BILL ANALYSIS



C.S.H.B. 235
By: Driver
March 2, 1995
Committee Report (Substituted)


BACKGROUND

Under current state law, many emergency communication centers do
not provide pre-arrival emergency medical information because of
civil liability concerns and the cost and lack of availability of
appropriate training for their employees and volunteers.

PURPOSE

This bill encourages emergency communication centers to provide
pre-arrival emergency medical information to callers by providing
for training and protocols to be offered by the Texas Department of
Health and by granting immunity from civil liability for damages
resulting from emergency medical information given by trained
employees or volunteers of an emergency communication center
following rules established by the Board of Health.

RULEMAKING AUTHORITY

This bill delegates rulemaking authority to Texas Board of Health
in Sections 1 and 4.

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subtitle B, Title 9, Health and Safety Code, by
adding a new Chapter 778, "Emergency Medical Information Services"
with the following sections:  
Sec. 778.001.   Defines terms.
Sec. 778.002    Permits trained employees and volunteers of an
emergency communication center to provide emergency medical
information of a type easily communicated by telephone to a person
not trained in emergency care.
Sec. 778.003.   Requires the Texas Board of Health ("the board") to
adopt minimum standards for emergency medical information training
programs, the form and content of information to be provided, and
the protocol for delivery of the information, and for maintaining
records of calls.  Requires the board to consider nationally
recognized training programs and training programs offered in this
state.
Sec. 778.004.  Requires that the employee or volunteer providing
emergency medical information services under this chapter must have 
completed a training program approved by the Department of Health
("the department").  Prohibits the department from charging a fee
for approval of a program.  Permits the department to require a
trained employee or volunteer to demonstrate competence in
providing emergency medical information or to require that the
training program include a demonstration of competence.  Permits
department to charge fee for reasonable expenses relating to the
demonstration of competence.
Sec. 778.005.  Requires the department to approve a protocol for
the delivery of emergency medical information if the protocol meets
the minimum standards set by the board.  Prohibits the department
from charging a fee for approval of a protocol.
Sec. 778.006.  Requires the department to assist emergency
communication centers, local governmental units, and other entities
that provide emergency medical information and to develop a model
training program and materials that these entities may use. 
Permits department to charge a reasonable fee for materials and
services provided under this section.
Sec. 778.007.  Provides that an emergency communication center is
not required to provide emergency medical information.
Sec. 778.008.  Grants immunity from liability under the Tort Claims
Act for an emergency communication center and an employee or
volunteer of an emergency communication center for property damage,
personal injury, or death arising in connection with the provision
of or failure to provide emergency medical information under the
provisions of this chapter.

SECTION 2.  Amends Section 84.007, Civil Practice and Remedies
Code, in the Charitable Immunity and Liability Act of 1987, to
exclude claims governed by
Section 778.008, Health and Safety Code.

SECTION 3.  Amends Section 101.062, Civil Practice and Remedies
Code, in the Tort Claims Act, to exclude claims against an
emergency communication center governed by Section 778.008, Health
and Safety Code.

SECTION 4.  Effective September 1, 1995.  Permits local
governmental unit or other entity to submit a training program and
protocol and to identify emergency communication centers to the
department on or after the effective date.  Provides that a
training program or protocol submitted between September 1 and
December 31, 1995 is approved on the date it is submitted to the
department, and approval continues until withdrawn by the
department.  Provides that an emergency communication center
identified for the provision of emergency medical information
between September 1 and December 31, 1995 is considered to be of a
type designated by board rule until that designation is withdrawn
by the department.  Requires that not later than January 1, 1996,
the board must adopt minimum standards and rules required by this
chapter.

SECTION 5.  Emergency clause.

COMPARISON OF ORIGINAL TO SUBSTITUTE

Original applied to a public safety answering point providing
emergency medical information through a 9-1-1 service.  Substitute
applies to an emergency communication center, defined as a location
staffed and equipped to receive and either transmit or dispatch
emergency calls.

Original required employee to complete a training program approved
by the Board of Health, permitted board to require employee to pass
an examination, and required board to adopt a manual and a protocol
for the delivery of emergency medical information.  Substitute
requires board to adopt minimum standards for emergency medical
information training programs, the form and content of information
that may be provided, and the protocol of delivery of the
information.  Substitute requires board to consider nationally 
recognized training programs and training programs offered in this
state.  Substitute requires that employee or volunteer providing
emergency medical information under this chapter must be trained in
a program approved by the Department of Health.  Substitute
prohibits the department from charging a fee for approval of a
program.  Substitute permits department to require employee to show
competence in providing emergency medical information.  Substitute
requires department to approve a protocol for delivery of emergency
medical information, and the department is prohibited from charging
a fee for approval of a protocol.  Substitute requires department
to assist emergency communication centers and to develop a model
training program and materials for which they can charge a fee not
to exceed the actual cost.

Original excluded claims under Section 771.053, Health and Safety
Code, pertaining to liability of 9-1-1 service providers and
officers of the providers.  Substitute excludes claims under
Section 84.007, Civil Practice and Remedies Code, the Charitable
Immunity and Liability Act of 1987.

Original required the Board of Health to approve a program and
adopt a manual and protocol by January 1, 1996.  Substitute 
requires the Board of Health to adopt minimum standards and rules
by January 1, 1996.  It permits an entity to submit to the
Department of Health a training program and protocol and to
identify one or more emergency communication centers beginning
September 1, 1995.  Any program, protocol, and center submitted for
approval between September 1 and December 31, 1995 is automatically
approved on the date submitted until approval is withdrawn by the
department.





SUMMARY OF COMMITTEE ACTION

Pursuant to notice posted on February 23, 1995, the Committee on
Public Safety convened in a public hearing on February 28, 1995 to
consider H.B. 235.  The chairman laid out H.B. 235 and recognized
the author, Representative Driver, to lay out the substitute to H.B
235.  The committee considered a complete substitute for the bill.
The following persons testified in favor of the substitute bill:
  Mike Pedigo representing the Denco Area 911 District; and
  Norman Hood representing Independent Colleges and Universities of
Texas; and
  Lavergne Schwender representing Greater Harris County 911
Emergency Network; and
  Ann Muzalewski representing herself; and
  Craig Hooser representing the Texas College of Emergency; and
  Craig Pardue representing Dallas County.
The following persons testified neutrally on the substitute bill:
  Mary Boyd representing the Advisory Commission on State Emergency
Communications; and
  Gene Weatherall representing the Texas Department of Health.
The substitute was adopted without objection.
The bill was reported favorably as substituted with the
recommendation that it do pass and be printed, by a record vote of
7 ayes, 0 nays, 0 PNV, and 2 absent.