By:  Moncrief                                          S.B. No. 674
       73R4150 JMM-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the creation of the Health Professions Council, the
    1-3  continuation and functions of the Midwifery Board and the
    1-4  regulation of the practice of midwifery, the continuation and
    1-5  functions of the Texas State Board of Examiners of Dietitians and
    1-6  the regulation of dietetics, and the abolition of the Texas Board
    1-7  of Licensure for Nursing Home Administrators and the transfer of
    1-8  the regulation of nursing home administrators to the Texas
    1-9  Department of Health; providing penalties.
   1-10        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-11                ARTICLE 1.  HEALTH PROFESSIONS COUNCIL
   1-12        SECTION 1.01.  Title 71, Revised Statutes, is amended by
   1-13  adding Chapter 6O and Article 4512p to read as follows:
   1-14                CHAPTER 6O.  HEALTH PROFESSIONS COUNCIL
   1-15        Art. 4512p.  HEALTH PROFESSIONS COUNCIL
   1-16        Sec. 1.  HEALTH PROFESSIONS COUNCIL.  The Health Professions
   1-17  Council is created to conduct the studies described by Section 2 of
   1-18  this article and to administer the other functions provided by this
   1-19  article.
   1-20        Sec. 2.  COUNCIL STUDIES.  The council shall perform the
   1-21  following studies about the feasibility and merits of:
   1-22              (1)  centralizing the investigatory functions of the
   1-23  state agencies that regulate health professions;
   1-24              (2)  centralizing complaint processing for state
    2-1  agencies that regulate health professions; and
    2-2              (3)  prohibiting a person who is not a physician from
    2-3  intervening in medical practice decisions made by an attending
    2-4  physician.
    2-5        Sec. 3.  TOLL-FREE TELEPHONE COMPLAINT SYSTEM.  (a)  The
    2-6  council shall establish and operate a toll-free telephone complaint
    2-7  system to provide assistance and referral services for persons
    2-8  making a complaint relating to a health profession regulated by the
    2-9  state.
   2-10        (b)  After the establishment of a toll-free telephone
   2-11  complaint system under this section, an agency of the state that
   2-12  regulates a health profession shall be required to list the
   2-13  toll-free telephone number of the system with the agency's regular
   2-14  telephone number.
   2-15        Sec. 4.  TRAINING AND GUIDELINES FOR MEMBERS OF STATE BOARDS
   2-16  AND COMMISSIONS.  (a)  The council shall establish a training
   2-17  program for the members of the boards and commissions in the state
   2-18  that regulate health professions.
   2-19        (b)  Before a member of a board or commission that regulates
   2-20  a health profession takes office, the member must attend at least
   2-21  one session of the training program established under this section.
   2-22        (c)  A training program established under this section shall
   2-23  provide information to a participant regarding:
   2-24              (1)  the enabling legislation that created the board or
   2-25  commission to which the member is appointed;
   2-26              (2)  the programs operated by that state agency;
   2-27              (3)  the role and functions of that state agency;
    3-1              (4)  the rules of that state agency with an emphasis on
    3-2  the rules that relate to disciplinary and investigatory authority;
    3-3              (5)  the current budget for that state agency;
    3-4              (6)  the results of the most recent formal audit of
    3-5  that state agency;
    3-6              (7)  the requirements of the open meetings law, Chapter
    3-7  271, Acts of the 60th Legislature, Regular Session, 1967 (Article
    3-8  6252-17, Vernon's Texas Civil Statutes), and its subsequent
    3-9  amendments and the open records law, Chapter 424, Acts of the 63rd
   3-10  Legislature, Regular Session, 1973 (Article 6252-17a, Vernon's
   3-11  Texas Civil Statutes), and its subsequent amendments;
   3-12              (8)  the requirements of the conflict of interest laws
   3-13  and other laws relating to public officials; and
   3-14              (9)  any applicable ethics policies adopted by that
   3-15  state agency or the Texas Ethics Commission.
   3-16                      ARTICLE 2.  MIDWIFERY BOARD
   3-17        SECTION 2.01.  Section 3, Texas Midwifery Act (Article 4512i,
   3-18  Vernon's Texas Civil Statutes), is amended by amending Subsection
   3-19  (b) and adding Subsections (c) and (d) to read as follows:
   3-20        (b)  The midwifery board is composed of the following nine
   3-21  members:
   3-22              (1)  three <six> midwives with at least three years of
   3-23  experience in the practice of midwifery, any <not more than three>
   3-24  of whom may be licensed health care professionals;
   3-25              (2)  one certified nurse-midwife;
   3-26              (3)  a person licensed to practice medicine who is
   3-27  certified by a national professional organization of physicians
    4-1  that certifies obstetricians and gynecologists;
    4-2              (4)  one person licensed to practice medicine who is
    4-3  certified by a national professional organization of physicians
    4-4  that certifies family practitioners or pediatricians; and
    4-5              (5)  three persons who are not practicing or trained in
    4-6  a health care profession and who represent the public interest, one
    4-7  of whom must be a parent with at least one child born with the
    4-8  assistance of a midwife.
    4-9        (c)  A person is not eligible for appointment as a public
   4-10  member of the midwifery board if the person or the person's spouse:
   4-11              (1)  is registered, certified, or licensed by an
   4-12  occupational regulatory agency in the field of midwifery;
   4-13              (2)  is employed by or participates in the management
   4-14  of a business entity or other organization regulated by the
   4-15  midwifery board or receiving funds from the midwifery board;
   4-16              (3)  owns or controls, directly or indirectly, more
   4-17  than 10 percent interest in a business entity or other organization
   4-18  regulated by the midwifery board or receiving funds from the
   4-19  midwifery board; or
   4-20              (4)  uses or receives a substantial amount of tangible
   4-21  goods, services, or funds from the midwifery board, other than
   4-22  compensation or reimbursement authorized by law for midwifery board
   4-23  membership, attendance, or expenses.
   4-24        (d)  Appointments to the midwifery board shall be made
   4-25  without regard to the race, color, disability, sex, religion, age,
   4-26  or national origin of the appointees.
   4-27        SECTION 2.02.  Section 3A, Texas Midwifery Act (Article
    5-1  4512i, Vernon's Texas Civil Statutes), is amended to read as
    5-2  follows:
    5-3        Sec. 3A.  Sunset provision.  The midwifery board is subject
    5-4  to Chapter 325, Government Code (Texas Sunset Act).  Unless
    5-5  continued in existence as provided by that chapter, the midwifery
    5-6  board is abolished and this Act expires September 1, 2005 <1993>.
    5-7        SECTION 2.03.  The Texas Midwifery Act (Article 4512i,
    5-8  Vernon's Texas Civil Statutes) is amended by adding Section 3B to
    5-9  read as follows:
   5-10        Sec. 3B.  CONFLICT OF INTEREST RESTRICTIONS.  (a)  An
   5-11  officer, employee, or paid consultant of a Texas trade association
   5-12  in the field of midwifery may not be a member or employee of the
   5-13  midwifery board who is exempt from the state's position
   5-14  classification plan or is compensated at or above the amount
   5-15  prescribed by the General Appropriations Act for step 1, salary
   5-16  group 17, of the position classification salary schedule.
   5-17        (b)  A person who is the spouse of an officer, manager, or
   5-18  paid consultant of a Texas trade association in the field of
   5-19  midwifery may not be a midwifery board member and may not be an
   5-20  employee of the midwifery board who is exempt from the state's
   5-21  position classification plan or is compensated at or above the
   5-22  amount prescribed by the General Appropriations Act for step 1,
   5-23  salary group 17, of the position classification salary schedule.
   5-24        (c)  For the purposes of this section, a Texas trade
   5-25  association is a nonprofit, cooperative, and voluntarily joined
   5-26  association of business or professional competitors in this state
   5-27  designed to assist its members and its industry or profession in
    6-1  dealing with mutual business or professional problems and in
    6-2  promoting their common interest.
    6-3        SECTION 2.04.  The Texas Midwifery Act (Article 4512i,
    6-4  Vernon's Texas Civil Statutes) is amended by adding Section 3C to
    6-5  read as follows:
    6-6        Sec. 3C.  EFFECT OF LOBBYING ACTIVITY.  A person may not
    6-7  serve as a member of the midwifery board or act as the general
    6-8  counsel to the midwifery board if the person is required to
    6-9  register as a lobbyist under Chapter 305, Government Code, and its
   6-10  subsequent amendments, because of the person's activities for
   6-11  compensation on behalf of a profession related to the operation of
   6-12  the midwifery board.
   6-13        SECTION 2.05.  The Texas Midwifery Act (Article 4512i,
   6-14  Vernon's Texas Civil Statutes) is amended by adding Section 3D to
   6-15  read as follows:
   6-16        Sec. 3D.  GROUNDS FOR REMOVAL FROM BOARD.  (a)  It is a
   6-17  ground for removal from the midwifery board if a member:
   6-18              (1)  does not have at the time of appointment the
   6-19  qualifications required by Section 3 of this Act;
   6-20              (2)  does not maintain during service on the midwifery
   6-21  board the qualifications required by Section 3 of this Act;
   6-22              (3)  violates a prohibition established by Section
   6-23  3(c), 3B, or 3C of this Act;
   6-24              (4)  cannot discharge the member's term for a
   6-25  substantial part of the term for which the member is appointed
   6-26  because of illness or disability; or
   6-27              (5)  is absent from more than half of the regularly
    7-1  scheduled midwifery board meetings that the member is eligible to
    7-2  attend during a calendar year unless the absence is excused by
    7-3  majority vote of the midwifery board.
    7-4        (b)  The validity of an action of the midwifery board is not
    7-5  affected by the fact that it is taken when a ground for removal of
    7-6  a midwifery board member exists.
    7-7        (c)  If the program coordinator has knowledge that a
    7-8  potential ground for removal exists, the program coordinator shall
    7-9  notify the presiding officer of the midwifery board of the ground.
   7-10  The presiding officer shall then notify the governor that a
   7-11  potential ground for removal exists.
   7-12        SECTION 2.06.  Section 8A, Texas Midwifery Act (Article
   7-13  4512i, Vernon's Texas Civil Statutes), is amended by adding
   7-14  Subsection (d) to read as follows:
   7-15        (d)  Subject to the approval of the Texas Board of Health,
   7-16  the midwifery board by rule shall establish reasonable and
   7-17  necessary fees so that the fees, in the aggregate, produce
   7-18  sufficient revenue to cover the costs of administering this Act.
   7-19  The fee amounts set by the midwifery board may be adjusted so that
   7-20  the total fees collected are sufficient to cover the cost of
   7-21  administering this Act.  The midwifery board may not set a fee for
   7-22  an amount less than the amount of that fee on September 1, 1993.
   7-23        SECTION 2.07.  The Texas Midwifery Act (Article 4512i,
   7-24  Vernon's Texas Civil Statutes) is amended by adding Section 8C to
   7-25  read as follows:
   7-26        Sec. 8C.  ANNUAL FINANCIAL REPORT.  The midwifery board shall
   7-27  file annually with the governor and the presiding officer of each
    8-1  house of the legislature a complete and detailed written report
    8-2  accounting for all funds received and disbursed by the midwifery
    8-3  board during the preceding fiscal year.  The annual report must be
    8-4  in the form and reported in the time provided by the General
    8-5  Appropriations Act.
    8-6        SECTION 2.08.  The Texas Midwifery Act (Article 4512i,
    8-7  Vernon's Texas Civil Statutes) is amended by adding Section 8D to
    8-8  read as follows:
    8-9        Sec. 8D.  PERSONNEL POLICIES.  (a)  The program coordinator
   8-10  or the coordinator's designee shall develop an intra-agency career
   8-11  ladder program.  The program shall require intra-agency posting of
   8-12  all nonentry level positions concurrently with any public posting.
   8-13        (b)  The program coordinator or the coordinator's designee
   8-14  shall develop a system of annual performance evaluations based on
   8-15  measurable job tasks.  All merit pay for midwifery board employees
   8-16  must be based on the system established under this subsection.
   8-17        SECTION 2.09.  The Texas Midwifery Act (Article 4512i,
   8-18  Vernon's Texas Civil Statutes) is amended by adding Section 8E to
   8-19  read as follows:
   8-20        Sec. 8E.  PUBLIC INTEREST INFORMATION.  (a)  The midwifery
   8-21  board shall prepare information of public interest describing the
   8-22  functions of the midwifery board and the midwifery board's
   8-23  procedures by which complaints are filed with and resolved by the
   8-24  midwifery board.  The midwifery board shall make the information
   8-25  available to the public and appropriate state agencies.
