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.