review of the order of the commissioner of
6-67 health:
6-68 (1) is instituted by filing a petition as provided by
6-69 Section 19, Administrative Procedure and Texas Register Act
6-70 (Article 6252-13a, Vernon's Texas Civil Statutes), and its
7-1 subsequent amendments; and
7-2 (2) is under the substantial evidence rule.
7-3 (o) If the court sustains the occurrence of the violation,
7-4 the court may uphold or reduce the amount of the penalty and order
7-5 the person to pay the full or reduced amount of the penalty. If
7-6 the court does not sustain the occurrence of the violation, the
7-7 court shall order that no penalty is owed.
7-8 (p) When the judgment of the court becomes final, the court
7-9 shall proceed under this subsection. If the person paid the amount
7-10 of the penalty and if that amount is reduced or is not upheld by
7-11 the court, the court shall order that the appropriate amount plus
7-12 accrued interest be remitted to the person within 30 days after the
7-13 judgment of the court becomes final. The rate of the interest is
7-14 the rate charged on loans to depository institutions by the New
7-15 York Federal Reserve Bank, and the interest shall be paid for the
7-16 period beginning on the date the penalty was paid and ending on the
7-17 date the penalty is remitted. If the person gave a supersedeas
7-18 bond and if the amount of the penalty is not upheld by the court,
7-19 the court shall order the release of the bond. If the person gave
7-20 a supersedeas bond and if the amount of the penalty is reduced, the
7-21 court shall order the release of the bond after the person pays the
7-22 amount.
7-23 (q) A penalty collected under this section shall be remitted
7-24 to the comptroller for deposit in the general revenue fund.
7-25 (r) All proceedings under this section are subject to the
7-26 Administrative Procedure and Texas Register Act (Article 6252-13a,
7-27 Vernon's Texas Civil Statutes) and its subsequent amendments.
7-28 SECTION 15. Section 241.104, Health and Safety Code, is
7-29 amended to read as follows:
7-30 Sec. 241.104. HOSPITAL PLAN REVIEWS. (a) The board by rule
7-31 shall adopt fees for hospital plan reviews according to a schedule
7-32 based on the estimated construction costs. If an estimated
7-33 construction cost cannot be established, the estimated cost is $105
7-34 per square foot.
7-35 (b) The fee schedule may not exceed the following:
7-36 Cost of Construction Fee
7-37 (1) $ 600,000 or less $ 500 <250>
7-38 (2) $ 600,001 - $ 2,000,000 1,000 <500>
7-39 (3) $ 2,000,001 - $ 5,000,000 1,500 <750>
7-40 (4) $ 5,000,001 - $10,000,000 2,000 <1,000>
7-41 (5) $10,000,001 and over 3,000 <1,500>
7-42 (c) The department shall charge a fee for field surveys of
7-43 construction plans reviewed under this section. The board by rule
7-44 shall adopt a fee schedule for the surveys that provides a minimum
7-45 fee of $100 and a maximum fee of $400 for each survey conducted.
7-46 SECTION 16. Section 222.024, Health and Safety Code, is
7-47 amended to read as follows:
7-48 Sec. 222.024. CERTIFICATION OR ACCREDITATION INSTEAD OF
7-49 INSPECTION. (a) A hospital licensed by the Texas Department of
7-50 Health or the Texas Department of Mental Health and Mental
7-51 Retardation is not subject to additional annual licensing
7-52 inspections before the agency issues the hospital a license under
7-53 Chapter 241 (Texas Hospital Licensing Law) or by the licensing
7-54 agency while the hospital maintains:
7-55 (1) certification under Title XVIII of the Social
7-56 Security Act (42 U.S.C. Section 1395 et seq.); or
7-57 (2) accreditation from the Joint Commission on
7-58 Accreditation of Healthcare <Health> Organizations, the American
7-59 Osteopathic Association, or other national accreditation
7-60 organization for the offered services.
7-61 (b) If the Texas Department of Mental Health and Mental
7-62 Retardation licenses <An agency licensing> a hospital exempt from a
7-63 licensing inspection under Subsection (a), that agency shall issue
7-64 a renewal license to the hospital if the hospital annually remits
7-65 any applicable fees and submits a copy of the most recent
7-66 inspection results report from the certification or accreditation
7-67 body.