   8-26        (b)  The midwifery board by rule shall establish methods by
   8-27  which consumers and service recipients are notified of the name,
    9-1  mailing address, and telephone number of the midwifery board for
    9-2  the purpose of directing complaints to the midwifery board.  The
    9-3  midwifery board may provide for that notification:
    9-4              (1)  on each registration form, application, or written
    9-5  contract for services of an individual or entity regulated by the
    9-6  midwifery board;
    9-7              (2)  on a sign prominently displayed in the place of
    9-8  business of each individual or entity regulated by the midwifery
    9-9  board; or
   9-10              (3)  in a bill for service provided by an individual or
   9-11  entity regulated by the midwifery board.
   9-12        (c)  The midwifery board shall list along with its regular
   9-13  telephone number the toll-free telephone number that may be called
   9-14  to present a complaint about a health professional if the toll-free
   9-15  number is established under other state law.
   9-16        SECTION 2.10.  The Texas Midwifery Act (Article 4512i,
   9-17  Vernon's Texas Civil Statutes) is amended by adding Section 8F to
   9-18  read as follows:
   9-19        Sec. 8F.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The
   9-20  program coordinator or the coordinator's designee shall prepare and
   9-21  maintain a written policy statement to assure implementation of a
   9-22  program of equal employment opportunity under which all personnel
   9-23  transactions are made without regard to race, color, disability,
   9-24  sex, religion, age, or national origin.  The policy statement must
   9-25  include:
   9-26              (1)  personnel policies, including policies relating to
   9-27  recruitment, evaluation, selection, application, training, and
   10-1  promotion of personnel that are in compliance with the Commission
   10-2  on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes)
   10-3  and its subsequent amendments;
   10-4              (2)  a comprehensive analysis of the midwifery board
   10-5  workforce that meets federal and state guidelines;
   10-6              (3)  procedures by which a determination can be made of
   10-7  significant underuse in the midwifery board workforce of all
   10-8  persons for whom federal or state guidelines encourage a more
   10-9  equitable balance; and
  10-10              (4)  reasonable methods to appropriately address those
  10-11  areas of underuse.
  10-12        (b)  A policy statement prepared under Subsection (a) of this
  10-13  section must cover an annual period, be updated annually, be
  10-14  reviewed by the Commission on Human Rights for compliance with
  10-15  Subsection (a)(1) of this section, and be filed with the governor's
  10-16  office.
  10-17        (c)  The governor's office shall deliver a biennial report to
  10-18  the legislature based on the information received under Subsection
  10-19  (b)  of this section.  The report may be made separately or as part
  10-20  of other biennial reports to the legislature.
  10-21        SECTION 2.11.  The Texas Midwifery Act (Article 4512i,
  10-22  Vernon's Texas Civil Statutes) is amended by adding Section 8G to
  10-23  read as follows:
  10-24        Sec. 8G.  TRAINING; STANDARDS OF CONDUCT INFORMATION.  (a)
  10-25  Each midwifery board member shall comply with the member training
  10-26  requirements established by any other state agency that is given
  10-27  authority to establish the requirements for the midwifery board.
   11-1        (b)  The midwifery board shall provide to its members and
   11-2  employees, as often as necessary, information regarding their
   11-3  qualifications for office or employment under this Act and their
   11-4  responsibilities under applicable laws relating to standards of
   11-5  conduct for state officers or employees.
   11-6        SECTION 2.12.  The Texas Midwifery Act (Article 4512i,
   11-7  Vernon's Texas Civil Statutes) is amended by adding Section 8H to
   11-8  read as follows:
   11-9        Sec. 8H.  PUBLIC PARTICIPATION IN MIDWIFERY BOARD HEARINGS.
  11-10  The midwifery board shall develop and implement policies that
  11-11  provide the public with a reasonable opportunity to appear before
  11-12  the midwifery board and to speak on any issue under the
  11-13  jurisdiction of the midwifery board.
  11-14        SECTION 2.13.  The Texas Midwifery Act (Article 4512i,
  11-15  Vernon's Texas Civil Statutes) is amended by adding Section 8I to
  11-16  read as follows:
  11-17        Sec. 8I.  DIVISION OF RESPONSIBILITY.  The midwifery board
  11-18  shall develop and implement policies that clearly define the
  11-19  respective responsibilities of the midwifery board and the staff of
  11-20  the midwifery board.
  11-21        SECTION 2.14.  The Texas Midwifery Act (Article 4512i,
  11-22  Vernon's Texas Civil Statutes) is amended by adding Section 8J to
  11-23  read as follows:
  11-24        Sec. 8J.  PROGRAM ACCESSIBILITY.  The midwifery board shall
  11-25  prepare and maintain a written plan that describes how a person who
  11-26  does not speak English can be provided reasonable access to the
  11-27  midwifery board's programs.  The midwifery board shall also comply
   12-1  with federal and state laws for program and facility accessibility.
   12-2        SECTION 2.15.  Section 10, Texas Midwifery Act (Article
   12-3  4512i, Vernon's Texas Civil Statutes), is amended by amending
   12-4  Subsection (c) and adding Subsection (i) to read as follows:
   12-5        (c)  On renewal of the documentation, the person must provide
   12-6  the program coordinator with evidence, acceptable under the rules
   12-7  of the board, of completion of mandatory continuing education as
   12-8  prescribed by the midwifery board.  The midwifery board by rule
   12-9  shall establish a minimum number of hours of continuing education
  12-10  required to renew a documentation under this Act.  The midwifery
  12-11  board may assess the continuing education needs of documented
  12-12  midwives and may require documented midwives to attend continuing
  12-13  education courses specified by the midwifery board.  The midwifery
  12-14  board by rule shall develop a process to evaluate and approve
  12-15  continuing education courses.
  12-16        (i)  The midwifery board shall identify the key factors for
  12-17  the competent performance by a documented midwife of the documented
  12-18  midwife's professional duties.  The midwifery board shall adopt a
  12-19  procedure to assess a documented midwife's participation in
  12-20  continuing education programs.
  12-21        SECTION 2.16.  Section 11, Texas Midwifery Act (Article
  12-22  4512i, Vernon's Texas Civil Statutes), is amended by adding
  12-23  Subsection (e) to read as follows:
  12-24        (e)  The midwifery board shall have the written portion of
  12-25  the examination, if any, validated by an independent testing
  12-26  professional.
  12-27        SECTION 2.17.  Sections 13(b), (d), and (e), Texas Midwifery
   13-1  Act (Article 4512i, Vernon's Texas Civil Statutes), are amended to
   13-2  read as follows:
   13-3        (b)  Each person who practices midwifery must apply to the
   13-4  department annually to be documented as a midwife.  The application
   13-5  must be accompanied by a nonrefundable <$50> application fee in an
   13-6  amount set by the midwifery board.  The application must include
   13-7  the information required by board rule.
   13-8        (d)  The initial documentation issued to a midwife may be
   13-9  issued at any time during the year.  The initial documentation must
  13-10  be issued before the midwife begins to practice midwifery within
  13-11  the state.  The term of the initial practice under the
  13-12  documentation begins on the date that the requirements are met and
  13-13  extends through December 31 of the initial year.  The midwifery
  13-14  board by rule may adopt a system under which documentations expire
  13-15  on various dates during the year.  For the year in which the
  13-16  documentation expiration date is changed, documentation fees
  13-17  payable on the original expiration date shall be prorated on a
  13-18  monthly basis so that each documented midwife shall pay only that
  13-19  portion of the documentation fee that is allocable to the number of
  13-20  months during which the documentation is valid.  On renewal of the
  13-21  documentation on the new expiration date, the total documentation
  13-22  renewal fee is payable <After the initial year of documentation,
  13-23  the term of the documentation begins on January 1 and ends on
  13-24  December 31 of each year.  A renewal application must be completed
  13-25  during December of the year preceding the year for which the
  13-26  renewal is requested>.
  13-27        (e)  The department may accept an application for renewal
   14-1  that is filed after the close of the documentation period during a
   14-2  grace period not to exceed 60 days after the end of the
   14-3  documentation period.  The department may charge a late filing fee
   14-4  in an amount set by the midwifery board <not to exceed $25>. The
   14-5  late filing fee must be paid in addition to the application fee.
   14-6  The board shall adopt rules to establish the duration of the grace
   14-7  period and the amount of the late filing fee.
   14-8        SECTION 2.18.  The Texas Midwifery Act (Article 4512i,
   14-9  Vernon's Texas Civil Statutes) is amended by adding Section 18C to
  14-10  read as follows:
  14-11        Sec. 18C.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The
  14-12  midwifery board shall keep an information file about each complaint
  14-13  filed with the midwifery board.  The midwifery board's information
  14-14  file shall be kept current and contain a record for each complaint
  14-15  of:
  14-16              (1)  all persons contacted in relation to the
  14-17  complaint;
  14-18              (2)  a summary of findings made at each step of the
  14-19  complaint process;
  14-20              (3)  an explanation of the legal basis and reason for a
  14-21  complaint that is dismissed; and
  14-22              (4)  other relevant information.
  14-23        (b)  If a written complaint is filed with the midwifery board
  14-24  that the midwifery board has authority to resolve, the midwifery
  14-25  board, at least as frequently as quarterly and until final
  14-26  disposition of the complaint, shall notify the parties to the
  14-27  complaint of the status of the complaint unless the notice would
   15-1  jeopardize an undercover investigation.
   15-2        (c)  The midwifery board by rule shall adopt a form to
   15-3  standardize information concerning complaints made to the midwifery
   15-4  board.  The midwifery board by rule shall prescribe information to
   15-5  be provided to a person when the person files a complaint with the
   15-6  midwifery board.
   15-7        (d)  The midwifery board shall provide reasonable assistance
   15-8  to a person who wishes to file a complaint with the midwifery
   15-9  board.
  15-10        SECTION 2.19.  The Texas Midwifery Act (Article 4512i,
  15-11  Vernon's Texas Civil Statutes) is amended by adding Section 18D to
  15-12  read as follows:
  15-13        Sec. 18D.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
  15-14  midwifery board shall adopt rules concerning the investigation of a
  15-15  complaint filed with the midwifery board.  The rules adopted under
  15-16  this subsection shall:
  15-17              (1)  distinguish between categories of complaints;
  15-18              (2)  ensure that complaints are not dismissed without
  15-19  appropriate consideration;
  15-20              (3)  require that the midwifery board be advised of a
  15-21  complaint that is dismissed and that a letter be sent to the person
  15-22  who filed the complaint explaining the action taken on the
  15-23  dismissed complaint;
  15-24              (4)  ensure that the person who filed the complaint has
  15-25  an opportunity to explain the allegations made in the complaint;
  15-26  and
  15-27              (5)  prescribe guidelines concerning the categories of
   16-1  complaints that require the use of a private investigator and the
   16-2  procedures for the midwifery board to obtain the services of a
   16-3  private investigator.
   16-4        (b)  The midwifery board shall dispose of all complaints in a
   16-5  timely manner.  The midwifery board shall establish a schedule for
   16-6  conducting each phase of a complaint that is under the control of
   16-7  the midwifery board not later than the 30th day after the date the
   16-8  complaint is received by the midwifery board.  The schedule shall
   16-9  be kept in the information file for the complaint and all parties
  16-10  shall be notified of the projected time requirements for pursuing
  16-11  the complaint.  A change in the schedule must be noted in the
  16-12  complaint information file and all parties to the complaint must be
  16-13  notified not later than the seventh day after the date the change
  16-14  is made.
  16-15        (c)  The program coordinator shall notify the midwifery board
  16-16  of a complaint that extends beyond the time prescribed by the
  16-17  midwifery board for resolving the complaint so that the midwifery
  16-18  board may take necessary action on the complaint.
  16-19        SECTION 2.20.  The Texas Midwifery Act (Article 4512i,
  16-20  Vernon's Texas Civil Statutes) is amended by adding Section 18E to
  16-21  read as follows:
  16-22        Sec. 18E.  INFORMAL PROCEEDINGS.  (a)  The midwifery board by
  16-23  rule shall adopt procedures governing:
  16-24              (1)  informal disposition of a contested case under
  16-25  Section 13(e), Administrative Procedure and Texas Register Act
  16-26  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  16-27  subsequent amendments; and
   17-1              (2)  informal proceedings held in compliance with
   17-2  Section 18(c), Administrative Procedure and Texas Register Act
   17-3  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   17-4  subsequent amendments.
