By:  West                                              S.B. No. 392
       73R4275 MLR-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to minimum standards for medical procedures involving
    1-3  sedation or contrast media.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subchapter D, Chapter 401, Health and Safety
    1-6  Code, is amended by adding Section 401.120 to read as follows:
    1-7        Sec. 401.120.  PROTOCOLS FOR PROCEDURES INVOLVING SEDATION OR
    1-8  CONTRAST MEDIA.  (a)  Notwithstanding any other provision of this
    1-9  code or the Medical Practice Act (Article 4495b, Vernon's Texas
   1-10  Civil Statutes), the board, after consultation with representatives
   1-11  from private professional medical organizations representing the
   1-12  practices of radiology, pediatrics, neurology, anesthesiology, and
   1-13  nursing, shall by rule establish procedures and protocols for
   1-14  outpatient medical procedures requiring sedation or the
   1-15  introduction of contrast media by a person performing those
   1-16  services and procedures in a location not otherwise licensed under
   1-17  this code.
   1-18        (b)  The procedures and protocols shall:
   1-19              (1)  establish guidelines for determining the dosage of
   1-20  medication and contrast media administered to a patient;
   1-21              (2)  require the administration of the medication by a
   1-22  licensed vocational nurse, registered nurse, or physician;
   1-23              (3)  require the past and present medical history of
   1-24  the patient;
    2-1              (4)  establish guidelines for appropriate monitoring
    2-2  until adequate recovery, including the patient being awake and
    2-3  conscious; and
    2-4              (5)  determine appropriate emergency drugs, equipment,
    2-5  and transfer procedures for treatment of complications.
    2-6        (c)  As part of the regular inspection under Subchapter C,
    2-7  the department shall determine whether the procedures and protocols
    2-8  established under this section are in place and are used as a part
    2-9  of the regular standard of practice and care.
   2-10        (d)  A person required to maintain the established protocols
   2-11  and procedures who fails to do so violates this section and is
   2-12  subject to the administrative penalty and procedures provided by
   2-13  Sections 401.384 through 401.390.
   2-14        (e)  The board may request that the attorney general bring an
   2-15  action to prohibit a person from engaging in an act or practice and
   2-16  to order compliance with this section and the procedures and
   2-17  protocols established under this section if the board determines,
   2-18  after a complaint or by other means, that the act or practice
   2-19  violates this section or an order made under this section and that
   2-20  there is an immediate and imminent danger to the public health and
   2-21  safety as a result of a continuing violation under this section.
   2-22  The action may be brought in a district court of:
   2-23              (1)  a county in which:
   2-24                    (A)  the defendant resides;
   2-25                    (B)  the defendant has done business;
   2-26                    (C)  the principal place of business of the
   2-27  defendant is located; or
    3-1                    (D)  the transaction occurred; or
    3-2              (2)  Travis County.
    3-3        (f)  The court may grant an injunction or restraining order
    3-4  on a proper showing.   If the court grants an injunction or
    3-5  restraining order, the court shall issue it without bond.
    3-6        (g)  The department may set the fees authorized under Section
    3-7  401.301 to cover the expenses incurred in administering this
    3-8  section.
    3-9        SECTION 2.  (a)  The Texas Board of Health shall adopt the
   3-10  procedures and protocols required under Section 401.120, Health and
   3-11  Safety Code, as added by this Act, and make them effective not
   3-12  later than the 90th day after the effective date of this Act.
   3-13        (b)  Initial inspections to determine compliance with Section
   3-14  401.120, Health and Safety Code, as added by this Act, shall be
   3-15  completed not later than the first anniversary of the effective
   3-16  date of the procedures and protocols.
   3-17        SECTION 3.  The importance of this legislation and the
   3-18  crowded condition of the calendars in both houses create an
   3-19  emergency and an imperative public necessity that the
   3-20  constitutional rule requiring bills to be read on three several
   3-21  days in each house be suspended, and this rule is hereby suspended,
   3-22  and that this Act take effect and be in force from and after its
   3-23  passage, and it is so enacted.