BILL ANALYSIS



C.S.H.B. 1408
By: McDonald
03-21-95
Committee Report (Substituted)


BACKGROUND

Home health agency personnel purchased, stored, transported and
administered sterile water and sterile saline to their patients for
years, until the law was changed in 1993. Section 142.0061 of the
Health and Safety Code, passed by the 73rd Legislature, requires a
home health agency to be licensed as a Class F Pharmacy under the
Texas Pharmacy Act in order to work with sterile water and sterile
saline. These items, used by nurses under a physician's order, were
typically considered supplies previously, and they were billed as
such to Medicare, Medicaid and insurance companies. However, the
Class F Pharmacy provision requires the sterile water and sterile
saline to be administered by prescription, which is not covered
under Medicare.

PURPOSE

H.B. 1408 authorizes a home and community support services agency
and its registered or licensed vocational nurses to purchase, store
or transport sterile water and sterile saline to administer to home
health and hospice patients without a Class F Pharmacy license.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly
grant any additional rulemaking authority to a state officer,
department, agency, or institution.

SECTION BY SECTION ANALYSIS

SECTION 1.     Amends Section 142.0061 of the Health and Safety
Code by changing the term home health agency to home and community
support services agency. Removes a Class F Pharmacy licensure
provision for a home and community support services agency and its
registered nurses or licensed vocational nurses. Allows these
groups to purchase, store or transport sterile water and sterile
saline to administer to home health and the newly added hospice
patients under a physician's order. Heparin flush kits for
intravenous purposes are removed from the provisions of this
section.

SECTION 2.     Section 483.041(c)(8) of the Health and Safety Code
is amended to conform with the change of terms in SECTION 1 of this
bill, referring to a home and community support services agency.
Heparin flush kits for intravenous purposes are removed from the
provisions of this section.

SECTION 3. Amends Section 19(f) of the Texas Pharmacy Act (Article
4542a-1, Vernon's Texas Civil Statutes), adding a provision
excluding a home and community support services agency that
possesses a dangerous drug as authorized by Section 142.0061 from
governance under this the Pharmacy Act.

SECTION 4. Amends Sections 29(b) and (c), Texas Pharmacy Act.
Section 29(b) deletes the Class F designation from the list of
existing pharmacy classifications. Section 29(c) deletes a
reference to Class F pharmacy requirements.

SECTION 5. Repeals Section 5(10), Texas Pharmacy Act, which
establishes Class F Pharmacy licensure.

SECTION 6. Effective date: September 1, 1995.

SECTION 7. Stipulates that this Act applies only to offenses
committed after the law goes into effect.

SECTION 8. Emergency clause.

COMPARISON OF ORIGINAL TO SUBSTITUTE

The substitute for H.B. 1408 contains non-substantive language
changes as recommended by Legislative Council.

SUMMARY OF COMMITTEE ACTION

H.B. 1408 was considered by the Public Health Committee in a public
hearing on March 21, 1995. The committee considered a complete
substitute for the bill. The substitute was adopted without
objection.

The following persons testified for the bill:
Representative McDonald, author of the bill.
Albert S. Gomez Jr., representing self.
Anne Couch, representing self and Girling Health Care Inc.
Doris Spicak, representing self and Texas Association Home Care.
Larry A. Farrow, representing the Texas Hospice Organization.
Lisa Selman, representing self.
Shelley Vasquez, R.N., representing self and Texas Association of
Home Care.

The bill was reported favorably as substituted, with the
recommendation that it do pass and be printed and be sent to the
Committee on Local and Consent Calendars, by a record vote of 8
Ayes, 0 Nays, 0 PNV, and 1 Absent.