   17-5        (b)  Rules adopted under this section must provide the
   17-6  complainant and the documented midwife an opportunity to be heard
   17-7  and must require the presence of a representative of the office of
   17-8  the attorney general to advise the midwifery board or midwifery
   17-9  board's employees.
  17-10        SECTION 2.21.  The Texas Midwifery Act (Article 4512i,
  17-11  Vernon's Texas Civil Statutes) is amended by adding Section 18F to
  17-12  read as follows:
  17-13        Sec. 18F.  MONITORING OF DOCUMENTED MIDWIVES.  The midwifery
  17-14  board by rule shall develop a system for monitoring documented
  17-15  midwives' compliance with the requirements of this Act.  Rules
  17-16  adopted under this section shall include procedures for monitoring
  17-17  a documented midwife who is ordered by the midwifery board to
  17-18  perform certain acts to ascertain that the documented midwife
  17-19  performs the required acts and to identify and monitor documented
  17-20  midwives who represent a risk to the public.
  17-21             ARTICLE 3.  TEXAS STATE BOARD OF EXAMINERS OF
  17-22                     DIETITIANS AND NUTRITIONISTS
  17-23        SECTION 3.01.  Section 1, Licensed Dietitian Act (Article
  17-24  4512h, Vernon's Texas Civil Statutes), is amended to read as
  17-25  follows:
  17-26        Sec. 1.  Short Title.  This Act may be cited as the Licensed
  17-27  Dietitian and Nutritionist Act.
   18-1        SECTION 3.02.  Sections 2(4), (7), and (8), Licensed
   18-2  Dietitian Act (Article 4512h, Vernon's Texas Civil Statutes), are
   18-3  amended to read as follows:
   18-4              (4)  "Board" means the Texas State Board of Examiners
   18-5  of Dietitians and Nutritionists.
   18-6              (7)  "Licensed dietitian and nutritionist" means a
   18-7  person licensed under this Act.
   18-8              (8)  "Provisional licensed dietitian and nutritionist"
   18-9  means a person provisionally licensed under this Act.
  18-10        SECTION 3.03.  Section 3, Licensed Dietitian Act (Article
  18-11  4512h, Vernon's Texas Civil Statutes), is amended by amending
  18-12  Subsections (a), (b), and (d)-(h) and adding Subsections (i) and
  18-13  (j) to read as follows:
  18-14        (a)  The Texas State Board of Examiners of Dietitians and
  18-15  Nutritionists is created.
  18-16        (b)  The board is composed of nine members.  Three members
  18-17  must be members of the general public.  Six members must be
  18-18  dietitians and nutritionists licensed under this Act.
  18-19        (d)  The professional discipline of dietetics includes five
  18-20  primary areas of expertise:  clinical, educational, management,
  18-21  consultation, and community.  In making the six professional
  18-22  appointments to the board, the governor shall consider and attempt
  18-23  to accomplish a continuing balance of representation among these
  18-24  areas of expertise.  Following the fourth anniversary date of the
  18-25  effective date of this Act, a licensee eligible for appointment as
  18-26  a professional board member must have been a licensed dietitian and
  18-27  nutritionist under this Act for at least three years before his
   19-1  appointment to the board.
   19-2        (e)  A person is not eligible for appointment as a public
   19-3  member of the board if the person or <and> the person's spouse:
   19-4              (1)  is registered, certified, or <are not> licensed by
   19-5  an occupational regulatory agency in the field of dietetics <health
   19-6  care>;
   19-7              (2)  is <are not> employed by or participates <and do
   19-8  not participate> in the management of a <an agency or> business
   19-9  entity or other organization regulated by the board or receiving
  19-10  funds from the board <that provides health-care services or that
  19-11  sells, manufactures, or distributes health-care supplies or
  19-12  equipment>; <and>
  19-13              (3)  owns or controls, directly or indirectly, <do not
  19-14  own, control, or have a direct or indirect interest in> more than a
  19-15  10 percent interest in <of> a business entity or other organization
  19-16  regulated by the board or receiving funds from the board; or <that
  19-17  provides health-care services or that sells, manufactures, or
  19-18  distributes health-care supplies or equipment.>
  19-19              (4)  uses or receives a substantial amount of tangible
  19-20  goods, services, or funds from the board, other than compensation
  19-21  or reimbursement authorized by law for board membership,
  19-22  attendance, or expenses.
  19-23        (f)  Appointments <It is the intent of the legislature that
  19-24  the membership of the board reflect the historical and cultural
  19-25  diversity of the inhabitants of this state; therefore,
  19-26  appointments> to the board shall <should> be made without regard to
  19-27  the <discrimination based on> race, color, disability <creed>, sex,
   20-1  religion, age, or national origin<, or geographical distribution>
   20-2  of the appointees.
   20-3        (g)  An officer, employee, or paid consultant of a Texas
   20-4  trade association in the field of dietetics may not be a member or
   20-5  employee of the board who is exempt from the state's position
   20-6  classification plan or is compensated at or above the amount
   20-7  prescribed by the General Appropriations Act for step 1, salary
   20-8  group 17, of the position classification salary schedule  <A member
   20-9  or employee of the board may not be an officer, employee, or paid
  20-10  consultant of a trade association in the field of health care>.
  20-11        (h)  A person who is the spouse of an officer, manager, or
  20-12  paid consultant of a Texas trade association in the field of
  20-13  dietetics may not be a board member and may not be an employee of
  20-14  the board who is exempt from the state's position classification
  20-15  plan or is compensated at or above the amount prescribed by the
  20-16  General Appropriations Act for step 1, salary group 17, of the
  20-17  position classification salary schedule.
  20-18        (i)  For the purposes of this section, a Texas trade
  20-19  association is a nonprofit, cooperative, and voluntarily joined
  20-20  association of business or professional competitors in this state
  20-21  designed to assist its members and its industry or profession in
  20-22  dealing with mutual business or professional problems and in
  20-23  promoting their common interest.
  20-24        (j) <(h)>  A person may not serve as a member of the board or
  20-25  act as general counsel to the board if the person <who> is required
  20-26  to register as a lobbyist under Chapter 305, Government Code,
  20-27  because of the person's activities for compensation on behalf of a
   21-1  profession related to the operation of <in a health-related area
   21-2  may not serve as a member of the board or act as the general
   21-3  counsel to> the board.
   21-4        SECTION 3.04.  Section 4, Licensed Dietitian Act (Article
   21-5  4512h, Vernon's Texas Civil Statutes), is amended to read as
   21-6  follows:
   21-7        Sec. 4.  Grounds for Removal.  (a)  It is a ground for
   21-8  removal from the board if a member:
   21-9              (1)  does not have at the time of appointment the
  21-10  qualifications required for appointment to the board;
  21-11              (2)  does not maintain during service on the board the
  21-12  qualifications required for appointment to the board; <or>
  21-13              (3)  violates a prohibition established by this Act;
  21-14              (4)  cannot discharge the member's term for a
  21-15  substantial part of the term for which the member is appointed
  21-16  because of illness or disability; or
  21-17              (5)  is absent from more than half of the regularly
  21-18  scheduled board meetings that the member is eligible to attend
  21-19  during a calendar year unless the absence is excused by majority
  21-20  vote of the board.
  21-21        (b)  The validity of an action of the board is not affected
  21-22  by the fact that is is taken when <If> a ground for removal of a
  21-23  member of <from> the board exists<, the board's actions taken
  21-24  during the existence of the ground for removal are valid>.
  21-25        (c)  If the executive secretary has knowledge that a
  21-26  potential ground for removal exists, the executive secretary shall
  21-27  notify the chairman of the board of the ground.  The chairman shall
   22-1  then notify the governor that a potential ground for removal
   22-2  exists.
   22-3        SECTION 3.05.  The Licensed Dietitian Act (Article 4512h,
   22-4  Vernon's Texas Civil Statutes) is amended by adding Section 7A to
   22-5  read as follows:
   22-6        Sec. 7A.  PERSONNEL POLICIES.  (a)  The executive secretary
   22-7  or the secretary's designee shall develop an intra-agency career
   22-8  ladder program.  The program shall require intra-agency posting of
   22-9  all nonentry level positions concurrently with any public posting.
  22-10        (b)  The executive secretary or the secretary's designee
  22-11  shall develop a system of annual performance evaluations based on
  22-12  measurable job tasks.  All merit pay for board employees must be
  22-13  based on the system established under this subsection.
  22-14        SECTION 3.06.  The Licensed Dietitian Act (Article 4512h,
  22-15  Vernon's Texas Civil Statutes) is amended by adding Section 7B to
  22-16  read as follows:
  22-17        Sec. 7B.  PUBLIC INTEREST INFORMATION.  (a)  The board shall
  22-18  prepare information of public interest describing the functions of
  22-19  the board and the board's procedures by which complaints are filed
  22-20  with and resolved by the board.  The board shall make the
  22-21  information available to the public and appropriate state agencies.
  22-22        (b)  The board by rule shall establish methods by which
  22-23  consumers and service recipients are notified of the name, mailing
  22-24  address, and telephone number of the board for the purpose of
  22-25  directing complaints to the board.  The board may provide for that
  22-26  notification:
  22-27              (1)  on each registration form, application, or written
   23-1  contract for services of an individual or entity regulated by the
   23-2  board;
   23-3              (2)  on a sign prominently displayed in the place of
   23-4  business of each individual or entity regulated by the board; or
   23-5              (3)  in a bill for service provided by an individual or
   23-6  entity regulated by the board.
   23-7        (c)  The board shall list along with its regular telephone
   23-8  number the toll-free telephone number that may be called to present
   23-9  a complaint about a health professional if the toll-free number is
  23-10  established under other state law.
  23-11        SECTION 3.07.  The Licensed Dietitian Act (Article 4512h,
  23-12  Vernon's Texas Civil Statutes) is amended by adding Section 7C to
  23-13  read as follows:
  23-14        Sec. 7C.  EQUAL EMPLOYMENT OPPORTUNITY POLICIES.  (a)  The
  23-15  executive secretary or the secretary's designee shall prepare and
  23-16  maintain a written policy statement to assure implementation of a
  23-17  program of equal employment opportunity under which all personnel
  23-18  transactions are made without regard to race, color, disability,
  23-19  sex, religion, age, or national origin.  The policy statement must
  23-20  include:
  23-21              (1)  personnel policies, including policies relating to
  23-22  recruitment, evaluation, selection, application, training, and
  23-23  promotion of personnel that are in compliance with the Commission
  23-24  on Human Rights Act (Article 5221k, Vernon's Texas Civil Statutes)
  23-25  and its subsequent amendments;
  23-26              (2)  a comprehensive analysis of the board workforce
  23-27  that meets federal and state guidelines;
   24-1              (3)  procedures by which a determination can be made of
   24-2  significant underuse in the board workforce of all persons for whom
   24-3  federal or state guidelines encourage a more equitable balance; and
   24-4              (4)  reasonable methods to appropriately address those
   24-5  areas of underuse.
   24-6        (b)  A policy statement prepared under Subsection (a) of this
   24-7  section must cover an annual period, be updated annually, be
   24-8  reviewed by the Commission on Human Rights for compliance with
   24-9  Subsection (a)(1) of this section, and be filed with the governor's
  24-10  office.
  24-11        (c)  The governor's office shall deliver a biennial report to
  24-12  the legislature based on the information received under Subsection
  24-13  (b)  of this section.  The report may be made separately or as part
  24-14  of other biennial reports to the legislature.
  24-15        SECTION 3.08.  The Licensed Dietitian Act (Article 4512h,
  24-16  Vernon's Texas Civil Statutes) is amended by adding Section 7D to
  24-17  read as follows:
  24-18        Sec. 7D.  TRAINING; STANDARDS OF CONDUCT INFORMATION.  (a)
  24-19  Each board member shall comply with the board member training
  24-20  requirements established by any other state agency that is given
  24-21  authority to establish the requirements for the board.
  24-22        (b)  The board shall provide to its members and employees, as
  24-23  often as necessary, information regarding their qualifications for
  24-24  office or employment under this Act and their responsibilities
  24-25  under applicable laws relating to standards of conduct for state
  24-26  officers or employees.
