1-1 By: Zaffirini, Moncrief, Harris of Tarrant S.B. No. 212
1-2 (In the Senate - Filed February 1, 1993; February 1, 1993,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; March 19, 1993, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 8, Nays 0;
1-6 March 19, 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. 212 By: Zaffirini
1-19 A BILL TO BE ENTITLED
1-20 AN ACT
1-21 relating to the regulation of medical rehabilitation services.
1-22 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-23 SECTION 1. Chapter 241, Health and Safety Code, is amended
1-24 by adding Subchapter F to read as follows:
1-25 SUBCHAPTER F. MEDICAL REHABILITATION SERVICES
1-26 Sec. 241.121. DEFINITION. In this subchapter,
1-27 "comprehensive medical rehabilitation" means the provision of
1-28 rehabilitation services that are designed to improve or minimize a
1-29 person's physical or cognitive disabilities, maximize a person's
1-30 functional ability, or restore a person's lost functional capacity
1-31 through close coordination of services, communication, interaction,
1-32 and integration among several professions that share the
1-33 responsibility to achieve team treatment goals for the person.
1-34 Sec. 241.122. LICENSE REQUIRED. Unless a person has a
1-35 license issued under this chapter, a person other than an
1-36 individual may not provide inpatient comprehensive medical
1-37 rehabilitation to a patient who requires medical services that are
1-38 provided under the supervision of a physician and that are more
1-39 intensive than nursing facility care and minor treatment.
1-40 Sec. 241.123. REHABILITATION SERVICES STANDARDS. (a) The
1-41 board by rule shall adopt standards for the provision of
1-42 rehabilitation services by a hospital to ensure the health and
1-43 safety of a patient receiving the services.
1-44 (b) The standards adopted by the board at a minimum shall
1-45 require a hospital that provides comprehensive medical
1-46 rehabilitation:
1-47 (1) to have a director of comprehensive medical
1-48 rehabilitation who is:
1-49 (A) a licensed physician;
1-50 (B) either board certified or eligible for board
1-51 certification in a medical specialty related to rehabilitation; and
1-52 (C) qualified by training and experience to
1-53 serve as medical director;
1-54 (2) to have medical supervision by a licensed
1-55 physician for 24 hours each day; and
1-56 (3) to provide appropriate therapy to each patient by
1-57 an interdisciplinary team consisting of licensed physicians,
1-58 rehabilitation nurses, and therapists as are appropriate for the
1-59 patient's needs.
1-60 (c) An interdisciplinary team for comprehensive medical
1-61 rehabilitation shall be directed by a licensed physician. An
1-62 interdisciplinary team for comprehensive medical rehabilitation
1-63 shall have available to it, at the hospital at which the services
1-64 are provided or by contract, members of the following professions
1-65 as necessary to meet the treatment needs of the patient:
1-66 (1) physical therapy;
1-67 (2) occupational rehabilitation;
1-68 (3) speech-language pathology;
2-1 (4) therapeutic recreation;
2-2 (5) social services and case management;
2-3 (6) dietetics;
2-4 (7) psychology;
2-5 (8) respiratory therapy; and
2-6 (9) rehabilitative nursing.
2-7 (d) A hospital shall prepare for each patient receiving
2-8 inpatient rehabilitation services a written treatment plan designed
2-9 for that patient's needs for treatment and care. The board by rule
2-10 shall specify a time after admission of a patient for inpatient
2-11 rehabilitation services by which a hospital must evaluate the
2-12 patient for the patient's initial treatment plan and by which a
2-13 hospital must provide copies of the plan after evaluation.
2-14 (e) A hospital shall prepare for each patient receiving
2-15 inpatient rehabilitation services a written continuing care plan
2-16 that addresses the patient's needs for care after discharge,
2-17 including recommendations for treatment and care and information
2-18 about the availability of resources for treatment or care. The
2-19 board by rule shall specify the time before discharge by which the
2-20 hospital must provide a copy of the continuing care plan. The
2-21 board's rules may allow a facility to provide the continuing care
2-22 plan by a specified time after discharge if providing the plan
2-23 before discharge is impracticable.
