By: Zaffirini, Moncrief S.B. No. 212 Harris of Tarrant A BILL TO BE ENTITLED AN ACT 1-1 relating to the regulation of medical rehabilitation services. 1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-3 SECTION 1. Chapter 241, Health and Safety Code, is amended 1-4 by adding Subchapter F to read as follows: 1-5 SUBCHAPTER F. MEDICAL REHABILITATION SERVICES 1-6 Sec. 241.121. DEFINITION. In this subchapter, 1-7 "comprehensive medical rehabilitation" means the provision of 1-8 rehabilitation services that are designed to improve or minimize a 1-9 person's physical or cognitive disabilities, maximize a person's 1-10 functional ability, or restore a person's lost functional capacity 1-11 through close coordination of services, communication, interaction, 1-12 and integration among several professions that share the 1-13 responsibility to achieve team treatment goals for the person. 1-14 Sec. 241.122. LICENSE REQUIRED. Unless a person has a 1-15 license issued under this chapter, a person other than an 1-16 individual may not provide inpatient comprehensive medical 1-17 rehabilitation to a patient who requires medical services that are 1-18 provided under the supervision of a physician and that are more 1-19 intensive than nursing facility care and minor treatment. 1-20 Sec. 241.123. REHABILITATION SERVICES STANDARDS. (a) The 1-21 board by rule shall adopt standards for the provision of 1-22 rehabilitation services by a hospital to ensure the health and 1-23 safety of a patient receiving the services. 1-24 (b) The standards adopted by the board at a minimum shall 2-1 require a hospital that provides comprehensive medical 2-2 rehabilitation: 2-3 (1) to have a director of comprehensive medical 2-4 rehabilitation who is: 2-5 (A) a licensed physician; 2-6 (B) either board certified or eligible for board 2-7 certification in a medical specialty related to rehabilitation; and 2-8 (C) qualified by training and experience to 2-9 serve as medical director; 2-10 (2) to have medical supervision by a licensed 2-11 physician for 24 hours each day; and 2-12 (3) to provide appropriate therapy to each patient by 2-13 an interdisciplinary team consisting of licensed physicians, 2-14 rehabilitation nurses, and therapists as are appropriate for the 2-15 patient's needs. 2-16 (c) An interdisciplinary team for comprehensive medical 2-17 rehabilitation shall be directed by a licensed physician. An 2-18 interdisciplinary team for comprehensive medical rehabilitation 2-19 shall have available to it, at the hospital at which the services 2-20 are provided or by contract, members of the following professions 2-21 as necessary to meet the treatment needs of the patient: 2-22 (1) physical therapy; 2-23 (2) occupational rehabilitation; 2-24 (3) speech-language pathology; 2-25 (4) therapeutic recreation; 2-26 (5) social services and case management; 2-27 (6) dietetics; 3-1 (7) psychology; 3-2 (8) respiratory therapy; and 3-3 (9) rehabilitative nursing. 3-4 (d) A hospital shall prepare for each patient receiving 3-5 inpatient rehabilitation services a written treatment plan designed 3-6 for that patient's needs for treatment and care. The board by rule 3-7 shall specify a time after admission of a patient for inpatient 3-8 rehabilitation services by which a hospital must evaluate the 3-9 patient for the patient's initial treatment plan and by which a 3-10 hospital must provide copies of the plan after evaluation. 3-11 (e) A hospital shall prepare for each patient receiving 3-12 inpatient rehabilitation services a written continuing care plan 3-13 that addresses the patient's needs for care after discharge, 3-14 including recommendations for treatment and care and information 3-15 about the availability of resources for treatment or care. The 3-16 board by rule shall specify the time before discharge by which the 3-17 hospital must provide a copy of the continuing care plan. The 3-18 board's rules may allow a facility to provide the continuing care 3-19 plan by a specified time after discharge if providing the plan 3-20 before discharge is impracticable. 3-21 (f) A hospital shall provide a copy of a treatment or 3-22 continuing care plan prepared under this section to the following 3-23 persons in the person's primary language, if practicable: 3-24 (1) the patient; 3-25 (2) a person designated by the patient; and 3-26 (3) as specified by board rule, family members or 3-27 other persons with responsibility for or demonstrated participation 4-1 in the patient's care or treatment. 4-2 (g) Rules adopted by the board under this subchapter may not 4-3 conflict with a federal rule, regulation, or standard. 4-4 SECTION 2. This Act takes effect September 1, 1993. 4-5 SECTION 3. The importance of this legislation and the 4-6 crowded condition of the calendars in both houses create an 4-7 emergency and an imperative public necessity that the 4-8 constitutional rule requiring bills to be read on three several 4-9 days in each house be suspended, and this rule is hereby suspended.