  24-27        SECTION 3.09.  The Licensed Dietitian Act (Article 4512h,
   25-1  Vernon's Texas Civil Statutes) is amended by adding Section 7E to
   25-2  read as follows:
   25-3        Sec. 7E.  PUBLIC PARTICIPATION IN BOARD HEARINGS.  The board
   25-4  shall develop and implement policies that provide the public with a
   25-5  reasonable opportunity to appear before the board and to speak on
   25-6  any issue under the jurisdiction of the board.
   25-7        SECTION 3.10.  The Licensed Dietitian Act (Article 4512h,
   25-8  Vernon's Texas Civil Statutes) is amended by adding Section 7F to
   25-9  read as follows:
  25-10        Sec. 7F.  DIVISION OF RESPONSIBILITIES.  The board shall
  25-11  develop and implement policies that clearly define the respective
  25-12  responsibilities of the board and the staff of the board.
  25-13        SECTION 3.11.  The Licensed Dietitian Act (Article 4512h,
  25-14  Vernon's Texas Civil Statutes) is amended by adding Section 7G to
  25-15  read as follows:
  25-16        Sec. 7G.  PROGRAM ACCESSIBILITY.  The board shall prepare and
  25-17  maintain a written plan that describes how a person who does not
  25-18  speak English can be provided reasonable access to the board's
  25-19  programs.  The board shall also comply with federal and state laws
  25-20  for program and facility accessibility.
  25-21        SECTION 3.12.  Sections 8(a), (b), and (c), Licensed
  25-22  Dietitian Act (Article 4512h, Vernon's Texas Civil Statutes), are
  25-23  amended to read as follows:
  25-24        (a)  After consultation with the commissioner or the
  25-25  department, the board by rule shall set reasonable and necessary
  25-26  <the> fees <imposed by this Act> in amounts that are adequate to
  25-27  collect sufficient revenue to meet the expenses necessary to
   26-1  administer this Act <without accumulating an unnecessary surplus in
   26-2  the Licensed Dietitian Act fund created by this section>.  The fee
   26-3  amounts set by the board may be adjusted so that the total fees
   26-4  collected are sufficient to cover the cost of administering this
   26-5  Act.  The board may not set a fee for an amount less than the
   26-6  amount of that fee on September 1, 1993.
   26-7        (b)  The department shall receive and account for funds
   26-8  derived under this Act.  The funds shall be deposited in the State
   26-9  Treasury to the credit of a special fund to be known as the
  26-10  Licensed Dietitian and Nutritionist Act fund to be used only for
  26-11  the administration of this Act.
  26-12        (c)  The <Not later than January 1 each year, the> department
  26-13  shall file annually with <make a written report to> the governor<,
  26-14  lieutenant governor,> and presiding officer of each <speaker of
  26-15  the> house of the legislature a complete and detailed written
  26-16  report <representatives> accounting for all funds received and
  26-17  disbursed by the board or the department for the administration of
  26-18  this Act during the preceding fiscal year.  The annual report must
  26-19  be in the form and reported in the time provided by the General
  26-20  Appropriations Act.
  26-21        SECTION 3.13.  Section 9(a), Licensed Dietitian Act (Article
  26-22  4512h, Vernon's Texas Civil Statutes), is amended to read as
  26-23  follows:
  26-24        (a)  An applicant for a dietitian and nutritionist license
  26-25  must submit a sworn application, accompanied by the application
  26-26  fee.
  26-27        SECTION 3.14.  Section 10(a), Licensed Dietitian Act (Article
   27-1  4512h, Vernon's Texas Civil Statutes), is amended to read as
   27-2  follows:
   27-3        (a)  To qualify for a license under this Act, an applicant
   27-4  must pass a competency examination.  Examinations shall be prepared
   27-5  or approved by the board and administered to qualified applicants
   27-6  at least twice each calendar year.  The board shall have the
   27-7  written portion of the examination, if any, validated by an
   27-8  independent testing professional.
   27-9        SECTION 3.15.  Section 11(a), Licensed Dietitian Act (Article
  27-10  4512h, Vernon's Texas Civil Statutes), is amended to read as
  27-11  follows:
  27-12        (a)  A person who meets the licensing qualifications under
  27-13  this Act is entitled to receive a license certificate as a licensed
  27-14  dietitian and nutritionist.
  27-15        SECTION 3.16.  Section 12, Licensed Dietitian Act (Article
  27-16  4512h, Vernon's Texas Civil Statutes), is amended to read as
  27-17  follows:
  27-18        Sec. 12.  License Expiration; Renewal.  (a)  A license is
  27-19  valid for one year from the date it is issued and may be renewed
  27-20  annually.
  27-21        (b)  The board <of health> by rule may adopt a system under
  27-22  which licenses expire on various dates during the year.  For the
  27-23  year in which the license expiration date is changed, license fees
  27-24  payable on the original expiration date shall be prorated on a
  27-25  monthly basis so that each licensee shall pay only that portion of
  27-26  the license fee that is allocable to the number of months during
  27-27  which the license is valid.  On renewal of the license on the new
   28-1  expiration date, the total license renewal fee is payable.
   28-2        (c)  A person may renew an unexpired license by paying to the
   28-3  board before the expiration date of the license the required
   28-4  renewal fee <to the department before the expiration date of the
   28-5  license>.
   28-6        (d)  If a person's license has been expired for <not more
   28-7  than> 90 days or less, the person may renew the license by paying
   28-8  to the board <department> the required renewal fee and a <penalty>
   28-9  fee that is one-half of the examination <renewal> fee for the
  28-10  license.
  28-11        (e)  If a person's license has been expired for longer <more>
  28-12  than 90 days but less than one year <two years>, the person may
  28-13  renew the license by paying to the board <department> all unpaid
  28-14  renewal fees and a <penalty> fee that is equal to the examination
  28-15  <renewal> fee for the license.
  28-16        (f)  If a person's license has been expired one year <two
  28-17  years> or longer <more>, the person may not renew the license.  The
  28-18  person may obtain a new license by submitting to reexamination and
  28-19  complying with the current requirements and procedures for
  28-20  obtaining an original <a> license.  However, the board may renew
  28-21  without reexamination an expired license of a person who was
  28-22  licensed in this state, moved to another state, and is currently
  28-23  licensed and has been in practice in the other state for the two
  28-24  years preceding application.  The person must pay to the board a
  28-25  fee that is equal to the examination fee for the license.
  28-26        (g)  At <The department shall notify each licensee in writing
  28-27  of the license expiration date at> least 30 days before the
   29-1  expiration of a person's license, the board shall send written
   29-2  notice of the impending license expiration to the person at the
   29-3  licensee's last known address according to the records of the board
   29-4  <that date and shall obtain from the licensee a signed receipt
   29-5  confirming receipt of notification>.
   29-6        SECTION 3.17.  The Licensed Dietitian Act (Article 4512h,
   29-7  Vernon's Texas Civil Statutes) is amended by adding Section 12A to
   29-8  read as follows:
   29-9        Sec. 12A.  CONTINUING EDUCATION.  (a)  The board by rule
  29-10  shall establish a minimum number of hours of continuing education
  29-11  required to renew a license under this Act.  The board may assess
  29-12  the continuing education needs of licensees and may require
  29-13  licensees to attend continuing education courses specified by the
  29-14  board.
  29-15        (b)  The board shall identify the key factors for the
  29-16  competent performance by a licensee of the licensee's professional
  29-17  duties.  The board shall adopt a procedure to assess a licensee's
  29-18  participation in continuing education programs.
  29-19        SECTION 3.18.  Section 13, Licensed Dietitian Act (Article
  29-20  4512h, Vernon's Texas Civil Statutes), is amended to read as
  29-21  follows:
  29-22        Sec. 13.  TEMPORARY <PROVISIONAL> LICENSE; INACTIVE STATUS.
  29-23  (a)  The board by rule may provide for the issuance of a temporary
  29-24  license.
  29-25        (b)  The board by rule may provide for a person who holds a
  29-26  license under this Act to be placed on inactive status.  Rules
  29-27  adopted under this section shall include a time limit for a
   30-1  licensee to remain on inactive status.  <A license to use the title
   30-2  of provisional licensed dietitian may be issued by the board on the
   30-3  filing of an application, payment of an application fee, and the
   30-4  submission of evidence of the successful completion of the
   30-5  educational requirement under Section 9 of this Act.  The initial
   30-6  application shall be signed by the supervising licensed dietitian.>
   30-7        (c) <(b)>  A temporarily <provisional> licensed dietitian and
   30-8  nutritionist shall be under the supervision and direction of a
   30-9  licensed dietitian and nutritionist.
  30-10        (d) <(c)>  A person qualified for a temporary <provisional>
  30-11  license under this Act is entitled to receive a license certificate
  30-12  as a temporarily <provisional> licensed dietitian and nutritionist.
  30-13  A temporarily <provisional> licensed dietitian and nutritionist
  30-14  must comply with Subsections (b) and (c) of Section 11 of this Act.
  30-15        (e) <(d)>  A temporary <provisional> license is valid for one
  30-16  year from the date it is issued and may be renewed annually by the
  30-17  same procedures established for renewal under Section 12 of this
  30-18  Act if the application for renewal is signed by the supervising
  30-19  licensed dietitian and nutritionist.
  30-20        SECTION 3.19.  Section 14, Licensed Dietitian Act (Article
  30-21  4512h, Vernon's Texas Civil Statutes), is amended to read as
  30-22  follows:
  30-23        Sec. 14.  PROVISIONAL LICENSE <RECIPROCITY>.  (a)  On receipt
  30-24  of an application and application fee, the board may grant a
  30-25  provisional license to <shall waive the examination requirement
  30-26  for> an applicant who<, at the time of application>:
  30-27              (1)  is licensed in good standing as a dietitian and
   31-1  nutritionist in another state, the District of Columbia, or a
   31-2  territory of the United States that has licensing requirements that
   31-3  are substantially equivalent to the requirements of this Act;
   31-4  <registered by the Commission on Dietitic Registration as a
   31-5  registered dietitian; or>
   31-6              (2)  has passed a national or other examination
   31-7  recognized by the board relating to dietetics; and
   31-8              (3)  is sponsored by a person licensed by the board
   31-9  under this Act with whom the provisional licensee may practice
  31-10  under this section <holds a valid license or certificate as a
  31-11  licensed or registered dietitian issued by another state with which
  31-12  this state has a reciprocity agreement>.
  31-13        (b)  An applicant for a provisional license may be excused
  31-14  from the requirement of Subsection (a)(3) of this section if the
  31-15  board determines that compliance with that subsection constitutes a
  31-16  hardship to the applicant.
  31-17        (c)  A provisional license is valid until the date the board
  31-18  approves or denies the provisional licensee's application for a
  31-19  license.  The board shall issue a license under this Act to the
  31-20  holder of a provisional license under this section if:
  31-21              (1)  the provisional licensee passes the examination
  31-22  required by Section 10 of this Act;
  31-23              (2)  the board verifies that the provisional licensee
  31-24  has the academic and experience requirements for a license under
  31-25  this Act; and
  31-26              (3)  the provisional licensee satisfies any other
  31-27  license requirements under this Act.
   32-1        (d)  The board must complete the processing of a provisional
   32-2  licensee's application for a license not later than the 180th day
   32-3  after the date the provisional license is issued.
   32-4        SECTION 3.20.  Section 15(a), Licensed Dietitian Act (Article
   32-5  4512h, Vernon's Texas Civil Statutes), is amended to read as
   32-6  follows:
   32-7        (a)  A person may not use the title or represent or imply
   32-8  that he has the title of "licensed dietitian," "provisional
   32-9  licensed dietitian," "licensed dietitian and nutritionist," or
  32-10  "provisional licensed dietitian and nutritionist" <"licensed
  32-11  dietitian" or "provisional licensed dietitian"> or use the letters
  32-12  "LD," "PLD," "LDN," or "PLDN" <"LD" or "PLD"> and may not use any
  32-13  facsimile of those titles in any manner to indicate or imply that
  32-14  the person is a licensed dietitian, <or> provisional licensed
  32-15  dietitian, licensed dietitian and nutritionist, or provisional
  32-16  licensed dietitian and nutritionist, unless the person holds an
  32-17  appropriate license issued under this Act.
