LSL H.B. 1933 75(R)    BILL ANALYSIS


PUBLIC HEALTH
H.B. 1933
By: Roman
4-9-97
Committee Report (Unamended)


BACKGROUND 

Many retired physicians would like to donate their time and efforts to
volunteer charity care, but are understandably wary of frivolous
malpractice claims.  In 1987, the Legislature adopted the Charitable
Liability and Immunity Act, which is in Chapter 84 of the Civil Practices
and Remedies Code.  This Act was intended to provide immunity for
volunteers, including physicians and other health care providers, but
these protections found in current Texas law are not clearly defined and
could be strengthened. Other states, such as Florida, South Carolina, and
Maryland, have recently adopted provisions to provide clear safeguards for
these retired professionals who are willing to provide free care.  

The Texas Medical Association estimates that there are close to 2,000
retired physicians in Texas.  The continuing medical education (CME)
requirement for retired physicians to maintain their license is 24 hours
annually, 12 of which are formal and 12 of which are informal.  Currently,
required CME hours for the retired physicians in Texas can be obtained by
attending TMA's annual session, or through specialty societies, accredited
hospitals and medical schools that offer CME.  Today, there are not any
CME activities specifically designed for either retired physicians or
physicians providing charity care. 

PURPOSE

H.B. 1933 enables retired physicians to provide charity care while
limiting the liability of such physicians, and requires these physicians
to complete continuing medical education seminar established by the Texas
Board of Medical Examiners. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill expressly grants additional
rulemaking authority to the Texas Board of Medical Examiners in SECTION 2
(Section 3.025(e), Medical Practice Act (Article 4495 b, Vernon's Texas
Civil Statutes)) and requires the Board to adopt these rules by January 1,
1998 in SECTION 5(b). 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 2.09, Medical Practice Act (Article 4495 b,
Vernon's Texas Civil Statutes) by adding Subsection (bb) to require the
board to provide information to licence holders concerning the exemption
of the annual registration fee for retired physicians who provide
volunteer charitable care. 

SECTION 2.  Amends Section 3.025(e), Medical Practice Act (Article 4495 b,
Vernon's Texas Civil Statutes) to require a retired physician who is
exempt from the annual registration fee to participate in continuing
medical education if the physician has been retired for five or more years
and is providing voluntary charity care.  Requires the retired physician
to fulfill the continuing medical education requirement by attending a
seminar, established under board rules, designed for physicians providing
such care.  Requires the board rules to prescribe the contents of the
seminar, the frequency with which a physician must attend the seminar, and
the method of enforcing the requirements of this subsection.  Makes
conforming change. 

SECTION 3.  Amends Subchapter E, Medical Practice Act (Article 4495 b,
Vernon's Texas Civil  Statutes) by adding Section 5.11 as follows: 

Subsection (a) establishes that, subject to Subsection (b) of this
section, a retired physician who is exempt from the annual registration
fee and who is providing voluntary charity care is not liable for an act
or omission resulting in personal injury to or death of a patient if
committed in the course of providing free health care services within the
scope of practice of the physician. 

Subsection (b) provides that Subsection (a) only applies if the patient
signs a specified written statement before the services are provided. 

Subsection (c) requires the written statement to be signed by the parent,
managing conservator, or legal guardian if the patient is a minor. 

Subsection (d) stipulates that this section does not apply to an act or
omission that is intentional, wilfully or wantonly negligent, or done with
conscious indifference or reckless disregard for the safety of others. 

SECTION 4.  Amends Section 84.007, Civil Practice and Remedies Code, by
adding Subsection (h) to establish that Section 84.004 does not apply to
an act or omission subject to Section 5.11, Medical Practice Act (Article
4495b, Vernon's Texas Civil Statutes). 

SECTION 5.   Subsection (a) provides the effective date:  September 1,
1997. 

Subsection (b) requires the Texas State Board of Medical Examiners to
adopt rules by January 1, 1998.  Establishes that a retired physician is
not required to comply with the requirements of Section 3.025 (e), Medical
Practice Act (Article 4495b, Vernon's Texas Civil Statutes), as amended by
this Act, before January 1, 1999. 

Subsection (c) establishes that the change in law made by this Act applies
only to events which occur on or after the effective date.  Provides that
the existing law is continued for events which occur before the effective
date of this Act. 

SECTION 6.  Emergency clause.