BILL ANALYSIS H.B. 1604 By: Glaze (Patterson) Health and Human Services 05-17-95 Senate Committee Report (Unamended) BACKGROUND The Texas Department of Health regulates the state's emergency medical services providers and has identified several provisions in Chapter 773, Health and Safety Code (Emergency Medical Services Act), that need to be updated. PURPOSE As proposed, H.B. 1604 deletes the requirement that emergency medical services providers purchase and maintain contractual liability insurance before operating a subscription program; establishes fees for certain applications; subjects course coordinators to administrative penalties; updates language; and repeals certain provisions of the Health and Safety Code. RULEMAKING AUTHORITY It is the committee's opinion that rulemaking authority is granted to the Texas Board of Health under SECTION 7 (Sections 773.050(b) and (c), Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 773.003(1), Health and Safety Code, to redefine "emergency medical services provider." SECTION 2. Amends Sections 773.011(c) and (d), Health and Safety Code, to delete references to contractual liability insurance. SECTION 3. Amends Section 773.042, Health and Safety Code, as follows: Sec. 773.042, New heading: BASIC LIFE-SUPPORT EMERGENCY MEDICAL SERVICES PROVIDER QUALIFICATIONS. Provides that a provider, rather than a vehicle, qualifies as a basic life-support emergency medical services (EMS) provider if it provides a vehicle that is designed for transporting the sick or injured and has personnel and sufficient equipment and supplies for providing basic life support. SECTION 4. Amends Section 773.043, Health and Safety Code, as follows: Sec. 773.043. New heading: ADVANCED LIFE-SUPPORT EMERGENCY MEDICAL SERVICES PROVIDER QUALIFICATIONS. Makes conforming changes. SECTION 5. Amends Section 773.044, Health and Safety Code, as follows: Sec. 773.044. New heading: MOBILE INTENSIVE-CARE PROVIDER QUALIFICATIONS. Makes conforming changes. SECTION 6. Amends Section 773.045, Health and Safety Code, as follows: Sec. 773.045. SPECIALIZED EMERGENCY MEDICAL SERVICES PROVIDER QUALIFICATIONS. Makes conforming changes. SECTION 7. Amends Sections 773.050(b)-(d), Health and Safety Code, as follows: (b) Requires the Texas Board of Health (board) to establish minimum standards for EMS personnel certification and performance, including provisional certification, and medical supervision of basic and advanced life-support systems. (c) Requires each out-of-state application for EMS personnel certification to be accompanied by a nonrefundable fee of $100. Authorizes the board to establish criteria for out-of-country EMS personnel certification. Requires each out-of-country application for certification to be accompanied by a nonrefundable fee of $150. (d) Prohibits the board from adopting a rule requiring the provision of advanced life-support or staffing except for providers of, rather than the operation of, advanced life-support emergency medical services, mobile intensive care, or specialized EMS. SECTION 8. Amends Section 773.051, Health and Safety Code, to authorize a municipality to establish certain standards for an EMS provider. SECTION 9. Amends Section 773.054, Health and Safety Code, by amending Subsection (c), and adding Subsection (d), as follows: (c) Requires each application under Subsection (a)(3) to be accompanied by a nonrefundable fee of $25 for a program instructor or examiner or $50 for a course coordinator. (d) Requires each application under Subsection (a)(2) to be accompanied by a nonrefundable fee of $25 for a basic course or training program or $50 for an advanced course or training program. Prohibits the Texas Department of Health (department) from requiring a fee for approval of a course or training program if the course coordinator or sponsoring agency does not receive compensation for providing the course or training program. SECTION 10. Amends Section 773.055(a), Health and Safety Code, to make nonsubstantive changes. SECTION 11. Amends Section 773.056(b), Health and Safety Code, to require the department to charge a fee of $5 to replace a lost or stolen certificate. SECTION 12. Amends Sections 773.057(b) and (c), Health and Safety Code, as follows: (b) Prohibits an application fee under this section from exceeding $150, rather than $100, for each EMS vehicle operated by the provider. Deletes a fee requirement for a fleet of EMS vehicles. (c) Authorizes the department to delegate vehicle inspections to the commissioners court of a county or the governing body of a municipality. SECTION 13. Amends Section 773.0571, Health and Safety Code, as follows: Sec. 773.0571. New heading: REQUIREMENTS FOR PROVIDER LICENSE. Deletes a provision requiring the department to conduct an inspection in order to determine whether to issue a license to an EMS provider. SECTION 14. Amends Section 773.0572, Health and Safety Code, to require a nonrefundable fee of $25 to accompany each application for a provisional license. SECTION 15. Amends Section 773.0611(c), Health and Safety Code, to require an EMS provider to pay to the department a nonrefundable fee of $25 if reinspection is necessary to determine compliance with this chapter and the rules adopted under this chapter, SECTION 16. Amends Section 773.065, Health and Safety Code, to authorize the commissioner of health (commissioner) to assess an administrative penalty against a course coordinator who violates this chapter. Makes conforming and nonsubstantive changes. SECTION 17. Amends Section 773.066, Health and Safety Code, to make conforming changes. SECTION 18. Amends Section 773.067, Health and Safety Code, as follows: (a) Requires a person charged, not later than the 30th day after the date on which an order charging the EMS provider or course coordinator with a penalty is final as provided by Chapter 2001, Government Code, to pay the penalty in full, or, with or without paying the penalty, to file a petition for judicial review contesting the occurrence of the violation, the amount of the penalty, or both. (b) Authorizes a person who acts under Subsection (a)(3), within the 30-day period, to stay enforcement of the penalty or request the court to stay enforcement of the penalty. (c) Authorizes the commissioner, if the commissioner receives a copy of an affidavit under Subsection (b)(2), to file with the court by a certain date a contest to the affidavit. Requires the court to hold a hearing on the facts alleged in the affidavit as soon as practicable, and to stay the enforcement of the penalty on finding that the alleged facts are true. Places the burden of proving financial inability to pay the penalty and give a supersedeas bond on the person who files an affidavit. (d) Authorizes the commissioner, if the person does not pay the amount of the penalty and the enforcement of the penalty is not stayed, to refer the matter to the attorney general for collection of the amount of the penalty. (e) Provides that judicial review of the commissioner's order is instituted by filing a petition as provided by Chapter 2001G, Government Code, and is under the substantial evidence rule. (f) Authorizes the court, if it sustains the occurrence of the violation, to uphold or reduce the amount of the penalty and order the person to pay the full or reduced amount of the penalty. Requires the court, if it does not sustain the occurrence of the violation, to order that no penalty is owed. (g) Requires the court to proceed under this subsection when the judgment of the court becomes final. Deletes provisions regarding payment of a penalty and the posting of a bond. SECTION 19. Repealer: Sections 773.010 (Transportation by Hospital), 773.053 (Notice of Rule Changes), and 773.068 (Refund of Administrative Penalty), Health and Safety Code. SECTION 20. Amends Section 774.003(b), Health and Safety Code, to authorize a commissioners court to enter into exclusive agreements with certain entities to provide emergency ambulance service. SECTION 21. Emergency clause. Effective date: upon passage.