BILL ANALYSIS C.S.H.B. 2909 By: Janek 03-28-95 Committee Report (Substituted) BACKGROUND In 1993, the Texas Legislature enacted the Licensed Perfusionists Act (Article 4529e, Vernon's Texas Civil Statutes). The act established a mechanism for the licensure and regulation of the practice of perfusion to assure that all perfusionists who practice in Texas meet certain minimal standards. A perfusionist is the allied health professional who operates the heart-lung machine during open-heart surgery. The perfusionist keeps the patient alive and functioning while the heart is stopped during surgery. Approximately 140 perfusionists participated in more than 21,000 open-heart procedures in Texas in 1992. Perfusionists are college graduates who are also graduates of a perfusion education program accredited by the American Medical Association's Committee on Allied Health Education Accreditation. As program graduates, they are eligible for a private professional certification examination administered by the American Board of Cardiovascular Perfusion. A perfusionist must also be examined by the Texas State Board of Examiners of Perfusionists (Perfusionists Board), which was initially appointed in 1994 after passage of the Licensed Perfusionists Act. PURPOSE H.B. 2909, as substituted, corrects problems encountered by the Perfusionists Board when implementing the Act, by adding flexibility in the supervision requirement, setting qualifications for non-Texas perfusionists, relaxing the requirement that a representative of the Attorney General attends informal complaint proceedings, and extending the application deadline for a "grandfathered" license application without examination from September 1, 1995, to December 31, 1995. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Amends Sec. 14(b), Article 4529e, V.T.C.S., to allow certain physicians to supervise a provisional licensed perfusionist when a licensed perfusionist is not reasonably available to provide the required supervision. As amended, the subsection permits a provisional licensed perfusionist to be supervised by a cardiovascular surgeon licensed in Texas and certified by the American Board of Thoracic Surgery, Inc., or certified in cardiovascular surgery by the American Osteopathic Board of Surgery. Such supervision is subject to approval by the Perfusionists Board. SECTION 2. Amends Section 17(a), Article 4529e, V.T.C.S., which outlines who is exempt from provisions of this Act. Subsection 17(a)(5)(A) adds the stipulation that residents of other states who are authorized to perform perfusion under the laws of their state of residence are exempt from this Act if they also are found by the Perfusionists Board to possess educational and training qualifications substantially similar to those required of persons qualified to practice in Texas. SECTION 3. Amends Section 20, Article 4529e, V.T.C.S., to add that the Perfusionists Board's counsel or a representative of the Attorney General's office, instead of just the latter, must be present to advise the board or its employees during an informal proceeding involving a complaint. SECTION 4. Outlines specific conditions under which a person practicing perfusion before this Act went into effect can be exempted from the examination requirement for licensing and provides a "grandfather" clause. SECTION 5. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE SECTION 1 of the original bill is amended by the substitute to reflect a name change from American Board of Cardiovascular Surgeons to American Board of Thoracic Surgery, Inc., and to include physicians certified in cardiovascular surgery by the American Osteopathic Board of Surgery among those physicians eligible to supervise a provisional licensed perfusionist. SECTION 3(b) of the substitute amends the way in which the Act proposes relaxing the requirement that a representative of the Attorney General attends informal complaint proceedings. The substitute requires that either a representative of the Attorney General's office or the legal counsel for the Perfusionists Board be present during informal complaint proceedings. The original bill proposes requiring the presence of the Attorney General's representative only if requested by the Perfusionists Board, an authorized representative of the Board, the complainant, or the license holder. SUMMARY OF COMMITTEE ACTION H.B. 2909 was considered by the committee in a public hearing on March 28, 1995. The committee considered a complete substitute for the bill. One amendment was offered to the substitute. The amendment was adopted without objection. The substitute was adopted without objection. The following person testified in favor of the bill: Greg Hooser, representing Texas Association of Perfusionists. The bill was reported favorably as substituted, with the recommendation that it do pass and be printed, by a record vote of 8 Ayes, 0 Nays, 0 PNV, and 1 Absent.