2-24 (f) A hospital shall provide a copy of a treatment or
2-25 continuing care plan prepared under this section to the following
2-26 persons in the person's primary language, if practicable:
2-27 (1) the patient;
2-28 (2) a person designated by the patient; and
2-29 (3) as specified by board rule, family members or
2-30 other persons with responsibility for or demonstrated participation
2-31 in the patient's care or treatment.
2-32 (g) Rules adopted by the board under this subchapter may not
2-33 conflict with a federal rule, regulation, or standard.
2-34 SECTION 2. This Act takes effect September 1, 1993.
2-35 SECTION 3. The importance of this legislation and the
2-36 crowded condition of the calendars in both houses create an
2-37 emergency and an imperative public necessity that the
2-38 constitutional rule requiring bills to be read on three several
2-39 days in each house be suspended, and this rule is hereby suspended.
2-40 * * * * *
2-41 Austin,
2-42 Texas
2-43 March 19, 1993
2-44 Hon. Bob Bullock
2-45 President of the Senate
2-46 Sir:
2-47 We, your Committee on Health and Human Services to which was
2-48 referred S.B. No. 212, have had the same under consideration, and I
2-49 am instructed to report it back to the Senate with the
2-50 recommendation that it do not pass, but that the Committee
2-51 Substitute adopted in lieu thereof do pass and be printed.
2-52 Zaffirini,
2-53 Chair
2-54 * * * * *
2-55 WITNESSES
2-56 FOR AGAINST ON
2-57 ___________________________________________________________________
2-58 Name: Dan Morales x
2-59 Representing: State of Texas
2-60 City: Austin
2-61 -------------------------------------------------------------------
2-62 FOR AGAINST ON
2-63 ___________________________________________________________________
2-64 Name: Dr. Charles Arnold x
2-65 Representing: Self
2-66 City: San Antonio
2-67 -------------------------------------------------------------------
2-68 Name: Thomas Suehs x
2-69 Representing: Tx Health Care Assn
2-70 City: Austin
3-1 -------------------------------------------------------------------
3-2 Name: David F. Briones, M.D. x
3-3 Representing: TSPP & TMA
3-4 City: El Paso
3-5 -------------------------------------------------------------------
3-6 Name: Florence Winn-Salmon x
3-7 Representing: TAMI
3-8 City: Austin
3-9 -------------------------------------------------------------------
3-10 Name: Mary Koch x
3-11 Representing: Inst. for Rehab and Research
3-12 City: Houston
3-13 -------------------------------------------------------------------
3-14 Name: Maurice Shaw x
3-15 Representing: TDH
3-16 City: Austin
3-17 -------------------------------------------------------------------
3-18 Name: Wylie Jordan, M.D. x
3-19 Representing: Self
3-20 City: Austin
3-21 -------------------------------------------------------------------
3-22 Name: Nancy Sims x
3-23 Representing: Tx Business Group on Health
3-24 City: Houston
3-25 -------------------------------------------------------------------
3-26 Name: Aaryce Hayes x
3-27 Representing: Advocacy, Inc.
3-28 City: Austin
3-29 -------------------------------------------------------------------
3-30 Name: Roger T. Jenkins x
3-31 Representing: Tyler Medical Rehab
3-32 City: Tyler
3-33 -------------------------------------------------------------------
3-34 Name: Marcia Baum x
3-35 Representing: NASW
3-36 City: Austin
3-37 -------------------------------------------------------------------
3-38 Name: Christine Devall x
3-39 Representing: Mental Health Assn
3-40 City: Austin
3-41 -------------------------------------------------------------------
3-42 Name: Joanne P. Hopkins x
3-43 Representing: NME
3-44 City: Austin
3-45 -------------------------------------------------------------------
3-46 Name: Patricia Vaughan x
3-47 Representing: Rehab Hospital of Austin
3-48 City: Austin
3-49 -------------------------------------------------------------------
3-50 Name: Kevin O'Hanlon x
3-51 Representing: TEA
3-52 City: Austin
3-53 -------------------------------------------------------------------
3-54 Name: Charles Arthur Stark x
3-55 Representing: Healthsouth Rehab
3-56 City: North Richland Hills
3-57 -------------------------------------------------------------------