  32-18        SECTION 3.21.  Section 16, Licensed Dietitian Act (Article
  32-19  4512h, Vernon's Texas Civil Statutes), is amended to read as
  32-20  follows:
  32-21        Sec. 16.  Complaint File and Status.  (a)  The board
  32-22  <department> shall keep an information file about each complaint
  32-23  filed with the board <related to a licensee>.
  32-24        (b)  If a written complaint is filed with the board that the
  32-25  board or department has authority to resolve <relating to a
  32-26  licensee>, the board <department>, at least as frequently as
  32-27  quarterly and until final disposition of the complaint, shall
   33-1  notify the parties to the complaint of the status of the complaint
   33-2  unless the notice would jeopardize an undercover investigation
   33-3  <until final disposition of the complaint>.
   33-4        SECTION 3.22.  The Licensed Dietitian Act (Article 4512h,
   33-5  Vernon's Texas Civil Statutes) is amended by adding Section 16A to
   33-6  read as follows:
   33-7        Sec. 16A.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The board's
   33-8  information file shall be kept current and contain a record for
   33-9  each complaint of:
  33-10              (1)  all persons contacted in relation to the
  33-11  complaint;
  33-12              (2)  a summary of findings made at each step of the
  33-13  complaint process;
  33-14              (3)  an explanation of the legal basis and reason for a
  33-15  complaint that is dismissed; and
  33-16              (4)  other relevant information.
  33-17        (b)  The board by rule shall adopt a form to standardize
  33-18  information concerning complaints made to the board.  The board by
  33-19  rule shall prescribe information to be provided to a person when
  33-20  the person files a complaint with the board.
  33-21        (c)  The board shall provide reasonable assistance to a
  33-22  person who wishes to file a complaint with the board.
  33-23        SECTION 3.23.  The Licensed Dietitian Act (Article 4512h,
  33-24  Vernon's Texas Civil Statutes) is amended by adding Section 16B to
  33-25  read as follows:
  33-26        Sec. 16B.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
  33-27  board shall adopt rules concerning the investigation of a complaint
   34-1  filed with the board.  The rules adopted under this subsection
   34-2  shall:
   34-3              (1)  distinguish between categories of complaints;
   34-4              (2)  ensure that complaints are not dismissed without
   34-5  appropriate consideration;
   34-6              (3)  require that the board be advised of a complaint
   34-7  that is dismissed and that a letter be sent to the person who filed
   34-8  the complaint explaining the action taken on the dismissed
   34-9  complaint;
  34-10              (4)  ensure that the person who filed the complaint has
  34-11  an opportunity to explain the allegations made in the complaint;
  34-12  and
  34-13              (5)  prescribe guidelines concerning the categories of
  34-14  complaints that require the use of a private investigator and the
  34-15  procedures for the board to obtain the services of a private
  34-16  investigator.
  34-17        (b)  The board shall dispose of all complaints in a timely
  34-18  manner.  The board shall establish a schedule for conducting each
  34-19  phase of a complaint that is under the control of the board not
  34-20  later than the 30th day after the date the complaint is received by
  34-21  the board.  The schedule shall be kept in the information file for
  34-22  the complaint and all parties shall be notified of the projected
  34-23  time requirements for pursuing the complaint.  A change in the
  34-24  schedule must be noted in the complaint information file and all
  34-25  parties to the complaint must be notified not later than the
  34-26  seventh day after the date the change is made.
  34-27        (c)  The executive secretary of the board shall notify the
   35-1  board of a complaint that extends beyond the time prescribed by the
   35-2  board for resolving the complaint so that the board may take
   35-3  necessary action on the complaint.
   35-4        SECTION 3.24.  The Licensed Dietitian Act (Article 4512h,
   35-5  Vernon's Texas Civil Statutes) is amended by adding Section 16C to
   35-6  read as follows:
   35-7        Sec. 16C.  INFORMAL PROCEEDINGS.  (a)  The board by rule
   35-8  shall adopt procedures governing:
   35-9              (1)  informal disposition of a contested case under
  35-10  Section 13(e), Administrative Procedure and Texas Register Act
  35-11  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  35-12  subsequent amendments; and
  35-13              (2)  informal proceedings held in compliance with
  35-14  Section 18(c), Administrative Procedure and Texas Register Act
  35-15  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
  35-16  subsequent amendments.
  35-17        (b)  Rules adopted under this section must provide the
  35-18  complainant and the licensee an opportunity to be heard and must
  35-19  require the presence of a representative of the office of the
  35-20  attorney general to advise the board or board's employees.
  35-21        SECTION 3.25.  The Licensed Dietitian Act (Article 4512h,
  35-22  Vernon's Texas Civil Statutes) is amended by adding Section 16D to
  35-23  read as follows:
  35-24        Sec. 16D.  MONITORING OF LICENSEE.  The board by rule shall
  35-25  develop a system for monitoring licensee's compliance with the
  35-26  requirements of this Act.  Rules adopted under this section shall
  35-27  include procedures for monitoring a licensee who is ordered by the
   36-1  board to perform certain acts to ascertain that the licensee
   36-2  performs the required acts and to identify and monitor licensees
   36-3  who represent a risk to the public.
   36-4        SECTION 3.26.  Section 17, Licensed Dietitian Act (Article
   36-5  4512h, Vernon's Texas Civil Statutes), is amended by amending
   36-6  Subsection (a) and adding Subsections (e) and (f) to read as
   36-7  follows:
   36-8        (a)  The board shall revoke or suspend a license, place on
   36-9  probation a person whose <probate a> license has been suspended
  36-10  <suspension>, or reprimand a licensee for <on proof of>:
  36-11              (1)  any violation of this Act; or
  36-12              (2)  any violation of a rule or code of ethics adopted
  36-13  by the board.
  36-14        (e)  If a license suspension is probated, the board may
  36-15  require the licensee to:
  36-16              (1)  report regularly to the board on matters that are
  36-17  the basis of the probation;
  36-18              (2)  limit practice to the areas prescribed by the
  36-19  board; or
  36-20              (3)  continue or review continuing professional
  36-21  education until the licensee attains a degree of skill satisfactory
  36-22  to the board in those areas that are the basis of the probation.
  36-23        (f)  The schedule of sanctions adopted by the board by rule
  36-24  shall be used by the State Office of Administrative Hearings for
  36-25  any sanction imposed as the result of a hearing conducted by that
  36-26  office.
  36-27        SECTION 3.27.  Section 18, Licensed Dietitian Act (Article
   37-1  4512h, Vernon's Texas Civil Statutes), is amended to read as
   37-2  follows:
   37-3        Sec. 18.  DUTIES OF BOARD <OF HEALTH>.  For the purpose of
   37-4  implementing this Act, the board <of health>:
   37-5              (1)  shall request and receive any necessary assistance
   37-6  of state educational institutions or other state agencies;
   37-7              (2)  shall prepare information of consumer interest
   37-8  describing the regulatory functions of the board, the procedures by
   37-9  which consumer complaints are filed and resolved, and the
  37-10  profession of dietetics;
  37-11              (3)  shall prepare a registry of licensed dietitians
  37-12  and nutritionists and provisional licensed dietitians and
  37-13  nutritionists and make this information available to the general
  37-14  public, licensees, and appropriate state agencies; and
  37-15              (4)  may request the attorney general or the
  37-16  appropriate county or district attorney to institute a suit to
  37-17  enjoin a violation of this Act in addition to any other action,
  37-18  proceeding, or remedy authorized by law.
  37-19        SECTION 3.28.  Section 19, Licensed Dietitian Act (Article
  37-20  4512h, Vernon's Texas Civil Statutes), is amended to read as
  37-21  follows:
  37-22        Sec. 19.  Sunset provision.  The Texas State Board of
  37-23  Examiners of Dietitians and Nutritionists is subject to Chapter
  37-24  325, Government Code (Texas Sunset Act).  Unless continued in
  37-25  existence as provided by that chapter, the board is abolished
  37-26  September 1, 2005 <1993>.
  37-27                ARTICLE 4.  NURSING HOME ADMINISTRATION
   38-1        SECTION 4.01.  Section 2, Texas Nursing Home Administrators
   38-2  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes), is
   38-3  amended to read as follows:
   38-4        Sec. 2.  Definitions.  For the purposes of this Act and as
   38-5  used herein:
   38-6              (1)  "Board"  <"board"> means the Texas Board of
   38-7  Health.  <"Texas Board of Licensure for Nursing Home
   38-8  Administrators";>
   38-9              (2)  "Nursing home administrator"  <"nursing home
  38-10  administrator"> means the person who administers, manages,
  38-11  supervises, or is in general administrative charge of a nursing
  38-12  home, irrespective of whether or not such individual has an
  38-13  ownership interest in such home, and whether or not his functions
  38-14  and duties are shared with one or more other persons.<;>
  38-15              (3)  "Nursing home"  <"nursing home"> means any
  38-16  institution or facility now or hereafter licensed as a "nursing
  38-17  home" or "custodial care home" by the Texas State Department of
  38-18  Public Health under the provisions of Chapter 242, Health and
  38-19  Safety Code.<;>
  38-20              (4)  "Practice of nursing home administration"
  38-21  <"practice of nursing home administration"> means the performance
  38-22  of acts by any person which amounts to the administration,
  38-23  management, supervision, and general administrative charge of a
  38-24  nursing home, whether or not such functions and duties are shared
  38-25  with one or more individuals.
  38-26              (5)  "Department" means the Texas Department of Health.
  38-27              (6)  "Committee" means the Advisory Committee for
   39-1  Nursing Home Administrators.
   39-2        SECTION 4.02.  Section 3, Texas Nursing Home Administrators
   39-3  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes), is
   39-4  amended to read as follows:
   39-5        Sec. 3.  ADVISORY COMMITTEE; ADMINISTRATION OF ACT  <CREATION
   39-6  AND COMPOSITION OF BOARD>.  (1)  There is hereby created within the
   39-7  department the Advisory Committee <Texas Board of Licensure> for
   39-8  Nursing Home Administrators which shall consist of nine (9)
   39-9  members.  Six  <The Commissioner of Human Services, or his
  39-10  designee, the Commissioner of Health, or his designee, and the
  39-11  Executive Director of the Texas Department on Aging, or his
  39-12  designee, shall be ex officio nonvoting members of the board.  Such
  39-13  designees shall be chosen from those representatives of the
  39-14  respective departments who are actively assigned to and are engaged
  39-15  in work in the nursing home field.  One member shall be a physician
  39-16  duly licensed by the State of Texas; one member shall be an
  39-17  educator connected with a university program in public health or
  39-18  medical or nursing home care administration within the State of
  39-19  Texas or a psychiatrist whose field includes geriatric or
  39-20  institutional psychiatry, or a psychologist whose field includes
  39-21  clinical psychology or educational psychology.  Four (4)> members
  39-22  shall be <duly> licensed nursing home administrators of the State
  39-23  of Texas and three<; however, at least one of these four shall
  39-24  represent a nonproprietary nursing home.  Three (3)> members must
  39-25  be representatives of the general public who are not licensed under
  39-26  this Act.
  39-27        (2)  Appointments to the committee <board> shall be made by
   40-1  the board <Governor with the advice and consent of the senate>.
   40-2  Appointments <to the board> shall be made without regard to the
   40-3  race, color, disability <creed>, sex, religion, age, or national
   40-4  origin of the appointees.
   40-5        (3)  At least one nursing home administrator member of the
   40-6  committee <board> shall be connected with, and representative of, a
   40-7  non-proprietary home <and one administrator member may, in addition
   40-8  to being a qualified nursing home administrator, be also a duly
   40-9  licensed professional registered nurse licensed by the Board of
  40-10  Nurse Examiners of the State of Texas>.
  40-11        (4)  Members  <Appointed members> of the committee <board>
  40-12  serve staggered terms of six (6) years with the terms of three (3)
  40-13  members expiring on January 31 of each odd-number year.  Vacancies
  40-14  on the committee <board> shall be filled by appointment for the
  40-15  unexpired portion of the term.
  40-16        (5)  All <appointive> members of the committee <board> who
  40-17  are nursing home administrators shall hold degrees from an
  40-18  accredited four year college or university and shall have special
  40-19  interest, background, and experience in the field of care for the
  40-20  aged.  They shall be residents of the State of Texas and citizens
  40-21  of the United States and shall be of good character.