7-68 (c) If the Texas Department of Health licenses a hospital
7-69 exempt from a licensing inspection under Subsection (a), that
7-70 agency shall issue a renewal license to the hospital if the
8-1 hospital annually:
8-2 (1) submits a complete application required by the
8-3 department;
8-4 (2) remits any applicable fees;
8-5 (3) submits a copy of documentation from the
8-6 certification or accreditation body showing that the hospital is
8-7 certified or accredited; and
8-8 (4) submits a copy of the most recent fire safety
8-9 inspection report from the fire marshal in whose jurisdiction the
8-10 hospital is located.
8-11 SECTION 17. Section 222.026, Health and Safety Code, is
8-12 amended to read as follows:
8-13 Sec. 222.026. COMPLAINT INVESTIGATIONS AND ENFORCEMENT
8-14 AUTHORITY <PATIENT TRANSFER AUTHORITY NOT AFFECTED>. (a) Sections
8-15 222.024, 222.025, and 222.0255 do not affect the authority of the
8-16 Texas Department of Health to implement and enforce the provisions
8-17 of Chapter 241 (Texas Hospital Licensing Law) to:
8-18 (1) reinspect a hospital if a hospital applies for the
8-19 reissuance of its license after a final ruling upholding the
8-20 suspension or revocation of a hospital's license, the assessment of
8-21 administrative or civil penalties, or the issuance of an injunction
8-22 against the hospital for violations of provisions of the licensing
8-23 law, rules adopted under the licensing law, special license
8-24 conditions, or orders of the commissioner of health; or
8-25 (2) investigate a complaint against a hospital and, if
8-26 appropriate, enforce the provisions of the licensing law on a
8-27 finding by the department that reasonable cause exists to believe
8-28 that the hospital has violated provisions of the licensing law,
8-29 rules adopted under the licensing law, special license conditions,
8-30 or orders of the commissioner of health; provided, however, that
8-31 the department shall coordinate with the federal Health Care
8-32 Financing Administration and its agents responsible for the
8-33 inspection of hospitals to determine compliance with the conditions
8-34 of participation under Title XVIII of the Social Security Act (42
8-35 U.S.C. Section 1395 et seq.), so as to avoid duplicate
8-36 investigations <relating to the transfer of hospital patients or
8-37 the department's means of implementing and enforcing those
8-38 provisions>.
8-39 (b) The department shall by rule establish a procedure for
8-40 the acceptance and timely review of complaints received from
8-41 hospitals concerning the objectivity, training, and qualifications
8-42 of the persons conducting the inspection.
8-43 SECTION 18. This Act takes effect September 1, 1993.
8-44 SECTION 19. If on the effective date of this legislation the
8-45 powers and duties of the Texas Board of Health, the commissioner of
8-46 health, and the Texas Department of Health have been transferred to
8-47 the Department of Public Health as provided for in Chapter 15, Acts
8-48 of the 72nd Legislature, 1st Called Session, 1991, each reference
8-49 in this Act to the Texas Board of Health, the commissioner of
8-50 health, or the Texas Department of Health means the Board of Public
8-51 Health, the director of the Department of Public Health, or the
8-52 Department of Public Health, respectively.
8-53 SECTION 20. The importance of this legislation and the
8-54 crowded condition of the calendars in both houses create an
8-55 emergency and an imperative public necessity that the
8-56 constitutional rule requiring bills to be read on three several
8-57 days in each house be suspended, and this rule is hereby suspended.
8-58 * * * * *
8-59 Austin,
8-60 Texas
8-61 April 29, 1993
8-62 Hon. Bob Bullock
8-63 President of the Senate
8-64 Sir:
8-65 We, your Committee on Health and Human Services to which was
8-66 referred S.B. No. 86, have had the same under consideration, and I
8-67 am instructed to report it back to the Senate with the
8-68 recommendation that it do not pass, but that the Committee
8-69 Substitute adopted in lieu thereof do pass and be printed.
8-70 Truan,
9-1 Acting Chair
9-2 * * * * *
9-3 WITNESSES
9-4 FOR AGAINST ON
9-5 ___________________________________________________________________
9-6 Name: Maurice Shaw x
9-7 Representing: TDH
9-8 City: Austin
9-9 -------------------------------------------------------------------
9-10 FOR AGAINST ON
9-11 ___________________________________________________________________
9-12 Name: Linda Wigman x
9-13 Representing: TDH
9-14 City: Austin
9-15 -------------------------------------------------------------------
9-16 Name: David Marwitz x
9-17 Representing: TX Hospital Asso
9-18 City: Austin
9-19 -------------------------------------------------------------------