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.