  40-22        In lieu of the degree requirement above specified an
  40-23  appointee who is a nursing home administrator representative may
  40-24  nevertheless qualify by submitting to the board <Governor>
  40-25  satisfactory evidence of two (2) years of practical experience as a
  40-26  nursing home administrator for each year, whether one or more, of
  40-27  four (4) years of college and such appointee shall receive credit
   41-1  toward the person's <his> qualifications for each full year of
   41-2  credits earned by the person <him> in an accredited college or
   41-3  university.
   41-4        (6)  Appointive members may be removed by the board
   41-5  <Governor> for just cause after notice and hearing.
   41-6        (7)  No person shall be eligible for appointment as a nursing
   41-7  home administrator representative unless the person <he> is the
   41-8  holder of a nursing home administrator's license under the
   41-9  provisions of this Act and is currently serving as a nursing home
  41-10  administrator.
  41-11        (8)  <No person shall be eligible for service on this board
  41-12  as a nursing home administrator representative unless he is the
  41-13  holder of a nursing home administrator's license under the
  41-14  provisions of this Act and is currently serving as a nursing home
  41-15  administrator.>
  41-16        <(9)>  All money collected under this Act shall be deposited
  41-17  in the state treasury in a designated separate account in the name
  41-18  of the department <board> and shall be subject to appropriation by
  41-19  the legislature only for use by the department <board>.
  41-20        (10)  The Advisory Committee <Texas Board of Licensure> for
  41-21  Nursing Home Administrators is subject to Chapter 325, Government
  41-22  Code (Texas Sunset Act).  Unless continued in existence as provided
  41-23  by that chapter, the committee <board> is abolished and this Act
  41-24  expires September 1, 2005 <1993>.
  41-25        (11)  The committee <board> is subject to the open meetings
  41-26  law, Chapter 271, Acts of the 60th Legislature, Regular Session,
  41-27  1967, as amended (Article 6252-17, Vernon's Texas Civil Statutes),
   42-1  and the Administrative Procedure and Texas Register Act, as amended
   42-2  (Article 6252-13a, Vernon's Texas Civil Statutes).
   42-3        SECTION 4.03.  Section 6, Texas Nursing Home Administrators
   42-4  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes), is
   42-5  amended to read as follows:
   42-6        Sec. 6.  FUNCTIONS AND DUTIES OF THE BOARD AND DEPARTMENT.
   42-7  (a)  It shall be the function and duty of the board and department,
   42-8  as appropriate, to:
   42-9              (1)  develop, impose, and enforce standards which must
  42-10  be met by individuals in order to receive a license as a nursing
  42-11  home administrator and standards which must be met by licensees,
  42-12  which standards shall be designed to insure that nursing home
  42-13  administrators will be individuals who are of good character and
  42-14  are otherwise suitable, and who, by training or experience in the
  42-15  fields of gerontology and institutional administration, are
  42-16  qualified to serve as nursing home administrators and
  42-17  satisfactorily perform the duties of nursing home administrators;
  42-18              (2)  develop and apply appropriate techniques,
  42-19  including examinations and investigations, for determining whether
  42-20  an individual meets such standards;
  42-21              (3)  issue licenses to individuals determined, after
  42-22  application of such techniques, to meet such standards, and revoke
  42-23  or suspend licenses previously issued by the board in any case
  42-24  where the individual holding any such license is determined
  42-25  substantially to have failed to conform to the requirements of such
  42-26  standards;
  42-27              (4)  establish and carry out procedures designed to
   43-1  insure that individuals licensed as nursing home administrators
   43-2  will, during any period that they serve as such, comply with the
   43-3  requirements of such standards;
   43-4              (5)  receive, investigate, and take appropriate action
   43-5  with respect to, any charge or complaint filed with the board to
   43-6  the effect that any individual licensed as a nursing home
   43-7  administrator has failed to comply with the requirements of such
   43-8  standards;
   43-9              (6)  conduct a continuing study and investigation of
  43-10  nursing homes and administrators of nursing homes within the State
  43-11  with a view to the improvement of the standards imposed for the
  43-12  licensing of such administrators and of procedures and methods for
  43-13  the enforcement of such standards with respect to administrators of
  43-14  nursing homes who have been licensed as such;
  43-15              (7)  conduct or cause to be conducted, one or more
  43-16  courses of instruction and training sufficient to meet the
  43-17  requirements of this Act, make provisions for the conduct of such
  43-18  courses and their accessibility to residents of this State, and
  43-19  establish and collect reasonable fees to be deposited into the
  43-20  general fund for instruction or training courses conducted by the
  43-21  board in amounts determined by the board to be sufficient to cover
  43-22  the costs of the courses, unless it finds that there are a
  43-23  sufficient number of courses conducted by others within this State
  43-24  to meet the needs of the State.  In lieu thereof the board may
  43-25  approve courses conducted within and without the State as
  43-26  sufficient to meet the education and training requirements of this
  43-27  Act; and
   44-1              (8)  on the written request of a person<, provide to
   44-2  each individual> who fails an examination administered by the
   44-3  department, the department shall furnish the person with <board> an
   44-4  analysis of the person's <individual's> performance on the
   44-5  examination.
   44-6        (b)  The department shall have the written portion of the
   44-7  examination, if any, validated by an independent testing
   44-8  professional.
   44-9        (c)  Not later than the 30th day after the date on which a
  44-10  licensing examination is administered under this Act, the
  44-11  department shall notify each examinee of the results of the
  44-12  examination.  However, if an examination is graded or reviewed by a
  44-13  national testing service, the department shall notify examinees of
  44-14  the results of the examination not later than the 14th day after
  44-15  the date on which the department receives the results from the
  44-16  testing service.  If the notice of examination results graded or
  44-17  reviewed by a national testing service will be delayed for longer
  44-18  than 90 days after the examination date, the department shall
  44-19  notify the examinee of the reason for the delay before the 90th
  44-20  day.
  44-21        SECTION 4.04.  Section 10, Texas Nursing Home Administrators
  44-22  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes), is
  44-23  amended to read as follows:
  44-24        Sec. 10.  Licenses and Fees.  (1)  The department <Board>
  44-25  shall license nursing home administrators in accordance with rules
  44-26  and regulations issued, and from time to time revised by it.  A
  44-27  nursing home administrator's license shall not be transferable and
   45-1  shall be valid for the period issued until surrendered for
   45-2  cancellation or suspended or revoked for violation of this Act or
   45-3  rules and regulations issued pursuant hereto.
   45-4        (2)  <Every holder of a nursing home administrator's license
   45-5  shall renew it biennially, by making application to the board.  The
   45-6  license remains valid and is subject to renewal for 30 days after
   45-7  the expiration date of the license.  The board shall notify each
   45-8  person licensed under this Act of the expiration date of the
   45-9  person's license and the amount of the fee that is required for its
  45-10  renewal.  The notice shall be mailed at least 30 days before the
  45-11  expiration date of the license.  A person renews an unexpired
  45-12  license or a license that has been expired for 30 days or less by
  45-13  paying to the board the renewal fee.  A person renews a license
  45-14  that has been expired for more than 30 days but less than one year
  45-15  by paying to the board the renewal fee plus $50.  A person may not
  45-16  renew a license that has been expired for one year or more, but the
  45-17  person may obtain a new license by applying for the license in the
  45-18  manner that a person applies for an original license.>  Renewals of
  45-19  licenses shall be granted as a matter of course, unless the
  45-20  department <board> finds, after due notice and hearing, that the
  45-21  applicant has acted or failed to act in such a manner or under
  45-22  circumstances, as would constitute grounds for suspension or
  45-23  revocation of a license.
  45-24        (3)  Each person licensed as a nursing home administrator
  45-25  shall pay an initial license fee to be fixed by the board <which
  45-26  shall not exceed $150>.  Renewal licenses shall be issued
  45-27  biennially at a fee to be set by the board <which shall not exceed
   46-1  $150 for the biennium>.  Reasonable fees shall be set by the board
   46-2  for the issuance of copies of public records in its office as well
   46-3  as for certificates or transcripts and duplicates of lost
   46-4  instruments.  Each applicant for examination and license shall
   46-5  accompany the application with an examination fee set by the board
   46-6  <not to exceed $150> which shall not be refundable, for
   46-7  investigation, processing, and testing purposes.  Upon the
   46-8  certification by any department, division, board or agency of the
   46-9  State of Texas of the necessity therefor, all examination fees and
  46-10  license fees provided for herein shall be waived for any employee
  46-11  of such state entity so long as such person remains an employee of
  46-12  the State of Texas and does not serve as a nursing home
  46-13  administrator of a nursing home operated other than by such state
  46-14  entity.  The board shall set the fees in amounts that are
  46-15  reasonable and necessary to produce sufficient money for
  46-16  administering this Act.  The fee amounts set by the board may be
  46-17  adjusted so that the total fees collected are sufficient to cover
  46-18  the cost of administering this Act.  The board may not set a fee
  46-19  for an amount less than the amount of that fee on September 1,
  46-20  1993.
  46-21        (4)  The department <board> may issue a nursing home
  46-22  administrator's license <for the regular fee> to any person who
  46-23  holds a current license as a nursing home administrator from
  46-24  another jurisdiction as provided by Section 10D of this Act<,
  46-25  provided that the board finds that the standards for licensure in
  46-26  such other jurisdiction are at least the substantial equivalent of
  46-27  those prevailing in this State; and that the applicant is otherwise
   47-1  qualified; and that the other state gives similar recognition and
   47-2  endorsement to nursing home administrators licenses of the State of
   47-3  Texas>.
   47-4        (5)  The department <board> shall have authority to receive
   47-5  and disburse funds received pursuant to Section 1908(e)(1) of the
   47-6  Social Security Act or from any other Federal source of funds or
   47-7  grants for the furtherance of board duties and responsibilities
   47-8  hereunder.
   47-9        SECTION 4.05.  The Texas Nursing Home Administrators
  47-10  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  47-11  amended by adding Section 10B to read as follows:
  47-12        Sec. 10B.  TEMPORARY LICENSE; INACTIVE STATUS.  (a)  The
  47-13  board by rule may provide for the issuance of a temporary license.
  47-14        (b)  The board by rule may provide for a person who holds a
  47-15  license under this Act to be placed on inactive status.  Rules
  47-16  adopted under this section shall include a time limit for a
  47-17  licensee to remain on inactive status.
  47-18        SECTION 4.06.  The Texas Nursing Home Administrators
  47-19  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  47-20  amended by adding Section 10C to read as follows:
  47-21        Sec. 10C.  MANDATORY CONTINUING EDUCATION.  (a)  The board by
  47-22  rule shall establish a minimum number of hours of continuing
  47-23  education required to renew a license under this Act.  The
  47-24  department may assess the continuing education needs of licensees
  47-25  and may require licensees to attend continuing education courses
  47-26  specified by the department.
  47-27        (b)  The department shall identify the key factors for the
   48-1  competent performance by a licensee of the licensee's professional
   48-2  duties.  The board shall adopt a procedure to assess a licensee's
   48-3  participation in continuing education programs.
   48-4        SECTION 4.07.  The Texas Nursing Home Administrators
   48-5  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
   48-6  amended by adding Section 10D to read as follows:
   48-7        Sec. 10D.  PROVISIONAL LICENSE.  (a)  On application, the
   48-8  board shall grant a provisional license under this Act.  An
   48-9  applicant for a provisional license under this section must:
  48-10              (1)  be licensed in good standing as a nursing home
  48-11  administrator in another state, the District of Columbia, or a
  48-12  territory of the United States that has licensing requirements that
  48-13  are substantially equivalent to the requirements of this Act;
  48-14              (2)  have passed a national or other examination
  48-15  recognized by the board relating to the practice of nursing home
  48-16  administration; and
  48-17              (3)  be sponsored by a person licensed under this Act
  48-18  with whom the provisional licensee may practice under this section.
  48-19        (b)  An applicant for a provisional license may be excused
  48-20  from the requirement of Subsection (a)(3) of this section if the
  48-21  board determines that compliance with that subsection constitutes a
  48-22  hardship to the applicant.
  48-23        (c)  A provisional license is valid until the date the board
  48-24  approves or denies the provisional licensee's application for a
  48-25  license.  The board shall issue a license under this Act to the
  48-26  holder of a provisional license under this section if:
  48-27              (1)  the provisional licensee passes the examination
   49-1  required by Section 6 of this Act;
   49-2              (2)  the board verifies that the provisional licensee
   49-3  has the academic and experience requirements for a license under
   49-4  this Act; and
   49-5              (3)  the provisional licensee satisfies any other
   49-6  license requirements under this Act.
