S.B. No. 1303 AN ACT 1-1 relating to the practice of medicine, including the rehabilitation 1-2 of impaired physicians and the unlicensed practice of medicine; 1-3 providing a penalty. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subsection (a), Section 3.07, Medical Practice 1-6 Act (Article 4495b, Vernon's Texas Civil Statutes), is amended to 1-7 read as follows: 1-8 (a) A person practicing medicine in this state must be 1-9 licensed under this Act. A person practicing medicine in violation 1-10 of this Act commits an offense. Except as provided by this 1-11 section, an offense under this section is a Class A misdemeanor. 1-12 (1) If it be shown in the trial of a violation of this 1-13 Act that the person has once before been convicted of a violation 1-14 of this Act, on conviction the person shall be punished for a third 1-15 degree felony. Each day of violation constitutes a separate 1-16 offense. On final conviction of an offense under this section, a 1-17 person forfeits all rights and privileges conferred by virtue of 1-18 his licensure under this Act. 1-19 (2) A person practicing medicine without a valid 1-20 license or permit and who causes physical or psychological harm to 1-21 another by such practice shall, on conviction, be punished for a 1-22 third degree felony. 1-23 (3) A person practicing medicine without a valid 2-1 license or permit and who causes financial harm to another by such 2-2 practice shall, on conviction, be punished for a state jail felony. 2-3 SECTION 2. Subchapter C, Medical Practice Act (Article 2-4 4495b, Vernon's Texas Civil Statutes), is amended by adding Section 2-5 3.081 to read as follows: 2-6 Sec. 3.081. REHABILITATION ORDER. (a) The board, through 2-7 an agreed order or after a contested proceeding, may impose a 2-8 nondisciplinary rehabilitation order on any licensee or, as a 2-9 prerequisite for issuing a license, on any licensure applicant, 2-10 based on one or more of the following: 2-11 (1) intemperate use of drugs or alcohol directly 2-12 resulting from habituation or addiction caused by medical care or 2-13 treatment provided by another physician; 2-14 (2) self-reported intemperate use of drugs or alcohol 2-15 during the last five years immediately preceding the report which 2-16 could adversely affect the reporter's ability to practice medicine 2-17 safely, but only if the reporting individual has not previously 2-18 been the subject of a substance-abuse-related order of the board; 2-19 (3) judgment by a court of competent jurisdiction that 2-20 the individual is of unsound mind; or 2-21 (4) findings of impairment based upon a mental or 2-22 physical examination offered to establish such impairment in an 2-23 evidentiary hearing before the board with opportunity for 2-24 opposition in full by such individual, or admissions by the 2-25 individual indicating that the licensee or applicant suffers from a 3-1 potentially dangerous limitation or an inability to practice 3-2 medicine with reasonable skill and safety by reason of illness or 3-3 as a result of any physical or mental condition. 3-4 (b) A rehabilitation order entered pursuant to this section 3-5 shall be a nondisciplinary private order and shall contain findings 3-6 of fact and conclusions of law. A rehabilitation order, if entered 3-7 by agreement, shall be an agreed disposition or settlement 3-8 agreement for purposes of civil litigation as provided for in 3-9 Section 4.02(i) of this Act and shall be exempt from the open 3-10 records law. 3-11 (c) A rehabilitation order entered pursuant to this section 3-12 may impose a revocation, cancellation, suspension, period of 3-13 probation or restriction, or any other terms and conditions 3-14 authorized under Section 4.12 of this Act or as otherwise agreed to 3-15 by the board and the individual subject to the order. 3-16 (d) The provisions of this section shall not prevent or 3-17 limit the authority of the board to take action to suspend a 3-18 license temporarily pursuant to Section 4.13 of this Act. 3-19 (e) Violation of a rehabilitation order entered pursuant to 3-20 this section may result in disciplinary action under the provisions 3-21 of this Act for contested matters or pursuant to the terms of the 3-22 agreed order. The violation of a rehabilitation order may be 3-23 grounds for disciplinary action based on unprofessional or 3-24 dishonorable conduct or any of the provisions of Section 3.08 of 3-25 this Act which may apply to the misconduct which resulted in 4-1 violation of the order. In addition, a violation of a 4-2 rehabilitation order may be grounds for temporary suspension of the 4-3 individual's license pursuant to Section 4.13 of this Act. 4-4 (f) The rehabilitation orders entered pursuant to this 4-5 section shall be kept in a confidential file which shall be subject 4-6 to an independent audit by state auditors or private auditors 4-7 contracted by the board to perform the audit. Audits may be 4-8 performed at any time at the direction of the board, but shall be 4-9 performed at least once every three years. The audit results shall 4-10 be reported in a manner so as to maintain the anonymity of all 4-11 licensees who are subject to rehabilitation orders and shall be a 4-12 public record. The audit shall be for the purpose of ensuring that 4-13 only qualified licensees are subject to rehabilitation orders. 4-14 SECTION 3. This Act takes effect September 1, 1995. 4-15 SECTION 4. The importance of this legislation and the 4-16 crowded condition of the calendars in both houses create an 4-17 emergency and an imperative public necessity that the 4-18 constitutional rule requiring bills to be read on three several 4-19 days in each house be suspended, and this rule is hereby suspended.