   49-7        (d)  The board must complete the processing of a provisional
   49-8  licensee's application for a license not later than the 180th day
   49-9  after the date the provisional license is issued.
  49-10        SECTION 4.08.  The Texas Nursing Home Administrators
  49-11  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  49-12  amended by adding Section 10E to read as follows:
  49-13        Sec. 10E.  LICENSE RENEWAL.  (a)  A person may renew an
  49-14  unexpired license by paying to the board before the expiration of
  49-15  the license the required renewal fee.
  49-16        (b)  If a person's license has been expired for 90 days or
  49-17  less, the person may renew the license by paying to the board the
  49-18  required renewal fee and a fee that is one-half of the examination
  49-19  fee for the license.
  49-20        (c)  If a person's license has been expired for longer than
  49-21  90 days but less than one year, the person may renew the license by
  49-22  paying to the board all unpaid renewal fees and a fee that is equal
  49-23  to the examination fee for the license.
  49-24        (d)  If a person's license has been expired for one year or
  49-25  longer, the person may not renew the license.  The person may
  49-26  obtain a new license by submitting to reexamination and complying
  49-27  with the requirements and procedures for obtaining an original
   50-1  license.  However, the board may renew without reexamination an
   50-2  expired license of a person who was licensed in this state, moved
   50-3  to another state, and is currently licensed and has been in
   50-4  practice in the other state for the two years preceding
   50-5  application.  The person must pay to the board a fee that is equal
   50-6  to the examination fee for the license.
   50-7        (e)  At least 30 days before the expiration of a person's
   50-8  license, the board shall send written notice of the impending
   50-9  license expiration to the person at the licensee's last known
  50-10  address according to the records of the board.
  50-11        SECTION 4.09.  Sections 11(1), (2), and (5)-(11), Texas
  50-12  Nursing Home Administrators Licensure Act (Article 4442d, Vernon's
  50-13  Texas Civil Statutes), are amended to read as follows:
  50-14        (1)  The department <board> shall be authorized to revoke,
  50-15  suspend, or refuse to renew<,> a nursing home administrator's
  50-16  license, assess an administrative penalty, issue a written
  50-17  reprimand, require participation in continuing education, or place
  50-18  a licensed nursing home administrator on probation after due notice
  50-19  and hearing upon the following grounds or any of them:
  50-20              (a)  upon proof that such licensee has wilfully or
  50-21  repeatedly violated any of the provisions of this Act or the rules
  50-22  adopted in accordance therewith;
  50-23              (b)  upon proof that such licensee has wilfully or
  50-24  repeatedly acted in a manner inconsistent with the health and
  50-25  safety of the patients of the home of which he is administrator;
  50-26              (c)  upon proof that the licensee obtained or attempted
  50-27  to obtain a license through misrepresentation or deceit, or by
   51-1  making a material misstatement of fact in a license application;
   51-2              (d)  upon proof of the intemperate use of alcohol or
   51-3  drugs which in the opinion of the board creates a hazard to
   51-4  patients;
   51-5              (e)  upon proof of a judgment of a court of competent
   51-6  jurisdiction finding the licensee insane;
   51-7              (f)  upon proof that such licensee has been convicted
   51-8  in a court of competent jurisdiction of a misdemeanor or a felony
   51-9  involving moral turpitude; and
  51-10              (g)  upon proof that the licensee has been negligent or
  51-11  incompetent in his duties as a nursing home administrator.
  51-12        (2)  The department <board> shall have jurisdiction to hear
  51-13  all disciplinary charges brought under the provisions of this Act
  51-14  against persons licensed as nursing home administrators and upon
  51-15  such hearings shall determine such charges upon their merits.
  51-16  Proceedings under this Act shall be begun by filing with the
  51-17  department <board> written charges under oath.  Such charges may be
  51-18  preferred by any person and after notice in writing of not less
  51-19  than fifteen (15) full days, stating the place and date of the
  51-20  hearing, accompanied by a copy of the complaint or charges, the
  51-21  board, or a hearing examiner designated by the board <majority
  51-22  thereof>, shall hold a hearing on said charges, cause a written
  51-23  record to be made of the evidence given at the hearing, accord the
  51-24  person charged a right to present evidence, be represented by an
  51-25  attorney, and to cross-examine the witnesses.  In this connection
  51-26  the board shall be authorized to issue subpoenas for witnesses at
  51-27  the hearing, either at the request of the person cited or on behalf
   52-1  of the board or its representative; to compel the attendance of
   52-2  witnesses, and administer oaths to witnesses.  Disobedience of a
   52-3  subpoena duly issued by the board or by its executive director
   52-4  under its direction, shall constitute a contempt of the board which
   52-5  shall be enforceable by any district court sitting in the county in
   52-6  which the hearing is being held upon petition of the board and the
   52-7  presentation to the court of evidence of wilful disobedience and if
   52-8  the district judge is of the opinion and finds that the subpoena
   52-9  was wilfully disobeyed, such judge shall be authorized to punish a
  52-10  subpoenaed witness in like manner and to the extent provided in
  52-11  like cases in civil actions in the district courts of Texas.
  52-12        (5)  The schedule of sanctions adopted by the board by rule
  52-13  shall be used by the department for any sanction imposed as the
  52-14  result of a hearing conducted under this Act.  <If a written
  52-15  complaint is filed with the board or the Texas Board of Health
  52-16  relating to a licensee under this Act, the board, at least as
  52-17  frequently as quarterly, shall notify the complainant of the status
  52-18  of the complaint until the complaint is finally resolved.>
  52-19        <(6)  The board must within 31 days from the date of filing
  52-20  of the complaint determine whether a hearing shall be held on such
  52-21  complaint or whether such complaint shall be dismissed and shall
  52-22  notify both the person who filed the complaint and the person
  52-23  against whom the complaint has been filed of the board's decision.>
  52-24        <(7)  If the board determines that a hearing should be held
  52-25  on a complaint, the board shall designate a hearing officer to
  52-26  conduct the hearing on the complaint.  The hearing shall be held
  52-27  within 61 days from the date that the written complaint was filed
   53-1  unless such time is extended in writing by the board.>
   53-2        <(8)  The hearing officer shall keep a complete record of the
   53-3  hearing and shall transmit the record to the board when completed.>
   53-4        <(9)  The hearing officer shall forward to the board the
   53-5  complete record of the hearing not later than 30 days from the date
   53-6  of the hearing along with the hearing officer's recommendations
   53-7  concerning what disciplinary action, if any, should be taken by the
   53-8  board with respect to the complaint.>
   53-9        <(10)  The board shall take action on such complaint by
  53-10  written order not later than the 120th day following the filing of
  53-11  the complaint, unless the date for hearing was delayed pursuant to
  53-12  Subsection (7) of this section, in which case the deadline for the
  53-13  order is extended accordingly.  Copies of the order and the record
  53-14  of the hearing shall be filed together in the office of the board,
  53-15  indexed, and made available for public inspection.>
  53-16        <(11)  The board shall maintain an information file on each
  53-17  complaint it receives.>
  53-18        SECTION 4.10.  The Texas Nursing Home Administrators
  53-19  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  53-20  amended by adding Section 11B to read as follows:
  53-21        Sec. 11B.  ADMINISTRATIVE PENALTIES.  (a)  The department may
  53-22  assess an administrative penalty against a person holding a license
  53-23  under this Act who violates a provision of this Act or a rule
  53-24  adopted by the board under this Act as provided by this section.
  53-25        (b)  The penalty for each violation may be in an amount not
  53-26  to exceed $2,500.  Each day a violation continues or occurs may be
  53-27  considered a separate violation for purposes of penalty assessment.
   54-1        (c)  In determining the amount of the penalty, the
   54-2  commissioner shall consider:
   54-3              (1)  the seriousness of the violation, including the
   54-4  nature, circumstances, extent, and gravity of the prohibited acts
   54-5  and the hazard or potential hazard posed to the health or safety of
   54-6  the public;
   54-7              (2)  the economic damage to property or the environment
   54-8  caused by the violation;
   54-9              (3)  the history of previous violations;
  54-10              (4)  the amount necessary to deter future violations;
  54-11              (5)  efforts to correct the violation; and
  54-12              (6)  any other matter that justice may require.
  54-13        (d)  If, after investigation of a possible violation and the
  54-14  facts surrounding that possible violation, the commissioner
  54-15  determines that a violation has occurred, the commissioner may
  54-16  issue a violation report stating the facts on which the conclusion
  54-17  that a violation occurred is based, recommending that an
  54-18  administrative penalty under this section be imposed on the person
  54-19  charged and recommending the amount of that proposed penalty.  The
  54-20  commissioner shall base the recommended amount of the proposed
  54-21  penalty on the seriousness of the violation determined by
  54-22  consideration of the factors set forth in Subsection (c) of this
  54-23  section.
  54-24        (e)  Not later than the 14th day after the date on which the
  54-25  report is issued, the commissioner shall give written notice of the
  54-26  report to the person charged.  The notice shall include a brief
  54-27  summary of the charges, a statement of the amount of the penalty
   55-1  recommended, and a statement of the right of the person charged to
   55-2  a hearing on the occurrence of the violation or the amount of the
   55-3  penalty, or both the occurrence of the violation and the amount of
   55-4  the penalty.
   55-5        (f)  Not later than the 20th day after the date on which
   55-6  notice is received, the person charged may accept the determination
   55-7  of the commissioner made under Subsection (d) of this section,
   55-8  including the recommended penalty, or make a written request for a
   55-9  hearing on the determination.
  55-10        (g)  If the person charged with the violation accepts the
  55-11  determination of the commissioner, the board shall issue an order
  55-12  approving the determination and ordering the payment of the
  55-13  recommended penalty.
  55-14        (h)  If the person charged requests a hearing or fails to
  55-15  timely respond to the notice, the commissioner shall set a hearing
  55-16  and give notice of the hearing.  The hearing shall be held by a
  55-17  hearing examiner designated by the department.  The hearing
  55-18  examiner shall make findings of fact and conclusions of law and
  55-19  promptly issue to the department a proposal for decision as to the
  55-20  occurrence of the violation, including a recommendation as to the
  55-21  amount of the proposed penalty if a penalty is warranted.  Based on
  55-22  the findings of fact, conclusions of law, and recommendations of
  55-23  the hearing examiner, the board by order may find a violation has
  55-24  occurred and may assess a penalty or may find that no violation has
  55-25  occurred.  All proceedings under this subsection are subject to the
  55-26  Administrative Procedure and Texas Register Act (Article 6252-13a,
  55-27  Vernon's Texas Civil Statutes) and its subsequent amendments.
   56-1        (i)  The commissioner shall give notice of the board's order
   56-2  to the person charged.  The notice shall include:
   56-3              (1)  the findings of fact and conclusions of law
   56-4  separately stated;
   56-5              (2)  the amount of the penalty ordered, if any;
   56-6              (3)  a statement of the right of the person charged to
   56-7  judicial review of the board's order, if any; and
   56-8              (4)  other information required by law.
   56-9        (j)  Within the 30-day period immediately following the day
  56-10  on which the order becomes final as provided by Section 16(c),
  56-11  Administrative Procedure and Texas Register Act (Article 6252-13a,
  56-12  Vernon's Texas Civil Statutes), and its subsequent amendments, the
  56-13  person charged with the penalty shall:
  56-14              (1)  pay the penalty in full; or
  56-15              (2)  if the person files a petition for judicial review
  56-16  contesting either the amount of the penalty or the fact of the
  56-17  violation or contesting both the fact of the violation and the
  56-18  amount of the penalty:
  56-19                    (A)  forward the amount to the commissioner for
  56-20  placement in an escrow account; or
  56-21                    (B)  in lieu of payment into escrow, post with
  56-22  the commissioner a supersedeas bond in a form approved by the
  56-23  commissioner for the amount of the penalty, the bond to be
  56-24  effective until all judicial review of the order or decision is
  56-25  final.
  56-26        (k)  If a person charged is financially unable to either
  56-27  forward the amount of the penalty for placement in an escrow
   57-1  account or post a supersedeas bond for the amount of the penalty,
   57-2  the person may satisfy the requirements of Subsection (j)(2) of
   57-3  this section by filing with the commissioner an affidavit sworn by
   57-4  the person charged, stating that the person is financially unable
   57-5  to either forward the amount of the penalty or post a bond.
   57-6        (l)  Failure to forward the money to or to post the bond or
   57-7  file the affidavit with the commissioner within the time provided
   57-8  by Subsection (j) of this section results in a waiver of all legal
   57-9  rights to judicial review.  Also, if the person charged fails to
  57-10  pay the penalty in full as provided under Subsection (j)(1) of this
  57-11  section or forward the money, post the bond, or file the affidavit
  57-12  as provided by Subsection (j) or (k) of this section, the
  57-13  commissioner may forward the matter to the attorney general for
  57-14  enforcement.
  57-15        (m)  Judicial review of the order or decision of the
  57-16  commission assessing the penalty shall be under the substantial
  57-17  evidence rule and shall be instituted by filing a petition with a
  57-18  district court in Travis County, as provided by Section 19,
  57-19  Administrative Procedure and Texas Register Act (Article 6252-13a,
  57-20  Vernon's Texas Civil Statutes), and its subsequent amendments.
  57-21        (n)  If the penalty is reduced or not assessed by the court,
  57-22  the commissioner shall remit to the person charged the appropriate
  57-23  amount plus accrued interest if the penalty has been paid or shall
  57-24  execute a release of the bond if a supersedeas bond has been
  57-25  posted.  The accrued interest on amounts remitted by the
  57-26  commissioner under this subsection shall be paid at a rate equal to
  57-27  the rate charged on loans to depository institutions by the New
   58-1  York Federal Reserve Bank and shall be paid for the period
   58-2  beginning on the date the penalty is paid to the commissioner under
   58-3  Subsection (j) of this section and ending on the date the penalty
   58-4  is remitted.
   58-5        (o)  A penalty collected under this section for a violation
   58-6  by a person licensed or permitted under this code shall be
   58-7  deposited in the state general revenue fund.
   58-8        SECTION 4.11.  The Texas Nursing Home Administrators
   58-9  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  58-10  amended by adding Section 11C to read as follows:
  58-11        Sec. 11C.  CIVIL PENALTY.  A person who violates this Act is
  58-12  liable to the state for a civil penalty of $1,000 for each day of
  58-13  violation.  At the request of the department, the attorney general
  58-14  shall bring an action to recover a civil penalty established by
  58-15  this section.
  58-16        SECTION 4.12.  The Texas Nursing Home Administrators
  58-17  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  58-18  amended by adding Section 11D to read as follows:
  58-19        Sec. 11D.  WRITTEN REPRIMAND AND CONTINUING EDUCATION AS
  58-20  SANCTIONS.  In addition to the other disciplinary actions
  58-21  authorized under this Act, the department may issue a written
  58-22  reprimand to a licensee who violates this Act or require that a
  58-23  licensee who violates this Act participate in continuing education
  58-24  programs.  The department shall specify the continuing education
  58-25  programs that may be attended and the number of hours that must be
  58-26  completed by an individual licensee to fulfill the requirements of
  58-27  this section.
   59-1        SECTION 4.13.  The Texas Nursing Home Administrators
   59-2  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
   59-3  amended by adding Section 11E to read as follows:
   59-4        Sec. 11E.  TERMS OF PROBATION.  If a license suspension is
   59-5  probated, the department may require the licensee to:
   59-6              (1)  report regularly to the department on matters that
   59-7  are the basis of the probation;
   59-8              (2)  limit practice to the areas prescribed by the
   59-9  department; or
  59-10              (3)  continue or review continuing professional
  59-11  education until the licensee attains a degree of skill satisfactory
  59-12  to the department in those areas that are the basis of the
  59-13  probation.
  59-14        SECTION 4.14.  The Texas Nursing Home Administrators
  59-15  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  59-16  amended by adding Section 11F to read as follows:
  59-17        Sec. 11F.  COMPLAINT PROCEDURE IN GENERAL.  (a)  The
  59-18  department shall keep an information file about each complaint
  59-19  filed with the department.  The department's information file shall
  59-20  be kept current and contain a record for each complaint of:
  59-21              (1)  all persons contacted in relation to the
  59-22  complaint;
  59-23              (2)  a summary of findings made at each step of the
  59-24  complaint process;
  59-25              (3)  an explanation of the legal basis and reason for a
  59-26  complaint that is dismissed; and
  59-27              (4)  other relevant information.
   60-1        (b)  If a written complaint is filed with the department that
   60-2  the department has authority to resolve, the department, at least
   60-3  as frequently as quarterly and until final disposition of the
   60-4  complaint, shall notify the parties to the complaint of the status
   60-5  of the complaint unless the notice would jeopardize an undercover
   60-6  investigation.
   60-7        (c)  The board by rule shall adopt a form to standardize
   60-8  information concerning complaints made to the department.  The
   60-9  board by rule shall prescribe information to be provided to a
  60-10  person when the person files a complaint with the department.
  60-11        (d)  The department shall provide reasonable assistance to a
  60-12  person who wishes to file a complaint with the department.
  60-13        SECTION 4.15.  The Texas Nursing Home Administrators
  60-14  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  60-15  amended by adding Section 11G to read as follows:
  60-16        Sec. 11G.  COMPLAINT INVESTIGATION AND DISPOSITION.  (a)  The
  60-17  board shall adopt rules concerning the investigation of a complaint
  60-18  filed with the department.  The rules adopted under this subsection
  60-19  shall:
  60-20              (1)  distinguish between categories of complaints;
  60-21              (2)  ensure that complaints are not dismissed without
  60-22  appropriate consideration;
  60-23              (3)  require that the department be advised of a
  60-24  complaint that is dismissed and that a letter be sent to the person
  60-25  who filed the complaint explaining the action taken on the
  60-26  dismissed complaint;
  60-27              (4)  ensure that the person who filed the complaint has
   61-1  an opportunity to explain the allegations made in the complaint;
   61-2  and
   61-3              (5)  prescribe guidelines concerning the categories of
   61-4  complaints that require the use of a private investigator and the
   61-5  procedures for the department to obtain the services of a private
   61-6  investigator.
   61-7        (b)  The department shall dispose of all complaints in a
   61-8  timely manner.  The department shall establish a schedule for
   61-9  conducting each phase of a complaint that is under the control of
  61-10  the department not later than the 30th day after the date the
  61-11  complaint is received by the department.  The schedule shall be
  61-12  kept in the information file for the complaint and all parties
  61-13  shall be notified of the projected time requirements for pursuing
  61-14  the complaint.  A change in the schedule must be noted in the
  61-15  complaint information file and all parties to the complaint must be
  61-16  notified not later than the seventh day after the date the change
  61-17  is made.
  61-18        (c)  The commissioner shall notify the board of a complaint
  61-19  that extends beyond the time prescribed by the board for resolving
  61-20  the complaint so that the board may take necessary action on the
  61-21  complaint.
  61-22        SECTION 4.16.  The Texas Nursing Home Administrators
  61-23  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  61-24  amended by adding Section 11H to read as follows:
  61-25        Sec. 11H.  INFORMAL PROCEEDINGS.  (a)  The board by rule
  61-26  shall adopt procedures governing:
  61-27              (1)  informal disposition of a contested case under
   62-1  Section 13(e), Administrative Procedure and Texas Register Act
   62-2  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   62-3  subsequent amendments; and
   62-4              (2)  informal proceedings held in compliance with
   62-5  Section 18(c), Administrative Procedure and Texas Register Act
   62-6  (Article 6252-13a, Vernon's Texas Civil Statutes), and its
   62-7  subsequent amendments.
   62-8        (b)  Rules adopted under this section must provide the
   62-9  complainant and the licensee an opportunity to be heard and must
  62-10  require the presence of a representative of the office of the
  62-11  attorney general to advise the department or department's
  62-12  employees.
  62-13        SECTION 4.17.  The Texas Nursing Home Administrators
  62-14  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes) is
  62-15  amended by adding Section 11I to read as follows:
  62-16        Sec. 11I.  MONITORING OF LICENSEE.  The board by rule shall
  62-17  develop a system for monitoring licensee's compliance with the
  62-18  requirements of this Act.  Rules adopted under this section shall
  62-19  include procedures for monitoring a licensee who is ordered by the
  62-20  department to perform certain acts to ascertain that the licensee
  62-21  performs the required acts and to identify and monitor licensees
  62-22  who represent a risk to the public.
  62-23         ARTICLE 5.  EFFECTIVE DATE, TRANSITION, AND EMERGENCY
  62-24        SECTION 5.01.  This Act takes effect September 1, 1993.
  62-25        SECTION 5.02.  (a)  A member of the Midwifery Board
  62-26  immediately before the effective date of this Act continues to
  62-27  serve as a member of the board on or after the effective date of
   63-1  this Act for the remainder of the member's term.  The Texas Board
   63-2  of Health shall make appointments to the board on or after the
   63-3  effective date of this Act as terms of members of the board expire
   63-4  and vacancies occur on the board to accomplish, as soon as
   63-5  possible, the membership plan for the board established by Section
   63-6  3, Texas Midwifery Act (Article 4512i, Vernon's Texas Civil
   63-7  Statutes), as amended by this Act.
   63-8        (b)  The Texas Board of Licensure for Nursing Home
   63-9  Administrators is abolished on the effective date of this Act.  As
  63-10  soon as possible after the effective date of this Act, the Texas
  63-11  Board of Health shall appoint the initial members of the Advisory
  63-12  Committee for Nursing Home Administrators.  In making the initial
  63-13  appointments, the board shall designate members to serve terms as
  63-14  follows:
  63-15              (1)  two licensed nursing home administrator members
  63-16  and one public member serve terms expiring February 1, 1995;
  63-17              (2)  two licensed nursing home administrator members
  63-18  and one public member serve terms expiring February 1, 1997; and
  63-19              (3)  two licensed nursing home administrator members
  63-20  and one public member serve terms expiring February 1, 1999.
  63-21        (c)  On the effective date of this Act, the Texas Board of
  63-22  Health assumes the functions of the Texas Board of Licensure for
  63-23  Nursing Home Administrators.  The obligations, rights, contracts,
  63-24  records and other property, and personnel of, and unspent money
  63-25  appropriated to or for the Texas Board of Licensure for Nursing
  63-26  Home Administrators are transferred to the Texas Board of Health.
  63-27  The rules of the abolished board are continued in effect as rules
   64-1  of the Texas Board of Health until superseded by rule of the Texas
   64-2  Board of Health.  A license in effect that was issued by the
   64-3  abolished board is continued in effect as a license of the Texas
   64-4  Department of Health.  A complaint, investigation, or other
   64-5  proceeding pending before the abolished board is transferred
   64-6  without change in status to the Texas Department of Health.  Any
   64-7  reference in law to the Texas Board of Licensure for Nursing Home
   64-8  Administrators means the Texas Board of Health or the Texas
   64-9  Department of Health, as appropriate.
  64-10        SECTION 5.03.  (a)  The changes in law made by this Act
  64-11  relating to a penalty that may be imposed apply only to a violation
  64-12  that occurs on or after the effective date of this Act.  A
  64-13  violation occurs on or after the effective date of this Act only if
  64-14  each element of the violation occurs on or after that date.  A
  64-15  violation that occurs before the effective date of this Act is
  64-16  governed by the law in effect on the date the violation occurred,
  64-17  and the former law is continued in effect for that purpose.
  64-18        (b)  The changes in law made by this Act to the
  64-19  qualifications of members of the Midwifery Board or the Texas State
  64-20  Board of Examiners of Dietitians do not affect the entitlement of a
  64-21  member appointed before September 1, 1993, to continue to hold
  64-22  office on the board for the term for which the member was
  64-23  appointed.  The changes in the qualifications apply only to a
  64-24  member appointed on or after September 1, 1993.
  64-25        SECTION 5.04.  Section 4, Texas Nursing Home Administrators
  64-26  Licensure Act (Article 4442d, Vernon's Texas Civil Statutes), is
  64-27  repealed.
   65-1        SECTION 5.05.  The importance of this legislation and the
   65-2  crowded condition of the calendars in both houses create an
   65-3  emergency and an imperative public necessity that the
   65-4  constitutional rule requiring bills to be read on three several
   65-5  days in each house be suspended, and this rule is hereby suspended.